Factors that influence happiness of nursing students according to COVID-19 infection status

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Methods Data were collected from October 4, 2023 to November 15, 2023. The subjects were 343 students enrolled in five nursing schools in four major cities (D, G, K, and Y) in Korea. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson’s correlation coefficients. Results For COVID + students, happiness was significantly affected by adaptation to campus life and family strengths. This model had r 2 = 0.401; i.e., it explained 40.1% of the variability in happiness. For COVID 0 students, happiness was significantly affected by adaptation to campus life and subjective health status, with r 2 = 0.346. Conclusions These results indicate the necessity of developing a happiness-promotion program for nursing students. College life adaptation Family strengths Happiness Leisure activities Nursing student Introduction According to the World Happiness Report 2022, the average happiness index for South Koreans was 5.94, ranking 59th out of 146 countries; it was 1.88 points below the first-ranked country, Finland [ 1 ]. However, early stages in the COVID-19 pandemic, the average happiness index for Korean university students was low, at 53.3 out of 100 [ 2 ]. Upon questioning about their current happiness, the most frequent response was 'uncertain' at 33.0%, followed by 'relatively happy' (29.2%), 'not very happy' (22.9%), 'not at all happy' (11.0%), and 'extremely happy' (3.9%). Only about three in ten Korean university students considered their lives to be happy. Before the COVID-19 pandemic, university students were already experiencing lower levels of happiness due to various factors such as the pressures of establishing a career path, academic demands, the transition from adolescence to adulthood, and peer pressure [ 3 ]. The happiness levels of university students further decreased due to changes in daily life caused by COVID-19, including reduced personal interactions with classmates and friends, and the interruption of academic and professional trajectories [ 4 ]. During the COVID-19 pandemic, countries around the world implemented various measures (e.g., quarantine measures, social distancing, remote working, mandatory mask-wearing) to mitigate stress and anxiety related to COVID-19, and to increase happiness. These measures aimed to create an environment conducive to economic, social, and political well-being [ 5 ], but they had more negative than positive effects on human happiness (e.g., deterioration in health, disruption of social relationships, decreased adaptability, financial worries) [ 6 – 8 ]. Strong social lockdowns that were implemented beginning in the early 2020s shifted classes in nursing theory from face-to-face to distance learning, and transformed nursing practice fields from clinical and community settings to simulation and online systems [ 9 , 10 ]. Nursing students, faced with restricted access to university facilities and reduced contact with peers and teachers, were compelled to adopt a remote education system while being granted increased autonomy, necessitating increased control over their learning process. However, the unprecedented and unanticipated shift to a remote education system resulted in a decline in academic adaptation among nursing students, compared to the pre-COVID-19 era, due to a lack of motivation, and decrease in attention, in effort, and in time investment in learning [ 8 , 11 , 12 ]. Nursing students faced problems issues in adapting to university life, including personal emotional adjustment, social adaptation, and institutional attachment. These adaptations are necessary to meet the various educational demands that arise from university expectations [ 13 ]. Leisure activities are critically important in protecting against the negative effects of the COVID-19 pandemic. However, due to the continuous remote education system during the pandemic, college students’ leisure activities decreased [ 14 ]. Nursing students were more anxious about others becoming infected with COVID-19 than about themselves becoming infected with it, and therefore intentionally chose self-quarantine, avoided direct contact with friends and family, and sometimes sought temporary living arrangements alone, thereby detaching themselves from support systems offered by family, friends, or colleagues [ 9 , 15 ]. Social lockdowns implemented to prevent COVID-19 further limited nursing students’ the social relationships, which are often cultivated by engaging in leisure activities [ 16 , 17 ]. During the COVID-19 pandemic, information collected from families was important in collecting knowledge about the disease and its risks [ 13 ]. Strong social lockdown measures implemented to prevent the spread of the COVID-19 pandemic forced nursing students to undertake online learning at home and to have limited interpersonal interactions with their family members [ 5 ]. In this changed home environment, nursing students often encounter conflicts, such as arguments, in maintaining a balance of power with other family members working online [ 18 ]. However, the happiness of nursing students increases as their emotional relationships with their family members improve [ 19 ]. Happiness is conceptualized as an subject's cognitive and emotional evaluation of their life [ 20 ]. People who experience happiness and satisfaction are likely to have greater self-discipline, self-regulation and coping abilities, which empower them to positively navigate their lives, even during crisis situations like the COVID-19 pandemic [ 19 ]. Throughout the COVID-19 pandemic, key factors that can reduce happiness have been identified; they include the degree of mobility restriction due to isolation and social-distancing measures, the perceived threat to interpersonal relationships such as love and friendship, concerns regarding educational pursuits and employment, the dynamics of remote work and returning to the office, and overall satisfaction with domestic life [ 21 , 22 ]. The ‘upward approach’ within happiness diffusion theory posits that overall life satisfaction and happiness are influenced by accumulating satisfaction in subject sub-factors that affect happiness. These sub-factors include health, income, leisure, family, academics, and occupation [ 20 ]. This research aims to provide foundational data for developing intervention programs to increase the happiness of Korean nursing students during the COVID-19 endemic era. The first step is to distinguish between nursing students who had been infected with COVID-19 (COVID + students) or had not been infected by COVID-19 (COVID 0 students). The second was to explore how their overall happiness was affected by subject happiness sub-factors, such as college life adaption, leisure satisfaction from club activities, and family strengths. The hypotheses of this study are as follows. Hypothesis 1 College life adaptation affects the happiness of both COVID + and COVID 0 nursing students. Hypothesis 2 Leisure satisfaction from club activities affect the happiness of both COVID + and COVID 0 students. Hypothesis 3 Family strengths affects the happiness of both COVID + and COVID + nursing students. Methods Research design This a descriptive survey study that utilized a self-reported questionnaire method. It is based on the upward approach within the theory of happiness diffusion as described by Diener 20 . The aim is to determine the impact of college life adaptation, leisure satisfaction from club activities, and family strengths on the happiness of South Korean nursing students during the COVID-19 endemic era. Research participants Participants were randomly sampled from five nursing departments in South Korean cities D, G, K, and Y. To ensure sufficient statistical power, the G*Power 3.1 program was used. The study required a minimum convenience sample size of 152 participants, considering a significance level (α) of 0.05, a power (1-β) of 0.90, an effect size of 0.15, and the incorporation of 11 independent variables. To meet this requirement, 370 questionnaires were distributed, accounting for non-response rates and unreliable responses. Of the responses received, 27 were discarded due to a high number of non-responses or insincere answers, leaving a final sample size of 343 participants (180 COVID + , 163 COVID 0 ). The specific selection criteria for the study were as follows. (1) Common Criteria: Participants were third and fourth-year nursing students who had experienced more than one year (more than three times per week) of remote learning between March 2020 and December 2022 due to the COVID-19 pandemic, and who had actively participated in club activities for more than six months (at least twice a month) within the past year. (2) COVID + Participants: Subjects who received a positive COVID-19 diagnosis from a health center or hospital after the outbreak and had an experience of isolation, as well as those whose infection was confirmed by an official notification or message from a health center or hospital. (3) COVID 0 Participants: Those who have not received a positive COVID-19 diagnosis from a health center or hospital since the outbreak of COVID-19. Research tools College life adaptation This study used a tool specifically developed for nursing college students by Park and Kim [ 23 ]. It is composed of 34 items in six subscales: nine items for interpersonal relations, nine items for major satisfaction, five items for major ease, five items for coping capacity, three items for job preparation, and three items for academic fidelity. Each item is rated on a 5-point Likert scale, starting from 1 point, where negative items are reverse-scored, so a high score corresponds to good overall adaptation to university life. In this study, the instrument had Cronbach’s α = 0.91. Leisure satisfaction from club activities This study used the Leisure Satisfaction Scale (LSS), developed by Beard and Ragheb [ 24 ] and validated for reliability and validity by Kim et al [ 25 ]. This scale consists of 24 items in six subscales: psychological, educational, social, relaxation, physical, and aesthetic. Each item is rated on a 5-point Likert scale from 1 = ‘Not at all,’ to 5 = ‘Very much so,’ so a high total score signifies high leisure satisfaction. In this study, the scale had Cronbach’s α = 0.97. Family strengths This study used the Korea Family Strengths Scale (KFSS-II), developed by Yoo et al [ 26 ]. This scale consists of five sub-areas: family resilience, mutual respect and acceptance, quality of bonding, economic stability and cooperation, and family culture and social participation, totaling 22 items. Each item is scored on a 5-point Likert scale from 1 = ‘Not at all’ to 5 = ‘Very much so’ 5, so a high total score indicates high family strengths. In this study, the scale had Cronbach’s α = 0.96. Happiness This study used the shortened Korean version of the happiness scale developed by Suh and Koo [ 27 ]. This scale consists of nine items across three core sub-factors of happiness experience: life satisfaction, positive emotions, and negative emotions. Life satisfaction assesses satisfaction with personal aspects, interpersonal relationships, and group belonging. Positive emotions and negative quantify emotions closely related to happiness. Each item is rated on a 7-point Likert scale, from 1 to 7, with happiness increasing with score. In this study, this scale had Cronbach’s α = 0.90. Data collection Data were collected from October 4, 2023, to November 15, 2023, as per approved guidelines. The researchers visited five nursing departments in major South Korean cities (D, G, K, and Y cities). They explained the study’s purpose and methodology to the department heads, secured their permission and cooperation for the research, and posted a recruitment announcement for participants. Subjects selected through the recruitment process were given detailed explanations by the researchers about the study’s purpose, anonymity, and confidentiality. The participants gave written consent for voluntary participation, completed the questionnaire, which the researchers later collected. For participants who reported a history of COVID-19 infection, the notification document or text message received from a health center or hospital was verified. Data analysis The collected data were analyzed using the SPSS/WIN 23.0 software program. The distributions of general characteristics of the subjects were presented as frequencies and percentages. Differences in happiness according to the subjects’ general characteristics were compared using t-tests and one-way ANOVA. The levels of college life adaptation, leisure satisfaction from club activities, family strengths, and happiness were reported as average and standard deviation. The correlation between happiness and related variables was examined using Pearson’s correlation coefficients. The assumptions for regression analysis of the independent variables were diagnosed considering multicollinearity, residuals, and singular values. Multiple linear regression analysis was conducted to identify factors that influence happiness. Ethical considerations This study was approved by the Kwangju Women's University Institutional Review Board (IRB NO.1041465-202308-HR-001-30). The survey questionnaire incorporated detailed explanations about the necessity and purpose of the study, research method, estimated time commitment, the possibility of withdrawal during the study, voluntary participation, potential benefits and disadvantages of participating, as well as the management and confidentiality of personal information. Contact information for the researchers was also provided for any inquiries related to the study. The survey was administered only to those who understood and consented to these terms, and their responses were included in the analysis. Participants were assured that the survey results would be quantified, processed, and used exclusively for the purposes of this research, that their anonymity would be preserved, and that they could opt out of the survey at any point without facing any negative consequences. Following these explanations, written consent was obtained from the students who agreed to participate. They then individually completed the questionnaires, which were collected directly by the research team. Results Demographic differences in happiness among participants how had been or had not been infected with COVID-19 Most subjects (291) were women; of them, 159 (88.3%) were COVID + and 132 (81.0%) were COVID 0 . The average happiness score was 5.16 (± 1.16) for COVID + subjects and 5.23 (± 1.10) for COVID 0 subjects; both scores were higher among men than among women, but the differences were not statistically significant. Most of COVID + subjects (94 subjects, 52.2%) were participants were 4th -year students, whereas most of the COVID 0 subjects were 3rd -year students (98 subjects, 60.1%). The average happiness score was higher for 3rd -year students, than for 4th -years students: 5.11 (± 0.99) for COVID + and 5.06 (± 1.01) for COVID 0 , but these differences were not statistically significant. Most participants came from nuclear families: 157 (87.2%) of COVID + and 142 (87.1%) of COVID 0 subjects. The average happiness score was higher for those in nuclear families among the COVID + (5.02 ± 1.04) and in extended families among the COVID 0 (5.42 ± 0.63), but the differences were not statistically significant. Most participants had one sibling: 90 (50.0%) of COVID + and 90 (55.2%) of COVID 0 subjects. The highest average happiness scores were for those with no siblings among the COVID + (5.18 ± 0.97) and those with one sibling among the COVID 0 (5.15 ± 0.90), but the differences were not statistically significant. Most participants reported having no religious affiliation: 120 (66.7%) of COVID + and 114 (69.9%) of COVID 0 . The average happiness score was slightly higher among those with no religious affiliation than among those who claimed an affiliation, i.e., 5.00 (± 1.06) for COVID + and 5.01 (± 0.96) for the COVID 0 , but the differences were not statistically significant. Most of both groups were members of one club: 115 (63.9%) of COVID + and 113 (69.3%) of COVID 0 . The average happiness score was highest for those in one club among the COVID + , at 5.00 (± 1.02), and in four clubs among the COVID + , at 5.83 (± 0.88), but these differences were not statistically significant. Most participants belonged to the 'medium' economic category: 149 (82.8%) of COVID + and 130 (79.8%) of COVID 0 . The average happiness score was highest for those in the 'high' economic category; i.e., 5.58 (± 1.01) for the COVID + and 5.39 (± 1.08) for the COVID 0 . This difference was statistically significant (F = 5.640, p = 0.004). Most participants self-evaluated their health status, as ‘good’; i.e., 107 (59.4%) of COVID + and 100 (61.3%) COVID 0 . The average happiness score was highest among those who rated their health as 'good'; i.e., 5.24 (± 0.99) for COVID + and 5.22 (± 0.89) for the COVID 0 . This difference was statistically significant (F = 11.801, p < 0.001) (Table 1 ). Table 1 Nursing students' happiness according to demographic characteristics (N = 343). Characteristics Category Infected (n = 180) Non-Infected (n = 163) n % M SD t/F p n % M SD t/F p Sex Male 21 11.7 5.16 1.16 0.920 0.359 31 19.0 5.23 1.10 1.524 0.129 Female 159 88.3 4.94 1.05 132 81.0 4.94 0.92 College year 3rd 86 47.8 5.11 0.99 1.808 0.072 98 60.1 5.06 1.01 1.063 0.289 4th 94 52.2 4.83 1.11 65 39.9 4.90 0.89 Family type Nuclear families 157 87.2 5.02 1.04 1.973 0.120 142 87.1 4.99 0.98 0.757 0.520 Single-parent families 13 7.2 4.40 1.24 10 6.1 4.90 0.78 Extended families 8 4.4 4.96 0.91 8 4.9 5.42 0.63 Etc 2 1.1 4.00 1.26 3 1.8 4.56 1.53 Number of siblings None 17 9.4 5.18 0.97 0.842 0.472 15 9.2 4.86 0.88 1.929 0.127 One 90 50.0 5.03 1.01 90 55.2 5.15 0.90 Two 46 25.6 4.78 1.16 48 29.4 4.81 1.02 3 or more 27 15.0 4.93 1.10 10 6.1 4.64 1.18 Religion Yes 60 33.3 4.90 1.07 -0.591 0.555 49 30.1 4.96 0.96 -0.302 0.763 No 120 66.7 5.00 1.06 114 69.9 5.01 0.96 Number of club registrations One 115 63.9 5.00 1.02 0.213 0.808 113 69.3 4.99 0.92 1.558 0.202 Two 57 31.7 4.92 1.13 43 26.4 4.89 1.03 Three 8 4.4 4.79 1.07 4 2.5 5.83 0.88 4 or more 0 0.0 - 3 1.8 5.56 1.28 Household economic level High a 23 12.8 5.58 1.01 5.862 0.003 c < a 26 16.0 5.39 1.08 5.640 0.004 c < ba Medium b 149 82.8 4.90 1.03 130 79.8 4.96 0.87 Low c 8 4.4 4.33 1.20 7 4.3 4.10 1.40 Subjective health status Good a 107 59.4 5.24 0.99 11.097 < 0.001 c < a 100 61.3 5.22 0.89 11.801 < 0.001 c < ba Normal b 65 36.1 4.62 1.06 58 35.6 4.73 0.91 Bad c 8 4.4 4.06 0.57 5 3.1 3.58 1.01 M = mean, SD = standard deviation Adaptation to college life, leisure satisfaction, family strengths, and happiness in relation to COVID-19 infection status Happiness scores were 3.55 ± 0.52 for the COVID + group and 3.52 ± 0.47 for the COVID + group. Regarding adaptation to college life, scores were 3.58 ± 0.67 for the COVID + and 3.49 ± 0.84 for the COVID 0 . In terms of leisure satisfaction, the scores were 4.12 ± 0.69 for the COVID + and 4.06 ± 0.67 for the COVID 0 . For family strengths, the COVID + group scored 4.96 ± 1.06, whereas the COVID 0 group scored 4.99 ± 0.96. None of these differences was statistically significant (Table 2 ). Table 2 Nursing students' happiness, college life adaption, leisure satisfaction from club activities, family strengths (N = 343). Variable Infected (n = 180) Non-Infected (n = 163) t p M SD M SD Nursing student happiness 3.55 0.52 3.52 0.47 -0.524 0.600 College life adaption 3.58 0.67 3.49 0.84 -1.099 0.272 Leisure satisfaction 4.12 0.69 4.06 0.67 -0.808 0.420 Family Strengths 4.96 1.06 4.99 0.96 0.271 0.787 Correlation among study variables Among the COVID + students, happiness showed a significant positive correlation with college life adaptation (r = 0.598, p < 0.001), leisure satisfaction (r = 0.345, p < 0.001), and family strengths (r = 0.387, p < 0.001). In the COVID 0 group, happiness also showed a significant positive correlation with college life adaption (r = 0.568, p < 0.001), leisure satisfaction (r = 0.262, p < 0.001), and family strengths (r = 0.331, p < 0.001) (Table 3 ). Table 3 Correlation between study variables (N = 343).인구학적 Variable Nursing student happiness Infected (n = 180) Non-Infected (n = 163) r p r p College life adaption 0.598 < 0.001 0.568 < 0.001 Leisure satisfaction 0.345 < 0.001 0.262 < 0.001 Family Strengths 0.387 < 0.001 0.331 < 0.001 Nursing student happiness 1 1 Factors that influenced happiness Multiple linear regression was conducted to identify factors that influenced the happiness of the participants. To determine the factors affecting participants' happiness, the analysis included statistically-significant variables: college life adaptation, leisure satisfaction, family strengths, and general characteristics (notably, subjective health status and college life adaptation). For COVID + subjects, the regression model for happiness was significant (F = 24.970, p < 0.001), with college life adaptation (b = 0.462, p = 0.001) and family strengths (b = 0.148, p = 0.025) having significant effects on happiness. These variables explained 40.1% of happiness. For COVID 0 subjects, the regression model for happiness was also significant (F = 18.177, p < 0.001), with college life adaptation (b = 0.456, p = 0.001) and subjective health status (b = 0.165, p = 0.016) having significant effects on happiness. These variables explained 34.6% of happiness. Regarding the fit of this regression model, the multicollinearity was checked by referring to tolerance limits, which were between 0.731 and 0.880 for COVID + subjects and between 0.681 and 0.883 for COVID 0 subjects; all of these values exceeded the threshold of 0.1. The Variance Inflation Factors (VIF) for COVID + subjects ranged from 1.136 to 1.368 and from 1.133 to 1.469 for COVID 0 subjects; these values were all below the threshold of 10. The Durbin-Watson test for residual normality in the model yielded values of 1.661 for COVID + subjects and 2.093 for COVID 0 subjects; these results indicate no autocorrelation in the residuals (Table 4 ). Table 4 Factors affecting the happiness of nursing students (N = 343).인구학적 Variable B SE β t p Infected (n = 180) (Constant) -0.679 0.536 - -1.267 0.207 Household economic level 0.155 0.160 0.060 0.966 0.335 Subjective health status 0.222 0.114 0.122 1.940 0.054 College life adaption 0.944 0.138 0.462 6.827 0.000 Leisure satisfaction 0.130 0.101 0.083 1.290 0.199 Family Strengths 0.228 0.101 0.148 2.257 0.025 Durbin-Watson = 1.661, Tolerance Limit = 0.731 ~ 0.880, VIF = 1.136 ~ 1.368, R²=0.418, Adjusted R²=0.401, F = 24.970, p < 0.001 Variable B SE β t p Non-Infected (n = 163) (Constant) 0.088 0.537 - 0.165 0.869 Household economic level 0.087 0.153 0.040 0.568 0.571 Subjective health status 0.286 0.117 0.165 2.436 0.016 College life adaption 0.926 0.156 0.456 5.927 0.000 Leisure satisfaction 0.016 0.081 0.014 0.194 0.846 Family Strengths 0.164 0.102 0.115 1.608 0.110 Durbin-Watson = 2.093, Tolerance Limit = 0.681 ~ 0.883, VIF = 1.133 ~ 1.469, R²=0.367, Adjusted R²=0.346, F = 18.177, p < 0.001 Discussion COVID-19 has been associated with an increase in negative emotions such as anxiety and depression among college students, particularly during their critical period of transition to adulthood and exploration. This increase in negative emotions contributes to a decrease in their overall happiness levels [ 6 ]. This study examined the effect of COVID-19 infection on the happiness of Korean nursing students. This analysis revealed that college life adaptation had the most significant effect on happiness among both COVID + and COVID 0 nursing students. College life adaptation is a specific form of social adaptation, and involves the process by which students adjust their behaviors and thoughts in response to the new environment of the college campus, encompassing living, studying, and social interactions [ 28 ]. The COVID-19 outbreak on university campuses was rapid and extensive, and these factors raised concerns about its potential to quickly spread to other communities. Nationally-implemented social containment policies for intercepting and preventing the spread of COVID-19 necessitated a shift from face-to-face academic classes and nursing practices to remote, online learning environments for nursing students [ 9 , 10 ]. Even before the COVID-19 pandemic, college students had already embraced a culture in which remote support systems using the internet, computers, and smartphones facilitated convenience in learning and daily life [ 28 ]. During the COVID-19 pandemic, most university-life activities shifted to online modes, and this transition to remote learning systems continues even in the era of COVID-19 becoming endemic. Nursing students, regardless of their COVID-19 infection status, relied on non-face-to-face university activities while adhering to national prevention guidelines such as avoiding direct contact, due to their heightened anxiety about infection among family and friends [ 9 , 15 ]. Excessive online activity can reduce an subject's ability to regulate emotions, and may thereby lead to depression, suicidal thoughts, academic failure, and social isolation [ 29 ]. Attending university entails an increase in freedom of choice and independence from parental supervision [ 28 ]. However, nursing students experienced increased psychological distress due to worries about the duration of the COVID-19 pandemic, the uncertainty of returning to normal life, loneliness from isolation, anxiety about limited clinical practice opportunities, and future uncertainties [ 30 ]. All of the subjects, both COVID + and COVID 0 realized the importance and necessity of face-to-face interactions in campus life, learning, and social engagement while adhering to long-term infection prevention lifestyle rules. During the change of COVID-19 from the epidemic to the endemic phase, the academic classes, clinical practice, and other campus activities of nursing education have changed from remote formats back to in-person formats. All of these nursing students, both COVID + and COVID 0 , have reinterpreted the current situation as an opportunity for professional growth as nurses. This reevaluation may explain why adaptation to university life significantly affects their happiness. Therefore, to increase the happiness of nursing students, programs must be developed and implemented that aid in job preparation, improve interpersonal relationships, and enhance problem-solving skills, along with regular academic classes and clinical practices, as part of college life adaption. For COVID + students, family strengths also influenced their happiness. During COVID-19, nursing students experienced elevated levels of negative emotions like anxiety and depression, especially when dealing with family illness or death, economic struggles due to the breadwinner's job loss, or conflicts with parents and siblings while staying at home for extended periods [ 31 ]. Specifically, COVID + nursing students experienced anxiety and depression due to uncertainties about infecting other family members, threats to their own and their family's health, and fears about the challenges of recovery [ 7 , 32 ]. Negative emotions persisted among 30–40% of COVID + students, even more than a month after their recovery [ 7 ]. During their COVID-19 infection, the primary source of care and concern often came from their own family, rather than others sources. Although direct contact was not possible, family members frequently visited to check on their condition, prayed for their speedy recovery, and provided food and necessary supplies. This unconditional acceptance and support from family members helped to inspire and motivate the participants to recover from COVID-19. Moreover, active family support also helped COVID + nursing students to positively embrace the healing process. This support strengthened their immune system and reduced feelings of anxiety and depression, and thus promoted health and wellness [ 33 , 34 ]. These factors indicate that family involvement in the process of recovery from COVID-19 infection assists the infected in resolving problems, and expedites the treatment process. For COVID + nursing students, the support and encouragement received from their families were instrumental in overcoming various discomforts and challenges encountered during the recovery process. Consequently, family strengths emerged as a significant factor influencing their happiness. The family is the most essential source of social support and provides support to its members in forms such as emotional, instrumental, informational, and reward support [ 34 ]. Hence, to boost the happiness of COVID + nursing students, interaction-enhancing programs for their families must be developed. Additionally, health-promotion programs that increase knowledge, attitudes, and practices concerning infectious diseases should be implemented to sustain family strengths consistently. For COVID 0 nursing students, subjective health status was another influential factor on their happiness. Subjective health status is the self-perceived assessment of one's overall health condition as good [ 35 ]. During the COVID-19 pandemic, COVID 0 nursing students shared similar fears as their infected peers, including the fear of contracting the virus, the fear of close contacts becoming infected, and uncertainties about the future [ 32 , 36 ]. Subjective health status helps to alleviate various stresses caused by COVID-19 and to increase a person’s ability to manage personal health threats. Increase in an subject’s subjective health status is correlated with a decrease in their subjective perception the risk of contracting COVID-19. This reduction in perceived risk leads to decreased negative emotions related to COVID-19, such as feelings of isolation, loneliness, fear, anxiety, and depression. In short, a high subjective health status causes reduction in perception of the risk of contracting COVID-19, and helps a person to maintain positive emotions in their daily life. In contrast, subjects with poor subjective evaluation of health may feel threatened by the risk of COVID-19 infection, and therefore adhere more strictly to preventive measures like wearing masks and limiting outdoor activities, than people who have high subjective evaluation of health [ 37 ]. During the endemic phase of COVID-19, COVID 0 nursing students are concerned about the possibility of eventually contracting COVID-19 as daily life transitions from remote to face-to-face interactions, despite the continued presence of the virus. This concern highlights the importance of subjective health status as an influencing factor on their happiness. Therefore, for to increase the happiness of COVID 0 nursing students, health care education programs that are aimed at improving their health status should be developed. Implications This research has explored the factors affecting the happiness of nursing students in relation to their COVID-19 infection status. Many studies in social sciences have investigated psychological factors linked to the COVID-19 context [ 12 , 21 , 28 ], but these studies these often yielded fragmented results. This problem indicates the importance of clearly distinguishing infection status as a preliminary step in a multifaceted examination of influencing factors, especially in developing programs and policy suggestions to increase happiness. This differentiation is crucial because psychological responses vary depending on infection status, a concept supported by previous research [ 38 ], which found that sensitivity to COVID-19 as a disease can aid in explaining the assessment of stress overload. Therefore, by investigating the happiness factors of nursing students based on their infection status, this study contributes uniquely by offering solutions tailored to their specific needs. It provides foundational data for future development of happiness-enhancement programs for nursing students, distinguishing this research from previous works. Limitations Firstly, this research involved random sampling from five nursing departments in D, G, K, and Y cities. Consequently, these findings may not be applicable to all nursing students across different regions in Korea. To increase generalizability, future research should consider nursing students in various locations to enhance generalizability population density and urban scale. Secondly, the study focused only on college life adaptation, leisure satisfaction, and family strengths as factors affecting nursing students' happiness; restriction of the analysis to a few aspects may miss out on a multifaceted examination of happiness. Future studies should explore a wider range of factors that may positively influence nursing students' happiness, than this study considered. Lastly, the use of quantitative research in this study may not sufficiently examine nursing students' happiness. Future research should employ qualitative methods to explore the practical significance of happiness in nursing students' experiences. Conclusion This research has contributed foundational data for the development of happiness enhancement programs for nursing students in the COVID-19 endemic era, by discerning the factors influencing their happiness relative to their COVID-19 infection status. In developing happiness-enhancement programs for nursing students during the COVID-19 endemic era, focus should be placed on college life adaptation. Additionally, for COVID + nursing students, the emphasis should be on family strengths, whereas for COVID 0 nursing students, the focus should be on their health status. Nursing students must be guided in implementing these aspects into their practices. Declarations Acknowledgements We would like to express our gratitude to the nursing schools who cooperated with the study. It is hoped that this study can contribute to the health promotion of nursing students. Author contributions Conceptualization: HO, Jung; Data handling: SW, Han; Research design: HO, Jung; Data analysis: SW, Han; Study validation: SW, Han; Supervision:HO, Jung; Data presentation: SW, Han; Draft preparation: HO, Jung and SW, Han; Study consultation: HO, Jung; Writing and reviewing, project administration: HO, Jung and SW, Han. All authors reviewed the manuscript. Ethics approval and consent to participate The research proposal was approved by the Ethics Committee of Kwangju Women's University (code: 1041465-202308-HR-001-30), and informed consent was obtained from participants. All procedures were carried out in accordance with the 1964 Helsinki declaration. Fundings The authors received no financial support for the research, authorship, and/or publication of this article. Data availability The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Consent for publication Not applicable. 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A Concise measure of subjective well-being (COMOSWB): Scale development and validation. Kor J Soc Pers Psychol. 2011;25(1):96-114. Bi X, Jin J. Psychological capital, college adaptation, and internet addiction: An analysis based on moderated mediation model. Front Psychiatry. 2021;12:0712964. http://doi.org/10.3389/fpsyt.2021.712964 Berardis DD, Fornaro M, Orsolini L, Ventriglio A, Vellante F, Giannantonio MD. Emotional dysregulation in adolescents: Implications for the development of severe psychiatric disorders, substance abuse, and suicidal ideation and behaviors. Brain Sci. 2020;10:1–5. http://doi.org/10.3390/brainsci10090591 Aslan H, Pekince H. Nursing students' views on the COVID-19 pandemic and their perceived stress levels. Perspect. Psychiatr. Care. 2021;57:695-701. https://doi.org/10.1111/ppc.12597 Koçak O, Koçak OE, Younis Y. The psychological consequences of COVID-19 fear and the moderator effects of individuals’ underlying illness and witnessing infected friends and family. Int. J. Environ. Res. Public. Health. 2021;18(4):1836. http://doi.org/10.3390/ijerph18041836 Prakash J, Dangi A, Chaterjee K, Yadav P, Srivastava K, Chauhan VS. Assessment of depression, anxiety and stress in COVID-19 infected individuals and their families. Med J Armed Forces India. 2021;77(2):S424-S429. http://doi.org/10.1016/j.mjafi.2021.06.013 Green N, Tappin D, Bentley T. Working from home before, during and after the COVID-19 pandemic: Implications for workers and organization. NZJ Employ Relat. 2020;45(2), 5–16. https://doi.org/10.24135/nzjer.v45i2.19 Kristina D, Indraswari C. Dealing the crisis together: The meaning of family support for employees infected by Covid-19. J. Psikologi. Integratif. 2022;10(1):49-64. Qiu J, Shen B, Zhao M, Wang Z, Xie B, Xu Y. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: Implications and policy recommendations. Gen Psychiatry. 2020;33(2): e100213. https://doi.org/https://dx.doi.org/10.1136%2Fgpsych-2020-100213 Mazza MG, Lorenzo R, Conte C, Poletti S, Vai B, Bollettini I, et al. Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors. Brain. Behav. Immun. 2020;89:594-600. https://doi.org/10.1016/j.bbi.2020.07.037 Inbar L, Shinan-Altman. Emotional reactions and subjective health status during the COVID-19 pandemic in Israel: The mediating role of perceived susceptibility. Psychol Health Med. 2020;26(1):75-84. https://doi.org/10.1080/13548506.2020.1858490 Amirkhan, J H. Stress overload in the spread of coronavirus. Anxiety Stress Coping. 2021;34(2):121-129. https://doi.org/10.1080/10615806.2020.1824271. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 26 Aug, 2024 Read the published version in BMC Nursing → Version 1 posted Editorial decision: Revision requested 15 May, 2024 Reviews received at journal 12 May, 2024 Reviewers agreed at journal 04 May, 2024 Reviewers agreed at journal 03 May, 2024 Reviewers agreed at journal 15 Apr, 2024 Reviews received at journal 08 Apr, 2024 Reviewers agreed at journal 08 Apr, 2024 Reviewers invited by journal 01 Apr, 2024 Editor invited by journal 22 Mar, 2024 Editor assigned by journal 22 Mar, 2024 Submission checks completed at journal 22 Mar, 2024 First submitted to journal 18 Mar, 2024 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. 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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-4121054","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":283433176,"identity":"fd0a84ed-3e13-4219-a912-0d938fa674d7","order_by":0,"name":"Hyun-Ok Jung","email":"","orcid":"","institution":"Catholic University of Daegu","correspondingAuthor":false,"prefix":"","firstName":"Hyun-Ok","middleName":"","lastName":"Jung","suffix":""},{"id":283433177,"identity":"455e40c3-23ee-4020-9fda-f27719c0d3f3","order_by":1,"name":"Seung-Woo Han","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAsklEQVRIiWNgGAWjYFACHiCuSIByDhCt5QzJWhjbSNEiPyP34OfCeWmJGw4wP/zAcOYeYS0GN/KSpWduywFqYTOWYLhRTIQW6RwDad5tFbkbDjCYMTB8SCCog0F+do7xb945IC3s34jTwnA7x0yatyEHqIUHaMsNIrQY3H9jZs1zLK1+5mGeYokEeGjjc1jPGePbPDXJxnzH2zd++HCMGIfBATMQk6RhFIyCUTAKRgFuAAChvDnqWPB+BAAAAABJRU5ErkJggg==","orcid":"","institution":"Kwangju Women’s University","correspondingAuthor":true,"prefix":"","firstName":"Seung-Woo","middleName":"","lastName":"Han","suffix":""}],"badges":[],"createdAt":"2024-03-18 07:50:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4121054/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4121054/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12912-024-02237-9","type":"published","date":"2024-08-26T15:57:36+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":63820977,"identity":"f461088e-2542-438a-875f-d09a39b6be48","added_by":"auto","created_at":"2024-09-02 16:10:42","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":821258,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4121054/v1/7d6a5d1c-6901-473d-9af1-300c0753a78a.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Factors that influence happiness of nursing students according to COVID-19 infection status","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAccording to the World Happiness Report 2022, the average happiness index for South Koreans was 5.94, ranking 59th out of 146 countries; it was 1.88 points below the first-ranked country, Finland [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. However, early stages in the COVID-19 pandemic, the average happiness index for Korean university students was low, at 53.3 out of 100 [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Upon questioning about their current happiness, the most frequent response was 'uncertain' at 33.0%, followed by 'relatively happy' (29.2%), 'not very happy' (22.9%), 'not at all happy' (11.0%), and 'extremely happy' (3.9%). Only about three in ten Korean university students considered their lives to be happy.\u003c/p\u003e \u003cp\u003eBefore the COVID-19 pandemic, university students were already experiencing lower levels of happiness due to various factors such as the pressures of establishing a career path, academic demands, the transition from adolescence to adulthood, and peer pressure [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The happiness levels of university students further decreased due to changes in daily life caused by COVID-19, including reduced personal interactions with classmates and friends, and the interruption of academic and professional trajectories [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDuring the COVID-19 pandemic, countries around the world implemented various measures (e.g., quarantine measures, social distancing, remote working, mandatory mask-wearing) to mitigate stress and anxiety related to COVID-19, and to increase happiness. These measures aimed to create an environment conducive to economic, social, and political well-being [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], but they had more negative than positive effects on human happiness (e.g., deterioration in health, disruption of social relationships, decreased adaptability, financial worries) [\u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eStrong social lockdowns that were implemented beginning in the early 2020s shifted classes in nursing theory from face-to-face to distance learning, and transformed nursing practice fields from clinical and community settings to simulation and online systems [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Nursing students, faced with restricted access to university facilities and reduced contact with peers and teachers, were compelled to adopt a remote education system while being granted increased autonomy, necessitating increased control over their learning process. However, the unprecedented and unanticipated shift to a remote education system resulted in a decline in academic adaptation among nursing students, compared to the pre-COVID-19 era, due to a lack of motivation, and decrease in attention, in effort, and in time investment in learning [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Nursing students faced problems issues in adapting to university life, including personal emotional adjustment, social adaptation, and institutional attachment. These adaptations are necessary to meet the various educational demands that arise from university expectations [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eLeisure activities are critically important in protecting against the negative effects of the COVID-19 pandemic. However, due to the continuous remote education system during the pandemic, college students\u0026rsquo; leisure activities decreased [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Nursing students were more anxious about others becoming infected with COVID-19 than about themselves becoming infected with it, and therefore intentionally chose self-quarantine, avoided direct contact with friends and family, and sometimes sought temporary living arrangements alone, thereby detaching themselves from support systems offered by family, friends, or colleagues [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Social lockdowns implemented to prevent COVID-19 further limited nursing students\u0026rsquo; the social relationships, which are often cultivated by engaging in leisure activities [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDuring the COVID-19 pandemic, information collected from families was important in collecting knowledge about the disease and its risks [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Strong social lockdown measures implemented to prevent the spread of the COVID-19 pandemic forced nursing students to undertake online learning at home and to have limited interpersonal interactions with their family members [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. In this changed home environment, nursing students often encounter conflicts, such as arguments, in maintaining a balance of power with other family members working online [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. However, the happiness of nursing students increases as their emotional relationships with their family members improve [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eHappiness is conceptualized as an subject's cognitive and emotional evaluation of their life [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. People who experience happiness and satisfaction are likely to have greater self-discipline, self-regulation and coping abilities, which empower them to positively navigate their lives, even during crisis situations like the COVID-19 pandemic [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Throughout the COVID-19 pandemic, key factors that can reduce happiness have been identified; they include the degree of mobility restriction due to isolation and social-distancing measures, the perceived threat to interpersonal relationships such as love and friendship, concerns regarding educational pursuits and employment, the dynamics of remote work and returning to the office, and overall satisfaction with domestic life [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. The \u0026lsquo;upward approach\u0026rsquo; within happiness diffusion theory posits that overall life satisfaction and happiness are influenced by accumulating satisfaction in subject sub-factors that affect happiness. These sub-factors include health, income, leisure, family, academics, and occupation [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThis research aims to provide foundational data for developing intervention programs to increase the happiness of Korean nursing students during the COVID-19 endemic era. The first step is to distinguish between nursing students who had been infected with COVID-19 (COVID\u003csup\u003e+\u003c/sup\u003e students) or had not been infected by COVID-19 (COVID\u003csup\u003e0\u003c/sup\u003e students). The second was to explore how their overall happiness was affected by subject happiness sub-factors, such as college life adaption, leisure satisfaction from club activities, and family strengths. The hypotheses of this study are as follows.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eHypothesis 1\u003c/strong\u003e \u003cp\u003eCollege life adaptation affects the happiness of both COVID\u003csup\u003e+\u003c/sup\u003e and COVID\u003csup\u003e0\u003c/sup\u003e nursing students.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eHypothesis 2\u003c/strong\u003e \u003cp\u003eLeisure satisfaction from club activities affect the happiness of both COVID\u003csup\u003e+\u003c/sup\u003e and COVID\u003csup\u003e0\u003c/sup\u003e students.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eHypothesis 3\u003c/strong\u003e \u003cp\u003eFamily strengths affects the happiness of both COVID\u003csup\u003e+\u003c/sup\u003e and COVID\u003csup\u003e+\u003c/sup\u003e nursing students.\u003c/p\u003e \u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eResearch design\u003c/h2\u003e \u003cp\u003eThis a descriptive survey study that utilized a self-reported questionnaire method. It is based on the upward approach within the theory of happiness diffusion as described by Diener \u003csup\u003e20\u003c/sup\u003e. The aim is to determine the impact of college life adaptation, leisure satisfaction from club activities, and family strengths on the happiness of South Korean nursing students during the COVID-19 endemic era.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eResearch participants\u003c/h2\u003e \u003cp\u003eParticipants were randomly sampled from five nursing departments in South Korean cities D, G, K, and Y. To ensure sufficient statistical power, the G*Power 3.1 program was used. The study required a minimum convenience sample size of 152 participants, considering a significance level (α) of 0.05, a power (1-β) of 0.90, an effect size of 0.15, and the incorporation of 11 independent variables. To meet this requirement, 370 questionnaires were distributed, accounting for non-response rates and unreliable responses. Of the responses received, 27 were discarded due to a high number of non-responses or insincere answers, leaving a final sample size of 343 participants (180 COVID\u003csup\u003e+\u003c/sup\u003e, 163 COVID\u003csup\u003e0\u003c/sup\u003e).\u003c/p\u003e \u003cp\u003eThe specific selection criteria for the study were as follows. (1) Common Criteria: Participants were third and fourth-year nursing students who had experienced more than one year (more than three times per week) of remote learning between March 2020 and December 2022 due to the COVID-19 pandemic, and who had actively participated in club activities for more than six months (at least twice a month) within the past year. (2) COVID\u003csup\u003e+\u003c/sup\u003e Participants: Subjects who received a positive COVID-19 diagnosis from a health center or hospital after the outbreak and had an experience of isolation, as well as those whose infection was confirmed by an official notification or message from a health center or hospital. (3) COVID\u003csup\u003e0\u003c/sup\u003e Participants: Those who have not received a positive COVID-19 diagnosis from a health center or hospital since the outbreak of COVID-19.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eResearch tools\u003c/h2\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003eCollege life adaptation\u003c/h2\u003e \u003cp\u003eThis study used a tool specifically developed for nursing college students by Park and Kim [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. It is composed of 34 items in six subscales: nine items for interpersonal relations, nine items for major satisfaction, five items for major ease, five items for coping capacity, three items for job preparation, and three items for academic fidelity. Each item is rated on a 5-point Likert scale, starting from 1 point, where negative items are reverse-scored, so a high score corresponds to good overall adaptation to university life. In this study, the instrument had Cronbach\u0026rsquo;s α\u0026thinsp;=\u0026thinsp;0.91.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eLeisure satisfaction from club activities\u003c/h2\u003e \u003cp\u003eThis study used the Leisure Satisfaction Scale (LSS), developed by Beard and Ragheb [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] and validated for reliability and validity by Kim et al [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. This scale consists of 24 items in six subscales: psychological, educational, social, relaxation, physical, and aesthetic. Each item is rated on a 5-point Likert scale from 1 = \u0026lsquo;Not at all,\u0026rsquo; to 5 = \u0026lsquo;Very much so,\u0026rsquo; so a high total score signifies high leisure satisfaction. In this study, the scale had Cronbach\u0026rsquo;s α\u0026thinsp;=\u0026thinsp;0.97.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eFamily strengths\u003c/h2\u003e \u003cp\u003eThis study used the Korea Family Strengths Scale (KFSS-II), developed by Yoo et al [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. This scale consists of five sub-areas: family resilience, mutual respect and acceptance, quality of bonding, economic stability and cooperation, and family culture and social participation, totaling 22 items. Each item is scored on a 5-point Likert scale from 1 = \u0026lsquo;Not at all\u0026rsquo; to 5 = \u0026lsquo;Very much so\u0026rsquo; 5, so a high total score indicates high family strengths. In this study, the scale had Cronbach\u0026rsquo;s α\u0026thinsp;=\u0026thinsp;0.96.\u003c/p\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003eHappiness\u003c/h2\u003e \u003cp\u003eThis study used the shortened Korean version of the happiness scale developed by Suh and Koo [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. This scale consists of nine items across three core sub-factors of happiness experience: life satisfaction, positive emotions, and negative emotions. Life satisfaction assesses satisfaction with personal aspects, interpersonal relationships, and group belonging. Positive emotions and negative quantify emotions closely related to happiness. Each item is rated on a 7-point Likert scale, from 1 to 7, with happiness increasing with score. In this study, this scale had Cronbach\u0026rsquo;s α\u0026thinsp;=\u0026thinsp;0.90.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eData collection\u003c/h2\u003e \u003cp\u003e Data were collected from October 4, 2023, to November 15, 2023, as per approved guidelines. The researchers visited five nursing departments in major South Korean cities (D, G, K, and Y cities). They explained the study\u0026rsquo;s purpose and methodology to the department heads, secured their permission and cooperation for the research, and posted a recruitment announcement for participants. Subjects selected through the recruitment process were given detailed explanations by the researchers about the study\u0026rsquo;s purpose, anonymity, and confidentiality. The participants gave written consent for voluntary participation, completed the questionnaire, which the researchers later collected. For participants who reported a history of COVID-19 infection, the notification document or text message received from a health center or hospital was verified.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eData analysis\u003c/h2\u003e \u003cp\u003eThe collected data were analyzed using the SPSS/WIN 23.0 software program. The distributions of general characteristics of the subjects were presented as frequencies and percentages. Differences in happiness according to the subjects\u0026rsquo; general characteristics were compared using t-tests and one-way ANOVA. The levels of college life adaptation, leisure satisfaction from club activities, family strengths, and happiness were reported as average and standard deviation. The correlation between happiness and related variables was examined using Pearson\u0026rsquo;s correlation coefficients. The assumptions for regression analysis of the independent variables were diagnosed considering multicollinearity, residuals, and singular values. Multiple linear regression analysis was conducted to identify factors that influence happiness.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eEthical considerations\u003c/h2\u003e \u003cp\u003e This study was approved by the Kwangju Women's University Institutional Review Board (IRB NO.1041465-202308-HR-001-30). The survey questionnaire incorporated detailed explanations about the necessity and purpose of the study, research method, estimated time commitment, the possibility of withdrawal during the study, voluntary participation, potential benefits and disadvantages of participating, as well as the management and confidentiality of personal information. Contact information for the researchers was also provided for any inquiries related to the study. The survey was administered only to those who understood and consented to these terms, and their responses were included in the analysis. Participants were assured that the survey results would be quantified, processed, and used exclusively for the purposes of this research, that their anonymity would be preserved, and that they could opt out of the survey at any point without facing any negative consequences. Following these explanations, written consent was obtained from the students who agreed to participate. They then individually completed the questionnaires, which were collected directly by the research team.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e \u003cb\u003eDemographic differences in happiness among participants how had been or had not been infected with COVID-19\u003c/b\u003e \u003c/p\u003e \u003cp\u003eMost subjects (291) were women; of them, 159 (88.3%) were COVID\u003csup\u003e+\u003c/sup\u003e and 132 (81.0%) were COVID\u003csup\u003e0\u003c/sup\u003e. The average \u003cem\u003ehappiness\u003c/em\u003e score was 5.16 (\u0026plusmn;\u0026thinsp;1.16) for COVID\u003csup\u003e+\u003c/sup\u003e subjects and 5.23 (\u0026plusmn;\u0026thinsp;1.10) for COVID\u003csup\u003e0\u003c/sup\u003e subjects; both scores were higher among men than among women, but the differences were not statistically significant.\u003c/p\u003e \u003cp\u003eMost of COVID\u003csup\u003e+\u003c/sup\u003e subjects (94 subjects, 52.2%) were participants were 4th -year students, whereas most of the COVID\u003csup\u003e0\u003c/sup\u003e subjects were 3rd -year students (98 subjects, 60.1%). The average happiness score was higher for 3rd -year students, than for 4th -years students: 5.11 (\u0026plusmn;\u0026thinsp;0.99) for COVID\u003csup\u003e+\u003c/sup\u003e and 5.06 (\u0026plusmn;\u0026thinsp;1.01) for COVID\u003csup\u003e0\u003c/sup\u003e, but these differences were not statistically significant.\u003c/p\u003e \u003cp\u003eMost participants came from nuclear families: 157 (87.2%) of COVID\u003csup\u003e+\u003c/sup\u003e and 142 (87.1%) of COVID\u003csup\u003e0\u003c/sup\u003e subjects. The average happiness score was higher for those in nuclear families among the COVID\u003csup\u003e+\u003c/sup\u003e (5.02\u0026thinsp;\u0026plusmn;\u0026thinsp;1.04) and in extended families among the COVID\u003csup\u003e0\u003c/sup\u003e (5.42\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63), but the differences were not statistically significant.\u003c/p\u003e \u003cp\u003eMost participants had one sibling: 90 (50.0%) of COVID\u003csup\u003e+\u003c/sup\u003e and 90 (55.2%) of COVID\u003csup\u003e0\u003c/sup\u003e subjects. The highest average happiness scores were for those with no siblings among the COVID\u003csup\u003e+\u003c/sup\u003e (5.18\u0026thinsp;\u0026plusmn;\u0026thinsp;0.97) and those with one sibling among the COVID\u003csup\u003e0\u003c/sup\u003e (5.15\u0026thinsp;\u0026plusmn;\u0026thinsp;0.90), but the differences were not statistically significant.\u003c/p\u003e \u003cp\u003eMost participants reported having no religious affiliation: 120 (66.7%) of COVID\u003csup\u003e+\u003c/sup\u003e and 114 (69.9%) of COVID\u003csup\u003e0\u003c/sup\u003e. The average happiness score was slightly higher among those with no religious affiliation than among those who claimed an affiliation, i.e., 5.00 (\u0026plusmn;\u0026thinsp;1.06) for COVID\u003csup\u003e+\u003c/sup\u003e and 5.01 (\u0026plusmn;\u0026thinsp;0.96) for the COVID\u003csup\u003e0\u003c/sup\u003e, but the differences were not statistically significant.\u003c/p\u003e \u003cp\u003eMost of both groups were members of one club: 115 (63.9%) of COVID\u003csup\u003e+\u003c/sup\u003e and 113 (69.3%) of COVID\u003csup\u003e0\u003c/sup\u003e. The average happiness score was highest for those in one club among the COVID\u003csup\u003e+\u003c/sup\u003e, at 5.00 (\u0026plusmn;\u0026thinsp;1.02), and in four clubs among the COVID\u003csup\u003e+\u003c/sup\u003e, at 5.83 (\u0026plusmn;\u0026thinsp;0.88), but these differences were not statistically significant.\u003c/p\u003e \u003cp\u003eMost participants belonged to the 'medium' economic category: 149 (82.8%) of COVID\u003csup\u003e+\u003c/sup\u003e and 130 (79.8%) of COVID\u003csup\u003e0\u003c/sup\u003e. The average happiness score was highest for those in the 'high' economic category; i.e., 5.58 (\u0026plusmn;\u0026thinsp;1.01) for the COVID\u003csup\u003e+\u003c/sup\u003e and 5.39 (\u0026plusmn;\u0026thinsp;1.08) for the COVID\u003csup\u003e0\u003c/sup\u003e. This difference was statistically significant (F\u0026thinsp;=\u0026thinsp;5.640, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.004).\u003c/p\u003e \u003cp\u003eMost participants self-evaluated their health status, as \u0026lsquo;good\u0026rsquo;; i.e., 107 (59.4%) of COVID\u003csup\u003e+\u003c/sup\u003e and 100 (61.3%) COVID\u003csup\u003e0\u003c/sup\u003e. The average happiness score was highest among those who rated their health as 'good'; i.e., 5.24 (\u0026plusmn;\u0026thinsp;0.99) for COVID\u003csup\u003e+\u003c/sup\u003e and 5.22 (\u0026plusmn;\u0026thinsp;0.89) for the COVID\u003csup\u003e0\u003c/sup\u003e. This difference was statistically significant (F\u0026thinsp;=\u0026thinsp;11.801, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\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\u003eNursing students' happiness according to demographic characteristics (N\u0026thinsp;=\u0026thinsp;343).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"15\"\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 \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c8\" namest=\"c3\"\u003e \u003cp\u003eInfected (n\u0026thinsp;=\u0026thinsp;180)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c15\" namest=\"c9\"\u003e \u003cp\u003eNon-Infected (n\u0026thinsp;=\u0026thinsp;163)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003et/F\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003et/F\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\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\u003e11.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.920\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.359\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e19.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e1.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1.524\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.129\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e81.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e4.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCollege\u003c/p\u003e \u003cp\u003eyear\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3rd\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e47.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1.808\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.072\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e60.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1.063\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.289\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4th\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e39.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e4.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eFamily\u003c/p\u003e \u003cp\u003etype\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNuclear families\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e157\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e87.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e1.973\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e142\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e87.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e4.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.757\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.520\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle-parent families\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e6.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e4.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExtended families\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e4.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEtc\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e4.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e1.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eNumber of siblings\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.842\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.472\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e9.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e4.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e1.929\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOne\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e55.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTwo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e29.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e4.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 or more\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e6.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e4.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e1.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eReligion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e-0.591\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.555\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e30.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e4.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e-0.302\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.763\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e66.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e69.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eNumber of club registrations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOne\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.808\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e69.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e4.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e1.558\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.202\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTwo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e26.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e4.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e1.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 or more\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e1.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eHousehold economic\u003c/p\u003e \u003cp\u003elevel\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigh\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e5.862\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003cp\u003ec\u0026thinsp;\u0026lt;\u0026thinsp;a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e16.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e1.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e5.640\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003cp\u003ec\u0026thinsp;\u0026lt;\u0026thinsp;ba\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedium\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e149\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e82.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e79.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e4.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLow\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e4.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e4.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e1.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSubjective health\u003c/p\u003e \u003cp\u003estatus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e107\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e11.097\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003cp\u003ec\u0026thinsp;\u0026lt;\u0026thinsp;a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e61.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e11.801\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003cp\u003ec\u0026thinsp;\u0026lt;\u0026thinsp;ba\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNormal\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e35.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e4.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBad\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e3.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"15\"\u003eM\u0026thinsp;=\u0026thinsp;mean, SD\u0026thinsp;=\u0026thinsp;standard deviation\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eAdaptation to college life, leisure satisfaction, family strengths, and happiness in relation to COVID-19 infection status\u003c/b\u003e \u003c/p\u003e \u003cp\u003eHappiness scores were 3.55\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52 for the COVID\u003csup\u003e+\u003c/sup\u003e group and 3.52\u0026thinsp;\u0026plusmn;\u0026thinsp;0.47 for the COVID\u003csup\u003e+\u003c/sup\u003e group. Regarding adaptation to college life, scores were 3.58\u0026thinsp;\u0026plusmn;\u0026thinsp;0.67 for the COVID\u003csup\u003e+\u003c/sup\u003e and 3.49\u0026thinsp;\u0026plusmn;\u0026thinsp;0.84 for the COVID\u003csup\u003e0\u003c/sup\u003e. In terms of leisure satisfaction, the scores were 4.12\u0026thinsp;\u0026plusmn;\u0026thinsp;0.69 for the COVID\u003csup\u003e+\u003c/sup\u003e and 4.06\u0026thinsp;\u0026plusmn;\u0026thinsp;0.67 for the COVID\u003csup\u003e0\u003c/sup\u003e. For family strengths, the COVID\u003csup\u003e+\u003c/sup\u003e group scored 4.96\u0026thinsp;\u0026plusmn;\u0026thinsp;1.06, whereas the COVID\u003csup\u003e0\u003c/sup\u003e group scored 4.99\u0026thinsp;\u0026plusmn;\u0026thinsp;0.96. None of these differences was statistically significant (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\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\u003eNursing students' happiness, college life adaption, leisure satisfaction from club activities, family strengths (N\u0026thinsp;=\u0026thinsp;343).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eInfected (n\u0026thinsp;=\u0026thinsp;180)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eNon-Infected (n\u0026thinsp;=\u0026thinsp;163)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eM\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eSD\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eM\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eSD\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNursing student happiness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-0.524\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.600\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCollege life adaption\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-1.099\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.272\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeisure satisfaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-0.808\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.420\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily Strengths\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.271\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.787\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eCorrelation among study variables\u003c/h2\u003e \u003cp\u003eAmong the COVID\u003csup\u003e+\u003c/sup\u003e students, happiness showed a significant positive correlation with college life adaptation (r\u0026thinsp;=\u0026thinsp;0.598, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), leisure satisfaction (r\u0026thinsp;=\u0026thinsp;0.345, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and family strengths (r\u0026thinsp;=\u0026thinsp;0.387, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). In the COVID\u003csup\u003e0\u003c/sup\u003e group, happiness also showed a significant positive correlation with college life adaption (r\u0026thinsp;=\u0026thinsp;0.568, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), leisure satisfaction (r\u0026thinsp;=\u0026thinsp;0.262, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and family strengths (r\u0026thinsp;=\u0026thinsp;0.331, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\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\u003eCorrelation between study variables (N\u0026thinsp;=\u0026thinsp;343).인구학적\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\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=\"char\" char=\".\" 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=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003eNursing student happiness\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eInfected (n\u0026thinsp;=\u0026thinsp;180)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eNon-Infected (n\u0026thinsp;=\u0026thinsp;163)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCollege life adaption\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.598\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.568\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeisure satisfaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.345\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.262\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily Strengths\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.387\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.331\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNursing student happiness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eFactors that influenced happiness\u003c/h2\u003e \u003cp\u003eMultiple linear regression was conducted to identify factors that influenced the happiness of the participants. To determine the factors affecting participants' happiness, the analysis included statistically-significant variables: college life adaptation, leisure satisfaction, family strengths, and general characteristics (notably, subjective health status and college life adaptation).\u003c/p\u003e \u003cp\u003eFor COVID\u003csup\u003e+\u003c/sup\u003e subjects, the regression model for happiness was significant (F\u0026thinsp;=\u0026thinsp;24.970, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), with college life adaptation (b\u0026thinsp;=\u0026thinsp;0.462, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001) and family strengths (b\u0026thinsp;=\u0026thinsp;0.148, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.025) having significant effects on happiness. These variables explained 40.1% of happiness. For COVID\u003csup\u003e0\u003c/sup\u003e subjects, the regression model for happiness was also significant (F\u0026thinsp;=\u0026thinsp;18.177, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), with college life adaptation (b\u0026thinsp;=\u0026thinsp;0.456, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001) and subjective health status (b\u0026thinsp;=\u0026thinsp;0.165, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.016) having significant effects on happiness. These variables explained 34.6% of happiness. Regarding the fit of this regression model, the multicollinearity was checked by referring to tolerance limits, which were between 0.731 and 0.880 for COVID\u003csup\u003e+\u003c/sup\u003e subjects and between 0.681 and 0.883 for COVID\u003csup\u003e0\u003c/sup\u003e subjects; all of these values exceeded the threshold of 0.1. The Variance Inflation Factors (VIF) for COVID\u003csup\u003e+\u003c/sup\u003e subjects ranged from 1.136 to 1.368 and from 1.133 to 1.469 for COVID\u003csup\u003e0\u003c/sup\u003e subjects; these values were all below the threshold of 10. The Durbin-Watson test for residual normality in the model yielded values of 1.661 for COVID\u003csup\u003e+\u003c/sup\u003e subjects and 2.093 for COVID\u003csup\u003e0\u003c/sup\u003e subjects; these results indicate no autocorrelation in the residuals (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFactors affecting the happiness of nursing students (N\u0026thinsp;=\u0026thinsp;343).인구학적\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\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfected (n\u0026thinsp;=\u0026thinsp;180)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e(Constant)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.679\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.536\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-1.267\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.207\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHousehold economic level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.060\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.966\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.335\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSubjective health status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.222\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.940\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.054\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCollege life adaption\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.944\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.462\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.827\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeisure satisfaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.083\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.290\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.199\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily Strengths\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.228\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.148\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.257\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.025\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eDurbin-Watson\u0026thinsp;=\u0026thinsp;1.661, Tolerance Limit\u0026thinsp;=\u0026thinsp;0.731\u0026thinsp;~\u0026thinsp;0.880, VIF\u0026thinsp;=\u0026thinsp;1.136\u0026thinsp;~\u0026thinsp;1.368,\u003c/p\u003e \u003cp\u003eR\u0026sup2;=0.418, Adjusted R\u0026sup2;=0.401, F\u0026thinsp;=\u0026thinsp;24.970, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-Infected (n\u0026thinsp;=\u0026thinsp;163)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e(Constant)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.088\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.537\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.869\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHousehold economic level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.087\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.153\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.040\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.568\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.571\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSubjective health status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.286\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.117\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.436\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCollege life adaption\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.926\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.156\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.456\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.927\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeisure satisfaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.081\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.194\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.846\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily Strengths\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.164\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.608\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.110\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eDurbin-Watson\u0026thinsp;=\u0026thinsp;2.093, Tolerance Limit\u0026thinsp;=\u0026thinsp;0.681\u0026thinsp;~\u0026thinsp;0.883, VIF\u0026thinsp;=\u0026thinsp;1.133\u0026thinsp;~\u0026thinsp;1.469,\u003c/p\u003e \u003cp\u003eR\u0026sup2;=0.367, Adjusted R\u0026sup2;=0.346, F\u0026thinsp;=\u0026thinsp;18.177, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eCOVID-19 has been associated with an increase in negative emotions such as anxiety and depression among college students, particularly during their critical period of transition to adulthood and exploration. This increase in negative emotions contributes to a decrease in their overall happiness levels [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. This study examined the effect of COVID-19 infection on the happiness of Korean nursing students.\u003c/p\u003e \u003cp\u003eThis analysis revealed that college life adaptation had the most significant effect on happiness among both COVID\u003csup\u003e+\u003c/sup\u003e and COVID\u003csup\u003e0\u003c/sup\u003e nursing students. College life adaptation is a specific form of social adaptation, and involves the process by which students adjust their behaviors and thoughts in response to the new environment of the college campus, encompassing living, studying, and social interactions [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. The COVID-19 outbreak on university campuses was rapid and extensive, and these factors raised concerns about its potential to quickly spread to other communities.\u003c/p\u003e \u003cp\u003eNationally-implemented social containment policies for intercepting and preventing the spread of COVID-19 necessitated a shift from face-to-face academic classes and nursing practices to remote, online learning environments for nursing students [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Even before the COVID-19 pandemic, college students had already embraced a culture in which remote support systems using the internet, computers, and smartphones facilitated convenience in learning and daily life [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. During the COVID-19 pandemic, most university-life activities shifted to online modes, and this transition to remote learning systems continues even in the era of COVID-19 becoming endemic.\u003c/p\u003e \u003cp\u003eNursing students, regardless of their COVID-19 infection status, relied on non-face-to-face university activities while adhering to national prevention guidelines such as avoiding direct contact, due to their heightened anxiety about infection among family and friends [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Excessive online activity can reduce an subject's ability to regulate emotions, and may thereby lead to depression, suicidal thoughts, academic failure, and social isolation [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAttending university entails an increase in freedom of choice and independence from parental supervision [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. However, nursing students experienced increased psychological distress due to worries about the duration of the COVID-19 pandemic, the uncertainty of returning to normal life, loneliness from isolation, anxiety about limited clinical practice opportunities, and future uncertainties [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. All of the subjects, both COVID\u003csup\u003e+\u003c/sup\u003e and COVID\u003csup\u003e0\u003c/sup\u003e realized the importance and necessity of face-to-face interactions in campus life, learning, and social engagement while adhering to long-term infection prevention lifestyle rules.\u003c/p\u003e \u003cp\u003eDuring the change of COVID-19 from the epidemic to the endemic phase, the academic classes, clinical practice, and other campus activities of nursing education have changed from remote formats back to in-person formats. All of these nursing students, both COVID\u003csup\u003e+\u003c/sup\u003e and COVID\u003csup\u003e0\u003c/sup\u003e, have reinterpreted the current situation as an opportunity for professional growth as nurses. This reevaluation may explain why adaptation to university life significantly affects their happiness. Therefore, to increase the happiness of nursing students, programs must be developed and implemented that aid in job preparation, improve interpersonal relationships, and enhance problem-solving skills, along with regular academic classes and clinical practices, as part of college life adaption.\u003c/p\u003e \u003cp\u003eFor COVID\u003csup\u003e+\u003c/sup\u003e students, family strengths also influenced their happiness. During COVID-19, nursing students experienced elevated levels of negative emotions like anxiety and depression, especially when dealing with family illness or death, economic struggles due to the breadwinner's job loss, or conflicts with parents and siblings while staying at home for extended periods [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Specifically, COVID\u003csup\u003e+\u003c/sup\u003e nursing students experienced anxiety and depression due to uncertainties about infecting other family members, threats to their own and their family's health, and fears about the challenges of recovery [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eNegative emotions persisted among 30\u0026ndash;40% of COVID\u003csup\u003e+\u003c/sup\u003e students, even more than a month after their recovery [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. During their COVID-19 infection, the primary source of care and concern often came from their own family, rather than others sources. Although direct contact was not possible, family members frequently visited to check on their condition, prayed for their speedy recovery, and provided food and necessary supplies. This unconditional acceptance and support from family members helped to inspire and motivate the participants to recover from COVID-19. Moreover, active family support also helped COVID\u003csup\u003e+\u003c/sup\u003e nursing students to positively embrace the healing process. This support strengthened their immune system and reduced feelings of anxiety and depression, and thus promoted health and wellness [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. These factors indicate that family involvement in the process of recovery from COVID-19 infection assists the infected in resolving problems, and expedites the treatment process.\u003c/p\u003e \u003cp\u003eFor COVID\u003csup\u003e+\u003c/sup\u003e nursing students, the support and encouragement received from their families were instrumental in overcoming various discomforts and challenges encountered during the recovery process. Consequently, family strengths emerged as a significant factor influencing their happiness. The family is the most essential source of social support and provides support to its members in forms such as emotional, instrumental, informational, and reward support [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Hence, to boost the happiness of COVID\u003csup\u003e+\u003c/sup\u003e nursing students, interaction-enhancing programs for their families must be developed. Additionally, health-promotion programs that increase knowledge, attitudes, and practices concerning infectious diseases should be implemented to sustain family strengths consistently.\u003c/p\u003e \u003cp\u003eFor COVID\u003csup\u003e0\u003c/sup\u003e nursing students, subjective health status was another influential factor on their happiness. Subjective health status is the self-perceived assessment of one's overall health condition as good [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. During the COVID-19 pandemic, COVID\u003csup\u003e0\u003c/sup\u003e nursing students shared similar fears as their infected peers, including the fear of contracting the virus, the fear of close contacts becoming infected, and uncertainties about the future [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. Subjective health status helps to alleviate various stresses caused by COVID-19 and to increase a person\u0026rsquo;s ability to manage personal health threats. Increase in an subject\u0026rsquo;s subjective health status is correlated with a decrease in their subjective perception the risk of contracting COVID-19. This reduction in perceived risk leads to decreased negative emotions related to COVID-19, such as feelings of isolation, loneliness, fear, anxiety, and depression. In short, a high subjective health status causes reduction in perception of the risk of contracting COVID-19, and helps a person to maintain positive emotions in their daily life. In contrast, subjects with poor subjective evaluation of health may feel threatened by the risk of COVID-19 infection, and therefore adhere more strictly to preventive measures like wearing masks and limiting outdoor activities, than people who have high subjective evaluation of health [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDuring the endemic phase of COVID-19, COVID\u003csup\u003e0\u003c/sup\u003e nursing students are concerned about the possibility of eventually contracting COVID-19 as daily life transitions from remote to face-to-face interactions, despite the continued presence of the virus. This concern highlights the importance of subjective health status as an influencing factor on their happiness. Therefore, for to increase the happiness of COVID\u003csup\u003e0\u003c/sup\u003e nursing students, health care education programs that are aimed at improving their health status should be developed.\u003c/p\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eImplications\u003c/h2\u003e \u003cp\u003eThis research has explored the factors affecting the happiness of nursing students in relation to their COVID-19 infection status. Many studies in social sciences have investigated psychological factors linked to the COVID-19 context [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], but these studies these often yielded fragmented results. This problem indicates the importance of clearly distinguishing infection status as a preliminary step in a multifaceted examination of influencing factors, especially in developing programs and policy suggestions to increase happiness. This differentiation is crucial because psychological responses vary depending on infection status, a concept supported by previous research [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e], which found that sensitivity to COVID-19 as a disease can aid in explaining the assessment of stress overload. Therefore, by investigating the happiness factors of nursing students based on their infection status, this study contributes uniquely by offering solutions tailored to their specific needs. It provides foundational data for future development of happiness-enhancement programs for nursing students, distinguishing this research from previous works.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eFirstly, this research involved random sampling from five nursing departments in D, G, K, and Y cities. Consequently, these findings may not be applicable to all nursing students across different regions in Korea. To increase generalizability, future research should consider nursing students in various locations to enhance generalizability population density and urban scale. Secondly, the study focused only on college life adaptation, leisure satisfaction, and family strengths as factors affecting nursing students' happiness; restriction of the analysis to a few aspects may miss out on a multifaceted examination of happiness. Future studies should explore a wider range of factors that may positively influence nursing students' happiness, than this study considered. Lastly, the use of quantitative research in this study may not sufficiently examine nursing students' happiness. Future research should employ qualitative methods to explore the practical significance of happiness in nursing students' experiences.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis research has contributed foundational data for the development of happiness enhancement programs for nursing students in the COVID-19 endemic era, by discerning the factors influencing their happiness relative to their COVID-19 infection status. In developing happiness-enhancement programs for nursing students during the COVID-19 endemic era, focus should be placed on college life adaptation. Additionally, for COVID\u003csup\u003e+\u003c/sup\u003e nursing students, the emphasis should be on family strengths, whereas for COVID\u003csup\u003e0\u003c/sup\u003e nursing students, the focus should be on their health status. Nursing students must be guided in implementing these aspects into their practices.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to express our gratitude to the nursing schools who cooperated with the study. It is hoped that this study can contribute to the health promotion of nursing students.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization: HO, Jung; Data handling: SW, Han; Research design: HO, Jung; Data analysis: SW, Han; Study validation: SW, Han; Supervision:HO, Jung; Data presentation: SW, Han; Draft preparation: HO, Jung and SW, Han; Study consultation: HO, Jung; Writing and reviewing, project administration: HO, Jung and SW, Han. All authors reviewed the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe research proposal was approved by the Ethics Committee of Kwangju Women\u0026apos;s University (code: 1041465-202308-HR-001-30), and informed consent was obtained from participants. All procedures were carried out in accordance with the 1964 Helsinki declaration.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFundings\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors received no financial support for the research, authorship, and/or publication of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor details\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e1. College of Nursing, The Research Institute of Nursing Science, Daegu Catholic University, Daegu, 42472, Republic of Korea.\u003c/p\u003e\n\u003cp\u003e2. Department of Nursing, Kwangju Women\u0026rsquo;s University, Gwangsan-gu, Gwangju 62396, Republic of Korea.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHelliwell JF, Wang S , Huang H, Norton M. World happiness report 2022: Happiness, benevolence, and trust during COVID-19 and beyond. World happiness report. https://worldhappiness.report/ed/2022/happiness-benevolence-and-trust-during-covid-19-and-beyond/. Accessed 10 September 2023.\u003c/li\u003e\n\u003cli\u003eCRS News. Happiness index of Korean university student. http://www.crs-news.com/16629. Accessed Retrieved December 10, 2023.\u003c/li\u003e\n\u003cli\u003eAuerbach RP, Alonso J, Axinn WG, Cuijpers P, Ebert DD, Green JG, et al. Mental disorders among college students in the world health organization world mental health surveys. 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Interactions between COVID-19 family home disruptions and relationships predicting college students\u0026rsquo; mental health over time. J Fam Psychol. 2023;37(5):592-602. https://doi.org/10.1037/fam0001085\u003c/li\u003e\n\u003cli\u003eGallegos M, Zaring-Hinkle B, Bra, JH. COVID-19 pandemic stresses and relationships in college students. Fam Relat. 2022;71(1):29-45. https://doi.org/10.1111/fare.12602\u003c/li\u003e\n\u003cli\u003eDiener E. Subjective well-being. Psychol Bull. 1984:95(3):542-575. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2162125\u003c/li\u003e\n\u003cli\u003eKamilcelebi H. Effects of the COVID-19 pandemic on happiness and socioeconomic conditions: Differences across countries and individuals\u0026apos; personality traits. J Econ Policy Res. 2022;9(2):353-372. https://doi.org/10.26650/JEPR1063845\u003c/li\u003e\n\u003cli\u003eTalit G, Stephanie R, Tamanna A. Happiness-lost: Did governments make the right decisions to combat Covid-19?. Global Labor Organization. 2020;556:1-28. https://www.econstor.eu/bitstream/10419/217494/1/GLO-DP-0556.pdf\u003c/li\u003e\n\u003cli\u003ePark SY, Kim JH. Campus life adaptation scale for nursing undergraduates: Development and psychometric evaluation. Nurse Educ Today. 2019;79:56-62. https://doi.org/10.1016/j.nedt.2019.05.014\u003c/li\u003e\n\u003cli\u003eBeard JG, Ragheb MG. Measuring leisure satisfaction. J Leis Res. 1980;12(1):20-33. https://doi.org/10.1080/00222216.1980.11969416\u003c/li\u003e\n\u003cli\u003eKim ML, Lee YJ, Hwang SH. Cross-cultural validation test and application of LSS-short form. J. Kor. Contents. Assoc. 2010;10(11):435-445. https://doi.org/10.5392/JKCA.2010.10.11.435\u003c/li\u003e\n\u003cli\u003eYoo YG, Lee IS, Kim SK, Choi HJ. Development of Korea family strengths scale(KFSS-Ⅱ). J Kor Home. Manag Assoc. 2013;31(4):113-129. http://doi.org/10.7466/JKHMA.2013.31.4.113\u003c/li\u003e\n\u003cli\u003eSuh EK, Koo JS. 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Care. 2021;57:695-701. https://doi.org/10.1111/ppc.12597\u003c/li\u003e\n\u003cli\u003eKo\u0026ccedil;ak O, Ko\u0026ccedil;ak OE, Younis Y. The psychological consequences of COVID-19 fear and the moderator effects of individuals\u0026rsquo; underlying illness and witnessing infected friends and family. Int. J. Environ. Res. Public. Health. 2021;18(4):1836. http://doi.org/10.3390/ijerph18041836\u003c/li\u003e\n\u003cli\u003ePrakash J, Dangi A, Chaterjee K, Yadav P, Srivastava K, Chauhan VS. Assessment of depression, anxiety and stress in COVID-19 infected individuals and their families. Med J Armed Forces India. 2021;77(2):S424-S429. http://doi.org/10.1016/j.mjafi.2021.06.013\u003c/li\u003e\n\u003cli\u003eGreen N, Tappin D, Bentley T. Working from home before, during and after the COVID-19 pandemic: Implications for workers and organization. NZJ Employ Relat. 2020;45(2), 5\u0026ndash;16. https://doi.org/10.24135/nzjer.v45i2.19\u003c/li\u003e\n\u003cli\u003eKristina D, Indraswari C. Dealing the crisis together: The meaning of family support for employees infected by Covid-19. J. Psikologi. Integratif. 2022;10(1):49-64. \u003c/li\u003e\n\u003cli\u003eQiu J, Shen B, Zhao M, Wang Z, Xie B, Xu Y. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: Implications and policy recommendations. Gen Psychiatry. 2020;33(2): e100213. https://doi.org/https://dx.doi.org/10.1136%2Fgpsych-2020-100213 \u003c/li\u003e\n\u003cli\u003eMazza MG, Lorenzo R, Conte C, Poletti S, Vai B, Bollettini I, et al. Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors. Brain. Behav. Immun. 2020;89:594-600. https://doi.org/10.1016/j.bbi.2020.07.037\u003c/li\u003e\n\u003cli\u003eInbar L, Shinan-Altman. Emotional reactions and subjective health status during the COVID-19 pandemic in Israel: The mediating role of perceived susceptibility. Psychol Health Med. 2020;26(1):75-84. https://doi.org/10.1080/13548506.2020.1858490\u003c/li\u003e\n\u003cli\u003eAmirkhan, J H. Stress overload in the spread of coronavirus. Anxiety Stress Coping. 2021;34(2):121-129. https://doi.org/10.1080/10615806.2020.1824271.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"College life adaptation, Family strengths, Happiness, Leisure activities, Nursing student","lastPublishedDoi":"10.21203/rs.3.rs-4121054/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4121054/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eHappiness is a cognitive and emotional evaluation of one\u0026rsquo;s life, and the upward approach affects satisfaction and happiness throughout life, whereas the downward approach refers to lower-level factors that affect happiness in actual areas of life.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eData were collected from October 4, 2023 to November 15, 2023. The subjects were 343 students enrolled in five nursing schools in four major cities (D, G, K, and Y) in Korea. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson\u0026rsquo;s correlation coefficients.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eFor COVID\u003csup\u003e+\u003c/sup\u003e students, happiness was significantly affected by adaptation to campus life and family strengths. This model had r\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.401; i.e., it explained 40.1% of the variability in happiness. For COVID\u003csup\u003e0\u003c/sup\u003e students, happiness was significantly affected by adaptation to campus life and subjective health status, with r\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.346.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThese results indicate the necessity of developing a happiness-promotion program for nursing students.\u003c/p\u003e","manuscriptTitle":"Factors that influence happiness of nursing students according to COVID-19 infection status","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-26 08:40:20","doi":"10.21203/rs.3.rs-4121054/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-05-15T07:03:32+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-05-12T13:40:24+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"256252248269195752099482858338558304990","date":"2024-05-04T17:22:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"268659315549444720572882739112081355005","date":"2024-05-03T14:23:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"07f818a0-5cb6-48f3-97e4-55e50891742a","date":"2024-04-15T06:20:41+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-04-08T10:49:48+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"31ba7eb1-6b29-4609-8a5e-1a74e3d5ae24","date":"2024-04-08T09:49:16+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-04-01T17:16:37+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-03-22T12:25:33+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-03-22T12:23:43+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-03-22T12:23:43+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2024-03-18T07:48:58+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e3b88bae-0cfa-4d02-939b-63b5e7ca0bec","owner":[],"postedDate":"March 26th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-09-02T16:02:03+00:00","versionOfRecord":{"articleIdentity":"rs-4121054","link":"https://doi.org/10.1186/s12912-024-02237-9","journal":{"identity":"bmc-nursing","isVorOnly":false,"title":"BMC Nursing"},"publishedOn":"2024-08-26 15:57:36","publishedOnDateReadable":"August 26th, 2024"},"versionCreatedAt":"2024-03-26 08:40:20","video":"","vorDoi":"10.1186/s12912-024-02237-9","vorDoiUrl":"https://doi.org/10.1186/s12912-024-02237-9","workflowStages":[]},"version":"v1","identity":"rs-4121054","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4121054","identity":"rs-4121054","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}