Belitung Nursing Journal最新文献

Background: The global prevalence of older adults with diabetes has increased, and family caregivers in Indonesia play a critical role in managing diabetes and providing personal care. However, caregiving can be complex and challenging, often negatively affecting caregivers' quality of life (QoL).

Objective: This study aimed to develop and test a hypothesized causal model of QoL among Indonesian family caregivers who care for dependent older persons with type 2 diabetes mellitus (T2DM) in 2024.

Methods: A cross-sectional, correlational study was conducted with 270 family caregivers recruited from five Community Health Centers. Data were collected using various scales: the Center for Epidemiologic Studies Depression Scale, the Zarit Burden Interview, the Duke University Religion Index, the Perceived Knowledge on T2DM Care Scale, the Family-Carer Diabetes Management Self-Efficacy Scale, the Multidimensional Scale of Perceived Social Support, and the Quality-of-Life Index. Descriptive statistics and Partial Least Squares Structural Equation Modeling (PLS-SEM) were used for analysis.

Results: The final model explained 89.1% of the variance in the quality of life (QoL) of family caregivers (R² = 0.893, Adjusted R² = 0.891), with 66% predictive relevance. Depression symptoms had the strongest negative direct effect on QoL, followed by caregiver burden. Self-efficacy and perceived knowledge had positive direct effects, while social support showed no significant direct effect. Indirect effects revealed that social support and self-efficacy positively influenced QoL through depression symptoms. The total effect (TE) analysis confirmed that depression symptoms had the strongest negative effect on QoL (TE = -0.744, p <0.001), while social support (TE = 0.443, p <0.001) and self-efficacy (TE = 0.413, p <0.001) had positive effects.

Conclusion: Reducing depression symptoms and caregiver burden, strengthening social support, and promoting self-efficacy could significantly improve the QoL of family caregivers who care for older persons with T2DM. Nursing practice should address caregivers' physical and emotional needs, provide education, foster social support, and support caregiver mental health.

Background: Ischemic stroke is the primary cause of neurological disability and can lead to psychological issues that affect self-efficacy. Changes in self-efficacy, in turn, influence the overall quality of life. Although many studies have examined factors that affect self-efficacy, quality of life, or both, few have specifically explored the role of demographic factors in shaping the quality of life in patients with ischemic stroke.

Objective: This study aimed to identify the correlations between demographic factors, self-efficacy, and quality of life Indonesian in patients with ischemic stroke.

Methods: This study employed a quantitative approach with a cross-sectional design. A total of 143 participants were recruited between February and April 2024 based on defined inclusion criteria. The research instruments included a demographic questionnaire, the Stroke Self-Efficacy Questionnaire, and the Specific Stroke Quality of Life Questionnaire. Data were analyzed using descriptive statistics, logistic regression, and Spearman rank test.

Results: The findings revealed that females were 2.213 times more likely (95% CI = 1.128-4.341; p = 0.031) to achieve high self-efficacy compared to males. Occupational status significantly influenced self-efficacy, with employed individuals being 6.333 times more likely (95% CI = 3.134-16.599; p <0.001) to achieve high self-efficacy. The duration of stroke experienced by respondents also had a significant impact, with an odds ratio (OR) of 1.908 (95% CI = 0.980-3.715; p = 0.025). Additionally, occupational status significantly affected the quality of life, as employed respondents were 7.213 times more likely to achieve a good quality of life (OR = 7.213; 95% CI = 3.134-16.599; p <0.001). There was a significant positive correlation between self-efficacy and quality of life (r = 0.898, p <0.001).

Conclusion: The results of this study provide valuable insights for nursing practice, emphasizing the importance of interventions to enhance patients' self-efficacy. By increasing patients' confidence in managing their condition, such interventions can lead to improved quality of life and better recovery outcomes. Strategies including health education, psychological support, and patient empowerment during rehabilitation are essential for strengthening self-efficacy and improving overall care outcomes. These findings highlight the need for healthcare professionals and families to address the psychological aspects of care in patients with stroke. Enhancing self-efficacy is critical in helping patients achieve a better quality of life and more successful recovery.

Background: Although substantial evidence exists regarding the treatment of pressure ulcers, there is a lack of studies demonstrating a comprehensive nursing approach for managing pressure ulcers in the ICU, particularly among patients with invasive mechanical ventilation from developing countries like Honduras. This gap in research is significant as the risk and impact of pressure ulcers on health recovery cannot be disregarded.

Objective: This study aimed to analyze Honduran nursing care for pressure ulcers in patients with invasive mechanical ventilation admitted to Intensive Care Units.

Methods: A qualitative study approach was used, with in-depth interviews conducted with 12 critical care nurses from July to September 2022. The interviews were recorded, and data analysis was performed using the participants' narratives following Colaizzi's steps.

Results: Three themes were obtained, which provide insight into the phenomenon: "The strengths in Honduran nursing interventions," "Negligence in the Honduran nursing care processes," and "Vulnerabilities in the organizational structures."

Conclusion: Nurses' experiences highlighted their timely reports and comprehensive, holistic care. However, they undergo negligence in their caring processes, such as low frequency of repositioning, lack of caring plans, and absence of self-training, leading to interdisciplinary work codependency for decision-making. Allocating resources toward nursing care and their professional growth is an investment in providing humane treatment and ensuring the prevention and management of pressure injuries in critical care patients. This study highlights the importance of comprehensive training and standardized protocols for intensive care nurses to improve pressure injury prevention and management in mechanically ventilated patients, emphasizing the need for regular patient repositioning, effective communication, and adequate resources to enhance patient care quality.

Background: Non-communicable diseases have become a leading global health challenge, with mortality rates steadily rising. Insufficient patient care can worsen chronic illness, often placing significant caregiving responsibilities on the patient's spouse. In some cases, spouses may need to leave their jobs to provide full-time care, especially during the end-of-life stage. Spousal caregivers often face emotionally distressing circumstances while caring for their loved ones, which can lead to elevated stress levels. However, research indicates that adequate social support can improve caregivers' quality of life, reducing some of the burdens associated with end-of-life care.

Objectives: This study aimed to assess and analyze the relationships between stress, social support, and quality of life experienced by spousal caregivers in Thailand, guided by Lazarus and Folkman's (1984) Stress and Coping Theory.

Methods: A correlational descriptive study design was used. The study was conducted with 84 spouses of patients in the end-of-life stage at a university hospital between October 2021 and March 2022. Data were collected using a questionnaire covering stress, social support, and quality of life and analyzed using Pearson's Product Moment and Spearman Rank Correlation Coefficients.

Results: The majority of spouses were women aged between 31 and 83 years (Mean = 61.24, SD = 10.42). The mean stress level was 6.40 (SD = 1.62), the mean social support was 55.07 (SD = 9.06), and the mean quality of life was 94.69 (SD = 10.04). There was no significant correlation between social support and stress (r = -0.098, p = 0.373). However, stress was negatively correlated with quality of life (r = -0.299, p = 0.006), and social support was positively related to quality of life (r = 0.219, p = 0.045).

Conclusion: Spousal caregivers of patients at the end-of-life stage experienced varying levels of stress, social support, and quality of life. While no significant relationship was found between social support and stress, stress negatively impacted quality of life, while higher social support was associated with improved quality of life. Healthcare providers, especially nurses, should assess and address the stress, social support, and overall well-being of spousal caregivers to enhance their quality of life.

Background: With an aging global population, establishing integrated systems for long-term care is challenging in several countries. Adequate and quality service for older adults in nursing homes can improve their quality of life. The career self-reliance of nurses working in nursing homes may affect the quality of life of older adults; this suggests a need for educational support for career self-reliance behavior.

Objective: Our study aimed to identify characteristics associated with the career self-reliance behaviors of nurses working in nursing homes.

Methods: Data were collected from nurses working in 789 nursing homes in Japan using questionnaires in 2018. The questionnaire consisted of the Scale of Career Self-Reliance Attitude, Career Self-Reliance Behavior to measure the degree of nurses' career self-reliance, questions about personal attributes, work environment, and work commitment; and the Clinical Nursing Competence Self-Assessment Scale. A multiple regression analysis was conducted using career self-reliance as the dependent variable and characteristics as the independent variables.

Results: Consequently, a total of 336 questionnaires were collected, of which 289 without missing data were analyzed. Of the 289 participants, 79 (27.3%) had certifications or licenses other than those for nursing or had completed graduate school. As a result of multiple regression analysis, a higher frequency of nursing practice (β = 0.38, p <0.001) was associated with career self-reliance attitudes. Having certifications or licenses other than those for nursing or completing graduate school (β = 0.11, p = 0.03), job satisfaction as a nurse (β = 0.12, p = 0.03), higher frequency of nursing practice (β = 0.28, p <0.001), and a higher degree of career self-reliance attitude (β = 0.45, p <0.001) were associated with career self-reliance behavior. Relationships with supervisors or colleagues were not associated with career self-reliance.

Conclusion: It is important for nurses working in nursing homes to enrich their nursing practice, continue learning, and be satisfied with their jobs to improve their career self-reliance. Nurses and administrators working in nursing homes should make efforts to obtain these characteristics for nurses' career self-reliance behaviors. Particularly, maintaining nursing practice frequency is essential for improving the quality of life of older adults through nurses' career self-reliance.

Background: Acupressure is a popular form of complementary nursing among adults. It stimulates the body's self-healing processes by enhancing energy flow, or "chi," along meridian channels. Acupressure can address many health issues and is also used on children because it is painless and straightforward. Although acupressure has existed for centuries, research on its applications for children remains limited.

Objective: This review aimed to categorize and synthesize the research conducted over 30 years on acupressure in children.

Design: A scoping review.

Data source: The databases searched were PubMed, ProQuest, Scopus, ScienceDirect, Wiley, Medline EBSCO, and Google Scholar. The inclusion criteria were original peer-reviewed articles in English or Indonesian that used acupressure as an intervention for children in any setting from 1991 until March 2022 and were updated until March 2024.

Review methods: This review followed the Joanna Briggs Institute Manual Methodologies. Subsequently, the retrieved articles were imported into the EndNote program version 20. Based on the identification results, 2924 articles were obtained, and 76 articles were retained. The review decision process was depicted in a PRISMA flow diagram.

Results: Of the 76 articles, 72% came from the Asian continent, 66% were published within the past ten years, and 59% were randomized controlled trials. Acupressure was most used (48%) by school-age children (7-12 years), with commonly targeted points being Neiguan (P6), Zusanli (ST36), Hegu (LI4), Yintang (Extra1), and auricular acupoints. Acupressure on children can be administered by acupuncturists, nurses, doctors, caregivers, and parents, offering six main benefits: alleviating nausea and vomiting, relieving pain, decreasing anxiety, relieving fatigue, increasing visual function, and increasing weight and height.

Conclusion: Acupressure offers numerous advantages for children with various conditions. Healthcare and nursing professionals should consider using it as a complementary intervention to address issues and problems in healthy and sick children. However, further studies are needed to evaluate its effectiveness.

Background: Self-management behaviors can prevent the negative consequences among patients with coronary heart disease (CHD). The reality of patients followed the self-management behaviors rate are unoptimistic.

Objective: This study aimed to examine whether self-efficacy serves as a mediating role between family functioning and self-management behaviors among coronary heart disease patients.

Methods: A cross-sectional approach was applied, and 140 patients with CHD were included using a cluster sampling strategy. Family functioning was assessed utilizing the Family APGAR Index, self-efficacy was evaluated using the Self-efficacy for Chronic Disease 6-item Scale, and self-management behaviors was examined utilizing the Coronary Artery Disease Self-Management Scale. Data were collected from July to October 2022 and analyzed using descriptive statistics and regression analyses to evaluate the mediating influence.

Results: The degree of self-management behaviors among patients with CHD was at a low level (Mean = 82.23, SD = 11.863). Self-efficacy had a direct and positive impact on self-management behaviors (β = 0.39, p <0.001). Moreover, self-efficacy had a partially intermediary function in the relationship between family functioning and self-management behaviors (indirect effect = 0.14, 95% CI [0.04, 0.27]; direct effect = 0.39, p <0.001).

Conclusion: Self-efficacy demonstrated an association with self-management behaviors and served as a mediation function in the relationship between self-management behaviors and family functioning. Therefore, the significance of family functioning and self-efficacy should be highlighted in nursing practice when developing methods to encourage patients with CHD to improve their self-management behaviors.

Background: Peripheral intravenous catheter (PIVC) insertion is a common procedure performed by nurses for hospitalized children, but phlebitis-an inflammation of the vein-is a frequent complication. The response of the mother, as the child's primary caregiver, plays a key role in the healing process when phlebitis occurs.

Objective: This study aimed to explore mothers' experiences and perceptions regarding the occurrence and management of phlebitis in their children during hospitalization.

Methods: A descriptive phenomenological design was employed for this study, conducted between August and October 2023. Semi-structured interviews were conducted with sixteen mothers whose children had experienced phlebitis during their hospital stay. The interviews were transcribed verbatim, and data were analyzed using content analysis. Each participant validated the transcripts before analysis.

Results: Three main themes emerged from the data: 1) Risk factors and causes of phlebitis; 2) Early detection and confirmation of phlebitis; and 3) Management of IV infusion occlusions.

Conclusion: Although the causes and risk factors for phlebitis in children cannot be entirely avoided, early detection by mothers can reduce some risks. The study also identified gaps in nursing practice, particularly regarding the management of infusion occlusions, with some practices deviating from standard procedures. To improve outcomes, nurses should adhere to evidence-based protocols for maintaining IV patency and proactively educate mothers on recognizing signs of phlebitis. Strengthening nurse-mother communication and ensuring consistent implementation of best practices are essential for preventing and effectively managing phlebitis in pediatric patients.

Background: Hand hygiene is a critical component of infection prevention and control (IPC) in healthcare settings, as emphasized by the World Health Organization (WHO). However, compliance with recommended hand hygiene practices remains suboptimal in many resource-limited settings, including Afghanistan. Despite its importance, limited research has been conducted on hand hygiene practices in Afghan healthcare facilities, highlighting the need for further investigation.

Objective: This study aimed to evaluate the self-reported hand hygiene practices of nurses at Mirwais Regional Hospital in Kandahar, Afghanistan.

Methods: A cross-sectional study was conducted among 141 nurses between August and October 2023. Self-reported hand hygiene compliance was assessed using WHO's "Your 5 Moments for Hand Hygiene" framework. Data on demographic characteristics, training, and compliance rates were collected. Descriptive statistics and logistic regressions were applied to analyze the data using SPSS version 26.0.

Results: The study found that 73.1% of nurses demonstrated good hand hygiene practices, while 26.9% had non-good compliance. Female nurses showed significantly higher compliance (87.5%) than their male counterparts (68.8%) with a p-value of 0.044, AOR = 1.15 (95% CI: 1.03-9.75). Nurses with a bachelor's degree had higher compliance (92.3%) compared to those with a diploma (59.4%) (p = 0.046, AOR = 2.1, 95% CI: 0.15-0.96). Nurses aged ≥30 years showed better compliance (96%) than those aged 20-29 years (75.3%) (p = 0.006, AOR = 2.1, 95% CI: 1.84-36.53). Hand hygiene training was positively associated with better compliance (88.3% vs. 61.9%, p = 0.004, AOR = 1.5, 95% CI: 0.07-0.6).

Conclusion: While overall compliance was relatively high, significant gaps persist, particularly among younger, less educated, and male nurses, as well as those in high-burden wards. Enhanced training programs, tailored strategies, and regular audits are essential for improving hand hygiene practices and strengthening infection prevention and control efforts, ultimately enhancing patient safety in resource-limited settings.

Background: Early pregnancy ultrasound provides a more accurate estimate of the estimated delivery date (EDD) than the last menstrual period (LMP). However, LMP-based EDD calculation remains common in resource-limited settings. Inaccurate EDDs can contribute to adverse birth outcomes. However, research examining the accuracy of LMP-based EDDs and their association with delivery-related adverse events is limited.

Objective: This study aimed to evaluate the accuracy of self-reported LMP in predicting EDD and its association with adverse events during delivery.

Methods: Data were analyzed from 171 pregnant women participating in the Indonesian Birth Cohort Study based in Makassar, Indonesia. This study utilized a prospective cohort design, employing descriptive statistics and Poisson regression analysis in Stata. Adverse events were defined as any unexpected negative occurrence during delivery, including issues related to healthcare access, birth attendance, and the medical condition of the mother and newborn.

Results: Mode of delivery and categorized differences between actual delivery date and estimated delivery date (ADD-EDD) were significantly associated with adverse events during delivery. Cesarean delivery was associated with a higher risk of adverse events compared to vaginal birth (Adjusted Risk Ratio [ARR] 1.11, 95% CI: 1.02-1.22, p <0.001). Additionally, ADD-EDD differences of ≤-15 days (ARR 1.49, 95% CI: 1.35-1.65), -14 to -8 days (ARR 1.33, 95% CI: 1.19-1.49), and ≥15 days (ARR 1.37, 95% CI: 1.20-1.58) showed an increased risk (all p <0.001). An ADD-EDD difference of 8 to 14 days was marginally significant (ARR 1.20, 95% CI: 1.00-1.44, p = 0.046). The ADD-EDD distribution showed notable gaps, with ADD deviations occurring as early as 109 days before and as late as 45 days after the EDD. On average, the ADD occurred approximately one week earlier (-7.15 days) than the EDD.

Conclusion: Lower accuracy of LMP-based EDDs and delivery mode is associated with increased adverse events during delivery. Transitioning from LMP-based EDDs to more accurate methods is necessary to improve maternal and neonatal care outcomes. Integrating routine early ultrasound for EDD calculation can better equip healthcare providers and nurses to plan deliveries, reduce risks, and improve patient outcomes in resource-limited settings.