Effect of digital technology interventions for cognitive function improvement in mild cognitive impairment and dementia: A systematic review and meta-analysis.

The development and commercialization of digital therapeutics are increasing. The aim of this study was to determine the effects of digital technology interventions on cognitive function, thereby providing evidence for the development and practical application of interventions to manage cognitive function in patients with mild cognitive impairment and dementia. We conducted a systematic review and meta-analysis of randomized controlled trials according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Randomized controlled trials on digital technology interventions published until April 2023 were searched in PubMed, Embase, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases without a period limit. Articles that identified the effects of digital technology interventions on cognitive function improvement in dementia and mild cognitive impairment were integrated and analyzed. RevMan software 5.4 was used for quality assessment and meta-analysis. Twelve out of 708 studies were included in the review and meta-analysis. Digital technology interventions had significant effects on global cognitive function (standardized mean difference [SMD] = 0.31; 95% confidence interval [CI] = 0.04-0.57; p = 0.02; I² = 60%). In addition, these interventions had significant effects on neuropsychological characteristics, including attention (SMD = 1.17; 95% CI = 0.36-1.97; p = 0.004; I² = 84%), visuospatial perception (SMD = 0.68; 95% CI = 0.19-1.17; p = 0.006; I² = 57%), and memory (SMD = 0.45; 95% CI = 0.19-0.71; p = 0.0007; I² = 22%). The results suggest that digital technology interventions help improve cognitive function in patients with dementia and mild cognitive impairment.

[Keyword Network Analysis and Topic Modeling of News Articles Related to Artificial Intelligence and Nursing].

PURPOSE: The purpose of this study was to identify the main keywords, network properties, and main topics of news articles related to artificial intelligence technology in the field of nursing. METHODS: After collecting artificial intelligence-and nursing-related news articles published between January 1, 1991, and July 24, 2022, keywords were extracted via preprocessing. A total of 3,267 articles were searched, and 2,996 were used for the final analysis. Text network analysis and topic modeling were performed using NetMiner 4.4. RESULTS: As a result of analyzing the frequency of appearance, the keywords used most frequently were education, medical robot, telecom, dementia, and the older adults living alone. Keyword network analysis revealed the following results: a density of 0.002, an average degree of 8.79, and an average distance of 2.43; the central keywords identified were 'education,' 'medical robot,' and 'fourth industry.' Five topics were derived from news articles related to artificial intelligence and nursing: 'Artificial intelligence nursing research and development in the health and medical field,' 'Education using artificial intelligence for children and youth care,' 'Nursing robot for older adults care,' 'Community care policy and artificial intelligence,' and 'Smart care technology in an aging society.' CONCLUSION: The use of artificial intelligence may be helpful among the local community, older adult, children, and adolescents. In particular, health management using artificial intelligence is indispensable now that we are facing a super-aging society. In the future, studies on nursing intervention and development of nursing programs using artificial intelligence should be conducted.

Efficacy of psychosocial interventions for pregnancy rates of infertile women undergoing in vitro fertilization: a systematic review and meta-analysis.

PURPOSE: This study aimed to analyze the efficacy of psychosocial interventions for improving pregnancy rates in infertile women undergoing in vitro fertilization (IVF) treatment through a systematic review and meta-analysis. METHODS: Twelve studies were included in the meta-analysis. To estimate the effect size, a meta-analysis of the studies was performed using RevMan 5.3. The possibility of publication bias was evaluated using funnel plots and Egger's method. RESULTS: A statistically significant effect size (standardized mean difference [SMD] = 1.39; 95% confidence interval [CI] = 1.11-1.71; p = 0.004; I2 = 19%) was found for the 12 studies that investigated the effects of psychosocial interventions on clinical pregnancy rates. The psychosocial interventions that had a significant effect on pregnancy rates were mind-body interventions (SMD = 1.37; 95% CI = 1.01-1.85; p = 0.040; I2 = 0%) and cognitive behavioral therapy (SMD = 2.19; 95% CI = 1.17-4.13; p = 0.010). CONCLUSIONS: The results suggest that psychosocial interventions affect pregnancy rates. Moreover, they indicate that mind-body interventions and cognitive behavioral therapy are beneficial for improving the pregnancy outcome in infertile women undergoing IVF.

Effects of mobile-based cognitive interventions for the cognitive function in the community-dwelling older adults: A systematic review and meta-analysis.

Cognitive interventions that can be operated using mobile gadgets could facilitate the maintenance and improvement in the cognitive function of the community-dwelling elderly. The aims of this study was to estimate influences for mobile-based cognitive interventions in the community-dwelling elderly. A systematic literature search were conducted using various databases such as the Cochrane Library, PubMed, the Excerpta Medica Database, and Cumulative Index to Nursing and Allied Health Literature. Published articles up to August 2021 were searched without period limit. Integrated and analyzed RCTs' results that identified the effects of mobile-based cognitive interventions on the cognitive function of community-dwelling older adults with normal cognitive function. A meta-analysis was performed by RevMan 5.3 version. The methodological quality was assessed by the Cochrane Collaboration risk of bias tool. Registered with PROSPERO, the registration number is CRD42021268788. Overall, 6 randomized controlled trials identified from 400 articles were included in meta-analysis. The mobile-based cognitive interventions were found to have a significant effect on the short-term memory [standardized mean difference(SMD)= 0.22; 95% confidence interval (CI)=0.13,0.32; p<.001; I²=0%], working memory (SMD=0.70; 95% CI=0.02,1.37; p=.040; I²=81%), reasoning (SMD=0.27; 95% CI=0.11,0.42; p<.001; I²=25%), and executive function (SMD=0.62; 95% CI=0.09,1.16; p=.020; I²=0%). Finally, Egger's regression test and a funnel plot were conducted to examine publication bias; however, there was no significant bias. The mobile-based cognitive interventions had significantly affirmative effect on the older adults' executive function, reasoning, short-term memory, and working memory. Such programs may be employed as a supportive or an alternative method for improving their cognitive functions.

Effect of Life Satisfaction on Depression among Childless Married Couples: A Cross-Sectional Study.

Depression among childless middle-aged and elderly people is a serious social problem in Korea. However, few studies examine the influence of life satisfaction on the depression of spouses as actors and partners. Hence, this study analyzes the influence of life satisfaction (a positive factor childless married couples may have) on depression. This cross-sectional study employed data on couples to analyze the effect of life satisfaction on the depression of childless married couples as actors and partners via the actor-partner interdependence model. The Korea Longitudinal Study of Aging was employed to investigate life satisfaction and depression among 207 childless middle-aged and elderly couples. Regarding actor effects, wives' (ß = -0.285, p = 0.004) and husbands' (ß = -0.403, p < 0.001) life satisfaction significantly affected individual depression. Regarding partner effects, husbands' life satisfaction (ß = -0.255, p = 0.011) significantly affected wives' depression, and the wives' life satisfaction (ß = -0.375, p < 0.001) significantly affected husbands' depression. A childless actor's life satisfaction affected own and partner's depression. Thus, spouses should work together to improve their life satisfaction, thereby improving their depression.

Effects of Mind-Body Programs on Infertile Women: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

PURPOSE: This study was to systematically review randomized controlled trials and conduct a meta analysis. The results of randomized controlled trials were integrated and analyzed to assess the effects of mind-body programs on anxiety, depression, quality of life, and pregnancy rate in infertile women. METHODS: Using electronic databases (i.e., Research Information Sharing Service, Korean Studies Information Service System, Korean Medical Database, National Digital Science Library, Cochrane Library, PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and PsycARTICLES), 10 of 2,259 studies were included for meta-analysis. To estimate the effect size, a meta-analysis of the studies was performed using RevMan 5.3. RESULTS: The mind-body program was effective in relieving anxiety [standardized mean difference (SMD) = -3.44; 95% confidence interval (CI) = -5.94, -0.95; p = .007; I2 = 69%] and depression (SMD = -5.79; 95% CI = -10.36, -1.22; p = .010; I2 = 86%). Furthermore, it was effective in enhancing the quality of life (SMD = 7.40; 95% CI = 2.92, 11.88; p = .001; I2 = 53%) and pregnancy rate (SMD = 2.06; 95% CI = 1.08, 3.95; p = .030; I2 = 73%). The mind-body program was found to relieve anxiety and depression in infertile women and improve their quality of life, thereby positively affecting the pregnancy rate. CONCLUSION: The mind-body program was found to relieve anxiety and depression in infertile women and improve their quality of life, thereby positively affecting the pregnancy rate. The mind-body program needs to be considered to a wider audience for positive effects on emotions and pregnancy outcomes of infertile women.

Effect of resilience on infertile couples' quality of life: an actor-partner interdependence model approach.

BACKGROUND: Infertility is an emerging socioeconomic issue affecting an individual's life and the nation. However, only few studies have examined the influence of resilience on the quality of life (QoL) of spouses as actors and partners. Hence, this study aimed to analyze the influence of resilience, a positive factor that infertile couples may have, on QoL using the actor-partner interdependence model (APIM). METHODS: By the analyses of couples' data, we analyzed the effect of resilience on the QoL of infertile couples as actors and partners. This cross-sectional study included 150 infertile couples. The Fertility Quality of Life and Resilience Scale was used to measure couples' QoL and resilience. APIM was applied to analyze QoL. RESULTS: In terms of actor effects, the resilience of both wives (ß = 0.201, p <  0.001) and husbands (ß = 0.713, p <  0.001) had a significant effect on individual QoL. With regard to partner effects, husbands' resilience (ß = 0.351, p <  0.001) had a significant impact on wives' QoL and the wives' resilience (ß = 0.219, p = 0.009) had a significant impact on husbands' QoL. CONCLUSIONS: The resilience of an infertile actor was found to affect both his/her own QoL and his/her partner's QoL. In the future, if a program is to be developed to improve couples' QoL, both spouses should work together to improve their resilience, thereby improving their QoL.

[Prediction Models of Mild Cognitive Impairment Using the Korea Longitudinal Study of Ageing].

PURPOSE: The purpose of this study was to compare sociodemographic characteristics of a normal cognitive group and mild cognitive impairment group, and establish prediction models of Mild Cognitive Impairment (MCI). METHODS: This study was a secondary data analysis research using data from "the 4th Korea Longitudinal Study of Ageing" of the Korea Employment Information Service. A total of 6,405 individuals, including 1,329 individuals with MCI and 5,076 individuals with normal cognitive abilities, were part of the study. Based on the panel survey items, the research used 28 variables. The methods of analysis included a χ²-test, logistic regression analysis, decision tree analysis, predicted error rate, and an ROC curve calculated using SPSS 23.0 and SAS 13.2. RESULTS: In the MCI group, the mean age was 71.4 and 65.8% of the participants was women. There were statistically significant differences in gender, age, and education in both groups. Predictors of MCI determined by using a logistic regression analysis were gender, age, education, instrumental activity of daily living (IADL), perceived health status, participation group, cultural activities, and life satisfaction. Decision tree analysis of predictors of MCI identified education, age, life satisfaction, and IADL as predictors. CONCLUSION: The accuracy of logistic regression model for MCI is slightly higher than that of decision tree model. The implementation of the prediction model for MCI established in this study may be utilized to identify middle-aged and elderly people with risks of MCI. Therefore, this study may contribute to the prevention and reduction of dementia.

[Simulation-based education program on postpartum hemorrhage for nursing students]. / 산후출혈 산모 간호 ì‹œë®¬ë ˆì´ì ˜ 교육 프로그램의 효과.

Purpose: This study was conducted to develop a simulation-based postpartum care education program for women with postpartum hemorrhage and to verify the effects of the program on postpartum care. Methods: This program was developed according to the ADDIE model of instructional system design, which consists of analysis, design, development, implementation, and evaluation phases. This quasi-experimental study used a non-equivalent control group pre- and post-test design, and data were collected from April 23 to May 4, 2015. To verify the effects of the program, 33 nursing students in the experimental group participated in a simulation program, whereas 31 students in the control group were given a case study. Results: The experimental group had statistically significantly higher scores for clinical performance (t=-4.80, p<.001), clinical judgment (t=-4.14, p<.001), and learning satisfaction (t=-10.45, p<.001) than the control group. Conclusion: The results of this study indicate that the simulation-based postpartum care education program for women with postpartum hemorrhage was effective for developing students' competency, implying that a similar program should be integrated into the clinical training component of the maternal nursing curriculum.

Application of the European quality indicators for psychosocial dementia care in long-term care facilities in the Asia-Pacific region: a pilot study.

OBJECTIVES: An Asia-Pacific regional collaboration group conducted its first multi-country research project to determine whether or not European quality indicators (QIs) for psychosocial care in dementia could be implemented as a valid tool in residential aged care across seven Asia-Pacific sites (Australia, Hong Kong Special Administrative Region, Mainland China, Malaysia, Singapore, South Korea, and Thailand). METHOD: Following the European QI protocol, auditing and data extraction of medical records of consenting residents with dementia were conducted by trained auditors with relevant health care backgrounds. Detailed field notes by the auditors were also obtained to describe the characteristics of the participating care facilities, as well as key issues and challenges encountered, for each of the 12 QIs. RESULTS: Sixteen residential care facilities in the seven Asia-Pacific sites participated in this study. Data from 275 residents' records revealed each of the 12 Qis' endorsement varied widely within and between the study sites (0%-100%). Quality of the medical records, family and cultural differences, definitions and scoring of certain indicators, and time-consuming nature of the QI administration were main concerns for implementation. CONCLUSION: Several items in the European QIs in the current format were deemed problematic when used to measure the quality of psychosocial care in the residential aged care settings in participating Asia-Pacific countries. We propose refinements of the European QIs for the Asian-Pacific context, taking into account multiple factors identified in this study. Our findings provide crucial insights for future research and implementation of psychosocial dementia care QIs in this region.

Removal of Hexavalent Chromium in Portland Cement Using Ground Granulated Blast-Furnace Slag Powder.

Using ground granulated blast-furnace slag (GGBS) under different alkaline conditions, we studied the mechanisms and extents of Cr(VI) reduction and sorption and compared them to reactions with Portland cement (PC). We also investigated the effects of mixing PC/GGBS ratios on Cr(VI) dissolution after carbonating the substrates. We observed a complete sorption and reduction of Cr(VI) to Cr(III) in a GGBS-in-Ca(OH)2 solution (pH > ~12.5) after 10 h, whereas in distilled water (pH = ~11.5) GGBS exhibited only marginal sorption and reduction (20%). Cr reactions with dissolved ions in supernatants derived from GGBS indicated that the anions dissolved from GGBS act as a reducing agent for Cr(VI) in a Ca(OH)2 solution. Soft X-ray absorption microscopy identified a partial reduction of Cr(VI) to Cr(III) on the GGBS surface. The carbonation of pure PC paste substantially increased the amount of dissolved Cr(VI) in a solution phase whereas a 5 wt % replacement of PC with GGBS significantly reduced the amount of dissolved Cr(VI). We concluded that in the mixed paste during the early curing stage GGBS reduced a significant fraction of Cr(VI) to Cr(III) and that the Cr(III) adsorbed in the GGBS-PC mixture's hydration products does not readily dissolve, even under carbonation conditions.

Role of Adsorption Phenomena in Cubic Tricalcium Aluminate Dissolution.

The workability of fresh Portland cement (PC) concrete critically depends on the reaction of the cubic tricalcium aluminate (C3A) phase in Ca- and S-rich pH >12 aqueous solution, yet its rate-controlling mechanism is poorly understood. In this article, the role of adsorption phenomena in C3A dissolution in aqueous Ca-, S-, and polynaphthalene sulfonate (PNS)-containing solutions is analyzed. The zeta potential and pH results are consistent with the isoelectric point of C3A occurring at pH ∼12 and do not show an inversion of its electric double layer potential as a function of S or Ca concentration, and PNS adsorbs onto C3A, reducing its zeta potential to negative values at pH >12. The S and Ca K-edge X-ray absorption spectroscopy (XAS) data obtained do not indicate the structural incorporation or specific adsorption of SO42- on the partially dissolved C3A solids analyzed. Together with supporting X-ray ptychography and scanning electron microscopy results, a model for C3A dissolution inhibition in hydrated PC systems is proposed whereby the formation of an Al-rich leached layer and the complexation of Ca-S ion pairs onto this leached layer provide the key inhibiting effect(s). This model reconciles the results obtained here with the existing literature, including the inhibiting action of macromolecules such as PNS and polyphosphonic acids upon C3A dissolution. Therefore, this article advances the understanding of the rate-controlling mechanism in hydrated C3A and thus PC systems, which is important to better controlling the workability of fresh PC concrete.

Phase Changes of Monosulfoaluminate in NaCl Aqueous Solution.

Monosulfoaluminate (Ca4Al2(SO4)(OH)12∙6H2O) plays an important role in anion binding in Portland cement by exchanging its original interlayer ions (SO42- and OH-) with chloride ions. In this study, scanning transmission X-ray microscope (STXM), X-ray absorption near edge structure (XANES) spectroscopy, and X-ray diffraction (XRD) were used to investigate the phase change of monosulfoaluminate due to its interaction with chloride ions. Pure monosulfoaluminate was synthesized and its powder samples were suspended in 0, 0.1, 1, 3, and 5 M NaCl solutions for seven days. At low chloride concentrations, a partial dissolution of monosulfoaluminate formed ettringite, while, with increasing chloride content, the dissolution process was suppressed. As the NaCl concentration increased, the dominant mechanism of the phase change became ion exchange, resulting in direct phase transformation from monosulfoaluminate to Kuzel's salt or Friedel's salt. The phase assemblages of the NaCl-reacted samples were explored using thermodynamic calculations and least-square linear combination (LC) fitting of measured XANES spectra. A comprehensive description of the phase change and its dominant mechanism are discussed.

Interaction of aqueous Zn(II) with hematite nanoparticles and microparticles. Part 1. EXAFS study of Zn(II) adsorption and precipitation.

Sorption of Zn(II)(aq) on hematite (alpha-Fe2O3) nanoparticles (average diameter 10.5 nm) and microparticles (average diameter 550 nm) has been examined over a range of total Zn(II)(aq) concentrations (0.4-7.6 mM) using Zn K-edge EXAFS spectroscopy and selective chemical extractions. When ZnCl2 aqueous solutions were reacted with hematite nanoparticles (HN) at pH 5.5, Zn(II) formed a mixture of four- and six-coordinated surface complexes [Zn(O,OH)4 and Zn(O,OH)6] with an average Zn-O distance of 2.04+/-0.02 A at low sorption densities (Gammaor=3.38 micromol/m2), we observed the formation of Zn(O,OH)6 surface complexes, with an average Zn-O distance of 2.09+/-0.02 A, a Zn-Zn distance of 3.16+/-0.02 A, and a linear multiple-scattering feature at 6.12+/-0.06 A. Formation of a Zn(OH)2(am) precipitate for the higher sorption density samples (Gamma>or=3.38 micromol/m2) is suggested on the basis of comparison of the EXAFS spectra of the sorption samples with that of synthetic Zn(OH)2am. In contrast, EXAFS spectra of Zn(II) sorbed on hematite microparticles (HM) under similar experimental conditions showed no evidence of surface precipitates even at the same total [Zn(II)(aq)] that resulted in precipitate formation in the nanoparticle system. Instead, Zn(O,OH)6 octahedra (d(Zn-O)=2.10+/-0.02 A) were found to sorb dominantly in an inner-sphere, bidentate, edge-sharing fashion on Fe3+(O,OH)6 octahedra at hematite microparticle surfaces, based on an EXAFS-derived Zn-Fe3+ distance of 3.44+/-0.02 A. CaCl2 selective extraction experiments showed that 10-15% of the sorbed Zn(II) was released from Zn/HN sorption samples, and about 40% was released from a Zn/HM sorption sample. These fractions of Zn(II) are interpreted as weakly bound, outer-sphere adsorption complexes. The combined EXAFS and selective chemical extraction results indicate that (1) both Zn(O,OH)4 and Zn(O,OH)6 adsorption complexes are present in the Zn/HN system, whereas dominantly Zn(O,OH)6 adsorption complexes are present in the Zn/HM system; (2) a higher proportion of outer-sphere Zn(II) surface complexes is present in the Zn/HM system; and (3) Zn-containing precipitates similar to Zn(OH)2(am) form in the nanoparticle system but not in the microparticle system, suggesting a difference in reactivity of the hematite nanoparticles vs microparticles with respect to Zn(II)(aq).

Interaction of Zn(II) with hematite nanoparticles and microparticles: Part 2. ATR-FTIR and EXAFS study of the aqueous Zn(II)/oxalate/hematite ternary system.

Sorption of Zn(II) to hematite nanoparticles (HN) (av diam=10.5 nm) and microparticles (HM) (av diam=550 nm) was studied in the presence of oxalate anions (Ox2-(aq)) in aqueous solutions as a function of total Zn(II)(aq) to total Ox2-(aq) concentration ratio (R=[Zn(II)(aq)]tot/[Ox2-(aq)]tot) at pH 5.5. Zn(II) uptake is similar in extent for both the Zn(II)/Ox/HN and Zn(II)/Ox/HM ternary systems and the Zn(II)/HN binary system at [Zn(II)(aq)](tot)<4 mM, whereas it is 50-100% higher for the Zn(II)/Ox/HN system than for the Zn(II)/Ox/HM ternary and the Zn(II)/HN and Zn(II)/HM binary systems at [Zn(II)(aq)]tot>4 mM. In contrast, Zn(II) uptake for the Zn(II)/HM binary system is a factor of 2 greater than that for the Zn(II)/Ox/HM and Zn(II)/Ox/HN ternary systems and the Zn(II)/HN binary system at [Zn(II)(aq)]tot<4 mM. In the Zn(II)/Ox/HM ternary system at both R values examined (0.16 and 0.68), attenuated total reflectance Fourier transform infrared (ATR-FTIR) results are consistent with the presence of inner-sphere oxalate complexes and outer-sphere ZnOx(aq) complexes, and/or type A ternary complexes. In addition, extended X-ray absorption fine structure (EXAFS) spectroscopic results suggest that type A ternary surface complexes (i.e., >O2-Zn-Ox) are present. In the Zn(II)/Ox/HN ternary system at R=0.15, ATR-FTIR results indicate the presence of inner-sphere oxalate and outer-sphere ZnOx(aq) complexes; the EXAFS results provide no evidence for inner-sphere Zn(II) complexes or type A ternary complexes. In contrast, ATR-FTIR results for the Zn/Ox/HN sample with R = 0.68 are consistent with a ZnOx(s)-like surface precipitate and possibly type B ternary surface complexes (i.e., >O2-Ox-Zn). EXAFS results are also consistent with the presence of ZnOx(s)-like precipitates. We ascribe the observed increase of Zn(II)(aq) uptake in the Zn(II)/Ox/HN ternary system at [Zn(II)(aq)]tot>or=4 mM relative to the Zn(II)/Ox/HM ternary system to formation of a ZnOx(s)-like precipitate at the hematite nanoparticle/water interface.

Adsorption of organic matter at mineral/water interfaces: 7. ATR-FTIR and quantum chemical study of lactate interactions with hematite nanoparticles.

The interaction of the l-lactate ion ( l-CH3CH(OH)COO(-), lact(-1)) with hematite (alpha-Fe2O3) nanoparticles (average diameter 11 nm) in the presence of bulk water at pH 5 and 25 degrees C was examined using a combination of (1) macroscopic uptake measurements, (2) in situ attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy, and (3) density functional theory modeling at the B3LYP/6-31+G* level. Uptake measurements indicate that increasing [ lact(-1)]aq results in an increase in lact(-1) uptake and a concomitant increase in Fe(III) release as a result of the dissolution of the hematite nanoparticles. The ATR-FTIR spectra of aqueous lact(-1) and lact(-1) adsorbed onto hematite nanoparticles at coverages ranging from 0.52 to 5.21 micromol/m2 showed significant differences in peak positions and shapes of carboxyl group stretches. On the basis of Gaussian fits of the spectra, we conclude that lact(-1) is present as both outer-sphere and inner-sphere complexes on the hematite nanoparticles. No significant dependence of the extent of lact(-1) adsorption on background electrolyte concentration was found, suggesting that the dominant adsorption mode for lact(-1) is inner sphere under these conditions. On the basis of quantum chemical modeling, we suggest that inner-sphere complexes of lact(-1) adsorbed on hematite nanoparticles occur dominantly as monodentate, mononuclear complexes with the hydroxyl functional group pointing away from the Fe(III) center.

Critical thinking ability of associate, baccalaureate and RN-BSN senior students in Korea.

The purpose of this study was to compare the critical thinking ability of students enrolled in associate, baccalaureate, and Registered Nurse-Bachelor of Science in Nursing (RN-to-BSN) programs in Korea. The participants were 301 undergraduate nursing students. The instrument used for this study was the Watson & Glaser Critical Thinking Appraisal (WGCTA). The data were analyzed using descriptive statistics, t-test, and analysis of variance with Scheffe's multiple comparison. The average critical thinking ability score was 41.59. Bachelor of Science in Nursing (BSN) students scored significantly higher on critical thinking than the other 2 groups. Students < or = 22 years of age scored higher than the other age groups on critical thinking. This study provides preliminary evidence that the length and content of an educational program is as important as its focus on enabling students to develop their critical thinking abilities. This finding suggests a need to infuse critical thinking activities early in existing secondary school curricula as a way of encouraging students to develop their thinking abilities earlier.