Purpose: In this study, we evaluated the association of communication competence, critical thinking disposition, and professional values with clinical teaching behavior in nurse preceptors. Methods: We conducted a cross-sectional descriptive study with 198 nurse preceptors from one tertiary hospital and one general hospital in Gyeonggi-do, Korea. Using structured questionnaires, data were collected from February 17 to March 9, 2025, and analyzed using the independent t-test, one-way analysis of variance (ANOVA), Pearson's correlation coefficient, and hierarchical multiple regression analysis. Results: The mean scores (5-point scales) were as follows: communication competence, 3.85±0.47; critical thinking disposition, 3.70±0.46; professional values, 4.36±0.48; and clinical teaching behavior, 4.06±0.49. There were significant positive correlations between clinical teaching behavior and communication competence, critical thinking disposition, and professional values. In hierarchical multiple regression analysis, communication competence (β=.30, p<.001), critical thinking disposition (β=.30, p<.001), and professional values (β=.21, p=.001) significantly predicted clinical teaching behavior (Adj R²=.41, F=34.88, p<.001). Preceptors who were 35 years or older and those with more than 84 months of clinical experience (both p<.01) demonstrated enhanced clinical teaching behavior. Conclusion: Communication competence, critical thinking disposition, and professional values were significantly and positively associated with the clinical teaching behavior of preceptors. Our findings suggest that competency-based preceptor development programs and organizational support tailored to levels of experience are pivotal for enhanced clinical teaching effectiveness.

Purpose: In this descriptive study, we examined the effects of depression on medication adherence in the elderly with chronic disease and confirmed the dual mediating effects of self-efficacy and health literacy. Methods: Using self-reported questionnaires, we collected data from 190 elderly people diagnosed with chronic disease and who were taking chronic disease drugs in area C from July 25 to August 25, 2023. SPSS Statistic version 29.0, PROCESS macro version 4.2 were used to analyze the collected data. An indirect effect test was used for bootstrapping, with the reliability interval set to 95% and bootstrapping set to 10,000. Results: The mediating effect of self-efficacy on the relationship between depression and medication adherence was found to be statistically significant (95% confidence interval=-0.13~-0.01), while the mediating effect of health literacy was not significant (95% confidence interval=-0.03~0.02). Conclusion: Self-efficacy had a clear mediating effect on how depression affected medication adherence. When a program to improve drug administration is considered, we recommend developing and applying an intervention procedure that promotes psychological support to lower depression and improved self-efficacy in the elderly with chronic disease.

Purpose: The objective of this study is to examine the historical transitions and evolving scope of practice of home health care advanced practice nurses in South Korea, with the goal of informing strategies for future role development and policy reform. Methods: Changes in the roles and responsibilities of home health care advanced practice nurses in South Korea over time were examined using a historical approach, drawing on domestic prior research, practice guidelines, newspapers, government reports, and relevant legislation. Data from July 2024 to October 2025 were collected, and all literature and documents publicly available by October 2025 were included. Sources comprised major government and academic platforms, including the Ministry of Health and Welfare, National Health Insurance Service, National Assembly Library, National Library of Korea, National Law Information Center, academic portals, and the archives of the Korean Academic Society of Home Health Care Nursing. Results: The roles and changes in practice of advanced practice nurses in home health care in South Korea were categorized into four periods: the incipient period (1970-1990), the preparatory period for institutionalization (1991-2000), the adjustment period (2001-2023), and the transitional resurgence period (2024-present). Conclusion: The roles of advanced practice nurses in home health care have been shaped by changes in policy and legislation. Clearly redefining their unique professional identity through expert consensus, enhancing understanding among the public, healthcare professionals, and policymakers while supporting targeted policy improvements and educational development is essential.

Purpose: This systematic review examined the cost-effectiveness of healthcare-associated infection (HAI) prevention and control (IPC) programs across healthcare settings. Methods: A search of international and domestic databases for studies published between January 1900 and August 2025 was conducted according to PRISMA 2020 guidelines. Ten studies reporting both IPC interventions and economic outcomes were included. Data extraction included study characteristics, intervention types, cost components, and economic results. The CHEERS 2022 checklist was used for assessment of reporting quality. Results: IPC interventions included hand hygiene improvement, environmental cleaning programs, antimicrobial stewardship, screening strategies, contact precaution policies, and prophylactic therapies. Five studies reported cost-effectiveness ratios (CERs), ranging from 5.59 to 950,000, reflecting wide variation in the intensity of the intervention and cost structure. Although lacking CERs, the remaining studies consistently reported cost savings, including reductions in antimicrobial use, HAI incidence, hospital-acquired complications, and bed-day costs. Of particular importance, none of the studies reported increased post-intervention costs, indicating a positive economic impact across settings. However, reporting quality was moderate. Essential elements of economic evaluation such as perspective, time horizon, discount rate, price year, currency conversion, or uncertainty analysis were not specified in many of the studies, limiting comparability and hindering robust synthesis. Substantial heterogeneity in input definitions, outcome metrics, and cost calculation approaches also constrained quantitative pooling. Conclusion: IPC programs provide consistent economic value by reducing HAI burden and use of healthcare resources. Future studies should improve methodological rigor and adhere to CHEERS reporting standards as an effort to strengthen the evidence base. High-quality economic evaluations are particularly needed in healthcare systems where the focus of IPC research has been more on clinical outcomes than on economic impact. In addition, effective IPC implementation requires consideration of the capacity and competency of the nursing workforce, highlighting the importance of integrating nursing roles into infection control practice and policy.

Purpose: The objective of this study was to determine whether cognitive flexibility can be regarded as a mediator between anxiety and self-confidence with clinical decision making and career identity of nursing students with clinical practice experience. Methods: Participants included 118 nursing students. SPSS/Win 27.0 and PROCESS macro 4.2, in cluding descriptive statistics, independent t-test, One-way ANOVA, Pearson correlation coefficients, and mediation analysis (Model 4, 5,000 bootstrap samples) were used for data analysis. Results: Significant differences in career identity were observed according to satisfaction with major and clinical practice. A significant correlation was observed between the variables of anxiety and self-confidence with clinical decision making, cognitive flexibility and career identity. The mediating effect of cognitive flexibility on the relationship between anxiety and self-confidence with clinical decision making and career identity showed no statistical significance; however, anxiety and self-confidence with clinical decision making each exerted significant direct effects on career identity. Conclusion: Based on these findings, development of systematic and proactive educational interventions that not only enhance nursing students'career identity and improve their satisfaction with their major and clinical practice, but also strengthen their self-confidence and reduce anxiety with clinical decision making will be necessary.

Purpose: The purpose of this study was to examine the effects of an eight week whole-body electromyostimulation (WB-EMS) program on body fat and blood glucose-related indicators in elderly patients with obesity and type 2 diabetes mellitus (T2DM). Methods: The participants included elderly patients (≥65 years) with a diagnosis of T2DM, a body fat percentage (BFP) of 30% or higher, and understanding of the purpose of the study. A total of 52 participants with obesity and T2DM were randomly assigned to either the WB-EMS group (n=25) or a control group (n=27). The WB-EMS program was conducted twice per week, with each session lasting 20 minutes, for a duration of eight weeks. Pre- and post-intervention measurements included weight, body mass index (BMI), waist circumference (WC), BFP, visceral fat area (VFA), fasting blood glucose (FBG), and hemoglobin A1c (HbA1c). T-tests, chi-square tests, and repeated measures ANOVA (RM-ANOVA) were used for analysis of data. Results: The results showed a significant time × group interaction for weight, BMI, WC, and VFA, and FBG (p<0.05), indicating that the observed changes could be attributed to the WB-EMS intervention. After the WB-EMS intervention, the WB-EMS group showed significant reductions in weight, BMI, WC, VFA, and FBG, while the control group showed no significant changes. Conclusion: The findings of this study suggest that the WB-EMS program can be safely and effectively utilized as a non-pharmacological intervention for elderly patients with obesity and T2DM. It may serve as a viable strategy for long-term management of blood glucose and obesity.