Jurnal Ners

FRONT MATTER VOL 20 ISSUE 3

Admin Jurnal Ners — Sun, 31 Aug 2025 00:00:00 +0700

Effect of sharia-based nursing care using swanson's caring model (ShariaSwanCare) on patient satisfaction: a quasi-experimental study

Thu, 28 Aug 2025 00:00:00 +0700

Introduction: This study aimed to evaluate the effect of Sharia-Based Nursing Care, utilizing Swanson’s Caring Model (ShariaSwanCare), on patient satisfaction in hospital settings.

Methods: A quasi-experimental pretest–posttest design with a control group was employed, involving 76 hospitalized patients (38 per group) selected via purposive sampling. Participants received a structured, five-day treatment for conditions such as hypertension, diabetes mellitus, cerebrovascular accident (stroke), and pneumonia. Eligibility criteria included compos mentis status and uninterrupted completion of the five-day treatment period. Patients who were transferred to other wards were excluded. The intervention group received ShariaSwanCare, administered daily for five consecutive days, with patient satisfaction assessed every 24 hours. The control group received standard hospital care without additional interventions. Data were analyzed using both paired t-tests and independent t-tests. A significance level of p < 0.05 was used for all analyses.

Results: Statistical analysis yielded a p-value of < 0.001, indicating that the implementation of ShariaSwanCare had a significant positive effect on patient satisfaction. Specifically, patients in the intervention group showed a greater increase in satisfaction scores compared to the control group. The paired t-test revealed a significant improvement from pre- to post-intervention in both groups, but the effect was more pronounced in the intervention group.

Conclusions: Sharia-based nursing practices, when integrated with Swanson’s Caring Model, can effectively enhance patient satisfaction. With appropriate training and structured implementation, these practices have the potential to be adopted across Islamic hospitals.

Occupational stress levels among indonesian nurses and midwives in Saudi Arabian healthcare settings: a comparative cross-sectional study

Akhir Fahruddin, Slametiningsih Slametiningsih, Dwi Setyorini, Sylvia Gusrina — Thu, 28 Aug 2025 00:00:00 +0700

Introduction: This study aimed to assess the occupational stress levels among Indonesian nurses and midwives working in Saudi Arabian healthcare settings.

Methods: This cross-sectional comparative study assessed occupational stress among Indonesian nurses and midwives working in Saudi Arabia using the Expanded Nursing Stress Scale (ENSS). A total of 166 respondents (85 nurses and 81 midwives) completed the survey from a professional WhatsApp group. A convenience sampling was attempted, and only those who voluntarily responded to the questionnaire were included. The primary dependent variable was occupational stress, while the independent variables included profession (nurse and midwife), age, sex, education level, workplace setting, marital status, and years of experience. The analytical tests used were Mann-Whitney and Kruskal-Wallis.

Results: Occupational stress among nurses (Mean = 109) and midwives (Mean = 107) was low in psychological, physical, and social environments. Workload was the most stressful factor for both nurses (Mean = 20.44) and midwives (Mean = 18.88). We found a significant difference in the level of stress based on their workplace (p = 0.038) and educational background (p = 0.005). There was no difference in the level of stress between nurses and midwives (p = 0.188).

Conclusions: In comparison, either nurses or midwives have a low level of occupational stress, which is related to psychological, physical, and social environments based on ENSS tools. Therefore, optimal healthcare management and policy should be maintained and improved for migrant nurses and midwives to foster better, sustainable healthcare development in the future.

Problems and needs of the older adults and their families infected with COVID-19 in the community of Northeastern Thailand: a qualitative study

ฺBualun Hinkaew, Pairin Yodsuban, Weha Kasemsuk, Prakaikaew Siripoon — Thu, 28 Aug 2025 00:00:00 +0700

Introduction: The COVID-19 pandemic has severely impacted older adults, particularly those with chronic illnesses, due to their heightened vulnerability and limited access to care. In Northeastern Thailand, many older adults live alone and face multifaceted health and social challenges. This study aimed to explore the problems and needs of older adults and their families infected with COVID-19 within the social and cultural context of this region.

Methods: A qualitative content analysis was conducted using data collected through observations, in-depth interviews, focus group discussions (FGDs), field notes, and participant observations in community settings. A total of 48 informants were purposively selected, including representatives from public and community organizations, health service units, local administrative organizations, local leaders and village headmen, and older adults and their family members who had been infected with COVID-19.

Results: The study identified five key themes reflecting the problems and needs of older adults and their families affected by COVID-19. Socially, participants experienced isolation and limited access to support networks. Economic challenges included income loss and insufficient financial assistance. Environmental issues involved inadequate housing and restricted access to essential services. Health-related problems encompassed physical decline and limited healthcare access. Politically and administratively, delays in assistance and ineffective coordination among agencies were reported.

Conclusions: Older adults and their families infected with COVID-19 encounter complex and multidimensional challenges. Community nurses play a vital role as health system managers in addressing these needs and ensuring accessible and appropriate primary health care services.

The impact of self-care behavior on quality of life among patients with heart failure in Malaysia: a cross-sectional study

Thu, 28 Aug 2025 00:00:00 +0700

Introduction: Individuals with heart failure anticipate adjustment to self-care behaviors following hospital discharge. Self-care in heart failure includes medication adherence, dietary modifications, symptom monitoring, and activity adjustment. Adequate self-care behavior may contribute to enhanced outcomes, decreased hospitalization, and improved quality of life in patients with heart failure. This study aimed to determine the level of self-care behavior, quality of life, and its relationships among patients with heart failure.

Methods: A cross-sectional study using purposive sampling was conducted among 200 heart failure patients at a teaching hospital in Selangor, Malaysia. The sample size was determined using G*Power to ensure adequate statistical power. Data were collected using the Self-Care of Heart Failure Index (SCHFI) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Descriptive statistics, Pearson’s correlation, and multiple linear regression were used in this study.

Results: The results indicated that the total mean score of self-care behavior was 145.42 and SD=16.23. Most patients demonstrated good quality of life (n=73, 36.5%), moderate quality of life (n=62, 31%), and poor quality of life (n=65, 32.5 %). Pearson's correlation revealed a significant (p<0.001) correlation (r = 0.651) between self-care behavior and quality of life.

Conclusions: In conclusion, this study demonstrated that higher levels of self-care are associated with better quality of life in patients with heart failure. It is recommended that nurses provide individualized self-care education at discharge, focusing on medication adherence, symptom monitoring, and lifestyle changes to improve quality of life.

Psychometric validation of Filipino versions of the survey of attitudes toward statistics and attitudes toward research for nursing students

Thu, 28 Aug 2025 00:00:00 +0700

Introduction: Despite the recognized importance of assessing nursing students' attitudes toward statistics and research, no validated instruments exist specifically for the Filipino context. This study aimed to evaluate the psychometric properties of the Filipino adaptations of the Survey of Attitudes toward Statistics (SATS-F) and Attitudes toward Research (ATR-F) scales.

Methods: A quantitative cross-sectional survey design, using convenience sampling, was employed to collect data from August to October 2022. Participants were Filipino nursing students taking nursing research and statistics courses who were at least 18 years old. Participants with >10% incomplete data on any instrument were excluded.

Results: Descriptive statistics showed mean scores ranging from 4.45 to 6.10 for ATR-F items and 2.88 to 5.55 for SATS-F items. A strong content validity was demonstrated, with S-CVI/Ave values of 0.94 for ATR-F and 0.98 for SATS-F. Principal Component Analysis (PCA) showed 75.3% of the cumulative explained variance for ATR-F and 61.9% for SATS-F. Pearson correlation analysis further supported construct validity, revealing a significant positive relationship (r = 0.50, p < 0.001) between ATR-F and SATS-F, which indicates a strong association between nursing students' attitudes toward research and statistics. Internal consistency reliability was established, with Cronbach's alpha coefficients of 0.87 for ATR-F and 0.90 for SATS-F.

Conclusions: SATS-F and ATR-F possess sound psychometric properties, rendering them reliable tools for assessing Filipino nursing students' attitudes toward statistics and research. Educators and researchers can use these culturally adapted and validated instruments to develop targeted interventions to enhance nursing students' preparedness for research-informed practice.

Exploring the promotion of sexual health literacy for sexually transmitted disease prevention among undergraduate students in Thailand: an ethnographic study

Sittisak Kreupimy, Peerapong Boonsawasdgulchai — Thu, 28 Aug 2025 00:00:00 +0700

Introduction: Although previous knowledge has proposed guidelines for promoting sexual health literacy in sexually transmitted disease (STD) prevention, there is a knowledge gap in studies about approaches to promote sexual health literacy for STD prevention among undergraduate students tailored to undergraduate students, who are influenced by specific personal, familial, and sociocultural factors.

Methods: This critical ethnographic study explored the promotion of sexual health literacy in STD prevention among undergraduate students in Thailand. The total number of participants was 63 persons, including undergraduate students, health care providers, university department representatives, university administrators, advisors or lecturers, parents, and friends. Data were collected by in-depth interviews, participatory observation, non-participatory observations, field notes, and documented studies. Verify the accuracy of the data using multiple periods, multiple individuals, multiple university departments, member checking, reflexivity, and qualitative research experts. Data were analyzed by thematic analysis.

Results: It consists of 2 parts: 1) Development of university mechanisms to prevent, deter, and support students, and 2) Providing health services to care and help for students.

Conclusions: The results of this research provide practical knowledge. However, the limitations need to be addressed in the implementation process. Recommendations are that University administrators should increase the integration and promotion of all elements of sexual health literacy to students. Student health centers should develop their competencies in providing counseling services to LGBTQ students. Policymakers should develop specific policies with student participation, and for future research, should explore integration models of all stakeholders and cross-university comparison research.

Structural constraints and patient agency in diabetes self-management: a critical case study in a primary healthcare center in Indonesia

Yulia Yulia, Wendy Abigail, Eileen Willis, Fathimath Shifaza — Thu, 28 Aug 2025 00:00:00 +0700

Introduction: Effective self-management is essential for individuals with Type 2 Diabetes Mellitus (T2DM), yet patients in Indonesia often encounter persistent barriers. This study explores patients’ perspectives on the challenges they face as well as the perceived supports available within the primary healthcare system.

Methods: A qualitative case study approach, based on Yin’s methodology, was employed. Guided by Habermas’s theory of communicative action and Honneth’s theory of recognition, data were collected through in-depth interviews with 14 patients, 28 clinical observations of patient–provider encounters, and one focus group with five healthcare professionals. Participants were recruited from a suburban primary healthcare center in Indonesia using purposive sampling. Reflexivity and field notes were maintained throughout the data collection process. Data were analyzed using thematic qualitative analysis. Triangulation across data sources helped enhance credibility and trustworthiness.

Results: Five key themes emerged: (1) Medical dominance in care provision, (2) Communication gaps, (3) Regulation-centered care, (4) Care quality, and (5) Patient self-empowerment. These themes reveal systemic, structural, and interpersonal barriers that constrain effective diabetes self-management in primary care.

Conclusions: Understanding the lived experiences of patients with T2DM is critical to informing practice and policy. To overcome these barriers, a shift toward patient-centered care, improved communication, and more inclusive support systems is essential within Indonesia’s healthcare system.

Effectiveness of resistance training to improve muscle strength and physical performance of patients with diabetes mellitus: a meta-analysis

Priscilla Mary Ntim Babae, Awurabena Quayeba Dadzie, Denny Maurits Ruku — Thu, 28 Aug 2025 00:00:00 +0700

Introduction: Metabolic disorders in diabetes mellitus (DM) sufferers, caused by insulin resistance, chronic muscle inflammation, and mitochondrial dysfunction, can affect muscle structure and function and reduce physical performance (PP). Thus, rehabilitation in the form of resistance training (RT) is needed to overcome these problems. This study aims to determine the effect of RT on muscle strength (MS; lower and upper limbs) and PP (primary outcome), as well as body mass index (BMI), VO2 peak, lean muscle mass, HbA1c, blood pressure (BP), and adverse events (secondary outcome) in patients with DM.

Methods: Six databases were used in a comprehensive search conducted from March to April 2025 to locate relevant articles. We used Standard Mean Difference (SMD), Mean Difference (MD), and Risk Difference with a 95% Confidence Interval (CI), to determine the effect of RT. We assess the quality of studies using the Joanna Briggs Institution checklist.

Results: 26 articles randomized controlled trial articles were included, showing that RT has a significant effect on improving MS (lower and upper limbs), PP (primary outcome), and VO2 peak, LMM (secondary outcome); Additionally, RT has a significant effect in lowering HbA1c and systolic blood pressure (SBP), but not significantly in reducing diastolic blood pressure (DBP) (secondary outcome) between the intervention group and control group of patients with DM. There were no RT-related adverse events.

Conclusions: RT is a rehabilitation recommendation to improve MS and PP and is also a rehabilitative effort for those living with DM.

Effectiveness of the health belief model-based husband empowerment module in enhancing postpartum contraceptive support readiness: a quasi-experimental study

Pipit Feriani, Rini Ernawati, Lia Kurniasari, Yhenti Widjayanti — Thu, 28 Aug 2025 00:00:00 +0700

Introduction: This study evaluated the effectiveness of a Health Belief Model (HBM)-based Husband Empowerment Module in enhancing husbands' preparedness behaviors for postpartum contraceptive support.

Methods: A quasi-experimental pre-posttest control group design was conducted at two community health centers in Samarinda, Indonesia. Sixty husbands of third-trimester pregnant women were recruited through a combination of sampling, purposive sampling, and random sampling. Purposive sampling was used to choose the treatment group, and random sampling was used to select the participants, who were assigned to the intervention (n=30) and control (n=30) groups. The intervention group received a comprehensive 12-session HBM-based module delivered through antenatal care visits, home visits, group discussions, and WhatsApp support over three months. Preparedness behavior was measured using validated questionnaires assessing awareness, facilitation ability, and appreciation. Nonparametric statistical analyses were employed.

Results: Post-intervention, the treatment group demonstrated significant improvements across all preparedness dimensions: awareness median scores increased from 9.0 to 11.0 (p<0.001), facilitation ability, from 5.0 to 6.0 (p<0.001), and appreciation from 4.0 to 5.0 (p<0.001), while the control group showed no significant changes (all p>0.05). Between-group comparisons revealed substantially higher preparedness in the intervention group with large effect sizes. Notably, 83.3% of intervention participants achieved good facilitation ability compared to 0% at baseline.

Conclusions: The HBM-based Husband Empowerment Module effectively enhanced husbands' preparedness for postpartum contraceptive support, suggesting that structured interventions can improve husband involvement in postpartum care and maternal health outcomes.

Pressure ulcer prevention among nurses in Malaysia: a cross-sectional survey

Nordianna Seman, Nasreen Maripen Kuta, Nur Liyana Nabihah Mamat — Thu, 28 Aug 2025 00:00:00 +0700

Introduction: Pressure ulcers (PUs) remain a global health issue, contributing to increased morbidity and premature mortality. Nurses play a central role in prevention, underscoring the significant role in addressing this issue through the rapidly evolving healthcare environment. Clinical competence requires sound knowledge, attitude, and practice that contribute to excellent outcomes, focusing on individual patient needs and the changing conditions of the healthcare setting. Therefore, this study is aimed to evaluate nurses’ knowledge, attitudes, and practices on preventing PUs.

Methods: This quantitative cross-sectional survey was conducted across three public hospitals in Malaysia. Using the two-stage cluster sampling strategy, registered nurses were recruited (n=210). Data were collected using a self-administered questionnaire with good reliability scores (α=0.76–0.82). Descriptive and inferential analyses were computed to address the objectives.

Results: Findings revealed low knowledge score (M=67.07, SD=7.78), neutral attitudes (M=73.28, SD=10.37), and excellent practices for pressure ulcer prevention (M=86.78, SD=15.05). Nurses’ attitudes were positively correlated with their practices (p<0.05), though no significant associations were observed between demographic factors and knowledge, attitude, and practice (p>0.05).

Conclusions: The findings provide valuable information about nurses' understanding of pressure ulcer prevention that may assist with future strategies and interventions to enhance the knowledge and attitudes among practicing nurses. The identified gaps may be filled with targeted interventions, and future studies looking at variables affecting nurses' attitudes and practices, and the effectiveness of educational interventions can be beneficial.

Development of a health coaching model to improve caregivers’ ability to care for patients with mental disorders

Thu, 28 Aug 2025 00:00:00 +0700

Introduction: This study aimed to develop a health coaching model grounded in these theoretical frameworks.

Methods: An explanatory cross-sectional design was employed, involving 155 caregivers purposively recruited from seven primary health care centers in Makassar, Indonesia. Eligible participants were primary caregivers from nuclear or extended families, aged ≥18, with complete contact information, available for home visits, and referred by the mental health program coordinator. Study variables included family, caregiver, patient, nurse, and health care service factors, as well as health coaching, planned behavior, behavioral intention, and caregiver ability. Data were collected between February to June 2024 using structured questionnaires and analyzed with Partial Least Squares-Structural Equation Modeling (SmartPLS v3.8).

Results: The family, patient, and nurse-related factors significantly affected health coaching. These factors, along with caregiver characteristics, also affected planned behavior, which in turn significantly influenced behavioral intention and caregiver ability.

Conclusions: Health coaching directly improved caregivers’ capability. These findings highlight the importance of comprehensive health coaching and family-centered training as integral components of mental health services.

Improving or worsening? : the development and evaluation of a VR-based psychotherapy to bullying victims and perpetrators in school adolescents

Sun, 31 Aug 2025 00:00:00 +0700

Introduction: This study evaluated the effectiveness of a Virtual Reality (VR)-based emotional regulation intervention in addressing bullying among school adolescents, focusing on changes in self-perceived roles as victims or bullies and associated difficulties.

Methods: This study used a quasi-experimental design, with 98 junior high school students assigned to either a four-session VR intervention (n=33) or a no-treatment control group (n=65). The intervention consisted of four 15-minute psychotherapy sessions using the PeriXa Batin VR module. Data were collected using the Strengths and Difficulties Questionnaire and System Usability Scale (SUS). Statistical analyses included the Mann-Whitney U test, a General Linear Model (GLM), and thematic analysis.

Results: The intervention was associated with a significant reduction in self-perceived bullying behaviors (p < 0.001), particularly among males. However, it also led to an increase in self-reported difficulty scores (p < 0.005). The VR module was received positively, with high usability ratings, although some participants reported minor technical issues and temporary discomfort, such as dizziness. The VR intervention effectively fostered self-awareness, which may explain both the reduction in bullying and the concurrent increase in emotional distress as victims confronted their experiences. The limitations include short intervention duration, small sample size, and reliance on self-reported data.

Conclusions: While VR is a promising tool, schools should implement it alongside support systems, such as counseling, to help students manage the challenges of increased self-awareness. Future research should focus on the long-term effects and integration of such technologies into comprehensive school wellness programs.

BACK MATTER VOL 20 ISSUE 3

Admin Jurnal Ners — Sun, 31 Aug 2025 00:00:00 +0700

Bridging health literacy gaps in health profession education: preparing students to provide holistic care.

Kusrini S. Kadar — Thu, 28 Aug 2025 00:00:00 +0700