Belitung Nursing Journal最新文献

Background: Adolescent pregnancy in Thailand and globally remains a major public health issue, often leading to significant health and social consequences. Among adolescents outside the formal education system, low levels of sexual and reproductive health literacy contribute to poor decision-making and increased risk of unintended pregnancy. Targeted, culturally sensitive interventions are essential to bridge these gaps and reduce associated hardships.

Objective: This study aimed to evaluate the sexual health literacy of Thai female adolescents in non-formal education, focusing on their knowledge levels, decision-making processes, and barriers to accessing accurate sexual health information and services.

Methods: A mixed-methods sequential explanatory design was used. Quantitative data were collected between November 2021 and September 2022, and qualitative data between December 2022 and August 2023. Multi-stage random sampling was used to select 270 participants aged 15-19 from non-formal education programs, yielding a final sample of 200 after excluding incomplete data (response rate = 74.07%). The qualitative phase involved semi-structured interviews with 30 participants who scored low on the sexual health literacy assessment. Information was gathered through semi-structured interviews to explore their knowledge and decision-making process. Descriptive statistics were used to analyze the quantitative data, and thematic analysis was used to analyze the qualitative responses.

Results: Participants demonstrated moderate overall sexual health literacy (M = 97.73, SD = 16.91). Decision-making regarding sexual practices scored the highest (88.79%), while access to health information and services scored the lowest (54.72%). Thematic analysis revealed four major themes: 1) The need for supplemental sexual education beyond formal classrooms, 2) Widespread misconceptions and reliance on unreliable contraceptive information sources, 3) Limited access to sexual health services for adolescents, and 4) The decision-making process prior to selecting a contraceptive method.

Conclusion: There is a clear need for targeted, comprehensive sexual health literacy programs that improve adolescents' knowledge, communication skills, and understanding of contraception. Engaging mothers and other female relatives as key influencers, along with the involvement of nurses and youth-friendly service providers, is essential. These initiatives should focus on preventing high-risk behaviors, delaying sexual initiation, and reducing unplanned pregnancies, especially in underserved non-formal education contexts.

Background: Self-management is essential for controlling blood pressure and requires consistent effort. Mobile health (mHealth) applications can support patients in independently managing hypertension and maintaining better control over their blood pressure.

Objective: This study aimed to evaluate the effectiveness of MaRiTensi mobile application in improving knowledge, motivation, self-efficacy, and self-care among patients with hypertension, as well as in lowering blood pressure.

Methods: A two-arm randomized controlled trial with a single-blind evaluator was conducted among 108 patients with hypertension, recruited from a private hospital and two health centers in Yogyakarta, Indonesia. The 12-week study was implemented from October 2023 to April 2024. Participants were randomly assigned to the intervention group, which used the MaRiTensi app, or the control group, which received usual care. Primary outcomes-knowledge, self-care, self-efficacy, and motivation-were measured using a validated questionnaire, while the secondary outcome-blood pressure-was assessed through clinical measurement. Ninety-nine participants completed the study and were included in the analysis. Repeated measures ANOVA was used to evaluate within-group changes over time. Intergroup comparisons were analyzed using the chi-square test, independent t-test, or Mann-Whitney U test.

Results: No significant baseline differences were found between the two groups (p >0.05). Significant improvements were observed in knowledge, self-care, and systolic and diastolic blood pressure in both groups (p <0.01). Self-efficacy significantly improved only in the intervention group (p <0.01). No significant changes in motivation were observed over time in either group (p >0.05). Significant between-group differences were found at the first evaluation for self-care (p = 0.005; d = 0.58), self-efficacy (p = 0.011; d = 0.52), motivation (p = 0.026; d = 0.44), systolic pressure (p = 0.039; d = 0.42), and diastolic pressure (p = 0.009; d = 0.54), and at the second evaluation for self-care (p = 0.024; d = 0.46).

Conclusions: MaRiTensi may effectively improve self-care, self-efficacy, and blood pressure control among patients with hypertension, although it showed limited impact on knowledge and motivation. The application shows promise as a nursing intervention, but further research is needed to assess its long-term effectiveness and sustainability.

Trial registry number: NCT06049862 [ClinicalTrials.gov].

Background: Virtual teaching has become an essential component of nursing education today, but its impact on practical courses remains unexplored. There is a need to understand how the quality of virtual teaching influences both academic performance and student satisfaction.

Objective: This study aims to explore how nursing students' satisfaction and academic performance in practical courses relate to the quality of virtual teaching in a Peruvian university in 2023.

Methods: A descriptive cross-sectional correlational study was conducted by surveying 125 nursing students in northern Peru from March to May 2023. The data were collected using the Online Education Scale and Academic Satisfaction Scale. Academic performance was assessed through documentary analysis of the students' general averages, and Kendall's tau-b test was used to assess the relationship. Additionally, Pearson's Chi-square test and both bivariate and multivariate logistic regression analyses were conducted to obtain more precise relationships.

Results: The study found that 54.4% of nursing students rated virtual teaching quality as low, with the same percentage reporting low satisfaction and 59.2% having low academic performance. Virtual teaching quality was positively correlated with satisfaction (τb = 0.415, p <0.01) and negatively with academic performance (τb = -0.176, p = 0.043). Pearson's Chi-square and logistic regression showed significant relationships in several virtual teaching dimensions. Virtual collaborative teaching and development of virtual capabilities were rated low by 72.8% and 60.8% of students, respectively. Both had significant odds ratios (COR: 4.1, AOR: 3.8, p = 0.012 and COR: 3.8, AOR: 3.5, p = 0.010). Virtual resources and accompaniment showed moderate ratings, with significant results for virtual resources (COR: 1.5, AOR: 1.3, p <0.001) and virtual accompaniment (COR: 1.2, AOR: 1.0, p = 0.040).

Conclusion: This study revealed that poor-quality virtual teaching negatively impacted nursing students in Peru, leading to reduced satisfaction and academic performance. The positive correlation between teaching quality and satisfaction suggests that improving virtual teaching could enhance student satisfaction. However, the negative correlation with academic performance highlights challenges in adapting practical nursing education to virtual formats. Improving virtual methodologies and exploring innovative strategies, such as hybrid learning models, are essential for improving outcomes in nursing education.

Background: The healthcare system, particularly the midwifery profession in Jordan, faces significant challenges that negatively impact midwives and the quality of maternal care, primarily due to resource limitations and increasing service demands. While quantitative research has examined burnout levels among Jordanian midwives, there is limited qualitative insight into their lived experiences, particularly in the southern region of Jordan.

Objective: This study aimed to explore the factors contributing to burnout among midwives in southern Jordan and to gain a deeper understanding of their professional experiences within the current healthcare context.

Methods: A qualitative descriptive approach was employed between 2023 and 2024. Ten midwives were purposively recruited from public hospitals and community health centers in southern Jordan. Data were collected through semi-structured, in-depth interviews and analyzed using thematic analysis. Trustworthiness was ensured using Lincoln and Guba's criteria: confirmability, credibility, dependability, and transferability.

Results: Two main themes emerged from the analysis: 1) the emotional and physical toll of undervaluation and its negative impact on job satisfaction, and 2) limited professional autonomy and challenges related to empowerment in clinical settings. These findings reflect both personal and structural contributors to burnout.

Conclusion: Burnout among midwives in southern Jordan is driven by emotional strain, lack of recognition, and restricted autonomy. These challenges affect not only job satisfaction but also the quality of care provided. Addressing these issues through supportive policies, improved working conditions, and greater professional recognition is critical for strengthening the midwifery workforce. The findings also offer valuable insights for other countries with similar healthcare structures and midwifery challenges.

Background: Stunting remains a critical public health issue in Indonesia, threatening the well-being of future generations. Community involvement, particularly by health cadres, is essential for effective prevention. However, structured assessments and follow-up initiatives to enhance their participation remain limited.

Objective: This study aimed to evaluate health cadres' knowledge, roles, and skills in stunting prevention programs.

Methods: A mixed-methods design with an embedded approach was applied in three phases. Phase 1: A quantitative survey assessed stunting knowledge among 193 cadres across 10 stunting locus villages in Bangka Belitung Province, Indonesia (October-December 2022). The survey tool was adapted from previous studies and analyzed using the RASCH IRT model and descriptive statistics. Phase 2: Qualitative data were collected through semi-structured interviews with 20 cadres selected from the survey pool, and analyzed thematically. Phase 3: The same 20 cadres were observed conducting anthropometric measurements to assess skill accuracy.

Results: Knowledge levels were generally low, with 52% of cadres scoring low to very low and only 48% achieving moderate to high scores. Three themes emerged: 1) cadres' perspectives on the causes and consequences of stunting, 2) their roles and actions in stunting prevention, and 3) their experiences during the COVID-19 pandemic. Observations revealed significant inaccuracies in anthropometric measurement techniques.

Conclusion: There is a clear need to improve cadres' knowledge and skills, especially in anthropometric assessment. Recommendations include implementing certification-based training, introducing innovative and standardized measurement tools, and offering accessible web-based learning platforms. Nurses play a crucial role in supporting cadre training and ensuring accurate growth monitoring at the community level.

Background: China has a high prevalence of Type 2 Diabetes Mellitus (T2DM), and more than half of the population has uncontrolled blood sugar levels. As a result, this leads to a reduction in health-related quality of life (HRQOL). Therefore, identifying the factors that influence HRQOL in individuals with uncontrolled T2DM is a clinical priority.

Objectives: This study aimed to describe the level of HRQOL among people with uncontrolled T2DM in Wenzhou, China, and to examine the predictive factors, including social support, diabetes distress, self-efficacy, and health literacy, in relation to HRQOL among these individuals.

Methods: This predictive correlational study used a simple random sampling technique to recruit 107 adults with uncontrolled T2DM from the Endocrinology outpatient department at the First Affiliated Hospital of Wenzhou Medical University in Wenzhou, China, between August and September 2024. Data were collected through questionnaires and standardized tools to assess the correlation between HRQOL, social support, health literacy, self-efficacy, and diabetes distress. Data were analyzed using descriptive statistics and multiple regression analysis.

Results: The HRQOL in this study was moderate (Mean = 3.34, SD = 0.31). Significant factors associated with HRQOL were health literacy (r = 0.819, p <0.01), self-efficacy (r = 0.825, p <0.01), and social support (r = 0.477, p <0.01). All predictor variables in the regression model collectively explained 79.8% of the variance in HRQOL among individuals with uncontrolled T2DM. Furthermore, health literacy (β = 0.426, p <0.001), self-efficacy (β = 0.463, p <0.001), and social support (β = 0.130, p = 0.009) were significant predictors of HRQOL.

Conclusion: Enhancing health literacy, self-efficacy, and social support is crucial for improving HRQOL. Healthcare professionals and nurses should develop and implement intervention programs that help individuals and families enhance their critical thinking abilities and adopt lifestyles that support disease management and improve HRQOL.

Background: Having a child with a chronic condition presents major stress for parents and can adversely affect parenting quality, thus jeopardizing children's outcomes. Self-compassion serves as an emotion regulation strategy to cope with stress from parenting, but remains unexplored, particularly in the parents' context related to their children's chronic illnesses.

Objective: This paper aimed to explore and analyze the concept of self-compassion in parents of children with chronic illnesses to inform future research, clinical practices, and intervention designs for improving parenting outcomes.

Methods: Walker and Avant's eight-step concept analysis approach was conducted, which comprised selecting the concept, defining analysis aims, conducting a literature search (2014-2024) using specified keywords across major databases (CINAHL, ScienceDirect, PubMed, Medline, ProQuest, Scopus and Google Scholar), identifying defining attributes, presenting model, borderline, related, and contrary cases, and outlining antecedents, consequences, and empirical referents.

Results: The attributes of self-compassion in parents of children with chronic illnesses consist of self-kindness, common humanity, mindfulness, and motivation to relieve suffering. Antecedents comprise illness perception, social support, and stigma. Consequences are improved parents' psychological well-being (decreased depression, anxiety, parental stress, and burnout), effective parenting (parental responsiveness and mindful parenting), and reduced children's difficulties (internalizing and externalizing symptoms).

Conclusion: This concept analysis offers the antecedents, attributes, and consequences of self-compassion in parents of children with chronic illnesses. Nursing care should focus on self-compassion education that incorporates interdisciplinary collaboration to enhance parents' understanding of their child's illness. Nurses should assess social support, encourage parents to seek support networks, and provide skill training to cope with stigma. Healthcare professionals need training for cultural competence to work with families from diverse cultural backgrounds and manage cultural differences in parenting practices and child-rearing standards.

Background: Volume overload is a common and serious complication in patients with heart failure, often leading to hospital readmissions and decreased quality of life. Effective self-management strategies are essential in preventing fluid accumulation and improving patient outcomes. Mobile technology offers a scalable means to support such interventions, particularly in culturally specific contexts.

Objective: This study aimed to evaluate the effectiveness of a self-management program delivered via the LINE application in reducing volume overload among Thai patients with heart failure.

Methods: A quasi-experimental design was employed with 46 participants randomly assigned to either a control or experimental group. The control group received standard care, while the experimental group participated in a four-week self-management program based on Lorig and Holman's theoretical framework, focusing on six key skills and three self-care tasks. Volume overload was assessed using a modified Framingham criteria-based instrument with confirmed content validity and acceptable reliability. Data were analyzed using paired and independent t-tests with IBM SPSS version 21.

Results: Post-intervention, the experimental group showed a significant reduction in fluid volume overload scores (M = 6.96, SD = 1.46) compared to pre-intervention (M = 8.65, SD = 1.57, t = 9.90, p <0.001, Cohen's d = 1.11). The control group showed no significant change. An independent t-test confirmed a statistically significant difference between the experimental and control groups post-intervention (t = 3.67, df = 44, p <0.001, Cohen's d = 1.08), indicating a substantial effect of the intervention.

Conclusion: The self-management program via the LINE application effectively reduced volume overload in Thai patients with heart failure. Integrating culturally familiar mobile technology and structured self-care education significantly enhanced patient engagement and health outcomes. This study highlights the importance of incorporating digital tools into patient education and follow-up for nursing practice to empower individuals in managing chronic conditions like heart failure. Future research should explore long-term impacts and scalability across diverse healthcare settings.

Trial registry number: Thai Clinical Trials Registry (TCTR20241124001).

Background: The promotion of quality of life for adolescents with type 1 diabetes mellitus enables them to achieve physical, psychological, and social development. Improving quality of life positively influences their well-being in adulthood.

Objective: This study aimed to identify the factors influencing quality of life in adolescents with type 1 diabetes mellitus.

Methods: Data were collected from April 2022 to February 2023. The quality of life of 146 adolescents with type 1 diabetes mellitus was analyzed. The data were analyzed using IBM SPSS Statistics 25.0, with t-tests, ANOVA, Pearson's correlation, and stepwise multiple regression.

Results: The quality of life of adolescents with type 1 diabetes was significantly correlated with depression (r = -0.31, p <0.001) and diabetes distress (r = -0.42, p <0.001). Stepwise multiple regression analysis identified diabetes distress (β = -0.38, p <0.001) and insulin treatment (β = 0.15, p = 0.048) as factors influencing quality of life.

Conclusion: Periodic education and nursing interventions to improve self-care capacity for adolescents with type 1 diabetes mellitus are essential for reducing diabetes distress. Additionally, it is important to promote the use of insulin pump at the national level, include expanding insurance coverage and offering personalized insulin pump education.