Earticle

Purpose: This study aimed to identify factors influencing university students’ intention to engage in preventive behaviors against sexually transmitted infections (STIs) and to provide foundational data for developing effective STI prevention education and intervention strategies. Methods: This descriptive correlational study included 196 students enrolled in universities in the Gyeonggi and Chungcheong regions of South Korea. Data were collected using a structured, self-administered questionnaire consisting of STIs knowledge, health beliefs (perceived susceptibility, severity, benefits, and barriers), and preventive behavioral intentions. The data were analyzed using descriptive statistics, t-tests, one-way ANOVA, Pearson’s correlation analysis, and hierarchical regression analysis using the Jamovi statistical program. Results: Overall STIs knowledge among participants was low, with a mean correct response rate of 31.9%; notable differences in knowledge across specific STIs were observed. Preventive behavioral intentions showed significant positive correlations with perceived severity and perceived benefits. However, hierarchical regression analysis indicated that perceived benefits were the only health belief factor that significantly influenced preventive behavior intention in the final model (β=.226, p=.009). In addition, sex and consistent condom use were identified as significant predictors of preventive behavioral intentions. Conclusion: These findings suggest that university students’ intentions to engage in STI-preventive behaviors are influenced more by health beliefs, particularly perceived benefits, than by knowledge alone. Therefore, STI prevention education and interventions should move beyond information-based approaches to emphasize the tangible benefits and positive outcomes of preventive behaviors.

Purpose: This study examined the intellectual structure of recent paramedicine research by conducting a keyword network analysis of articles published in The Korean Journal of Emergency Medical Services between 2021 and 2025. Methods: A total of 171 articles published over five years were analyzed. Author keywords were extracted and refined through a standardization process, resulting in 36 keywords that appeared at least three times. A two-mode binary matrix was constructed to calculate the keyword frequencies and co-occurrence relationships. A one-mode keyword network was generated, and the degree and betweenness centralities were computed using UCINET 6.0. Cluster analysis and network visualization were performed to identify the thematic structures. Results: The most frequent keywords were paramedic (35) and paramedic students (22), followed by emergency medical services, cardiopulmonary resuscitation, and emergency departments. Centrality analysis revealed that students and paramedics occupied the most central positions in both degree and betweenness measures, serving as key connectors across multiple thematic areas. Mental health–related keywords, including Anxiety, Stress, and Depression, also showed relatively high centrality. Four thematic clusters were identified: paramedic practice and resuscitation; student academic and clinical performance; psychological stress and mental health; and peripheral/emerging topics. Conclusion: Recent paramedic research in Korea has demonstrated a multilayered structure in which traditional clinical themes coexist with expanding educational and psychological domains. This study provides a structural understanding of the current research trends and offers a foundation for future agenda-setting in paramedicine.

Purpose: This study examined posttraumatic stress (PTS) and posttraumatic growth (PTG) among ambulance professionals according to their MBTI personality types. This study aimed to identify personality-based coping strategies that reduce PTS and promote PTG, thereby providing foundational data to improve the quality and efficiency of emergency medical services. Methods: A descriptive survey design was used. Participants were 157 ambulance professionals working in metropolitan cities A and B. Data were collected from March 25 to April 15, 2024, using structured questionnaires, including general characteristics, the MBTI Form M, the Korean version of the Impact of Event Scale-Revised (IES-R-K), and the Korean Post-Traumatic Growth Inventory (K-PTGI). Data were analyzed using SPSS 23.0 for descriptive statistics, t-tests, analysis of variance (ANOVA) with Scheffé’s post hoc test, correlation analysis, and hierarchical regression. Results: Introversion (53.5%), sensing (76.4%), thinking (51.0%), and perception (51.0%) were predominant; ISTJ (20.4%) was the most frequent type. The mean PTS score was 12.91/88, and 12.1% were classified as high risk. The mean PTG score was 47.17/80, which was the highest for changes in self-perception. The PTS differed significantly according to education level, license status, and injury experience during trauma dispatch, whereas the PTG differed according to injury experience. Although MBTI type was not significantly related to PTS, extroversion (E) and feeling (F) were associated with higher PTG. PTS and PTG were positively correlated (p=.015), and the E-I and T-F indicators explained 11% of PTG variance. Conclusion: Personality traits influence PTG among ambulance professionals. Therefore, stress management and psychological support programs tailored to personality traits are recommended.

Purpose: This study aimed to analyze longitudinal changes in the perceptions of emergency medical technicians (EMTs) regarding the introduction of a licensure system and identify the structural causes of occupational conflicts concerning implementation methods (EMT-paramedic priority vs. simultaneous implementation for EMT-paramedics and EMT-basics). Methods: A descriptive cross-sectional study was conducted using survey data from 10,787 EMTs (6,611 in 2020 and 4,176 in 2023). Data were analyzed using chi-square tests with adjusted residuals and a binomial logistic regression model to determine the factors influencing the preferred implementation method. Results: While 97.4% of the respondents supported the licensure system, significant differences emerged regarding the implementation methods. EMT-paramedics strongly preferred priority implementation. Conversely, EMT-Basics, those with more clinical experience, and public-sector workers significantly preferred simultaneous implementation. Controlling for general characteristics, the logistic regression indicated that EMT-Basics were 26.48 times more likely to prefer simultaneous implementation compared to the reference group of EMT-Paramedics (aOR=26.48, p<.001). Conclusion: Despite a strong consensus on the necessity of licensure, severe occupational conflicts exist regarding the implementation methods. Resolving the dualized training system and securing educational homogeneity are essential prerequisites for a successful transition. However, as specific reform measures lack social consensus, further discussions and follow-up studies are required to develop a detailed roadmap.

Purpose: This study examined the effects of general, occupational, and sleep-related characteristics on sleep quality in firefighters using the Korean version of the Pittsburgh Sleep Quality Index (PSQI-K). Methods: A cross-sectional survey was conducted from August 15 to 31, 2025 among 217 firefighters working in regions C and D. Data were collected using a self-administered online questionnaire. Sleep quality was assessed using the PSQI-K. Differences in sleep quality according to general, occupational, and sleep-related characteristics were analyzed using the chi-square test. Multiple regression analysis was performed to identify factors associated with the PSQI-K total scores. Results: The mean PSQI-K score was 7.37±3.52, and 37.3% of participants were classified as poor sleepers (PSQI-K≥8.5). Significant differences in sleep quality were observed according to educational level, job type, work schedule, experience with sleep-related symptoms, treatment history, and the timing of sleep problem recognition. In the multiple regression analysis, experience of sleep-related symptoms(β=-.482, p<.001) and treatment history (β=-.168, p=.004) were significantly associated with PSQI-K total scores. The overall regression model was statistically significant (F=13.117, p<.001), explaining 38.9% of the variance in sleep quality. Conclusion: Sleep-related symptoms and treatment history were significantly associated with sleep quality in firefighters. These findings suggest that sleep health problems are closely related to sleep quality in firefighters, and highlight the importance of systematic sleep health management in fire service organizations.

Purpose: This study aimed to analyze injury patterns among construction workers using on-site emergency care records and identify differences according to occupational characteristics. Methods: This retrospective observational study used emergency treatment records from an on-site emergency care center at a large-scale construction site in Korea between January 2021 and December 2023. A total of 1,968 injury cases were analyzed. The injury types were reclassified according to the Nature of Injury categories in the Occupational Injury and Illness Classification System (OIICS). Descriptive statistics and chi-square tests were used to examine the differences in injury characteristics. Results: The most common injury types were contusions/blunt injuries (35.3%) and skin or soft tissue injuries (32.7%). The hands were the most frequently affected body part (34.6%). Significant differences in injury distribution were observed according to trade type and job category (p<.05). Seasonal differences were also identified, with a higher proportion of injuries occurring during summer. Conclusion: Construction site injuries showed consistent patterns according to occupational and seasonal characteristics. The analysis of on-site emergency care records using the OIICS framework may provide practical information for injury prevention and on-site emergency response planning.

Purpose: This study aimed to examine the discrepancy between the professional identity perceived by 119 paramedics and the non-emergency tasks they perform in practice and to investigate how this discrepancy influences job stress and job satisfaction. Methods: In-depth interviews were conducted with 23 paramedics from Korean 119 emergency service nationwide between January 12 and 30, 2026. Data were analyzed using Colaizzi’s phenomenological method. Results: Three categories and ten subcategories were identified. First, participants affirmed their identity as emergency medical professionals and derived job satisfaction from the competent execution of professional responsibilities in pre-hospital settings. Second, factors such as non-emergency dispatches, expanded social welfare roles, marginalization within the emergency medical system, and the burden of responsibility under limited autonomy contributed to increased job stress, revealing a discrepancy between professional ideals and actual work experiences. Third, despite recurring burnout, the participants sustained their duties by accepting this discrepancy and reconstructing their professional identities. Resilience was supported by emotional recovery through peer interactions, expansion of professional meaning to buffer role ambiguity, and reaffirming pride and satisfaction. In this process, job satisfaction serves as a crucial driving force, stabilizing professional identity, and mitigating the negative impacts of job stress. Conclusion: This study highlights the gap between ideals and realities in the work of 119 paramedics and underscores the role of their experiences in shaping professional identity. These findings expand our understanding of identity formation and suggest the need for institutional strategies, including the introduction of a community paramedic system, to support and sustain professional identities.

Purpose: This study aimed to identify the factors associated with hand washing performance in daily life among paramedic students expected to work in high-risk infectious environments. Unlike previous studies that focused mainly on knowledge or clinical practice contexts, this study examined hand washing behavior in daily life and explored the behavioral and environmental determinants of performance. Methods: This study aimed to identify factors associated with hand washing performance in daily life among paramedic students expected to work in high-risk infectious environments. Unlike previous studies that focused mainly on knowledge or clinical practice contexts, this study examined hand washing behavior in daily life and explored the behavioral and environmental determinants of performance. Results: The mean knowledge score was high (14.30±1.01), whereas performance was relatively lower (48.99±7.11), indicating a gap between knowledge and behavior. No significant correlations were observed between knowledge and performance. Multiple regression analysis showed that not living with parents (β=0.239, p=.003), longer hand washing time (β=0.286, p<.001), and use of air dryers (β =0.203, p=.008) were associated with higher performance, whereas turning off the faucet using bare hands was associated with lower performance (β=−0.153, p=.045). Conclusion: Behavioral and environmental factors influenced hand washing performance more than knowledge alone. This study adds to the existing literature by suggesting that daily life habits, rather than cognitive factors, play a key role in hand washing behavior among paramedic students. These findings highlight the need for practice-based education emphasizing habit formation and repeated training. As the data were collected during the COVID-19 pandemic, interpretation should consider the context of the pandemic.

Purpose: This qualitative phenomenological study explored the lived experiences of transfer students in paramedicine and examined the meaning and structure of university life after transfer. Methods: This study was approved by the Institutional Review Board of K University (KNU_IRB_2023-094). Data were collected from November 1 to November 30, 2023, through in-depth interviews with 12 transfer students. Open-ended questions focused on their experiences after the transfer and the meaning they attributed to the transfer into paramedicine. Data were analyzed using Colaizzi’s phenomenological method (1978). Results: Five major categories and seventeen subcategories were identified. The key themes were as follows: (1) a sense of alienation due to limited networking opportunities, (2) difficulties in academic adaptation, (3) the need for institutional support and guidance, (4) gaining a sense of belonging through participation in community activities, and (5) perceiving the transfer experience as a stepping stone toward becoming a paramedic. Although participants initially experienced academic burden, clinical stress, and social alienation, they gradually reconstructed their professional identities through peer collaboration, faculty support, and self-directed learning. Conclusion: Transfer students in paramedicine face multifaceted academic and social challenges. However, they ultimately perceive their experiences as a foundation for professional growth. These findings highlight the need for a structured orientation, academic support, and integrated educational planning to facilitate successful adaptation and professional development.

Purpose: This study compared and analyzed integrated items (A-type) reflecting clinical scenarios with basic medical science items (B-type) within the basic medical sciences section of the national examination for paramedics by applying the 2-parameter logistic (2PL) Item Response Theory (IRT) model. Methods: Thirty pairs of items, each consisting of one A-type item and one B-type item, were developed for this study. The examination was conducted using a randomized crossover design with 147 paramedic students who had completed the national certification exam one week prior. Data analysis was performed using the R software package. Results: The results indicated that Type A items demonstrated an average discrimination power similar to or slightly higher than Type B items, while maintaining a difficult structure that showed better alignment with the distribution of student competencies. Furthermore, analyses of the Test Characteristic Curves (TCC) and Test Information Functions (TIF) revealed that the proficiency levels required to reach the same score thresholds were higher for A-type items. The focus of information provision also shifted toward competency intervals closer to the mean. Conclusion: Overall, gradually increasing the number of integrated items in the National Paramedic Exam will increase the assessment standards and practical suitability. This change must be paired with clinical linkage education and case-based learning to ensure effective integration into the curriculum.

Purpose: This study aimed to compare and analyze chest compression methods performed by a single rescuer in children with out-of-hospital cardiac arrest according to changes in compression support sites. Methods: This study analyzed the accuracy, fatigue, and preference of 28 paramedic students at K University when performing 8 min of CPR using wrist- and elbow-wrapping chest compression methods. Results: The wrist-wrapped chest compression method had a deeper average chest compression depth (t=4.74, p<.001), whereas the elbow-wrapped chest compression method had more subjects performing the optimal chest compression depth range (40-50 mm) and a higher optimal relaxation rate (Z=-3.14, p=.002). Conclusion: The elbow- and wrist-wrapped chest compression techniques showed different strengths and limitations in each subcomponent of CPR quality. Additional replication studies with larger samples are needed to ensure the validity and generalizability of these results.

Purpose: This study aimed to analyze undertriage occurring during prehospital trauma triage by comparing paramedic assessments of major trauma with the Revised Trauma Score (RTS) criteria and identifying factors associated with undertriage. Methods: This retrospective observational study analyzed the prehospital care reports of 23,030 trauma patients transported by 119 emergency medical services (EMS) in a single province between February 1, 2024, and January 31, 2025. Among these patients, 380 with RTS <7 were defined as having RTS-defined major trauma and included in the final analysis. Cases in which 119 EMT classified the RTS-defined major trauma patients as non-major were defined as under-triage, whereas cases classified as major were considered triage concordance with the RTS-based classification. Cross-tabulation analyses were conducted using general and clinical characteristics, primary injury site, and mechanism of injury as variables, followed by univariate logistic regression analysis. Results: Decreased systolic blood pressure and oxygen saturation were significantly associated with a lower likelihood of undertriage. In contrast, age ≥80 years and injury mechanisms, such as falls and slips, were significantly associated with an increased likelihood of undertriage. Conclusion: Prehospital triage criteria should be refined for trauma patients aged ≥80 years and for injury mechanisms involving falls or slips. Careful attention is required to avoid underestimating the likelihood of major trauma in elderly patients with fall-related injuries, even when their vital signs are within the normal range.

Purpose: This study examined the effect of interprofessional collaboration (IPC) competence on organizational commitment among level-1 emergency medical technicians (EMT-Paramedics) working in emergency medical institutions and verified the mediating role of psychological empowerment. Methods: This study used a descriptive cross-sectional survey design. Participants were 176 EMT-Paramedics working in emergency medical institutions in South Korea. Data were collected using the Interprofessional Collaborative Competency Attainment Survey (ICCAS), Psychological Empowerment Scale (PES), and Revised Organizational Commitment Questionnaire (Revised-OCQ). Data were analyzed using descriptive statistics, independent t-tests, one-way analysis of variance (ANOVA), Pearson’s correlation coefficients, multiple regression, mediation analysis with the Hayes’ PROCESS macro (Model 4), and bootstrapping. Results: Mean scores on a 5-point scale were 4.13±0.62 for IPC competence, 4.08±0.64 for psychological empowerment, and 3.71±0.67 for organizational commitment. IPC competence was significantly higher among EMT-Paramedics working in higher-level emergency medical centers and among those with more than six years of clinical experience. IPC competence showed significant positive correlations with both psychological empowerment and organizational commitment. In the multiple regression analysis, psychological empowerment was the strongest predictor of organizational commitment, whereas IPC competence did not show a significant direct effect. The mediation analysis confirmed that psychological empowerment partially mediated the relationship between IPC competence and organizational commitment, with an indirect effect accounting for approximately 65% of the total effect. Conclusion: These findings suggest that enhancing IPC competence and psychological empowerment through interprofessional education and organizational support strategies may strengthen organizational commitment among EMT-Paramedics working in emergency medical institutions.

Purpose: This study evaluated the effect of overhead space above an ambulance stretcher on endotracheal intubation (ETI) performance in a simulated prehospital setting and sought to estimate an appropriate spatial distance for airway management. Methods: A randomized crossover experimental study was conducted with 44 paramedic students at the Konju National University who had completed advanced airway training. The participants performed ETI on a high-fidelity simulator at three distances (40, 70, and 100 cm) in a mock ambulance setting. The order of the conditions was randomly assigned. The primary outcomes were the intubation success rate and time to first ventilation. Secondary outcomes included first-attempt failure, procedure time > 30 s, dental injury sound occurrence, and subjective discomfort (visual field, posture, and equipment handling) measured using a numeric rating scale. Data were analyzed using repeated-measures ANOVA and Cochran’s Q test. Results: No significant differences were found across the distance conditions in success rate (p = .135), intubation time (p = .262), first-attempt failure, dental injury, or procedure time exceeding 30 s. However, the discomfort significantly decreased as the distance increased (p < .001). The 40 cm condition showed higher discomfort scores than the 70 cm and 100 cm conditions, while no significant difference was observed between the 70 cm and 100 cm. A large effect size was observed for posture-related discomfort (ηp2= .339). Conclusion: Although ETI performance was not significantly affected by distance, a space of at least 70 cm improved operator comfort. These findings support new ambulance designs and emphasize the ergonomic considerations for prehospital airway management.

Purpose: This study examined electric scooter usage among university students and assessed their educational needs regarding traffic safety to support the development of effective instructional content. Methods: We conducted a descriptive survey using a structured questionnaire. Data were collected through an online survey using the Naver Form from November 6 to 17, 2024. The Borich Needs Assessment and the Locus for Focus models were used to identify educational priorities. Results: Participants showed low compliance with legal regulations such as helmet use, licensing, and solo riding. High educational needs were identified for topics such as legal responsibilities and appropriate actions after accidents, which are mainly related to traffic law violations. Conclusion: There is a strong need for practical safety education that includes scenario-based simulations and audiovisual tools rather than focusing solely on legal knowledge.