Purpose: This study evaluates the longitudinal effectiveness of a case management program for patients with chronic mental illness. Methods: Data from 509 patients with chronic mental illness who underwent case management at a public health center over a 10-year period, starting in 2010, were retrospectively analyzed. Results: Most of the participants were women (54.8%), had a mean age of 65.2 years, had less than an elementary school education (47.0%), and were unemployed (62.5%). In the outcome evaluation, global functioning significantly improved from 62.39±6.87 at enrollment to 68.45±5.06 in the seventh year. Mental status significantly decreased from 21.87±6.87 at enrollment to 20.51±6.76 in the second year. Depression among older adults decreased significantly from 8.96±3.69 at enrollment to 6.36±3.62 in the second year. Self-reported depression significantly decreased from 16.09±8.49 at enrollment to 12.08±7.29 in the second year. Suicidal ideation significantly decreased from 6.83±6.61 at enrollment to 4.63±5.04 in the second year. Most variables did not significantly improve after two years but did not worsen. Conclusion: Evidence suggests that mental health case management has a significant effect on global functioning, health status, depression, and suicidal ideation in community-dwelling patients with chronic mental illness, and, therefore, should be scaled up.

This study analyzes the effects of a telehealth program for the older adult population. A comprehensive search across the CINAHL, PubMed, DBpia, KISS, and RISS databases yielded 2,731 studies, with 10 studies meeting the inclusion criteria. SIGN was used for quality assessment, and CMA 4.0 and Revman 5.4 were used to analyze the effect size. The effect size for physiological indicators was -1.4 and for psychological indicators was 4.73, which was large but statistically insignificant. Of all physiological indicators, glycated hemoglobin level showed a medium effect size (ES=-0.43), and of all psychological indicators, quality of life (ES=14.12), subjective health (ES=1.05), and depression (ES=-2.14) showed large effect sizes. In the subgroup analysis, studies targeting healthy older adults (ES=3.25) and those that included the interactive program (ES=1.89) showed large effect sizes. The RCT programs (ES=0.76) showed a medium effect size. The findings confirm that telehealth programs have a significant effect on the older adult population.

Purpose: This study analyzes attitudes toward suicide and the risk factors for suicidal behavior in Y City. Methods: A descriptive research was conducted by employing the original data of the "Y City Mental Health Survey". The study participants were adults aged 18 years or older living in Y City and 533 individuals participated in the survey. The research tool was a structured questionnaire consisting of the Depression Screening Questionnaire, the impact of exposure to suicide by others, items related to suicidal ideation, attitudes toward suicide, and respondent characteristics. Results: Analysis of the risk factors affecting suicidal behavior revealed that exposure to others' suicidal experiences (adjusted odds ratio [aOR]=2.83, 95% confidence interval [CI]=1.22~6.56) and the taboo toward suicide(aOR=1.92, 95% CI=1.14~3.23) increased the odds of suicidal behavior by 2.83 times and 1.92 times, respectively. However, absence of depression (aOR=0.14, 95% CI=0.05~0.42), resignation (aOR=0.62, 95% CI=0.40~0.95), and the incomprehensibility score for suicide (aOR=0.51, 95% CI=0.28~0.90) decreased the odds of suicidal behavior by 0.14, 0.62, and 0.51 times, respectively. Conclusion: A suicide prevention program that can change attitudes toward and values relating to suicide could reduce suicide rates.

Purpose: This study explores the physical, emotional, and social changes experienced by gynecologic cancer survivors with lower limb lymphedema and their adaptation strategies thereof. Methods: This qualitative study adopted a phenomenological approach. Data were collected from 11 survivors through face-to-face and online interviews conducted between November 2021 and December 2023. The researcher personally conducted each interview, which lasted 90-120 minutes. Results: The analysis revealed 4 theme clusters, 13 subthemes, and 31 themes. The theme clusters were "Accepting the Unexpected Guest," "Enduring and Walking Together," "Loving Oneself," and "Hoping for a Better Life." The participants experienced sudden swelling, physical discomfort, fatigue, sleep disturbance, emotional distress, disrupted daily life, strained relationships, financial burdens, and limited medical support. Some participants expressed frustration with health care professionals because of their passive attitudes and lack of information. Nevertheless, participants engaged in self-care practices, explored alternative management options, and proposed improvements to treatment and education. Conclusion: Lower limb lymphedema significantly affects the lives of gynecological cancer survivors. Comprehensive patient-centered strategies,including individualized care, consistent emotional support, and accessible educational resources, are essential for promoting adaptive coping and improving quality of life.

Purpose: This study investigates the effectiveness of providing healthcare management services for older adults at one primary healthcare post in a medically vulnerable rural area. Methods: The average ages of older adults who could walk to the community center was 79.6 years old (34 participants) and of those who had significant mobility constraints was 86.7 years old (10 participants). Approximately 77% of the participants were in the pre-frailty stage or higher, and 100% of those who received home visits were frail. Results: The p-value for TUG speed after the provision of healthcare services was 4.18229 × 10^-6 <.005, and the p-value for systolic blood pressure was .008, which indicated a significant effect with p-value <.05. In the survey, respondents reported high satisfaction, improved flexibility and subjective health status, and a decrease in pain and the frequency of painkiller use. Conclusion: It can be concluded that it is effective in preventing frailty, managing systolic blood pressure, improving satisfaction among elderly beneficiaries, enhancing physical flexibility, and managing chronic diseases.

Purpose: This study aimed to examine differences in job performance competencies and perceived competency needs according to work experience among public health practitioners, utilizing nationwide census data, to inform the development of career-stage-specific training programs. Methods: A descriptive cross-sectional study was conducted with 1,398 public health practitioners. Competency levels were compared across three career groups(<5 years, 5~10 years, and >10 years) using x² tests and one-way ANOVA. Results: Practitioners with more than 10 years of experience reported significantly higher levels of both job performance and perceived competency needs, particularly in domains such as health promotion, program planning, and leadership. No significant differences were observed between those with less than 5 years and those with 5~10 years of experience. Primary health care competency consistently showed the highest scores in both performance and perceived need across all groups, whereas strategic planning competencies-including analytical assessment and report writing-were rated comparatively low. Conclusion: These findings underscore the evolving role of public health practitioners from clinical service providers to coordinators of integrated care. Tailored training programs that reflect career stages are essential to enhance key competencies, particularly in planning and coordination, and to strengthen the implementation of community-based integrated care.

Purpose: This study investigated the factors associated with depressive symptoms among adults residing in rural South Korea, with particular attention to the potential role of serum vitamin D levels. Methods: A cross-sectional analysis was conducted using data from the 2022 Korea National Health and Nutrition Examination Survey (KNHANES). A total of 532 adults aged 19-64 years living in rural areas were included. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), and serum 25-hydroxyvitamin D₃ [25(OH)D₃] levels were measured through laboratory testing. Logistic regression was performed to evaluate associations, adjusting for sociodemographic, behavioral, and clinical variables. Results: No significant association was found between serum vitamin D levels and depressive symptoms. However, several factors were independently associated with greater odds of depressive symptoms, including younger age, female sex, low education level, low household income, frequent alcohol consumption, presence of chronic disease, and high perceived stress. Among these, perceived stress showed the strongest association with depressive symptoms. Conclusion: These findings suggest that psychosocial and health-related factors may have a stronger influence on depression in rural populations than serum vitamin D levels. Public health strategies aimed at reducing stress, managing chronic disease, and alleviating economic hardship may be more effective in improving mental health outcomes in rural settings. Further longitudinal studies are warranted to explore the role of vitamin D in more vulnerable subgroups.

Purpose: This study explores the roles and scope of nursing practice in rural primary care across the United States, Canada, Australia, and the United Kingdom using a qualitative comparative case study. The implications for the use of nursing professionals in rural Korea are derived. Methods: A qualitative comparative case study approach was employed to examine how each country has institutionalized NPs or advanced nurse practitioners (ANPs) as key providers of rural primary care, focusing on their legal authority, roles, and integration into health systems. Results: In the studied countries, NPs or ANPs function as autonomous primary care providers in underserved rural areas, with authority in diagnosis, prescribing, and chronic disease management. In contrast, although Korean rural nurses-especially community health practitioners-often perform similar functions, their roles are not legally recognized, lack a defined scope of practice, and do not grant advanced practice authority. Conclusion: This gap in Korea's healthcare system limits both the autonomy and sustainability of rural primary care services. Based on international comparisons, this study highlights the need for (1) legal recognition of advanced nursing roles, (2) development of NP employment incentives, and (3) enhancement of rural nursing education and training. Strengthening nursing-led primary care in rural and underserved areas could improve healthcare accessibility and equity. The findings offer a foundational perspective for reforming Korea's rural healthcare system and developing institutional policies for the expansion of nurse practitioners.

Purpose: This study analyzes the literature published in the Journal of Korean Rural Nursing using topic modeling and latent Dirichlet allocation in order to identify key research topics and future directions for rural nursing research. Methods: Topic modeling was conducted using text network analysis to identify research trends by deriving the key research topics from 159 papers published in the Journal of Korean Rural Nursing from 2006 to 2024. The relationships among the topics were subsequently analyzed. Results: Seven key topics emerged from topic modeling analysis: community-based infection prevention and health practice capacity, chronic disease management and integrated care for older adults, lifestyle-related health behaviors and cardiovascular metabolic risk factors, community health resources and health and welfare services,mental health and quality of life during older adulthood, learner interaction and self-efficacy in nursing education, and health management and cognitive decline issues among female older adults. Conclusion: This study reveals the current trends in rural nursing research by analyzing key research topics and establishing the direction in which rural nursing research will proceed.