Symptom trajectory types during recovery from acute exacerbation of COPD and their association with systemic inflammatory burden and prognosis.

As of June 2025, South Korea has become a super-aged society, with 10,558,842 persons aged 65 years or older accounting for 20.6% of the total population []. As of 2023, older adults had 2.2 physician-diagnosed chronic diseases, on average. Further, 5.2% of this age group had been hospitalized (excluding long-term care hospitals) during the previous year, with a mean length of stay of 17.3 days []. In 2022, national health insurance expenditures surpassed 100 trillion Korean won (KRW), with those aged 65 and older accounting for 43.1% of the total []. Population aging is a global social phenomenon, and the United Nations (UN) has urged member states to develop healthcare systems that meet the medical needs of older adults []. Older adult inpatients who are cared for by clinical nurses typically present with complex health problems that require specialized care []. Beyond acute admission issues, the age-related decline of physical and cognitive functions mean that older adults require more direct nursing care than other age groups. They are also relatively vulnerable to safety incidents such as falls, which necessitates repeated education for both patients and caregivers, even in daily-living domains beyond treatment and procedures [-]. Even among nurses with adequate geriatric nursing knowledge and attitudes, such circumstances can lead to burnout, perceived nursing burden, and stress [,]. Hospital nurses’ job-related stress contributes not only to individual outcomes such as physical health problems, burnout, anxiety, and job dissatisfaction, but also to organizational risks by lowering performance and engagement and thereby threatening organizational goals []. Previous work identified geriatric nursing stress as a key variable affecting the quality of geriatric nursing performance []. Building on this knowledge, parallels with the consequences of general job stress can be reasonably inferred. Nevertheless, to provide nursing services commensurate with the rising demand for geriatric care in an aging era, a more specific and empirical investigation of stress related to geriatric nursing is needed. Geriatric nursing stress is often more intense in care domains that combine the characteristics of older patients (e.g., multimorbidity and geriatric syndromes) with nursing tasks, as well as in treatment-related decision-making processes that require close interactions—not only with the patient, but also with caregivers []. In general, work-related stress is affected by factors at the organizational and environmental levels, along with individual-level factors []. However, in geriatric nursing, the stress from caregivers and patients exceeds work-related stress []. Previous studies have therefore largely focused on individual-level variables, such as emotional labor and communication ability [] or empathy []. Because interactions with older adults, whose response times in daily life and in coping with illness may slow due to declines in physical function and neural conduction velocity [], constitute work-related stressors, we determined that an examination of organizational and environmental factors is also necessary.