Purpose: This qualitative study aimed to explore and interpret the meaning and essence of end-of-life care as experienced by nurses in internal medicine wards caring for patients who had completed advance directives (AD). It sought to understand the psychological conflicts, ethical dilemmas, and evolving perceptions of care encountered by nurses during the end-of-life process. Additionally, the study focuses on providing foundational data to support the clinical implementation of the AD system, thereby contributing strategies that improve the quality of end-of-life care and uphold patients' rights and dignity in hospital settings. Methods: A qualitative content analysis was conducted using in-depth, semi-structured interviews with 12 nurses from internal medicine wards in tertiary hospitals located in Seoul and surrounding metropolitan areas. Participants had direct experience in providing end-of-life care for patients with ADs. Interviews focused on capturing nurses’ real-life experiences and reflections related to such care. Data were analyzed systematically following the eight-step qualitative content analysis method proposed by Downe and Wamboldt, allowing for the identification of meaningful categories, themes, and patterns. Results: Analysis revealed five major themes and 16 subthemes. The major themes included: (1) Experiences of repeated end-of-life care and advance directives in internal medicine wards, reflecting the frequent encounters of nurses with terminally-ill patients and their ADs; (2) Multifaceted experiences of end-of-life care based on ADs, suggesting the complexities of care shaped by the presence or absence of ADs; (3) Limitations and dilemmas in AD implementation, highlighting the ethical conflicts arising from low public awareness and inconsistent clinical practices; (4) Shifts in perceptions of life and death, including the development of practical attitudes towards death through repeated exposure to dying patients, illustrating the evolving views of nurses; and (5) Hopes for improving end-of-life care in internal medicine wards, emphasizing the need for enhanced care environments, educational support, and institutional backing. Conclusion: The findings underscore the importance of increasing awareness and improving the clinical application of ADs. Establishing systematic support structures is essential to respect patient autonomy and enhance the quality of end-of-life care in internal medicine wards.

Purpose: This study aimed to explore the experiences, essence, and structure of charge nurses operating in rotational appointment systems in tertiary hospitals. Methods: This qualitative study adopted a phenomenological approach. The participants were 11 charge nurses with rotational role experience working in tertiary hospitals in a metropolitan area. Data were collected through individual in-depth interviews lasting an average of 40~60 minutes and, conducted between July 8 and August 30, 2024. Colaizzi's phenomenological method was used for data analysis, which led to the identification of 35 themes, 14 theme clusters, and five categories. Results: The study revealed five categories: (1) ‘Taking the first step as a charge nurse,’ (2) ‘Enduring the weight of being a charge nurse,’ (3) ‘Creating my own charge nurse role,’ (4) ‘Mixed emotions returning after completing the rotation,’ and (5) ‘Ready to take the leap to the next level.’ The findings indicated that charge nurses experienced significant personal and professional growth while performing their roles. They demonstrated leadership, coordinated tasks and personnel, supported staff development, resolved issues, and facilitated communication. This role had a positive impact on both individual professional development and organizational efficiency. Despite initial feelings of anxiety and fear, charge nurses embraced challenges and contributed to improvements in organizational culture and patient safety while setting new goals for continuous growth even after completing their roles. Even in the post-term, they continued to expand their perspectives as nursing managers, increased their influence, and set new goals while pursuing ongoing growth and development. Conclusion: This study provides an in-depth understanding of the experiences of charge nurses in rotational systems in tertiary hospitals. Given the crucial role of charge nurses in the nursing leadership pipeline, it is essential to establish comprehensive hospital-wide programs to nurture leadership skills among front-line nursing managers and create supportive policies that fully enable their engagement.

Purpose: This study explored the comprehensive experiences of nurses who volunteered for medical services at Saemangeum Jamboree using a systematic qualitative Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis framework. Methods: Semi-structured in-depth interviews were conducted with 12 nurses between March and October 2024. The collected data were analyzed using a conventional content analysis methodology with ATLAS.ti 6.2 software. Subsequently, the derived subcategories were systematically organized and classified within a SWOT matrix framework to provide structured insights into the experiences of the volunteer nursing. Results: The comprehensive analysis yielded 125 meaningful codes, which were systematically categorized into 23 distinct sub-themes and ultimately structured into 14 overarching themes within the SWOT matrix framework. The identified strengths included nursing expertise and clinical competency, building therapeutic trust through patient-centered care, and creative problem-solving in crisis situations. The identified weaknesses included experiencing physical and emotional exhaustion, language barriers due to limited foreign language proficiency, and initial resource constraints that compromised the quality of care. The opportunities identified included patient thankfulness reinforcing commitment to duty and guardians, valuable experience in cross-disciplinary collaboration highlighting the importance of teamwork, and increased sponsorship resources throughout the event progression. The identified threats encompassed a lack of response from administrative organization, absence of standardized nursing protocols or manuals, occurrence of the coronavirus disease 2019, ambiguity in roles and responsibility, and insufficient measures to ensure physical safety in the service area. Conclusion: The comprehensive findings of this study suggest that maximizing the effectiveness of nurse volunteers and enhancing volunteer satisfaction in future large-scale international events requires strengthened pre-event training programs, establishment of a systematic resource management system, and development of comprehensive response protocols for various emergency situations. This study provides essential foundational data and practical insights for planning and operating medical volunteer programs at similar international events and contributes valuable knowledge to the field of disaster nursing and humanitarian healthcare delivery.

Purpose: This study aimed to explore the experiences of unmarried mothers with institutional living experiences in terms of adaptation and self-reliance in the community, as well as the factors that promote and hinder self-reliance. Methods: Data were collected through one-on-one in-depth interviews with six unmarried mothers who lived in unmarried mother-child family welfare facilities before and after childbirth and then moved to the community after leaving the facilities. Based on the collected data, a qualitative case study was conducted using Yin's method of analysis. Results: The results derived five units of analysis and eleven categories. The eleven categories were as follows: ‘The last space I relied on,’ ‘Preparing for self-reliance by adapting to community life’, ‘Choices of your own life,’ ‘Consideration of the environment for raising children,’ ‘Strengthening human capital,’ ‘Self-restraint to secure self-reliance fund,’ ‘Building a support system within a homogeneous group,’ ‘Policy and social service support,’ ‘Planning a future with your child,’ ‘Exterior and disconnection,’ and ‘Dilemma between non-national support recipients and national support recipients.’ Conclusion: Based on the results, we discuss the need for social welfare policies that consider changes in the characteristics of unmarried mothers, social service support, ways to improve social relationships, and the development of self-reliance programs.

Purpose: Despite being preventable, diabetes is a major non-communicable disease with a steadily increasing premature mortality rate. Diabetes can cause various complications if not properly managed; therefore, it is necessary to consistently implement management strategies, such as diet and exercise. However, in reality, there are several difficulties. Among these, a lack of motivation, which is a psychological factor, is a major barrier. Therefore, this study aimed to analyze intervention studies based on motivational and self-determination theories for patients with type 2 DM to seek solutions and present future directions. Methods: We searched and analyzed studies utilizing motivational and self-determination theories from 2013 to 2023 using the PubMed database. Results: One study applied Motivational Theory only, whereas the other two applied self-determination theory only. Most studies have utilized theories other than motivational and self-determination theories. As an intervention method, there were many studies that used group sessions of 4~6 or more times and used communication devices such as cell phones to convey, check, or encourage implementation of the mediation content. Among the quantitative studies, only 10 applied Motivational Theory to measure physiological variables. Nine of these studies tested HbA1c levels and reported effective results. In addition, four studies measured physical activity (three reported that it was effective) and seven studies measured socio-psychological variables, reporting that it improved diabetes knowledge and self-efficacy and reduced depression. Conclusion: According to the results of this study, it is beneficial to develop programs in the future by incorporating theories that have been confirmed to be significant, in addition to motivational and self-determination theories. Furthermore, the newly developed intervention program should be structured to increase implementation by providing four to six small group education sessions and forming networks between educators and subjects, as well as providing continuous management through communication tools such as social media and fostering a solid psychological foundation through religious and spiritual experiences so that patients can actively manage themselves(diet control and exercise management).