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 and 3 others
Korean high school students studying for the national exam spend roughly 12 hours a day on academics, sleep under 6 hours, and 44% regularly skip breakfast — a pattern the review traces to exam culture and filial duty, not individual weakness.
No intervention was tested.
Key findings
1Two root causes of occupational imbalance emerged across the 16 included studies: the CSAT exam culture (excessive study hours, disrupted routines, overreliance on private tutoring) and Confucian filial piety, which frames academic success as a moral debt to parents and further suppresses rest, leisure, and self-directed activity.
2Across the included studies the pattern is consistent: students study approximately 12 hours per day (OECD average 6–8), sleep under 6 hours, 44% regularly skip breakfast, 73% are enrolled in private tutoring at an average cost of ₩770,000 (USD 570) per month, and national survey data cited in the review show 44.3% report stress, 21.4% depressive symptoms, and 13.5% suicidal ideation.
3The authors argue the imbalance is driven by structural and cultural factors — the exam system, parental expectations, and institutionalised private education — rather than by individual deficits, and that addressing it requires changing environmental and institutional conditions, not just teaching students coping skills.
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What it does not show
14 of the 16 included studies were quantitative cross-sectional surveys; only one was qualitative and one mixed-methods, so the review captures what students do but has limited insight into how they experience and assign meaning to their daily routines. No longitudinal data were included, so the review cannot speak to long-term outcomes such as identity formation or career direction. Regional variation (urban versus rural) was not examined, so it is unclear whether students in less urbanised areas experience less occupational overload. 15 of the 16 included studies were originally published in Korean, which the authors acknowledge may introduce language and methodological dominance bias. Intervention studies were explicitly excluded from the review, so the paper maps the problem but offers no evidence that any specific programme or therapy changes outcomes. The review is descriptive and thematic; it does not synthesise effect sizes or compare outcomes across studies.
Declared interests
No funding was received for this manuscript. The authors declare no conflicts of interest.
The easy way to misread this
This is a scoping review that maps a problem; it does not test whether any specific occupational therapy intervention or school programme works. The findings describe what Korean high school students experience under the CSAT system and Confucian family expectations — they are not evidence that a particular therapy, routine redesign, or parental education programme will change those outcomes. Generalising the findings to students in other countries or educational systems would go beyond what the review supports, as the authors themselves note the patterns are embedded in a specific cultural and institutional context.
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