Japan Journal of Nursing Science最新文献

{"title":"Risk factors of skin barrier dysfunction in older adults: A systematic review","authors":"Issei Konya,&nbsp;Inaho Shishido,&nbsp;Moe Nemoto,&nbsp;Rika Yano","doi":"10.1111/jjns.12597","DOIUrl":"10.1111/jjns.12597","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Skin barrier dysfunction can trigger various skin disorders in older adults. Skin barrier assessment is essential for nurses and caregivers to prevent skin disorders; however, the evidence available for clinical assessment is limited. This systematic review aimed to clarify the risk factors of skin barrier dysfunction in older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This review adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The four databases were searched using multiple terms related to “aged” and “skin barrier.” The search was initially run on April 19, 2023, and rerun on October 12, 2023. Peer-reviewed quantitative studies in English were included, with no publication time limit being set. Two reviewers assessed the risk of bias in a blinded and independent manner using JBI tools. Owing to the heterogeneity of the results, a narrative synthesis was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the database-identified 4833 studies, 20 studies were included. The extracted factors were categorized as demographic characteristics, functional characteristics, chronic diseases, nutritional status, skin condition, and environmental factors. However, owing to high risk of bias and inconsistent results across studies, only chronic kidney disease and dry skin were considered risk factors for skin barrier dysfunction in older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Assessment of chronic kidney disease and dry skin in daily skin care may guide the development of personalized skincare programs to maintain skin integrity in older adults. Furthermore, cohort studies that consider confounding factors and the reliability of measurements are needed for an in-depth investigation into skin barrier dysfunction and more risk factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jjns.12597","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between organizational justice and serious psychological distress among hospital nursing staff during the COVID-19 pandemic: A cross-sectional study","authors":"Satoshi Ikeda,&nbsp;Makoto Masumitsu,&nbsp;Satomi Aomoto,&nbsp;Masanori Yamashita,&nbsp;Haruka Kakeda,&nbsp;Eri Nagatomo,&nbsp;Yukiko Kiyota,&nbsp;Michiko Matsueda,&nbsp;Hikaru Hori","doi":"10.1111/jjns.12595","DOIUrl":"10.1111/jjns.12595","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Amidst the COVID-19 pandemic, the association between organizational justice and psychological distress among hospital nursing staff is underexplored. Thus, this cross-sectional study, conducted in Fukuoka Prefecture, Japan, examined the relationship between organizational justice and serious psychological distress (SPD) among hospital nursing staff during COVID-19.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study surveyed 783 hospital nursing staff using the Organizational Justice Questionnaire and Effort-Reward Imbalance Questionnaire. The Kessler K6 scale was used to measure SPD. Sociodemographic and occupational characteristics were controlled for as potential confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of SPD was 14.4%, with a mean K6 score of 6.5. Moderate procedural justice (odds ratio [OR] = 2.38, 95% confidence interval [CI] = 1.14–4.94, <i>p</i> = .021) and low distributive justice (effort-reward imbalance) (OR = 3.66, 95% CI = 2.01–6.67, <i>p</i> &lt; .001) were associated with SPD, even after adjustment for confounders. Interactional justice showed significance only in the crude model. Effort-reward imbalance had the strongest association with SPD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings showed that moderate procedural justice and low distributive justice were associated with SPD, highlighting the need for organizational interventions to address these factors. Imbalances in effort/reward had the greatest impact, highlighting the critical role of distributive justice in mental health. Thus, in the context of a pandemic, extreme procedural justice is not necessarily associated with mental health, and efforts to ensure distributive justice are critical to improving the mental health of hospital nursing staff. Moreover, organizational stressors should be addressed during disruptive conditions such as infectious disease outbreaks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diversity and limitations of electroencephalogram and event-related potential applications in nursing research: A scoping review","authors":"Huiling Hu,&nbsp;Bilin Wu,&nbsp;Huijun Li,&nbsp;Binlin Wang,&nbsp;Xue Wu","doi":"10.1111/jjns.12593","DOIUrl":"10.1111/jjns.12593","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This scoping review was conducted to provide a comprehensive summary of how electroencephalogram (EEG) and event-related potentials (ERPs) have been used in nursing research, with the goal of mapping the themes and methods of nursing research involving EEGs or ERPs as a measurement tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The eligibility criteria were determined according to the Population, Concept, and Context principle. A systematic electronic search of articles in the PubMed, Web of Science, Embase, CINAHL, APA PsycInfo, and Scopus databases was carried out for the period from database establishment to November 21, 2022. The included studies were analyzed using descriptive statistics and content analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The review process culminated in 45 articles, evidencing an increasing trend and dispersion characteristics of EEG in nursing research and reflecting five thematic domains of inquiry related to nursing. There was a deficiency of detailed reports of EEG recording and data analysis parameters in nursing research. The common EEG bands in nursing research were Delta, Theta, Alpha, Beta, Gamma. The ERP components used frequently were P3, P2, N1, N2, P1, N170, and feedback-related negativity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The wide variety of EEG components used show broad potential for studying nursing questions. In the future, it will be necessary to increase the depth of the research content, the repeatability of the experiment and the standardization of the report. Nursing researchers should give full play to the characteristics of nursing and establish a systematic and complete EEG research system for nursing.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing learning motivation and academic achievement in nursing students through metaverse-based learning: A randomized controlled study","authors":"Esin Çetinkaya Uslusoy,&nbsp;Ayse Aydinli,&nbsp;Faruk Durna","doi":"10.1111/jjns.12594","DOIUrl":"10.1111/jjns.12594","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Generation Z students do not get much benefit from traditional distance education methods. Instead, they need new platforms and methods that will motivate them and increase their success.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A randomized controlled study was performed on 42 students. The experimental group students were presented with metaverse, and the control group students were taught the distance education course.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this study, in the students' Instructional Materials Motivation Survey, the mean scores of both the experimental and control groups exhibited no significant difference before the intervention. Regarding the effect of metaverse-based learning on students' Instructional Materials Motivation Survey, the mean score of the control group was 82.55 ± 13.18, and the mean score of the experimental group was 96.52 ± 9.54 and there was a significant difference between groups after the intervention. When the academic achievement levels of the groups were examined, it was determined that the experimental group scored 76.57 ± 13.33 and the control group received 64.40 ± 16.42 points. It was determined there was a significant difference between the groups in terms of learning motivation and academic achievement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study results show that the participants accepted the important role of metaverse as an effective learning method compared to traditional distance education methods. It is recommended to expand the use of metaverse in various fields of nursing education.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139998135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of peer-to-peer oral care objective structured clinical examination-based learning for nursing students","authors":"Satoru Haresaku,&nbsp;Maki Miyoshi,&nbsp;Masumi Muramatsu,&nbsp;Mayumi Monji,&nbsp;Hisae Aoki,&nbsp;Hitomi Maeda,&nbsp;Mami Miyazono,&nbsp;Mika Obuse,&nbsp;Fuyuko Nakashima,&nbsp;Souhei Uchida,&nbsp;Hidechika Iino,&nbsp;Kazuyuki Akinaga,&nbsp;Akiko Chishaki,&nbsp;Toru Naito","doi":"10.1111/jjns.12591","DOIUrl":"10.1111/jjns.12591","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Nurses' skills and confidence in providing oral care to patients play important roles in healthcare. Studies have proved that peer-to-peer learning and assessment can help improve nurses’ skills and confidence. However, no study has investigated it using an objective assessment checklist. This study investigated an oral hygiene practice training program for nursing students. It focused on their oral healthcare skills, confidence, and perspectives regarding implementing an objective structured clinical examination (OSCE).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A pre- and post-survey of 97 nursing students from a nursing school in Japan was conducted as a peer-to-peer oral health education training program that included an assessment and performance checklist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Confidence in performing and assessing oral care significantly improved after attending the program. Furthermore, the changes were significantly greater in the developed program than in the training program without the checklist. The mean total assessment scores (0–25) of the first, second, third, and fourth participants in the four-student groups were 22.1, 23.4, 23.9, and 24.1, respectively. The mean scores of the second, third, and fourth participant groups were significantly higher than that of the first participant group (<i>p</i> &lt; .01). Fifty-two positive and 58 negative comments were received regarding the implementation of the program with professional assessments and the checklist. The most common positive comment mentioned that the evaluation by professionals improved oral care learning and skills.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study developed a program to improve nursing students' confidence and oral care delivery skill building in an OSCE-style delivery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving hygiene care via nursing education","authors":"Yusrita Zolkefli","doi":"10.1111/jjns.12592","DOIUrl":"10.1111/jjns.12592","url":null,"abstract":"","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of different bed head angles on the hemodynamic parameters of intensive care patients lying in the supine position: A quasi-experimental study","authors":"Şenay Yiğit Avcı,&nbsp;Dilek Yılmaz","doi":"10.1111/jjns.12589","DOIUrl":"10.1111/jjns.12589","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The aim of this study was to research the effect of different bed head angles on the hemodynamic parameters of intensive care patients lying in the supine position.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was a non-randomized and non-controlled, quasi-experimental repeated measures study. The study was conducted with 50 intensive care patients aged 18 and over in a general surgery intensive care unit in Turkey. With each patient in the supine position, the bed head was raised to an angle of 0°, 20°, 30°, and 45° without a pillow, and the hemodynamic parameters of central venous pressure, systolic and diastolic blood pressure, heart rate, breathing rate, and peripheral oxygen saturation were recorded after 0 and 10 min.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>It was found that the mean central venous pressure value measured at min 0 and 10 was higher when the intensive care patients' bed head angle was raised to 45° than when the bed head was at an angle of 0° or 20° (<i>p</i> &lt; .05). It was found that the patients' other hemodynamic parameters were not affected by different bed head angles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>It was concluded as a result of this research that in intensive care patients in the supine position, only central venous pressure was affected by bed head angle, and that central venous pressure measurement can be reliably made at a bed head angle of 30°.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A breast milk production model for achieving exclusive breastfeeding in low-risk primiparas who had vaginal births at 4 months postpartum: A prospective cohort study","authors":"Kaori Takahata,&nbsp;Shigeko Horiuchi,&nbsp;Ai Miyauchi,&nbsp;Yuriko Tadokoro,&nbsp;Takuya Shuo","doi":"10.1111/jjns.12588","DOIUrl":"10.1111/jjns.12588","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to investigate the thresholds of milk production for predicting the achievement of exclusive breastfeeding (EBF) at 4 months postpartum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The inclusion criteria were singleton, low-risk primiparas, non-cesarean section, and healthy mothers and infants. Temporary feeding of artificial milk in the past was included. Women who could be judged to have intentionally used artificial milk were excluded from the analysis. Measurements of the 24-h milk production by test weights were obtained at early postpartum (days 3–4) and at 1 month postpartum. To predict the achievement of EBF at 4 months postpartum, the area under the receiver operating characteristic (ROC) curve was calculated for early postpartum and 1 month milk production.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 80 eligible participants analyzed. ROC analysis of milk production for achieving EBF at 4 months revealed an area under the curve (AUC) of 0.736 (95% CI: [0.625, 0.848]) for early postpartum and an AUC of 0.854 (95% CI: [0.772, 0.936]) for 1 month postpartum. The proposed thresholds are 102 g/day (higher sensitivity) and 161 g/day (higher specificity) at early postpartum, and 527 g/day (higher sensitivity) at 1 month postpartum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In low-risk primiparas, the milk production models at early postpartum and 1 month postpartum showed a high accuracy for predicting the achievement of EBF at 4 months postpartum. The present study indicates that even when formula milk is temporarily used, it is still possible to reach the goal of achieving EBF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Theory-based obesity intervention program for women: A randomized controlled study","authors":"Seda Göger,&nbsp;Ayşe Çevirme","doi":"10.1111/jjns.12590","DOIUrl":"10.1111/jjns.12590","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To determine the effect of the education and counseling intervention given to overweight and obese women according to the theory of planned behavior on their health behaviors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study consisted of 78 overweight and obese women in total, between the ages of 18–49. While the women in the intervention group were given a 6-month training program and 6-month counseling service structured according to the theory of planned behavior, the women in the control group were given standard obesity training and were put on hold for 6 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was a decrease in the post-test anthropometric measurement values of the intervention group compared to the pretest. While there was no statistically significant change in the activity status of the control group over time, the inactivity rate of the intervention group decreased; however, the minimal activity rate increased over time. The post-test healthy life style behaviors scale II health responsibility, physical activity, nutrition, stress management and total scores of the intervention group were higher than those of the control group, and the differences were significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>It has been determined that the education and counseling services applied to overweight and obese women based on the theory of planned behavior are effective in gaining positive health behaviors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Team-based learning in Indonesian midwifery education: Implementation research","authors":"Yunefit Ulfa,&nbsp;Shigeko Horiuchi,&nbsp;Eri Shishido,&nbsp;Yukari Igarashi","doi":"10.1111/jjns.12587","DOIUrl":"10.1111/jjns.12587","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aims to implement team-based learning (TBL) and assess the impact on faculty members and students within midwifery education in Indonesia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Proctor's Framework for Implementation Research serves as the guiding approach in investigating the role of implementation strategies in implementing TBL within the context of midwifery education. The RE-AIM (Reach, Efficacy, Adoption, Implementation, and Maintenance) framework was utilized to assess the outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this study, the implementation of TBL has demonstrated significant reach, with broad participation among both faculty and students in two schools. The efficacy of TBL is evident through enhanced student knowledge, engagement and active learning. Adoption of TBL was observed in both schools, with faculty and students expressing interest and active participation. High levels of implementation fidelity were maintained, even though with challenges related to preparation and implementation. These findings suggest that TBL can be successfully integrated into midwifery education, with positive implications. Regarding maintenance, faculty members have expressed their intention to continue using TBL in various topics for future lectures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The implementation of TBL in Indonesian midwifery education has shown substantial reach and efficacy. Faculty and students are highly interested in adopting TBL for future use. Despite some implementation challenges, the study suggests that TBL can be effectively incorporated with minor adjustments, emphasizing its feasibility and potential impact. This research contributes to understanding TBL's applicability in various educational settings, especially in low-resource institutions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139665297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}