Earticle

Objectives: This study was intended to analyze factors affecting satisfaction with outpatient medical service based on a “Medical Service Experience Survey”. Methods: The study surveyed 8,062 users of outpatient medical services in 2017, 8,124 users in 2019, 6,692 users in 2021, and 8,613 users in 2023. Results: Elderly patients, elementary school graduates, first-quintile income earners, rural dwellers, and those living in medically underserved areas reported high satisfaction with outpatient medical services. Customer-centered systems and administrative services have become increasingly important factors in determining customer satisfaction with medical institutions. Conclusions: Medical institutions need to provide customer-centered hospital systems and administrative services to increase patient satisfaction. We expect that this study’s results will inform medical institutions seeking to provide high-quality, data-driven medical services.

Objectives: This study analyzed time-series changes in stroke occurrence in Korea and the factors influencing stroke diagnosis. Methods: Differences in stroke diagnosis and the impact of related factors such as socioeconomic status, health behaviors, and disease characteristics were analyzed among 4,262 individuals aged 40 and over using a complex sample design methodology. Results: Among individuals aged 40 and over, risk factors influencing stroke included: the 50-59 (OR, odds ratio=1.243, 95% CI=0.293-5.266) and, 60-69 (OR=2.841, 95% CI=0.73M1.054) age groups, having a separated marital status (OR=8.078, 95% CI=1.082-60.329), varying levek of alcohol consumption at 1-2 drinks (OR=1.160, 95% CI=0.604-2.230), 3-4 drinks (OR=1.048, 95% 0=0.562-1.954), 7-9 drinks (OR=1.338, 95% CI=0.535-3.343), and 10 or more drinks (OR=1.495, 95% CI=5.983-3.736), as well as pre-hypertension (OR=1.587, 95% CI=0.691-3.647), and hypertension (OR=3.090, 95% CM.353-7.057). Conclusions: The findings suggested that expanding community-based health education on stroke prevention for individuals aged 40 and above is important.

Objectives: This study is intended to analyze research trends around adolescent suicide in South Korea over the past 20 years (2005–2024) using text-mining techniques. The goal is to identify key themes and changes in the academic discourse related to adolescent suicide to inform future prevention strategies. Methods: A total of 1,378 Korean academic articles were collected from the RISS database using the keywords “adolescent” and “suicide.” After text preprocessing of titles and abstracts, frequency analysis, N-gram (2-gram and 3-gram) analysis, and keyword co-occurrence network analysis were conducted to examine major terms and thematic structures. Results: Word frequency and TF-IDF analyses indicated the high relevance of terms such as “adolescent,” “suicide,” “ideation,” “depression,” “stress,” and “prevention.” The research topics were classified into eight distinct clusters based on network and CONCOR analyses. Conclusions: This study provides a comprehensive overview of trends in South Korean research on adolescent suicide. The findings highlight the need for more preventive and policy-driven research to address the emerging challenges affecting adolescents.

Objectives: This study examined preferred leadership styles and generational conflict among millennial and generation Z (MZ) nurses, and their effects on organizational commitment. Methods: A descriptive correlational study was conducted at a tertiary hospital in South Korea with 221 MZ nurses born between 1980 and 2000. Results: Authentic leadership was the most preferred, followed by transformational and servant leadership. Conversely, transactional leadership was the least preferred. Only transformational leadership showed a significant positive effect on organizational commitment by enhancing trust, motivation, and vision. Generational conflict negatively impacted commitment, especially among nurses with longer tenures in the same unit owing to monotony and limited growth. Conclusions: Transformational leadership is key to strengthening organizational commitment in MZ nurses. Reducing generational conflict through better communication, job rotation, and career development is recommended to boost their engagement and job satisfaction.

Objectives: This study examined the effect of the local extinction risk index (LERI) on the allocation of healthcare resources, with emphasis on the effects of demographic changes and population aging on regional health systems. Methods: This study utilized balanced panel data from 2012 to 2021 for 18 regions in Gangwon Province to analyzed the relationship between the LERI and healthcare resources, which was measured using the number of doctors and hospital beds. Control variables were included based on the social determinants of a health model to account for non-medical influencing factors. The LERI was defined as the ratio of females aged 20–39 to those aged 65 and above. A random-effects model was applied to evaluate both time-series and cross-sectional effects. Results: Higher LERI values were generally associated with increased availability of healthcare resources. However, high-risk areas tended to have fewer hospital beds per capita, and this occurrence increased over the study period. Conclusions: The study reveals severe resource gaps in high-risk regions, calling for population-sensitive policies to ensure equitable health care access.

Objectives: This study aimed to evaluate the effects of health behaviors, grit, and physiological indicators on elderly individuals at risk off metabolic syndrome, based on King’s Goal Attainment Theory (1981). Methods: A non-equivalent control group with a pre-/post-test experimental design was used. The intervention group (n = 23) participated in a 12-week health promotion program based on the Goal Attainment Theory, which took place from June 16, 2022, to September 8, 2022. Data were analyzed using frequency and percentage, mean, standard deviation, chi-square test, Fisher's exact test, independent t-test, Mann-Whitney U-test, paired t-test, Wilcoxon signed-rank test, and ANCOVA. Results: The experimental group showed statistically significant differences in health behavior (Z = -5.60, p < .001), grit (t = 7.62, p < .001), body mass index (BMI) (t = -2.67, p = .011), and fasting blood glucose levels (Z = -3.06, p = .002) compared to the control group. Conclusions: This program is an effective nursing intervention designed to change health behaviors and improve the overall health of elderly individuals requiring long-term management.

Objectives: This study aimed to explore the retention experiences of experienced nurses and identify factors influencing their experience in clinical settings, to provide foundational data for developing measurement tools and informing workforce policies. Methods: Using Strauss and Corbin’s grounded theory methodology, in-depth interviews were conducted with eight nurses with over three years’ hospital experience in Gyeongsangnam-do, South Korea. Data were collected from January to February 2025 and analyzed through open, axial, and selective coding. Results: A total of 66 concepts, 47 subcategories, and 19 categories emerged. The core category was “maintaining employment through balance between career development and personal life.” influencing factors included work schedule, job satisfaction, economic needs, work–family balance, and interpersonal relationships. Nurses employed strategies such as internal adaptation, role transition, and prioritizing life balance. Key conditions promoting retention included supportive work environments, stable income, and flexible systems. Conclusions: For sustainable nurse retention, institutions must create flexible workplaces, enhance career development, and support life-stage-adjusted policies.

Objectives: This study examined the factors influencing the quality of life (QoL) of obese adults, with emphasis on the mediating roles of physical activity and generalized anxiety disorder (GAD). Methods: Data were obtained from the 9th Korea National Health and Nutrition Examination Survey, including 2,066 obese adults. Structural equation modeling and bootstrapping were performed to analyze the relationships among health recognition, physical activity, GAD, and QoL. Results: Health recognition showed a significant negative direct effect on QoL (estimate = -0.135, p < 0.001). However, through the multiple mediation of physical activity and GAD (estimate = 0.418, p < 0.01), the total effect became positive (estimate = 0.283, p < 0.01). This finding suggests a complete mediation pathway in which health recognition enhances physical activity, thus subsequently reducing GAD and ultimately improving QoL. Conclusions: Health recognition affects QoL positively through behavioral and psychological pathways. Integrated strategies promoting health literacy, physical activity, and mental-health support are necessitated to improve the QoL of obese adults.

Objectives: This study attempted to identify the effects of job esteem, nursing practice environment, and communication within organizations on hospital nurses’ quality of nursing services. Methods: The sample comprised 210 nurses from four general hospitals with 100-500 beds. Data were collected using self-directed questionnaires and analyzed using t-tests, Pearson’s correlation coefficients, and stepwise multiple regression. Results: Job esteem, nursing practice environment, and communication within organizations were positively correlated with the quality of nursing services. Stepwise regression analysis identified job esteem (β=.533, p<.001) and communication within organizations (β=.280, p<.001) as factors affecting the quality of nursing services, with a total explanatory power of 58.0%. Conclusions: To enhance the quality of nursing services for hospital nurses, it is necessary to develop and implement an education program that can strengthen communication within organizations and promote job esteem.

Objectives: This study aimed to understand the level of unmet medical experience in terms of medical accessibility and to provide basic data necessary for medical accessibility and policy establishment. Methods: The research data were analyzed using the SPSS statistical program, using the original data from the National Health and Nutrition Survey. Results: It was confirmed that the unmet medical rate continued to decrease. The most common reasons for unmet medical care were "lack of time," with the second being "economic reasons" and the third being "light symptoms." And Gender, age, average monthly gross household income, and insurance benefit types were found to have a significant causal relationship with unmet medical care was not met. Conclusions: The cause of the unmet medical care is believed to be resolved if strengthening coverage, providing information, and diversity of policies are promoted at the same time.