A Scoping Review of Occupational Imbalance Among Korean High School Students: Insights Through the PEO Model.

Ji-Eun Choi, Yu-Jin Jung, Mi-Jin Kwon, Myung-Hwa Lee, Soo-Jin Park, Sun-Joung Leigh An

Journal: Occupational therapy international 2026;2026(1):e7917526

PMID: 41998863

Abstract

BACKGROUND

Korean high school students (KHSSs) face immense academic pressures due to the College Scholastic Ability Test (CSAT), a national milestone that determines their future academic and career paths. While extensive societal and governmental support is provided to optimize conditions for examinees, the overwhelming focus on exam preparation disrupts students' daily routines, leading to significant occupational imbalances that adversely affect their physical, mental, and emotional well-being.

AIM

This study was aimed at analyzing the factors contributing to occupational imbalance among KHSS using the person-environment-occupation (PEO) model and explore occupational therapy interventions and recommendations to address these challenges.

METHODS

A scoping review was conducted, synthesizing research published between 2015 and 2024 in Korean and English. Sixteen studies focusing on KHSS were included, retrieved from databases such as KISS, RISS, DBpia, Web of Science, and PubMed.

RESULTS

Using the PEO model, two key themes were identified. The first, preparation for the CSAT, includes reliance on after-school private education, nighttime self-study routines, and unhealthy coping mechanisms such as excessive caffeine use and limited leisure. The second, educational and social climate, reflects the influence of Confucian cultural values that emphasize academic achievement and a hypercompetitive environment fostering peer comparison and anxiety. These factors create a misalignment between KHSS' personal needs (person), high-pressure environments (environment), and disrupted daily routines (occupation), resulting in significant physical, emotional, and mental strain.

CONCLUSION

Addressing these imbalances requires systemic policy reforms to reduce academic pressures, alongside occupational therapy interventions such as stress management programs, lifestyle redesign, advocacy, education, and training programs. Collaboration with psychologists for additional counseling is crucial to support emotional well-being. These combined strategies can foster resilience, holistic development, and a healthier balance between academic and personal life.

Copyright © 2026 Ji-Eun Choi et al. Occupational Therapy International published by John Wiley & Sons Ltd.

Address: HOPE Parent Training Center, Seoul, Republic of Korea.; Department of Occupational Therapy, Graduate School of Inje University, Gimhae-si, Republic of Korea, inje.ac.kr.; The Liberal Arts School, SuSeong University, Daegu, Republic of Korea.; Department of Multimedia Design, Inje University, Gimhae-si, Republic of Korea, inje.ac.kr.; HOPE Parent Training Center, Seoul, Republic of Korea.; Department of Occupational Therapy, Graduate School of Inje University, Gimhae-si, Republic of Korea, inje.ac.kr.; Department of Occupational Therapy, Inje University, Gimhae-si, Republic of Korea, inje.ac.kr.
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