Belitung Nursing Journal最新文献

Background: Juvenile delinquency with a history of alcohol use is a growing concern with a significant impact on their holistic well-being. Life purpose (LP) has been recognized as essential for enhancing adolescent wellness. LP should therefore be useful in addressing juvenile delinquency.

Objective: This quasi-experimental study investigated the effect of the life purpose program on the wellness of juvenile delinquents with a history of alcohol use in Southern Thailand.

Methods: Sixty-seven delinquents, aged 15 to 19, from the Juvenile Detention Center were randomly assigned to either the intervention group (n = 35) or the control group (n = 32). The intervention group engaged in an eight-week purpose program, whereas the control group continued with routine care. Wellness outcomes were measured using the Wellness Scale (WS) and analyzed through multilevel mixed-effects modeling.

Results: At baseline, there were no significant differences in wellness scores between the control and intervention groups. Following the intervention, wellness scores at weeks 16 and 24 were significantly higher in the intervention group compared to the control group (t = -6.101, p <0.001; t = -2.856, p = 0.008, respectively). The multilevel mixed effects model confirmed a significant improvement in wellness scores over time in the intervention group (β = 3.746; 95% CI = 0.22-7.27; p = 0.037).

Conclusion: The program was successful in improving wellness among juvenile delinquents with a history of alcohol use and shows promise for broader application. It should be implemented by nurses and other professionals as part of efforts to promote a sense of life purpose in similar populations. However, further research is needed to evaluate its long-term impact and sustainability. Integrating the life purpose program into existing rehabilitation processes may enhance the overall well-being of juvenile detainees.

Trial registry number: Thai Clinical Trials Registry (TCTR20241217002).

Background: Patients with a history of traumatic life events who enter the healthcare system are especially vulnerable, often posing greater challenges to care delivery. However, little is known about the capacity of nursing staff, especially nursing students, to deliver trauma-informed care (TIC).

Objective: This study aimed to assess the knowledge, attitude, and practice of trauma-informed care among Chinese nursing students.

Methods: A cross-sectional study was employed to survey undergraduate nursing students from a medical college in eastern China. Data were collected using an established self-administered questionnaire on TIC knowledge, attitude, and practice (KAP) consisting of 21 items. The content validity scale-level CVI was 0.950, and the reliability with Cronbach's α coefficient was 0.963.

Results: A total of 118 undergraduate nursing students, ranging from first to fourth year, participated in the survey, and ultimately, 117 students were included in the study, yielding an effective response rate of 99.15%. The average scores for KAP were 70.83±14.58, 77.78±11.11, and 66.67±16.67; however, the good levels of KAP accounted for 16.2%, 45.3% and 6.0%, respectively. Additional analysis showed a weak positive correlation between knowledge and attitude (r_s = 0.211, p = 0.022), while there was a moderate positive correlation between knowledge and practice, attitude and practice (r_s = 0.309, p < 0.001; r_s = 0.310, p < 0.001). Univariate analysis indicated that year of study and experience in caring for trauma patients were significantly related to practice (p = 0.039, p = 0.002).

Conclusion: The students' KAP on trauma-informed care was not at a good level, especially regarding practice and knowledge, and required further strengthening. The findings provide baseline information for further development of a KAP-TIC comprehensive course and exploration of practice ability-centered TIC education for nursing students. Assessing the effectiveness of the newly developed TIC course and learning outcomes in clinical practice is also recommended.

Background: The quality of life (QoL) of family caregivers supporting older persons with functional dependence due to Type 2 Diabetes Mellitus (T2DM) is a growing concern. Accurately assessing caregiver well-being requires culturally appropriate, valid, and reliable instruments. However, such tools remain limited in the Indonesian context.

Objective: This study aimed to translate the Quality of Life Index (QLI) into Indonesian and evaluate the psychometric properties of the Indonesian version (QLI-I) among family caregivers of dependent older persons with T2DM.

Methods: Brislin's back-translation method was used to ensure linguistic and conceptual equivalence in the translation process. Content validity was assessed by a panel of five experts. Psychometric evaluation was conducted on a purposive sample of 394 family caregivers recruited from eleven community health centers in Medan, Indonesia. Construct validity was examined using confirmatory factor analysis (CFA), while convergent validity and construct reliability (CR) were analyzed to assess measurement accuracy.

Results: The Indonesian version of the Quality of Life Index (QLI-I) demonstrated strong construct validity, with standardized factor loadings ranging from 0.707 to 0.870. CFA indicated an acceptable model fit based on the following indices: Root Mean Square Error of Approximation (RMSEA) = 0.067, ratio of chi-square to degrees of freedom (CMIN/df) = 2.779, Comparative Fit Index (CFI) = 0.906, Incremental Fit Index (IFI) = 0.906, Goodness of Fit Index (GFI) = 0.814, and Tucker-Lewis Index (TLI) = 0.898. Composite Reliability (CR) values were high across all domains: Health/Functioning (HF) = 0.957, Family (FA) = 0.876, Social/Economic (SE) = 0.924, and Psychological/Spiritual (PS) = 0.922. Average Variance Extracted (AVE) values met the recommended threshold for each domain: HF = 0.633, FA = 0.586, SE = 0.605, and PS = 0.627. All constructs demonstrated acceptable discriminant validity, confirming the distinctiveness of each domain.

Conclusion: The QLI-I is a valid and reliable instrument for assessing the QoL of family caregivers of dependent older persons with T2DM. Its use in clinical and community settings can support nurses and healthcare professionals in identifying caregiver needs and developing culturally appropriate, evidence-based interventions to enhance caregiver well-being.

Background: Metabolic syndrome (MetS) is a cluster of chronic conditions, including obesity, hyperglycemia, hypertension, and dyslipidemia, known to significantly increase the risk of cardiovascular diseases (CVDs). Effective interventions are needed to control the progression of MetS.

Objective: This study aimed to determine the effectiveness of the Self-Efficacy Enhancement (SEE) program on health behaviors and clinical outcomes in individuals with Metabolic Syndrome (MetS).

Methods: A quasi-experimental study with a two-group pretest-posttest design was conducted from September 2023 to January 2024. A purposive sample of 70 participants with MetS was recruited from two healthcare settings in Thailand. Participants were divided into two groups: an experimental group (n = 35) and a control group (n = 35). The experimental group received the SEE program based on Self-Efficacy Theory, while the control group received only routine nursing care for 12 weeks. Data were collected using a Personal Information questionnaire, a Health Behavior questionnaire, and clinical outcome assessments, including waist circumference (WC), blood pressure (BP), fasting plasma glucose (FPG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL cholesterol), and non-high-density lipoprotein cholesterol (non-HDL cholesterol), before and after the 12-week program. Data were analyzed using descriptive statistics, paired t-test, independent t-test, Wilcoxon signed-rank test, Mann-Whitney U-test, and ANCOVA.

Results: Following the SEE program, the experimental group exhibited significant improvements in health behaviors (t = -12.830, p <0.001), a reduction in WC (t = 3.809, p <0.001), decreased SBP (z = -4.554, p <0.001) and DBP (t = -5.178, p <0.001), and an increase in HDL cholesterol (z = -3.193, p <0.001) compared to baseline measures. Furthermore, compared to the control group, the experimental group demonstrated significantly improved health behaviors (F = 193.86, p <0.001), lower WC (F = 19.58, p <0.001), lower FPG (F = 12.39, p <0.001), lower SBP (F = 25.04, p <0.001), lower DBP (F = 19.49, p <0.001), and lower non-HDL cholesterol (F = 8.49, p <0.01). Partial eta-squared (η²) indicated large effects for health behaviors, WC, FPG, SBP, DBP, TC, and HDL cholesterol; non-HDL cholesterol showed a medium effect. TC and HDL cholesterol showed no significant change after completing the program.

Conclusion: The SEE program improved health behaviors and clinical outcomes, supporting its integration into standard MetS care in nursing practice. Through e-health, education, exercise guidance, role modeling, and support, the program can boost confidence in adopting he

Background: Integrated Management of Neonatal and Childhood Illness (IMNCI) is a critical strategy aimed at improving child health outcomes. In Bhutan, nurses play a frontline role in implementing IMNCI guidelines, yet factors influencing their implementation remain underexplored.

Objective: This study aimed to identify the predictors of IMNCI implementation among nurses in selected hospitals in Bhutan.

Methods: A correlational predictive design was used, involving 107 nurses from nine hospitals across Bhutan. Data on demographics, supplies/resources, supervision, attitude, workload, nurse management skills, and IMNCI implementation were collected between November and December 2023 through structured questionnaires. Multiple linear regression analysis was conducted to determine factors predicting IMNCI implementation.

Results: Nurse management skill was the only significant predictor of IMNCI implementation (β = 0.321, p <0.001), while other variables such as supplies/resources, supervision, attitude, years of service, training, and workload showed no significant predictive value. The model explained 16.8% of the variance in IMNCI implementation.

Conclusion: Nurse management skills play a pivotal role in effective IMNCI implementation in Bhutanese hospitals. However, the modest explanatory power suggests other factors may influence implementation, warranting further research to enhance child healthcare delivery through strengthened nurse leadership and systemic support.

Background: Schizophrenia is a chronic and disabling mental illness that presents a significant public health challenge worldwide. It affects multiple aspects of an individual's life, often resulting in poor health outcomes, disability, and impaired daily functioning. With advances in ongoing care and relapse prevention, the focus of treatment has shifted toward promoting remission and personal recovery. However, few studies have explored the lived experiences of recovery among individuals with schizophrenia in Southeast Asia, especially within the Thai cultural context.

Objective: This study aimed to explore the lived experiences of recovery among individuals with schizophrenia in Northeastern Thailand.

Methods: A qualitative hermeneutic phenomenological approach was used. Twenty-three community-dwelling individuals in the recovery phase of schizophrenia were purposively selected. Data were collected through in-depth, face-to-face interviews between December 2021 and June 2022. Interviews were transcribed verbatim and analyzed using hermeneutic analysis to identify underlying themes.

Results: Participants described recovery as a process of "bringing life back to normal living." Two interrelated themes emerged: (1) Being normal through social connectedness, and (2) Living a happy and meaningful life. These themes highlight the importance of social roles, community acceptance, emotional well-being, and culturally rooted definitions of normalcy in the recovery process.

Conclusion: Recovery from schizophrenia extends beyond symptom control to include social reintegration and the restoration of purpose and well-being. Psychiatric nurses play a vital role in supporting this process by developing interventions that transcend biomedical treatment, fostering social connectedness, personal meaning, and emotional resilience. Culturally sensitive, holistic care strategies are essential to help individuals achieve their own definitions of a fulfilling and "normal" life.

Background: Falls among older adults in institutional care are a significant concern due to their serious consequences and are further complicated by staffing constraints. Identification of key risk factors is essential for targeted prevention and closer monitoring.

Objective: To identify the fall risk factors among older adults in institutional care and evaluate their relationships with overall fall risk.

Methods: This retrospective cross-sectional study analyzed data from 184 residents of a public institutional care home in Selangor, Malaysia. Data were collected from January 2023 to October 2023 through fall risk assessments and medical records. A history of falls over the past 12 months was documented. Fall risk was assessed using the Downton Fall Risk Index (DFRI). Descriptive statistics were used to summarize participant characteristics and the prevalence of falls. Ordinal logistic regression was conducted to identify factors associated with higher fall risk scores.

Results: The study included 184 participants (60.3% male), with the majority aged 70-79 years (45.4%). Common comorbidities were hypertension (50.5%) and diabetes mellitus (28.8%), with sensory impairments such as visual (50.0%) and hearing (32.1%) deficits. Polypharmacy was reported in 23% of participants, and almost a quarter had a history of falls. A high fall risk was observed in 39.7% of cases. Ordinal logistic regression revealed significant predictors of higher fall risk: hypertension (OR 5.93, 95% CI 2.18-16.14), polypharmacy (OR 5.53, 95% CI 2.11-14.47), visual impairment (OR 16.28, 95% CI 3.38-78.41), hearing impairment (OR 17.64, 95% CI 3.50-88.85), cognitive impairment (OR 33.12, 95% CI 4.61-237.88), psychiatric illness (OR 4.76, 95% CI 1.23-18.44), and female sex (OR 2.61, 95% CI 1.19-5.74).

Conclusion: Regular fall risk assessments and tailored intervention plans that address these factors are crucial for reducing falls and improving the quality of life for this vulnerable population. These findings provide practical guidance for healthcare professionals, including nursing staff, in institutional care to prioritize high-risk residents and implement early preventive strategies.

Background: Health-related quality of life (HRQoL) is a critical indicator in individuals with cancer. Patients diagnosed with hepatocellular carcinoma (HCC) commonly experience a decline in HRQoL due to both the progression of the disease and the adverse effects associated with treatment. Despite the high prevalence of HCC in Thailand, there is a paucity of research examining the HRQoL of Thai patients and the factors that may influence it.

Objective: This study aimed to examine HRQoL in Thai patients with HCC and evaluated the relationships between disease stage, comorbidities, albumin level, functional status (FS), self-management behaviors (SMBs), and HRQoL.

Methods: A correlational, cross-sectional study was conducted with 408 patients with HCC recruited from six hospitals in central Thailand between April and September 2024. Data collection included demographic and clinical information, along with the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) scale, Inventory of Functional Status-Cancer (IFS-CA), and the SMB scale for patients with HCC. All instruments were validated and reliable. Data were analyzed using descriptive statistics and multiple regression analysis.

Results: Most participants were at intermediate (38.97%) or advanced (24.26%) stages of HCC. Overall HRQoL was high (mean FACT-Hep score = 147.92 ± 26.09). Disease stage, comorbidities, albumin level, FS, and SMBs were all significantly correlated with HRQoL (r = 0.771). Together, these factors explained 58.9% of the variance in HRQoL (adjusted R² = 0.589, F _{(5, 402)} = 117.745, p <0.001). Significant predictors of HRQoL included disease stage (β = -0.116), comorbidities (β = -0.080), albumin level (β = 0.278), FS (β = 0.388), and SMBs (β = 0.296). Among these, FS was the strongest predictor.

Conclusion: Improving self-management behaviors, functional status, and nutritional status shows promise for enhancing HRQoL in patients with HCC. These findings can guide nurses in developing interventions to support patients with HCC and improve their quality of life.

Background: Assessing empathy in adolescents is essential for developing effective school bullying prevention programs. However, no validated instrument for evaluating empathy in Indonesian adolescents was previously available.

Objective: This study aimed to evaluate the validity and reliability of the Indonesian version of the EmQue-CA and its subscales, providing a tool for assessing empathy in adolescents in Indonesia.

Methods: Psychometric testing was conducted in January and February 2024 following the translation and cross-cultural adaptation of the EmQue-CA into Indonesian. A total of 140 junior high school students aged 13 to 15 were selected through multistage sampling. Exploratory Factor Analysis (EFA) was performed to determine the factor structure, while reliability was assessed using Cronbach's alpha and test-retest reliability.

Results: EFA supported a three-factor structure-affective empathy (3 items), cognitive empathy (3 items), and intention to comfort (4 items)-consisting of 10 items in total, which accounted for 65.97% of the variance. The instrument showed strong internal consistency (Cronbach's alpha = 0.96) and excellent test-retest reliability (r = 0.96, 95% CI: 0.94-0.97).

Conclusion: The 10-item Indonesian version of the EmQue-CA is a valid and reliable tool for assessing empathy in adolescents. It can be used by school nurses, healthcare professionals, and educators to support the development of empathy-based interventions in school settings.