Research in Community and Public Health Nursing

Most-read articles are from the articles published in 2023 during the last three month.

Original Articles

[English] Digital Health Literacy and Associated Factors Among Older Adults Living Alone in South Korea: A Cross-Sectional Study: Minhwa Hwang, Gahye Kim, Seonghyeon Lee, Yeon-Hwan Park; Res Community Public Health Nurs. 2024;35(4):389-400. Published online December 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00766

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Abstract PDF: Purpose
This study aimed to examine the level of digital health literacy and identify factors associated with digital health literacy among older adults living alone in South Korea.
Methods
A cross-sectional study was conducted on 140 older adults aged 65 and above who live alone. Descriptive statistics and non-parametric methods were used to explore the relationship between digital health literacy and independent variables. A generalized linear model was used to identify factors associated with digital health literacy.
Results
Among 140 smartphone-owning older adults living alone, 52.1% were using the Internet via digital devices, and the participants’ average digital health literacy score was 6.64±7.46. Univariate analysis results showed significant differences in digital health literacy according to age, education level, and multimorbidity. The factors associated with digital health literacy were identified as gender (B=−0.36, p=.031), age (B=−0.06, p<.001), education level (B=0.12, p<.001), and sleep problems (B=−0.06, p=.006).
Conclusion
Despite widespread Internet and smartphone use, older adults living alone with chronic diseases showed low levels of digital health literacy, which were significantly associated with gender, age, education level, and sleep problems. Enhancing digital health literacy among vulnerable populations is crucial for the effective implementation of digital health services. Collaborative efforts, including tailored digital health interventions to enhance the digital health literacy of vulnerable populations and supportive policies, are essential to bridge the digital divide and promote health equity.

[English] The Burden Experience of Family Caregiver of Older Adults with Chronic Illness: Nova Yustisia, Titin Aprilatutini, Tuti Anggriani Utama, Mahmasoni Masdar; Res Community Public Health Nurs. 2023;34(2):85-95. Published online June 30, 2023; DOI: https://doi.org/10.12799/rcphn.2022.00304

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3 Citations

Purpose
This study aims to find out further about the burden on families in undertaking caregiving for the elderly with chronic illnesses.
Methods
A qualitative study was developed using in-depth interviews with 12 family caregivers selected by purposive sampling in July 2022. The thematic analysis was then carried out using the Colaizzi method, and N-Vivo 12 Qualitative Data Analysis Software was used to assist with the content analysis.
Results
The result from the experience interview analysis of caregivers participating in this study were 54 codes which were categorized into thirteen categories. Then, they were derived into four themes, as follows: 1) Physical burden of the caregivers for the elderly with chronic illness, 2) Psychological burden of the caregivers for the elderly with chronic illness, 3) Obstacle of caregivers for the elderly with chronic illness, 4) The state of caregivers who perform caregiving for the elderly with chronic illness.
Conclusion
The experience of caregivers in undertaking caregiving for the elderly with chronic disease has many obstacles, such as physical, psychological, and economic burdens. Caregivers often find positive aspects of their experiences while caregiving for the elderly, although their burden also constantly increases. Health facilities should pay serious attention to family caregivers and facilitate programs that can help reduce the burden on family caregivers.

Citations

Citations to this article as recorded by

Enhancing Communication and Empathy Skills in Geriatric Care: Nurses' Reflections on Simulation‐Based Training for Patient Interaction and Education
Sobhia Ahmed Abdel Kader Mohammed, Mostafa Shaban
Journal of Clinical Nursing.2025;[Epub] CrossRef
Mastering the Art of Caregiving: Instructional Approaches to Teaching Healthcare‐Related Procedural Skills to Informal Caregivers—An Integrative Review
An Ling Siew, Esther Yin Hui Chew, Ee‐Yuee Chan, Elaine Kee Chen Siow
Journal of Advanced Nursing.2025;[Epub] CrossRef
Relationship between Care Burden and Health Anxiety in the Family Caregivers of the Older Adults with Alzheimer’s Disease
Mohammad Sadegh Sargolzaei, Daniyal Kohestani, Tahereh Alsadat Khoubbin Khoshnazar, Hossein Asghari Asl
Ageing International.2024; 49(2): 280. CrossRef

Review Articles

[English] A Systematic Review of Questionnaire Measuring eHealth Literacy: Jung-Won Ahn, Mi Young Kim; Res Community Public Health Nurs. 2024;35(3):297-312. Published online September 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00752

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1 Citations

Abstract PDF

Purpose
This review aims to summarize the characteristics of currently used questionnaires measuring eHealth literacy and assess the quality of their psychometric properties in self-reported assessments within community settings.
Methods
The systematic analysis was conducted using the COnsensus-based Standards for the selection of health Measurement INstruments checklist to evaluate the methodological quality of studies on measurement properties.
Results
A total of 21 studies, including 19 questionnaires, were reviewed. The findings indicated that the quality of psychometric assessments for eHealth literacy was generally rated as 'good,' with most studies addressing multiple aspects of reliability and validity. Internal reliability, content validity, hypothesis testing, and responsiveness were particularly well-supported, each receiving over 10 sufficient ratings. However, there was limited evidence regarding measurement errors, test-retest reliability, criterion validity, and analyses of floor and ceiling effects.
Conclusion
This study contributes to the enhancement of eHealth literacy measurement tool selection and improves the reporting of their validity and reliability, thereby increasing the credibility of future research.

Citations

Citations to this article as recorded by

Current status of systematic review studies on patient-reported outcome measures published in Korean journals
Duck-Hee Chae, Jiyeon Lee, Eun-Hyun Lee
Research in Community and Public Health Nursing.2025; 36: 1. CrossRef

[English] Optimistic bias: Concept analysis: Miseon Shin, Juae Jeong; Res Community Public Health Nurs. 2024;35(1):112-123. Published online March 29, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00360

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Abstract PDF: Purpose
The purpose of this study was to analyze and clarify the concept of ‘optimistic bias.’
Methods
A review of the literature was conducted using several databases. The databases were searched using the following keywords: optimistic bias, optimism bias, and concept analysis. The literature on optimistic bias was reviewed using the framework of Walker and Avant’s conceptual analysis process.
Results
Optimistic bias can be defined by the following attributes: 1) underestimation of personal risk, 2) vague confidence, 3) positive future prediction and 4) lack of risk recognition. The antecedents of optimistic bias are as follows: 1) risk perception, 2) self-efficacy, and 3) risk controllability. The consequences of optimistic bias are as follows: 1) reduced anxiety, 2) providing emotional stability, 3) negative consequences for preventive health behavior, 4) lack of attention to risk-related information, and 5) negative consequences for self-protection behavior.
Conclusion
The definition and attributes of optimistic bias identified by this study can provide a common understanding of this concept and help to develop a nursing intervention program effective in preventing, protecting, and improving health of subjects in the field of nursing practice.

Original Articles

[English] Patterns of Adolescent Substance Use: A Comparative Study among the United States, Canada, England, and South Korea from 2014-2021: Chaehee Kim, Kihye Han, Jieun Kim, Alison M. Trinkoff, Sihyun Park, Hyejin Kim; Res Community Public Health Nurs. 2024;35(2):179-193. Published online June 28, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00535

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Abstract PDF: Purpose
This study aimed to identify the cross-national estimates of substance use, explore problematic substance use patterns among adolescents across countries and over time, and examine the relationship of individual characteristics on substance use patterns.
Methods
This study employed a time-series secondary data analysis spanning from 2014 to 2021 across four countries (United States, Canada, England, and South Korea). We analyzed the usage of five substances (alcohol, binge drinking, cigarettes, electronic cigarettes, and illicit drugs) alongside demographic characteristics. A descriptive analysis was performed to identify estimates of substance use across countries. Latent class analysis was employed to examine adolescents’ substance use patterns across time and countries. A multinomial logistic regression model was fit to assess the relationship between latent class and demographic characteristics.
Results
Adolescents in the United States and Canada had the highest substance use, while Korean adolescents had the lowest, particularly concerning drugs. Latent class analysis revealed two classes (light-user and heavy-user), with the addition of a third class (moderate-user) in some instances. The substance use patterns, while differing significantly among nations, exhibited consistency over time. During COVID-19, a decrease in heavy-substance users was observed across countries. Male or older participants were more likely to belong to the heavy-user class.
Conclusion
This research offers valuable insights into the variations in substance use patterns between nations and over time. A tailored approach is essential to prevent adolescents from becoming heavy-substance users. This approach should consider country regulations and demographics for a targeted and comprehensive preventive strategy.

[English] Factors Related to Smoking Relapse Within Six-Months of Smoking Cessation Among Inpatients: Ji Eun Bae, Chul-Woung Kim, Seung Eun Lee, Myungwha Jang; Res Community Public Health Nurs. 2023;34(4):307-319. Published online December 29, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00213

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Abstract PDF: Purpose
The purpose of this study is to identify factors associated with smoking relapse within 6 months after quit attempts among inpatients of a university hospital.
Methods
The subjects of this study were 572 inpatients of the National University Hospitals in Daejeon & Sejong who had enrolled in the smoking cessation service provided by the Daejeon·Sejong Tobacco Control Center and attempted to quit smoking. The data used in the study were extracted from the Smoking Cessation Service Integrated Information System. The Kaplan-Meier method and Cox Proportional hazards model were used to identify variables associated with smoking relapse within 6 months.
Results
The smoking relapse rate within 6 months was 76.7%, and variables associated with relapse included the absence of supporters for quitting smoking (hazard ratio [HR]=1.42, 95% confidence interval [CI]=1.00-2.02), nicotine dependence (HR=1.09, 95% CI=1.03-1.15), the use of prescription medications (including varenicline or bupropion) (HR=3.99, 95% CI=1.83-8.71), and the number of consultations (HR=0.67, 95% CI= 0.63-0.70).
Conclusion
As a result of the study, the number of consultations showed the strongest correlation with abstinence within 6 months. This implies that it is necessary to increase the counseling participation rate of the subjects so that smoking cessation counseling can be continued after discharge, and it is also required to provide support education to guardians during hospitalization for effective smoking relapse prevention.

[English] Smartphone dependency latent profile classification and association with emotional and behavioral difficulties among high school students in Korea: Eunjoo Kim, Min Kyung Song; Res Community Public Health Nurs. 2024;35(1):84-98. Published online March 29, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00465

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Abstract PDF: Purpose
The pervasive integration of smartphones into adolescents’ daily lives has resulted in a concerning upsurge in smartphone dependency among high school students. Due to the diverse types and severity levels of smartphone dependency, there is a critical need for research to explore its heterogeneity. This study aimed to identify latent profile of smartphone dependency in high school students based on the four subdomains of smartphone dependency: disturbance of adaptive functions, virtual life orientation, withdrawal, and tolerance. In addition, we explored how emotional and behavioral difficulties differ according to the profiles.
Methods
We used data from 2,195 Korean high school students from the Korean Children and Youth Panel Survey 2018. Latent profile analysis (LPA) was performed to identify smartphone dependency latent profile. Statistical analysis including chi-square test, Analysis of Variance (ANOVA), and ranked Analysis of Covariance (ANCOVA) confirmed differences in smartphone use characteristics and emotional-behavioral difficulties according to the classified latent profile.
Results
LPA identified four distinct latent profiles of smartphone dependency among high school students; 1) Underdependent type, 2) Moderate type, 3) Habitual user type, and 4) Virtual space dependent type. The results of ranked ANCOVA, controlling for gender, geographical location, economic status, parental smartphone dependency, and relational variables, revealed that habitual user type exhibited significantly higher rates of attention deficit hyperactivity disorder, social withdrawal, and depressive symptoms compared to other types.
Conclusion
The identification of these profiles provides a foundation for developing tailored intervention programs for adolescents with different levels and patterns of smartphone dependency.

[English] Effects of Virtual Reality Cardiopulmonary Resuscitation Practice on the Knowledge, Skills, and Attitudes of Nursing Students: A single-blind randomized controlled trial (RCT): Jui Kim, Jung-Hee Song, Young-Ok Ha; Res Community Public Health Nurs. 2024;35(4):415-423. Published online December 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00689

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Abstract PDF: Purpose
This study aimed to assess the effects of virtual reality (VR) cardiopulmonary resuscitation (CPR)—as compared to those of face-to-face Basic Life Support (BLS) education—on nursing students’ knowledge, skills, and attitudes.
Methods
Forty-four participants were recruited from nursing schools in Gyeonggi-do, Republic of Korea, and randomized into two groups: VR CPR (experimental group) and BLS (control group). The participants’ CPR knowledge, cardiac compression quality, self-efficacy, confidence, and attitudes toward education were evaluated.
Results
At enrollment, the control and experimental groups showed similar results for all the variables. After the intervention, results showed that the cardiac compression score and the hand position accuracy in the experimental group were significantly higher than in the control group. Meanwhile, knowledge, self-efficacy, and confidence were improved in both groups, though there was no significant difference between the two groups.
Conclusion
The study results showed that VR CPR education is just as effective as face-to-face BLS training for nursing students. Therefore, developing high-quality VR educational content in the future is necessary.

[English] Factors affecting cultural adaptation stress by gender among multicultural adolescents in Korea: Seungwoo Han; Res Community Public Health Nurs. 2023;34(4):320-331. Published online December 29, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00276

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Abstract PDF: Purpose
This paper is a descriptive survey research to identify factors that affect acculturation stress in multicultural adolescents, and provide basic information that can be used to develop ways to improve their mental health.
Methods
This study used the data of the 2nd multicultural adolescents panel study provided on December 30, 2022 by the National Youth Policy Institute. The subjects of this study were 1,520 multicultural adolescents in the fourth grade of elementary school and the survey period was from July to November 2020. The dependent variable was acculturation stress, and the explanatory variables were as follows: mother’s and father’s country of origin, region size, home economic conditions, academic achievement, experience of discrimination, mother’s level of education, father’s level of education, and number of close friends. Data analysis involved calculation of descriptive statistics, analysis of differences in the level of acculturative stress and general characteristics between male and female adolescents, and multiple regression analysis.
Results
This study found that there are gender differences in significant influencing factors for acculturation stress among multicultural adolescents. For males, factors influencing acculturation stress were identified as regional size, mother's education level, parental support, and teacher support. For females, they were regional size, experience of discrimination, number of close friends, parental support, and self-esteem.
Conclusion
The results of this study suggest that psychiatric nurses should provide psychiatric nursing and counseling to multicultural adolescents in addition to clinical psychiatric nursing. Various mental health programs should be developed for multicultural adolescents, with a focus on counseling, education, and family therapy.

Review Article

[English] Factors Related to Diabetes Self-Care among Immigrants in the United States: A Scoping Review: Jung Eun Kim; Res Community Public Health Nurs. 2023;34(2):171-182. Published online June 30, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00094

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Abstract PDF

Purpose
The purpose of this scoping review was to explore related factors in diabetes self-care among immigrants in the U.S. Diabetes is one of the fastest-growing chronic illnesses, but little is known about factors in self-care among minority immigrants in the U.S.
Methods
The Arksey and O’Malley (2005) methodological framework guided this review, which examined 16 articles, including qualitative, quantitative, and mixed-methods designs. PRISMA guidelines were used with five Databases. Search terms included: immigrants in the U.S., type 2 diabetes, self-care, and self-management.
Results
Factors related to diabetes self-care among immigrants were identified: (1) changed dietary lifestyle, (2) low economic and health insurance, (3) social support and resources, (4) low English proficiency, (5) psychological contexts, and (6) gender roles.
Conclusion
Given the culturally unique related factors in diabetes self-care among immigrants, healthcare professionals must be knowledgeable and responsive to the ethnic minority immigrants’ needs to promote effective diabetes self-care.

Citations

Citations to this article as recorded by

Educational Needs and Priorities of People with Diabetes and Healthcare Providers in South Korea: A Mixed-Methods Study
Shinae Seo, Chun-Ja Kim, Hee Sun Kang, Elizabeth A. Schlenk
Journal of Transcultural Nursing.2025; 36(2): 195. CrossRef
Effectiveness of a Person-Centered and Culturally Sensitive Course of Treatment in Arabic-, Turkish-, and Urdu-Speaking Individuals With Type 2 Diabetes (the ACCT2 Study): Protocol for a Pragmatic Randomized Controlled Trial
Natasja Bjerre, Lene Christensen, Christina Hoeiberg, Cecilie Ottosson, Mie Klarskov Jensen, Nanna Kildsig, Trine Kjeldgaard Møller, Anne-Ditte Termannsen, Bettina Ewers, Britt Hollender-Schou, Rikke Molin Grue, Ulla Bjerre-Christensen, Solveig Jansen, Ka
JMIR Research Protocols.2025; 14: e67319. CrossRef

Original Articles

[English] Bidirectional Relationship Between Depression and Frailty in Older Adults aged 70-84 years using Random Intercepts Cross-Lagged Panel Analysis: Ji Hye Shin, Gyeong A Kang, Sun Young Kim, Won Chang Won, Ju Young Yoon; Res Community Public Health Nurs. 2024;35(1):1-9. Published online February 29, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00381

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2 Citations

Abstract PDF

Purpose
Depression and frailty are common health problems that occur separately or simultaneously in later life. The two syndromes are correlated, but they need to be distinguished to promote successful aging. Previous studies have examined the reciprocal relationship between depression and frailty, but there are limitations in the methods or statistical analysis. This study aims to confirm the potential prospective bidirectional and causal relationship between depression and frailty.
Methods
We used data from 887 older adults aged 70 to 84 from the Korean Frailty and Aging Cohort Study (KFACS) in 2016, 2018, and 2020 (3 waves). We separated the within-individual process from the stable between-individual differences using the random intercepts cross-lagged panel model.
Results
Significant bidirectional causal effects were observed in 2 paths. Older adults with higher depression than their within-person average at T1 had a higher risk of frailty at T2 (β=.22, p=.008). Subsequently, older adults with higher-than-average frailty scores at T2 showed higher depression at T3 (β=.14, p=.010). Autoregressive effects were only significant from T2 to T3 for both constructs (Depression: β=.16, p=.044; Frailty: β=.13, p=.028). At the between-person level, the correlation was significant between the random intercepts between depression and frailty (β=.47, p<.001).
Conclusions
We find that depressed older adults have an increased risk of frailty, which contributes to the onset of depression and the maintenance of frailty. Therefore, interventions for each condition may prevent the entry and worsening of the other condition, as well as prevent comorbidity.

Citations

Citations to this article as recorded by

Four-year associations of wish-to-die trajectories with changes in the frailty of European citizens aged 50 and over
Marcelo de Maio Nascimento, Adilson Marques, Gerson Ferrari, Francisco Martins, Cíntia França, Élvio R. Gouveia, Andreas Ihle
Journal of Affective Disorders.2025; 379: 624. CrossRef
Suicide in later life: the role of frailty and depression
Brian Draper, Anne P.F. Wand
Current Opinion in Psychiatry.2025;[Epub] CrossRef

[English] Analysis of Educational Needs of Home Care Nurses: Utilizing Borich’s Needs Assessment and the Locus for Focus Model: Dasom Kim, Hyeongsu Kim, Young Ko; Res Community Public Health Nurs. 2024;35(3):240-253. Published online September 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00605

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Abstract PDF: Purpose
This study analyzed educational needs of home care nurses to improve the quality of home care service and identify priority educational subjects.
Methods
This study analyzed the training priorities of 54 home care nurses working at community service centers or public health centers in Seoul, Korea, using the Borich Needs Assessment and the Locus of Focus model. The home care nurses’ tasks were categorized into 21 tasks and 85 task elements.
Results
Six priority educational subjects were identified: 1) health assessment and monitoring, 2) nursing records and information management, 3) health education and counseling techniques, 4) home care supplies management, 5) recipient identification and communication skills, and 6) care recipient classification and management. Activities related to one-on-one health management, such as health screening, measurements, and disease management counseling, were found to be high priorities. In contrast, small group program planning and operation were rated as a low priority.
Conclusion
This study underscores the importance of incorporating identified educational needs into training curricula for home care nurses. Regular assessment and integration of these needs into educational programs are crucial for enhancing nursing competence and service quality.

[English] Factors Associated with Nurse Self-Leadership: A Cross-Sectional Study of Nurses Working at Public Health Centers and Primary Healthcare Posts: Saeryun Kim, Younkyoung Kim; Res Community Public Health Nurs. 2024;35(3):195-206. Published online September 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00493

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Abstract PDF Supplementary Material: Purpose
This study aimed to analyze the factors influencing self-leadership among public health nurses as they implement health promotion projects in public health centers and primary healthcare posts.
Methods
The study sampled 120 public health nurses from 22 public health centers and their associated primary healthcare posts in J province. Data were collected from October 11 through October 25, 2022.
Results
Employment at a primary healthcare post instead of a public health center (β=.23, p=.012), was significantly associated with self-leadership in model 1 (adjusted R2=.17, F=4.56, p<.001). Furthermore, communicative competence (β=.48, p<.001) and nursing professionalism (β=.26, p=.001) were significantly associated with self-leadership in model 2 (adjusted R2=.51, F=14.77, p<.001).
Conclusion
Open and self-directed work environments, along with opportunities for education and training, are necessary to enhance communicative competence and nursing professionalism. These improvements may, in turn, strengthen self-leadership among nurses, facilitating the implementation of health promotion projects within public health institutions.

[English] Priorities of Family Caregivers in Preserving Functional Abilities of Individuals with Alzheimer's Disease Living at Home: A Best-Worst Scaling Approach: Eunhye Cho, Youngran Yang, Hyun Kyung Kim, Hye Young Kim; Res Community Public Health Nurs. 2024;35(2):156-167. Published online June 28, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00556

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Abstract PDF Supplementary Material: Purpose
The decline in cognitive abilities among individuals with Alzheimer’s disease significantly impacts their Activities of Daily Living (ADLs), creating challenges and stress for their caregivers. This study aimed to investigate the priorities of family caregivers of community-dwelling individuals with Alzheimer's disease concerning the preservation of their loved ones' ADLs.
Methods
We employed a cross-sectional design with a best-worst scaling approach (BWS), and developed a BWS questionnaire utilizing the 10 daily living items from the Disability Assessment for Alzheimer’s Disease scale. This questionnaire was administered to 132 caregivers of individuals with Alzheimer's disease. Data analysis was conducted using SPSS WIN 21.0 and the R statistical program.
Results
The results revealed that "using the toilet without accidents" emerged as the top-ranked ADL that family caregivers preferred to preserve for the longest duration among individuals with Alzheimer's disease living at home. In contrast, "Managing money appropriately" was identified as a daily living activity considered relatively less critical to preserve. The study further indicated a preference among caregivers for preserving physical ADLs over instrumental ADLs.
Conclusion
This research provides clinical evidence shedding light on the priorities of family caregivers in preserving the functional abilities of individuals with Alzheimer's disease within the community.

[English] Impact of Marital Dissolution Timing and Duration on Self-Rated Health of Marriage Immigrants in Single-Person Households in South Korea: Duckhee Chae, Kyeong Hwa Kang, Nakyung Kim, Keiko Asami, Jongdae Kim; Res Community Public Health Nurs. 2025;36(1):122-129. Published online March 31, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01011

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Abstract PDF: Purpose
This study examined associations between timing of marital dissolution, duration since marital dissolution, and self-rated health among marriage immigrants in South Korea who live in single-person households.
Methods
This cross-sectional study employed a secondary analysis of data from the 2021 Korean National Multicultural Family Survey. We performed binary logistic regression analyses to examine the relationships between the variables of interest while controlling for social support, economic well-being, psychological well-being, and sociodemographic characteristics. Data from 407 marriage immigrant single-person households were included in the analyses.
Results
Marriage immigrants’ self-rated health fluctuated over time but generally exhibited a downward trend following marital dissolution. After controlling for confounders, marital dissolution after age 50 and longer duration since dissolution (e.g., 3-6 years and 9+ years) were associated with increased odds of poor self-rated health. Unemployment and depressive symptoms significantly increased the odds of poor self-rated health, while higher social support had a protective effect.
Conclusion
Transitioning to singlehood after marital dissolution may have long-term negative health consequences, particularly for those experiencing this transition later in life. Proactive interventions focusing on social support and health resource acquisition within the initial 3 years of separation may be crucial to mitigate health decline.

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