Jurnal Ners

Evaluating the FACIT-Sp-12: a systematic review of measurement properties of spiritual well-being in cancer patients

Achmad Fauji — 2025-11-30

Introduction: This study aims to investigate whether the FACIT-Sp-12's measurement properties yield the most accurate spiritual data for cancer patients.

Methods: This systematic review examined full-text studies written in English and involving patients with cancer published between 2000 and 2024, using cross-sectional, randomized controlled trials, case-control, and quasi-experimental designs. This study used the MEDLINE (PubMed and EBSCO), ScienceDirect, Scopus, Taylor and Francis, and selected ProQuest databases. We assessed the papers methodically using the PRISMA flow before reviewing ten of them. The Consensus-based Standards for the Selection of Health Measurement Instruments tool has been used for evaluating the review articles.

Results: We found that various studies on spirituality in cancer patients conducted in different countries have employed diverse research methods. All these studies used the FACIT-Sp-12, which has been modified and adapted for cultural contexts. Cronbach's alpha ranges from 0.70 to 0.91, indicating that FACIT-Sp-12 is consistent across studies. COSMIN has been used to evaluate and critique FACIT-Sp-12; however, its structural validity, Cronbach's alpha for the subscales, intraclass correlation, and measurement error remain unsatisfactory. Some publications examine hypotheses and provide satisfactory responses, but there is little discussion on criterion validity or cross-cultural adaptation.

Conclusions: We determined that patients with cancer could use the FACIT-Sp-12. This study suggests using the FACIT-Sp-12 spiritual assessment tool for cancer patients in research and nursing care.

The role of patient portals for cancer patients: a systematic review of benefits, challenges, and opportunities

Halfie Zaqiyah Gusti Puspitasari — 2025-11-30

Introduction: Cancer patients have a complex journey. Technological developments offer convenience in communicating and accessing health information. Cancer patient portals were developed to coordinate and integrate care by overcoming existing barriers. This study aims to explain the benefits, challenges, and opportunities of using patient portals in oncology services.

Methods: The design of this study was a systematic review, with the source articles drawn from PubMed, ScienceDirect, ProQuest, EBSCOhost, and Scopus. Inclusion and exclusion criteria were used to screen articles with the PRISMA 2020 guidelines. A critical appraisal was conducted using the JBI Critical Appraisal Checklist 2020 and the MMAT 2018. Narrative descriptive approaches are used for data synthesis.

Results: We screened 3,301 articles using inclusion, exclusion, and duplication criteria, resulting in 10 articles for analysis. Communication and care coordination (n=4) were among the main benefits of using patient portals. Perceived obstacles such as limited resources (n=2), socio-demographic challenges (n=3), and limited information sources (n=2) are still found. On the other hand, the use of patient portals creates opportunities to address information needs and provide assistance (n=1), increase security and privacy (n=1), and improve service efficiency (n=2).

Conclusions: Patient portals play an essential role in improving coordination and engagement among cancer patients, despite ongoing challenges related to access and digital literacy. For nursing, these portals strengthen nurses' roles in education, coordination, and the use of evidence-based technology to improve the quality of care.

FRONT MATTER VOL 20 ISSUE 4

Admin Jurnal Ners — 2025-11-30

Empowering primiparous mothers with e-coaching for enhanced self-efficacy in postpartum and newborn care

Ariani Fatmawati — 2025-11-30

Introduction: Postpartum challenges pose significant stress and diminish maternal confidence among first-time mothers. These challenges are exacerbated by limited healthcare access, cultural influences, and logistical barriers, which complicate postpartum self-management, particularly in resource-constrained settings. Addressing these issues is essential.

Methods: The study employed an explanatory sequential mixed-methods design. The initial phase involved a quasi-experimental survey to compare self-efficacy scores between intervention and control groups, each consisting of 30 participants. Self-efficacy was measured using the Perceived Maternal Parenting Self-Efficacy (PMP S-E) scale, and the Mann-Whitney test was employed to compare group means. The second phase was a qualitative study. Participants from the intervention group were selected using simple random sampling based on odd-numbered identifiers, resulting in 15 primiparous women. Data were analyzed using thematic analysis.

Results: Participants in both groups had comparable age distributions and educational backgrounds. The intervention group achieved a significantly higher mean score (65) compared to the control group (41.8), confirmed by a Mann-Whitney test (p < 0.001) with a large effect size (Cohen's d = 5.15). Qualitative findings identified five themes and 15 categories.

Conclusions: E-coaching effectively enhances maternal self-efficacy in primiparous mothers, offering a promising approach to addressing postpartum challenges in resource-limited settings.

Understanding predictors of caregivers’ treatment-seeking behavior for mental health: the roles of stigma, motivation, relationship, and literacy

Rizki Fitryasari — 2025-11-30

Introduction: Caregivers play a crucial role in seeking timely treatment for individuals with mental disorders. However, reliance on traditional healing practices often leads to delayed medical care. This study aims to identify predictors of caregivers' treatment-seeking efforts, focusing on the role of stigma, motivation, relationship with the patient, and mental health literacy.

Methods: A cross-sectional study involving 301 caregivers of patients with mental disorders was conducted in two mental hospitals using cluster sampling. Variables studied include sociodemographic factors, caregiving burden, stigma, social support, motivation, mental health literacy, and treatment-seeking behavior. The data were collected through validated questionnaires as instruments. Multivariate regression analysis was performed to identify significant predictors of treatment-seeking behavior.

Results: The study revealed that caregivers' relationship with the patient, perceived stigma, caregiving motivation, and mental health literacy significantly predicted treatment-seeking behavior (p < 0.05). Mental health literacy emerged as the strongest predictor (β = 0.349), followed by motivation (β = 0.202), stigma (β = -0.125), and relationship with the patient (β = -0.108). Together, these variables explained 23.4% of the variance in treatment-seeking efforts.

Conclusions: Mental health literacy is the most influential factor in caregivers' efforts to seek medical treatment. Interventions aimed at increasing mental health literacy and reducing stigma are critical to enhancing caregivers' engagement with formal healthcare services. Findings support the development of culturally appropriate education and support programs to improve mental health outcomes.

Roles and success factors of community health nurses in providing health care for people with disabilities in southern Thailand: a qualitative descriptive study

Todsaporn Tongyoy — 2025-11-30

Introduction: People with disabilities (PWDs) are considered a vulnerable group due to their condition, which makes it difficult for them to access the services provided. Community health nurses (CHNs) are considered a key mechanism for supporting the implementation of activities that promote the quality of life of PWDs in the community. Therefore, this qualitative study aims to describe the role of CHNs in providing health care to PWDs in southern Thailand.

Methods: A qualitative descriptive study was conducted from May 2024 to October 2024 in southern Thailand. Data were collected through in-depth interviews, observations, and focus group discussions (FGDs). Data collection continued until saturation was achieved. A total of 39 participants were divided into five groups composed of 1) CHNs; 2) Village headman; 3) Village Health Volunteers (VHVs); 4) PWDs; and 5) family caregivers were recruited based on inclusion criteria using a purposive sampling technique. Data were analyzed using thematic analysis.

Results: Two themes were identified in this study: 1) CHNs’ role in providing health care for PWDs, and 2) Key factors affecting the success of CHNs in providing health care for PWDs.

Conclusions: The findings revealed the significant roles of CHNs in providing health care for PWDs. Prioritizing disability care in community settings is essential. Systematic data collection and utilization can enhance care effectiveness. Capacity development programs for CHNs in disability care management are needed, and collaborative partnerships with relevant organizations should be strengthened. Policymakers must develop comprehensive strategies to optimize CHNs’ roles in community-based disability care.

Knowledge, attitude, practice, and salt intake on obesity-related hypertension among institutional older adults: a comparative cross-sectional study

Farapti Farapti — 2025-11-30

Introduction: This study aims to assess the differences in knowledge, attitudes, practices, and salt intake among older adults with and without OB-HT in an institutional setting.

Methods: A comparative cross-sectional study was conducted among 50 older adults (25 with OB-HT and 25 controls) in a nursing home in Indonesia. A visual-based questionnaire assessed sodium knowledge and attitude. Salt taste sensitivity was evaluated using a ranked salt intensity test on chicken soup formulations with varying salt levels (0.612–1.125 g/100 mL), and salt preference was measured using a hedonic sensory test. Energy and sodium intake were estimated using a semi-quantitative food frequency questionnaire (SQ-FFQ). Statistical analysis included chi-square, t-test, and Mann-Whitney U test (p < 0.05).

Results: There was no significant difference in sodium-related food knowledge; however, males had lower sodium knowledge scores (p = 0.029). Attitudes toward high-sodium foods differed significantly only among males (p = 0.023). Older adults with OB-HT exhibited significantly lower salt taste sensitivity, particularly among males (p = 0.043), and demonstrated a stronger preference for higher sodium concentrations in food (p = 0.046). Notably, sodium intake differed only among females (p = 0.047).

Conclusions: This study highlighted the relationship between OB-HT and dietary habits, emphasizing the need to identify sex-specific differences in knowledge, attitudes, and practices regarding salt intake among older adults.

Comparison of anesthesia onset and duration between needle and needle-free methods in pediatric circumcision

Y. Sigit Kumara — 2025-11-30

Introduction: Various anesthesia methods are utilized during circumcision, including needle anesthesia (NA) and needle-free anesthesia (NFA). However, research on differences in the total duration of anesthetic action between these methods remains limited. Therefore, this study aimed to evaluate the effectiveness of NA and NFA techniques in circumcision.

Methods: This observational study employed a prospective cohort design and an independent t-test. A total of 56 participants were included, with 28 patients assigned to each technique. Data collection was conducted using an observation sheet. Consecutive sampling was applied, and the primary variables measured were the onset of anesthetic drug, duration of anesthetic effect, and total duration of anesthetic action.

Results: The onset of anesthetic drug, measured as the time from administration to numbness, averaged 4.53 minutes and 3.14 minutes using the NA and NFA methods, respectively (p<0.001). The average duration of anesthetic effect, measured as the time from the onset of numbness to anesthesia dissipation, was 95.39 minutes and 79.00 minutes in the NA and NFA methods, respectively (p<0.001). Finally, the total duration of anesthetic action was 100.46 minutes and 82.54 minutes using the NA and NFA methods, respectively (p<0.001).

Conclusions: The NFA method facilitates a faster onset, while the NA method provides a longer duration of anesthetic effect. These findings may assist clinicians in selecting anesthesia techniques based on procedural duration and patient comfort in pediatric circumcision. Further studies are suggested to explore other influencing factors.

Associations of physical activity and mental well-being with resilience in patients with heart failure: a cross-sectional

Beti Kristinawati — 2025-11-30

Introduction: Heart failure is a common chronic condition that significantly impairs the physical and mental well-being of individuals impacted. Resilience is a dynamic occurrence involving constructive responses to adversity. The researcher aims to investigate the relationship between physical activity and mental health on resilience in heart failure patients.

Methods: This study employed a quantitative, cross-sectional design. The population comprised 186 patients with heart failure at the cardiac outpatient department of Surakarta Regional General Hospital. A total of 140 participants were selected from this population using purposive sampling, based on specific criteria. The dependent variable is resilience, and the independent variables are physical activity and mental well-being. The data were gathered through the Adult Resilience Measure-Revised (ARM-R), the Mental Health Questionnaire incorporating the Depression, Anxiety, Stress Scale (DASS-42), and the Physical Activity Questionnaire derived from the International Physical Activity Questionnaire-Short Form (IPAQ-SF). The analyses used were the chi-square test and multiple linear regression analysis.

Results: This study found a weak, positive relationship between mental well-being, physical activity, and resilience, with a combined R-value of 0.355. The R² value of 0.126 indicates that mental well-being and physical activity together account for 12.6% of the variance in resilience. The remaining 87.4% of the variance is due to other undetermined factors.

Conclusions: Physical activity and mental well-being are positively, though weakly, related to resilience in heart failure patients. Both still contribute to improving resilience. Therefore, rehabilitation programs combining moderate physical activity and psychological support are recommended to enhance resilience and quality of life.

Mitigating chemotherapy-induced oral mucositis: a comparative trial of cryotherapy and normal saline

Heba Salama — 2025-11-30

Introduction: Oral mucositis is one of the most prevalent and serious complications of chemotherapy that causes physical discomfort and impacts patients’ functional ability, emotional well-being, and quality of life. It can also delay treatment, prolong hospitalization, and contribute to psychological issues. This study aimed to compare the effects of cryotherapy and regular saline mouthwash on oral mucositis in cancer patients resulting from chemotherapy.

Methods: A quasi-experimental study design was used, involving a sample of 64 cancer patients who were recruited from the Oncology Center at Mansoura University Hospital, Mansoura, Egypt, over 6 months. Two equal groups of thirty-two cancer patients each were randomly selected into study and control groups from the study population. This study used a single tool divided into two sections: demographic data, a health-related data sheet, and the World Health Organization (WHO) mucositis scale. The Monte Carlo exact test was used to obtain an accurate p-value.

Results: Incidence of severe and moderate mucositis was lower in the cryotherapy group on the 21^st day, where the p-value was 0.004. On the 7^th- and 14^th-day measurements, there were no statistical differences.

Conclusions: The positive effect of cryotherapy on lowering chemotherapy-induced oral mucositis in cancer patients validated our research hypothesis.

Development and validation of the maternal role adaptation system model (MRASM) to improve breastfeeding success

Nurus Safaah — 2025-11-30

Introduction: The success of breastfeeding is a critical indicator of comprehensive adaptation during the maternal transition. Existing theoretical models address maternal adaptation separately, resulting in a lack of integration in predicting breastfeeding success. This research aimed to develop and validate the Maternal Role Adaptation System Model (MRASM) using Structural Equation Modeling.

Methods: A cross-sectional study was conducted with 150 postpartum women recruited through purposive sampling from five community health centers in East Java, Indonesia. Eight latent constructs measured using validated instruments: focal stimuli (breast pain, fatigue, nutrition), contextual stimuli (spousal and healthcare support, information access, economic status), residual stimuli (social norms, cultural values, beliefs), coping mechanisms, emotional responses, self-concept, role function, and breastfeeding success. Data were analyzed using Structural Equation Modeling with Partial Least Squares (SEM-PLS) via Smart-PLS 4.0.

Results: The MRASM demonstrated excellent psychometric properties (Cronbach's α > 0.678, composite reliability > 0.802, AVE > 0.508). Environmental stimuli (focal, contextual, and residual) significantly influenced maternal coping mechanisms, which in turn affected emotional responses, self-concept, and role function. Emotional responses (β = 0.356, p = 0.001) and self-concept (β = 0.268, p<0.001) are the strongest predictors of breastfeeding success, explaining 26.7% of outcome variance. These findings provide healthcare professionals with specific intervention targets: managing physical symptoms, enhancing coping resources, and supporting maternal emotional well-being and self-efficacy.

Conclusions: MRASM integrates Roy's and Mercer's models to address postpartum adaptation holistically, providing healthcare professionals with an evidence-based framework to support maternal role transition and breastfeeding success.

Risk factors associated with metabolic syndrome in older people in slum areas: a cross-sectional study

Sri Supadmi — 2025-11-30

Introduction: Older people are at high risk of metabolic syndrome (MetS), non-communicable diseases, and mortality. This makes it difficult for older people in slum areas to achieve healthy and productive quality of life (QOL). In Indonesia, a developing country with a significant and growing number of slum areas, research on this issue remains scarce. This study aimed to analyze the risk factors that play a role in the incidence of MetS in older people living in slum areas.

Methods: This was a cross-sectional study. The participants were male and female residents aged ≥45 years, with a total sample size of 150. The participants were selected through simple random sampling from a list of older people. Data analysis was performed using the chi-squared test for bivariate analysis and binary logistic regression for multivariate analysis.

Results: The majority of the participants were female (62%), aged between 60-74 years (53.33%), with low-level education (86%), nutritional status in the overweight and obese categories (41.4%), and residence duration <5 years (70%). There was a significant association between district (p < 0.001) and body mass index (BMI) (p < 0.001) with MetS. Overweight participants were more likely to have MetS (AOR 3.75; 95%CI, 1.37-10.24), and the risk was higher among those with obesity (AOR 11.85; 95%CI, 3.90-35.97).

Conclusions: The risk of MetS in slum dwellers is higher if they are overweight or obese. Periodic evaluation of body weight can help to control the incidence of MetS.

Predictors of nutritional status and fluid balance among ESRD patients undergoing hemodialysis

Esi Afriyanti — 2025-11-30

Introduction: Patients with End-Stage Renal Disease (ESRD) undergoing hemodialysis must accommodate significant lifestyle modifications, emphasizing nutritional management and fluid restriction, to realize optimal therapeutic outcomes due to the stringent adherence required by the treatment. Deviations from adherence can precipitate complications, compromising the clinical status of patients.

Methods: This study employed a quantitative, correlational, and cross-sectional methodology to evaluate 245 ESRD patients undergoing hemodialysis who met the inclusion criteria. Data were acquired utilizing a multistage sampling technique, incorporating proportional random and consecutive sampling, and employing questionnaires addressing knowledge, family support, and perception (B-IPQ).

Results: The participants' average age was 51.37±11.804 years, with males representing 60% (147 individuals) of the sample. A significant 81.6% (200 participants) demonstrated proficient knowledge levels. Family support was assessed as satisfactory for 90.6% (222 participants), and 82% (201 participants) exhibited positive perceptions. The analysis identified a significant correlation between Duration of Illness and IDWG (p<0.05), evidenced by a Pearson's correlation coefficient (r) of 0.153. A noteworthy inverse relationship between knowledge levels and Ureum (p<0.05) was also observed.

Conclusions: The findings suggest a correlation between knowledge and nutritional management, particularly regarding urea levels, while the duration of hemodialysis is correlated with IDWG. Conversely, factors related to family support did not demonstrate a significant correlation with aspects of nutrition and fluid management, such as urea, creatinine, Hb, sodium, and potassium.

BACK MATTER VOL 20 ISSUE 4

Admin Jurnal Ners — 2025-11-30

Indonesian Nurses Abroad: Leveraging Migration as Human Capital for National Advancement

Arsyad Syauqi — 2025-11-30