Belitung Nursing Journal最新文献

Background: Nursing students frequently encounter education-related stress (ES) arising from demanding academic workloads, clinical responsibilities, and personal adjustments during their training. Persistent stress can negatively impact learning outcomes, clinical performance, and psychological well-being. Emotional intelligence (EI), which involves the ability to perceive, understand, and manage emotions in oneself and others, is recognized as a protective factor that helps individuals regulate stress and adapt to challenges. However, research exploring the relationship between EI and ES among nursing students in Indonesia remains limited.

Objective: This study examined the association between EI and ES among baccalaureate nursing students at a public university in Indonesia.

Methods: A cross-sectional correlational design was conducted from September to November 2024 with 225 participants selected through stratified random sampling. Data were collected using the Indonesian version of the Trait Emotional Intelligence Questionnaire-Short Form and the Indonesian-translated Arabic Higher Education Stress Inventory. Descriptive statistics summarized the levels of EI and ES, while Spearman's correlation, Mann-Whitney U, and Kruskal-Wallis tests were used to assess associations between variables.

Results: Most students demonstrated moderate levels of EI (73.8%) and ES (64%). The median (IQR) scores were 138.00 (29) for EI and 37.00 (8) for ES. A significant negative correlation was found between EI and ES (rₛ = -0.445, p <0.01), indicating that students with higher EI experienced lower stress levels. Among demographic variables, only gender was significantly associated with ES (p = 0.05), with men reporting higher mean ranks than women.

Conclusion: The findings highlight the importance of emotional intelligence in mitigating education-related stress among nursing students. Incorporating EI development into nursing curricula through emotional regulation training, reflective practices, and social-emotional learning strategies can build resilience, improve coping skills, and boost students' academic and clinical performance. Further long-term studies are recommended to investigate the causal relationships and effectiveness of EI-based interventions.

Background: Nurses demonstrate varying levels of self-directed learning competence, which is influenced by multiple individual and contextual factors. Identifying profiles with varying levels of self-directed learning is essential for providing targeted support and training. However, there is limited research exploring the potential profiles of self-directed learning competence among nurses.

Objectives: This study aimed to identify distinct latent profiles of self-directed learning competence among nurses and analyze the influencing factors.

Methods: A cross-sectional study design was used. Nurses were recruited using a convenience sampling from four tertiary hospitals in Guangzhou, China, between August 2024 and February 2025. The Self-Directed Learning Competence Scale for Nurses was used to assess the self-directed learning Competence of nurses. Latent profile analysis was performed to identify different potential profiles. Pearson's chi-square test and multinomial logistic regression were used to explore the factors influencing self-directed learning competence.

Results: A total of 740 nurses participated. Three latent profiles of self-directed learning competence were identified: low (n = 356, 48.1%), medium (n = 291, 39.3%), and high (n = 93, 12.5%). The self-directed learning competence of nurses was influenced by various factors, including Junior college and below (OR = 0.555, p= 0.043); Monthly number of night shifts = 3~4 (OR = 2.859, p = 0.029); Learning atmosphere = neutral (OR = 0.342, p = 0.018) and good (OR = 0.412, p = 0.038); Learning willingness (OR = 1.425, p <0.001), Difficulty of title promotion = difficult (OR = 2.628, p = 0.029) and Job stress (OR = 0.981, p <0.001).

Conclusion: The study revealed diverse profiles of self-directed learning competence among nurses. Nursing managers should design differentiated strategies based on these profiles. Enhancing organizational support and stimulating learning motivation can help improve nurses' self-directed learning competence, thereby promoting their professional development and improving the overall quality of clinical nursing care.

[This corrects the article DOI: 10.33546/bnj.3899.].

Background: Middle adolescents with conduct problems (CP) are at higher risk for aggression than their peers. However, factors contributing to this phenomenon remain insufficiently understood, particularly in Indonesia.

Objective: This study aimed to examine the direct and indirect relationships among parental monitoring, self-esteem, self-control, peer deviance, media violence exposure, academic self-concept, and aggression, using Problem Behavior Theory and supported literature review as a conceptual framework.

Methods: A cross-sectional correlational design was employed. Data were collected from May to June 2023 from students aged 14 to 16 years with CP across nine junior high schools in Aceh Province, Indonesia. Instruments included the Parental Monitoring Instrument, Rosenberg Self-Esteem Scale, Brief Self-Control Scale, Deviant Peer Scale, Extended Content-Based Media Exposure Scale, Academic Self-Concept Questionnaire, and Aggression Problem Behavior Frequency Scale Adolescent Rating. Data were analyzed using path analysis with LISREL 8.80 and the Sobel test.

Results: A total of 423 students participated in the study. Self-control and peer deviance were directly associated with aggression (z = -1.93, β = -0.19, and z = 2.41, β = 0.35, p <0.05, respectively). Self-esteem showed an indirect association with aggression, mediated by self-control (z = -1.783, β = -0.795, p = 0.038). Peer deviance mediated the effects of parental monitoring and media violence exposure on aggression (z = 2.126, β = 1.020, p = 0.017, and z = 2.14, β = 1.055, p = 0.017, respectively). The model explained 42 percent of the variance in aggression.

Conclusion: The findings highlight the importance of regular screening for conduct problems and aggression by community nurses and school-based counseling teachers, as well as the development of interventions focusing on peer deviance and self-control, which were identified as the most significant predictors of aggression.

Background: Indonesia's rapidly aging demographic presents significant challenges, particularly in dementia among older people in resource-limited settings, such as nursing homes. However, there are limited reports on the deterioration of cognitive function and risk factors of dementia among older people in nursing homes. Early identification of dementia is essential for timely intervention and management.

Objective: This study aimed to investigate and follow up on the cognitive function and risk factors of dementia among older people living in nursing homes.

Methods: An observational cohort study was conducted over 6 months (April to October 2024) involving 162 participants from government (n = 83) and private nursing homes (n = 79). Implementation of early dementia screening was carried out using the Montreal Cognitive Assessment in the Indonesian version (MoCA INA) instrument to indicate cognitive function impairment. In addition, the Self-reporting of Physical Activity Questionnaire Indonesia (SPAQ-I) was used to identify physical activity. Descriptive statistics, McNemar, Chi-square, Fisher's Exact, Independent t-test, and multivariate regression were then used to analyze data.

Results: Older individuals did not differ in terms of gender, age, education, or length of stay. However, residents of the private nursing home had significantly higher physical activity levels (t = -2.04, p = 0.040), and a greater proportion engaged in adequate activity (65.8% vs. 50.6%, χ² = 4.23, p = 0.040). Over a six-month period, cognitive function significantly declined among residents in the government nursing home (normal: p = 0.021; mild: p = 0.012; moderate: p = 0.003), whereas no significant change was observed among residents in the private nursing home. At the endpoint, mean cognitive function scores were slightly higher in the private nursing home (20.23 ± 3.45) than in the government nursing home (19.70 ± 4.39), with a very small effect size (Cohen's d = 0.13). Multiple regression analysis revealed that older age (β = -0.396, p <0.001) and lower levels of physical activity (β = 0.163, p = 0.030) were significantly associated with lower cognitive scores.

Conclusion: Dementia screening can enhance care planning for age-related cognitive impairment by enabling early identification and management. Early detection allows nurses to implement more effective care strategies. Additionally, higher physical activity levels were associated with better cognitive function, highlighting a modifiable factor that may help maintain cognitive health among older adults in nursing homes.

Background: In 2022, Mpox presented significant challenges globally, particularly in Brazil, where cases surged among men who have sex with men (MSM). Health literacy (HL) is essential for promoting health within this group.

Objective: To analyze the HL of MSM in the context of Mpox transmission in Brazil.

Methods: This was a national cross-sectional study conducted in a virtual setting. An electronic survey was carried out from September to December 2022. A translated and adapted version of the Health Literacy Scale (HLS-14) and a questionnaire containing sociodemographic information, sexual behaviors, and knowledge and beliefs about Mpox were administered. The distribution of predictor variables across health literacy (HL) levels was explored descriptively. Associations between predictors and HL were analyzed using Pearson's Chi-square test (p < 0.20 for inclusion in multivariate analysis). A generalized linear Poisson model with robust variance was used to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals. Model fit was assessed with the omnibus test and information criteria (AIC, deviance, log-likelihood). Significance was set at p <0.05.

Results: The final sample included 1,449 MSM, with an overall prevalence of 53.83% (n = 780) for satisfactory HL. In the bivariate analysis, 15 of the 27 variables met the statistical criterion (p <0.20) for inclusion in the multivariate model, with six retained in the final model. Reporting non-adherence to treatment if diagnosed with Mpox (aPR: 1.73; 95% CI: 1.44-2.07), a prior Mpox diagnosis (aPR: 1.17; 95% CI: 1.04-1.32), having a basic education level (aPR: 1.15; 95% CI: 1.02-1.31), using apps to seek sex (aPR: 1.15; 95% CI: 1.04-1.27), and seeking sex at parties and clubs (aPR: 1.14; 95% CI: 1.04-1.26) were independently associated with a higher prevalence of satisfactory HL.

Conclusion: HL levels among MSM during the Mpox public health emergency in Brazil were low, shaped by individual, economic, and social factors. The findings can guide nursing practice regarding how MSM deal with information and make decisions in contexts of episodic health events, as well as the HL strategies to be implemented in nursing therapy.

Background: Intrinsic capacity (IC), as defined by the World Health Organization (WHO), represents the composite of an individual's physical and mental capacities and forms a cornerstone of the healthy aging framework. Understanding its determinants is essential for designing effective interventions, particularly in low- and middle-income countries (LMICs) where population aging is accelerating amid limited resources and fragmented health systems. Mapping these determinants supports evidence-based strategies that enhance functional ability and resilience among older adults.

Objective: This scoping review aimed to systematically map and categorize the determinants of IC among older adults in LMICs, providing an evidence base to inform nursing practice and policy development.

Methods: Following PRISMA-ScR guidelines, four databases (Web of Science, PubMed, Scopus, and EBSCOhost) were searched for peer-reviewed studies published between January 2015 and April 2025. Data were synthesized thematically and classified into four determinant domains.

Results: Thirty-six studies met inclusion criteria. The determinants of IC were grouped into four domains: (1) sociodemographic (age, gender, education, marital and economic status, living arrangement, residence); (2) biological, physiological, and disease-related (chronic diseases, multimorbidity, body mass index, frailty, polypharmacy, biomarkers); (3) behavioral and lifestyle (physical activity, diet, smoking, alcohol use, sleep, health-seeking behavior); and (4) environmental (housing quality, social participation, community support, healthcare accessibility). Advancing age, chronic disease burden, frailty, and social isolation were linked to reduced IC, while education, good nutrition, physical activity, and supportive environments were protective.

Conclusion: Intrinsic capacity in older adults from LMICs is shaped by interrelated social, biological, behavioral, and environmental factors. For nursing and health policy, these findings emphasize the need to shift from disease-centered to proactive, function-oriented care. Integrating IC monitoring into routine nursing practice, promoting health literacy, and creating age-friendly environments are critical for sustaining IC and promoting equitable, healthy aging. Findings from this review may serve as a valuable reference for practitioners and policymakers in LMICs.

Registry: Open Science Framework (OSF) [10.17605/OSF.IO/HQ6PG].

Background: Sarcopenia threatens the functional ability of older adults and may be underdiagnosed in homeless populations. Older homeless adults face heightened risks due to malnutrition and comorbidities. However, evidence on sarcopenia in this group remains limited, particularly in institutional settings in Thailand. Understanding the prevalence and associated factors of sarcopenia in this vulnerable population is essential to guide early detection, tailored interventions, and policy development.

Objectives: To investigate the prevalence of sarcopenia risk and possible sarcopenia, and to identify associated risk factors among older homeless adults.

Methods: This cross-sectional study was conducted in 2023 among homeless adults aged 50 years or older residing in a home for the destitute. Participants were purposively recruited based on predetermined inclusion criteria. Sarcopenia risk and possible sarcopenia were determined according to the Asian Working Group for Sarcopenia (AWGS) 2019 guidelines. Calf circumference was measured to identify sarcopenia risk, while handgrip strength and physical performance assessed using the Five-Times Sit-to-Stand Test were used to determine possible sarcopenia. Data were analyzed using descriptive statistics and multinomial logistic regression.

Results: Of the 163 participants, 74.9% were classified as having sarcopenia risk, while 71.2% had possible sarcopenia. Multinomial logistic regression analysis revealed that a low body mass index (BMI) was significantly associated with sarcopenia risk (OR = 0.538, 95% CI [0.359, 0.807], p = 0.003). Possible sarcopenia was significantly associated with older age (OR = 1.173, 95% CI [1.061, 1.298], p = 0.002), lower BMI (OR = 0.564, 95% CI [0.448, 0.710], p < 0.001), and the presence of comorbidities (OR = 5.045, 95% CI [1.025, 24.847], p = 0.047).

Conclusion: Sarcopenia risk and possible sarcopenia are highly prevalent among older homeless adults. BMI was a key protective factor, while age and comorbidities significantly increased the risk. These findings highlight the need for targeted interventions focusing on nutrition and early prevention strategies to mitigate sarcopenia in this vulnerable population. Nurses play a critical role in early screening and implementing tailored interventions to support prevention and management efforts.

Background: Discontinuation of antiretroviral therapy (ART) among people living with HIV (PLHIV) presents significant challenges for HIV care, often leading to physical deterioration, emotional distress, and social isolation. Although prior studies have addressed barriers to adherence, little is known about the experiences of PLHIV following treatment discontinuation in the Indonesian context.

Objective: To explore the experiences of Indonesian PLHIV who have discontinued ART.

Methods: This qualitative study employed a descriptive phenomenological approach and was conducted in three urban areas of Indonesia (Jakarta, Yogyakarta, and Bandar Lampung) between August and September 2024. Fifteen participants were purposively recruited from community-based organizations. In-depth semi-structured interviews were conducted, transcribed verbatim, and analyzed using Colaizzi's method to identify themes and meanings in the narratives.

Results: Three major themes emerged: (1) Physical and psychological consequences of ARV discontinuation, including fatigue, anxiety, and a sense of losing control; (2) Prolonged social strain and stigma, marked by loss of support and moral judgment from others; and (3) Searching for meaning and coping without treatment, including spiritual resignation and detachment from bodily control. These themes reflect the complex, multidimensional burdens PLHIV face after stopping treatment, particularly in the Indonesian context, where HIV stigma is deeply rooted in sociocultural and religious norms, and access to mental health support remains limited.

Conclusion: ART discontinuation is not merely a clinical event but a deeply human experience shaped by physical decline, emotional conflict, social rejection, and existential adaptation. To improve long-term HIV care outcomes, healthcare systems must integrate psychosocial and spiritual support for individuals who disengage from treatment, encouraging re-engagement through nonjudgmental and person-centered care. For nursing practice, this study emphasizes the importance of developing empathetic communication, providing culturally sensitive counseling, and actively addressing stigma during care interactions.

Background: Although breastfeeding is widely recognized for its essential nutritional and protective health benefits for infants, exclusive breastfeeding rates remain suboptimal in many populations globally and within Saudi Arabia. There is a paucity of region-specific data detailing the barriers to breastfeeding among mothers, particularly in the Northern Border region. Understanding these barriers is crucial for developing culturally appropriate interventions and public health policies that can enhance breastfeeding practices and maternal support systems.

Objective: This study aimed to identify and analyze the barriers affecting exclusive breastfeeding among mothers in the Northern Border region of Saudi Arabia.

Methods: A community-based cross-sectional survey was conducted among mothers aged 18 years and older residing in the Northern Border region of Saudi Arabia between February and May 2025. Data were collected using a structured, pre-validated online questionnaire in Arabic, disseminated via social media platforms to ensure broad participation. Descriptive statistics were used to summarize participant characteristics and knowledge levels, while inferential statistics were used to examine associations between demographic factors, knowledge scores, and identified barriers.

Results: A total of 453 mothers participated in the study (mean age: 36.9 ± 8.1 years), of whom 91.6% reported prior breastfeeding experience. Knowledge scores ranged from 24 to 60 (mean: 46.1 ± 6.9). Higher knowledge levels were observed among mothers aged over 40 years (p = 0.0001), those with more than four children (p = 0.02), and participants with an average standard of living (p = 0.0001). Previous breastfeeding experience was significantly associated with older age (p <0.001) and employment status (p = 0.03). Working mothers, particularly those employed on shifts or hourly wages, reported significantly more barriers to exclusive breastfeeding (p = 0.001, p = 0.03, p = 0.0006). The most frequently reported challenges included insufficient workplace support and inadequate maternity leave, affecting 69.5% of respondents.

Conclusion: Barriers to exclusive breastfeeding in the Northern Border region are predominantly workplace-related and institutional, including limited lactation facilities, lack of designated nursing breaks, rigid work schedules, and insufficient organizational support. Addressing these challenges through the implementation of supportive workplace policies, flexible scheduling, and targeted health education initiatives could substantially improve exclusive breastfeeding rates and promote better maternal and infant health outcomes.