Belitung Nursing Journal最新文献

Background: Anthropometric measurements during early childhood are critical as they represent the initial stages at which nutritional status is determined. Practitioners who measure children's growth must have similar and adequate skills in anthropometric measurement to ensure the validity of data regarding children's nutritional status, particularly concerning stunting prevalence.

Objective: This study aimed to explore the measurement practices conducted by community health workers (CHWs) in Indonesia, who are responsible for providing data related to children's growth and, consequently, their nutritional status.

Methods: A qualitative descriptive design was employed using online focus group discussions ranging from 1 to 1.5 hours. Data were collected from ten health professionals and eight CHWs, with analysis performed using thematic analysis.

Results: Four themes emerged: barriers to measurement accuracy, varied skills in measurement, mothers' behavior influenced by children's reactions, and strategies for dealing with traumatized children.

Conclusion: Practical issues that arose during routine anthropometric measurements included the reliability of measurements, the skill levels of examiners, the interplay between mothers' and children's reactions, and approaches to managing traumatized children during measurements. To effectively enhance integrated health posts (Posyandu) services, it is crucial to maintain calibrated, validated equipment and implement comprehensive training with periodic refreshers for CHWs. Additionally, improving facility infrastructure, fostering CHWs' communication skills, and simplifying child-friendly measurement procedures will collectively optimize service quality, promote cooperation, and strengthen community trust.

Background: Nursing documentation is essential for legal accountability, continuity of care, and patient safety. While electronic nursing documentation offers advantages such as improved clarity, efficiency, and reduced workload, no nationwide study has examined which documentation types are most used in Indonesia or how nurse characteristics influence these choices. Addressing this gap is critical for guiding policy and supporting the transition to digital systems.

Objective: This study aimed to determine the types of nursing documentation systems most used by nurses in Indonesia and to examine nurse characteristics associated with documentation type.

Methods: A cross-sectional online survey was conducted in March 2023 among 894 nurses from 34 of Indonesia's 38 provinces. Data collected included sociodemographic characteristics, workplace settings, and documentation types (paper-based, electronic, or combination). Associations between nurse characteristics and documentation types were analyzed using the Kruskal-Wallis test, with post-hoc Mann-Whitney U tests comparing the distribution of education levels between each pair of documentation-type groups.

Results: Most participants were women (75.8%), held a diploma in nursing (53.5%), had over 12 years of work experience (35.3%), and worked in tertiary healthcare facilities (43.3%). Paper-based documentation was predominant (66.6%), followed by combination systems (24.7%) and electronic systems alone (8.7%). Paper-based use was slightly higher in Western Indonesia (66.8%) compared to Eastern Indonesia (64.8%). Education level was significantly associated with documentation type (p = 0.014). Post-hoc analysis showed that nurses using electronic documentation had higher education levels than those using paper-based (p = 0.006) or combination systems (p = 0.006), with electronic documentation most common among nurses holding a Master's/Specialist degree (28.1%). No significant associations were found with sex, work experience, career level, service level, healthcare unit, or region.

Conclusion: Paper-based nursing documentation remains dominant in Indonesia, with limited adoption of electronic systems. Higher educational attainment is associated with greater use of electronic documentation, highlighting the need for improved computer literacy training, infrastructure investment, and institutional and governmental support to facilitate the transition to digital documentation.

Background: Home-based cardiac rehabilitation (HBCR) serves as a crucial alternative to center-based cardiac rehabilitation (CBCR) for patients with heart failure (HF), aiming to enhance access and adherence. However, evidence of its effectiveness is dispersed across numerous systematic reviews with varying findings, necessitating a high-level synthesis to clarify HBCR's overall impact.

Objective: To synthesize and critically evaluate evidence from systematic reviews and meta-analyses on the effectiveness of home-based cardiac rehabilitation in improving health outcomes among patients with heart failure.

Design: An umbrella review of systematic reviews and meta-analyses.

Data sources: A systematic search was conducted in the Cochrane Library, JBI Evidence Synthesis, PubMed, Medline, CINAHL, Epistemonikos, and ThaiJo databases for studies in English or Thai up to April 11, 2025.

Review methods: The review adhered to JBI and PRISMA guidelines. Outcomes included functional capacity, quality of life (QOL), mortality, hospital readmissions, and adverse events. Study quality was assessed using the JBI checklist.

Results: Fifteen systematic reviews and meta-analyses met the inclusion criteria, all of which were of high methodological quality. The evidence consistently demonstrates that HBCR significantly enhances functional capacity compared to usual care, with outcomes comparable to those of CBCR. However, findings for other outcomes were inconsistent; HBCR's impact on QOL and left ventricular ejection fraction (LVEF) varied due to program content and methodological heterogeneity, and it did not significantly reduce mortality or hospital readmissions compared to usual care or CBCR. No significant differences in adverse events were observed between HBCR, CBCR, and usual care.

Conclusion: HBCR is a safe and effective intervention for improving functional capacity in patients with heart failure, offering a viable alternative to CBCR. However, its effects on quality of life, hospital readmissions, and mortality remain inconsistent. These findings highlight HBCR's potential role in expanding access, though further research is needed to optimize program design.

Registry: PROSPERO (CRD42023484051).

Background: The relationship between self-care behaviors, physiological indicators, and quality of life (QoL) in Type 2 Diabetes Mellitus (T2DM) remains underexplored in Indonesian populations. Understanding these factors is crucial for designing culturally appropriate interventions.

Objective: To examine the direct effects of four self-care domains on QoL and the potential mediating roles of HbA1c, blood pressure, and BMI among Indonesian patients with T2DM.

Methods: A cross-sectional exploratory study was conducted August to September 2022 among 128 purposively selected patients from community health centers. Self-care (SCODI) and QoL (DQOL) were measured using validated questionnaires, and HbA1c, blood pressure, and BMI were obtained from clinical records. Structural equation modeling (SEM) was conducted using IBM AMOS version 24.

Results: The SEM analysis yielded an overidentified model (df = 1578) with acceptable fit indices (CFI = 0.908, RMSEA = 0.082, CMIN/df = 1.851). Self-maintenance significantly predicted QoL, HbA1c, and blood pressure. Self-monitoring reduced blood pressure and BMI but was negatively associated with QoL. Self-management improved HbA1c but increased blood pressure and BMI, with a borderline positive effect on QoL. Self-confidence was positively associated with BMI but not with QoL, HbA1c, or blood pressure. Among physiological indicators, only HbA1c significantly predicted QoL.

Conclusion: The direct effects of self-care behaviors on quality of life were more significant than the indirect effects mediated by clinical indicators, emphasizing the importance of strengthening daily self-care skills as a core strategy to enhance well-being in patients with T2DM. Given the exploratory cross-sectional design, findings should be interpreted as associative rather than causal. Future longitudinal research should validate these pathways and develop culturally sensitive intervention models that empower patients to sustain effective self-care behaviors over time.

Background: Pre-eclampsia and eclampsia remain major causes of maternal morbidity and mortality. Healthcare providers' knowledge and attitudes are critical for effective management.

Objective: This study aimed to assess healthcare providers' knowledge and attitudes regarding the management of pre-eclampsia and eclampsia in Jordan.

Methods: A cross-sectional study was conducted from September to October 2024 among 147 healthcare providers from seven public hospitals across three regions in Jordan. Data were collected via a structured questionnaire and analyzed using descriptive statistics, bivariate tests, and multivariate logistic regression.

Results: Overall, 88% demonstrated adequate knowledge of pre-eclampsia, and 83% demonstrated adequate knowledge of eclampsia. In bivariate analysis, knowledge was associated with educational program and training attendance. However, after adjusting for other variables in the multivariate model, only education and gender remained significant, while training was no longer associated with knowledge. For attitudes, 78% had a positive attitude. Although gender and education were associated with attitudes in bivariate analyses, these associations did not remain statistically significant in the multivariate model.

Conclusion: Healthcare providers showed generally adequate knowledge and predominantly positive attitudes toward managing pre-eclampsia and eclampsia. Higher educational attainment independently predicted knowledge, while no independent predictors of attitude were identified. The study highlighted the need for continuous, focused educational training programs, particularly for nurses and midwives. The modest sample size and focus on public hospitals should be considered when interpreting the results.

Background: Youth suicidal behavior is a critical public health concern worldwide. Addressing suicidal behaviors among youth is essential; however, limited research has explored the complex relationships between psychosocial risk and protective factors influencing suicidal behavior in Saudi youth, especially within their unique cultural and religious context. Bridging this gap is vital for developing culturally sensitive prevention strategies.

Objective: This study aimed to investigate psychosocial risk and protective factors associated with suicidal behaviors among Saudi youth.

Methods: A cross-sectional descriptive study was conducted from May to August 2024 with 400 university students. Data were collected using standardized and validated instruments. Statistical analyses included chi-square tests to explore demographic associations with suicide risk, correlation matrices, a suicide heatmap to visualize factor interrelations, scatterplots, and multiple linear regression to identify significant predictors.

Results: Findings showed that 11.8% of youth were classified as at suicidal risk. Suicide risk behavior correlated positively with life stressors (r = 0.60, p <0.01) and interpersonal needs-perceived burdensomeness and thwarted belongingness (r = 0.31, p <0.01)-and negatively with resilience (r = -0.10, p <0.01) and perceived social support (r = -0.22, p <0.01). The regression model significantly predicted suicide risk behavior (F _{(4, 748)} = 61.89, p <0.001), explaining 38.5% of the variance (Adjusted R² = 0.379). Life stressors (β = 0.562, p <0.001) and interpersonal needs (β = 0.115, p = 0.009) were significant positive predictors, while resilience and social support were not significant predictors.

Conclusions: Although suicide prevalence among Saudi youth is relatively low, a significant minority remains at risk, particularly those experiencing family problems, low income, and who have no friends. Life stressors and unmet interpersonal needs are major risk factors. These findings emphasize the vital role of nursing practice in suicide prevention through routine screening, counseling, stress management, and fostering social support. Integrating these strategies in academic and community settings can enhance mental health outcomes and reduce suicide risk among Saudi youth.

Background: The COVID-19 pandemic has severely affected older adults worldwide, with the Egyptian geriatric population facing vulnerabilities due to limited healthcare access and cultural factors. Posttraumatic stress disorder (PTSD) following COVID-19 may significantly impact physical and mental health, yet data specific to older Egyptians are limited.

Objective: This study aimed to assess the prevalence of PTSD and its association with physical and mental health outcomes among older adults in Egypt after COVID-19 infection.

Methods: A cross-sectional study included 290 geriatric patients (≥60 years) recruited from outpatient clinics at two Egyptian university hospitals. Data collection took place over three months, from September to December 2023. PTSD symptoms were measured using the PTSD Checklist-Civilian Version (PCL-C), and physical and mental health were evaluated by the 12-item Short Form Health Survey (SF-12). Pearson correlation and multiple linear regression were used to analyze the relationships between PTSD and health outcomes, controlling for sociodemographic and clinical factors.

Results: Moderate PTSD symptoms were present in 60.3% of participants, and 18.6% showed severe symptoms. Physical health (PCS mean = 31.97, SD = 6.66) and mental health (MCS mean = 32.54, SD = 13.34) scores were significantly reduced. PTSD symptom clusters, such as hyperarousal and avoidance, were negatively correlated with physical and mental health components (e.g., hyperarousal vs. PCS: r = -0.206, p <0.001). The regression model explained 59% of the variance in health outcomes (adjusted R² = 0.59). Higher PTSD symptom severity was associated with a small but statistically significant negative effect on health outcomes (B = -0.20, p = 0.033). Chronic disease status showed the largest negative association (B = -12.34, p <0.001), indicating a substantial impact on health. Age demonstrated a modest negative association (B = -0.15, p = 0.049), while gender and education were not significantly associated with health outcomes.

Conclusion: Nearly four out of five older Egyptian adults experienced moderate to severe PTSD after COVID-19, and PTSD symptoms were significantly associated with poorer physical and mental health. Chronic illness emerged as the strongest determinant of health outcomes, with age showing a modest effect. These findings highlight the importance of culturally sensitive, trauma-informed nursing interventions that address both PTSD and chronic illness to improve the well-being of older adults.

Background: Healthy aging is a key goal of global public health and aging policy initiatives. Understanding its prevalence and associated determinants is essential for designing targeted interventions and promoting well-being among older adults.

Objective: This study aimed to estimate the global prevalence of healthy aging and to identify its associated factors across different countries.

Methods: A systematic review and meta-analysis were conducted. A comprehensive literature search was conducted in Web of Science, PubMed, EBSCO Discovery Service (EDS), Scopus, and ProQuest from database inception to February 2025. Two independent reviewers screened articles, extracted data, and assessed study quality using the Newcastle-Ottawa Quality Assessment Scale (NOS) and the Agency for Healthcare Research and Quality (AHRQ) Methodology Checklist. Eligible studies were included in a meta-analysis using Stata 18.0 and R version 4.5.0.

Results: A total of 39 studies involving 300,624 participants were included. The pooled prevalence of healthy aging was 23.0% (95% CI: 18%-27%). After adjusting for publication bias using the trim-and-fill method, the estimate decreased to 15.6% (95% CI: 11.0%-20.1%), suggesting possible overestimation in the original estimate. Significant associations with healthy aging were found for age (≥75 years), gender, marital status, educational level, economic level, social participation, employment status, economy, smoking status, alcohol consumption, physical activity, body mass index (BMI), and self-rated health.

Conclusions: The findings indicate that fewer than one in four older adults meet the criteria for healthy aging globally, with substantial variation across regions. A wide range of sociodemographic, behavioral, and health-related factors influence this outcome. These results underscore the importance of addressing modifiable determinants in future public health efforts to promote healthy aging.

Registry: PROSPERO [CRD42024542942].

Background: The Burnout Assessment Tool (BAT), an instrument for measuring burnout among healthcare professionals, was originally developed in English and remains unadopted and unvalidated within the Thai healthcare context. Despite its widespread international use, cultural and linguistic variations necessitate rigorous contextual validation.

Objective: This study aimed to translate the BAT into Thai (T-BAT) and evaluate its psychometric properties among Thai nurses, addressing critical gaps in cross-cultural burnout assessment.

Methods: A cross-sectional survey was conducted among 1,005 nurses from two government hospitals in Thailand, employing a multistage sampling with quota-based convenience selection. Participant inclusion criteria comprised full-time nursing employment, a minimum bachelor's degree in nursing, and at least three months of hospital work experience. The BAT underwent a back-translation process to ensure linguistic and cultural equivalence. The psychometric evaluation encompassed descriptive statistical analysis, internal consistency assessment, known-group validity testing through hypothesis, and construct validation via confirmatory factor analysis (CFA). Finally, Rasch analysis, evaluating item performance and measurement precision, was used.

Results: The T-BAT exhibited robust psychometric characteristics, including internal consistency (Cronbach's alpha = 0.93), known-group validity (significant score variations across nurse subgroups), and construct validity (confirmatory factor analysis validating the proposed four-factor model). Finally, Rasch analysis demonstrated optimal item performance, including fit statistics within acceptable ranges (Infit: 0.78-1.40; Outfit: 0.73-1.41). Person and item reliability indices consistently exceeded 0.80, indicating high reliability of the scale.

Conclusion: The study substantiates the T-BAT as a reliable and valid instrument for assessing burnout among Thai nurses. This culturally adapted tool provides a context-specific approach to understanding burnout, potentially enabling more targeted interventions by healthcare policymakers, hospital administrators, and nursing leaders.

Background: In Indonesia's Muslim society, serodiscordant couples navigate a complex web of faith, fear, and stigma. While HIV care efforts have advanced, understanding how religious beliefs and emotional responses shape disclosure remains limited.

Objective: This study aimed to explore the lived experiences of serodiscordant couples in South Sulawesi, Indonesia, with a focus on how faith, fear, and gender roles influence HIV understanding and disclosure practices.

Methods: A qualitative, phenomenological approach was employed, involving 34 participants who participated in in-depth interviews and focus group discussions conducted between February and May 2019. Data were thematically analyzed to capture emotional, cultural, and relational dimensions of HIV disclosure.

Results: Two main themes emerged. (1) Faith and Fear: Navigating HIV Understanding, which includes knowledge of HIV, emotional responses to an HIV diagnosis, the role of religious teachings in shaping health decisions, and the fear of social exclusion; and (2) HIV Status Disclosure and Its Complexities, highlighting motivations for disclosure, barriers to openness, and the personal impact of revealing one's HIV status to a partner. Disclosure was often delayed or mediated by third parties, driven by fear of rejection, shame, and limited communication skills.

Conclusion: The findings revealed the dual role of faith as both a support and a barrier, and the complex interplay of gender dynamics in disclosure decisions. Community nurses in Indonesia's primary health care settings should then play a critical role in HIV prevention by providing culturally sensitive, Islamic-faith-based counseling, gender-responsive disclosure support, and collaboration with peer support groups to foster trust, reduce stigma, and improve adherence.