Belitung Nursing Journal最新文献

Background: The craving for sexuality and closeness continues into old age, although the means of expressing it may change. Beyond direct sexual encounters, older adults can express their sexuality through gentle affection, warm embraces, holding hands, and other intimate gestures. However, aging can also impact their sexual experiences.

Objective: This study aimed to explore the lived experiences of sexuality among older adults living in the countryside of Cebu, Philippines, during their senior years.

Methods: A qualitative descriptive phenomenological design was employed. Purposive sampling was used to select ten participants. Data were collected from September to December 2023, and Colaizzi's method of data analysis was applied to ensure thorough interpretation.

Results: Three major themes emerged: 1) Being Centered: An actualized form of sexuality in later years; 2) Being Connected: A strong sense of intimacy in later years; and 3) Being Conveyed: Diversifying expressions of sexuality in later years.

Conclusion: Despite advancing age, older adults can remain active in their intimate relationships and achieve a healthy marital life characterized by life satisfaction. They express their love for their partners by being centered, connected, and attuned to each other's needs and feelings. These findings highlight the importance for geriatric nurses to recognize and support the sexual health and intimacy needs of older adults, facilitating discussions and providing resources that promote overall well-being and quality of life.

Background: Chronic kidney disease (CKD) is a leading cause of death, with a rising incidence worldwide. Effective disease management requires health literacy (HL) interventions to optimize patients' self-management. However, difficulties in communication between patients and healthcare providers often impede improvements in HL. While HL interventions should prioritize enhancing communication quality, current evidence supporting this approach remains limited.

Objective: This study aimed to investigate the effectiveness of a Health Literacy Enhancement (HLE) program on CKD knowledge, self-management behaviors, and clinical outcomes in people with CKD.

Methods: A quasi-experimental study using a two-group pretest-posttest design was conducted from December 2022 to March 2023. Fifty-two participants with stage 3 to 4 CKD, recruited from outpatient CKD clinics in two district hospitals in Central Thailand, were divided into two groups. Participants in the experimental group (n = 25) received the HLE Program based on Baker's HL concept, while the control group (n = 27) received usual care for 12 weeks. Data were collected twice before and after the 12-week program using a demographic form, CKD knowledge, CKD self-management behaviors (SMBs), and clinical outcomes, including blood pressure (BP), hemoglobin A1c (HbA1c), estimated glomerular rate (eGFR), body mass index (BMI), and waist circumference (WC). Data were analyzed using descriptive statistics, Chi-square, Paired t-test, and Independent t-test.

Results: Following the HLE Program, the experimental group had a significantly higher score in CKD knowledge (t = 8.79, p <0.001) and self-management behaviors (SMBs) (t = 7.70, p <0.001). They also achieved a better average estimated glomerular filtration rate (eGFR) (t = 3.14, p <0.01) and had lower systolic blood pressure (SBP) (t = -2.54, p <0.05) and diastolic blood pressure (DBP) (t = -2.05, p <0.05) compared to the control group and their baseline measures. The effect sizes (Cohen's d) were substantial, indicating large effects for CKD knowledge (2.44), self-management behaviors (2.14), and eGFR (0.87), while SBP (-0.71) and DBP (-0.55) indicated medium effects. However, no significant differences were observed in HbA1c, BMI, and WC.

Conclusion: The HLE program can enhance effective patient-provider communication using plain language, leading to significant improvements in CKD knowledge and SMBs, as well as clinical outcomes, including eGFR and BP. Nurses should implement this program to enhance HL in people with CKD, leading to effective self-management and helping slow the progression of the disease.

Trial registry number: Thai Clinical Trials Registry (TCTR20240920001).

Background: Stroke is the leading cause of disability and the second leading cause of death worldwide. In the Philippines, there is a lack of a unified system for the care of community-dwelling patients with stroke. Furthermore, rehabilitation facilities are underutilized, and human resources and financial support policies are lacking. Nurses have become valuable human resources in rehabilitation. Current literature has inconsistent and weak evidence on the effectiveness of home-based post-stroke rehabilitation.

Objective: This study aimed to determine essential elements that constitute a nurse-coordinated post-stroke home care rehabilitation in the Philippines.

Methods: A literature review was conducted to generate items for a tool that would elicit important elements of post-stroke home care rehabilitation in terms of structure, process, and outcome domains. Two rounds of the modified e-Delphi technique were conducted with a panel of 10 experts, and the content validity index (CVI) was calculated. Using the developed tool, a cross-sectional survey was conducted among nurses in the Philippines in March 2024. The responses were subjected to principal component analysis.

Results: The validated tool contains 55 items with an item level CVI range of 0.9-1.0 and a scale level CVI of 0.99. Online survey responses were received from 326 participants. The first principal component for each domain was analyzed. Structure elements involve an interdisciplinary team that integrates policy and funding for home visits and telehealth services, ensuring culturally responsive home environments. Process elements involve collaborative planning and evidence-based treatment processes coordinated by nurses, prioritizing patient and family engagement. Nurses may perform therapies delegated by rehabilitation specialists. Outcomes elements focus on achieving patient- and family-centered goals, enhancing daily activities, and improving overall quality of life.

Conclusion: Given the complexity of community-based rehabilitation, this study determined the essential elements of post-stroke home care rehabilitation. These elements are crucial in providing guidance to policymakers, clinicians, and patients in the delivery of home-based post-stroke care.

Background: Death is a natural part of life that no one can avoid. Listening to patients and supporting their needs during the dying process is crucial. However, dying patients are often not given a voice or choices regarding their care plans. Additionally, discussing death is difficult, even for those who consider themselves religious or have faith. Death is often avoided as a topic within the community, including the Christian community. Many people shy away from discussions about death and dying, as these topics are usually considered "taboo" and uncomfortable. Nurses' perspectives on a "peaceful death" can contribute to high-quality care and a good-quality death. However, there is a lack of evidence regarding a "peaceful death" from the nurses' perspective, particularly from Christian nurses in Indonesia.

Objective: This study aimed to explore the perspectives of Christian nurses on a peaceful death in Indonesia.

Methods: The study employed a qualitative descriptive design conducted between January and April 2024. The study sample was recruited through the distribution of an e-flyer via social media. Interviews were conducted using six open-ended questions. All interviews were audiotaped and transcribed. Eighteen Christian nurses were interviewed, including three male and fifteen female nurses. Participants were selected through purposive sampling. The study was analyzed using thematic analysis.

Results: Three main themes were developed: 1) Components of a Peaceful Death, 2) Companionship and Care, and 3) Knowing the Final Destination.

Conclusion: This study identified key perspectives on a peaceful death from Christian nurses. Understanding these views will help nurses, particularly Christian nurses, provide optimal care and prepare patients to achieve a peaceful death. These perspectives will enrich nursing knowledge in providing end-of-life care to dying patients based on their beliefs.

Background: An individual's sexual orientation plays a fundamental role in their self-identity, relationships, and health. Years have shown both progressive and regressive responses to the LGBT community's social acceptance, particularly observable in various areas. Yet existing literature overlooks the Filipino healthcare settings, particularly with lesbian, gay, bisexual, and transgender (LGBT) staff nurses. Exploring their perspectives and experiences, whether challenges or successes, is crucial for gaining insights into occupational matters, workplace dynamics, and policy development.

Objective: The research aimed to explore the lived experiences of LGBT staff nurses in the hospital settings.

Methods: Husserl's Transcendental Phenomenology research design was utilized in this study. Participants included LGBT staff nurses with at least a year of experience at any hospital department. Individualized unstructured interviews were conducted with three participants interviewed face-to-face and five through online video conferencing platforms from March to April 2024. All interviews were transcribed, coded, themed, and analyzed using Colaizzi's approach. Data saturation was achieved with eight participants.

Results: Seven themes emerged, including: Recognizing Gender Stereotypes, Optimizing Nursing Care, Yearning for Acceptance, Generating Meaningful Relationships, Battling Heteronormative Gender Norms, Inspiring Potentials beyond Gender and Profession, and Valuing the Progress of LGBT Inclusivity.

Conclusion: The study revealed that LGBT staff nurses had multifaceted experiences with patients, colleagues, and superiors in the hospital settings as their workplace. They faced gender stereotyping and battled against limits on expression but fought to defend their authentic identities. They built relationships with colleagues and strived to be defined beyond societal perceptions. As they yearn for amplified LGBT acceptance in the workplace and society, they expressed gratitude for progress towards acceptance of the LGBT community.

Background: As the population ages, the prevalence of dementia in Indonesia is rapidly increasing. In Indonesia, dementia care is primarily provided by informal or family caregivers. However, there is limited information about these caregivers' understanding of dementia and the factors that may influence their knowledge. Given that family members are the primary source of dementia care in Indonesia, it is essential to understand their knowledge and identify any gaps to inform future educational interventions.

Objective: To explore the knowledge of dementia among Indonesian family caregivers and identify the sociodemographic factors associated with dementia knowledge.

Methods: A cross-sectional survey was conducted in 2022 with 200 family caregivers who were members of Alzheimer's Indonesia (ALZI) support groups. These caregivers received invitations via ALZI to complete a translated version of the Dementia Knowledge Assessment Scale (DKAS-I). Independent t-tests and ANOVAs were used to examine differences in dementia knowledge across various subgroups, such as gender, education, and age.

Results: Seventy-six family caregivers completed the DKAS-I (38% response rate). Respondents had an average age of 49 years, were mostly female, and the majority were children of people with dementia. Over two-thirds of the DKAS-I items were answered correctly by family caregivers, with the 'care considerations' domain scoring the highest. Age, relationship to the person with dementia (being a child), and prior dementia education were significantly correlated with higher dementia knowledge in our sample.

Conclusion: Family caregivers of people living with dementia across 10 Indonesian provinces who were members of dementia support groups demonstrated moderate dementia knowledge. Targeted education is needed to address gaps in knowledge about communication and behavioural changes in people with dementia and other areas related to quality of care. There is an opportunity for gerontological nurses with specialised dementia knowledge to lead educational initiatives for family caregivers to enhance their capacity. Future research should also investigate the dementia knowledge of caregivers in the general population, who may be older and less educated compared to the participants in this study.

Background: Thalassemia is a hereditary blood disorder that poses significant challenges for affected children and their families. Caregivers, particularly mothers, often experience difficulties in managing their child's condition. Understanding their current experience is crucial for improving care and support.

Objective: This study aimed to explore the experiences of mothers caring for children with thalassemia in Banten, Indonesia.

Methods: A qualitative descriptive approach was employed, involving semi-structured in-depth interviews with eleven mothers of children diagnosed with thalassemia. Data were collected from April to May 2023. The interviews were audio recorded, and the data were analyzed verbatim using Colaizzi's method to identify key themes related to the experiences.

Results: Three themes were developed: 1) Perception of thalassemia as a genetic condition, 2) Emotional, logistical, and practical caregiving challenges, and 3) Support received by mothers in caring for children with thalassemia.

Conclusion: The findings highlight the multifaceted challenges faced by mothers of children with thalassemia and emphasize the need for improved communication, emotional support, and care coordination from nurses and healthcare providers. Future research should focus on expanding support systems and exploring effective interventions to enhance the quality of life for families navigating the complexities of chronic illness.

Background: The current model for managing type 2 diabetes mellitus (T2DM) is healthcare provider-centered rather than patient-centered. This approach may overlook individual patients' unique needs, potentially impacting the effectiveness of T2DM management goals.

Objective: This study aimed to develop a patient-centered care model based on self-efficacy to enhance self-care and improve the quality of life for individuals with T2DM.

Methods: The study employed a cross-sectional design with a sample size of 250 respondents recruited through multistage random sampling, Jember regency, East Java, Indonesia. The study variables included exogenous factors (people with T2DM, situational treatment, family, and healthcare services) and endogenous factors (self-efficacy, self-care, and quality of life). Data were collected from August to December 2022 using a questionnaire and analyzed descriptively and inferentially using SEM-PLS.

Results: The developed model was a good fit with strong predictive relevance (SRMR = 0.065; Q2 = 0.049). All exogenous factors-people with T2DM, situational treatment, family, and healthcare services-significantly affected self-efficacy (42.2%, 37%, 8.1%, and 17.3%; p <0.001). Self-efficacy had a 61.6% effect on self-care, and self-care had a 27.1% effect on quality of life (p <0.001). Only situational treatment factors had a direct effect on self-care (21.7%; p <0.001). All exogenous factors also influenced the quality of life through self-efficacy and self-care (7%, 6.2%, 1.3%, and 2.9%; p <0.05).

Conclusions: A patient-centered care model based on self-efficacy for managing T2DM can improve self-care behaviors and quality of life for individuals with T2DM. This model can be utilized by nurses in healthcare services to enhance the management of T2DM.

Background: There remains a significant gap in understanding what nulliparous (NP) women desire in terms of treatment for pelvic organ prolapse (POP) before pregnancy and childbirth.

Objective: This study aimed to assess the perceptions of young NP women without POP regarding various POP treatments and identify their preferred treatment options to enhance quality in nursing practice.

Methods: This study employed a qualitative descriptive design involving thirteen young NP women at the Faculty of Medicine, Ovidius University from Constanța, Romania. Age, body mass index (BMI), comorbidities, previous surgical interventions, and smoking status were evaluated. Participants underwent a semi-structured interview from January to February 2024, during which their perceptions of different POP treatments were explored. The interviews were audio-recorded and transcribed verbatim and were analyzed using content analysis.

Results: The mean age of the NP women without POP was 24.23 years, with 61.53% having a BMI of 30 or greater and 69.23% reporting previous surgical interventions. Four dominant themes emerged: 1) the Internet as a source of information about treatments for POP; 2) insufficient knowledge about POP symptoms; 3) the preference for supervised PFM training; and 4) choosing the surgical treatments by vaginal route, although wishing to preserve the uterus.

Conclusion: The findings indicated that young NP women's perceptions of POP treatments were primarily influenced by online information. The preferred treatment for POP among young NP women was conservative, with a strong emphasis on supervised PFM training. This study provides valuable insights into nursing practice by highlighting NP women's perceptions and preferences for PFM training as a treatment for POP, potentially contributing to delaying the onset of this condition in their lives.