Current Status of Intervention Studies on Korean Firefighters and Recommendations for Further Research: A Scoping Review

Current Status of Intervention Studies on Korean Firefighters and Recommendations for Further Research: A Scoping Review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Current Status of Intervention Studies on Korean Firefighters and Recommendations for Further Research: A Scoping Review Hanbit Jin, Hyungsun Jun, Jisu Ha, Inae Youn, Jungtae Leem This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4446023/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Firefighters in Korea experience a range of health issues due to the unique demands of their profession and the organizational culture within which they operate. However, to date, there has been a paucity of intervention studies reflecting the specific characteristics of firefighters. Therefore, this scoping review aimed to identify the current status and characteristics of intervention studies on firefighters in Korea and to make recommendations for further research. Methods The review was conducted in seven stages, in accordance with the methodological guidelines for scoping reviews framed by the Joanna Briggs Institute. For reporting, we adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. The literature search included articles published in Korean and international journals till January 25, 2024. Data were extracted according to a previously developed analysis framework and the Template for Intervention Description and Replication checklist. The protocol for this study was registered with the Open Science Framework and can be accessed via the following link: https://osf.io/s378j/ . Results A total of 35 articles were included in the review. The analysis revealed an imbalance in terms of research topics, design, outcome variables, and delivery format of interventions in the design and content of the reviewed studies. In terms of research ethics, researchers must ensure that the rules and guidelines regarding bioethics are followed. The review also highlighted a lack of research that reflected the characteristics and needs of firefighting organizations. Conclusions Future research must include various intervention studies on firefighters’ health problems and implement sensitive research designs that consider research ethics. It is also important to listen to the needs of firefighting organizations and collaborate with experts with firefighting knowledge to create flexible research designs that can accommodate the characteristics of individual firefighters and organizations. Republic of Korea Firefighter Intervention study Scoping review Figures Figure 1 Background Firefighters are employed in a complex occupational environment, characterized by a number of specific job characteristics and organizational climates. The job characteristics of firefighters can be summarized as follows: “hazardousness,” “uncertainty,” “shift work,” “urgency,” and “role ambiguity” [ 1 ]. The term “hazardousness” refers to job characteristics involving various risk factors such as physical injuries and psychological trauma that occur during job performance. Uncertainty implies that disasters are inherently uncertain [ 2 ], necessitating firefighting organizations to be on standby 24/7 to respond to unforeseeable disasters. Further, Article 13 of the "Firefighter Duty Regulations" (Work Method of 119 Safety Centers) [ 3 ] states that shift work should typically follow a three-shift system (three shifts, two rotations). However, in cases where firefighting conditions render this impractical, a two-shift system (two shifts, one rotation) may be used if the workload permits. The attribute of urgency implies that in urgent situations such as fires and disasters, swift dispatch and arrival at the scene are crucial for minimizing disaster spread [ 4 ], necessitating firefighters to maintain alertness even during standby. Unpredictable situations occur repeatedly during emergency dispatches and on-site activities; however, the individual discretion of firefighters is limited. Role ambiguity arises when there is inadequate clarity regarding roles or information about a scene [ 5 ]. This has been shown to have a significant negative impact on job performance, particularly in complex job roles such as firefighting [ 6 ]. The job characteristics of firefighters are not universally applicable. Firefighting organizations perform various tasks, including responding to disaster scenes, emergency treatment and transportation of patients, disaster prevention, computational work, communication, and 119-reporting tasks. Therefore, individualized psychological and social interventions targeting firefighters are essential because the personal situations of individuals and their environments differ [ 7 ]. However, individualized interventions carry the risk of disclosing personal information, necessitating a careful research design. Identifying at-risk groups and providing interventions can involve stigmatization; therefore, caution is necessary. Firefighters are often perceived as emphasizing trustworthiness and robustness because of the nature of their profession. This perception leads to concerns about experiencing disadvantages or being perceived as weak because of mental health treatment [ 8 ]. Moreover, firefighting organizations are characterized by hierarchical organizational climates that prioritize rank in the performance of hazardous duties. If elements of prejudice and discrimination against the vulnerable are tolerated in such organizational climates, stigmatization may occur [ 9 ]. The social condemnation and decreased self-esteem associated with stigma have been demonstrated to have deleterious effects on individuals' reputations and professional careers [ 10 ]. Consequently, interventions targeting firefighters should be designed considering the job characteristics and organizational climate of firefighting organizations. Firefighters are frequently exposed to environments that can cause physical injuries and psychological trauma. The uncertainty of firefighting duties has been shown to negatively affect job performance, sleep patterns, and social/familial relationships [ 11 ]; moreover, shift work-related circadian rhythm sleep-wake disorders can significantly impair mental and physical health [ 12 ]. Furthermore, the urgency of firefighting tasks to meet the golden hour for firefighting, rescue, and emergency medical activities can lead to circadian rhythm disruption and stress [ 13 ]. A systematic review on non-cancerous health risks among firefighters [ 14 ] found that firefighters have a higher risk of mental disorders, hearing impairment, myocardial infarction, and ischemic stroke than the general population. The International Agency for Research on Cancer has classified firefighting as a Group 1 carcinogen owing to the elevated risk of cancer associated with occupational exposure among firefighters. Additionally, firefighters frequently sustain injuries during urgent on-site activities, with musculoskeletal injuries such as tension, sprains, and muscle pain accounting for 36% of the cases [ 15 ]. These health issues among firefighters have been demonstrated to negatively impact their job performance [ 16 ], as indicated by a 60% higher rate of turnover due to health problems observed among firefighters than among workers in other fields [ 17 ]. Consequently, firefighter health issues extend beyond individual concerns to encompass socio-economic losses [ 18 ], underscoring the importance of implementing interventions to address these health concerns. These issues necessitate structured programs tailored to the characteristics of firefighters for prevention, treatment, and case management. Intervention studies are necessary to develop and evaluate these programs. While numerous intervention studies targeting Korean firefighters have been conducted, most have been group-based face-to-face programs. However, they have been criticized for not adequately reflecting the characteristics of firefighters and the demands of their work environment [ 19 ]. Group-based face-to-face programs are typically conducted in the workplace during working hours. In such cases, there is often a lack of safe and comfortable spaces outside the workplace for conducting counseling sessions with high-risk groups for specific conditions, which may result in some participants refusing to participate [ 20 ]. Additionally, practitioners of the "Visiting Counseling Center for Firefighters," organized by the National Fire Agency, have often found it challenging to meet research participants due to urgent deployments [ 21 ]. Another issue, as evidenced by a study targeting 119 emergency medical technicians, is that while most fire stations (88.3%) operate health management programs, they mostly focus on operating fitness facilities or holding special lectures, thus lacking diversity [ 22 ]. Problems with health management programs include programs that do not meet the demands of the participants, one-time operations, and coercion to participate, resulting in low satisfaction [ 22 ]. From the perspective of firefighter health and safety policies, ensuring anonymity among users of mental-health-related programs has emerged as a significant issue [ 23 ]. Although numerous literature reviews have been conducted on the health problems of Korean firefighters, most have focused on specific areas such as mental health and psychological intervention studies [ 20 , 21 , 24 ], post-traumatic stress disorder (PTSD) [ 25 – 27 ], and suicidal ideation [ 28 ], thus limiting their scope. Moreover, no literature review has examined whether these studies reflect firefighter characteristics. The objectives of this study were as follows: first, to ascertain the current status and characteristics of intervention studies for firefighters in Korea; second, to determine the extent to which intervention studies for firefighters in Korea reflect the characteristics of firefighters; and third, to propose recommendations for designing intervention studies for firefighters in Korea. Furthermore, we aim to conduct a series of research projects in the future to identify the unmet health needs of firefighters and promote their health through a combination of qualitative research [ 29 ], survey research, and retrospective chart reviews. Methods This study employed a scoping review methodology to understand the current status and characteristics of intervention studies targeting Korean firefighters and to provide recommendations for subsequent research [ 30 ]. The scoping review methodology comprises seven steps, based on the methodological guidance provided by the Joanna Briggs Institute [ 31 ]. Furthermore, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist [ 32 ] for reporting. The protocol for this study was registered on the Open Science Framework and can be accessed at https://osf.io/s378j/ . Review questions The following research questions will be addressed in this study: (1) What is the current status and characteristics of intervention studies on Korean firefighters published in academic journals since 2010? (2) With respect to the aforementioned studies, to what extent have their study designs considered firefighters’ characteristics? Inclusion criteria Therapeutic interventions can be defined as intentional engagement in difficult situations to improve or prevent the worsening of problems, leading to positive physical or mental outcomes or beneficial effects [ 33 ]. Intervention studies targeting firefighters encompass multidisciplinary perspectives, including medicine, nursing, social sciences, engineering, arts, physical education, agriculture, and marine sciences. In each discipline, terms such as "treatment," "education," "experimental garments," or "intervention" have been used. Accordingly, the term "intervention" is employed in this study to encompass a multidisciplinary perspective. Furthermore, intervention studies targeting Korean firefighters have gradually increased since the enactment of the "Firefighters Health, Safety, and Welfare Act" in 2012 [ 24 ]. Considering the aim of examining current research trends, this study focused on literature published after 2010. The inclusion criteria were as follows: (1) Literature published in academic journals after 2010; (2) Articles reporting interventions; (3) Studies in which participants include Korean firefighters and rookie firefighters; (4) No restrictions on outcome variables, study design, or language. The following document types were excluded: dissertations, government documents, policy reports, and conference proceedings. Search strategy A literature search was conducted from January 25, 2024 to February 1, 2024, targeting articles published in Korean and international academic journals until January 25, 2024. The search strategy was developed in collaboration with a librarian affiliated with the National Medical Center. The databases used for the search included PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), DataBase Periodical Information Academic (DBpia), Research Information Sharing Service (RISS), Oriental Medicine Advanced Searching Integrated System (OASIS), Korea Citation Index (KCI), Korean studies Information Service System (KISS), ScienceON, Korean Medical Database (KMBASE), and International Clinical Trials Registry Platform (ICTRP). Furthermore, we conducted a thorough examination of the citations and references in the existing literature. The search terms used for Korean academic journals were "firefighter," "fire service," and "fireman," while "firefighter" and "Korea" were used for international journals. To ensure comprehensive coverage, search terms related to interventions were excluded. Based on the specified search terms, search strategies were devised according to the characteristics of each database. The detailed search strategies can be found in Additional file 1 ( Supplementary Table 1) . The process of including and excluding literature was conducted independently by two researchers (HJ and HJ). In the event of a discrepancy, a consensus was reached through discussions between the researchers. If a consensus could not be reached, a third researcher (JL) was consulted for the final selection. The titles and abstracts of the studies were initially reviewed based on the inclusion and exclusion criteria. Subsequently, the full texts of the initially selected literature were examined, and a final selection was made. The reasons for excluding studies that did not meet the inclusion criteria were recorded. Evidence screening and selection and data extraction The analysis framework used in this study was developed based on the criteria used in previous literature reviews [ 34 ]. The framework included publication year, author, journal information, study design, intervention type, participant age, sample size, and outcome variables. Subsequently, we reviewed existing studies and performed a pilot extraction using five articles to develop the final analysis framework, which included aspects such as funding support, identification of high-risk groups, ethical considerations, firefighter classification, years of service, sex, and inclusion/exclusion criteria before conducting the main extraction. Additionally, we extracted additional information according to the Template for Intervention Description and Replication (TIDieR) checklist [ 35 ] to improve intervention reporting. The data extraction process was conducted independently by two researchers (HJ and HJ) using Microsoft Excel. In the event of a discrepancy, a consensus was reached through discussions between the researchers. If a consensus could not be reached, a third researcher was consulted for a final decision (JL). The rationale for including items in the final analytical framework and the assumptions made during data extraction are presented in Additional file 2 ( Supplementary 1) . Data analysis and presentation of results The extracted data were presented in tables or figures in accordance with the objectives of this study. Although the general characteristics of the included studies, protection of participant anonymity and confidentiality and research ethics, and data regarding the TIDieR checklist were not analyzed, they were presented in the form of tables. Subsequently, the data were supplemented through frequency and percentage analyses, descriptive summaries, and critical discussions of the research results. The literature search results were reported in the form of a flow diagram following the PRISMA-ScR guidelines ( Fig. 1 ) . Results Study selection A total of 4,340 studies were identified through database and citation searches, and the resultant data were managed using EndNote X9 software (Clarivate Analytics, Philadelphia, PA, USA). Following the exclusion of 1,845 duplicate documents, the remaining 2,495 studies underwent a first-round selection based on the inclusion and exclusion criteria, and their titles and abstracts were reviewed. Consequently, 2,436 studies were excluded, leaving 59 studies for full-text screening. Subsequently, 24 studies were excluded based on the inclusion/exclusion criteria after reviewing the full text, resulting in a final sample of 35 studies ( Fig. 1 ) . General characteristics of the included studies Table 1 presents the general characteristics of the 35 studies in the final sample. The publication years were divided into three categories: 2010–2014 (n = 3; 8.5%), 2015–2019 (n = 16; 45.7%), and 2020–2024 (n = 16; 45.7%). Given that only one publication from 2024 was included in the search, the trend appears to have gradually increased over time. The number of participants in the included studies ranged from 12 to 1,859. Regarding research design, quantitative studies were the most prevalent at 29 studies (82.9%), including 2 randomized controlled trials (5.7%), 10 quasi-experimental studies (28.6%), and 17 pre-experimental studies (48.6%). Further, while five studies (14.3%) followed a mixed-methods design (14.3%), only one (2.9%) had a qualitative design. The majority of the selected studies (n = 27; 77.1%) employed psychological and social interventions. With respect to outcome measures, 9 studies (25.7%) used objective measurements, while 26 (74.3%) used self-report questionnaires. Table 1 General characteristics of included studies Year_Author Intervention Sample size (Initial->Final) Objective measurements Provide selection criteria Target specific participants Sex Classifications Age Duration of service True-experimental study 2019_Baek[ 38 ] Korean red ginseng E:32->28 C:31->27 Normal controls:37 O O X X X NR 2024_Kim[ 50 ] The virtual mate exercise training program E:10->9 C:10 O X Man NR X NR Quasi-experimental study 2013_Nam[ 71 ] Stress management program E:26->21 C:26->20 X X X X X X 2014_Park[ 73 ] Emotional Freedom Technique Program E:41 C:44 X X Man X X X 2015_Shim[ 44 ] Music therapy E:21 C:21 X O X X X X 2016_Baek[ 74 ] Music listening 88->80 E:40 C:40 X O X X X X 2016_Lee[ 75 ] Protective equipment 12 O O Man NR X X 2017_Paik[ 70 ] Group arts psychotherapy E:10 C:10 X X Man X X X 2018_Han[ 7 ] PTSD Management Program E:25->22 C:25->22 X O X X X X 2020A_Lee[ 37 ] Integrative art therapy program E:54 C:54 X X X Prospective firefighters NR O 2022_Hur[ 49 ] Educational program for peer psychological support E:20 C:20 X X X X X X 2023A_Kim[ 76 ] Two new Cardiopulmonary Resuscitation training methods Medical VR: 64->60 Flipped learning: 64->61 O X X X X X Pre-experimental study 2014_Chung[ 48 ] Eye Movement Desensitization and Reprocessing 15->7 X O NR NR NR NR 2016_Kim[ 77 ] Critical Incident Stress Debriefing 30 X X X NR X X 2017_Kim[ 40 ] Mental health improvement program 679->502 X X X NR X NR 2017_Mo[ 41 ] Integrated management program for PTSD 170 X X X NR X X 2017_Lee[ 78 ] Trauma group education 21 X X Man NR X X 2018_Lee[ 8 ] Meditation program 26 X X X First aid X X 2018_Shin[ 42 ] Camp program 90-> F/U 1m 20-> F/U 3m 61-> F/U 6m 39 X X X X X X 2019_Park[ 79 ] Forest therapy program 293->196 X X X NR X X 2020B_Lee[ 45 ] Personalized bird sounds 24 O X X X X NR 2020_Kim[ 80 ] High-Intensity Interval Training program 16 O X NR NR X NR 2020_Jang[ 46 ] Sleep intervention 45->39 X X X NR X X 2020_Won[ 20 ] Mental health promotion program 1,859 X X X NR X NR 2021_Jang[ 81 ] Experience of the care farm 16 O X X X X X 2022_Park[ 72 ] Hoegi-type forest healing program 72->63 X X NR X X X 2022_Cha[ 39 ] Forest-based trauma stress management program 23->20 O O X X X ≥ 3years 2022_Lee[ 82 ] Four interventions for promoting voluntary exercise training 175->99 X O NR X NR NR 2023B_Kim[ 47 ] Meditation-based healing program 23->20 X O X X X X Mixed-method design study 2018_Yook[ 43 ] Body-psychological exercise program E:12->11 C:12->11 X X NR X X NR 2019B_Kim[ 36 ] Meditation–based healing program 80 X X X X X X 2019A_Kim[ 83 ] Nomex body cooling garment 16 O X Man NR X X 2023_Bak[ 84 ] Simsang-poetry therapy program E:15->9 C:9 X X X NR X X 2023_Kwak[ 19 ] Online post-traumatic growth program E:17->16 C:17 X O NR First aid X ≥ 3years Qualitative study 2022_Yoon[ 85 ] Happy art therapy 787 X X X NR X NR C, Control group; E; Experimental group; NR, Not Reported; PTSD, Post-Traumatic Stress Disorder The characteristics of the participants were examined in terms of sex, age, firefighter classification, and length of service. Ten studies (28.6%) provided specific inclusion/exclusion criteria. Among the included studies, 6 that did not report sex were excluded. An examination of the remaining studies revealed that the participants comprised 4,108 males (89.5%) and 484 females (10.5%), with no studies designed to include individuals of other genders. Six studies exclusively involved male firefighters, while none involved female firefighters exclusively. However, one study implemented different interventions based on gender during certain stages of the program [ 36 ]. The ages of the study participants ranged from 20s to 60s, and no study specifically targeted a particular age group. Studies targeting specific firefighter classifications included one focusing on first aid personnel who participated in a mindfulness meditation program [ 8 ], one evaluating an online trauma growth program for firefighters with more than three years of first aid service [ 19 ], and one implementing integrated art therapy for rookie firefighters [ 37 ]. Additionally, one study included both nurses and firefighters from high-stress occupations to investigate the effects of red ginseng [ 38 ]. The length of service of firefighters ranged from less than one year to over 20 years. Studies that included length of service as a criterion for participant selection included one study targeting first aid personnel with over three years of service [ 19 ], one study targeting individuals with over three years of first aid service [ 39 ], and one study implementing integrated art therapy for rookie firefighters [ 37 ]. Further details regarding the general characteristics of the included studies are provided in Additional file 3 ( Supplementary Table 2) . Protection of participant anonymity and confidentiality and research ethics Information regarding participant protection and research ethics for the final selection of 35 studies are presented in Table 2 . Among the selected studies, 15 (42.9%) reported obtaining Institutional Review Board (IRB) approval, and 26 (74.3%) mentioned obtaining participant consent. Seven studies (20%) identified high-risk groups, with five (71.4%) mentioning IRB approval and all seven (100%) mentioning obtaining participant consent. Additionally, six studies (85.7%) mentioned details regarding financial support, indicating a higher frequency with regard to ensuring participant anonymity and confidentiality and research ethics compared to studies that did not classify high-risk groups. In the final sample of 35 studies, 15 (42.9%) explicitly stated that they had received financial support, while only one (2.9%) explicitly stated that they had not received financial support. Nineteen studies (54.3%) did not specify whether the authors had received financial support. Table 2 Participant protection and research ethics Year_Author Classifying high-risk groups Purpose and protection measures Ethical consideration Funding IRB Consent True-experimental study 2019_Baek[ 38 ] O Study inclusion criteria is high-risk groups O O O 2024_Kim[ 50 ] X O O O Quasi-experimental study 2013_Nam[ 71 ] X O O NR 2014_Park[ 73 ] X X X NR 2015_Shim[ 44 ] O Study inclusion criteria is high-risk groups X O NR 2016_Baek[ 74 ] X X O O 2016_Lee[ 75 ] X X X O 2017_Paik[ 70 ] X X X NR 2018_Han[ 7 ] O Study inclusion criteria is high-risk groups To ensure confidentiality, all stages of the program were conducted with all firefighters in the fire departments of the experimental group. Personal counselling was conducted on a one-to-one basis in a confidential space. O O O 2020A_Lee[ 37 ] X X O NR 2022_Hur[ 49 ] X X X NR 2023A_Kim[ 76 ] X O O X Pre-experimental study 2014_Chung[ 48 ] O Identify and implement other interventions for high-risk groups The treatment progress and diagnosis results were communicated to individuals individually. O O O 2016_Kim[ 77 ] X X X NR 2017_Kim[ 40 ] X O O NR 2017_Mo[ 41 ] O Identify and follow up with high-risk groups X O O 2017_Lee[ 78 ] X X X NR 2018_Lee[ 8 ] X X O NR 2018_Shin[ 42 ] X O O O 2019_Park[ 79 ] X X O NR 2020B_Lee[ 45 ] X X X NR 2020_Kim[ 80 ] X X O NR 2020_Jang[ 46 ] X O O O 2020_Won[ 20 ] O Identify and counsel high-risk groups. O O O 2021_Jang[ 81 ] X X O O 2022_Park[ 72 ] X X X NR 2022_Cha[ 39 ] X O O NR 2022_Lee[ 82 ] X O O O 2023B_Kim[ 47 ] X X O NR Mixed-method design study 2018_Yook[ 43 ] X O O O 2019B_Kim[ 36 ] X X O NR 2019A_Kim[ 83 ] X O O O 2023_Bak[ 84 ] X X O NR 2023_Kwak[ 19 ] O Identify and counsel high-risk groups The intervention was conducted face-to-face, and all participants used nicknames to ensure anonymity. O O O Qualitative study 2022_Yoon[ 85 ] X X X NR IRB, Institutional Review Board; NR, Not Reported; PTSD, Post-Traumatic Stress Disorder TIDieR checklist The description and replication of the interventions included in the final sample of 35 studies were extracted according to the TIDieR checklist, and the results are presented in Additional file 4 ( Supplementary Table 3) . Among the 34 quantitative and mixed-methods studies, 16 (47.1%) divided the participants into experimental and control groups when implementing the interventions. Further, six qualitative and mixed-methods studies were identified, employing various methodologies, including phenomenological analysis, content analysis, case study, live experiential study, focus group interviews; one study had an unspecified methodology. Among the 35 included studies, four involved researcher-led interventions and 15 involved interventions by other professionals, such as therapists. To ascertain how the research design of the final 35 studies reflected the characteristics of firefighters' work, data were extracted using the TIDieR checklist. The results are summarized in Table 3 . Fifteen studies (42.9%) involved interventions within fire stations, whereas 13 (37.1%) involved interventions outside fire stations. One study did not specify the intervention location, and six studies did not describe it. A total of 13 studies (37.1%) conducted interventions during working hours, whereas 13 (37.1%) conducted interventions outside working hours. One study did not specify the timing of the intervention, while seven studies did not describe it. Tailored interventions were implemented in 12 studies (34.3%). These included six studies that employed individual counseling [ 7 , 40 – 43 , 20 ], two studies that utilized musical instruments or bird sounds based on participants' preferences [ 44 , 45 ], two studies that provided individual sleep goals and personal management strategies [ 46 , 47 ], one study that adjusted the frequency of intervention based on participants' improvement status [ 48 ], and one study that conducted different interventions for men and women during certain program stages [ 36 ]. Table 3 Studies that considered firefighters’ job characteristics Year_Author Where † When † Tailoring How F/NF I/G True-experimental study 2019_Baek[ 38 ] X X X F I 2024_Kim[ 50 ] O * X F, NF I Quasi-experimental study 2013_Nam[ 71 ] O O X F G 2014_Park[ 73 ] O O X F G 2015_Shim[ 44 ] NR NR O F G 2016_Baek[ 74 ] O X X F G 2016_Lee[ 75 ] X X X F I 2017_Paik[ 70 ] O O X F G 2018_Han[ 7 ] ** ** O F I, G 2020A_Lee[ 37 ] O O X F G 2022_Hur[ 49 ] NR NR X NF NR 2023A_Kim[ 76 ] O O X F, NF G Pre-experimental study 2014_Chung[ 48 ] X X O F I 2016_Kim[ 77 ] O O X F G 2017_Kim[ 40 ] O O O F I, G 2017_Mo[ 41 ] O O O F I, G 2017_Lee[ 78 ] NR NR X F G 2018_Lee[ 8 ] X X X F G 2018_Shin[ 42 ] X X O F I, G 2019_Park[ 79 ] X X X F G 2020B_Lee[ 45 ] O O O F I 2020_Kim[ 80 ] NR NR X F G 2020_Jang[ 46 ] NR NR O F, NF I, G 2020_Won[ 20 ] O O O F I, G 2021_Jang[ 81 ] X NR X F G 2022_Park[ 72 ] X X X F G 2022_Cha[ 39 ] X X X F G 2022_Lee[ 82 ] O O X F G 2023B_Kim[ 47 ] X X O F G Mixed-method design study 2018_Yook[ 43 ] NR NR O F I, G 2019B_Kim[ 36 ] X X O F G 2019A_Kim[ 83 ] X X X F I 2023_Bak[ 84 ] O O X F G 2023_Kwak[ 19 ] X X X NF G Qualitative study 2022_Yoon[ 85 ] O O X F G * Participants participate on their own time ** Depending on the program configuration, O or X Where (Was the intervention conducted in the fire station?); When (Was the intervention conducted during work hours?) F, Face-to-face; G, Group; I, Individual; NF, Non-face-to-face; NR, Not reported The most prevalent mode of intervention delivery was the face-to-face group intervention, employed in 19 studies (54.3%). Thirty studies (85.7%) exclusively utilized face-to-face interventions, three studies (8.6%) exclusively provided non-face-to-face interventions, and two studies (5.7%) employed a combination of face-to-face and non-face-to-face methods. Among the non-face-to-face intervention studies, one employed online lectures [ 49 ], another conducted online lectures and anonymous group counseling via social networking services [ 19 ], and another utilized a virtual mate exercise training program instead of an exercise instructor [ 50 ]. Group-only interventions were the most common, comprising 21 studies (60%), followed by individual-only interventions in 6 studies (17.1%). Seven studies (20%) employed a combination of group and individual interventions, whereas one (2.9%) did not specify the intervention format. Discussion This study used a scoping review methodology to analyze 35 intervention studies on Korean firefighters published in Korean and international academic journals since 2010. The characteristics of the identified intervention studies and three key factors regarding future research directions are discussed. The number of intervention studies targeting Korean firefighters has increased consistently. In Korea, there has been a growing awareness of the importance of firefighter welfare, as evidenced by the enactment in 2012 of the Framework Act on Health, Safety and Welfare of Firefighting Officials, the Human Rights Status Survey of Korean Firefighters in 2015 [ 51 ], the conversion of local firefighters to national civil servants in 2020, and the establishment of a national fire hospital (scheduled for completion by 2025). Moreover, the occurrence of major disasters, such as the Gyeongju and Pohang earthquakes in 2016 and the Pyeongtaek logistics warehouse fire in 2022, in which firefighters were urgently required and tragically lost their lives, has served to heighten awareness regarding the health issues facing firefighters. The analysis suggests that the intervention studies on Korean firefighters, along with the quantitative research, should consider firefighter characteristics in the research design process. Among the studies included in this review, recent publications have made efforts to reflect firefighter characteristics by conducting focus group interviews with current firefighters to identify on-site needs and by selecting the most comfortable spaces and timeframes for participants to conduct research. Moving forward, intervention research that reflects firefighters’ job characteristics and organizational climate is needed. Recommendations for future research This study summarized three key factors for improving the quality of intervention research: design and content, tailoring and ethics, and characteristics and demands of the field. Design and content Although the number of intervention studies on firefighters has been increasing steadily, there has been a notable imbalance in terms of the research topics, study designs, outcome variables, and forms of intervention delivery. A mental health survey conducted by the Fire Administration in 2021 indicated that PTSD was reported by 5.7%, depressive symptoms by 4.4%, sleep problems by 22.8%, and problematic drinking by 22.7% [ 52 ]. The rate of PTSD of 5.7% is significantly higher than the prevalence of PTSD in the general population, reaching approximately tenfold [ 51 ]. This review indicated that Korean firefighters are at an elevated risk of mental health issues, with numerous intervention studies being conducted to address this issue. However, the principles of mental health promotion programs outlined by the World Health Organization and International Labor Organization indicate that they should be comprehensive, in conjunction with other health promotion programs, in order to be effective. Firefighters who have experienced PTSD have been found to exhibit significantly higher rates of cardiovascular, respiratory, musculoskeletal, and nervous system symptoms than those who have not [ 53 ]. Since mental health problems often manifest as biological symptoms, such as insomnia or pain, maintaining biological health is crucial for mental health management [ 54 ]. Most of the studies included in this review focus on psychological and social interventions to address mental health issues. In future research, it is essential to design intervention studies that employ a multidimensional approach to address mental health issues among firefighters in Korea and integrate them with other health promotion programs. In addition to mental health issues, Korean firefighters face various health problems. According to the Human Rights Status Survey of Korean Firefighters [ 51 ], 48% of the respondents reported experiencing pain or discomfort related to musculoskeletal issues; 5.4%, asthma attacks; 29.1%, skin symptoms; and 22.7%, hearing loss. Particularly, there was evidence of unmet medical demands for pain, rehabilitation, and burns [ 55 ]. Moreover, the International Agency for Research on Cancer has designated firefighting as a Group 1 carcinogen because of the high risk of cancer associated with occupational exposure among firefighters. Consequently, firefighters incur significantly higher costs than general public officials for mental health, cardiovascular, and musculoskeletal disorders. They spend 6.1 times more on mood disorders, 12.4 times more on hypertension, and 8.4 times more on lumbar disc issues [ 56 ], leading to a substantial economic burden due to medical expenses. Firefighters’ health issues can have socioeconomic implications beyond individual concerns [ 18 ]. Therefore, intervention studies addressing various health issues are essential for promoting the mental and physical health of firefighters, reducing medical expenses, and ensuring societal safety. Therefore, it is crucial to conduct high-quality intervention studies using optimal experimental designs. Randomized controlled trials (RCTs) are the gold standard for evidence-based research, in which participants are randomly assigned to experimental and control groups. This methodology ensures that the two groups are homogeneous except for the intervention, which allows for causal inference. However, RCTs require significant resources, such as manpower and costs, which are often unavailable in research settings. Therefore, it is essential to provide research funding for conducting RCTs. Studies that receive formal research funding can allocate more resources based on economic benefits [ 57 , 58 ]. This enables the provision of high-quality interventions, which ultimately enhances the quality of research. Among the 35 studies included in this review, only two (5.7%) employed an RCT design. In both articles, an explicit statement was made that the research had received funding. However, in 19 studies (54.3%), research funding support was not clearly disclosed, making it difficult to discuss the research design and funding. Therefore, future studies should be transparent regarding research funding. Moreover, increased research funding is essential to actively implement RCT methodology in future research, thereby boosting the quality of intervention studies on firefighters. The most prevalent format of intervention delivery among the included studies was the group-based face-to-face format (n = 19, 54.3%), with only four studies (11.4%) conducting follow-up observations. Given that firefighters are repeatedly exposed to traumatic incidents, repeated training over multiple sessions is necessary to enhance psychological resilience and proficiency in required skills [ 59 ]. Moreover, studies with extended follow-up observation periods are necessary to investigate the long-term effects of these interventions. However, considering the irregular response times and shiftwork characteristics of the firefighters, repeated training over multiple sessions may interfere with their work and rest. Furthermore, as organizations are sensitive to the stigma associated with health issues, it has been difficult to recruit candidates willing to participate publicly in group programs [ 21 ]. Moreover, the use of self-report questionnaires in group-based face-to-face intervention programs may have resulted in participants underreporting their health issues, which could have compromised the reliability of the results. Regarding the outcome variables, 26 studies (74.3%) employed self-report questionnaires. It is well established that self-report questionnaires may introduce bias in the results, as respondents may present themselves as healthier than they actually are, and individuals with higher social desirability tend to report less stress than they actually experience [ 60 , 61 ]. Consequently, to provide evidence of intervention effectiveness that is not limited to a single dimension and to present objective results, it is necessary to use objective measurement tools along with self-report questionnaires. However, most of the studies included in this review reported interventions at the group level. In such cases, completing self-report questionnaires as a group may facilitate research progress, as it would be challenging to measure objective indicators for each participant individually. Among the studies included, only 4 out of 21 studies (19%) that provided group interventions and 5 out of 6 studies (83.3%) that provided individual interventions used objective evaluation tools. The group-level intervention studies employed relatively simple evaluation indicators, such as saliva cortisol analysis or tests following checklists for educational evaluation. Individual intervention studies utilized relatively complex evaluation indicators, including blood tests, physical and biochemical indicator evaluations, and bio-signal analysis. Consequently, it is essential to develop a range of intervention formats tailored to the specific research context and intervention type rather than relying on a single uniform group-based face-to-face approach. Furthermore, research designs that incorporate both self-report questionnaires and objective evaluation indicators are necessary. Studies involving long-term follow-up observations to assess the long-term effects of interventions and case management of research participants are needed as well. Tailoring and ethics Firefighters are exposed to different risks depending on their assigned tasks [ 62 – 64 ], working periods [ 65 ], and gender [ 66 ], and the resulting health issues vary, making individual health issues heterogeneous within the group. Moreover, firefighting is among the occupations with the highest prevalence of mental health issues requiring case management [ 52 ]. Scholars have opined that suicide prevention strategies should prioritize the early identification of high-risk groups and the enhancement of emotional coping skills [ 28 ], underscoring the necessity for tailored interventions over uniform ones. However, a limitation of existing studies is the lack of targeting specific firefighter groups in the selection criteria of the included studies. Only seven studies (20%) classified high-risk groups. Furthermore, 12 studies (34.3%) conducted interventions tailored to individual characteristics rather than implementing a common intervention for all participants. This is related to the fact that only 10 (28.6%) of the included 35 studies specified the inclusion and exclusion criteria in their design, indicating that most studies targeted all firefighters and lacked customization during the research process. Although intervention studies targeting all firefighters are necessary, there is a need for interventions that consider individual characteristics. Furthermore, it is essential to provide evidence-based interventions by referencing past studies, pilot studies, or expert consensus when designing the research and selecting appropriate participants. Topics that are stigmatizing and socially sensitive, such as identifying high-risk groups for diseases and investigating experiences of discrimination, must prioritize the protection of participants’ privacy and confidentiality. In particular, stigma poses a significant issue in male-dominated occupations such as firefighters [ 67 ]. A nationwide study conducted among firefighters revealed that the majority of firefighters at risk of developing PTSD did not seek treatment, with 33.8% citing concerns about potential stigma [ 55 ]. Furthermore, a survey on firefighters’ human rights status [ 51 ] found that 40% of female firefighters had experienced workplace discrimination in the past year, with 57% attributing it to gender. However, 98% of female firefighters who experienced sexual harassment did not report this to the authorities. This indicates that firefighters, considering that the nature of their profession emphasizes trustworthiness and robustness, have significant concerns about being stigmatized or perceived as vulnerable [ 8 ]. Therefore, when addressing topics such as identification of high-risk groups for diseases or discrimination experiences among firefighters, it is essential to instill trust in research participants regarding personal information protection and research ethics. Among the studies included in this review, only 15 (42.9%) mentioned obtaining IRB approval, while 26 (74.3%) mentioned obtaining participant consent. This represents a more favorable outcome in terms of research ethics compared to the trend analysis of health-related intervention studies for children conducted at regional child centers [ 68 ], where only two out of 109 studies (1.8%) obtained IRB approval and 41 studies (37.6%) obtained participant consent. However, since the implementation of the Basic Act on Bioethics in Korea in 2013, all research involving human subjects must undergo review and approval by the appropriate IRB before proceeding. Therefore, when designing studies on high-risk group identification and discrimination, as well as intervention studies involving humans, it is essential that researchers consider the protection of participants’ privacy and confidentiality and the ethical conduct of the research in advance, with these plans being established and approved by the IRB. When conducting intervention studies, both adherence to approved IRB protocols and documenting the implementation of these protocols in the article are essential. Among the five studies that identification of high-risk groups and obtained IRB approvals, three explicitly addressed participant protection methods ( Table 2 ) . Despite adherence to IRB-approved participant protection and research ethics, one study [ 7 ] reported difficulties in participants sharing their experiences due to concerns about the potential negative consequences in their careers and fear of appearing vulnerable during one-on-one counseling sessions. Employees experiencing mental health issues often hesitate to disclose their problems because of concerns about stigma in the workplace [ 69 ]. This underscores the significance of addressing social skills, such as the attitudes of intervention providers and the establishment of trust with participants, in addition to IRB approval, in intervention studies. Furthermore, sensitive research designs that consider appropriate intervention methods, timing, and location are essential to accommodate participants' needs. In group-based, face-to-face programs, it is of paramount importance to ensure that populations that are high-risk or discriminated against are not singled out. If the identification of high-risk groups or discrimination experiences is intended, all stages of the program should target the entire participant group, with individual feedback on diagnostic results and research progress. In instances where this is not a viable option, alternative methodologies such as online or virtual reality-based interventions, in conjunction with anonymization techniques employing pseudonyms or other means, can safeguard the privacy of participants. Furthermore, if the study design identifies high-risk groups or those who have experienced discrimination as the sole participants, it may be necessary to consider alternative modalities of intervention delivery. For instance, the intervention could be delivered individually or virtually, rather than in a group-based face-to-face program. Moreover, to mitigate negative perceptions and biases towards mental health treatment among firefighters, it is necessary to implement programs that target all firefighters. Characteristics and demands of the field Despite the numerous intervention studies targeting Korean firefighters, these studies have failed to adequately reflect the irregular duty hours and demands of fieldwork, including irregular emergency response times and shift work. Among the 35 studies included in this review, various opinions regarding suitable intervention locations and timings were identified through post-intervention reflections. The limitations of studies that conducted interventions within fire departments during the workday were described as follows: ‘The intervention was not easily implemented in an environment where we had to wait for an emergency response. The sirens and emergency response affected the implementation of and participation in the intervention [ 70 ].’, ‘We were unable to see a significant difference in outcome 'variables because we had to leave in the middle of the intervention due to unexpected work events [ 71 ].’, and ‘It was not uncommon to have to return to the site without meeting the participants due to emergency response [ 21 ].’ Overall, interventions conducted at fire stations during working hours encountered challenges in separating firefighter duties from intervention provisions, making it difficult to assess intervention effectiveness. Therefore, future interventions should aim to increase intervention focus by separating intervention time and location from work responsibilities. The limitations of studies that conducted interventions outside of the fire station during off-duty hours were described as follows: ‘Conducting the intervention after work may have the physical and psychological burden on participants [ 72 ].’, and ‘Using personal time, such as holidays, may have reduced participation and effectiveness [ 7 ].’ Due to the nature of shift work among firefighters, providing interventions during personal time after long shifts may burden the participants and reduce intervention effectiveness. Moreover, given the varying shift schedules of firefighters, it may be challenging to gather all participants at designated times. Overall, future efforts should focus on improving working conditions such as ensuring sufficient staffing for shift work or providing interventions directly at fire stations during working hours. Some studies have attempted to address these issues, including the implementation of shorter intervention sessions to accommodate emergency response constraints [ 46 ], scheduling of interventions during low average emergency response times, provision of separate spaces within fire stations [ 70 ], overcoming the limitations of past studies, and conducting research outside the workplace [ 42 ]. However, these measures did not provide fundamental solutions. Consequently, future research should investigate the intervention timing and locations that maximize the effectiveness of interventions targeting firefighters. The preceding recommendations are reflections based on researchers' perspectives through the review of the intervention studies. There is a paucity of research analyzing the opinions of firefighters—the research participants—through qualitative studies to identify solutions. Among the 35 studies selected for this review, six employed qualitative methods, including five mixed-method studies (14.3%) and one qualitative study (2.9%). One study [ 19 ] designed an intervention based on the demands and perceptions related to the intervention, identified through focus group interviews with 12 firefighters. The findings suggested the need for flexibility to accommodate individual and organizational characteristics of firefighters, practical content provided by firefighting experts, avoidance of outcome orientation, and inclusion of positive content rather than focusing solely on negative aspects. This study used a flexible research design that allowed participants to select the most comfortable time and space outside their working hours. Additionally, to avoid stigma, the study conducted anonymous online counseling rather than a somewhat uncomfortable psychological program. In this manner, the intervention was tailored to the needs of the participants and involved experts in firefighting psychology, demonstrating a deep understanding of firefighting. Among the 35 studies, 4 (11.4%) involved researchers directly providing the intervention, while 15 (42.9%) involved other professionals, such as specialized therapists. The majority of these professionals were not firefighting experts but were experts in the specific intervention. Future research should focus on meeting firefighters' demands by having intervention experts provide interventions, while including firefighting experts in the research design and intervention provision process to meet their unmet needs. Furthermore, discussions on suitable intervention locations and timings have been revealed to be researcher-centric in post-intervention reflections. Consequently, future research should focus on the participants during the research design phase. Moreover, given the current dissatisfaction resulting from one-sided program operations that do not meet participants' demands and lack diversity [ 22 ], there is a need for research to ascertain the demands of the field regarding the types of intervention studies required. Strengths and limitations This is the first comprehensive scoping review of intervention studies targeting Korean firefighters. It provides an integrated analysis of existing intervention studies from various perspectives based on firefighters’ job characteristics and organizational culture. The significance of this study lies in the recommendations for subsequent intervention studies. Alongside this scoping review, the research team will conduct qualitative [ 29 ] and survey research targeting Korean firefighters to identify unmet healthcare needs. Additionally, clinical data based on a memorandum of understanding between the Seoul Korean Medicine Association and Seoul Metropolitan Fire and Disaster Headquarters will be leveraged through retrospective chart reviews to undertake a series of research tasks aimed at promoting the health of Korean firefighters. The results of this study will serve as foundational data for future intervention studies targeting Korean firefighters. However, this study had some limitations. First, as the study focused on publications in Korean and international journals since 2010, there may have been studies published before 2010 that were excluded, including theses, government documents, policy reports, and conference proceedings. Second, as only intervention studies targeting Korean firefighters were included, the findings may not apply to other countries and regions. Conclusions Firefighter health issues extend beyond individual concerns to encompass socio-economic losses, underscoring the importance of implementing interventions to address these health concerns. These issues necessitate structured programs tailored to the characteristics of firefighters for prevention, treatment, and case management. This study employed a scoping review methodology to examine the characteristics of 35 intervention studies targeting Korean firefighters, the research on which has been steadily increasing since 2010. Recommendations for future research were provided. The three key factors identified in this study for improving the quality of intervention studies on Korean firefighters were as follows: study design and content, tailoring and ethics, and characteristics and demands of the field. These factors are summarized as follows. First, existing intervention studies were found to be imbalanced in terms of research topics, design, outcome variables, and formats of interventions. Hence, we concluded that diverse intervention studies addressing health issues among firefighters are needed and that financial support is crucial to ensure high-quality research design. Second, owing to the diverse characteristics of individual firefighters, tailored interventions, and protection of personal information for vulnerable participants are essential. Furthermore, a meticulous research design that adheres to the tenets of research ethics is imperative. Finally, there is a dearth of research analyzing the characteristics and needs of firefighters in the field. Future research must ascertain the needs of firefighters through qualitative research and collaborate with experts in the field of firefighting to design flexible research designs that can accommodate the characteristics of individual firefighters and organizations. The results of this study will serve as foundational data for future intervention studies targeting Korean firefighters. Furthermore, we aim to conduct a series of research projects in the future to identify the unmet health needs of firefighters and promote their health through a combination of qualitative research, survey research, and retrospective chart reviews. Abbreviations IRB Institutional Review Board PRISMA-ScR Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews PTSD Post-Traumatic Stress Disorder RCTs Randomized Controlled Trials TIDieR Template for Intervention Description and Replication Declarations Ethics approval and consent to participate Not applicable Consent for publication Not applicable Availability of data and materials The datasets analyzed in the current study are available from the corresponding author upon request. Competing interests The authors declare that they have no competing interests Funding This study was supported by the National Research Foundation of Korea (RS-2023-00250325). Authors' contributions IY and JL designed the study and reviewed the manuscript. HJ(Hanbit Jin) wrote the manuscript. HJ (Hanbit Jin) and HJ (Hyungsun Jun) conducted eligibility checks, data extraction, and data synthesis. JH conducted the search and synthesized the data. All the authors have read and approved the final manuscript. Acknowledgements We thank Soohyun Lee of the Medical Information Library of the National Medical Center for her assistance with the literature search. References Kwak B-G, Ryu J. The Effects of Job Characteristics of Firefighters Dispatched to Disaster Sites on Job Satisfaction. Fire Science and Engineering. 2023;37:146–54. Comfort LK. Managing disaster: Strategies and policy perspectives. (No Title). 1988. 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Supplementary Files Additionalfile1.docx File name: Additional file 1 File format: .docx Title of data: Supplementary Table 1. Search strategy Description of data: Table Additionalfile2.docx File name: Additional file 2 File format: .docx Title of data: Supplementary 1. Rationale for including items in the final analytical framework and assumptions made in the data extraction Description of data: Table Additionalfile3.docx File name: Additional file 3 File format: .docx Title of data: Supplementary Table 2. More information about the general characteristics of the included studies Description of data: Table Additionalfile4.docx File name: Additional file 4 File format: .docx Title of data: Supplementary Table 3. Intervention description and replication of the included studies Description of data: Table Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4446023","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":308736644,"identity":"eb095198-6620-42f8-8380-44624387537a","order_by":0,"name":"Hanbit Jin","email":"","orcid":"","institution":"Wonkwang University","correspondingAuthor":false,"prefix":"","firstName":"Hanbit","middleName":"","lastName":"Jin","suffix":""},{"id":308736645,"identity":"3fecfaf4-0722-4b56-9240-ef6a5a66236f","order_by":1,"name":"Hyungsun Jun","email":"","orcid":"","institution":"Wonkwang University","correspondingAuthor":false,"prefix":"","firstName":"Hyungsun","middleName":"","lastName":"Jun","suffix":""},{"id":308736649,"identity":"2e7b88e8-6774-499b-9102-b8aeb1d7ca3b","order_by":2,"name":"Jisu Ha","email":"","orcid":"","institution":"National Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Jisu","middleName":"","lastName":"Ha","suffix":""},{"id":308736651,"identity":"5f20fdb2-0b2e-42bc-b508-811a8450b213","order_by":3,"name":"Inae Youn","email":"","orcid":"","institution":"National Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Inae","middleName":"","lastName":"Youn","suffix":""},{"id":308736654,"identity":"21fe54cc-d64f-4678-8d5b-efd5e58cd206","order_by":4,"name":"Jungtae Leem","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5klEQVRIie3RPQrCMBiA4S8U4lLpWikq3sDSwUXxKoZCJwcncYwU0qXiGm8RF+dKQJforKMIzoIguFmLi0va0SHvloSH/AGYTH8Yoha1ANwWrsUZosUcLiPoQ/qBY+9G1UixD0BEVnzcrUYsTuaPyUwSodSzsWLQdiiO7to9OIk9rmQg9otNY83A5xmWvIQwq85kU6jD5nxhgATUYv1NvgSJ0/j2IcOqJOrk18fn/GBEAJZ6kl5iz1bFI/de/OiGXOJQS/wk3D7sWfGVVz+d9gfLhAV6Qn/Hbv7uWgDQLlk3mUwmE8AbF65NRGEQHC0AAAAASUVORK5CYII=","orcid":"","institution":"Wonkwang University","correspondingAuthor":true,"prefix":"","firstName":"Jungtae","middleName":"","lastName":"Leem","suffix":""}],"badges":[],"createdAt":"2024-05-20 01:42:23","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4446023/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4446023/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":57937812,"identity":"8d779f6b-a00a-4cde-af94-af5222a596ed","added_by":"auto","created_at":"2024-06-07 17:43:46","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":62618,"visible":true,"origin":"","legend":"\u003cp\u003ePRISMA Flow diagram\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-4446023/v1/fddc8e129127ec8a96e09754.png"},{"id":64742010,"identity":"79cd89a4-7dfa-4718-b2cd-f5edcccce021","added_by":"auto","created_at":"2024-09-18 09:02:58","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1326567,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4446023/v1/b5a5c50f-1793-48a7-86a7-d9da39635f51.pdf"},{"id":57937809,"identity":"ecaed563-0534-4ba5-89f2-b15c2218fd12","added_by":"auto","created_at":"2024-06-07 17:43:45","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":19181,"visible":true,"origin":"","legend":"\u003cp\u003eFile name: Additional file 1\u003c/p\u003e\n\u003cp\u003eFile format: .docx\u003c/p\u003e\n\u003cp\u003eTitle of data: Supplementary Table 1. Search strategy\u003c/p\u003e\n\u003cp\u003eDescription of data: Table\u003c/p\u003e","description":"","filename":"Additionalfile1.docx","url":"https://assets-eu.researchsquare.com/files/rs-4446023/v1/b1dc867fa69c7a0d9d269de5.docx"},{"id":57937810,"identity":"0f9bec78-2cc4-4c43-8202-339f1e4d07b5","added_by":"auto","created_at":"2024-06-07 17:43:45","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":21325,"visible":true,"origin":"","legend":"\u003cp\u003eFile name: Additional file 2\u003c/p\u003e\n\u003cp\u003eFile format: .docx\u003c/p\u003e\n\u003cp\u003eTitle of data: Supplementary 1. Rationale for including items in the final analytical framework and assumptions made in the data extraction\u003c/p\u003e\n\u003cp\u003eDescription of data: Table\u003c/p\u003e","description":"","filename":"Additionalfile2.docx","url":"https://assets-eu.researchsquare.com/files/rs-4446023/v1/f1283889c549fa6a00904f41.docx"},{"id":57937807,"identity":"8d126399-a1f0-4bbf-83cc-c6a5bdd6b923","added_by":"auto","created_at":"2024-06-07 17:43:44","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":60294,"visible":true,"origin":"","legend":"\u003cp\u003eFile name: Additional file 3\u003c/p\u003e\n\u003cp\u003eFile format: .docx\u003c/p\u003e\n\u003cp\u003eTitle of data: Supplementary Table 2. More information about the general characteristics of the included studies\u003c/p\u003e\n\u003cp\u003eDescription of data: Table\u003c/p\u003e","description":"","filename":"Additionalfile3.docx","url":"https://assets-eu.researchsquare.com/files/rs-4446023/v1/ed4c03cb9bf7b0834079d244.docx"},{"id":57937811,"identity":"9ef14ab1-c2fa-4104-b63c-42c9218bc4ba","added_by":"auto","created_at":"2024-06-07 17:43:45","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":50848,"visible":true,"origin":"","legend":"\u003cp\u003eFile name: Additional file 4\u003c/p\u003e\n\u003cp\u003eFile format: .docx\u003c/p\u003e\n\u003cp\u003eTitle of data: Supplementary Table 3. 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The job characteristics of firefighters can be summarized as follows: \u0026ldquo;hazardousness,\u0026rdquo; \u0026ldquo;uncertainty,\u0026rdquo; \u0026ldquo;shift work,\u0026rdquo; \u0026ldquo;urgency,\u0026rdquo; and \u0026ldquo;role ambiguity\u0026rdquo; [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The term \u0026ldquo;hazardousness\u0026rdquo; refers to job characteristics involving various risk factors such as physical injuries and psychological trauma that occur during job performance. Uncertainty implies that disasters are inherently uncertain [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], necessitating firefighting organizations to be on standby 24/7 to respond to unforeseeable disasters. Further, Article 13 of the \"Firefighter Duty Regulations\" (Work Method of 119 Safety Centers) [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] states that shift work should typically follow a three-shift system (three shifts, two rotations). However, in cases where firefighting conditions render this impractical, a two-shift system (two shifts, one rotation) may be used if the workload permits. The attribute of urgency implies that in urgent situations such as fires and disasters, swift dispatch and arrival at the scene are crucial for minimizing disaster spread [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e], necessitating firefighters to maintain alertness even during standby. Unpredictable situations occur repeatedly during emergency dispatches and on-site activities; however, the individual discretion of firefighters is limited. Role ambiguity arises when there is inadequate clarity regarding roles or information about a scene [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. This has been shown to have a significant negative impact on job performance, particularly in complex job roles such as firefighting [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe job characteristics of firefighters are not universally applicable. Firefighting organizations perform various tasks, including responding to disaster scenes, emergency treatment and transportation of patients, disaster prevention, computational work, communication, and 119-reporting tasks. Therefore, individualized psychological and social interventions targeting firefighters are essential because the personal situations of individuals and their environments differ [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. However, individualized interventions carry the risk of disclosing personal information, necessitating a careful research design. Identifying at-risk groups and providing interventions can involve stigmatization; therefore, caution is necessary. Firefighters are often perceived as emphasizing trustworthiness and robustness because of the nature of their profession. This perception leads to concerns about experiencing disadvantages or being perceived as weak because of mental health treatment [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Moreover, firefighting organizations are characterized by hierarchical organizational climates that prioritize rank in the performance of hazardous duties. If elements of prejudice and discrimination against the vulnerable are tolerated in such organizational climates, stigmatization may occur [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The social condemnation and decreased self-esteem associated with stigma have been demonstrated to have deleterious effects on individuals' reputations and professional careers [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Consequently, interventions targeting firefighters should be designed considering the job characteristics and organizational climate of firefighting organizations.\u003c/p\u003e \u003cp\u003eFirefighters are frequently exposed to environments that can cause physical injuries and psychological trauma. The uncertainty of firefighting duties has been shown to negatively affect job performance, sleep patterns, and social/familial relationships [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]; moreover, shift work-related circadian rhythm sleep-wake disorders can significantly impair mental and physical health [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Furthermore, the urgency of firefighting tasks to meet the golden hour for firefighting, rescue, and emergency medical activities can lead to circadian rhythm disruption and stress [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. A systematic review on non-cancerous health risks among firefighters [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] found that firefighters have a higher risk of mental disorders, hearing impairment, myocardial infarction, and ischemic stroke than the general population. The International Agency for Research on Cancer has classified firefighting as a Group 1 carcinogen owing to the elevated risk of cancer associated with occupational exposure among firefighters. Additionally, firefighters frequently sustain injuries during urgent on-site activities, with musculoskeletal injuries such as tension, sprains, and muscle pain accounting for 36% of the cases [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. These health issues among firefighters have been demonstrated to negatively impact their job performance [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], as indicated by a 60% higher rate of turnover due to health problems observed among firefighters than among workers in other fields [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Consequently, firefighter health issues extend beyond individual concerns to encompass socio-economic losses [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], underscoring the importance of implementing interventions to address these health concerns.\u003c/p\u003e \u003cp\u003eThese issues necessitate structured programs tailored to the characteristics of firefighters for prevention, treatment, and case management. Intervention studies are necessary to develop and evaluate these programs. While numerous intervention studies targeting Korean firefighters have been conducted, most have been group-based face-to-face programs. However, they have been criticized for not adequately reflecting the characteristics of firefighters and the demands of their work environment [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Group-based face-to-face programs are typically conducted in the workplace during working hours. In such cases, there is often a lack of safe and comfortable spaces outside the workplace for conducting counseling sessions with high-risk groups for specific conditions, which may result in some participants refusing to participate [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Additionally, practitioners of the \"Visiting Counseling Center for Firefighters,\" organized by the National Fire Agency, have often found it challenging to meet research participants due to urgent deployments [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Another issue, as evidenced by a study targeting 119 emergency medical technicians, is that while most fire stations (88.3%) operate health management programs, they mostly focus on operating fitness facilities or holding special lectures, thus lacking diversity [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Problems with health management programs include programs that do not meet the demands of the participants, one-time operations, and coercion to participate, resulting in low satisfaction [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. From the perspective of firefighter health and safety policies, ensuring anonymity among users of mental-health-related programs has emerged as a significant issue [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Although numerous literature reviews have been conducted on the health problems of Korean firefighters, most have focused on specific areas such as mental health and psychological intervention studies [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], post-traumatic stress disorder (PTSD) [\u003cspan additionalcitationids=\"CR26\" citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], and suicidal ideation [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], thus limiting their scope. Moreover, no literature review has examined whether these studies reflect firefighter characteristics.\u003c/p\u003e \u003cp\u003eThe objectives of this study were as follows: first, to ascertain the current status and characteristics of intervention studies for firefighters in Korea; second, to determine the extent to which intervention studies for firefighters in Korea reflect the characteristics of firefighters; and third, to propose recommendations for designing intervention studies for firefighters in Korea. Furthermore, we aim to conduct a series of research projects in the future to identify the unmet health needs of firefighters and promote their health through a combination of qualitative research [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e], survey research, and retrospective chart reviews.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis study employed a scoping review methodology to understand the current status and characteristics of intervention studies targeting Korean firefighters and to provide recommendations for subsequent research [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. The scoping review methodology comprises seven steps, based on the methodological guidance provided by the Joanna Briggs Institute [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Furthermore, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] for reporting. The protocol for this study was registered on the Open Science Framework and can be accessed at \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://osf.io/s378j/\u003c/span\u003e\u003cspan address=\"https://osf.io/s378j/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eReview questions\u003c/h2\u003e \u003cp\u003eThe following research questions will be addressed in this study:\u003c/p\u003e \u003cp\u003e(1) What is the current status and characteristics of intervention studies on Korean firefighters published in academic journals since 2010?\u003c/p\u003e \u003cp\u003e(2) With respect to the aforementioned studies, to what extent have their study designs considered firefighters\u0026rsquo; characteristics?\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eInclusion criteria\u003c/h2\u003e \u003cp\u003eTherapeutic interventions can be defined as intentional engagement in difficult situations to improve or prevent the worsening of problems, leading to positive physical or mental outcomes or beneficial effects [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Intervention studies targeting firefighters encompass multidisciplinary perspectives, including medicine, nursing, social sciences, engineering, arts, physical education, agriculture, and marine sciences. In each discipline, terms such as \"treatment,\" \"education,\" \"experimental garments,\" or \"intervention\" have been used. Accordingly, the term \"intervention\" is employed in this study to encompass a multidisciplinary perspective. Furthermore, intervention studies targeting Korean firefighters have gradually increased since the enactment of the \"Firefighters Health, Safety, and Welfare Act\" in 2012 [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Considering the aim of examining current research trends, this study focused on literature published after 2010. The inclusion criteria were as follows: (1) Literature published in academic journals after 2010; (2) Articles reporting interventions; (3) Studies in which participants include Korean firefighters and rookie firefighters; (4) No restrictions on outcome variables, study design, or language. The following document types were excluded: dissertations, government documents, policy reports, and conference proceedings.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eSearch strategy\u003c/h2\u003e \u003cp\u003eA literature search was conducted from January 25, 2024 to February 1, 2024, targeting articles published in Korean and international academic journals until January 25, 2024. The search strategy was developed in collaboration with a librarian affiliated with the National Medical Center. The databases used for the search included PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), DataBase Periodical Information Academic (DBpia), Research Information Sharing Service (RISS), Oriental Medicine Advanced Searching Integrated System (OASIS), Korea Citation Index (KCI), Korean studies Information Service System (KISS), ScienceON, Korean Medical Database (KMBASE), and International Clinical Trials Registry Platform (ICTRP). Furthermore, we conducted a thorough examination of the citations and references in the existing literature. The search terms used for Korean academic journals were \"firefighter,\" \"fire service,\" and \"fireman,\" while \"firefighter\" and \"Korea\" were used for international journals. To ensure comprehensive coverage, search terms related to interventions were excluded. Based on the specified search terms, search strategies were devised according to the characteristics of each database. The detailed search strategies can be found in Additional file 1 (\u003cb\u003eSupplementary Table\u0026nbsp;1)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eThe process of including and excluding literature was conducted independently by two researchers (HJ and HJ). In the event of a discrepancy, a consensus was reached through discussions between the researchers. If a consensus could not be reached, a third researcher (JL) was consulted for the final selection. The titles and abstracts of the studies were initially reviewed based on the inclusion and exclusion criteria. Subsequently, the full texts of the initially selected literature were examined, and a final selection was made. The reasons for excluding studies that did not meet the inclusion criteria were recorded.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eEvidence screening and selection and data extraction\u003c/h2\u003e \u003cp\u003eThe analysis framework used in this study was developed based on the criteria used in previous literature reviews [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. The framework included publication year, author, journal information, study design, intervention type, participant age, sample size, and outcome variables. Subsequently, we reviewed existing studies and performed a pilot extraction using five articles to develop the final analysis framework, which included aspects such as funding support, identification of high-risk groups, ethical considerations, firefighter classification, years of service, sex, and inclusion/exclusion criteria before conducting the main extraction. Additionally, we extracted additional information according to the Template for Intervention Description and Replication (TIDieR) checklist [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e] to improve intervention reporting.\u003c/p\u003e \u003cp\u003eThe data extraction process was conducted independently by two researchers (HJ and HJ) using Microsoft Excel. In the event of a discrepancy, a consensus was reached through discussions between the researchers. If a consensus could not be reached, a third researcher was consulted for a final decision (JL). The rationale for including items in the final analytical framework and the assumptions made during data extraction are presented in Additional file 2 (\u003cb\u003eSupplementary 1)\u003c/b\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eData analysis and presentation of results\u003c/h2\u003e \u003cp\u003eThe extracted data were presented in tables or figures in accordance with the objectives of this study. Although the general characteristics of the included studies, protection of participant anonymity and confidentiality and research ethics, and data regarding the TIDieR checklist were not analyzed, they were presented in the form of tables. Subsequently, the data were supplemented through frequency and percentage analyses, descriptive summaries, and critical discussions of the research results. The literature search results were reported in the form of a flow diagram following the PRISMA-ScR guidelines \u003cb\u003e(\u003c/b\u003eFig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eStudy selection\u003c/h2\u003e \u003cp\u003eA total of 4,340 studies were identified through database and citation searches, and the resultant data were managed using EndNote X9 software (Clarivate Analytics, Philadelphia, PA, USA). Following the exclusion of 1,845 duplicate documents, the remaining 2,495 studies underwent a first-round selection based on the inclusion and exclusion criteria, and their titles and abstracts were reviewed. Consequently, 2,436 studies were excluded, leaving 59 studies for full-text screening. Subsequently, 24 studies were excluded based on the inclusion/exclusion criteria after reviewing the full text, resulting in a final sample of 35 studies \u003cb\u003e(\u003c/b\u003eFig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eGeneral characteristics of the included studies\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents the general characteristics of the 35 studies in the final sample. The publication years were divided into three categories: 2010\u0026ndash;2014 (n\u0026thinsp;=\u0026thinsp;3; 8.5%), 2015\u0026ndash;2019 (n\u0026thinsp;=\u0026thinsp;16; 45.7%), and 2020\u0026ndash;2024 (n\u0026thinsp;=\u0026thinsp;16; 45.7%). Given that only one publication from 2024 was included in the search, the trend appears to have gradually increased over time. The number of participants in the included studies ranged from 12 to 1,859. Regarding research design, quantitative studies were the most prevalent at 29 studies (82.9%), including 2 randomized controlled trials (5.7%), 10 quasi-experimental studies (28.6%), and 17 pre-experimental studies (48.6%). Further, while five studies (14.3%) followed a mixed-methods design (14.3%), only one (2.9%) had a qualitative design. The majority of the selected studies (n\u0026thinsp;=\u0026thinsp;27; 77.1%) employed psychological and social interventions. With respect to outcome measures, 9 studies (25.7%) used objective measurements, while 26 (74.3%) used self-report questionnaires.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eGeneral characteristics of included studies\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eYear_Author\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eIntervention\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSample size\u003c/p\u003e \u003cp\u003e(Initial-\u0026gt;Final)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eObjective measurements\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eProvide\u003c/p\u003e \u003cp\u003eselection criteria\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c9\" namest=\"c6\"\u003e \u003cp\u003eTarget specific participants\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eClassifications\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eDuration of service\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003eTrue-experimental study\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2019_Baek[\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKorean red ginseng\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eE:32-\u0026gt;28\u003c/p\u003e \u003cp\u003eC:31-\u0026gt;27\u003c/p\u003e \u003cp\u003eNormal controls:37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e 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\u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQuasi-experimental study\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2013_Nam[\u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStress management program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eE:26-\u0026gt;21\u003c/p\u003e \u003cp\u003eC:26-\u0026gt;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2014_Park[\u003cspan citationid=\"CR73\" class=\"CitationRef\"\u003e73\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmotional Freedom Technique Program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eE:41\u003c/p\u003e \u003cp\u003eC:44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2015_Shim[\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMusic therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eE:21 \u003c/p\u003e \u003cp\u003eC:21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2016_Baek[\u003cspan citationid=\"CR74\" class=\"CitationRef\"\u003e74\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMusic listening\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e88-\u0026gt;80\u003c/p\u003e \u003cp\u003eE:40\u003c/p\u003e \u003cp\u003eC:40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e 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colname=\"c7\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2020A_Lee[\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntegrative art therapy program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eE:54\u003c/p\u003e \u003cp\u003eC:54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eProspective firefighters\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2022_Hur[\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEducational program for peer psychological support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eE:20\u003c/p\u003e \u003cp\u003eC:20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2023A_Kim[\u003cspan citationid=\"CR76\" class=\"CitationRef\"\u003e76\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTwo new Cardiopulmonary Resuscitation training methods\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMedical VR:\u003c/p\u003e \u003cp\u003e64-\u0026gt;60\u003c/p\u003e \u003cp\u003eFlipped learning: \u003c/p\u003e \u003cp\u003e64-\u0026gt;61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePre-experimental study\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2014_Chung[\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEye Movement Desensitization and Reprocessing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15-\u0026gt;7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2016_Kim[\u003cspan citationid=\"CR77\" class=\"CitationRef\"\u003e77\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCritical Incident Stress Debriefing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2017_Kim[\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMental health improvement program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e679-\u0026gt;502\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2017_Mo[\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntegrated management program for PTSD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e170\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2017_Lee[\u003cspan citationid=\"CR78\" class=\"CitationRef\"\u003e78\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTrauma group education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2018_Lee[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMeditation program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFirst aid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2018_Shin[\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCamp program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e90-\u0026gt;\u003c/p\u003e \u003cp\u003eF/U 1m 20-\u0026gt;\u003c/p\u003e \u003cp\u003eF/U 3m 61-\u0026gt;\u003c/p\u003e \u003cp\u003eF/U 6m 39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2019_Park[\u003cspan citationid=\"CR79\" class=\"CitationRef\"\u003e79\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eForest therapy program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e293-\u0026gt;196\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2020B_Lee[\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePersonalized bird sounds\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2020_Kim[\u003cspan citationid=\"CR80\" class=\"CitationRef\"\u003e80\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigh-Intensity Interval Training program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2020_Jang[\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSleep intervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45-\u0026gt;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2020_Won[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMental health promotion program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1,859\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2021_Jang[\u003cspan citationid=\"CR81\" class=\"CitationRef\"\u003e81\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExperience of the care farm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2022_Park[\u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e72\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHoegi-type forest healing program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72-\u0026gt;63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2022_Cha[\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eForest-based trauma stress management program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23-\u0026gt;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;3years\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2022_Lee[\u003cspan citationid=\"CR82\" class=\"CitationRef\"\u003e82\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFour interventions for promoting voluntary exercise training\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e175-\u0026gt;99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2023B_Kim[\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMeditation-based healing program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23-\u0026gt;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMixed-method design study\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2018_Yook[\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBody-psychological exercise program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eE:12-\u0026gt;11\u003c/p\u003e \u003cp\u003eC:12-\u0026gt;11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2019B_Kim[\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMeditation\u0026ndash;based healing program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2019A_Kim[\u003cspan citationid=\"CR83\" class=\"CitationRef\"\u003e83\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNomex body cooling garment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2023_Bak[\u003cspan citationid=\"CR84\" class=\"CitationRef\"\u003e84\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSimsang-poetry therapy program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eE:15-\u0026gt;9\u003c/p\u003e \u003cp\u003eC:9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2023_Kwak[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOnline post-traumatic growth program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eE:17-\u0026gt;16\u003c/p\u003e \u003cp\u003eC:17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFirst aid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;3years\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQualitative study\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2022_Yoon[\u003cspan citationid=\"CR85\" class=\"CitationRef\"\u003e85\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHappy art therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e787\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"9\"\u003eC, Control group; E; Experimental group; NR, Not Reported; PTSD, Post-Traumatic Stress Disorder\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe characteristics of the participants were examined in terms of sex, age, firefighter classification, and length of service. Ten studies (28.6%) provided specific inclusion/exclusion criteria. Among the included studies, 6 that did not report sex were excluded. An examination of the remaining studies revealed that the participants comprised 4,108 males (89.5%) and 484 females (10.5%), with no studies designed to include individuals of other genders. Six studies exclusively involved male firefighters, while none involved female firefighters exclusively. However, one study implemented different interventions based on gender during certain stages of the program [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. The ages of the study participants ranged from 20s to 60s, and no study specifically targeted a particular age group. Studies targeting specific firefighter classifications included one focusing on first aid personnel who participated in a mindfulness meditation program [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], one evaluating an online trauma growth program for firefighters with more than three years of first aid service [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], and one implementing integrated art therapy for rookie firefighters [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. Additionally, one study included both nurses and firefighters from high-stress occupations to investigate the effects of red ginseng [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. The length of service of firefighters ranged from less than one year to over 20 years. Studies that included length of service as a criterion for participant selection included one study targeting first aid personnel with over three years of service [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], one study targeting individuals with over three years of first aid service [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e], and one study implementing integrated art therapy for rookie firefighters [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. Further details regarding the general characteristics of the included studies are provided in Additional file 3 (\u003cb\u003eSupplementary Table\u0026nbsp;2)\u003c/b\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eProtection of participant anonymity and confidentiality and research ethics\u003c/h2\u003e \u003cp\u003eInformation regarding participant protection and research ethics for the final selection of 35 studies are presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. Among the selected studies, 15 (42.9%) reported obtaining Institutional Review Board (IRB) approval, and 26 (74.3%) mentioned obtaining participant consent. Seven studies (20%) identified high-risk groups, with five (71.4%) mentioning IRB approval and all seven (100%) mentioning obtaining participant consent. Additionally, six studies (85.7%) mentioned details regarding financial support, indicating a higher frequency with regard to ensuring participant anonymity and confidentiality and research ethics compared to studies that did not classify high-risk groups. In the final sample of 35 studies, 15 (42.9%) explicitly stated that they had received financial support, while only one (2.9%) explicitly stated that they had not received financial support. Nineteen studies (54.3%) did not specify whether the authors had received financial support.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eParticipant protection and research ethics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eYear_Author\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eClassifying high-risk groups\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePurpose and protection measures\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eEthical\u003c/p\u003e \u003cp\u003econsideration\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFunding\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIRB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eConsent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTrue-experimental study\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2019_Baek[\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStudy inclusion criteria is high-risk groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2024_Kim[\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQuasi-experimental study\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2013_Nam[\u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2014_Park[\u003cspan citationid=\"CR73\" class=\"CitationRef\"\u003e73\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2015_Shim[\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStudy inclusion criteria is high-risk groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2016_Baek[\u003cspan citationid=\"CR74\" class=\"CitationRef\"\u003e74\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2016_Lee[\u003cspan citationid=\"CR75\" class=\"CitationRef\"\u003e75\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2017_Paik[\u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e70\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2018_Han[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStudy inclusion criteria is high-risk groups\u003c/p\u003e \u003cp\u003eTo ensure confidentiality, all stages of the program were conducted with all firefighters in the fire departments of the experimental group. Personal counselling was conducted on a one-to-one basis in a confidential space.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2020A_Lee[\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2022_Hur[\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2023A_Kim[\u003cspan citationid=\"CR76\" class=\"CitationRef\"\u003e76\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePre-experimental study\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2014_Chung[\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIdentify and implement other interventions for high-risk groups\u003c/p\u003e \u003cp\u003eThe treatment progress and diagnosis results were communicated to individuals individually.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2016_Kim[\u003cspan citationid=\"CR77\" class=\"CitationRef\"\u003e77\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2017_Kim[\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2017_Mo[\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIdentify and follow up with high-risk groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2017_Lee[\u003cspan citationid=\"CR78\" class=\"CitationRef\"\u003e78\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2018_Lee[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2018_Shin[\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2019_Park[\u003cspan citationid=\"CR79\" class=\"CitationRef\"\u003e79\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2020B_Lee[\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2020_Kim[\u003cspan citationid=\"CR80\" class=\"CitationRef\"\u003e80\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2020_Jang[\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2020_Won[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIdentify and counsel high-risk groups.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2021_Jang[\u003cspan citationid=\"CR81\" class=\"CitationRef\"\u003e81\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2022_Park[\u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e72\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2022_Cha[\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2022_Lee[\u003cspan citationid=\"CR82\" class=\"CitationRef\"\u003e82\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2023B_Kim[\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMixed-method design study\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2018_Yook[\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2019B_Kim[\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2019A_Kim[\u003cspan citationid=\"CR83\" class=\"CitationRef\"\u003e83\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2023_Bak[\u003cspan citationid=\"CR84\" class=\"CitationRef\"\u003e84\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2023_Kwak[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIdentify and counsel high-risk groups\u003c/p\u003e \u003cp\u003eThe intervention was conducted face-to-face, and all participants used nicknames to ensure anonymity.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQualitative study\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2022_Yoon[\u003cspan citationid=\"CR85\" class=\"CitationRef\"\u003e85\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eIRB, Institutional Review Board; NR, Not Reported; PTSD, Post-Traumatic Stress Disorder\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eTIDieR checklist\u003c/h2\u003e \u003cp\u003eThe description and replication of the interventions included in the final sample of 35 studies were extracted according to the TIDieR checklist, and the results are presented in Additional file 4 (\u003cb\u003eSupplementary Table\u0026nbsp;3)\u003c/b\u003e. Among the 34 quantitative and mixed-methods studies, 16 (47.1%) divided the participants into experimental and control groups when implementing the interventions. Further, six qualitative and mixed-methods studies were identified, employing various methodologies, including phenomenological analysis, content analysis, case study, live experiential study, focus group interviews; one study had an unspecified methodology. Among the 35 included studies, four involved researcher-led interventions and 15 involved interventions by other professionals, such as therapists.\u003c/p\u003e \u003cp\u003eTo ascertain how the research design of the final 35 studies reflected the characteristics of firefighters' work, data were extracted using the TIDieR checklist. The results are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. Fifteen studies (42.9%) involved interventions within fire stations, whereas 13 (37.1%) involved interventions outside fire stations. One study did not specify the intervention location, and six studies did not describe it. A total of 13 studies (37.1%) conducted interventions during working hours, whereas 13 (37.1%) conducted interventions outside working hours. One study did not specify the timing of the intervention, while seven studies did not describe it. Tailored interventions were implemented in 12 studies (34.3%). These included six studies that employed individual counseling [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan additionalcitationids=\"CR41 CR42\" citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], two studies that utilized musical instruments or bird sounds based on participants' preferences [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e], two studies that provided individual sleep goals and personal management strategies [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e], one study that adjusted the frequency of intervention based on participants' improvement status [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e], and one study that conducted different interventions for men and women during certain program stages [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eStudies that considered firefighters\u0026rsquo; job characteristics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eYear_Author\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWhere\u003c/p\u003e \u003cp\u003e\u0026dagger;\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWhen\u003c/p\u003e \u003cp\u003e\u0026dagger;\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTailoring\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eHow\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF/NF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eI/G\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTrue-experimental study\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2019_Baek[\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eI\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2024_Kim[\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF, NF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eI\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQuasi-experimental study\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2013_Nam[\u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2014_Park[\u003cspan citationid=\"CR73\" class=\"CitationRef\"\u003e73\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2015_Shim[\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2016_Baek[\u003cspan citationid=\"CR74\" class=\"CitationRef\"\u003e74\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2016_Lee[\u003cspan citationid=\"CR75\" class=\"CitationRef\"\u003e75\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eI\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2017_Paik[\u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e70\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2018_Han[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eI, G\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2020A_Lee[\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2022_Hur[\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2023A_Kim[\u003cspan citationid=\"CR76\" class=\"CitationRef\"\u003e76\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF, NF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePre-experimental study\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2014_Chung[\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eI\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2016_Kim[\u003cspan citationid=\"CR77\" class=\"CitationRef\"\u003e77\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2017_Kim[\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eI, G\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2017_Mo[\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eI, G\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2017_Lee[\u003cspan citationid=\"CR78\" class=\"CitationRef\"\u003e78\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2018_Lee[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2018_Shin[\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eI, G\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2019_Park[\u003cspan citationid=\"CR79\" class=\"CitationRef\"\u003e79\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2020B_Lee[\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eI\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2020_Kim[\u003cspan citationid=\"CR80\" class=\"CitationRef\"\u003e80\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2020_Jang[\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF, NF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eI, G\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2020_Won[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eI, G\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2021_Jang[\u003cspan citationid=\"CR81\" class=\"CitationRef\"\u003e81\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2022_Park[\u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e72\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2022_Cha[\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2022_Lee[\u003cspan citationid=\"CR82\" class=\"CitationRef\"\u003e82\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2023B_Kim[\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMixed-method design study\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2018_Yook[\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eI, G\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2019B_Kim[\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2019A_Kim[\u003cspan citationid=\"CR83\" class=\"CitationRef\"\u003e83\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eI\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2023_Bak[\u003cspan citationid=\"CR84\" class=\"CitationRef\"\u003e84\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2023_Kwak[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQualitative study\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2022_Yoon[\u003cspan citationid=\"CR85\" class=\"CitationRef\"\u003e85\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e* Participants participate on their own time\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e** Depending on the program configuration, O or X\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eWhere (Was the intervention conducted in the fire station?); When (Was the intervention conducted during work hours?)\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eF, Face-to-face; G, Group; I, Individual; NF, Non-face-to-face; NR, Not reported\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe most prevalent mode of intervention delivery was the face-to-face group intervention, employed in 19 studies (54.3%). Thirty studies (85.7%) exclusively utilized face-to-face interventions, three studies (8.6%) exclusively provided non-face-to-face interventions, and two studies (5.7%) employed a combination of face-to-face and non-face-to-face methods. Among the non-face-to-face intervention studies, one employed online lectures [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e], another conducted online lectures and anonymous group counseling via social networking services [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], and another utilized a virtual mate exercise training program instead of an exercise instructor [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]. Group-only interventions were the most common, comprising 21 studies (60%), followed by individual-only interventions in 6 studies (17.1%). Seven studies (20%) employed a combination of group and individual interventions, whereas one (2.9%) did not specify the intervention format.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study used a scoping review methodology to analyze 35 intervention studies on Korean firefighters published in Korean and international academic journals since 2010. The characteristics of the identified intervention studies and three key factors regarding future research directions are discussed.\u003c/p\u003e \u003cp\u003eThe number of intervention studies targeting Korean firefighters has increased consistently. In Korea, there has been a growing awareness of the importance of firefighter welfare, as evidenced by the enactment in 2012 of the Framework Act on Health, Safety and Welfare of Firefighting Officials, the Human Rights Status Survey of Korean Firefighters in 2015 [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e], the conversion of local firefighters to national civil servants in 2020, and the establishment of a national fire hospital (scheduled for completion by 2025). Moreover, the occurrence of major disasters, such as the Gyeongju and Pohang earthquakes in 2016 and the Pyeongtaek logistics warehouse fire in 2022, in which firefighters were urgently required and tragically lost their lives, has served to heighten awareness regarding the health issues facing firefighters.\u003c/p\u003e \u003cp\u003eThe analysis suggests that the intervention studies on Korean firefighters, along with the quantitative research, should consider firefighter characteristics in the research design process. Among the studies included in this review, recent publications have made efforts to reflect firefighter characteristics by conducting focus group interviews with current firefighters to identify on-site needs and by selecting the most comfortable spaces and timeframes for participants to conduct research. Moving forward, intervention research that reflects firefighters\u0026rsquo; job characteristics and organizational climate is needed.\u003c/p\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eRecommendations for future research\u003c/h2\u003e \u003cp\u003eThis study summarized three key factors for improving the quality of intervention research: design and content, tailoring and ethics, and characteristics and demands of the field.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eDesign and content\u003c/h2\u003e \u003cp\u003eAlthough the number of intervention studies on firefighters has been increasing steadily, there has been a notable imbalance in terms of the research topics, study designs, outcome variables, and forms of intervention delivery. A mental health survey conducted by the Fire Administration in 2021 indicated that PTSD was reported by 5.7%, depressive symptoms by 4.4%, sleep problems by 22.8%, and problematic drinking by 22.7% [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. The rate of PTSD of 5.7% is significantly higher than the prevalence of PTSD in the general population, reaching approximately tenfold [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. This review indicated that Korean firefighters are at an elevated risk of mental health issues, with numerous intervention studies being conducted to address this issue. However, the principles of mental health promotion programs outlined by the World Health Organization and International Labor Organization indicate that they should be comprehensive, in conjunction with other health promotion programs, in order to be effective. Firefighters who have experienced PTSD have been found to exhibit significantly higher rates of cardiovascular, respiratory, musculoskeletal, and nervous system symptoms than those who have not [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e]. Since mental health problems often manifest as biological symptoms, such as insomnia or pain, maintaining biological health is crucial for mental health management [\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e]. Most of the studies included in this review focus on psychological and social interventions to address mental health issues. In future research, it is essential to design intervention studies that employ a multidimensional approach to address mental health issues among firefighters in Korea and integrate them with other health promotion programs.\u003c/p\u003e \u003cp\u003eIn addition to mental health issues, Korean firefighters face various health problems. According to the Human Rights Status Survey of Korean Firefighters [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e], 48% of the respondents reported experiencing pain or discomfort related to musculoskeletal issues; 5.4%, asthma attacks; 29.1%, skin symptoms; and 22.7%, hearing loss. Particularly, there was evidence of unmet medical demands for pain, rehabilitation, and burns [\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e]. Moreover, the International Agency for Research on Cancer has designated firefighting as a Group 1 carcinogen because of the high risk of cancer associated with occupational exposure among firefighters. Consequently, firefighters incur significantly higher costs than general public officials for mental health, cardiovascular, and musculoskeletal disorders. They spend 6.1 times more on mood disorders, 12.4 times more on hypertension, and 8.4 times more on lumbar disc issues [\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e], leading to a substantial economic burden due to medical expenses. Firefighters\u0026rsquo; health issues can have socioeconomic implications beyond individual concerns [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Therefore, intervention studies addressing various health issues are essential for promoting the mental and physical health of firefighters, reducing medical expenses, and ensuring societal safety.\u003c/p\u003e \u003cp\u003eTherefore, it is crucial to conduct high-quality intervention studies using optimal experimental designs. Randomized controlled trials (RCTs) are the gold standard for evidence-based research, in which participants are randomly assigned to experimental and control groups. This methodology ensures that the two groups are homogeneous except for the intervention, which allows for causal inference. However, RCTs require significant resources, such as manpower and costs, which are often unavailable in research settings. Therefore, it is essential to provide research funding for conducting RCTs. Studies that receive formal research funding can allocate more resources based on economic benefits [\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e]. This enables the provision of high-quality interventions, which ultimately enhances the quality of research. Among the 35 studies included in this review, only two (5.7%) employed an RCT design. In both articles, an explicit statement was made that the research had received funding. However, in 19 studies (54.3%), research funding support was not clearly disclosed, making it difficult to discuss the research design and funding. Therefore, future studies should be transparent regarding research funding. Moreover, increased research funding is essential to actively implement RCT methodology in future research, thereby boosting the quality of intervention studies on firefighters.\u003c/p\u003e \u003cp\u003eThe most prevalent format of intervention delivery among the included studies was the group-based face-to-face format (n\u0026thinsp;=\u0026thinsp;19, 54.3%), with only four studies (11.4%) conducting follow-up observations. Given that firefighters are repeatedly exposed to traumatic incidents, repeated training over multiple sessions is necessary to enhance psychological resilience and proficiency in required skills [\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e]. Moreover, studies with extended follow-up observation periods are necessary to investigate the long-term effects of these interventions. However, considering the irregular response times and shiftwork characteristics of the firefighters, repeated training over multiple sessions may interfere with their work and rest. Furthermore, as organizations are sensitive to the stigma associated with health issues, it has been difficult to recruit candidates willing to participate publicly in group programs [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Moreover, the use of self-report questionnaires in group-based face-to-face intervention programs may have resulted in participants underreporting their health issues, which could have compromised the reliability of the results. Regarding the outcome variables, 26 studies (74.3%) employed self-report questionnaires. It is well established that self-report questionnaires may introduce bias in the results, as respondents may present themselves as healthier than they actually are, and individuals with higher social desirability tend to report less stress than they actually experience [\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e, \u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e]. Consequently, to provide evidence of intervention effectiveness that is not limited to a single dimension and to present objective results, it is necessary to use objective measurement tools along with self-report questionnaires. However, most of the studies included in this review reported interventions at the group level. In such cases, completing self-report questionnaires as a group may facilitate research progress, as it would be challenging to measure objective indicators for each participant individually. Among the studies included, only 4 out of 21 studies (19%) that provided group interventions and 5 out of 6 studies (83.3%) that provided individual interventions used objective evaluation tools. The group-level intervention studies employed relatively simple evaluation indicators, such as saliva cortisol analysis or tests following checklists for educational evaluation. Individual intervention studies utilized relatively complex evaluation indicators, including blood tests, physical and biochemical indicator evaluations, and bio-signal analysis. Consequently, it is essential to develop a range of intervention formats tailored to the specific research context and intervention type rather than relying on a single uniform group-based face-to-face approach. Furthermore, research designs that incorporate both self-report questionnaires and objective evaluation indicators are necessary. Studies involving long-term follow-up observations to assess the long-term effects of interventions and case management of research participants are needed as well.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eTailoring and ethics\u003c/h2\u003e \u003cp\u003eFirefighters are exposed to different risks depending on their assigned tasks [\u003cspan additionalcitationids=\"CR63\" citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e], working periods [\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e], and gender [\u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e66\u003c/span\u003e], and the resulting health issues vary, making individual health issues heterogeneous within the group. Moreover, firefighting is among the occupations with the highest prevalence of mental health issues requiring case management [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. Scholars have opined that suicide prevention strategies should prioritize the early identification of high-risk groups and the enhancement of emotional coping skills [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], underscoring the necessity for tailored interventions over uniform ones. However, a limitation of existing studies is the lack of targeting specific firefighter groups in the selection criteria of the included studies. Only seven studies (20%) classified high-risk groups. Furthermore, 12 studies (34.3%) conducted interventions tailored to individual characteristics rather than implementing a common intervention for all participants. This is related to the fact that only 10 (28.6%) of the included 35 studies specified the inclusion and exclusion criteria in their design, indicating that most studies targeted all firefighters and lacked customization during the research process. Although intervention studies targeting all firefighters are necessary, there is a need for interventions that consider individual characteristics. Furthermore, it is essential to provide evidence-based interventions by referencing past studies, pilot studies, or expert consensus when designing the research and selecting appropriate participants.\u003c/p\u003e \u003cp\u003eTopics that are stigmatizing and socially sensitive, such as identifying high-risk groups for diseases and investigating experiences of discrimination, must prioritize the protection of participants\u0026rsquo; privacy and confidentiality. In particular, stigma poses a significant issue in male-dominated occupations such as firefighters [\u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e67\u003c/span\u003e]. A nationwide study conducted among firefighters revealed that the majority of firefighters at risk of developing PTSD did not seek treatment, with 33.8% citing concerns about potential stigma [\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e]. Furthermore, a survey on firefighters\u0026rsquo; human rights status [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e] found that 40% of female firefighters had experienced workplace discrimination in the past year, with 57% attributing it to gender. However, 98% of female firefighters who experienced sexual harassment did not report this to the authorities. This indicates that firefighters, considering that the nature of their profession emphasizes trustworthiness and robustness, have significant concerns about being stigmatized or perceived as vulnerable [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Therefore, when addressing topics such as identification of high-risk groups for diseases or discrimination experiences among firefighters, it is essential to instill trust in research participants regarding personal information protection and research ethics. Among the studies included in this review, only 15 (42.9%) mentioned obtaining IRB approval, while 26 (74.3%) mentioned obtaining participant consent. This represents a more favorable outcome in terms of research ethics compared to the trend analysis of health-related intervention studies for children conducted at regional child centers [\u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e], where only two out of 109 studies (1.8%) obtained IRB approval and 41 studies (37.6%) obtained participant consent. However, since the implementation of the Basic Act on Bioethics in Korea in 2013, all research involving human subjects must undergo review and approval by the appropriate IRB before proceeding. Therefore, when designing studies on high-risk group identification and discrimination, as well as intervention studies involving humans, it is essential that researchers consider the protection of participants\u0026rsquo; privacy and confidentiality and the ethical conduct of the research in advance, with these plans being established and approved by the IRB.\u003c/p\u003e \u003cp\u003eWhen conducting intervention studies, both adherence to approved IRB protocols and documenting the implementation of these protocols in the article are essential. Among the five studies that identification of high-risk groups and obtained IRB approvals, three explicitly addressed participant protection methods \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e. Despite adherence to IRB-approved participant protection and research ethics, one study [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] reported difficulties in participants sharing their experiences due to concerns about the potential negative consequences in their careers and fear of appearing vulnerable during one-on-one counseling sessions. Employees experiencing mental health issues often hesitate to disclose their problems because of concerns about stigma in the workplace [\u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e69\u003c/span\u003e]. This underscores the significance of addressing social skills, such as the attitudes of intervention providers and the establishment of trust with participants, in addition to IRB approval, in intervention studies. Furthermore, sensitive research designs that consider appropriate intervention methods, timing, and location are essential to accommodate participants' needs. In group-based, face-to-face programs, it is of paramount importance to ensure that populations that are high-risk or discriminated against are not singled out. If the identification of high-risk groups or discrimination experiences is intended, all stages of the program should target the entire participant group, with individual feedback on diagnostic results and research progress. In instances where this is not a viable option, alternative methodologies such as online or virtual reality-based interventions, in conjunction with anonymization techniques employing pseudonyms or other means, can safeguard the privacy of participants. Furthermore, if the study design identifies high-risk groups or those who have experienced discrimination as the sole participants, it may be necessary to consider alternative modalities of intervention delivery. For instance, the intervention could be delivered individually or virtually, rather than in a group-based face-to-face program. Moreover, to mitigate negative perceptions and biases towards mental health treatment among firefighters, it is necessary to implement programs that target all firefighters.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eCharacteristics and demands of the field\u003c/h2\u003e \u003cp\u003eDespite the numerous intervention studies targeting Korean firefighters, these studies have failed to adequately reflect the irregular duty hours and demands of fieldwork, including irregular emergency response times and shift work. Among the 35 studies included in this review, various opinions regarding suitable intervention locations and timings were identified through post-intervention reflections. The limitations of studies that conducted interventions within fire departments during the workday were described as follows: \u0026lsquo;The intervention was not easily implemented in an environment where we had to wait for an emergency response. The sirens and emergency response affected the implementation of and participation in the intervention [\u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e70\u003c/span\u003e].\u0026rsquo;, \u0026lsquo;We were unable to see a significant difference in outcome 'variables because we had to leave in the middle of the intervention due to unexpected work events [\u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e].\u0026rsquo;, and \u0026lsquo;It was not uncommon to have to return to the site without meeting the participants due to emergency response [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u0026rsquo; Overall, interventions conducted at fire stations during working hours encountered challenges in separating firefighter duties from intervention provisions, making it difficult to assess intervention effectiveness. Therefore, future interventions should aim to increase intervention focus by separating intervention time and location from work responsibilities. The limitations of studies that conducted interventions outside of the fire station during off-duty hours were described as follows: \u0026lsquo;Conducting the intervention after work may have the physical and psychological burden on participants [\u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e72\u003c/span\u003e].\u0026rsquo;, and \u0026lsquo;Using personal time, such as holidays, may have reduced participation and effectiveness [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u0026rsquo; Due to the nature of shift work among firefighters, providing interventions during personal time after long shifts may burden the participants and reduce intervention effectiveness. Moreover, given the varying shift schedules of firefighters, it may be challenging to gather all participants at designated times. Overall, future efforts should focus on improving working conditions such as ensuring sufficient staffing for shift work or providing interventions directly at fire stations during working hours. Some studies have attempted to address these issues, including the implementation of shorter intervention sessions to accommodate emergency response constraints [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e], scheduling of interventions during low average emergency response times, provision of separate spaces within fire stations [\u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e70\u003c/span\u003e], overcoming the limitations of past studies, and conducting research outside the workplace [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. However, these measures did not provide fundamental solutions. Consequently, future research should investigate the intervention timing and locations that maximize the effectiveness of interventions targeting firefighters.\u003c/p\u003e \u003cp\u003eThe preceding recommendations are reflections based on researchers' perspectives through the review of the intervention studies. There is a paucity of research analyzing the opinions of firefighters\u0026mdash;the research participants\u0026mdash;through qualitative studies to identify solutions. Among the 35 studies selected for this review, six employed qualitative methods, including five mixed-method studies (14.3%) and one qualitative study (2.9%). One study [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] designed an intervention based on the demands and perceptions related to the intervention, identified through focus group interviews with 12 firefighters. The findings suggested the need for flexibility to accommodate individual and organizational characteristics of firefighters, practical content provided by firefighting experts, avoidance of outcome orientation, and inclusion of positive content rather than focusing solely on negative aspects. This study used a flexible research design that allowed participants to select the most comfortable time and space outside their working hours. Additionally, to avoid stigma, the study conducted anonymous online counseling rather than a somewhat uncomfortable psychological program. In this manner, the intervention was tailored to the needs of the participants and involved experts in firefighting psychology, demonstrating a deep understanding of firefighting.\u003c/p\u003e \u003cp\u003eAmong the 35 studies, 4 (11.4%) involved researchers directly providing the intervention, while 15 (42.9%) involved other professionals, such as specialized therapists. The majority of these professionals were not firefighting experts but were experts in the specific intervention. Future research should focus on meeting firefighters' demands by having intervention experts provide interventions, while including firefighting experts in the research design and intervention provision process to meet their unmet needs. Furthermore, discussions on suitable intervention locations and timings have been revealed to be researcher-centric in post-intervention reflections. Consequently, future research should focus on the participants during the research design phase. Moreover, given the current dissatisfaction resulting from one-sided program operations that do not meet participants' demands and lack diversity [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], there is a need for research to ascertain the demands of the field regarding the types of intervention studies required.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and limitations\u003c/h2\u003e \u003cp\u003eThis is the first comprehensive scoping review of intervention studies targeting Korean firefighters. It provides an integrated analysis of existing intervention studies from various perspectives based on firefighters\u0026rsquo; job characteristics and organizational culture. The significance of this study lies in the recommendations for subsequent intervention studies. Alongside this scoping review, the research team will conduct qualitative [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e] and survey research targeting Korean firefighters to identify unmet healthcare needs. Additionally, clinical data based on a memorandum of understanding between the Seoul Korean Medicine Association and Seoul Metropolitan Fire and Disaster Headquarters will be leveraged through retrospective chart reviews to undertake a series of research tasks aimed at promoting the health of Korean firefighters. The results of this study will serve as foundational data for future intervention studies targeting Korean firefighters.\u003c/p\u003e \u003cp\u003eHowever, this study had some limitations. First, as the study focused on publications in Korean and international journals since 2010, there may have been studies published before 2010 that were excluded, including theses, government documents, policy reports, and conference proceedings. Second, as only intervention studies targeting Korean firefighters were included, the findings may not apply to other countries and regions.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eFirefighter health issues extend beyond individual concerns to encompass socio-economic losses, underscoring the importance of implementing interventions to address these health concerns. These issues necessitate structured programs tailored to the characteristics of firefighters for prevention, treatment, and case management. This study employed a scoping review methodology to examine the characteristics of 35 intervention studies targeting Korean firefighters, the research on which has been steadily increasing since 2010. Recommendations for future research were provided. The three key factors identified in this study for improving the quality of intervention studies on Korean firefighters were as follows: study design and content, tailoring and ethics, and characteristics and demands of the field. These factors are summarized as follows. First, existing intervention studies were found to be imbalanced in terms of research topics, design, outcome variables, and formats of interventions. Hence, we concluded that diverse intervention studies addressing health issues among firefighters are needed and that financial support is crucial to ensure high-quality research design. Second, owing to the diverse characteristics of individual firefighters, tailored interventions, and protection of personal information for vulnerable participants are essential. Furthermore, a meticulous research design that adheres to the tenets of research ethics is imperative. Finally, there is a dearth of research analyzing the characteristics and needs of firefighters in the field. Future research must ascertain the needs of firefighters through qualitative research and collaborate with experts in the field of firefighting to design flexible research designs that can accommodate the characteristics of individual firefighters and organizations. The results of this study will serve as foundational data for future intervention studies targeting Korean firefighters. Furthermore, we aim to conduct a series of research projects in the future to identify the unmet health needs of firefighters and promote their health through a combination of qualitative research, survey research, and retrospective chart reviews.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIRB\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eInstitutional Review Board\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePRISMA-ScR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePreferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePTSD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePost-Traumatic Stress Disorder\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRCTs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eRandomized Controlled Trials\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eTIDieR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eTemplate for Intervention Description and Replication\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials\u003c/p\u003e\n\u003cp\u003eThe datasets analyzed in the current study are available from the corresponding author upon request.\u003c/p\u003e\n\u003cp\u003eCompeting interests\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eThis study was supported by the National Research Foundation of Korea (RS-2023-00250325).\u003c/p\u003e\n\u003cp\u003eAuthors\u0026apos; contributions\u003c/p\u003e\n\u003cp\u003eIY and JL designed the study and reviewed the manuscript. HJ(Hanbit Jin) wrote the manuscript. HJ (Hanbit Jin) and HJ (Hyungsun Jun) conducted eligibility checks, data extraction, and data synthesis. JH conducted the search and synthesized the data. All the authors have read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003eAcknowledgements\u003c/p\u003e\n\u003cp\u003eWe thank Soohyun Lee of the Medical Information Library of the National Medical Center for her assistance with the literature search.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eKwak B-G, Ryu J. The Effects of Job Characteristics of Firefighters Dispatched to Disaster Sites on Job Satisfaction. Fire Science and Engineering. 2023;37:146\u0026ndash;54.\u003c/li\u003e\n\u003cli\u003eComfort LK. Managing disaster: Strategies and policy perspectives. 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Crisisonomy. 2017;13:17\u0026ndash;33.\u003c/li\u003e\n\u003cli\u003eShin J, Sim M, Lee J, Lee DY, Jeon K, Oh S, et al. Stress Relief and Related Factors in Camp Program for Firefighters. stress. 2018;26:88\u0026ndash;94.\u003c/li\u003e\n\u003cli\u003eYook Y. The Effects of Mindfulness based Body-Psychological Exercise Program on the Reduction of Post-Traumatic Stress(PTSD) Symptoms in Fire Officials. Korean Society of Sport Psychology. 2018;29:57\u0026ndash;73.\u003c/li\u003e\n\u003cli\u003eShim G-S, Kim N-S, Bang S-H. Effects of Short-Term Music Therapy in Fire Fighters with Post-Traumatic Stress Risk. Journal of Korea Academia-Industrial cooperation Society. 2015;16:4040\u0026ndash;7.\u003c/li\u003e\n\u003cli\u003eLee BJ, Cho DU, Lee S. A Study on the Reduction of Stress for Firefighters According to Shift Work Using Personalized Birds Sound. The Journal of Korean Institute of Communications and Information Sciences. 2020;45:715\u0026ndash;21.\u003c/li\u003e\n\u003cli\u003eJang EH, Hong Y, Kim Y, Lee S, Ahn Y, Jeong KS, et al. The Development of a Sleep Intervention for Firefighters: The FIT-IN (Firefighter\u0026rsquo;s Therapy for Insomnia and Nightmares) Study. Int J Environ Res Public Health. 2020;17:8738.\u003c/li\u003e\n\u003cli\u003eKim M-H, Kim H, Yi I. Effects of a Meditation-Based Healing Program on Stress Level, Stress Vulnerability, and Sleep Quality of Fire Officers. Fire Science and Engineering. 2023;37:81\u0026ndash;8.\u003c/li\u003e\n\u003cli\u003eChung YH, Kim NH, Kim DH, Bae JH, Kwon JS, Jang JH, et al. The Psychological Characteristics and Functional Magnetic Resonance Imaging Findings in Firefighters with Partial Posttraumatic Stress Disorder and the Effect of Treatment by Using Eye Movement Desensitization and Reprocessing. JOURNAL OF THE KOREAN NEUROPSYCHIATRIC ASSOCIATION. 2014;53:122\u0026ndash;33.\u003c/li\u003e\n\u003cli\u003eHur M, Jung I. Development of the Educational Program for Fire Officials\u0026rsquo; Peer Psychological Support. Fire Science and Engineering. 2022;36:71\u0026ndash;81.\u003c/li\u003e\n\u003cli\u003eKim J-B, Xiang Y-Y, Kim C-B, Seo D, Song W, Lee H, et al. Improving Cardiorespiratory and Muscular Function of Korean Firefighters: A Kinect-Based Mixed Reality Device Exercise Intervention Randomized Control Trial. J Occup Environ Med. 2024;66:118\u0026ndash;22.\u003c/li\u003e\n\u003cli\u003eKim S-S. Survey on the Human Rights Situation of Firefighters. National Human Rights Commission; 2015.\u003c/li\u003e\n\u003cli\u003eNational Fire Agency. 2021 Firefighter Mental Health Survey and Analysis. http://www.nfa.go.kr:8005/wv/ezpdf/customLayout.jsp?contentId=L0RBVEEvbmZhL25mYS53YXIvdXBsb2FkLy9ib2FyZC8vYmJzXzAwMDAwMDAwMDAwMDAwMTAvMjAyMTEyMDUvMjAyMTEyMDUyMDM5NDczMzc5Ni5wZGY%3D. Accessed 5 Apr 2024.\u003c/li\u003e\n\u003cli\u003eMcFarlane AC, Atchison M, Rafalowicz E, Papay P. Physical symptoms in post-traumatic stress disorder. J Psychosom Res. 1994;38:715\u0026ndash;26.\u003c/li\u003e\n\u003cli\u003eKim I, Kim S. Police, Firefighter, and Coast Guard Mental Health Project Integration and Operation Plan Study (2017). KOREAN NATIONAL POLICE AGENCY.\u003c/li\u003e\n\u003cli\u003eKim JE, Dager SR, Jeong HS, Ma J, Park S, Kim J, et al. Firefighters, posttraumatic stress disorder, and barriers to treatment: Results from a nationwide total population survey. PLoS One. 2018;13:e0190630.\u003c/li\u003e\n\u003cli\u003eMin J, Kim Y, Kim HS, Han J, Kim I, Song J, et al. Descriptive analysis of prevalence and medical expenses of cancer, cardio-cerebrovascular disease, psychiatric disease, and musculoskeletal disease in Korean firefighters. Ann Occup Environ Med. 2020;32:e7.\u003c/li\u003e\n\u003cli\u003eMelnyk B, Morrison-Beedy D. Intervention research: Designing, conducting, analyzing, and funding. Springer publishing company; 2012.\u003c/li\u003e\n\u003cli\u003eRosenbloom JL, Ginther DK, Juhl T, Heppert JA. The Effects of Research \u0026amp; Development Funding on Scientific Productivity: Academic Chemistry, 1990-2009. PLoS One. 2015;10:e0138176.\u003c/li\u003e\n\u003cli\u003eDenkova E, Zanesco AP, Rogers SL, Jha AP. Is resilience trainable? An initial study comparing mindfulness and relaxation training in firefighters. Psychiatry Res. 2020;285:112794.\u003c/li\u003e\n\u003cli\u003eAdrian F, Monika H. Response bias in self-report measures of general health. Personality and Individual Differences. 1983;4:519\u0026ndash;25.\u003c/li\u003e\n\u003cli\u003eParkes KR. Social Desirability, defensiveness and self-report psychiatric inventory scores. Psychol Med. 1980;10:735\u0026ndash;42.\u003c/li\u003e\n\u003cli\u003eJin C, YeonJoo S. Differences in quality of sleep, job stress, fatigue, job satisfaction, and posttraumatic stress disorder according to the type of work in fire-fighting officers. The Korean Journal of Emergency Medical Services. 2018;22:149\u0026ndash;62.\u003c/li\u003e\n\u003cli\u003eRyu J, Ha E-H, Choi K, Kim JE, Park S, Kim H. Firefighters and Posttraumatic Stress Disorder. Journal of Korean Society of Biological Psychiatry. 2017;24:10\u0026ndash;8.\u003c/li\u003e\n\u003cli\u003eKim MG, Ahn Y-S. Associations between lower back pain and job types in South Korean male firefighters. Int J Occup Saf Ergon. 2021;27:570\u0026ndash;7.\u003c/li\u003e\n\u003cli\u003eKim JM, Suh BS, Jung KY, Kim DI, Kim WS, Cho HS, et al. The study for musculoskeletal symptoms and job stress in firemen. Journal of Korean Society of Occupational and Environmental Hygiene. 2007;17:111\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eHan M, Park S, Park JH, Hwang S-S, Kim I. Do police officers and firefighters have a higher risk of disease than other public officers? A 13-year nationwide cohort study in South Korea. BMJ Open. 2018;8:e019987.\u003c/li\u003e\n\u003cli\u003eClement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N, et al. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med. 2015;45:11\u0026ndash;27.\u003c/li\u003e\n\u003cli\u003ePark J, Baek S, Im M. Trends in Health-related Interventions on Children Attending Community Child Care Centers in South Korea. Child Health Nursing Research. 2018;24:241\u0026ndash;51.\u003c/li\u003e\n\u003cli\u003eBeatty J. Chronic Illness Stigma and Its Relevance in the Workplace. In: Thomson SB, Grandy G, editors. Stigmas, Work and Organizations. New York: Palgrave Macmillan US; 2018. p. 35\u0026ndash;54.\u003c/li\u003e\n\u003cli\u003ePaik Y, Choi M sun. The Effects of Group Arts Psychotherapy on Job Stress and Stress Coping Style for Fire-Fighting Officers. Korean Journal of Arts Therapy. 2017;17:157\u0026ndash;73.\u003c/li\u003e\n\u003cli\u003eNam CY, Kim HS, Kwon SH. Effects of a Stress Management Program Providing Cognitive Behavior Therapy on Problem-focused Coping, Job Stress, and Depression in Firefighters. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 2013;22:12\u0026ndash;21.\u003c/li\u003e\n\u003cli\u003ePark S, Park B-J. Effects of Forest Healing Program in Urban Forest on the Mental Health of Fire Officials and Satisfaction. Journal of recreation and landscape. 2022;16:47\u0026ndash;56.\u003c/li\u003e\n\u003cli\u003eChanseok P. Redesigning education programs for alleviating disaster response officials\u0026rsquo; stressㆍPTSD and it\u0026rsquo;s empirical analysis for effectiveness. Journal of Korea Safety Management \u0026amp; Science. 2014;16:147\u0026ndash;57.\u003c/li\u003e\n\u003cli\u003eBaek M-L, Kim Y-R. Effect of Music Listening on Convergent Job Stress of Fire-Fighter. Journal of the Korea Convergence Society. 2016;7:99\u0026ndash;104.\u003c/li\u003e\n\u003cli\u003eLee Y, Suk KJ, Bang C-H, Lee J-K, Huh Y-S, Park E. Effects of Wearing Firefighter Protective Clothing with Heavy Personal Protective Equipment on Physical, Biochemical, and Perceived Fatigue Parameters in Firefighting Officials. Journal of Wellness. 2016;11:195\u0026ndash;206.\u003c/li\u003e\n\u003cli\u003eKim E-A, Cho K-J. Comparing the Effectiveness of Two New CPR Training Methods in Korea: Medical Virtual Reality Simulation and Flipped Learning. Iran J Public Health. 2023;52:1428\u0026ndash;38.\u003c/li\u003e\n\u003cli\u003eKim EK, Park CS. A Study on the CISD Effectiveness. Crisisonomy. 2016;12:185\u0026ndash;93.\u003c/li\u003e\n\u003cli\u003eLee M-N, Na O-H. Pre-to-Post Recognition of Trauma Group Education for Fire fighters. Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology. 2017;7:413\u0026ndash;21.\u003c/li\u003e\n\u003cli\u003ePark C-H, Kang J, An M, Park S. Effects of Forest Therapy Program on Stress levels and Mood State in Fire Fighters. Fire Science and Engineering. 2019;33:132\u0026ndash;41.\u003c/li\u003e\n\u003cli\u003eKim C, Ji C, Kim S. Effects of a High-Intensity Interval Training Program on the Fitness and Performance of Firefighters. Fire Science and Engineering. 2020;34:97\u0026ndash;102.\u003c/li\u003e\n\u003cli\u003eJang HS, Yoo E, Kim JH, Jin JS, Kim JS, Ryu DY. Analysis of Psychological and Physiological Changes According to the Experience of the Care Farm of Fire-fighters. Journal of Korean Society of Rural Planning. 2021;27:71\u0026ndash;83.\u003c/li\u003e\n\u003cli\u003eLee CG, Kwon J, Park S, Ahn C, Seo D-I, Song W, et al. Process and Outcome Evaluations of Interventions to Promote Voluntary Exercise Training Among South Korean Firefighters. Am J Mens Health. 2022;16:15579883221076897.\u003c/li\u003e\n\u003cli\u003eKim DH, Jung JY, Kim D-H, Lee J-Y. Effects of Wearing Nomex Body Cooling Garment inside Firefighting Protective Equipment on the Efficiency of Performance During Simulated Firefighters\u0026rsquo; Tasks. The Korean Society of Living Environmental System. 2019;26:9\u0026ndash;24.\u003c/li\u003e\n\u003cli\u003eBak J. The Effects of Simsang-Poetry Therapy on the Mental Health of Firefighters. The Journal of Humanities and Social science. 2023;14:101\u0026ndash;16.\u003c/li\u003e\n\u003cli\u003eYoon H-S, Yoon H. A Case Study on the Application of the Happy Arts Therapy Program to Prevent Mental Health Problems of Fire-fighting Officers. Official Journal of the Koeran Society of Dance Science. 2022;39:1\u0026ndash;27.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Republic of Korea, Firefighter, Intervention study, Scoping review","lastPublishedDoi":"10.21203/rs.3.rs-4446023/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4446023/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eFirefighters in Korea experience a range of health issues due to the unique demands of their profession and the organizational culture within which they operate. However, to date, there has been a paucity of intervention studies reflecting the specific characteristics of firefighters. Therefore, this scoping review aimed to identify the current status and characteristics of intervention studies on firefighters in Korea and to make recommendations for further research.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003e The review was conducted in seven stages, in accordance with the methodological guidelines for scoping reviews framed by the Joanna Briggs Institute. For reporting, we adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. The literature search included articles published in Korean and international journals till January 25, 2024. Data were extracted according to a previously developed analysis framework and the Template for Intervention Description and Replication checklist. The protocol for this study was registered with the Open Science Framework and can be accessed via the following link: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://osf.io/s378j/\u003c/span\u003e\u003cspan address=\"https://osf.io/s378j/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA total of 35 articles were included in the review. The analysis revealed an imbalance in terms of research topics, design, outcome variables, and delivery format of interventions in the design and content of the reviewed studies. In terms of research ethics, researchers must ensure that the rules and guidelines regarding bioethics are followed. The review also highlighted a lack of research that reflected the characteristics and needs of firefighting organizations.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eFuture research must include various intervention studies on firefighters\u0026rsquo; health problems and implement sensitive research designs that consider research ethics. It is also important to listen to the needs of firefighting organizations and collaborate with experts with firefighting knowledge to create flexible research designs that can accommodate the characteristics of individual firefighters and organizations.\u003c/p\u003e","manuscriptTitle":"Current Status of Intervention Studies on Korean Firefighters and Recommendations for Further Research: A Scoping Review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-07 17:43:37","doi":"10.21203/rs.3.rs-4446023/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0ac23526-4a4e-4f6e-9957-e65b87b0749b","owner":[],"postedDate":"June 7th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-09-18T08:54:51+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-07 17:43:37","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4446023","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4446023","identity":"rs-4446023","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}