Most-read articles are from the articles published in 2023 during the last three month.
Original Article
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[English]
The Burden Experience of Family Caregiver of Older Adults with Chronic Illness
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Nova Yustisia
, Titin Aprilatutini
, Tuti Anggriani Utama
, Mahmasoni Masdar
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Res Community Public Health Nurs. 2023;34(2):85-95. Published online June 30, 2023
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DOI: https://doi.org/10.12799/rcphn.2022.00304
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10,258
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Abstract
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- Purpose
This study aims to find out further about the burden on families in undertaking caregiving for the elderly with chronic illnesses.
Methods
A qualitative study was developed using in-depth interviews with 12 family caregivers selected by purposive sampling in July 2022. The thematic analysis was then carried out using the Colaizzi method, and N-Vivo 12 Qualitative Data Analysis Software was used to assist with the content analysis.
Results
The result from the experience interview analysis of caregivers participating in this study were 54 codes which were categorized into thirteen categories. Then, they were derived into four themes, as follows: 1) Physical burden of the caregivers for the elderly with chronic illness, 2) Psychological burden of the caregivers for the elderly with chronic illness, 3) Obstacle of caregivers for the elderly with chronic illness, 4) The state of caregivers who perform caregiving for the elderly with chronic illness.
Conclusion
The experience of caregivers in undertaking caregiving for the elderly with chronic disease has many obstacles, such as physical, psychological, and economic burdens. Caregivers often find positive aspects of their experiences while caregiving for the elderly, although their burden also constantly increases. Health facilities should pay serious attention to family caregivers and facilitate programs that can help reduce the burden on family caregivers.
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Citations
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- Enhancing Communication and Empathy Skills in Geriatric Care: Nurses' Reflections on Simulation‐Based Training for Patient Interaction and Education
Sobhia Ahmed Abdel Kader Mohammed, Mostafa Shaban
Journal of Clinical Nursing.2025;[Epub] CrossRef - Mastering the Art of Caregiving: Instructional Approaches to Teaching Healthcare‐Related Procedural Skills to Informal Caregivers—An Integrative Review
An Ling Siew, Esther Yin Hui Chew, Ee‐Yuee Chan, Elaine Kee Chen Siow
Journal of Advanced Nursing.2025;[Epub] CrossRef - Relationship between Care Burden and Health Anxiety in the Family Caregivers of the Older Adults with Alzheimer’s Disease
Mohammad Sadegh Sargolzaei, Daniyal Kohestani, Tahereh Alsadat Khoubbin Khoshnazar, Hossein Asghari Asl
Ageing International.2024; 49(2): 280. CrossRef
Review Articles
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[English]
A Systematic Review of Questionnaire Measuring eHealth Literacy
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Jung-Won Ahn
, Mi Young Kim
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Res Community Public Health Nurs. 2024;35(3):297-312. Published online September 30, 2024
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DOI: https://doi.org/10.12799/rcphn.2024.00752
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Abstract
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- Purpose
This review aims to summarize the characteristics of currently used questionnaires measuring eHealth literacy and assess the quality of their psychometric properties in self-reported assessments within community settings.
Methods
The systematic analysis was conducted using the COnsensus-based Standards for the selection of health Measurement INstruments checklist to evaluate the methodological quality of studies on measurement properties.
Results
A total of 21 studies, including 19 questionnaires, were reviewed. The findings indicated that the quality of psychometric assessments for eHealth literacy was generally rated as 'good,' with most studies addressing multiple aspects of reliability and validity. Internal reliability, content validity, hypothesis testing, and responsiveness were particularly well-supported, each receiving over 10 sufficient ratings. However, there was limited evidence regarding measurement errors, test-retest reliability, criterion validity, and analyses of floor and ceiling effects.
Conclusion
This study contributes to the enhancement of eHealth literacy measurement tool selection and improves the reporting of their validity and reliability, thereby increasing the credibility of future research.
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Citations
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- Current status of systematic review studies on patient-reported outcome measures published in Korean journals
Duck-Hee Chae, Jiyeon Lee, Eun-Hyun Lee
Research in Community and Public Health Nursing.2025; 36: 1. CrossRef
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[English]
Optimistic bias: Concept analysis
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Miseon Shin
, Juae Jeong
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Res Community Public Health Nurs. 2024;35(1):112-123. Published online March 29, 2024
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DOI: https://doi.org/10.12799/rcphn.2023.00360
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Abstract
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- Purpose
The purpose of this study was to analyze and clarify the concept of ‘optimistic bias.’
Methods
A review of the literature was conducted using several databases. The databases were searched using the following keywords: optimistic bias, optimism bias, and concept analysis. The literature on optimistic bias was reviewed using the framework of Walker and Avant’s conceptual analysis process.
Results
Optimistic bias can be defined by the following attributes: 1) underestimation of personal risk, 2) vague confidence, 3) positive future prediction and 4) lack of risk recognition. The antecedents of optimistic bias are as follows: 1) risk perception, 2) self-efficacy, and 3) risk controllability. The consequences of optimistic bias are as follows: 1) reduced anxiety, 2) providing emotional stability, 3) negative consequences for preventive health behavior, 4) lack of attention to risk-related information, and 5) negative consequences for self-protection behavior.
Conclusion
The definition and attributes of optimistic bias identified by this study can provide a common understanding of this concept and help to develop a nursing intervention program effective in preventing, protecting, and improving health of subjects in the field of nursing practice.
Original Articles
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[English]
Patterns of Adolescent Substance Use: A Comparative Study among the United States, Canada, England, and South Korea from 2014-2021
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Chaehee Kim
, Kihye Han
, Jieun Kim
, Alison M. Trinkoff
, Sihyun Park
, Hyejin Kim
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Res Community Public Health Nurs. 2024;35(2):179-193. Published online June 28, 2024
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DOI: https://doi.org/10.12799/rcphn.2024.00535
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- Purpose
This study aimed to identify the cross-national estimates of substance use, explore problematic substance use patterns among adolescents across countries and over time, and examine the relationship of individual characteristics on substance use patterns.
Methods
This study employed a time-series secondary data analysis spanning from 2014 to 2021 across four countries (United States, Canada, England, and South Korea). We analyzed the usage of five substances (alcohol, binge drinking, cigarettes, electronic cigarettes, and illicit drugs) alongside demographic characteristics. A descriptive analysis was performed to identify estimates of substance use across countries. Latent class analysis was employed to examine adolescents’ substance use patterns across time and countries. A multinomial logistic regression model was fit to assess the relationship between latent class and demographic characteristics.
Results
Adolescents in the United States and Canada had the highest substance use, while Korean adolescents had the lowest, particularly concerning drugs. Latent class analysis revealed two classes (light-user and heavy-user), with the addition of a third class (moderate-user) in some instances. The substance use patterns, while differing significantly among nations, exhibited consistency over time. During COVID-19, a decrease in heavy-substance users was observed across countries. Male or older participants were more likely to belong to the heavy-user class.
Conclusion
This research offers valuable insights into the variations in substance use patterns between nations and over time. A tailored approach is essential to prevent adolescents from becoming heavy-substance users. This approach should consider country regulations and demographics for a targeted and comprehensive preventive strategy.
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[English]
Digital Health Literacy and Associated Factors Among Older Adults Living Alone in South Korea: A Cross-Sectional Study
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Minhwa Hwang
, Gahye Kim
, Seonghyeon Lee
, Yeon-Hwan Park
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Res Community Public Health Nurs. 2024;35(4):389-400. Published online December 30, 2024
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DOI: https://doi.org/10.12799/rcphn.2024.00766
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- Purpose
This study aimed to examine the level of digital health literacy and identify factors associated with digital health literacy among older adults living alone in South Korea.
Methods
A cross-sectional study was conducted on 140 older adults aged 65 and above who live alone. Descriptive statistics and non-parametric methods were used to explore the relationship between digital health literacy and independent variables. A generalized linear model was used to identify factors associated with digital health literacy.
Results
Among 140 smartphone-owning older adults living alone, 52.1% were using the Internet via digital devices, and the participants’ average digital health literacy score was 6.64±7.46. Univariate analysis results showed significant differences in digital health literacy according to age, education level, and multimorbidity. The factors associated with digital health literacy were identified as gender (B=−0.36, p=.031), age (B=−0.06, p<.001), education level (B=0.12, p<.001), and sleep problems (B=−0.06, p=.006).
Conclusion
Despite widespread Internet and smartphone use, older adults living alone with chronic diseases showed low levels of digital health literacy, which were significantly associated with gender, age, education level, and sleep problems. Enhancing digital health literacy among vulnerable populations is crucial for the effective implementation of digital health services. Collaborative efforts, including tailored digital health interventions to enhance the digital health literacy of vulnerable populations and supportive policies, are essential to bridge the digital divide and promote health equity.
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[English]
Priorities of Family Caregivers in Preserving Functional Abilities of Individuals with Alzheimer's Disease Living at Home: A Best-Worst Scaling Approach
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Eunhye Cho
, Youngran Yang
, Hyun Kyung Kim
, Hye Young Kim
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Res Community Public Health Nurs. 2024;35(2):156-167. Published online June 28, 2024
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DOI: https://doi.org/10.12799/rcphn.2024.00556
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Supplementary Material
- Purpose
The decline in cognitive abilities among individuals with Alzheimer’s disease significantly impacts their Activities of Daily Living (ADLs), creating challenges and stress for their caregivers. This study aimed to investigate the priorities of family caregivers of community-dwelling individuals with Alzheimer's disease concerning the preservation of their loved ones' ADLs.
Methods
We employed a cross-sectional design with a best-worst scaling approach (BWS), and developed a BWS questionnaire utilizing the 10 daily living items from the Disability Assessment for Alzheimer’s Disease scale. This questionnaire was administered to 132 caregivers of individuals with Alzheimer's disease. Data analysis was conducted using SPSS WIN 21.0 and the R statistical program.
Results
The results revealed that "using the toilet without accidents" emerged as the top-ranked ADL that family caregivers preferred to preserve for the longest duration among individuals with Alzheimer's disease living at home. In contrast, "Managing money appropriately" was identified as a daily living activity considered relatively less critical to preserve. The study further indicated a preference among caregivers for preserving physical ADLs over instrumental ADLs.
Conclusion
This research provides clinical evidence shedding light on the priorities of family caregivers in preserving the functional abilities of individuals with Alzheimer's disease within the community.
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[English]
Factors Related to Smoking Relapse Within Six-Months of Smoking Cessation Among Inpatients
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Ji Eun Bae
, Chul-Woung Kim
, Seung Eun Lee
, Myungwha Jang
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Res Community Public Health Nurs. 2023;34(4):307-319. Published online December 29, 2023
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DOI: https://doi.org/10.12799/rcphn.2023.00213
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Abstract
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- Purpose
The purpose of this study is to identify factors associated with smoking relapse within 6 months after quit attempts among inpatients of a university hospital.
Methods
The subjects of this study were 572 inpatients of the National University Hospitals in Daejeon & Sejong who had enrolled in the smoking cessation service provided by the Daejeon·Sejong Tobacco Control Center and attempted to quit smoking. The data used in the study were extracted from the Smoking Cessation Service Integrated Information System. The Kaplan-Meier method and Cox Proportional hazards model were used to identify variables associated with smoking relapse within 6 months.
Results
The smoking relapse rate within 6 months was 76.7%, and variables associated with relapse included the absence of supporters for quitting smoking (hazard ratio [HR]=1.42, 95% confidence interval [CI]=1.00-2.02), nicotine dependence (HR=1.09, 95% CI=1.03-1.15), the use of prescription medications (including varenicline or bupropion) (HR=3.99, 95% CI=1.83-8.71), and the number of consultations (HR=0.67, 95% CI= 0.63-0.70).
Conclusion
As a result of the study, the number of consultations showed the strongest correlation with abstinence within 6 months. This implies that it is necessary to increase the counseling participation rate of the subjects so that smoking cessation counseling can be continued after discharge, and it is also required to provide support education to guardians during hospitalization for effective smoking relapse prevention.
Review Article
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[English]
Factors Related to Diabetes Self-Care among Immigrants in the United States: A Scoping Review
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Jung Eun Kim
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Res Community Public Health Nurs. 2023;34(2):171-182. Published online June 30, 2023
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DOI: https://doi.org/10.12799/rcphn.2023.00094
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3,189
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Abstract
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- Purpose
The purpose of this scoping review was to explore related factors in diabetes self-care among immigrants in the U.S. Diabetes is one of the fastest-growing chronic illnesses, but little is known about factors in self-care among minority immigrants in the U.S.
Methods
The Arksey and O’Malley (2005) methodological framework guided this review, which examined 16 articles, including qualitative, quantitative, and mixed-methods designs. PRISMA guidelines were used with five Databases. Search terms included: immigrants in the U.S., type 2 diabetes, self-care, and self-management.
Results
Factors related to diabetes self-care among immigrants were identified: (1) changed dietary lifestyle, (2) low economic and health insurance, (3) social support and resources, (4) low English proficiency, (5) psychological contexts, and (6) gender roles.
Conclusion
Given the culturally unique related factors in diabetes self-care among immigrants, healthcare professionals must be knowledgeable and responsive to the ethnic minority immigrants’ needs to promote effective diabetes self-care.
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Citations
Citations to this article as recorded by

- Educational Needs and Priorities of People with Diabetes and Healthcare Providers in South Korea: A Mixed-Methods Study
Shinae Seo, Chun-Ja Kim, Hee Sun Kang, Elizabeth A. Schlenk
Journal of Transcultural Nursing.2025; 36(2): 195. CrossRef
Original Articles
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[English]
Effects of Virtual Reality Cardiopulmonary Resuscitation Practice on the Knowledge, Skills, and Attitudes of Nursing Students: A single-blind randomized controlled trial (RCT)
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Jui Kim
, Jung-Hee Song
, Young-Ok Ha
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Res Community Public Health Nurs. 2024;35(4):415-423. Published online December 30, 2024
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DOI: https://doi.org/10.12799/rcphn.2024.00689
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- Purpose
This study aimed to assess the effects of virtual reality (VR) cardiopulmonary resuscitation (CPR)—as compared to those of face-to-face Basic Life Support (BLS) education—on nursing students’ knowledge, skills, and attitudes.
Methods
Forty-four participants were recruited from nursing schools in Gyeonggi-do, Republic of Korea, and randomized into two groups: VR CPR (experimental group) and BLS (control group). The participants’ CPR knowledge, cardiac compression quality, self-efficacy, confidence, and attitudes toward education were evaluated.
Results
At enrollment, the control and experimental groups showed similar results for all the variables. After the intervention, results showed that the cardiac compression score and the hand position accuracy in the experimental group were significantly higher than in the control group. Meanwhile, knowledge, self-efficacy, and confidence were improved in both groups, though there was no significant difference between the two groups.
Conclusion
The study results showed that VR CPR education is just as effective as face-to-face BLS training for nursing students. Therefore, developing high-quality VR educational content in the future is necessary.
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[Korean]
A Path Analysis for Health-related Quality of Life in Long-term Care Insurance In-home Service Users
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Je Hyun Kim
, Seung Mi Park
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Res Community Public Health Nurs. 2023;34(1):1-11. Published online March 31, 2023
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DOI: https://doi.org/10.12799/rcphn.2022.00283
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3,268
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2
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Abstract
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- Purpose
The purpose of this study is to construct and verify a path model for the factors affecting on quality of life in long-term care insurance in-home service users.
Methods
Total 246 participants using long-term care insurance in-home service were recruited from long-term care agencies. Data collection was conducted using a structured questionnaire from March 1st to March 31st 2021. The collected data were analyzed using SPSS 26 and AMOS 26 programs.
Results
The hypothetical path model was suitable for explaining the health-related quality of life in long-term care insurance in-home service users and has an explanatory power of 39.8%. Long-term care grade, depression, perceived health status, social support, age and living arrangement had a significant total effect on the quality of life in long-term care insurance in-home service users.
Conclusion
Long-term care insurance in-home service policies need to be expanded, such as screening and relieving depression, strengthening social support, and fostering a positive perception of health to improve the quality of life of the elderly.
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Citations
Citations to this article as recorded by

- Factors associated with health literacy in older adults aged 65 and over: a secondary data analysis of the 2021 Korea Health Panel applying the Andersen behavioural model
Yeong Eun Kim, Ol Han, Chang Sun Moon
BMJ Open.2025; 15(3): e085696. CrossRef - Prediction model of health-related quality of life in older adults according to gender using a decision tree model: a study based on the Korea National Health and Nutrition Examination Survey
Hee Sun Kim, Seok Hee Jeong
Journal of Korean Biological Nursing Science.2024; 26(1): 26. CrossRef
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[English]
Reliability and Validity of the Korean Version of 8-item Health Literacy Assessment Tool (K-HLAT-8)
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Mirae Jo
, Eun-mi Kwak
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Res Community Public Health Nurs. 2024;35(4):351-362. Published online December 30, 2024
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DOI: https://doi.org/10.12799/rcphn.2024.00682
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- Purpose
The purpose of this study was to evaluate the validity and reliability of the Korean version of the Health Literacy Assessment Tool (K-HLAT-8) for Korean adults.
Methods
The survey was conducted from April 1, 2020 to May 30, 2020 at a university hospital, a university, and one community picnic area with adults who understood the purpose of the study and voluntarily agreed to participate. A total of 220 adults participated in this study. After forward and backward translation of the original version of the Health Literacy Assessment Tool 8 (HLAT-8) into Korean, construct validity (confirmatory factor analysis), convergent validity, and reliability were evaluated. Convergent validity was confirmed through the correlation between the K-HLAT-8 and the Self-As Carer Inventory (SCI).
Results
Construct validity, evaluated using confirmatory factor analysis, showed good fit. The K-HLAT-8 showed a positive correlation with the SCI score. In terms of internal consistency, Cronbach’s α of the K-HLAT-8 was 0.85. For test-retest reliability, the intraclass correlation coefficient (ICC) was .99 (95% CI: 0.97~0.99).
Conclusion
The reliability and validity were confirmed, so K-HLAT-8 can be applied to evaluate the health literacy of Korean adults. Furthermore, these assessment results should be used as basic data to implement programs that can improve health literacy.
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[Korean]
The Effect of Dual Sensory Impairment on Cognitive Function Decline in the Elderly: The Moderating Effect of Social Support
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Soo Jee Yang
, Ju Young Yoon
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Res Community Public Health Nurs. 2023;34(3):217-227. Published online September 27, 2023
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DOI: https://doi.org/10.12799/rcphn.2023.00255
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- Purpose
This study verified that the dual sensory impairment (DSI) in the elderly is associated with cognitive impairment (CI) and confirmed how change in cognitive function varies depending on the social support (SS).
Methods
For a study sample of Korean older people, data from the Korean Longitudinal Study of Ageing (KLoSA) from the 7th (2018) to the 8th (2020), were included in this cross-sectional descriptive study. Among people who responded in both 2018 and 2020, a total of 2,069 people of those who are 65 years of age or older, and have living children and normal cognitive function, were analyzed. X2 -test, t-test and logistic regression analyses were utilized.
Results
First, the number of elderly with visual impairment (VI), hearing impairment, and DSI increased on 8th data compared with 7th data. In addition, 22.9% of the 2,069 people showed a decrease in cognitive function. Second, compared to the elderly with normal sensory function, the cognitive function of the elderly with only VI was found to be more degraded, and the cognitive function of the elderly with DSI was found to be much more degraded. In addition, among SS, only participation in social gatherings was found to show significant change in cognitive function of the elderly with DSI. Third, the interaction effect of participating in social gatherings was not significant in the CI of the elderly with DSI.
Conclusion
VI and DSI effected cognitive function, but participation in social gatherings such as SS has not significant interaction effect on CI of the elderly with DSI.
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[Korean]
The Relation among Uncertainty, Social Support, Care Burden of Mothers having Children with Developmental Disabilities
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Kyoung Eun Jeong
, Min Hyun Suk
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Res Community Public Health Nurs. 2023;34(2):117-126. Published online June 30, 2023
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DOI: https://doi.org/10.12799/rcphn.2022.00346
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3,101
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Abstract
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- Purpose
This descriptive correlation study aimed to confirm the relation among uncertainty, social support, care burden of mothers having children with developmental disabilities.
Methods
The participants were 111 mothers having children with autistic spectrum disorder or intellectual disability. The collected data were analyzed by descriptive statistics, t-test, ANOVA, Pearson’s correlation coefficient and multiple regression using IBM SPSS 23.0 in the study.
Results
Uncertainty and social support were significantly correlated to caregiver burden. As a result of multiple regression analysis, the factors affecting caregiver burden were children’s age, the expense for caring, the period suspected child disabilities, and uncertainty. These factors accounted for 40.8% of caregiver burden.
Conclusion
In order to reduce the burden of caring for mothers with children with developmental disabilities, it is necessary to establish a system that can detect children with developmental disabilities early and to develop and provide an integrated guide suitable for the growth and development stage of children with developmental disabilities.
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Citations
Citations to this article as recorded by

- The effect of intolerance of uncertainty, sleep quality, and social support on caregiver burden in parents of children with chronic diseases: A cross-sectional study
Furkan Doğaner, Raziye Celen
Journal of Pediatric Nursing.2025; 81: e106. CrossRef - Adaptation and validation of the Korean version of the parental perception of uncertainty scale (K-PPUS) in parents of children with developmental disabilities
Heejung Choi, GyeongAe Seomun
Journal of Pediatric Nursing.2025; 82: 47. CrossRef - The effect of counseling services provided in rehabilitation centers on parents' caregiving burden and quality of life
Mehmet Uçar, Rukuye Aylaz
WORK: A Journal of Prevention, Assessment & Rehabilitation.2025;[Epub] CrossRef - Spousal support, parent–nurse partnership and caregiver burden among parents of children with chronic diseases: A cross‐sectional study
Jihye Kim, Heemin Chae, Yoonjung Kim
Journal of Clinical Nursing.2024; 33(7): 2649. CrossRef
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[English]
Factors Associated with Nurse Self-Leadership: A Cross-Sectional Study of Nurses Working at Public Health Centers and Primary Healthcare Posts
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Saeryun Kim
, Younkyoung Kim
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Res Community Public Health Nurs. 2024;35(3):195-206. Published online September 30, 2024
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DOI: https://doi.org/10.12799/rcphn.2024.00493
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Supplementary Material
- Purpose
This study aimed to analyze the factors influencing self-leadership among public health nurses as they implement health promotion projects in public health centers and primary healthcare posts.
Methods
The study sampled 120 public health nurses from 22 public health centers and their associated primary healthcare posts in J province. Data were collected from October 11 through October 25, 2022.
Results
Employment at a primary healthcare post instead of a public health center (β=.23, p=.012), was significantly associated with self-leadership in model 1 (adjusted R2=.17, F=4.56, p<.001). Furthermore, communicative competence (β=.48, p<.001) and nursing professionalism (β=.26, p=.001) were significantly associated with self-leadership in model 2 (adjusted R2=.51, F=14.77, p<.001).
Conclusion
Open and self-directed work environments, along with opportunities for education and training, are necessary to enhance communicative competence and nursing professionalism. These improvements may, in turn, strengthen self-leadership among nurses, facilitating the implementation of health promotion projects within public health institutions.
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[English]
Cyberbullying among University Students during the E-learning Transformation Era: The Role of the Student-Teacher Relationship and Virtual Classroom Community
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Samiha Sayed
, Lucy AbuElEla
, Ahlam Sarhan
, Doaa El Demerdash
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Res Community Public Health Nurs. 2023;34(2):135-146. Published online June 30, 2023
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DOI: https://doi.org/10.12799/rcphn.2023.00038
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- Purpose
The current study assesses cyberbullying among university students and explores the role of the student-teacher relationship and virtual classroom community.
Methods
A descriptive exploratory study on four randomly selected colleges at Damanhour University/Egypt. Participants were recruited conveniently using an equal allocation of 150 students/college (600 students). The European Cyberbullying Intervention Project Questionnaire (ECIPQ), Rovai's Classroom Community Scale (RCCS), and the Student Version of The Teacher-Student Relationship Inventory (S-STRI) were used for data collection.
Results
Low cyber victimization was reported by 66.5% of the students, while 39.8% reported low cyberaggression behaviors. The highest percent reported average virtual class connectedness (77.3%), learning experience (70.3%), and overall virtual classroom community (80.8%). Besides, highly satisfying teacher relationships (82.3%); average (38.8%) and low (35.8%) instrumental help; low conflict (68.0%); and average total teacher-student relationship (70.5%). Regression analysis revealed that the increased scores of the total teacher-student relationship scale (p<0.05) with its two domains [satisfaction and instrumental help (p<0.01)] and the total classroom community scale (p<0.05) with its domains [connectedness (p<0.01) and learning experience (p<0.05)] decreased the likelihood of cyber victimization and cyberaggression. However, perceived conflicting teacher relationships increased the likelihood of cyber victimization (p<0.05) and cyberaggression (p<0.01).
Conclusion
Cyberbullying is a concern among university students, and the students’ perceived nature of their relationships with their teachers and sense of virtual classroom community play a pivotal role in shaping their involvement in cyberaggression and exposure to cyber victimization. Thus, developing mass media campaigns to enhance awareness about cyberbullying and cyber civility regulations is recommended.