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Background: Despite the many advantages of flipped learning, it is challenging for educators to ensure that students complete the pre‐class learning assignments before the in‐class session. Objectives: Using a learning analytics approach, this study analysed students' pre‐class video‐watching behaviour in flipped learning with a focus on learners' resource management strategies, procrastination, and repeated video‐watching. Methods: For the empirical study, three types of data (i.e., log data, survey and exam) were obtained from 70 undergraduate students who were enrolled in pre‐service teacher program designed in a flipped classroom including pre‐class videos and in‐class session. Results and conclusions: The findings showed significant differences between the non‐procrastination group and procrastination group in their video watching time and resource management strategies. Those who watched the pre‐class videos at home/dorm greatly outnumbered those who did not, and they performed better than students who watched the pre‐class videos in other locations. What are the major takeaways from the study?: This finding highlights the importance of resource management strategies in terms of the time and study environment to promote success in flipped learning courses. However, the number of times students accessed the pre‐class videos or watched the videos before class was not correlated with learning achievement. The reason for re‐watching pre‐class videos is a suggested future direction so instructors can design effective flipped learning courses. Lay Description: What is already known about this topic?: Flipped learning is a type of blended learning that combines two teaching and learning modes: face‐to‐face learning and online learning. The effectiveness of flipped learning has also been demonstrated in many empirical studies and meta‐analyses.Despite the many advantages of flipped learning, it is challenging to ensure that students complete the pre‐class materials before class.Data‐driven decisions based on the learning analytics approach can help instructors revise the in‐class activities more adoptively and individual learners can be more engaged in flipped learning. What this paper adds?: Using a learning analytics approach, this study analysed students' pre‐class video‐watching behaviour in flipped learning with a focus on learners' resource management strategies, procrastination, and repeated video‐watching.We also examined the correlations among pre‐class video‐watching behaviour variables and learning achievement.This study highlights the following: (1) The no‐procrastination group had better resource management strategies than the procrastination group; (2) students who watched pre‐class videos at home outperformed those who watched them in other locations: (3) the number of times students accessed pre‐class videos was not correlated with learning achievement; and (4) whether or not students watched pre‐class videos prior to the in‐class sessions was not correlated with learning achievement. Implications for practise and/or policy: Although flipped learning gives students considerable autonomy in terms of when and where to watch pre‐class videos at their convenience, it is necessary to help students develop resource management strategies by providing role models, best practises, and statistics in previous flipped learning classes.Research findings suggest that instructors should provide guidelines and learning strategies on how to review or repeat the pre‐class videos to improve the quality of learning.To encourage students to repeat the videos, the pre‐class videos should be short and concise. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate senior baccalaureate nursing students' knowledge and visual differentiation ability for the pressure injury classification system (PICS) and incontinence-associated dermatitis (IAD). Methods: A cross-sectional survey was conducted using a paper-based questionnaire with 120 senior baccalaureate nursing students in South Korea. Data were collected using a knowledge test (KT) and a visual differentiation tool (VDT) based on 21 photographs with clinical information related to PICS and IAD. Results: Students had relatively high KT scores (62.6%), and low VDT scores (35.6%). Critical issues in this study were nursing students' lack of an adequate visual differentiation ability to accurately assess the stage of pressure injury and IAD and their higher level of confusion in identifying unstageable, deep tissue injuries, and IAD compared to stage 1-4 injuries. Satisfaction with education (r=.20, p<.05) and exposure to various teaching methods (r=.21, p<.05) exhibited significant correlations with higher VDT scores. Conclusion: The findings of this study suggest that increasing students' satisfaction with their education and applying various teaching methods can contribute to the improvement of visual differentiation ability in PICS. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to examine the relationships among patient safety competency, systems thinking and missed nursing care. Background: Patient safety competency and systems thinking are important nurse attributes that promote patient safety. Missed nursing care is known to negatively impact patient safety. However, how nurses' patient safety competency and systems thinking relate to missed nursing care is unknown. Methods: A cross‐sectional survey design was used to collect data from nurses practicing in two general hospitals in South Korea. Data were collected between 3 March and 17 April 2020. Questionnaires were distributed to nurses providing direct care in general and specialty units. Patient safety competency, systems thinking and missed nursing care were measured using reliable and valid instruments. A total of 432 complete sets of data were used in final analysis. Results: Higher patient safety competency of nurses was associated with lower missed nursing care. Systems thinking partially mediated the relationship between knowledge of patient safety competency and missed nursing care, and attitudes of patient safety competency and missed nursing care. Conclusions: The knowledge, skills and attitudes sub‐scales of patient safety competency showed somewhat different effects in the relationship between missed nursing care and systems thinking, suggesting that each attribute may tap into a separate aspect of patient safety. Summary statement: What is already known about this topic? Patient safety can be threatened when nurses are not competent to provide safe care to patients.Systems thinking is an essential nurse attribute that enhances patient safety competency.Greater missed nursing care has been associated with negative patient outcomes including adverse events such as medication error, fall with injury and patient mortality. What this paper adds? Higher patient safety competency of nurses was associated with less missed nursing care.Nurses' systems thinking had a mediating effect on the relationship between the patient safety knowledge and attitude competencies and missing nursing care.Nurses' systems thinking had the effect of reducing missed nursing care, but only when nurses exhibited patient safety knowledge and attitude competencies. The implications of this paper: By enhancing patient safety competency, missed nursing care can be reduced and negative patient outcomes may decrease accordingly.Strategies to increase systems thinking should be applied as a way to reduce missed care and increase patient safety. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to investigate the relationship between transformational leadership (TL) and the innovative behavior of Korean workers. To this end, this paper also examines whether knowledge sharing and perceived organizational support (POS) influence the above causal relationship. Design/methodology/approach – The paper used a cross-sectional design, with questionnaires administered to 356 employees working in Korea manufacturing firms to test the relationship between TL and innovative behavior through knowledge sharing and the moderating role of POS. Findings – TL was significantly related to both employee innovative behavior and knowledge sharing. The results also shown that knowledge sharing mediated and POS positively moderated the relationship between TL and innovative behavior of employees. Research limitations/implications – Future research should examine antecedents of knowledge sharing and measure the effect of TL in other level such as team level, to enhance generalizability. Data should be also collected longitudinally, to extend the current cross-sectional design. Practical implications – Understanding the link between TL and innovative behavior with mediating and moderating factors can provide useful information to increase positive leadership outcomes and innovation performance. Originality/value – The findings point toward a positive relationship between TL and innovative behavior with mediating and moderating factors. In doing so, the paper adds to a body of work where innovative behavior was connected with leaders’ behavior and organizational-level predictors. [ABSTRACT FROM AUTHOR]

Nurses' turnover intention has increased since the COVID-19 pandemic. Emotional labor is reportedly high among nurses in Korea, and a positive psychological capital can help reduce turnover intention. This cross-sectional study investigated the factors influencing turnover intention in nurses during the COVID-19 pandemic. Survey data were collected from 155 nurses caring for patients with COVID-19 at a university hospital in South Korea in March 2022. Self-reported and paper-based questionnaires on emotional labor, positive psychological capital, and turnover intention were employed. The mean values for emotional labor, positive psychological capital, and turnover intention were 54.52/80, 58.03/90, and 38.92/50, respectively, and 77.8% of nurses reported planning to quit working. Turnover intention correlated with emotional labor (r = 0.17; p = 0.041) and had no significant relationship with positive psychological capital. Sex (β = 0.24; p = 0.003) and emotional labor (β = 0.18; p = 0.019) affected turnover intention, with 9% explanatory power. Female nurses caring for patients with COVID-19 had a higher turnover intention than male nurses. Finally, the higher the emotional labor of nurses caring for patients with COVID-19, the higher the turnover intention. To reduce the turnover intention of nurses, hospitals need to help them enhance their emotional labor and positive psychological capital by establishing measures such as emotional coaching programs or psychological capital interventions. [ABSTRACT FROM AUTHOR]

Background: With the proliferation of the internet and the development of internet‐based healthcare interventions, eHealth is expected to be an effective complement to traditional healthcare services. However, without understanding the characteristics of the user population, eHealth itself can isolate older adults. Aim: This study aims to identify the characteristics of internet use and the factors associated with eHealth use among older adults. Methods: A secondary data analysis was conducted from a cross‐sectional descriptive study. A convenience sample of 186 community dwelling older adults was recruited at two senior welfare centres in Korea. The data collected included demographic characteristics, health related characteristics, internet use, eHealth use and eHealth literacy. Multiple linear regression was utilized to determine factors related to eHealth use. Results: Among 186 respondents, 98 reported that they used the internet. Internet usage was associated with educational attainment, marital status, cognitive function and possession of internet‐enabled devices. The results of multiple regression analysis showed that greater eHealth usage was related to more positive perception of eHealth usability and better eHealth literacy among older adults. Conclusion: Educational programmes for older adults should be developed to facilitate digital capability and eHealth literacy. Useful and effective online health resources that are easy to use should be also developed. Summary statement: What is already known about this topic? With an ageing society, health promotion and management of chronic diseases are becoming increasingly important; thus, the social burden of healthcare is expected to increase.eHealth can help individuals manage chronic disease effectively and promote changing behaviours for better health, but older adults may not be able to use the internet and eHealth. What this paper adds? This paper identified the factors related to internet use in adults aged 65 and over: higher educational level, married/partnered marital status, better cognitive function and possession of internet‐enabled devices.This paper identified factors facilitating eHealth use: older adults who perceived eHealth as more useful and had better eHealth literacy used eHealth more frequently. The implications of this paper: Education for older adults to enhance their skills to use internet‐enabled devices and increase their capability to interpret health‐related information can facilitate eHealth accessibility and enable them to take advantage of the benefits of health technologies.Useful online health resources that are evidence‐based and easy‐to‐use can encourage older adults to use eHealth. [ABSTRACT FROM AUTHOR]

This study seeks to understand how citizens' more intrinsic cultural orientations shape their attitudes toward the importance of ethics. Drawing upon the Grid-Group Cultural Theory, we investigate how four different cultural orientations influence citizens' attitudes toward ethics in distinctive ways. Our multivariate analysis of the survey responses of 1,260 Seoul citizens revealed that strong hierarchs, egalitarians, and individualists are more likely to recognize the importance and necessity of public ethics. Fatalist orientation, however, did not show a statistically significant relationship with the importance and necessity of public ethics. It was individualism that exerted the most significant influence over the importance of ethics in personal life, while the perception of the importance of ethics in the public sector and the necessity for ethics training for public officials were found to be mostly supported by strong hierarchs. We conclude this paper by discussing the theoretical and practical ramifications of these findings. [ABSTRACT FROM AUTHOR]

Aim: If not conducted correctly, nursing handover can threaten patient safety, and so nursing students require good handover education. This study evaluated a handover education programme based on situated learning theory in a clinical practicum. Methods: A quasi‐experimental design and convenience sampling technique were used. The participants (fourth‐grade nursing students recruited from a college in the C province of South Korea) were assigned to an intervention group (n = 38) or a control group (n = 39). A handover education programme that included lectures, expert observations, role playing, peer learning and reflection was received by the intervention group. The control group attended lectures and observed handovers. The handover skills of all participants were tested 2 weeks before and on the last day of the clinical practicum. Handover performance ability, handover clinical judgement ability and handover self‐efficacy were outcome variables. Results: Significant improvements in handover performance ability, handover clinical judgement ability and handover self‐efficacy were observed in the intervention group compared with the control group. Conclusion: The significance of this study lies in the development and application of a programme based on situated learning theory for handover education. Application of theory‐based handover education in clinical practicums is recommended to improve the handover capabilities of nursing students. Summary statement: What is already known about this topic? Nursing handover is considered very important for optimizing nursing performance and securing the continuity and safety of patient care.Nurse educators must develop and validate educational strategies to resolve handover deficiencies among nursing students. What this paper adds? The self‐evaluation of handover performance ability, handover clinical judgement ability and handover self‐efficacy were better in nursing students who received handover education based on situated learning theory than in the control group. The implications of this paper: Theory‐based handover education applied in a clinical practicum context can allow nursing students to improve relevant capabilities prior to graduating as a clinical nurse.Situated learning theory provides a theoretical basis upon which to support practical handover learning. [ABSTRACT FROM AUTHOR]

Background: Preschool‐age children in hospitals are at a high risk of unexpected incidents. Safety incidents in hospitals can cause serious damage to the children. Objective: To determine the effectiveness of the mobile‐type mHealth Safe Kids Hospital (SKH) application (app) for the prevention of hospitalized child safety incidents. Design: This study used a three‐group, randomized controlled trial pre‐post design. Setting(s): This study was conducted in the pediatric ward of three general hospitals in Korea. Participants: A total of 124 eligible hospitalized children and their caregivers were enrolled in the study from June to December 2018. Of these, 116 finally participated in the study, and 8 were excluded because they were discharged before the intervention. Methods: Hospitalized preschool‐age children and their caregivers were randomly allocated into three groups: experimental group I (n = 39), experimental group II (n = 39), and the control group (n = 38). Experimental group I received the SKH app intervention, the experimental group II received a paper‐based intervention, whereas the control group received the usual intervention. Participants' outcomes of awareness, knowledge, and behavior related to hospital safety, were assessed at two time points: baseline and 24 h after the intervention. Results: Hospital safety awareness had a higher increase after intervention in experimental groups I and II than in the control group. Among the four subdomains of hospital safety awareness, there was a significant increase in the scores of experimental group I on three subdomains after the intervention: falls (F = 8.19, p < 0.001), burns (F = 6.73, p = 0.002), and medical devices (F = 6.81, p = 0.002). In hospital safety knowledge and safety behavior, experimental group I had the highest average score after the intervention compared with experimental group II and the control group; however, there was no statistically significant difference in the average score of the three groups. Conclusions: Using the SKH app is easy to attract the interest of preschool‐age children and is also easy for nurses to use in clinical trials; thus, it is considered to be a useful educational intervention to prevent safety incidents in clinical fields in future. Clinical Relevance: It is thought to contribute to the prevention of preschool‐age children's safety incidents in pediatric wards. [ABSTRACT FROM AUTHOR]

Aim: The study purpose was to investigate effects of a cognitive rehabilitation programme on cognitive function, self‐management and quality of life in patients with chronic obstructive pulmonary disease. Background: Cognitive impairment is frequently observed in chronic obstructive pulmonary disease patients, and it interferes with many aspects of self‐management, which is fundamental to disease management and quality of life. Design The design is quasi‐experimental. Methods: Data collection was performed between June 2018 and March 2019. Study participants were 60 in‐ or out‐patients with chronic obstructive pulmonary disease. The cognitive rehabilitation programme involved six 30‐min sessions administered over a period of 2 weeks and consisted of six areas: attention, memory, language, visuospatial perception, executive function and problem solving. Cognitive function, self‐management and quality of life were measured at three times (preintervention and immediately and 4 weeks after intervention). Results: Cognitive function, self‐management and quality of life were found to be significantly improved over time after administration of the cognitive rehabilitation programme. However, no significant improvement was observed in the control group. Conclusions: Our findings support the potential usefulness of cognitive intervention to promote cognitive function, self‐management ability and quality of life in patients with chronic obstructive pulmonary disease. Summary statement: What is already known about this topic? Cognitive impairment interferes with many aspects of self‐management, such as monitoring symptoms, adherence to medication regimens and the maintenance of healthy lifestyles, which are fundamental to the management of chronic obstructive pulmonary disease (COPD).Despite the importance of cognitive functions, few studies have been attempted to the investigate effects of cognitive rehabilitation programmes in COPD patients. What this paper adds? Cognitive function, self‐management and quality of life were significantly improved over time after administration of the cognitive rehabilitation programme. The implications of this paper: Our findings support the importance of cognitive rehabilitation intervention for improving cognitive function, self‐management ability and quality of life in COPD patients.The present study also provides a resource for an effective cognitive rehabilitation programme that can be used by nurses or other clinical practitioners to improve cognitive function in COPD patients with cognitive impairment. [ABSTRACT FROM AUTHOR]

Aim: This study examined the effect of an individualized educational intervention on the knowledge, attitudes and self‐management ability after 12 weeks for outpatients with atrial fibrillation. Methods: A randomized control‐group pretest‐post‐test experimental design was used. Elderly outpatients with atrial fibrillation aged over 65 years were recruited from a university hospital in Korea. The experimental group received a 50‐min individualized education on self‐management, one telephone counselling after 8 weeks and maintenance of a self‐management diary for 12 weeks. Data were collected from November 2017 to April 2018 and analysed using SPSS 22.0 for descriptive statistics and hypothesis testing. Results: The participants' mean age was 71.9 (4.6) years. Compared to the control group (n = 29), the experimental group (n = 31) showed a significantly greater improvement in knowledge regarding atrial fibrillation and stroke prevention (t = −2.27, p =.027) and self‐management behaviours (t = −8.02, p <.001). There were no significant group differences in attitudes towards atrial fibrillation. Conclusion: The findings suggest that education for elderly people with atrial fibrillation should be individualized, focusing on self‐management in daily life to prevent cardiovascular complications. Future research is needed to confirm the long‐term effects of such education programmes. SUMMARY STATEMENT: What is already known about this topic? Older adults with AF tend to lack the knowledge and have inadequate self‐management skills regarding their illness. Their awareness of AF should be raised, especially regarding cardiovascular complications, such as stroke and heart failure, and prevention of complications.Patients with AF, mostly older people and those with comorbid conditions, need to be educated on the different approaches apart from the usual education to prevent developing strokes. What this paper adds? Individualized education focused on self‐management to prevent cardiovascular complications was more effective in increasing the knowledge and self‐management behaviour among Korean older adults with AF compared with those patients receiving routine medical education.Education for patients with AF should be tailored to meet the needs of older adults and those with comorbidities and focus on self‐management to prevent cardiovascular complications in daily life. The implications of this paper: Individualized education and telephone counselling can help improve knowledge of complications and self‐management among elderly people with AF.Health care professionals need to provide periodical counselling and education to elderly people with AF to enhance their self‐management behaviour in daily life to prevent cardiovascular complications. [ABSTRACT FROM AUTHOR]

Aggression in dating relationships is a serious problem that can have long-term negative consequences. While research had been increasing in western societies concomitant with an increasing awareness of intimate partner violence (IPV) perpetration, studies in Asian societies are still few and far between. This paper examines dating violence perpetration among college students in South Korea. Overall violence, emotional, and physical violence are examined respectively. Witnessed parental conflict is used as the main explanatory variable consistent with much of the literature on intimate partner violence perpetration, and also examines the effect of the self-conscious emotion of guilt on dating violence perpetration. Guilt had been shown in the psychological literature to be prosocial and adaptive, but its role has been largely ignored in the IPV and aggression literature. Both its direct and moderating effects on dating violence are examined. Anonymous surveys were administered to college students in four universities across four cities and four regions in South Korea. Three hundred and thirty students who have had a dating experience are included in the analyses. Results show that both witnessed parental conflict and guilt are independently related to dating violence overall, and also to emotional and physical violence. Guilt moderates the effect of witnessed parental conflict on emotional but not physical violence. A closer examination of the role of self-conscious emotions on dating aggression is important. The results extend the generally western theories of dating violence to South Korea and provide evidence of the relevance of these theories cross-culturally. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to identify the nursing stress factors, which affect turnover intention in hospital nurses. Background: Nursing stress is known to be an important predictor of turnover intention in nurses. Although nurses experience various sources of stress across work environments, cultures, and generations, little is known about the stress factors affecting turnover intention in nurses. Design A descriptive cross‐sectional design was employed. Methods: A total of 329 nurses were recruited through convenience sampling from 27 hospitals in South Korea. Data were collected from May to November 2018 using a questionnaire. Results: Among the stress factors, stress from patients and their families, workload stress, stress from conflicts with supervisors, and stress from conflicts with peers were associated with turnover intention in hospital nurses. These variables explained 40.0% of the variance in turnover intention among hospital nurses. Conclusions: Stress from interpersonal relationships with patients and their families, supervisors, and peers may have a considerable impact on turnover intention. To reduce nursing turnover intention, coping strategies to reduce stress from patients and their families should be established. It is necessary to provide programmes that foster interpersonal relationship skills in the workplace. Nurse managers may encourage communication among nurses to establish positive relationships. SUMMARY STATEMENT: What is already known about the topic? Nurses' turnover continues to remain a challenging issue across work environments, cultures, and generations.Nursing stress has a great impact on turnover intention in hospital nurses. However, little is known about the stress factors that affect turnover intention in nurses. What this paper adds? Among the nursing stress factors, stress from patients and families had a strong effect on turnover intention in hospital nurses, followed by stress from workload, conflicts with supervisors, and conflicts with peers. The implications of this paper: Our findings suggest that stress from interpersonal relationships might have a considerable impact on turnover intention.Coping strategies to reduce stress from patients and family need to be first established to reduce the turnover intention in hospital nurses.Nurse managers should be aware of the effects of interpersonal relationships on turnover intention and encourage communication among nurses to establish positive relationships. [ABSTRACT FROM AUTHOR]

Universities around the world face a common challenge - producing graduates with the necessary practical skills for employment. Cooperative education and work-integrated learning (WIL) make a valuable contribution to increasing graduate employability, however, there are differences in the level of cooperation from industry and government commitment. A comparative study of WIL in Germany, Australia, and South Korea, focusing predominantly on three universities, showed differences in the approaches to achieving practical experience and increasing graduate employability. The data underlying the research was derived from questionnaires, a focus group session, and the development of a descriptive, multi-case study. This allowed comparisons and contrasts between the three universities to be identified. The results and conclusions outlined in this paper aim to highlight best practice in cooperative education and WIL and provide recommendations for the future development of cooperative education, in order to improve graduate employability. [ABSTRACT FROM AUTHOR]

Aim: The awareness for the need for end‐of‐life care has increased among noncancer patients. However, studies on the topic have rarely targeted the needs of noncancer patients who want to die at home. This study assessed the end‐of‐life care needs of noncancer patients who were receiving care and wanted to die at home. Methods: A cross‐sectional study design was used and involved 200 participants who were diagnosed as noncancer patients and receiving home care nursing. Data were collected on demographics, disease, Palliative Performance Scale (PPS) scores, and end‐of‐life care needs, in April and May, 2016. Results: Among the six areas of care, "supporting fundamental needs" of patients required the most care, followed by "coordination among family or relatives." Multivariate analysis revealed that the duration of home care nursing held a significant association with end‐of‐life care needs. Conclusion: By reflecting on the comprehensive care needs of patients with chronic illnesses and including them in the care process, it will be possible to provide better quality palliative care to patients at home in the end‐of‐life stages. SUMMARY STATEMENT: What is already known about this topic? Noncancer patients at the end‐of‐life stage have complex needs and problems that are difficult to solve, compared with cancer patients.Noncancer patients need to receive effective symptom management or sufficient support for satisfactory care.End‐of‐life care is still mainly focused on cancer patients and attention to noncancer patients is lacking. What this paper adds? Among the six areas of care, "supporting fundamental needs" of patients required the most care, followed by "coordination among family or relatives."Duration of home care nursing and an income level were significantly associated with higher end‐of‐life care needs. The implications of this paper: Home care nurses must clearly assess the care needs of noncancer patients at the end‐of‐life stage and subsequently provide comprehensive patient‐centered care based on this assessment.It is important to adjust the care direction between patient, family, and medical staff from early on for patients who want to die at home.The results highlight needs for the development of interventions that focus on the duration of home care nursing of patients. [ABSTRACT FROM AUTHOR]

Background: This study aims to establish the mechanism by which virtual reality (VR) media characteristics affect learning transfer in a VR‐based job‐training environment. The two main determinants of learning transfer are the technology and the learner, but not many studies have considered both factors simultaneously. Objectives: This study aims to ascertain the mechanism by which VR media characteristics affect learning transfer with flow as a mediator, and to explore whether presence moderates the effect of VR media characteristics on flow. Methods: A survey of semiconductor facilities engineers who received VR‐based job training was conducted. A total of 106 responses were used in the statistical analysis. A path analysis was conducted to determine the promotional mechanism that connects VR media characteristics, flow, and learning transfer. Results and Conclusions: The results were as follows. First, VR media characteristics had a positive impact on learning transfer. Second, flow acted as a mediator in the relationship between VR media characteristics and learning transfer. Third, presence played a moderating role in the relationship between VR media characteristics and flow. Key takeaways: This study is significant as it identifies elements to consider in relation to both the technological and learner aspects of VR while designing a VR‐based job‐training programme. A corporation should consider VR media characteristics from a technological perspective, and flow and presence from a learner's perspective. Lay Description: What is already known about this topic: Corporations provide virtual reality (VR)‐based job training because of its positive impact.Interactions between the VR environment and learners impact flow.Presence is important as learner's subjective awareness affects efficacy. What this paper adds: VR media characteristics influence learning transfer in VR‐based job training.VR media characteristics affect flow, which, in turn, affects learning transfer.Presence moderates the relationship between VR media characteristics and flow. Implications for practice and/or policy: VR media characteristics influence learning transfer in VR‐based job training.VR media characteristics affect flow, which, in turn, affects learning transfer.Presence moderates the relationship between VR media characteristics and flow. [ABSTRACT FROM AUTHOR]

Purpose - This paper aims to examine the effects of compatible characteristics between parent firms on the extent to which international joint ventures (IJVs) acquire marketing knowledge. Compatible organisational characteristics are a particularly important component for absorptive capacity in that it may play a pivotal role in extending the prior relevant knowledge base and promoting a favourable learning environment. A series of hypotheses based on the literature is tested, which suggests that: there is a close association between IJV size and the level of knowledge acquisition, and compatible characteristics between parents positively influence marketing knowledge acquisition in IJVs. Design/methodology/approach - The data were obtained by a survey. Questionnaires were posted to the CEOs of IJVs in Korea. A total of 688 questionnaires were sent out and 128 were returned, giving a response rate of 18.6 per cent. Findings - The paper finds that the marginal differences in mean values indicate that firm size does not significantly influence the extent of knowledge acquisition in IJVs. A series of regmession analyses was undertaken and it was found that the impact of compatible organisational culture on knowledge acquisition was positive and significant. Research limitations/implications - There are some limitations to the study. First, the data used were collected from only one country. Second, only marketing skills were considered, leaving aside other important types of knowledge that can contribute to IJV operations. Third, the measurement used for the acquisition of marketing knowledge has some drawbacks, in that it is based on the perceptual judgements of key managers, without employing objective measurements. In addition, the relatively low response rate and the low number of responses from large firms are clearly further limitations. Practical implications - The findings suggest that compatible culture should be a crucial partner selection criterion for both local and foreign firms. Originality/value - Very few studies have analysed small and medium-sized IJVs, and fewer have focused on marketing knowledge acquisition particularly in a dynamically energetic environment (South Korea in this case). The paper also contributes to the current literature by confirming the positive relationship between compatible organisational culture and marketing knowledge acquisition. [ABSTRACT FROM AUTHOR]

Extensive research on the coronavirus disease 2019 (COVID‐19) is underway. However, there are not many studies on the use of masks, which are essential for infection prevention. This descriptive study aimed to understand the factors influencing the use of masks by Korean adults during COVID‐19. We conducted an online survey with 280 adults in South Korea between August and September 2020, analyzing the data using SPSS version 24.0. Multiple regression analyses were performed to understand the factors that influence individuals' use of masks. The participants' perceived susceptibility, perceived barriers, other people's dignity, compliance with public order, reasonable decision making, and subjective norms explained 21.6% of mask use. Mask use is expected to increase further if people perceive a personal need to wear masks, if their peers perceive the importance of mask use, and if they possess civic consciousness that considers society as a whole. This paper makes a significant contribution to the field of public health, with evidence‐based recommendations for increasing mask use, going beyond simply attributing mask use to individual preferences. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate respondents’ satisfaction with smart device-based testing (SBT), as well as its convenience and advantages, in order to improve its implementation. The survey was conducted among 108 junior medical students at Kyungpook National University School of Medicine, Korea, who took a practice licensing examination using SBT in September 2015. The survey contained 28 items scored using a 5-point Likert scale. The items were divided into the following three categories: satisfaction with SBT administration, convenience of SBT features, and advantages of SBT compared to paper-and-pencil testing or computer-based testing. The reliability of the survey was 0.95. Of the three categories, the convenience of the SBT features received the highest mean (M) score (M= 3.75, standard deviation [SD]= 0.69), while the category of satisfaction with SBT received the lowest (M= 3.13, SD= 1.07). No statistically significant differences across these categories with respect to sex, age, or experience were observed. These results indicate that SBT was practical and effective to take and to administer. [ABSTRACT FROM AUTHOR]

Purpose To examine the effect of auricular acupressure therapy on primary dysmenorrhea among female high school students in South Korea. Design A randomized controlled trial was employed. Methods The study sample consisted of 91 female high school students, with 45 participants in the experimental group and 46 in the control group in two regions of South Korea. The average age of the participants was 16.7 years, and the average age of menarche was 12.2 years. Auricular acupressure therapy including an auricular acupressure needle on skin paper tape was applied on an ear for 3 days during periods of extreme primary dysmenorrhea. The acupoint names were Jagung, Sinmun, Gyogam, and Naebunbi. For the placebo control group, only the skin paper tape without an auricular acupressure needle was applied on the same acupoints. Measures used were the Menstrual Distress Questionnaire to assess primary dysmenorrhea, and the visual analog scale to assess abdominal and back pain of participants. Findings There were significant differences on abdominal pain ( t = 24.594, p < .001), back pain ( t = 22.661, p < .001), and primary dysmenorrhea ( t = 32.187, p < .001) between the two groups. Auricular acupressure therapy decreased abdominal pain, back pain, and primary dysmenorrhea of female high school students in South Korea. Conclusions Auricular acupressure therapy was an effective intervention for alleviating abdominal pain, back pain, and primary dysmenorrhea of female high school students in South Korea. For feasibility of the auricular acupressure therapy in practice, it is needed to train and learn the exact positions of acupoints in ear. Clinical Relevance Health providers should consider providing auricular acupressure therapy as an alternative method for reducing abdominal and back pain, and primary dysmenorrhea in female high school students in South Korea. [ABSTRACT FROM AUTHOR]

INTRODUCTION To explore the current situation of exposure of Korean adolescents to secondhand smoke (SHS) in households our study aimed to determine the relationship between family member smoking status, exposure to tobacco information through mass media, and household SHS exposure. METHODS The present study uses pooled data from the Korean adolescent health behavior online survey conducted in 2015, 2018 and 2021, with 157944 participants. The regression models were used to explore the association between the smoking status of households, and exposure to tobacco information through mass media, and household SHS exposure in adolescents, controlling for potential confounding factors. RESULTS SHS exposure duration of Korean adolescents in households was 0.88 days per week. The households with smokers including the father (β=1.087; 95% CI: 1.0--1.126), mother (β=1.461; 95% CI: 1.379-- 1.543), siblings (β=0.545; 95% CI: 0.493--0.597), grandparents (β=0.224; 95% CI: 0.174--0.272), and other relatives (β=0.170; 95% CI: 0.126--0.214), showed a positive association with SHS exposure in adolescents within the household. At the same time, information about anti-smoking ads on television (β= -0.042; 95% CI: -0.069 -- -0.015) and public transportation (β= -0.031; 95% CI: -0.054 -- -0.010), showed a negative association with SHS exposure in adolescents. However, broadcasts, online, and newspaper non-smoking ads were not associated with SHS exposure (p>0.05). In addition, regression models revealed that exposure to cigarette advertising in magazines (β=0.131; 95% CI: 0.097--0.166), networks (β=0.151; 95% CI: 0.127-- 0.175), convenience stores (β=0.061; 95% CI: 0.035--0.087), and supermarkets (β=0.133; 95% CI: 0.108--0.158) is associated with SHS exposure in adolescents. Finally, our study showed stronger ties between SHS exposure, family smoking, and tobacco ads in girls. The link between maternal smoking, supermarket ads, and adolescent SHS exposure intensified in 2021 compared to 2015. CONCLUSIONS Family and media were identified as potential factors associated with SHS exposure in adolescents. Therefore, publicity and education regarding household SHS hazards, and smoking bans in media, can be helpful in protecting adolescents from SHS. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to explore the role of clinical research coordinators (CRCs) and identify the importance and performance of the role as well as the factors that affect the professional recognition of their role. Methods: A total of 102 CRCs from 10 hospitals were recruited for a survey. The Clinical Trial Nursing Questionnaire scale developed by Ehrenberger and Lillington was used to collect data for the importance–performance analysis. The importance and performance data were plotted on a two‐dimensional grid, and multiple stepwise linear regression analysis was used to determine the influencing factors on the CRC role. Results: The influencing factors on the importance of the CRC role were frequency of protocol assessment, implementation and evaluation and professional nursing role performance. The influencing factors on performance were formal education and training in clinical research, institutional career ladder system for professional development and identification as a principal investigator in research studies. The influencing factor on the professional nursing role perception was the lower component of the 'performance of professional nursing role'. Conclusion: Formal educational preparation, identification as a principal investigator in research studies and clear career progression are supportive factors to the professional recognition of CRC as a specialized nursing role. Summary statement: What is already known about this topic? Clinical trials ultimately contribute to improving public health.A clinical trial process should cover a number of tasks, such as provision of study information to patients, recruitment of patients, screening and obtainment of their consent.Clinical trial nurses affect the quality of clinical trials, but little is described about the scope and contribution of their roles in clinical trials. What is already known about this topic? This study explored the role of clinical research coordinators (CRCs) and their professional role recognition in the wake of policy changes in South Korea since 2015.Formal education, role delineation and career ladder schemes are critical factors to the career advancement of CRCs, as shown in the study results.Identifying the changes and effects of the relevant policy has implications to the South Korean context and beyond, serving as a reference for countries considering setting up CRC roles or establishing an educational system for CRCs. The implications of this paper: Formal education, role delineation and career ladder schemes are critical factors to the career advancement of CRCs.To improve the performance and professional awareness of CRCs, a government‐led system and policies on formal education and career ladder are needed so that CRCs can fulfil their role in improving public health. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study aimed to measure the frequency of spiritual needs, identify the factors associated with these needs among Korean and American persons living with an advance chronic illness and compare them from a cross‐cultural perspective. Background: Persons with serious or life‐limiting illnesses often have spiritual needs. Unmet spiritual needs are associated with poor well‐being and threaten psychological health. Little is known about how specific spiritual needs vary across cultures. Design: A quantitative, cross‐sectional, observational cross‐cultural comparison was undertaken. Methods: The study has been prepared in accordance with the STROBE guidelines. Convenience sampling was used to recruit participants from outpatient clinics in South Korea and Southern California (N = 202). Spiritual needs were measured using the Spiritual Interests Related to Illness Tool (SpIRIT); demographic and illness‐related variables were also assessed using paper‐and‐pencil questionnaires. Data were analysed using various parametric statistical tests, including multiple regression analysis. Results: The findings quantify the intensity and types of spiritual needs that persons living with an advanced chronic illness experience. Furthermore, they show how the spiritual needs of religiously diverse samples of South Koreans and Americans differ. The findings also indicate that self‐reported spirituality and religiosity independently explain a substantial amount of the variance in spiritual needs. Conclusions: In both the samples, spiritual needs were reported and associated with spirituality and religiosity. Although all the eight domains of spiritual needs assessed by the SpIRIT were pertinent to the Korean and American samples, they were prioritised differently. Relevance to clinical practice: Screening patients to ascertain how important spirituality or religiosity is to them may help clinicians focus their in‐depth assessments on those who report high levels of spirituality or religiosity because these patients may experience the strongest spiritual needs. The SpIRIT shows promise as a measure of diverse spiritual needs. [ABSTRACT FROM AUTHOR]

Background: Due to the global COVID‐19 pandemic, online learning became the only way to learn during this unprecedented crisis. This study began with a simple but vital question: What factors influenced the success of online learning during the COVID‐19 pandemic with a focus on online learning self‐efficacy? Objectives: The purpose of this study was to examine the structural relationship among self‐efficacy (SE) in time management, SE in technology use, SE in an online learning environment, and learning engagement. Methods: The participants of the study were 1205 undergraduates who were enrolled in a residential undergraduate program in South Korea in spring semester, 2020. The online survey was administered to collect data for this research and the survey results were analyzed using structural equation modeling. Results and Conclusions: SE in technology use had a significant but negative influence on learning engagement and had a positive impact on SE in an online learning environment. SE in time management had a significant positive impact on SE in an online learning environment and learning engagement. SE in an online learning environment also significantly influenced learning engagement. Implications: SE in technology use itself did not enhance learning engagement. In addition, indirect effects of SE in technology use and SE in time management on learning engagement through SE in an online learning environment were confirmed in this study. This indicates the influential role of SE in an online learning environment on learning engagement of online learners. Lay Description: What is already known about this topic: COVID‐19 forced almost all students to learn online.Time management plays a major role in the success of online learning.Technology self‐efficacy is a requirement in online learning.The learning engagement variable explains learning achievement and attitudes. What this paper adds: Self‐efficacy (SE) in time management and SE in technology use enhanced SE in an online learning environment.SE in technology use itself did not enhance learning engagement.SE in time management and in SE an online learning environment significantly influenced learning engagement.SE in an online learning environment mediated the relationship between SE in technology use and learning engagement as well as between SE in time management and learning engagement. Implications for practice and/or policy: It is important to promote students' online learning self‐efficacy to enhance learning engagement in online learning.Practitioners should be aware that SE in technology use improves learning engagement through SE in an online learning environment.SE in time management should be promoted for successful online learning. [ABSTRACT FROM AUTHOR]

Background: An association between health literacy and health outcomes has been widely reported in the literature. However, models exploring the links between health literacy and the outcomes of health literacy need further testing. The purpose of this study was to examine the pathways of health literacy on diabetes self‐care activities amongst patients with Type 2 diabetes. Methods: A cross‐sectional survey using secondary data analysis was conducted on 155 patients with Type 2 diabetes recruited from the diabetes clinics of two university hospitals in a metropolitan city in South Korea. Structural equation modelling analysis using bootstrapping was carried out using the AMOS software. Results: Health literacy had no significant direct effect on diabetes self‐care activities. Rather, health literacy had a significant indirect effect on diabetes self‐care activities mediated through diabetes knowledge and patient activation. Conclusion: These findings indicate that interventions intended to improve self‐care activity amongst older adults with low health literacy should include strategies to enhance patients' knowledge, as well as their activation for diabetes self‐care. SUMMARY STATEMENT: What is already known about this topic? Health literacy is known to be a factor influencing self‐management of patients with diabetes.Low level of health literacy is associated with adverse health outcomes of patients with chronic illness.It is important to understand the processes through which health literacy affects health outcomes. What is already known about this topic? Health literacy had a significant direct effect on knowledge and patient activation but not on diabetes self‐care activities.Health literacy had a significant indirect effect on diabetes self‐care activities mediated through diabetes knowledge and patient activation. The implications of this paper: Interventions intended to improve self‐care activities amongst older adults with low health literacy should include strategies to enhance patients' knowledge, as well as their activation for diabetes self‐care.For patients with low health literacy, information processing should be used to facilitate the advancement of their knowledge and the subsequent influence of this knowledge on diabetes self‐care activities.Patient activation should be encouraged by nurses during interactions with patients with diabetes. [ABSTRACT FROM AUTHOR]

INTRODUCTION Although previous studies have addressed the association between smoking and obstructive sleep apnea (OSA), there are few studies on the association between electronic cigarette use and OSA. Thus, we aimed to evaluate the association between the dual use of electronic and conventional cigarettes and OSA. METHODS Data from 7350 participants of the 2019-2021 Korean National Health and Nutrition Examination Survey were analyzed in this population-based study. The STOP-Bang score was calculated using eight items: snoring, tiredness, observed apnea, high blood pressure, body mass index, age, neck circumference, and sex. The main independent variable was smoking behavior. A multiple logistic regression analysis was performed. Subgroup analysis was conducted to analyze the association between smoking behavior in detail and OSA, and stratified analyses were additionally performed. RESULTS Of the 7350 participants, 417 (5.7%) had a high risk of OSA, according to the STOP-Bang score. Compared to the non-smoker group, the dual user group had a 2.46-fold increase in the odds of OSA (adjusted odds ratio, AOR = 2.45; 95% CI: 1.04-5.79). Current non-smokers who were dual users in the past had increased odds of having OSA (AOR=3.61; 95% CI: 1.32-9.92). In the stratified analyses, dual cigarette use was significantly associated with OSA in females and those with a low physical activity level. CONCLUSIONS Dual users and cigarette-only users had an increased probability of developing OSA. Even if they are not currently smoking or vaping, individuals who were dual users in the past were associated with a higher risk of OSA. The association between dual cigarette use and OSA was more pronounced in females and those with a low physical activity level. While intervening for obstructive sleep apnea or investigating risk factors, new smoking methods such as vaping and dual use should be considered along with conventional smoking. [ABSTRACT FROM AUTHOR]

INTRODUCTION Tobacco users are categorized as single, dual, and triple users based on the number of tobacco products (cigarettes, e-cigarettes, and heated tobacco products) used. This study addressed a literature gap by examining how adult Korean tobacco users' quit attempts/plans differed based on the user type, and the associated psychosocial and subjective health-related factors. METHODS We used a questionnaire to examine participants' self-reported health, stress, health concerns, health behavior, tobacco addiction, intentions/plans to quit, and demographic characteristics. Data were analyzed using chi-squared tests, one-way analysis of variance, and multiple linear regression. RESULTS Of the 1288 tobacco users, 55.4%, 28.3%, and 16.4% were single, dual, and triple users, respectively. Self-rated health and stress were lowest among single users and highest among triple users. Most user types had intentions/plans to quit, especially triple users. Quit attempts and plans increased with increasing health behaviors and time elapsed before first tobacco use in the morning, but decreased with higher stress and self-rated addiction. CONCLUSIONS Intentions/plans to quit tobacco use varied based on the type of tobacco user. Multiple users had higher self-rated health, plans to quit, and self-reported addiction; they considered themselves healthy or engaged in healthy behaviors to offset problems from tobacco use and used multiple tobacco products to quit smoking. Highly stressed users had fewer plans to quit and used tobacco for stress relief. Thus, the provision of accurate information about tobacco products and stress management is important to promote successful quitting. [ABSTRACT FROM AUTHOR]

Flipped learning recently gained attention as an effective instructional approach to enhance learning engagement, causing many universities to implement it. To enhance student engagement in large university classes, this study examined the effects of self‐efficacy, self‐regulation and social presence on learning engagement in a large university class using a flipped learning approach. A total of 390 undergraduates who were enrolled in a large general education class using flipped learning at a university in Korea participated in this study. The learners completed an online survey measuring the variables of this study. The research findings indicated that self‐regulation affected social presence as well as learning engagement. Self‐efficacy affected social presence and indirectly affected learning engagement through social presence. Finally, social presence affected learning engagement. Social presence also mediated the relationship between self‐efficacy and learning engagement as well as between self‐regulation and learning engagement. This study confirmed the significant effects of self‐regulation and social presence on students' learning engagement in large university classes. Lay Description: What is already known about this topic: Self‐efficacy is an important influential factor in learning.Self‐regulation plays a major role in the success of flipped learning.The establishment of social presence is an important factor to enhance learning engagement. Learning engagement has a significant impact on learning achievement and attitudes.Many universities still offer large classes despite students' low learning engagement. What this paper adds: Self‐efficacy indirectly affected learning engagement through social presence in flipped learning.Self‐regulation influenced both social presence and learning engagement in flipped learning.Social presence directly and indirectly affected learning engagement in flipped learning.Social presence mediated the relationship between self‐efficacy and learning engagement as well as between self‐regulation and learning engagement in flipped learning. Implications for practice and/or policy: It is important to promote students' self‐regulation for enhancing learning engagement in large university classes with flipped learning.Students' self‐regulation skills should be checked as a prerequisite for enrolling in a large flipped class. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Adolescents who partake in one health risk behaviour (HRB) easily adopt other HRBs, simultaneously or subsequently.Multiple HRBs might threaten adolescents' future health in adulthood.Adolescents with psychological problems have higher rates of smoking, alcohol use, early sexual initiation and activity, and illicit substance use compared with others. What does this paper add to existing knowledge?: A considerable number of Korean adolescents with mental health problems were engaged in multiple HRBs. For those with mental health problems, more than half of the Korean adolescents with multiple HRBs tended to use alcohol and cigarettes concurrently.Korean adolescents who felt depressed and had suicidal ideation were more likely to engage in a greater number of HRBs.Substance abuse is the most prevalent problem that is combined with other HRBs among those with depression and suicidal ideation compared to those who exhibited other HRBs. What are the implications for practice?: When mental health nurses working in schools and community centres for mental health identify Korean adolescents with significant depression and suicide ideation levels, they should also assess adolescents' engagement in multiple HRBs.Population‐based campaigns and policy changes that emphasize both psychological health and risky behaviour reduction among adolescents should be provided simultaneously to students and school nurses. Introduction: There is limited understanding about whether poor mental health is associated with certain combinations of multiple health risk behaviours (HRBs) such as smoking, drinking, early sexual activity and substance abuse. Aim: To determine the prevalence of multiple HRBs and to identify associations between poor mental health and multiple HRBs as the number of HRBs increases. Methods: This cross‐sectional study was conducted using the 2016 Korea Youth Risk Behavior Web‐based Survey (N = 65,528). Descriptive statistics and multinomial logistic regression analyses were conducted using the complex sample data. Results: Overall, 28.6% and 13.9% of Korean adolescents were involved in one or multiple HRBs, respectively. Adolescents who were depressed (OR = 1.43–4.47, 95% CI = 1.37–1.49 to 3.23–6.20) and/or who had suicidal ideation (OR = 1.33–3.19, 95% CI = 1.25–1.42 to 2.25–4.51) were more likely to engage in multiple HRBs. Discussion: A considerable numbers of Korean adolescents are engaged in multiple HRBs. When adolescents self‐reported depression and suicidal ideation, they were more likely to engage in a greater number of HRBs than single HRB. Implications for practice: Tailored interventions to decrease multiple HRBs should be designed and provided by considering adolescents' mental health status and needs. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Mental health treatments have become patient‐centred. Evaluating recovery in people with mental health difficulties living in the community can help to develop better client‐centred services.Community integration is critical to recovery in patients with mental health difficulties. What does this paper add to existing knowledge?: This is the first study to use a single integrated measure of mental health recovery to evaluate the effect of community integration.Physical community integration was the easiest goal for most to reach. Developing independence/self‐actualization was harder.In mental health recovery, most people were able to overcome stuckness. Developing abilities for basic functioning was harder.Participating in mental health centre day programmes promoted mental health recovery in people with mental health difficulties living in the community.Independence/self‐actualization, psychological integration and social support improved mental health recovery in people with mental health difficulties living in the community. What are the implications for practice?: There is a need to develop and actively promote programmes that attract people with mental health difficulties living in the community so that they will actively use mental health centre services.Offering systematic social skills training and occupational rehabilitation therapy to people with mental health difficulties living in the community may help them function independently.Mental health service programmes should provide volunteer opportunities for people with mental health difficulties living in the community to facilitate a sense of belonging.Mental health nurses should serve as a social support resource for people with mental health difficulties living in the community by providing education to family and friends on how to support patients' recovery, and invigorating integration projects such as "making healthy friends." Introduction: Although community integration of people with mental health difficulties and a consumer‐centred recovery paradigm are of global importance, little research has been conducted on community integration factors that directly affect mental health recovery. Aim: This study investigated the relationship between community integration and mental health recovery in people with mental health difficulties living in the community in South Korea. Method: Data were collected from 155 people with mental health difficulties living in the community, using the Self‐Reporting Scale of Community Integration and the Mental Health Recovery Measure (Korean version), and analysed using hierarchical regression analysis. Results: Among the community integration subscales, independence/self‐actualization, psychological integration and social support were significant factors in mental health recovery, explaining 47.3% of the variance. Discussion: An effective intervention strategy for mental health recovery of people with mental health difficulties living in the community may reinforce community integration by carefully considering independence/self‐actualization, psychological integration and social support. Implications for practice: Mental health nurses should provide intervention to people with mental health difficulties living in the community to help them develop strategies for functioning independently, experiencing a sense of achievement and developing a sense belonging in the community. [ABSTRACT FROM AUTHOR]

introduction Occupational health nurses (OHNs) in South Korea who visit the workplace periodically could play a key role in smoking cessation. It would be helpful to assess their understanding of smoking hazards and smoking cessation methods to encourage them to provide smoking intervention services at the workplace. This study aimed to investigate the knowledge of smoking hazards and perceptions of smoking cessation methods among OHNs. methods We conducted an anonymous self-administered cross-sectional questionnaire survey of 108 OHN nurses employed in an occupational health service outsourcing specialized agency with 19 regional branches in Korea from July to August 2019. We assessed the perceptions of the OHNs about smoking interventions, hazards of smoking, and perceived competence to counsel smokers according to training experience, using chi-squared tests and Fisher's exact tests. results The majority of the nurses underestimated the smoking-attributable fraction for lung cancer (78.7%), chronic obstructive pulmonary disease (64.8%), and mortality (49.0%), regardless of training experience on smoking cessation, while more than half perceived their skill and knowledge to counsel patients concerning smoking as inadequate (56.5%). However, those trained in smoking cessation interventions felt more competent in smoking cessation counselling, with 52.2% and 29.3% in the trained and non-trained groups, respectively (p=0.019). conclusions The OHNs in this study underestimated smoking hazards and perceived themselves as lacking counselling skills regarding smoking cessation interventions. It is necessary to encourage OHNs to promote smoking cessation by increasing their knowledge, skills and competence in smoking cessation interventions. [ABSTRACT FROM AUTHOR]

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Aims: Global business today usually requires organizations to be present locally in countries where their customers are. To do this successfully, good cooperation with local people is needed. Therefore, this paper focuses on the integration of cultures in the business world. The insights from this study are expected to benefit Slovenian expatriates to foreign companies in South Korea, as well as national culture researchers. The main goals of this research include a comparison of Hofstede's IBM survey results with the researched working environment, and identifying the benefits of merging two national cultures for the working environment. Methods: A questionnaire was distributed to purposive samples within the researched working environments and the collected data analysed used SPSS, where the hypotheses were tested using a chi-square test and t-test for independent samples. Results: The results revealed significant differences between the two national cultures in the working environment, e.g.: fear of expressing disagreement towards superiors, commitment to work, preference of challenges, tendency to avoid conflicts and innovations -- all differed according to nationality. Conclusion: Working together with people from different cultures requires a certain amount of adaptation (learning about another culture, expecting situations that are not usual). If this adaptation is successful, then cooperation between the different cultures can also be successful, leading to a potential output that is even better than cooperation between people from the same culture. [ABSTRACT FROM AUTHOR]

This study aimed to introduce an ego-resiliency questionnaire for preadolescents (the ER-P) by restructuring the ER89 using the data of 1398 preadolescents from the Panel Study on Korean Children. The ER-P was proposed as a 10-item second-order instrument with two factors (Optimal Regulation and Openness to Life Experiences). The ER-P achieved configural, metric, and scalar levels of measurement invariance across gender. The ER-P scores exhibited correlations with personality traits of the five-factor model and general happiness, providing evidence of its convergent validity. This suggests that the ER-P has sound psychometric properties for evaluating ego-resiliency in Korean preadolescents. The validation of the ego-resiliency questionnaire specifically tailored for younger individuals marks a significant expansion of the ego-resiliency research domain, especially considering that existing instruments were initially designed for adults. The ER-P will be useful in education, counseling, and research settings that require information on preadolescents' self-rated inner strength. [ABSTRACT FROM AUTHOR]

Since suicide is one of the major health problems worldwide, the goal of the present study is to develop a psychometrically sound suicide risk screening tool named Suicide Screening Questionnaire- Self-Rating (SSQ-SR) to quantify the risk of suicidal behavior. The development process includes item generation, item revision and refinement, and validation. A total sample of 2,238 adults in South Korea was used for analysis. The results of factor analysis showed that the SSQ-SR, containing 25 items, supported a three-factor model: "Situational factors," "Negative self-perceptions and mental health factors," and "Suicidal thoughts and behaviors." Also, SSQ-SR showed satisfying internal consistency, concurrent validity and discriminant validity. Lastly, the results of ROC analysis showed a cut-off point of 33.5 for the low-risk group and 36.5 for the high-risk group. Considering these results, the current results demonstrate the SSQ-SR is a valid scale and therefore can contribute to future suicide-related studies and prevention. [ABSTRACT FROM AUTHOR]

Background: This study aimed to elucidate the determinants of healthcare utilization in South Korea's dual healthcare system, encompassing both Western medicine and Korean medicine, through the Andersen Model. An integrative non-recursive path model of healthcare utilization determinants was proposed and analyzed. Methods: A path analysis using structural equation modeling, followed by mediation analysis, was conducted to determine the magnitude of the effect for each pathway. The 2020 data from the Korea Health Panel were used. Results: Structural equation modeling revealed that need factors, such as chronic diseases, disability, and self-rated health status, were the most significant drivers of both WM and KM utilization, while enabling factors significantly impacted WM utilization. Interestingly, WM and KM utilization were found to positively influence each other, contradicting the assumption of substitutional healthcare use. Mediation analysis further highlighted the interconnected nature of healthcare utilization pathways, with enabling and need factors showing significant indirect effects on utilization via the counterpart system. These findings underscore the importance of considering mutual influences in healthcare policy and resource allocation to enhance accessibility and efficiency. While the cross-sectional nature of the data limits causal inference, this study offers a robust theoretical framework and practical insights for addressing the complexities of healthcare utilization in dual-system contexts. Conclusion: The findings reveal that when traditional medicine functions within the national healthcare system, both Western medicine and traditional medicine are influenced by similar determinants in the same environment. Future research should explore longitudinal data to confirm these findings and investigate potential moderating effects of predisposing and enabling factors on WM and KM interactions. [ABSTRACT FROM AUTHOR]

Background: Given the crucial role of integrating acupuncture treatment into primary care for managing chronic diseases, this study endeavors to identify the utilization of acupuncture among chronic disease patients seeking primary care services in Korea. Additionally, it aims to evaluate their knowledge level and perceptions related to acupuncture use. Methods: A descriptive cross-sectional study was conducted among chronic disease patients attending a primary care clinic in Korea. A self-reported questionnaire comprising 37 items was employed to evaluate the utilization of acupuncture treatment. These items covered socio-demographic information, respondents' health status, levels of acupuncture knowledge, and patterns of acupuncture use. Using the SPSS Statistics 26.0 Network Version program, descriptive statistics, a chi-square test, and a logistic regression analysis were performed to identify factors associated with acupuncture treatment. Results: Out of 370 respondents, 44.3% reported utilizing acupuncture treatment. The most popular reason for the utilization of acupuncture was to enhance the effectiveness of the current treatment. The patients with musculoskeletal disease had the highest utilization rate of 53.2%. The main source of information for acupuncture use was family and friends. The average score for the level of knowledge on acupuncture treatment among the respondents was 65.4%, and the knowledge level of the acupuncture group was high. Potential predictors of acupuncture use included musculoskeletal disease, and intention to recommend acupuncture. Conclusion: This study highlights the widespread acceptance of acupuncture use among patients with chronic diseases in primary healthcare context. Integration of acupuncture into primary care emerges as a viable avenue for effective chronic disease management, and fostering a comprehensive and holistic approach to healthcare. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

The health literacy of immigrants has been often viewed in a deficit model. By using structuration theory as a theoretical lens, this study aimed to uncover the health literacy development of Korean immigrants in the U.S. as an agentic behavior during the COVID-19 pandemic. A total of 20 semi-structured interviews were conducted with Korean immigrants in the U.S. Findings reveal how the participants' experience was shaped by structural forces such as conflicting but co-existing public health systems between the U.S. and Korea, information overload, and the uncertainty surrounding the pandemic. Participants also employed strategies such as constantly comparing the public health guidelines from the two countries, critically appraising the information, deliberately choosing which guideline to follow, combating misinformation, and regulating media consumption. These strategies enabled them to develop health literacy by leveraging their immigrant status as an advantage. Theoretical, practical, and policy implications are discussed. [ABSTRACT FROM AUTHOR]

Background: With South Korea's growing aging population, the demand for accessible rehabilitation solutions is increasing. Home-based robotic rehabilitation presents a feasible alternative to conventional in-clinic rehabilitation. This study explores the impact of the Rebless robotic rehabilitation device in a home-based setting for people with physical disabilities and their caregivers. Methods: We prospectively collected data from individuals with brain disorders or physical disabilities living in Dongdaemun-gu, from August 2023 to March 2024. Participants completed an 8-week rehabilitation program using the Rebless robotic device. Assessments were conducted at baseline and after the eight-week program, measuring motor function, caregiver burden, and quality of life. Exercises were performed three times weekly for at least 90 min total. Results: We conducted an intervention with 26 adults with physical or neurological disabilities, of which 20 completed the program. Significant improvements were observed in upper limb function within the elbow exercise group (Fugl–Meyer assessment for upper extremity, p = 0.043) and a reduction in caregiver burden across the total groups (Zarit Burden Interview, p = 0.003). However, no statistically significant changes were found in balance and mobility measures (Berg balance scale, timed up-and-go, 10 m walk test). Conclusions: Home-based robotic rehabilitation demonstrates potential for improving upper limb function and reducing caregiver burden and mental health, proving beneficial to both patients and caregivers. [ABSTRACT FROM AUTHOR]

In the midst of a pandemic like COVID-19, migrant workers are highly vulnerable to the risk of mental health challenges and disorders. This study aimed to examine the variations in mental health and associated factors among migrant workers in Korea during and after the COVID-19 pandemic. A total of 830 migrant workers were included in this quantitative population-based study across two distinct COVID-19 periods: 415 from August 15, 2020 to January 20, 2021 (termed "during COVID-19" post-WHO pandemic declaration) and 415 from June 10 to September 18, 2023 (termed "after COVID-19" post-WHO and Korean Government announcement of the end COVID-19 as a global health emergency). The mental health of migrants was assessed using Patient Health Questionnaire-9 for depression and Generalized Anxiety Disorder-7 for anxiety, and compared between the two defined COVID-19 periods. Migrant workers exhibited higher means of depression (15.99 ± 5.16 vs. 8.78 ± 5.77) and anxiety (11.02 ± 4.45 vs. 6.97 ± 4.42) during the COVID-19 compared to after the COVID-19. The prevalence of severe depression (30.4% vs. 8.2%, p =.038) and severe anxiety (24.1% vs. 5.3%, p =.047) was significantly higher during the COVID-19 than after the pandemic. Changes in the mean depression scores among migrants were significantly influenced by living status (0.12 ± 11.10, p =.030) and employment status (0.44 ± 10.33, p =.043), while changes in mean anxiety scores were influenced by social relief funds (2.88 ± 8.61, p =.046) and employment status (1.13 ± 8.39, p =.012). This study highlights the increased susceptibility of migrant workers to depression and anxiety during COVID-19 compared to after the pandemic. Thus, it is imperative to prioritize the expansion of social support funds, ensure employment stability, and implement regular health check-up services to reduce mental health disorders among migrants. [ABSTRACT FROM AUTHOR]

INTRODUCTION Direct and indirect smoking exposure is highly related to mental health in children. This study aimed to identify the association between exposure to smoking or secondhand smoke (SHS) and attention deficit hyperactivity disorder (ADHD). METHODS We used data from the Korean National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2019, including variables such as diagnosed ADHD, smoking status, SHS, and urine cotinine levels among children and adolescents. We estimated the risk of ADHD according to smoking or SHS exposure in various exposure groups using adjusted logistic or linear regression models. RESULTS Among 16434 participants, 133 children were diagnosed with ADHD (0.8%). Of these, 58 (43.6%) were aged <12 years and 75 (56.3%) were aged ≥12 years. Smoking was significantly associated with ADHD (crude odds ratio, OR=1.48; 95% CI: 1.14-3.26 and adjusted odds ratio, AOR=1.22; 95% CI: 1.02-1.64). SHS exposure and ADHD were attenuated after adjustment (OR=2.42; 95% CI: 1.08-4.02; AOR=1.42; 95% CI: 0.86-2.64) in the logistic regression model. Smoking history was statistically associated with a younger age of ADHD diagnosis in the linear regression model. CONCLUSIONS Smoking and the amount of smoking among children and adolescents was associated with ADHD. [ABSTRACT FROM AUTHOR]

Background/Objectives: The aim of this paper is to provide basic data for preparing measures to improve the level of behavior for the dental radiation workers' safety management on the radiation usage. Method/Statistical Analysis: The survey was conducted over a 15-day period from October 30, 2018 to November 13, 2018. A total of 300 copies of the questionnaire were distributed, of which 237 were collected, except 63, which were incompletely prepared. The questionnaire used for this study was modified and supplemented with reference to Park's questionnaire. The questionnaires used in the survey consisted total of 27 questions which were 5 general characteristics questions, 8 items related to radiation exposure knowledge. Findings: The highest level of radiation exposure anxiety was 41 (65.1%) out of 123 health related students said 'do not fear', where 56 (58.9%) out of 114 non-health related students said 'normal' so that non-health related students had higher anxiety on radiation exposure and there was a significant difference. The questionnaire on radiation safety management was the highest among the total 123 health related students, with 71 (57.7%) said 'do not have it', 30 (24.4%) said 'do not know well', 22 (17.9%) said 'have it'. Among the 115 non-health related students, the highest was 57 (49.6%) with 'do not have it', 53 (46.1%) with 'do not know well', 5 (4.3%) with 'have it' so that safety management was not well managed in dental hospitals and there was a significant difference. Improvements/Applications: Therefore, radiation workers need education and the importance of education related to radiation defense. [ABSTRACT FROM AUTHOR]

BACKGROUND: Work-related musculoskeletal disorders (WMSDs) are estimated to be the most common and frequent of all occupational diseases in agriculture in Korea, but the full extent of the problem has yet to be surveyed. OBJECTIVE: This paper presents the results of a survey investigating the extent of WMSDs among self-employed farmers in Korea. It also describes ergonomics based preventive interventions initiated by the Korean government. METHOD: The prevalence of WMSDs was surveyed among 358 farmers using a questionnaire adapted from the Nordic questionnaires, employing three case definitions. RESULTS: The results showed that the overall prevalence rates of WMSDs by case definition 1 (any symptoms), 2 (symptoms with a pain intensity of moderate or greater), and 3 (symptoms with a pain intensity of high or greater) were 97.2%, 83.2%, and 39.7% respectively and that the shoulder, knee and lower back disorder rates were higher than those of other body parts. Compared to the prevalence rates of WMSDs for workers in other industries in Korea as well as USA farmers, the overall rates for farmers in Korea were much higher. The interventions, which adopted a participatory approach involving government, farmers, ergonomics, technical and industrial hygiene experts, showed benefits in terms of work efficiency, safety and farmer satisfaction. CONCLUSIONS: The high WMSD symptom prevalence showed that agriculture is one of the most hazardous industries in Korea, and the Korean government's interventions were effective and successful. [ABSTRACT FROM AUTHOR]

The subject of dying well has attracted much attention, but to date there have been few papers that have examined what this actually means and what components must be present to qualify as dying well. The present study investigates how Koreans envision dying well, how this is affected by demographic factors, and how their ideas correlate with factors related to quality of life. A total of 1,000 survey participants were recruited nationwide by means of a stratified random sampling method for each region, gender, and age group. Based on previous studies conducted on the perception of dying well or a "good death," we came up with six main themes of that we further classified into 20 subthemes. We constructed a dying well assessment tool using a total of 57 items and used these to conduct a survey through Gallup Korea. The items covered matters such as death preparation, religious and spiritual factors, physical symptoms, medical treatment, social relationships, and death environment. The quality-of-life (QOL) index and the perception of dying well were highly correlated regardless of the theme, with a high QOL generally correlated with a high score for dying well. For Koreans, the general perception of dying well is most strongly associated with death preparation, such as the making provisions for the costs associated with dying and making funeral arrangements. The next-most important component is the acceptance of death and psychological dignity such as spirituality. From a demographic point of view, individual health and stress conditions had some significant correlations with subthemes of dying well. Other factors did not show significant correlation. Surprisingly, it was found that age did not change Koreans' perceptions of what it means to die well. Discussions about death and dying well are increasingly relevant in aging populations, but it does not appear in various forms at the individual level in reality. Future studies will need to develop measurement tools around more sensitive issues of death or investigate the developmental aspects of thinking through longitudinal research. [ABSTRACT FROM AUTHOR]

Aims: This paper presents updated prevalence estimates of awareness, ever‐use, and current use of nicotine vaping products (NVPs) from 14 International Tobacco Control Policy Evaluation Project (ITC Project) countries that have varying regulations governing NVP sales and marketing. Design, Setting, Participants and Measurements: A cross‐sectional analysis of adult (≥ 18 years) current smokers and ex‐smokers from 14 countries participating in the ITC Project. Data from the most recent survey questionnaire for each country were included, which spanned the period 2013–17. Countries were categorized into four groups based on regulations governing NVP sales and marketing (allowable or not), and level of enforcement (strict or weak where NVPs are not permitted to be sold): (1) most restrictive policies (MRPs), not legal to be sold or marketed with strict enforcement: Australia, Brazil, Uruguay; (2) restrictive policies (RPs), not approved for sale or marketing with weak enforcement: Canada, Malaysia, Mexico, New Zealand; (3) less restrictive policies (LRPs), legal to be sold and marketed with regulations: England, the Netherlands, Republic of Korea, United States; and (4) no regulatory policies (NRPs), Bangladesh, China, Zambia. Countries were also grouped by World Bank Income Classifications. Country‐specific weighted logistic regression models estimated adjusted NVP prevalence estimates for: awareness, ever/current use, and frequency of use (daily versus non‐daily). Findings NVP awareness and use were lowest in NRP countries. Generally, ever‐ and current use of NVPs were lower in MRP countries (ever‐use = 7.1–48.9%; current use = 0.3–3.5%) relative to LRP countries (ever‐use = 38.9–66.6%; current use = 5.5–17.2%) and RP countries (ever‐use = 10.0–62.4%; current use = 1.4–15.5%). NVP use was highest among high‐income countries, followed by upper–middle‐income countries, and then by lower–middle‐income countries. Conclusions: With a few exceptions, awareness and use of nicotine vaping products varied by the strength of national regulations governing nicotine vaping product sales/marketing, and by country income. In countries with no regulatory policies, use rates were very low, suggesting that there was little availability, marketing and/or interest in nicotine vaping products in these countries where smoking populations are predominantly poorer. The higher awareness and use of nicotine vaping products in high income countries with moderately (e.g. Canada, New Zealand) and less (e.g. England, United States) restrictive policies, is likely due to the greater availability and affordability of nicotine vaping products. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to identify factors that facilitate individual knowledge sharing. Specifically, the authors investigated the roles of coworker support and individual characteristics, i.e., exchange ideology and learning orientation on knowledge sharing. Design/methodology/approach – Data were collected from questionnaires distributed to employees and their direct supervisors in two companies in South Korea. Hierarchical regression analyses and simple slope test were performed to test the hypotheses. Findings – Coworker support and learning orientation is positively but exchange ideology is negatively related to knowledge sharing. Furthermore, when coworker support is low, knowledge sharing is mainly dependent on each individual’s characteristics. However, when coworker support is high, employees showed high level of knowledge sharing irrespective of their individual characteristics. Research limitations/implications – This study suggested that the support from coworker as well as individuals’ characteristics plays an important role in determining their knowledge sharing behaviors. Moreover, the authors found the significant interaction effects of coworker support and individual characteristics on knowledge sharing, drawing on insights from trait activation theory. Practical implications – For organizations to encourage individual knowledge sharing behaviors, they may need to maintain the work environment that encourages the peer workers to support each other. Originality/value – Although many actions have been adopted to foster knowledge management in organizations, employees may still be reluctant to share their knowledge. This paper highlights not only the main effects of coworker support and individual differences but also the interaction effect between them in facilitating knowledge sharing. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Despite the increase of studies into the predictors of psychological distress, few have attempted to address the mediation of stress in the relationship between early trauma and psychological distress., What does this paper add to existing knowledge? In this study, college students with trauma exposure before the age of 18 years reported high levels of college life stress and psychological distress. In addition, of the subcategories of early trauma, emotional abuse was most highly correlated with current stress and psychological distress., This paper confirmed the partial mediating effect of stress between early trauma and psychological distress among Korean college students. In other words, this study found a direct effect of early trauma on current psychological distress and an indirect effect of early trauma on psychological distress mediated through life stress., What are the implications for practice? Early trauma and stress should be considered when developing interventions for college students' mental health, although individuals with trauma exposure have difficulties disclosing their traumatic event. Therefore, we suggest that stress management may be easier to apply and more effective in promoting college students' mental health than trauma-focused interventions., Abstract Introduction Research has shown that early trauma and stress may affect current psychological distress. However, few studies have attempted to address the mediation of stress between early trauma and psychological distress. Aim This cross-sectional observational study aimed to examine the mediating effects of stress on the association between early trauma and psychological distress in Korean college students. Method Participants included 216 college students (51.4% male) who completed self-report questionnaires assessing early trauma, college life stress, and psychological distress. Results Early trauma, stress, and psychological distress were significantly correlated. Of the subcategories of early trauma, emotional abuse was most highly correlated with stress and psychological distress. The bootstrapping results indicate that stress is a partial mediator between early trauma and psychological distress after controlling for covariates including socioeconomic status, habitation status, and gender. Discussion The results imply that both early trauma and stress should be considered when developing interventions for college students' mental health. However, individuals with trauma exposure tend to have difficulties disclosing their traumatic event. Therefore, we suggest that stress management may be more feasible and effective in promoting college students' mental health than trauma-focused interventions. [ABSTRACT FROM AUTHOR]

Background: The Integrated Palliative care Outcome Scale (IPOS) is a key tool for assessing the quality of palliative care using patient-reported outcomes. This study aimed to culturally adapt and translate the IPOS to Korean and verify its psychometric properties for use in palliative care settings. Methods: The IPOS was translated and culturally adapted, followed by validation in 119 terminally ill cancer patients and 28 healthcare providers across six Hospice and Palliative Care Units from September 2023 to January 2024. Reliability was assessed using internal consistency, test-retest reliability, and inter-rater reliability. Concurrent validity was assessed using Spearman's correlation coefficients between the IPOS items and the corresponding EORTC QLQ-C15-PAL and the corresponding FACIT-Sp-12. Results: The Korean IPOS demonstrated good internal consistency, with Cronbach's alphas of 0.74 for patients and 0.81 for staff. The test-retest reliability showed moderate-to-good stability, with an intra-class correlation coefficient of 0.722 for the IPOS total score. Concurrent validity was supported by moderate correlations with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative Care (EORTC QLQ-C15-PAL) and Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-Sp-12). Known-group validity was demonstrated by significant differences in the IPOS scores across Phase of Illness. Conclusion: The Korean IPOS is reliable and valid for assessing palliative care outcomes. This validation supports its use in clinical practice and research and provides a robust framework for evaluating and improving palliative care delivery in Korea. [ABSTRACT FROM AUTHOR]

This study investigated the impact of task types (functional vs. social) and the gendered voices (female vs. male) of Siri, an intelligent virtual assistant (IVA), on social presence and trust perceptions toward the IVA. In an online experiment involving 172 participants, individuals were randomly assigned to one of four conditions, interacting with Siri on their iPhones for various task inquiries. Results from multivariate analyses of covariances revealed significant differences in trust levels based on the type of task. Trust was found to be higher for functional tasks when assisted by Siri, compared to social tasks. However, there was no significant difference in trust based on Siri's gendered voices. Post-hoc analyses indicated significant interactions between the gender match of participants and Siri's gendered voices in two dimensions of trust. Men tended to trust the male-voiced Siri more than the female-voiced Siri, while women did not exhibit a preference for the female voice over the male voice. This study successfully replicated the task effect observed in prior research but did not replicate the gender effect. Key distinctions between the current study and previous ones include language and the participants' nationality, with this study focusing on Korean participants interacting with Korean Siri. [ABSTRACT FROM AUTHOR]

Background: Human papilloma virus (HPV) affects both males and females, but in South Korea, vaccination rates for boys are significantly lower due to cultural stigma and limited awareness. Effective strategies are needed to close this gap. Methods: This study evaluated a 6-week smartphone-based HPV prevention program for mothers of school-aged boys, designed using the extended theory of planned behavior (E-TPB). The program aimed to enhance knowledge, attitudes, subjective norms, and self-efficacy, with the goal of increasing vaccination intention and uptake. The E-TPB incorporated knowledge as a key element to improve behavioral intention and vaccination uptake. A nonequivalent control group pre-test–post-test design included 54 mothers (28 in the experimental group and 26 in the control group). Results: The experimental group showed significant improvements in HPV knowledge (p < 0.001; d = 1.41), HPV vaccine knowledge (p < 0.001; d = 1.13), attitudes (p < 0.001; r = 0.48), subjective norms (p = 0.014; d = 0.61), self-efficacy (p < 0.001; r = 0.53), and vaccination intention (p < 0.001; r = 0.58). The experimental group achieved a vaccination uptake rate of 25.0%, compared to 4.0% in the control group, representing a six-fold increase (RR = 6.25; p = 0.033; h = 0.64). Conclusions: The program effectively addressed key factors influencing vaccination behavior, leading to significant increases in HPV vaccination rates among boys. Smartphone-based education shows promise in reducing gender disparities in vaccination uptake, though further studies with larger samples are needed to validate these findings. [ABSTRACT FROM AUTHOR]