Research in Community and Public Health Nursing

Original Articles

[English] Digital Ageism and Ageism Among Middle-Aged and Older Adults and the Mediating Role of Expectations Regarding Aging: A Cross-Sectional Study: Gahye Kim, Aeri Jung; Res Community Public Health Nurs. 2026;37(3):403-412. Published online September 30, 2026; DOI: https://doi.org/10.12799/rcphn.2026.01809

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Abstract PDF: Purpose
This study examined whether expectations regarding aging mediate the relationship between ageism and digital ageism among middle-aged and older adults and whether this indirect effect differs by age group.
Methods
A cross-sectional design was employed to analyze the data of 300 South Korean adults aged 45 years or older, recruited via an online research panel through sampling stratified by age and gender. Ageism, expectations regarding aging, and digital ageism were assessed using validated self-report scales. Mediation and moderated mediation were tested using Hayes’ PROCESS Models 4 and 14 with bias-corrected bootstrapping.
Results
Digital ageism was positively correlated with ageism (r=.41, p<.001) and negatively correlated with expectations regarding aging (r=-.37, p<.001). Expectations regarding aging partially mediated the relationship between ageism and digital ageism (B=0.22; 95% boot CI=0.11-0.35). Middle-aged adults showed higher digital ageism than older adults (t=2.90, p=.004); however, the mediating pathway did not differ by age group.
Conclusions
The findings suggest that expectations regarding aging may play a mediating role in the association between ageism and digital ageism. Interventions to reduce digital ageism should target both ageist beliefs and negative expectations regarding aging and should be implemented starting in midlife rather than focusing exclusively on older adulthood.

[English] Influence of Health Behaviors, Women's Health, and Employment Characteristics on Obesity Among Married Working Women: A Descriptive Cross-Sectional Study: Hye Young Song, Gye Hyun Jung; Res Community Public Health Nurs. 2026;37(3):413-423. Published online September 30, 2026; DOI: https://doi.org/10.12799/rcphn.2026.01795

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Abstract PDF: Purpose
This study aimed to identify sociodemographic, health-behavior, women’s health, and employment characteristics associated with obesity among married working women in Korea. Methods: This descriptive cross-sectional secondary analysis used pooled data from the 2022–2023 Korea National Health and Nutrition Examination Survey (KNHANES). The final sample included 1,364 married salaried women aged 19–64 years with complete data on all study variables. Complex-sample Rao–Scott chi-square tests and hierarchical logistic regression analyses were performed using KNHANES stratification, clustering, and sampling weights.
Results
The weighted prevalence of obesity was 26.9%. In the fully adjusted model, obesity was associated with middle school education or less (vs. college or higher), mid-high household income (vs. high income), absence of strength training, sleep duration <6 h (vs. 6-8 h), hypertension, and diabetes. The addition of employment characteristics produced little change in model explanatory power.
Conclusion
Obesity among married working women was associated with socioeconomic characteristics, health behaviors, and metabolic health conditions. Because this study was cross-sectional, the findings should be interpreted as associations rather than causal relationships. Obesity-prevention strategies for this population should prioritize modifiable health behaviors while also considering the broader social context in which these behaviors occur.

[English] Exploring Subjectivity Types of Community Health Visiting Nurses' Core Competencies: A Q-Methodological Approach: Gab Sun Song, Gyeong-Sun Jeong, Hoo Jeung Cho; Res Community Public Health Nurs. 2026;37(3):392-402. Published online September 30, 2026; DOI: https://doi.org/10.12799/rcphn.2026.01739

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Abstract PDF: Purpose
This study aimed to identify subjective types of core competencies among community health visiting nurses.
Methods
Q-methodology, which focuses on individual subjectivity, was applied. Thirty-two Q-statements were selected and ranked by 40 community health visiting nurses using a forced 9-point distribution from May 10 to June 30, 2025. The data were analyzed using the Personal Computer - Q methodology Analysis(PC-QUANL) program.
Results
Four types were identified: the client-centered relational care type (Type I), collaborative decision-making and resource coordination type (Type II), clinical expertise and judgment type (Type III), and community resource linkage type (Type IV). The four types accounted for 52.9% of the total variance, with explanatory powers of 39.6% (Type I), 5.0% (Type II), 4.9% (Type III), and 3.4% (Type IV). Across the types, trust-based relationships emerged as a recurrent priority, whereas collaboration and resource coordination, clinical expertise and judgment, and community resource linkage differentiated the types.
Conclusion
These findings clarify how community health visiting nurses subjectively prioritize core competencies and may be considered when designing competency education and ongoing competency-development strategies for these nurses.

[English] Development of Competency-Based Qualification Standards for School Health Teachers: Eun Suk Choi, Jun Hwa Choi; Res Community Public Health Nurs. 2026;37(3):229-245. Published online September 30, 2026; DOI: https://doi.org/10.12799/rcphn.2026.01662

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Abstract PDF: Purpose
This study aimed to develop and refine competency-based qualification standards for school health teachers in Korea by reflecting recent changes in the school health environment, the 2022 revised national curriculum, and teacher certification policies.
Methods
This methodological study used a comprehensive literature review of domestic and international policies and professional standards, analysis of school health teacher education curricula, expert panel consultations, and a public hearing. Data were analyzed using inductive qualitative content analysis and synthesized to restructure and systematically refine the qualification standards.
Results
The revised qualification standards were structured as a competency-based framework consisting of eight domains, twenty qualification standards, and eighty detailed criteria. The eight domains were professional attitudes, understanding of learners, subject knowledge, health education, health counseling, health management, general teaching competencies, and professionalism and leadership. The framework was developed to enhance coherence between teacher education curricula and the teacher recruitment examination system.
Conclusion
The updated standards provide a standardized, competency-based foundation that reflects the dual identity of school health teachers as educators and school nursing professionals. They may guide teacher education programs, recruitment examination criteria, and continuing professional development, thereby strengthening coherence across teacher preparation, selection, and professional development systems.

[English] Factors Associated with Health-Promoting Behaviors among Late Middle-Aged Women: Focusing on Aging Anxiety, Social Support, Self-Efficacy, and Physiological Indicators: Yu Jin Shin, Hye Kyung Lee; Res Community Public Health Nurs. 2026;37(3):346-357. Published online September 30, 2026; DOI: https://doi.org/10.12799/rcphn.2026.01655

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Abstract PDF: Purpose
The purpose of this study was to identify the relationships between aging anxiety, social support, and self-efficacy, and to determine the factors influencing health-promoting behaviors among late middle-aged women. Methods: This study utilized a descriptive research design. The participants were 136 late middle-aged women visiting vocational training centers in Sejong Special Self-Governing City. Data were collected using structured questionnaires regarding general characteristics, aging anxiety, social support, and self-efficacy. Physiological indicators, including blood glucose levels and body mass index (BMI), were also measured. Results: The factors significantly influencing health-promoting behaviors in late middle-aged women were social support (β=.40, p<.001), subjective health status categorized as "healthy" (β=.27, p=.019) or "average" (β=.29, p=.009), blood glucose levels (β=.17, p=.010), BMI (β=.16, p=.012), and aging anxiety (β=-.16, p=.042). These factors explained 48.9% of the total variance in health-promoting behaviors (adjusted R²=.489). Conclusion: The findings suggest that psychological, social, and physiological factors should be considered when developing health promotion strategies for late middle-aged women. Community-based programs that enhance social support and nursing interventions addressing health perception, aging anxiety, and physiological health management may help support health-promoting behaviors in this population.

[English] Structural Model of Health Promoting Behaviors of General Hospital Nurses: Se Si Ra Kim, Eun A Kim; Res Community Public Health Nurs. 2026;37(3):296-308. Published online September 30, 2026; DOI: https://doi.org/10.12799/rcphn.2026.01634

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Abstract PDF: Purpose
This study aimed to test and validate a structural model explaining health promoting behaviors among nurses working in general hospitals and to identify key factors influencing health promoting behaviors.
Methods
A hypothetical model was constructed based on the Theory of Planned Behavior and prior empirical studies. Health consciousness, social support, and self-efficacy were specified as exogenous variables, while behavior intention and health promoting behaviors were treated as endogenous variables. Data were collected from June 8 to June 24, 2024, from 345 nurses employed at three general hospitals in a G metropolitan city. Partial least squares structural equation modeling (PLS-SEM) was conducted using SPSS Statistics 26.0 and SmartPLS 4.0.9.6 to assess model fit and test the hypotheses.
Results
The PLSc model showed SRMR=.06, dULS=1.13 and dG=.43, but did not meet the predefined criterion for model fit based on dULS; therefore, PLS-SEM was used for the final analysis. VIF values confirmed the absence of multicollinearity. The adjusted R² for health promoting behaviors was 58%. Health consciousness had the strongest effect, followed by social support, self-efficacy, and behavior intention. Predictive relevance (Q²) ranged from .36 to .56. Six of the seven hypotheses were supported.
Conclusion
Therefore, in nursing education and practice, it is necessary to develop and apply strategic interventions that enhance health consciousness and self-efficacy and strengthen social support and behavior intention.

[English] Personal Assistant Service Patterns and Health Behaviors Among Adults with Disabilities: A Latent Class Analysis: Min Ji Kang, Ju Young Yoon; Res Community Public Health Nurs. 2026;37(3):358-373. Published online September 30, 2026; DOI: https://doi.org/10.12799/rcphn.2026.01613

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Abstract PDF: Purpose
This study aimed to classify patterns of Personal Assistant Service (PAS) among adults with disabilities in Korea using latent class analysis (LCA) based on the Behavioral Model for Vulnerable Populations (BMVP).
Methods
A cross-sectional descriptive study was conducted using data from the Disability and Life Dynamics Panel (2018-2023). The most recent observation per individual was selected to ensure analytic independence, yielding 482 adults. LCA was performed using six service use domains. Multinomial logistic regression examined factors associated with class membership, and modified Poisson regression assessed associations between latent classes and five health behaviors.
Results
Three classes were identified: Comprehensive Support (36.3%), Physical and Social Support (36.1%), and Household Support (27.6%). Compared with non-users, service users showed greater socioeconomic and health vulnerability, including more severe disability, lower income, living alone, lower social support, and higher depression. Women and individuals with greater disability severity and daily-living limitations showed higher odds of belonging to the Comprehensive Support class. After adjusting for covariates, the Comprehensive Support class showed a significantly lower prevalence of physical activity and alcohol consumption compared to the Household Support class, while previously observed differences in fast food intake were attenuated.
Conclusion
PAS is associated with health behaviors among adults with disabilities, although current service structures may not fully address health enhancing behaviors. Expanding PAS to include tailored physical activity support, health management, and psychosocial care may help reduce health disparities among adults with disabilities.

[English] Successful Aging and Its Related Factors Among Older Adults: A Comparative Analysis of Baby Boomers and Preceding Generations: Gyeong-Suk Jeon, Kyungwon Choi; Res Community Public Health Nurs. 2026;37(3):282-295. Published online September 30, 2026; DOI: https://doi.org/10.12799/rcphn.2026.01606

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Abstract PDF Supplementary Material: Purpose
Korea’s older adults comprise distinct birth cohorts with different social, economic, and cultural experiences. We compared successful aging between baby boomers (65-69 years) and the preceding generation (≥70 years) and examined SDH-based correlates across generations. Methods: We conducted a cross-sectional secondary analysis of the 2023 National Survey of Older Koreans (N=9,951). Successful aging was defined as meeting all three Rowe and Kahn domains: avoidance of disease/disability, maintenance of physical and mental function, and continued engagement with life. Predictors were organized within an SDH framework (socio-demographic/economic status, health behaviors and healthcare utilization, and social capital/community environment). Weighted estimates and generation-stratified multivariable logistic regression were performed; SDH × generation interactions were tested. Results: Successful aging prevalence was 22.4% overall and higher among baby boomers than the preceding generation (37.3% vs 14.4%). In adjusted models, higher household income and stronger social support networks were associated with higher odds of successful aging in both generations, whereas no health check-up in the past two years was associated with lower odds. Education and absence of a spouse/partner were more strongly related to successful aging in the preceding generation, while cognitive function check-up was positively associated among baby boomers. Interaction tests did not show consistent generational differences for all predictors after full adjustment. Conclusion: Successful aging in Korea differs markedly by generation and is shaped by SDH across the life course. Generation-sensitive strategies to strengthen late-life economic security, promote preventive care use, and enhance social capital and participation may reduce inequalities.

[English] Professional Role Identity of Medical Support Nurses in Tertiary Hospitals: A Qualitative Content Analysis: Suejin Kim, Jina Choo, Yura Shin, Songwhi Noh, Jiye Min, Youngsoo Chu, Mi Yu, Soonhee Yoon, Sung Reul Kim, Yura Choi, Eunyeong Park, Gyuhee Han, Eunsil Jeong, Soohyun Ryu, Gyeongeun Choi; Res Community Public Health Nurs. 2026;37(3):246-260. Published online September 30, 2026; DOI: https://doi.org/10.12799/rcphn.2026.01585

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Abstract PDF: Purpose
In South Korea, the healthcare workforce dispute between the government and medical associations in 2024 accelerated the expansion of medical support roles. Since the early 2000s, tertiary hospitals have relied on experienced nurses to perform expanded medical support and care coordination functions within physician-led services; these roles were later and formally referred to as “medical support nurses,” and national efforts are now underway to formalize this role. This study aims to identify the professional identity of medical support nurses by exploring how nurses working in tertiary hospitals perceive and construct their current roles and challenges within the context of the ongoing institutionalization of this role. Methods: Participants were 37 medical support nurses and 7 physicians in an S tertiary hospital in Seoul. Qualitative content analysis based on the approach of Graneheim and Lundman was conducted using data from six focus groups. Results: Three themes emerged: “Pride and Certainty of Being an Essential Professional,” highlighting their bridging and clinical coordination roles; “Ambiguity and Instability due to an Ungranted Professional Position,” reflecting insecurity and identity ambiguity; and “Desire and Desperation of Specialized Professional Settlement,” underscoring the need for recognition, structured education, and career pathways. Conclusion: Medical support nurses may play a vital role in continuity of care; however, they continue to face unclear legal and professional boundaries. Institutionalization—including legal definition, standards for clinical practice, standardized education, and career development—is urgently needed to strengthen the professional identity of medical support nurses and to support workforce policy development for this group.

[English] Support Needs and Stigma in Online Mental Health Discussions: Evidence from Large-Scale Comment Analysis: Soontae An, Hannah Lee, Nayoung Oh; Res Community Public Health Nurs. 2026;37(3):329-345. Published online September 30, 2026; DOI: https://doi.org/10.12799/rcphn.2026.01536

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Abstract PDF: Purpose
This study aimed to characterize mental health discourse in user comments on YouTube videos about depression and bipolar disorder, focusing on how personal experience, stigma, and community building are expressed in digital interactions.
Methods
A total of 100 videos were identified using the keywords “depression” and “bipolar disorder.” Using the YouTube API, video metadata and 16,241 comments were collected. Most videos were produced by individual doctors, media outlets, and general hospitals, focusing on treatment, diagnosis, and symptoms. After removing non-informative, duplicated, or commercial posts, 13,183 comments were analyzed. Using GPT-5, comments were classified into eight predefined categories.
Results
“Personal Experience” was the most frequent category (9,551), followed by “Needs for Community Building: Emotional” (3,842) and “Needs for Community Building: Instrumental” (2,873). Actual “Community Building: Emotional Support” (1,345) and “Community Building: Instrumental Support” (549) appeared less frequently. Stigma-related discourse included “Social Stigma” (1,717) and “Internalized Stigma” (1,184), while “Non-evidence-based Advice” appeared in 1,146 comments. Co-occurrence analysis revealed strong associations between “Personal Experience” and “Needs for Community Building: Emotional” (.56), “Needs for Community Building: Instrumental” (.36), and “Internalized Stigma” (.33).
Conclusion
Expert mental health video comment sections functioned primarily as experience- and emotion-centered spaces where users expressed substantial emotional and informational needs but received limited reciprocal support. These findings highlight the need for digital mental health environments integrating evidence-based information with structured support frameworks.

[English] Psychological Distress among Mongolian International Undergraduate Students in South Korea and Their Domestic Peers in Mongolia: A Cross-Sectional Study: Battushig Bolorchimeg, Duckhee Chae, Nakyung Kim; Res Community Public Health Nurs. 2026;37(3):261-270. Published online September 30, 2026; DOI: https://doi.org/10.12799/rcphn.2026.01508

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Abstract PDF Supplementary Material: Purpose
This study examined the impact of international migration on mental health by comparing paid employment, health behaviors, loneliness, and psychological distress between Mongolian international undergraduates in South Korea and their peers in Mongolia. Methods: A cross-sectional design was used with a convenience sample of 200 undergraduates recruited from five universities in South Korea and two universities in Mongolia. Data were analyzed using independent t-tests, χ² tests, Pearson correlation analyses, and multivariable regression analyses. Results: Compared to their peers in Mongolia, international students were more likely to be employed, engage in health risk behaviors (alcohol use, smoking), and report greater loneliness. These patterns were particularly evident among female students, with higher rates of paid employment, smoking, and loneliness. Loneliness predicted psychological distress in both groups after controlling for age and gender (domestic students: B=0.60, 95% CI 0.37-0.84; international students: B=0.35, 95% CI 0.11-0.58), while paid employment (B=6.00, 95% CI 0.49-11.52) predicted distress only among international students. Conclusion: These findings highlight the need for targeted mental health support for international students, especially females, focusing on reducing loneliness and employment-related stress as well as policies to ease financial pressures and ensure fair working conditions for self-funded students.

[English] Socioeconomic and Health-Related Factors Associated with Glaucoma Prevalence and Awareness: A Cross-Sectional Study: Yunmi Kim, Hyojoo Kang; Res Community Public Health Nurs. 2026;37(3):309-319. Published online September 30, 2026; DOI: https://doi.org/10.12799/rcphn.2025.01473

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Abstract PDF: Purpose
Glaucoma is a leading cause of irreversible blindness worldwide; however, awareness remains low in many countries, including Korea. This study aimed to examine the prevalence of glaucoma and the level of glaucoma awareness and to identify socioeconomic and health-related factors associated with these outcomes among Korean adults.
Methods
This cross-sectional study used nationally representative data from 13,787 participants aged 40-79 years from the Korea National Health and Nutrition Examination Survey (2017-2020). All analyses accounted for the complex sampling design using sampling weights, stratification, and clustering. The Rao-Scott chi-square test and multivariable logistic regression analyses were conducted to identify factors associated with glaucoma prevalence and awareness.
Results
The overall prevalence of glaucoma was 4.7%, and only 18.9% of individuals with glaucoma were aware of their condition. Multivariable logistic regression analyses showed that older age, male sex, and hypertension were significantly associated with higher glaucoma prevalence (p<.05). In contrast, glaucoma awareness increased with age but was significantly lower among individuals with low household income.
Conclusion
These findings highlight the need for targeted community-based interventions and nurse-led education programs to improve glaucoma awareness and promote early detection, particularly among socioeconomically disadvantaged populations.

[English] The Effects of Health-Promoting Behavior, Health Self-Efficacy, and Health Literacy on Aging Anxiety among Late Middle-Aged Adults: A Cross-Sectional Descriptive Study: Hye Su Jung, So Young Shin; Res Community Public Health Nurs. 2026;37(2):200-211. Published online June 30, 2026; DOI: https://doi.org/10.12799/rcphn.2026.01599

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Abstract PDF: Purpose
This study aimed to investigate the levels and correlations of health-promoting behavior, health self-efficacy, health literacy, and aging anxiety, and the factors influencing aging anxiety in late middle-aged adults.
Methods
The subjects included 164 late middle-aged adults aged 50–64 years residing in B metropolitan city, South Korea. An online questionnaire was administered through a professional online research company from June 10th to 16th, 2025 to assess general characteristics, health-promoting behavior, health self-efficacy, health literacy, and aging anxiety. Collected data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA with Duncan tests, Pearson correlation coefficients, and multiple linear regression.
Results
A total of 164 subjects with a mean (±SD) age of 56.70 (±4.08) years were included in the final analyses. Aging anxiety had significant negative correlations with health-promoting behavior (r=-.38, p<.001), health self-efficacy (r=-.31, p<.001), and health literacy (r=-.17, p=.029). In the final multiple regression analysis, having one chronic disease (β=.24, p=.003), subjective health rated as ‘average’ (β=.28, p=.002) and ‘poor’ (β=.29, p=.010), and perceived economic status rated as ‘moderate’ (β=.33, p=.008) and ‘low’ (β=.34, p=.010) were associated with higher aging anxiety, whereas higher health-promoting behavior (β=-.23, p=.003) and health self-efficacy (β=-.21, p=.010) were associated with lower aging anxiety. The model explained 33% of the variance in aging anxiety (F=8.93, p<.001).
Conclusion
Enhancing health-promoting behavior and health self-efficacy and improving chronic disease management, subjective health, and economic stability of late middle-aged adults will ultimately reduce their aging anxiety and positively impact their psychological well-being and healthy aging.

[English] Assessing the association between Health Literacy and Health-Related Lifestyle Behaviors Among the older adults in Pathum Thani, Thailand: A Cross-Sectional Survey: Issara Siramaneerat, Warisara Sukumolchan, Chalit Chaowilai, Rutshaporn Chaitoopthong; Res Community Public Health Nurs. 2026;37(2):179-189. Published online June 30, 2026; DOI: https://doi.org/10.12799/rcphn.2025.01494

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Abstract PDF: Purpose
The study explores the relationship between socio-demographic factors, health literacy, and health-related behavior (HLB) among elderly individuals in Pathum Thani, Thailand.
Methods
A total of 440 elderly participants were selected through convenience sampling and completed surveys assessing socio-demographic factors, health literacy, and health perception of illness. The data were analyzed using multiple linear regression to identify predictors of HLB.
Results
In the final model, marital status (married), higher income levels, income sufficiency, and living with family were significant predictors of HLB (p<.05). Health literacy was a significant positive predictor (β=.18, p<.01), while illness perception also showed a significant positive effect (β=.12, p<.001). The model explained 38% of the variance in HLB (R²=.38). Notably, health literacy and illness perception contributed additional explanatory power beyond socio-demographic factors.
Conclusion
Both socio-demographic and cognitive factors play important roles in shaping health-related behaviors among older adults. Interventions should prioritize improving health literacy and promoting appropriate illness perceptions to enhance healthy behaviors in this population.

[Korean] A History of Korean Nurses’ Efforts to Define Their Scope of Practice and Secure Their Rights: Focusing on the 1969 ‘Busanjin Health Center Injection Incident’: Hae Ri Lee, Kyujin Choi; Res Community Public Health Nurs. 2026;37(2):190-199. Published online June 30, 2026; DOI: https://doi.org/10.12799/rcphn.2025.01466

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Abstract PDF: Purpose
This study examines how nurses’ scope of practice was constructed through legal and sociopolitical processes in Korea, focusing on the 1969 “Busanjin Health Center Injection Incident.”
Methods
By examining court rulings, newspaper articles, healthcare and labor documents from the time, this research analyzes the background, sociopolitical context, and societal impact of the incident.
Results
At the time, nurses’ injection practices were widely performed but not clearly defined within the ambiguous legal category of ‘assistance in medical treatment.’ The incident brought this ambiguity into public and legal dispute, making nurses’ scope of practice a visible issue. Nurses’ collective action, particularly the refusal to administer injections, functioned as a critical mechanism that prompted renewed deliberation and contributed to the reconstruction of nurses’ scope of practice.
Conclusion
These findings suggest that nurses’ scope of practice, previously lacking clear legal definition, became socially visible through the incident and was subsequently reconstructed through practice and collective action. This case highlights that nurses’ scope of practice is not fixed by formal regulation but emerges through the interaction between practice and social context, with implications for understanding nurses’ scope of practice in the context of integrated care.

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