STRESS

Review Article

Occupational Stress, Coping, and Outcomes among Korean Nurses: An Integrative Review Based on the Transactional Model of Stress and Coping: Myungji Kim, Hyunkyung Choi; STRESS. 2025;33(3):127-135. Published online September 30, 2025; DOI: https://doi.org/10.17547/kjsr.2025.33.3.127

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Abstract PDF: Background
Korean nurses face high levels of occupational stress due to staff shortages and work overload. This stress varies depending on each individual’s cognitive appraisal and coping strategies and affects both the quality of nursing care and the well-being of the nurses themselves. Therefore, this study is intended to conduct a comprehensive investigation into the cognitive appraisal, coping strategies, and occupational stress outcomes of Korean nurses.
Methods
This integrative review study was based on Lazarus and Folkman’s transactional model of stress and coping. Literature published in Korean or English between March 1984 and July 2025 was reviewed using the RISS, KISS, DBpia, PubMed, and CINAHL databases.
Results
Fourteen studies (13 quantitative descriptive and 1 qualitative) were analyzed regarding occupational stress and coping strategies among nurses. Three key attributes were identified: a high level of occupational stress related to various factors, the use of active and passive coping strategies, and outcomes from coping with occupational stress. No study to date has specifically examined occupational stress appraisal.
Conclusions
It is important to develop strategies that help nurses actively cope with occupational stress, allowing for adaptive outcomes, rather than inefficient ones. These findings are expected to serve as foundational data for the development of occupational stress management programs. Future studies on nurses’ occupational stress will also need to include the concept of cognitive appraisal.

Original Articles

Effects of Loneliness on Stress in Middle-Aged and Older Adults: Sequential Dual Mediating Roles of Social Interaction Anxiety and Self-Control: Seung Chul Lee, Wonil Choi, SoYeong Yoon, Soo Rim Noh; STRESS. 2025;33(2):93-102. Published online June 30, 2025; DOI: https://doi.org/10.17547/kjsr.2025.33.2.93

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Abstract PDF: Background
The aim of this study is to identify the psychological pathways linking loneliness to stress among middle-aged and older adults, focusing on the mediating roles of social interaction anxiety and self-control.
Methods
A total of 580 adults aged 40∼71 years completed an online self-report questionnaire. Structural equation modeling was used to test a sequential mediation model, and covariates such as age, sex, depression, and extraversion were controlled for.
Results
Loneliness was positively associated with stress and social interaction anxiety, and negatively with self-control. Social interaction anxiety and self-control each mediated the relationship between loneliness and stress. Moreover, a significant sequential mediation pathway was observed: loneliness was associated with higher levels of social interaction anxiety, which in turn was negatively related to self-control, and lower self-control was linked to heightened stress. After controlling for covariates, only the indirect effect via social interaction anxiety remained significant. This suggests that anxiety in social contexts may serve as a robust emotional mechanism underlying the association between loneliness and perceived stress.
Conclusions
This study empirically supports the sequential mediation model in which loneliness increases social interaction anxiety, which in turn reduces self-control, ultimately elevating stress. These findings highlight the importance of considering both interpersonal and intrapersonal factors in mental health interventions for aging populations. Addressing loneliness, reducing social interaction anxiety, and strengthening self-control may be effective targets for psychological intervention and community-based programs tailored to the needs of middle-aged and older adults.

Moderated Mediating Effect of Anxiety by Household Type on the Relationship between Daily Life Stress and Non-Suicidal Self-Injury among Adolescents: RaeHyuck Lee; STRESS. 2024;32(4):188-195. Published online December 27, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.4.188

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2 Citations

Abstract PDF

Background
This study examined the impact of adolescents’ daily life stress on non-suicidal self-injury among adolescents, focusing on the mediating role of anxiety and the moderated mediating effect of anxiety by household type (two-parent vs. single-parent households).
Methods
This study utilized data from the Korean Teenagers’ Mental Health Study, conducted by the National Youth Policy Institute and applied the PROCESS macro method for analysis.
Results
First, daily life stress significantly increased the likelihood of non-suicidal self-injury among adolescents. Second, anxiety played a full mediating role. Third, no significant difference was observed in the direct impact of daily life stress on non-suicidal self-injury between adolescents from two-parent and single-parent households. Fourth, the mediating effect of anxiety on the relationship between daily life stress and non-suicidal self-injury was more pronounced among adolescents in single-parent households than those in two-parent households.
Conclusions
The findings highlight the need for tailored interventions to deal with non-suicidal self-injuries among adolescents, particularly in the context of household type.

Citations

Citations to this article as recorded by

The Influence of Attention-Deficit/Hyperactivity on School Adjustment among Adolescents: Focusing on the Moderated Mediation Effect of Depression by Household Economic Status
RaeHyuck Lee
STRESS.2025; 33(1): 13. CrossRef
The Influence of School Maladjustment on Non-Suicidal Self-Injury among Adolescents: Focusing on the Moderated Mediating Effect of Anxiety According to Single-Parent Family Status
RaeHyuck Lee, Jaekyoung Lee
STRESS.2025; 33(3): 155. CrossRef

Does Stress Affect Adolescent Anxiety by Mediating Sleep Time?: Si On Jang; STRESS. 2024;32(3):142-152. Published online September 30, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.3.142

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1 Citations

Abstract PDF

Background
Health is essential for the sustainable well-being, yet high stress, anxiety, and lack of sleep among Korean adolescents have become significant social concerns.
Methods
This study examined the impact of stress on anxiety and investigated whether sleep time mediates this relationship in 46,870 male and female adolescents, ranging from first-year of middle school students to third-year high school students. Data were obtained from the "18th Korea Youth Risk Behavior Survey" conducted by the Korea Disease Control and Prevention Agency.
Results
The analysis showed that increased stress was associated with reduced sleep time and higher anxiety levels, stress was found to heighten anxiety, partly by reducing sleep time.
Conclusions
Based on these findings, the study recommends: ① developing mental health indicators to quickly identify adolescents at risk for mental health issues, ② encouraging cooperation between schools, government agencies, healthcare providers to enhance access to mental health programs for adolescents, and ③ implementing policies that promote healthy behaviors, ensure adequate sleep, and improve overall well-being.

Citations

Citations to this article as recorded by

Comparative effects of music therapy and aromatherapy on stress, quality of life, and happiness among shift nurses in Korea: a randomized controlled trial
So-heun Lee, Won-jong Kim, Eun-Hi Choi, Myung-Haeng Hur
Journal of Korean Biological Nursing Science.2024; 26(4): 337. CrossRef

Review Article

An Integrative Review of Psychosocial Intervention Programs for Children and Adolescents who Experienced Traumatic Events: Eun-Mi Seol, Soo-Hyun Nam; STRESS. 2024;32(3):121-132. Published online September 30, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.3.121

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Abstract PDF: Background
This integrative review study aims to analyze the core components, intervention strategies, and effects of psychosocial intervention programs conducted for children and adolescents in Korea who have experienced traumatic events.
Methods
The integrative review involved a search of major domestic databases using key terms such as 'children’, 'adolescents’, 'trauma’, 'post-traumatic stress’, 'intervention’, and 'education’. A total of 10 studies were selected for analysis based on predefined criteria.
Results
The 10 selected studies were categorized into three types of interventions based on the environment and structure of the intervention delivery: individual-based interventions targeting only children and adolescents, family-based interventions involving family members, and school-based interventions conducted within schools. These interventions were found to be effective in addressing mental health issues caused by trauma in children and adolescents.
Conclusions
Despite the serious nature of traumatic experiences among children and adolescents, this integrative review found that domestic research on psychosocial interventions for this population lacks rigorous study design and is limited in the selection of participants and trauma events. Therefore, the study suggests the need for the development and dissemination of more proactive psychosocial interventions for children and adolescents. The findings of this study are expected to serve as foundational data for the development of trauma managing programs for this population.

Original Articles

Influence of the Negative Life Changes Experienced after Becoming Single Mothers on Parenting Stress: Focusing on the Moderated Mediation Effect of Depression by Low-Income Status: RaeHyuck Lee; STRESS. 2024;32(2):85-93. Published online June 28, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.2.85

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Abstract PDF: Background
This study examines the influence of negative life changes experienced after becoming single mothers and their influence on parenting stress, focusing on the moderated mediation effect of depression influenced by low-income status.
Methods
The research questions were tested by using raw data from the Survey of Single-parent Families and applying the PROCESS macro method.
Results
First, the negative life changes experienced after becoming single mothers were found to positively and significantly influence parenting stress. Second, a partial mediation effect was observed: The levels of negative life changes increased the levels of depression, which, in turn, increased the levels of parenting stress. Third, the mediating effect of depression on the relationship between single mothers’ negative life changes and parenting stress was more pronounced for those with low income compared to those with medium and high income.
Conclusions
This study suggests strategies to address single mothers’ parenting stress.

Stress and Coping of Self-Quarantined People Focusing on Negative Cases of the Coronavirus Disease: A Qualitative Study: Kyung Im Kang, Chanhee Kim, Min Hye Lee; STRESS. 2024;32(2):74-84. Published online June 28, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.2.74

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Abstract PDF: Background
In South Korea, many people have experienced self-quarantine due to coronavirus disease (COVID-19). This study explored stress, coping, and post-quarantine changes among people who were self-quarantined because of close contact but tested negative for COVID-19 in the early days of the pandemic.
Methods
Qualitative interviews were conducted with four focus groups, each comprising five people. Data were analyzed using inductive content analysis.
Results
Three categories of stress and coping during self-quarantine and post-quarantine changes emerged. First, the category of content related to stress comprised “problems that are difficult to handle alone.” The subcategories were “painful body and mind,” “the experience of being in a jail without bars,” and “repeated internal and external conflicts.” Second, the category for various stress-coping methods was labeled “struggling my way,” and the subcategories were “coping methods that helped me overcome” and “coping methods that added difficulty.” Finally, the category for changes after self-quarantine was labeled “more mature me.” The subcategories involved “thorough observation of infection prevention measures in daily life,” “living together,” and “a new realization of life.”
Conclusions
Our findings contribute toward developing online or offline health programs to help individuals who self-quarantined but tested negative for infectious diseases, allowing them to feel confident to self-quarantine in good health.

Academic Mental Health and Stress Mindset among High School Students: Job Demands-Resources Model: Ji-Eon Kim, Hyo-Shim Cho, Tae-Hyung Kwon, Eun-Young Kim, Ochir Erdenezaya Tsogt, Soohyun Cho; STRESS. 2024;32(2):66-73. Published online June 28, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.2.66

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Abstract PDF: Background
This study aimed to identify stress mindset as an intervention factor for academic stress management within the framework of the Job Demands-Resources Model. We investigated the role of a stress mindset in the relationship between academic demands, resources, burnout, engagement as academic mental health.
Methods
From the perspective of academic interpersonal perceptions, 391 first- and second-year high school students were analyzed using a structural equation model consisting of observed variables with demands and resources from parents, teachers, and peers.
Results
The low-stress mindset group showed a significant pathway from academic demands to academic burnout. The high-stress mindset group demonstrated pathways from academic resources to academic burnout and engagement.
Conclusions
These findings highlight the significance of a stress mindset in enhancing the academic mental health of high school students.

Relationship between Mindfulness and Stress Response in High School Students: Mediating Effect of Self-Regulation Ability: Yoonjung Choi, Mihee Lee, Jeongik Choi; STRESS. 2024;32(1):19-28. Published online March 28, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.1.19

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Abstract PDF: Background
This study explored the applicability of mindfulness meditation as an intervention approach in school counseling for managing daily stress in high school students. The study investigated the mediating effect of self-regulation ability on the relationship between mindfulness and stress response.
Methods
Data from 244 high school students (119 men and 125 women) were used to examine the mediating effect, controlling for academic variables using Hayes’ (2013) Process Macro Model 4.
Results
There was a positive correlation between mindfulness and self-regulation abilities, and mindfulness and self-regulation abilities were negatively correlated with stress response. Moreover, for students who perceived higher academic achievement levels, self-regulation abilities were positively correlated, and stress response were negatively correlated. Results showed a full mediating effect of self-regulation ability on the adverse relationship between mindfulness and stress response. The mediating effects of self-regulation modes were differentially observed in the adverse relationship between mindful consciousness and attitude dimensions of stress response.
Conclusions
These findings suggest that when applying mindfulness meditation as a daily stress management strategy for high school students, enhancing their self-regulation ability should be the focus of intervention.

Effect of Daily Stress on School Adjustment among Children at Community Child Centers: Mediating Roles of Inattention and Social Withdrawal: RaeHyuck Lee; STRESS. 2024;32(1):1-8. Published online March 28, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.1.1

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4 Citations

Abstract PDF

Background
This study verifies the influence of daily stress on school adjustment through inattention and social withdrawal among children at community child centers.
Methods
Analyses were performed on data collected from the Child Panel Survey of the Community Child Centers, followed by a series of regression analyses.
Results
First, daily stress had a negative and significant influence on school adjustment. Second, both inattention and social withdrawal among children mediated the influence of daily stress on school adjustment. Finally, the influence of daily stress on school adjustment was serially dual-mediated through inattention and social withdrawal.
Conclusions
This study presents evidence-based strategies that could help the school adjustment of children at community child centers.

Citations

Citations to this article as recorded by

The Influence of Attention-Deficit/Hyperactivity on School Adjustment among Adolescents: Focusing on the Moderated Mediation Effect of Depression by Household Economic Status
RaeHyuck Lee
STRESS.2025; 33(1): 13. CrossRef
Happiness experiences among South Korean elementary school students receiving local children’s center services: a qualitative study using Giorgi’s phenomenological method
Hae Kyung Jo
Child Health Nursing Research.2025; 31(2): 96. CrossRef
Moderated Mediating Effect of Anxiety by Household Type on the Relationship between Daily Life Stress and Non-Suicidal Self-Injury among Adolescents
RaeHyuck Lee
STRESS.2024; 32(4): 188. CrossRef
A Phenomenological Study on Breast Cancer Survivors' Experiences of Mind Subtraction Meditation
Mi Ra Yun
Asian Oncology Nursing.2016; 16(3): 158. CrossRef

The Moderating Role of Perceived Social Support in the Relation between Type D Personality and PTSD Symptoms among ICU and ER Nurses: Sohyeon Kim, Myung-Ho Hyun; STRESS. 2023;31(4):197-204. Published online December 28, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.4.197

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Abstract PDF: Background
This study examined the moderating effects of four types of perceived social support on the relation between type D personality and post-traumatic stress disorder (PTSD) symptoms among ICU and ER nurses.
Methods
Data were collected from 223 ICU and ER nurses in university or general hospitals located in Seoul. A questionnaire survey method was used for data collection and SPSS Windows 28.0 and PROCESS Macro Program were used for data analysis.
Results
The results showed that only the moderating effect of senior support was statistically significant, while perceived support from family, friends, and coworkers were not. Specifically, the effect of type D personality on post-traumatic stress disorder (PTSD) symptoms was weaker in ICU and ER nurses who perceived higher social support from senior nurses.
Conclusions
The study highlighted the significance of senior support in protecting the psychological health of ICU and ER nurses. Additionally, it addressed the major considerations in developing practical interventions in hospital settings.

Developing Smoking Cessation Program for Female Smokers and Assessment of Its Impacts: Kyung Hyun Suh; STRESS. 2023;31(4):189-196. Published online December 28, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.4.189

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Abstract PDF: Background
Female smokers find it challenging to quit smoking. The number of female smokers in Korea has not seen any decline. This study developed a smoking cessation program tailored for female smokers and evaluated its effectiveness.
Methods
The treatment group, which was subjected to the smoking cessation program, was composed of seven adult female smokers and five female college students who smoked. The control group comprised 7 adult female smokers and 5 female college students who wanted to quit smoking.
Results
Of the 12 participants in the control group, only 1 (8.3%) reported that she had maintained abstinence for 4 months and 1 week, while 5 (41.7%; 3 adults and 2 students) out of the 12 in the treatment group managed to abstain. For female smokers in this group, the motivation and empowerment to quit smoking increased significantly after participating in the program, and these positive effects were sustained for up to 3 months after the completion of the program.
Conclusions
Female smokers who participated in the program that was developed as part of this study exhibited a significant abstinence rate, and their motivation and empowerment to quit smoking improved. These results indicate that this smoking cessation program can be clinically useful in helping female smokers quit smoking.

The Mediating Role of Sleep Problems in the Relationship between Economic Hardship and Quality of Life: A Short-Term Longitudinal Study: Hansol Moon, Eun-Jung Shim; STRESS. 2023;31(4):175-181. Published online December 28, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.4.175

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Abstract PDF: Background
We examined the mediating effect of sleep problems on the relationship between economic hardship (i.e., economic stress and subjective socioeconomic status) and quality of life (QOL).
Methods
We analyzed data from 232 students who completed all three self-report surveys over the course of the semester, employing a simple mediation model examined by the SPSS PROCESS Macro.
Results
The findings revealed that higher levels of economic stress at Time 1 (T1) were associated with higher levels of sleep problems at T2 which, in turn, were associated with a poorer QOL at T3. In contrast, subjective socioeconomic status at T1 was not associated with sleep problems at either T2 or QOL at T3.
Conclusions
The current results suggest that improving sleep problems may be effective in mitigating the negative impact of economic stress on QOL among university students.

Influence of Single Parents’ Parenting Stress on Adolescent Children’s Internet Addiction: Focusing on the Moderating Effect of Family Economic Status: Jaekyoung Lee, RaeHyuck Lee; STRESS. 2023;31(3):142-147. Published online September 30, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.3.142

2,300 View
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Abstract PDF: Background
This study investigated the influence of parenting stress among single parents on the level of Internet addiction in their adolescent children, while also considering the moderating effect of family economic status.
Methods
An analysis was conducted using regression models to assess direct and moderating effects, utilizing data from the 2021 Survey of Single-parent Families, focusing on single parents with adolescent children.
Results
It was observed that single parents’ parenting stress had a positive and significant influence on the level of Internet addiction seen in their adolescent children. Furthermore, this influence was observed to be even stronger when the family’s economic status was lower.
Conclusions
This study empirically examined the influence of parenting and economic circumstances on the level of Internet addiction among adolescent children in single-parent families, drawing on nationally representative data. The study also underscored the need for diverse intervention strategies.

Qualitative Study on Patient Distress and Needs in Chronic Illness: Cardiovascular, Cerebrovascular, and Chronic Renal Diseases: Eun Jung Yang, Donghee Jeong, Bong-Jin Hahm, Eun-Jung Shim; STRESS. 2023;31(3):113-122. Published online September 30, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.3.113

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Abstract PDF: Background
We examined various types of distress and needs experienced by patients with chronic illness.
Methods
We conducted in-depth interviews with 35 patients with cardiovascular, cerebrovascular and chronic renal diseases.
Results
The majority of participants reported experiencing physical distress, such as pain from symptoms or after-effects. They also felt burdensome to others and saw a decrease in their social relationships because of physical limitations caused by their chronic illness. Besides symptom management, they expressed a need for psychological counselling to cope with psychosocial distress.
Conclusions
The findings suggest the importance of integrative management for patients with chronic illness, addressing both physical symptoms and psychosocial distress.

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