Purpose: This study examined the impact of a virtual reality intervention program based on psychological needs on behavioral and psychological symptoms, apathy, and quality of life (QOL) in patients with dementia or mild cognitive impairment living in nursing facilities. Methods: This study is nonequivalent control group pretest-posttest design of quasi-experimental study. The study collected data from November 18, 2020 to July 24, 2021 from patients with dementia or mild cognitive impairment (30 in the experimental group and 30 in the control group) at three nursing facilities in G city using self-reporting and caregiver-informant reporting methods. The analysis employed the chi-square test, Fisher's exact test, paired t-test, independent t-test, Wilcoxon signed rank test, Mann-Whitney U, repeated measures ANOVA, GEE, using SPSS/WIN 27.0. Results: The severity of behavioral and psychological symptoms (Wald 𝛘² = 2.68, p = .102) and the care burden of caregivers (Wald 𝛘² = 1.72, p = .190) were not significant and was no significant time and group interaction effect (Wald 𝛘² = 0.63, p = .426, Wald 𝛘² = 0.52, p =. 471). The difference in apathy and QOL score were statistically significant for the group-time interaction (F = 43.65, p < .001; F = 4.35, p = .041). Conclusion: The virtual reality intervention program of this study shows a positive effect on the apathy reduction and QOL of patients with dementia or mild cognitive impairment residing in nursing facilities.

Purpose: The study aimed to understand the delirium experience of intensive care unit (ICU) patients. Methods: We performed a qualitative study using Colaizzi's phenomenological method. Eleven patients, who experienced delirium according to the Confusion Assessment Method for ICU, participated after transferring to general wards from the ICU. Individual in-depth semi-structured interviews ranging from 30 minutes to 2 hours in length were conducted between November 2018 and August 2019. Results: Nine themes and four theme clusters emerged. The four theme clusters were: 1) "Overwhelmed by fear," which describes the experience of a patient close to death and the feeling of difficulty in understanding disorganized thinking; 2) "Anxious about not understanding the situation," which means that patients' sense of time and space were disordered in the ICU; 3) "Being deserted," which indicates the feeling of being separated from others and yourself; and 4) "Resistance to protect my dignity," which indicates that the dignity and autonomy of an individual in the patient's position at the ICU, are ignored. Conclusion: Nursing interventions are needed that would enable patients to maintain orientation and self-esteem in the ICU. In addition, healthcare providers need to provide information about the unfamiliar environment in the ICU in advance.

Purpose: This study aimed to investigate the influence of social capital on the depression of older adults living in rural areas. Methods: Data sets were obtained from the 2019 Korea Community Health Survey. The participants were 39,390 older adults over 65 years old living in rural areas. Indicators of social capital included trust, reciprocity, network, and social participation. Depression-the dependent variable-was measured using the Patient Health Questionnaire-9 (PHQ-9). Hierarchical ordinal logistic regression was conducted to identify factors associated with depression after adjusting the data numbers to 102,601 by applying the Synthetic Minority Oversampling Technique (SMOTE). Results: The independent variables-indicators of social capital-exhibited significant association with the depression of older adults. The odds ratios of depression were higher in groups without social capital variables. Conclusion: To reduce depression, we recommend increasing social capital. Factors identified in this study need to be considered in older adult depression intervention programs and policies.

Purpose: This study aimed to construct and test a hypothetical model to explain the predictive factors and causal pathways for exercise levels in patients with ankylosing spondylitis based on the self-determination theory. A conceptual framework was constructed assuming that autonomy support by health care providers would satisfy the three basic psychological needs of patients, which would increase their autonomous motivation for exercise, resulting in its initiation and continuation. Methods: This cross-sectional study included 221 patients with ankylosing spondylitis who were visiting rheumatology clinics in two tertiary hospitals. Health Care Climate Questionnaire-exercise regularly, Basic Psychological Needs Satisfaction scale, Behavior Regulation in Exercise Questionnaire-2, and exercise level were used to collect data. Results: The fitness of the hypothetical model met the recommended level (𝛘²/df ≤ 3, SRMR ≤ .08, RMSEA ≤ .08, GFI ≥ .90, AGFI ≥ .85, NFI ≥ .90, TLI ≥ .90, CFI ≥ .90). The model effect analysis revealed that autonomy support by health care providers had a positive effect on patients' autonomy, competence, relatedness, autonomous motivation, and exercise level. Competence and relatedness had positive effects on autonomous motivation and exercise level, respectively. Autonomous motivation had a positive effect on exercise level. Conclusion: The predictive factors of exercise level in patients with ankylosing spondylitis were autonomous motivation, health care providers' autonomy support, competence, and relatedness. Considering these factors, we recommend the development of an effective program for improving exercise levels in these patients.

Purpose: Climate change has various negative effects on human health, which has resulted in increased burden on the health care system. Nurses contribute significantly to assessing climate-related health risks and creating a healthy environment. This study aimed to evaluate the reliability and validity of the Korean version of the Climate, Health, and Nursing Tool (K-CHANT) to measure nurses' awareness, motivation, concern, and behaviors at work and at home regarding climate change and health. Methods: The 22 items of English CHANT were translated into Korean with forward-backward translation techniques. Internal consistency reliability, test-retest reliability, and construct validity using confirmatory factor analysis were performed using SPSS WIN (25.0) and AMOS (26.0). Survey data were collected from 220 master's, doctoral, and post-doctoral nursing students. Results: The K-CHANT consists of 20 items across 5 domains. Two items of the original CHANT were excluded because of low content validity index and standardized regression weights. The internal consistency reliability of the K-CHANT, assessed by Cronbach's α was .81, with an intraclass correlation coefficient of .66~.90. The five subscales model was validated by confirmatory factor analysis (SRMR < .08, RMSEA < .08, AGFI > .70, CFI > .70). Conclusion: The K-CHANT has satisfactory construct validity and reliability to measure nurses' awareness, motivation, concern, and behaviors at work and at home regarding climate change and health. Future research should examine nurses' perceptions and behaviors related to the health effects of climate change and develop an action plan to improve it.

Purpose: This study discovered a substantive theory of the experience and process of peer support work among people with mental illness. Methods: The participants were members of community-based mental health facilities and had been working as peer supporters for more than six months. The data were collected through in-depth interviews with twelve participants and analyzed using Corbin and Strauss's grounded theory approach. Results: The core category was "becoming a healer going with patients in the journey of recovery," and the core phenomenon was "identity confusion as a peer supporter." The causal conditions were "starting peer support work without certainty" and "standing at the boundary between the therapist and patient." The intervening conditions were "willingness to become a successful peer supporter," "feeling a sense of homogeneity with the patient," "accepting the mental illness," and "support from people around." The action and interaction strategies were "letting go of greed," "being open about oneself," "developing professional skills," "maintaining wellness in the body and mind," and "being with the patient." The consequences were "becoming a useful person," "changing attitude toward life," "expansion of the sense of self-existence," "recovering from mental illness," and "discovering a role as peer supporter." Finally, the substantive theory of "becoming a healer going with patients in the journey of recovery" was derived. Conclusion: This study provides a holistic understanding of peer support work and the implications of interventions to help people with mental illness in a person-centered recovery process.

Purpose: This study examined characteristics and patterns of interorganizational networks for smoking prevention and cessation in Korea. Methods: We surveyed two community health centers, ninety-five hospitals or clinics, ninety- two pharmacies, and sixty-five health welfare organizations in two districts of Seoul in 2020. Data on the organizations' characteristics of smoking cessation and interorganizational activities for information sharing, client referral, and program collaboration were collected and analyzed using network statistics and blockmodeling. Results: Network size was in the order of information sharing, client referral, and program collaboration networks. Network patterns for interorganizational activities on information sharing, client referral, and program collaboration among four organizations were similar between the two districts. Community health centers provided information and received clients from a majority of the organizations. Their interactions were not unidirectional but mutual with other organizations. Pharmacies were involved in information sharing with health welfare organizations and client referrals to hospitals or clinics. Health welfare organizations were primarily connected with the community health centers for client referrals and program collaboration. Conclusion: A community health center is the lead agency in interorganizational activities for smoking prevention and cessation. However, hospitals or clinics, pharmacies, and health welfare organizations also participate in interorganizational networks for smoking prevention and cessation with diverse roles. This study would be evidence for developing future interorganizational networks for smoking prevention and cessation.

Purpose: This study was aimed at investigating the incidence and risk factors of dyslipidemia in menopausal women using a Korean community-based longitudinal study. Methods: The subjects were 245 postmenopausal women without dyslipidemia who had participated in the Ansan-Ansung cohort study from 2001~2002 (baseline) to 2015~2016 (seventh follow-up visit). The dyslipidemia incidence was measured as incidence proportion (%) and incidence rate per 100 person-years. The predictors of developing dyslipidemia were analyzed with Cox's proportional hazard model. Results: The incidence of new dyslipidemia during the follow-up period was 78.4% (192 patients), and 11.9 per 100 person-years. Mean duration from menopause to developing dyslipidemia was 5.3 years in new dyslipidemia cases. The triglyceride/high density lipoprotein (TG/HDL-C) ratio at baseline (hazard ratio = 2.20; 95% confidence interval = 1.39~3.48) was independently associated with developing dyslipidemia. Conclusion: Dyslipidemia occurs frequently in postmenopausal women, principally within five years after menopause. Therefore, steps must be taken to prevent dyslipidemia immediately after menopause, particularly in women with a high TG/HDL-C ratio at the start of menopause.

Purpose: The study aimed to translate the Couple Satisfaction Index (CSI 32) into Korean, to evaluate the reliability and validity of CSI 32 and short-form (CSI 16, 4) in the Korean context, and to determine a cut-off score for Korean couples. Methods: Korean Versions of the Couple Satisfaction Index (K-CSI) 32 was translated, back-translated, and reviewed by five bilingual experts. Confirmatory factor analysis (CFA) was conducted with data from a sample of 218 couples (N = 436) to test construct validity. Validity and reliability were evaluated. The receiver's operating characteristics curve analysis was used to obtain the cut-off score. Results: The construct validities of K-CSI 32, 16, and 4 were verified using one-factor structures. The results of CFA showed a slightly better fit for K-CSI 16 and 4 than for K-CSI 32. Convergent validity was supported by significant positive correlations of K-CSI with Kansas Marital Satisfaction Scale, Dyadic Adjustment Scale, and Family Relationship Assessment Scale. Moreover, the significant differences in K-CSI between normal and depressive group demonstrated known-group validity. Cut-off scores of 105.5 on K-CSI 32, 50.25 on K-CSI 16, and 13.25 on K-CSI 4 were validated to identify distressed couple relationships. Conclusion: For clinical practice, the reliable and valid K-CSI 32 has the potential to measure changes in couple satisfaction after couple therapy or interventions. Applying K-CSI 32 may facilitate research on couple and family relationships in nursing and contribute to the discussion on the role of couple satisfaction in mental health.