Jurnal Ners

Psycho-educational program for enhancing resilience among family caregivers of patients with leukemia in Egypt: a quasi-experimental study

Ahmed Mohamed Mustafa gaafr — 2025-05-31

Introduction: Caring for a loved one with leukemia presents significant challenges and often leads to a substantial caregiver burden. Resilience, adapting and coping effectively with adversity, is crucial for caregivers’ well-being. Psychoeducational interventions incorporating coping strategies, stress management, and decision-making skills have been widely recognized to foster resilience. This study evaluated the effectiveness of a structured psychoeducational program to enhance resilience among family caregivers of patients with leukemia.

Methods: This quasi-experimental pre-post study assessed the effectiveness of a psychoeducational program among 57 family caregivers of patients with leukemia at the National Cancer Institute in Egypt. The Family Resilience Assessment Scale (FRAS) was administered before and after a structured 21-session program. Data were analyzed using IBM SPSS Statistics 23, paired t-tests assessing resilience changes, and Spearman’s correlation to examine associations with demographic and psychological factors. The reliability of the FRAS was confirmed using Cronbach’s alpha (≥0.70).

Results: 66.7% of caregivers were female, 36.8% were aged 25–30, 49.1% were married, and 66.7% provided care for more than eight hours daily. Statistically significant improvements (p < 0.01) were observed in communication, emotional expression, problem solving, resource utilization, maintaining a positive outlook, family connectedness, spirituality, meaning making, and flexibility after the intervention.

Conclusions: The psychoeducational program significantly improved resilience among family caregivers of patients with leukemia. These findings highlight the importance of integrating such interventions into caregiver support programs to reduce stress and promote well-being. Future studies should examine the long-term sustainability of these benefits.

Nurses’ experience of using platform for phlebitis assessment based on telemedicine consultation system: a qualitative descriptive study

Pramote Thangkratok — 2025-05-31

Introduction: Current methods for assessing phlebitis rely on nurses' experiences. Integrating advanced systems, such as a Clinical Decision Support System and a Telemedicine Consultation System, is essential for more comprehensive and expert-driven diagnosis and treatment recommendations. This study explored nurses' experiences using a platform for phlebitis assessment based on a telemedicine consultation system.

Methods: A qualitative study based on constructivist theory was conducted using focus group interviews with 12 registered nurses recruited from a community hospital in Thailand, between November 2022 and March 2023. The interviews were then recorded and transcribed. Data analysis followed Miles and Huberman's framework, which comprised three stages: (1) data reduction, involving the selection, organization, and coding of key data; (2) data display, structuring the data into themes to identify patterns; and (3) conclusion drawing and verification to ensure accuracy and validity through systematic comparison and cross-checking.

Results: Four themes emerged: accuracy, referring to the precision of the assessments; feasibility, which pertains to how practical the system is for daily clinical use; propriety, concerning ethical and professional considerations such as patient confidentiality and alignment with nursing practices; and utility, evaluating the overall usefulness and value of the platform in enhancing assessment efficiency.

Conclusions: The platform for phlebitis assessment based on the telemedicine consultation system can accurately evaluate and diagnose phlebitis. It is suitable for practical use in clinical settings and can improve patient care quality.

Factors associated with older adults’ neglect among relatives in urban areas of Indonesia: a cross-sectional study

Ezalina Ezalina — 2025-05-31

Introduction: The aging adult population increases its vulnerability to neglect and other associated risks due to decreased physical and mental competence. Older adults who cannot adapt owing to reduced physical and mental capabilities become dependent on others, particularly family members. Older adults can become neglected if they are not adequately cared for. This study aimed to identify factors associated with neglect among older adults who live with their relatives in Pekanbaru City, Indonesia.

Methods: A cross-sectional study with a sample size of 382 Older adults was conducted utilizing multi-stage cluster sampling. The questionnaire measuring tool was conducted through structured direct interviews with the Older adults, specifically to inquire about the variables of Older adults’ neglect, family support, social engagement, and family health tasks, which have been tested for validity and reliability. The data was analyzed using descriptive statistics, the chi-squared test, and binary logistic regression.

Results: The neglect experienced by the older adults was high, namely 190 people (49.74%), low, 192 people (50.26%), Family support (p<0.05), family health duties (p<0.05), and social engagement (p<0.05) were associated with Older adults neglect. The binary logistic regression analysis revealed a significant relationship between Older adults’ marital status(widow or widower) and the occurrence of neglect (p<0.05; OR: 29.0; CI: 3.2-25.9).

Conclusions: the older adults’ status (married, widow, or widower) significantly influences negligence among older adults.

Effects of murottal al-qur'an therapy on anxiety and vital signs among primigravida pregnant women in pre-operation caesarean section

Fathiya Lutfil Yumni — 2025-05-31

Introduction: This research aims to analyze the effect of Murottal Al-Qur'an Therapy on reducing anxiety and vital signs in primigravid pregnant women before C-Section surgery.

Methods: A quasi-experimental study on pregnant women who will undergo C-Section surgery at a hospital in Surabaya, Indonesia. A total of 84 respondents (42 in the intervention group and 42 in the control group) were recruited using purposive sampling. Anxiety variables were measured using the Zung Self-Rating Anxiety Scale (ZSRAS), and vital signs (pulse, blood pressure, respiration rate) were measured using a sphygmomanometer and a calibrated clock. Data analysis was used to test the Wilcoxon Signed Rank Test and the Mann-Whitney Test.

Results: The intervention group's vital signs for blood pressure decreased to 120.98 mmHg and diastolic blood pressure to 70.08 mmHg. The mother's pulse showed an average of 79.95 times per minute and respiration an average of 20 times per minute. Testing the effect of Murottal Al-Qur'an Therapy showed a significant effect on the Intervention group for anxiety (p=0.001), systolic pressure (p=0.005), diastolic pressure (p=0.001), pulse (p=0.005), and respiration rate (p=0.001), respectively. The difference test shows a significant difference after the intervention, with a p-value of <0.001.

Conclusions: Murottal Al-Qur'an Therapy can reduce anxiety levels, systolic and diastolic blood pressure, pulse rate, and respiration rate in primigravida pregnant women who will undergo C-Section surgery. So, the results of this research can be applied by primary nurses in maternity rooms or operating rooms for primigravida pregnant patients who will undergo cesarean Section surgery.

Factors contributing to the provision of complementary food by fathers to improve the growth of children aged 6-24 months: a cross sectional study

Nur Mukarromah — 2025-05-31

Introduction: Providing complementary foods to children aged 6-24 months has many obstacles that have an impact on the child's growth. So far, the mother has played the most role, fathers tend to pay less attention in giving complementary food. The purpose of this study was to analyze the factors that contribute to the provision of complementary foods by fathers to improve the growth of children aged 6-24 months.

Methods: A cross-sectional approach on 366 children aged 6-24 months who were recruited using simple random sampling. The variables consisted of children age, gender, father's age, father's education, father's job, mother's age, mother's education, mother's job dan father's role and the growth of children age 6-24 months. Data was analysis binary logistic regression.

Results: The study showed positive father involvement (72%) and normal growth (76.5%). The multivariate analysis show that father's education, father's job, mother's age, mother's education, mother's job and father's role have a significant relationship with the growth chart. Father's role is the most dominant variable because its OR is the highest (p = 0.001; OR = 2.128; CI = 1.263-3.433), which means that a supportive or better father's role will make the provision of complementary food better and improve the child's growth chart.

Conclusions: Fathers play an important role to give complementary feeding in children aged 6-24 months. This study is expected to be applied with a wider range of areas in order to obtain comparisons with research that has been done.

Parenting self-efficacy mediates relationship between caregiving burden and parenting stress among parents of adolescents with disabilities: a cross-sectional study

Mundakir Mundakir — 2025-05-31

Introduction: The study examines the role of parenting self-efficacy as a mediator in the relationship between caregiver burden and parenting stress.

Methods: A cross-sectional study was conducted with 204 parents of children with disabilities. Data were collected using self-administered questionnaires, including the General Information Questionnaire, Zarit Burden Interview Questionnaire, Parenting Sense of Competence Scale (PSOC Scale), and Parenting Stress Index. Data analysis included multiple linear regression and Hayes’s PROCESS Macro.

Results: The mean scores for caregiving burden, parenting self-efficacy, and parenting stress were 16.98 (SD = 10.10), 31.03 (SD = 6.72), and 61.72 (SD = 12.84), respectively. Parenting stress was negatively correlated with parenting self-efficacy (r = –0.35, p < 0.001). The findings reveal that caregiving burden significantly reduces parenting self-efficacy (B = −0.16, p < 0.001), which in turn lowers the ability of caregivers to manage stress (B = −0.48, p < 0.001). While caregiving burden has a direct effect on parenting stress (B = 0.07, p < 0.001), the total impact, including both direct and indirect influences, remains significant (B = 0.52, p < 0.001) with mediation percentages of 12.9%.

Conclusions: The findings suggest that strategies to enhance parenting self-efficacy could significantly reduce the negative impact of caregiving burden on parenting stress. By improving self-efficacy, caregivers may better manage stress, highlighting the importance of targeted interventions that boost self-efficacy.

Burnout and resilience among moroccan healthcare professionals: a comprehensive multi-hospital study

Hicham Guider — 2025-05-31

Introduction: This study examines the relationship between burnout and resilience among physicians and caregivers, aiming to determine whether the type of setting and demographic characteristics, such as gender and hospital hierarchy, have any impact.

Methods: This multicenter cross-sectional study recruited 296 healthcare professionals through convenience sampling by self-administered questionnaires evaluating the Maslach Burnout Inventory and Connor-Davidson Resilience Scale. Data were analyzed using statistical methods, including correlation analysis and Multiple Correspondence Analysis (MCA).

Results: From 158 valid responses, the mean scores for each scale were: EE at 28.44±12.90, DP at 9.96±6.47, and PA at 29.01±10.48; resilience was 23.78±7.71. All three had positive correlations with resilience. There were no significant differences in resilience or burnout between men and women. However, EE and PA were significantly correlated with male resilience, while all three burnout dimensions were associated with female resilience. Local hospitals reported higher mean scores for resilience and PA, whereas provincial hospitals exhibited elevated EE and DP scores. In regional hospitals, resilience was only associated with PA, whereas in provincial hospitals, it was correlated with both EE and PA.

Conclusions: We found a high prevalence of burnout and inadequate resilience among healthcare professionals, underscoring the importance of considering these factors in the development of health policies and the implementation of preventive and remedial strategies.

Development of a palliative end of life care (PEOLC) model based on transcultural nursing for patients in need of long-term care

Israfil Israfil — 2025-05-31

Introduction: Palliative end-of-life care (PEOLC) is heavily impacted by culture and always discusses death, bereavement, uncertainty, loss, grief, and incurable disease. Long-term care and more culturally sensitive nursing care are essential to address the diverse needs of patients. This study aimed to develop a PEOLC model grounded in transcultural nursing principles, with a focus on enhancing the quality of care for patients requiring long-term support.

Methods: This study employed a cross-sectional explanatory design involving 180 patients with chronic illnesses as participants selected using simple random sampling. The proposed model involved eight variables: patient factors, nurse factors, service factors, family factors, technology factors, the PEOLC model, quality of life, and quality of death. A valid questionnaire was used to collect data, and we employed SEM-PLS to analyse the results.

Results: The PEOLC model had an R2 value of 0.61. These findings showed that 60.1% of the variability of PEOLC variables was explained by the patient, family, nurse, service, and technology aspects. For each construct, a value of Q2 > 0 (0.083) indicated that the model was appropriate. The path coefficient value of 0.343 indicates that the service factors make the most significant contribution to the PEOLC model.

Conclusions: This research led to the development of the PEOLC model, which comprises eight variables. It provides a comprehensive framework for integrating transcultural nursing principles into long-term care and emphasises the importance of cultural sensitivity in delivering personalised and effective end-of-life care.

Optimisation of the role of families of chronic hypertension patients based on the mcmaster model of family functioning in self-care agency

Jujuk Proboningsih — 2025-05-31

Introduction: This study aims to analyse the impact of the McMaster Model of Family Functioning (MMFF) on the self-care agency of patients with chronic hypertension in Surabaya.

Methods: This study employs an analytical observational design with a cross-sectional approach, involving 300 respondents from families of patients with hypertension who meet the inclusion criteria. The independent variables examined include the six dimensions of the McMaster Model of Family Functioning (MMFF): problem-solving, communication, family roles, affective responsiveness, affective involvement, and behaviour control. Meanwhile, the dependent variable is self-care agency, which consists of medication, physical activity, and diet. Hypothesis testing was conducted using SEM-PLS, which was processed with SmartPLS 4.0.4 software.

Results: The analysis results indicate that the MMFF has a positive and significant effect on self-care agency, with a coefficient of 0.340 (CI = 0.247 – 0.445). The effect size result obtained an effect size value of 0.131. Structured and adaptive family support, particularly in communication and affective involvement, has enhanced patients' motivation to adhere to medication and engage in self-care activities.

Conclusions: This study expands on previous research on the role of family support in self-care agencies, by involving the McMaster Family Function Model (MMFF) to analyse the specific role of family functions in improving self-care agencies in chronic hypertension patients, thus providing a more comprehensive, contextual, and relevant perspective for family-based interventions. These results also enrich other theoretical studies, namely the Family-Centred Care (FCC) Model, Social Support Theory, and Health Belief Model (HBM).

Digital innovations for adolescent mental health: evaluating the impact of genziheal web-based education model

Reza Indra Wiguna — 2025-05-31

Introduction: Mental health problems among adolescents remain a global public health concern, highlighting the need for accessible and innovative educational interventions. This study evaluated the effectiveness of a web-based mental health education model through the Genziheal platform in improving knowledge levels and reducing symptoms of mental health disorders among adolescent students.

Methods: A quasi-experimental, pretest-posttest control group design was employed involving 130 senior high school students (intervention group: n=80; control group: n=50). Data were collected using the Self-Reporting Questionnaire-29 (SRQ-29) and a validated mental health knowledge questionnaire. Paired t-test and Mann-Whitney tests were used for analysis.

Results: The intervention group demonstrated a significant increase in mental health knowledge (mean score improved from 11.0 ± 2.8 to 12.2 ± 3.2; p = 0.008), while no significant change was observed in the control group. However, no significant differences were found in mental health symptoms between pre- and post-test stages in both groups (p > 0.05).

Conclusions: The Genziheal platform effectively enhanced students’ mental health literacy but did not significantly reduce symptoms of mental health disorders. These findings suggest that web-based educational tools can support mental health awareness among adolescents but should be complemented with parental involvement and professional support to address psychological symptoms. This study also highlights the potential integration of digital mental health interventions into school-based health promotion programs. The findings contribute to the development of scalable, culturally contextualized digital health promotion tools, particularly in resource-constrained settings such as Indonesia.

Strengthening maternal referral systems during public health emergencies: insights from Indonesia’s covid-19 response

Muhammad Ardian Cahya Laksana — 2025-05-31

Introduction: This study assesses hospital readiness in maternal referral hospitals six months after the onset of the pandemic, aiming to inform future public health emergency responses.

Methods: A descriptive and exploratory mixed-methods design was employed. Surveys and focus group discussions were conducted with 127 hospitals in the COVID-19 maternal referral hospitals by the East Java Provincial Government using the modified WHO hospital readiness checklist for COVID-19 2020. Quantitative data were analyzed descriptively, and qualitative data from focus group discussions were thematically analyzed to get deeper insights into the challenges faced by hospitals.

Results: A total of 105 hospitals (83%) responded to the survey. While PPE supplies were largely adequate, gaps in infrastructure, including negative-pressure rooms, isolation areas, and diagnostic capacity, persisted. Financial constraints, particularly delays in the National Health Insurance Scheme (BPJS Kesehatan) claims, further strained hospital operations. FGDs revealed that PCR delays, staffing shortages, and underdeveloped referral coordination systems hindered the delivery of maternal services.

Conclusions: Strengthening maternal referral systems requires improving diagnostic capabilities, investing in essential infrastructure, and ensuring timely financial reimbursement. Collaborative efforts among the Ministry of Health, BPJS Kesehatan, and healthcare facilities are crucial to enhancing maternal healthcare resilience during future public health emergencies.

A survey of suicide risk among university students across three regions in Java, Indonesia

Ninik Yunitri — 2025-05-31

Introduction: Suicide remains a significant global health and social problem, with Indonesia showing a lower suicide rate compared to other Asian countries. However, the underreporting of cases in Indonesia suggests that the incidence rate of suicide is higher than documented. This study aimed to identify the risk of suicide among Indonesian college students.

Methods: A cross-sectional study was conducted involving 557 students from three universities across Java Island, recruited using the purposive sampling method. The Beck Scale for Suicide Ideation (BSSI) was used to assess suicide risk. The data was analyzed using descriptive statistics to determine the prevalence of suicide-related outcomes. Additionally, linear regression analysis was conducted to examine the associations between suicide risk, suicidal ideation, suicide planning, and self-control in relation to age, sex, and year of study.

Results: The average suicide risk among college students was 4.04 (SD= 6.60; 95%CI = 3.49 – 4.59) out of 38, indicating a generally low risk. However, 34.6% of students experienced the desire to die at least once, and 12.7% had a strong desire to make active suicide attempts. Furthermore, 15.8% of students found suicide an acceptable solution to their problems. Gender was found to be significant predictor of overall suicide risk, ideation and self-control.

Conclusions: These findings highlight the need for targeted interventions and support for college students to prevent suicide and promote mental well-being.

FRONT MATTER VOL 20 ISSUE 2

Admin Jurnal Ners — 2025-05-31

BACK MATTER VOL 20 ISSUE 2

Admin Jurnal Ners — 2025-05-31

Empowering self-care in nursing and midwifery: enhancing mental wellbeing to sustain perseverance and resilience

Khadizah H. Abdul-Mumin — 2025-05-31