Jurnal Ners

BACK MATTER VOL 19 ISSUE 4

Admin Jurnal Ners — Sat, 30 Nov 2024 00:00:00 +0700

Lived experiences of hypertensive older adults living alone in Kendari City: a phenomenological aprroach

Asminarsih Zainal Prio, junaiti Sahar, Etty Rekawati — Sat, 30 Nov 2024 00:00:00 +0700

Introduction: This study aimed to explore lived experiences as evidence-based in developing health services for hypertensive older adults living alone.

Methods: This study employed a qualitative phenomenological approach, with in-depth and semi-structured interviews of hypertensive older adults living alone in Kendari City Southeast Sulawesi. Purposive sampling was utilized. 15 participating older adults, predominantly female, and with ages ranging from 61-80. Data were collected from April until July 2022, and Colaizzi’s steps were used to guide the data analysis.

Results: Three themes were identified: 1) health changes in the older adults living alone consisting of physical, emotional, social, and spiritual changes; 2) coping mechanisms consisting of emotion-focused coping, biobehavior-focused coping, social-focused coping, and spiritual-focused coping; and 3) healthcare needs consisting of health information needs, regular health checks, group activities, and spiritual activities.

Conclusions: This research highlights the needs of hypertensive older adults living alone to adapt to their health changes and requiring holistic hypertensive care as well as regular health services. Recommendations in this study include developing a holistic hypertensive care program consisting of physical, psychological, social, and spiritual activities. Further research needs to explore the effectiveness of holistic hypertension care on blood pressure, stress, coping, and quality of life of older adults with hypertension by comparing older adults living alone with older adults living with family, and qualitative research using ethnographic methods to determine the adaptation process of the older adults living alone according to culture.

Exploring empathy of nursing students and the extent of their clinical experiences: a cross-case analysis

Sat, 30 Nov 2024 00:00:00 +0700

Introduction: Empathy is the ability of a nurse to understand the circumstances, experiences, and feelings of the patients. It is a vital component of a nurse as this enables the nurse to respond therapeutically to the needs of the clients, thereby providing quality nursing care. This study explored the development of empathy among nursing students based on their hospital exposure and other factors that provide a more in-depth understanding of the phenomenon investigated.

Methods: Using the intrinsic case study method, the study interviewed six nursing students as informants, selected based on their extent of clinical exposure through purposive sampling. A standardized Jefferson Scale of Empathy (JSE) was also used to provide information on empathy. A cross-case analysis was used to generate the findings of this study.

Results: Findings generated five themes: maintaining empathy level across different conditions, prior clinical experiences affect empathy levels, empathy increases with knowledge, expression of empathy is hindered by academic workload and mismatch between perceived and objectively measured empathy levels.

Conclusions: Empathy was more developed by nursing students when they were exposed to patient care experiences. The extent of knowledge and the continued experience in the clinical field are major factors that contribute to their increased empathy levels of nursing students.

Barriers and enablers to the implementation of person-centred care in an Indonesian hospital: a qualitative study

Wan Nishfa Dewi, Elda Nazriati — Sat, 30 Nov 2024 00:00:00 +0700

Introduction: Person-centred care (PCC) is increasingly considered as one of the criteria standards for delivering healthcare in hospitals. Registered nurses are increasingly expected to provide PCC in daily practice. However, although the hospital commits to enhancing and improving PCC, implementing this approach into practice has faced barriers and enablers. As the implementation of PCC is still at an early stage of development, it is well-recognised that the need to identify barriers and enablers is essential. This study aims to explore these barriers and enablers to implementing PCC in Indonesian hospitals.

Methods: This study employed a qualitative exploratory study conducted from July 2023 to September 2023 at a public hospital in Pekanbaru, Riau Province. It applied semi-structured interviews to collect data on barriers and enablers to implement PCC from 2 managers and 12 nurses from the medical ward. All participants were selected using a purposive sampling technique. Data collected from interviews were transcribed and then thematically analysed.

Results: Three barriers-related themes emerged, namely time constraints and workload, lack of resources, and communication challenges. Furthermore, three enablers themes also emerged, including leadership, commitment, and sufficient monitoring and supervision.

Conclusions: The study results lead hospital managers and policymakers to overcome existing barriers using adaptive planning and strategies and to improve enablers with well-trained professionals and strong leadership to deliver a PCC approach into practice. The implications to practice are that healthcare organisations must continue their support to decrease the barriers and optimise professional care in healthcare facilities to improve healthcare services.

Chronic energy deficiency in young pregnant women in rural Indonesia: an analysis of basic health survey 2018

Titik Kuntari, Utami Utami, Vita Widyasari, Sri Supadmi, Emi Azmi Choironi — Sat, 30 Nov 2024 00:00:00 +0700

Introduction: Chronic energy deficiency (CED) significantly impacts maternal health and child development. Socioeconomic conditions and access to health services cause young mothers in rural areas to have different health problems from those in urban areas. The study aimed to analyze the factors associated with CED among young pregnant women in rural areas in Indonesia.

Methods: Secondary data for this cross-sectional study were obtained from the 2018 Basic Health Research Survey. One thousand one hundred and thirty-nine pregnant women aged <25 years were involved as subjects. Age, number of family members, education, occupation, gravida, abortion, supplementary feeding, and iron tablets during pregnancy were included as independent variables. Binomial logistic regression analysis was performed to measure the association between the independent and dependent variables. The strength of the association was expressed by p-value <0.05.

Results: The three factors associated with CED were age (p=0.001), education (p=0.013), and supplementary feeding (p<0.001).

Conclusions: Equitable education, increasing the age at which moms can become pregnant, and efforts to fulfill the nutrition needs of pregnant women by providing supplemental food based on community empowerment are significant. Family and community involvement will ensure the sustainability of this CED prevention program.

Factors, barriers and adherence of nurses to patient education in public hospitals of Lanao del Sur, Philippines

Naseha M. Omar, Naima D. Mala, Ashley A. Bangcola — Sat, 30 Nov 2024 00:00:00 +0700

Introduction: Patient education is a core responsibility in nursing, vital for improving patient understanding and active participation in their healthcare decisions. There are various factors that impact nurses' ability to provide patient education, but little is known about how these factors influence adherence in public hospitals, particularly in resource-limited settings. This study investigates nurses' adherence to patient education protocols in Lanao del Sur, Philippines, while evaluating facilitating factors and barriers.

Methods: This study employed a quantitative, descriptive, cross-sectional correlational research design. Seventy-six nurses from two public district hospitals participated. Data were gathered through surveys on demographics, adherence to patient education, facilitators, and barriers. Correlation analyses, including Pearson’s correlation and Spearman’s rho, assessed relationships between variables, with Cramer’s V used for categorical data. Statistical significance was set at α = 0.05.

Results: Most participants were married females aged 31-40, with incomes of 10,000-39,000 PHP, college-educated, and assigned to wards, with 3 months to 3 years of tenure. Nurses acknowledged the importance of patient education and identified 14 barriers. Adherence to patient education showed negative correlations with age, income, educational attainment, and tenure, but positive correlations with gender, marital status, and area of assignment. Facilitating factors positively correlated with adherence, as did barriers.

Conclusions: Identifying factors affecting nurses' adherence to patient education is vital for improving these practices. Findings will support the Nursing Patient Education Development Program, enhancing patient education in Lanao del Sur's public hospitals.

The performance of physical activity and health-related quality of life in patients with heart failure: a cross-sectional study

Denny Maurits Ruku, Hsing Mei Chen — Sat, 30 Nov 2024 00:00:00 +0700

Introduction: This study aimed to describe self-reported PA performance and determine predictors regarding health-related quality of life (HRQOL) among heart failure (HF) patients.

Methods: A cross-sectional design was adopted, and data were collected using a questionnaire comprising demographic characteristics, illness-related factors, self-report health status (SRHS) questionnaire, international PA questionnaire, and Minnesota Living with Heart Failure questionnaire. Subsequently, data were analyzed using Pearson correlation coefficient, t-test, one-way ANOVA, and hierarchical multiple regression.

Results: The mean age for the total participants of 180 HF patients was 59.92 ± 11.90 years, with 60% being male, and the mean HRQOL score was 42.96 ± 20.47. HRQOL had significant correlations with HF medication (r= 0.20, p< 0.01), health status (HS) (r= 0.35, p< 0.01), PA (r= -0.52, p< 0.01), and HRQOL was associated with the New York Heart Association (NYHA) classification (F= 94.57, p< 0.001). Meanwhile, age, gender, job, marital status, religion, level of education, hemoglobin, body mass index, length of diagnostic HF, and comorbidities did not have a significant relationship with HRQOL. Three variables were significant predictors of HRQOL, namely HS (β= 0.21, p< 0.01), NYHA Class III (β= 0.15, p< 0.05), and PA (β= -0.31, p< 0.001).

Conclusions: Regular PA is crucial in improving HRQOL of HF patients. In addition, HS, HF medication, and NYHA Class should be considered in providing care for HF patients aimed at improving HRQOL.

A pilot translation and adaptation of the Diabetes Obstacle Questionnaire (DOQ) to measure obstacles and challenges in diabetes management for people with diabetes in Indonesia

Niken Safitri Dyan Kusumaningrum, Fitria Handayani — Sat, 30 Nov 2024 00:00:00 +0700

Introduction: Identifying the issues faced by Indonesians living with diabetes is crucial to address them appropriately. However, a standardized tool cannot measure the obstacles encountered in managing illness. Therefore, there is a need for widely accepted assessment tools to investigate these problems. This article explains the findings of the pilot translation and adaptation of the Diabetes Obstacle Questionnaire (DOQ) for people with diabetes in Indonesia.

Methods: The English version of the DOQ was cross-culturally adapted and translated into Bahasa, Indonesia. The completion of the questionnaire required approximately 30 min for each of the 61 respondents, all of whom were Indonesians diagnosed with diabetes. Factor analysis, product moment, and Cronbach’s alpha were used in STATA SE 13.1 for data analysis.

Results: The original 78 items underwent a systematic process of translation and adaptation to align with the Indonesian context. Twenty-one items were eliminated, leaving 57 valid question items following a judgement of expert and statistical analysis. The reliability coefficient of the Indonesian version of the DOQ was acceptable, with a value of 0.96 for all items. The coefficient varied between 0.82 and 0.99 for different scales, indicating high internal consistency reliability.

Conclusions: The Indonesian version of the 57-item DOQ is an acceptable instrument that can be used to identify obstacles faced by people with diabetes in Indonesia. This can facilitate researchers in investigating the problems faced by those living with diabetes in managing their condition.

Effectiveness of prone position with its moderating factors in non-intubated acute respiratory distress syndrome patients: a meta-analysis

Sat, 30 Nov 2024 00:00:00 +0700

Introduction: While numerous meta-analyses have explored the efficacy of awake prone position (APP), most have concentrated solely on intubation rate among Covid-19 patients without comprehensively identifying the influencing factors. This study aims to evaluate the efficacy of APP along with its moderating factors on oxygenation, intubation rate, and mortality in non-intubated acute respiratory distress syndrome (ARDS) patients.

Methods: We conducted a systematic search in PubMed, Web of Science, and CINAHL from inception to December 2022. JBI critical appraisal tools were used to assess the study quality. Random-effects model was employed to calculate pooled standardized mean difference for continuous outcomes and risk ratio for dichotomous outcomes.

Results: Among the 39 studies included, most patients were suffering from Covid-19, using conventional oxygen therapy, and receiving APP outside the ICU. APP significantly improved the PaO2/FiO2 ratio (SMD=0.70, 95% CI=0.51-0.88) and SpO2/FiO2 ratio (SMD=0.76, 95% CI=0.51-1.01), while also reducing the risk of intubation (RR=0.66, 95% CI=0.51-0.85) and mortality (RR=0.62, 95% CI=0.49-0.78). Factors including severity, respiratory device, body mass index, detail of position, use of medication assistance, total duration, follow-up time, position at follow-up, and study design significantly influence the effectiveness of APP. APP did not lead to significant improvements in length of stay and adverse events

Conclusions: APP is a safe and beneficial intervention, enhancing oxygenation and reducing intubation and mortality rates in non-intubated ARDS patients. Importantly, various patient and intervention characteristics should be taken into account when implementing APP. Further well-designed experimental studies are needed to strengthen the evidence base.

Psychometric validation of the nursing professional values scale-revised: Vietnamese version

Mei-Chih Huang, Thi-Phuong-Thao Pham — Sat, 30 Nov 2024 00:00:00 +0700

Introduction: The Nursing Professional Values Scale has been widely used to assess the professional values of practicing nurses, nursing students, and faculty members across different countries. This study seeks to validate the psychometric properties of the Vietnamese version of the Nursing Professional Values Scale-Revised (NPVS-R).

Methods: A quantitative survey was conducted with the questionnaire of NPVS-R version which was converted from English to Vietnamese by three expert translators, followed by a back-translation by three bilingual experts, then three nursing scholars from different regions of Vietnam assessed the language and content validity. Data were collected from 669 nurses through the Vietnamese Nursing Association network and analyzed by using SPSS and AMOS software. The scale was evaluated based on validity of content and construct, and internal consistency.

Results: The Vietnamese NPVS-R scale comprises 25 items across four subscales: Caring, Activism, Trust, Professional, and Justice. Confirmatory factor analysis revealed factor loadings between 0.595 and 0.929, with a chi-square value of 955.303. Fit indices (CFI = 0.935, CMIN/DF = 3.605, RMSEA = 0.062) were satisfactory. Cronbach’s alpha was good, ranging from 0.861 and 0.877, and item-to-total correlations spanned 0.501 to 0.775. There exist significant differences of nurses’ perception on the subscales based on their gender, age, and working experience.

Conclusions: NPVS-R is a reliable instrument to measure the professional values of nurses in the distinct Vietnamese context and language. It can serve as a valuable tool for nursing care development and competency assessment across various care units in Vietnam and benefit international comparisons.

Parental support and influencing factors for school-age children's healthy movement behavior: a cross-sectional study

Sat, 30 Nov 2024 00:00:00 +0700

Introduction: Optimizing healthy lifestyles in children requires parental support for healthy movement behaviors. This study analyzed factors influencing parental support for school-age children's movement activities.

Methods: This study employed an analytic descriptive design with a cross-sectional approach, involving a sample of 355 mothers with school-age children. The independent variables included family, child, and environmental factors, whereas the dependent variable was parental support for healthy movement behaviors, as assessed through a questionnaire. Data analysis was performed using binary logistic regression with backward elimination.

Results: The factors that significantly influenced parental support for their children's engagement in light physical activities included the children's own level of participation in such activities (OR=2.52, 95% CI=0.76-6.67). Factors affecting support for moderate to vigorous activities were maternal exercise habits (OR=3.37; 95% CI=1.18-9.65), children's sports habits (OR=5.18; 95% CI=1.64-16.26), and the presence of personal gadgets (OR=0.45, 95% CI=0.23-0.86). Parental support for preventing sedentary behaviors was influenced by parental knowledge (OR=2.33; 95% CI=1.34-4.05), mother's sleep duration (OR=2.46; 95% CI=1.27-4.75), and gadgets (OR=0.55; 95% CI=0.31-0.95). Factors affecting support for adequate sleep included children's light activities (OR=3.42; 95% CI=1.27-9.23) and their ownership of personal gadgets (OR=0.44; 95% CI=0.24-0.79)

Conclusions: Parental support is influenced by the knowledge and physical activity habits of both mother and child, as well as gadget use and maternal sleep patterns. Pediatric nurses can enhance this support through health education focused on promoting healthy movement behaviors within families.

The dementia certified nurse process for acquiring knowledge for care of older adult patients with dementia in acute care hospitals: a qualitative descriptive study

Sonoko Kabaya, Tayo Nagahata, I Gede Juanamasta — Sat, 30 Nov 2024 00:00:00 +0700

Introduction: This study aimed to explore DCNs’ perceived knowledge acquisition in older adult patients with dementia in acute-care hospitals.

Methods: The study used qualitative methods, with 14 Japanese DCNs involved in the snowball sampling method. Face-to-face interviews were conducted between June and December 2016 by the principal investigator. A qualitative content analysis was used in this study. The study results were divided into nine categories and 31 sub-categories.

Results: This study highlights the process through which DCNs in acute-care hospitals acquire expertise in caring for older adults with dementia. Initially, DCNs faced dilemmas between patients’ resistance to treatment and their professional priorities, leading to emotional and cognitive shifts that motivated them to seek specialized knowledge and refine their care methods. By reflecting on their experiences, integrating patient-centered approaches, and sharing insights with team members, DCNs deepened their understanding, adapted care strategies, and enhanced their clinical capacity to meet patients' needs effectively.

Conclusions: Nurses should provide appropriate training before taking care of the patients. Knowledge should be combined with patient’s problems and behavior. Thus, nurses become more flexible in adapting to patients with dementia. These findings emphasize the importance of fostering reflective practices and educational interventions to enhance DCNs’ expertise, enabling them to provide patient-centered care and improve outcomes for older adults with dementia.

FRONT MATTER VOL 19 ISSUE 4

Admin Jurnal Ners — Sat, 30 Nov 2024 00:00:00 +0700

A systematic review and meta-analysis of sleep hygiene implementation and its effect on sleep quality and fatigue in patients undergoing hemodialysis

Hesti Fathan Nurfais Fauziah, Erna Rochmawati, Aasim Padela — Sat, 30 Nov 2024 00:00:00 +0700

Introduction: The prevalence of patients undergoing hemodialysis who experience sleep disturbances and fatigue is high. Pharmacologic management has consequences and adverse effects, therefore, integrative intervention is important to be investigated. Sleep hygiene is one such integrative intervention that improves comfort including enhancing sleep quality and reducing fatigue. However, none have synthesized the effect of sleep hygiene intervention, particularly in the hemodialysis setting. This systematic review aims to synthesize the effectiveness of sleep hygiene in improving sleep quality and fatigue in patients undergoing hemodialysis.

Methods: This is a systematic review and meta-analysis of randomized controlled trials and quasi-experimental studies. Relevant studies were gathered by searching five databases from 2008-2023 using several keywords, such as sleep hygiene, sleep quality and fatigue. Quality assessment was conducted using relevant tools from the Joanna Briggs Institutes (JBI). Following that, synthesis of research findings was conducted using Review Manager version 5.4.

Results: Seven studies of 3,633 screened were included, with one high-quality study (88%) and six studies of moderate quality (61-76%). The review indicated a significant difference in sleep quality (MD = -2.36; 95% CI = -4.28, -0.44; p=0.016). However, there was no significant difference in fatigue (SMD = -0.08; 95% CI = -0.40, 0.24; p=0.61).

Conclusions: The evidence supports that sleep hygiene is effective in enhancing sleep quality. This systematic review contributes evidence to support the inclusion of sleep hygiene into holistic nursing to assist patients in improving sleep quality and reducing fatigue.

Logotherapy for Social Isolation and Loneliness of Informal Carers

Ken Hok Man HO, Daphne Sze Ki CHEUNG, Alina Yee Man NG — Sat, 30 Nov 2024 00:00:00 +0700