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

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.