Jurnal Ners

BACK MATTER VOL 19 ISSUE 3

Admin Jurnal Ners — Sat, 31 Aug 2024 00:00:00 +0700

Critical care nurses' perceptions toward withdrawal of life-sustaining treatments: a phenomenology study

Ibrahim Ahmd Alabd, Sahar Yassien Mohammad, Dalia Ali Ameen — Sat, 31 Aug 2024 00:00:00 +0700

Introduction: Withdrawing life-sustaining measures involves complex legal and ethical considerations, and few healthcare providers have received specialized training in this area. This study explored critical care nurses' perceptions of withdrawing life-sustaining treatment.

Methods: A qualitative phenomenological design was used, a purposive sample of 15 individuals of both sexes for nurses working in the ICU for at least six months. The study was conducted in seven critical care units at four hospitals at Ain Shams University. The data collection process involved audio recordings of semi-structured open-ended interviews and the data were analyzed based on Tesch’s method.

Results: Study results revealed that the sample age ranged from 24 to 38 and ranged from 1 year to 14 years working in ICU at various levels starting from nursing staff to head nurses. Critical care nurses' perceptions were reflected through four main themes and related subthemes. The main themes that shaped nurses' perceptions were attitudes toward withholding and withdrawing life-sustaining treatments, ethical perceptions, beliefs impact, and legal framework.

Conclusions: Nurses face difficult experiences influencing their perceptions of life-sustaining treatment withdrawal, emphasizing the importance of policy guidance to prevent decisions based only on beliefs. Therefore, further qualitative and quantitative studies are required.

Keywords: life-sustaining treatments, Perceptions, qualitative design, themes, withdrawal

The effect of therapeutic regimen education on improving the self-efficacy in cancer patients undergoing haemodialysis: a quasi-experimental study

Indah Susilowati, Tuti Nuraini, Dewi Gayatri, Yati Afiyanti — Tue, 09 Jul 2024 00:00:00 +0700

Introduction: Cancer treatments often comes with varying adverse effects on both functional and physiological status of cancer patients, such as reduced kidney function, necessitating haemodialysis. The aim of this study was to determine the effect of therapeutic regimen education on the treatment self-efficacy of cancer patients undergoing haemodialysis.

Methods: This study used a quasi-experimental method, involving 136 participants divided into control and intervention groups. The intervention group was given therapeutic regimen education that lasted for 4 weeks. The self-efficacy score was measured before and after intervention in both groups. Pre- and post-intervention scores were measured using the Chronic Kidney Disease Self-Efficacy instrument (r = 0.845). Paired t-test and independent t-test were used, respectively.

Results: The results show that the patients who received therapeutic regimen education had significant increases in self-efficacy scores (p < 0.001). The mean (SD) score for all sub-variables increased after treatment: autonomy, from 15.07 (4.29) to 26.50 (1.74); personal integrity, from 11.63 (3.92) to 23.68 (2.59); problem-solving, from 10.66 (3.98) to 18.85 (0.82); and seeking social support, from 7.13 (2.38) to 14.06 (1.62). From the statistical test results, a significant difference in each dimension of self-efficacy was found between before and after treatment (p < 0.001). When the post test scores between intervention and control were compared, it showed significant different between them (p < 0.001).

Conclusions: Therapeutic regimen education can increase treatment self-efficacy in cancer patients undergoing haemodialysis treatment, which can affect the patient’s healing process.

Keywords: cancer patients, haemodialysis, self-efficacy, therapeutic regimen education

Leadership competencies and managerial competencies of nurse managers in Kuala Lumpur Hospital, Malaysia

Sat, 31 Aug 2024 00:00:00 +0700

Introduction: The roles of nurse managers are crucial to the success of healthcare organizations, requiring specific skills and competencies. Accordingly, nurse managers are expected to possess leadership and management skills. Therefore, it is essential to investigate the relationship between leadership and managerial competencies among hospital nurse managers. This study seeks to determine the impact of three different leadership competencies, namely administrative skill, interpersonal skill, and conceptual skill, on the managerial competencies of nurse managers at Kuala Lumpur Hospital.

Methods: This cross-sectional quantitative study adopted Northouse’s (2019) leadership competencies questionnaires and Mind Tool’s (2018) management skills assessment tool. A total of 247 participants, all of whom were nurse managers at the Kuala Lumpur Hospital, Malaysia, were recruited for this study. Multiple regression analysis was used to test the hypothesis.

Results: The findings revealed that nurse managers at Kuala Lumpur Hospital possessed high levels of all three leadership skills and managerial competencies. However, the only significant predictor of managerial competencies among the respondents is the conceptual skill of leadership (beta = 0.820, p < 0.01).

Conclusions: This study emphasizes conceptual skills (cognitive abilities, analytical reasoning, and decision-making) in predicting managerial competencies among nurse managers. Developing these skills is critical for effective leadership and smooth healthcare organization operations.

Keywords: administrative skill, conceptual skill, interpersonal skill, leadership competencies, mental health

Navigating care: family information needs and responsibilities in the context of schizophrenia caregiving

Sat, 31 Aug 2024 00:00:00 +0700

Introduction: : Families of schizophrenia patients need to obtain information from health services about how to care for them. Limited information and understanding of responsibilities in caring are still obstacles to becoming an empowered family in caring for patients with schizophrenia. The study aimed to explore family needs regarding information from health services and family responsibilities when caring for patients with schizophrenia.

Methods: This study used a descriptive qualitative design. The study involved families who cared for patients with schizophrenia in Surabaya, Indonesia. Twenty participants were obtained using purposive sampling techniques and the sample size was determined by data saturation. Data were collected using in-depth interviews, field notes and interview question guides. The data were processed with content analysis.

Results: The results showed eight themes. Families need information about patient conditions, medication, routine control, and counseling for patient conditions as well as for families. The family describes the responsibilities carried out for the patient as providing support for patient treatment, fulfilling daily needs, helping with social skills, and providing activities in spare time.

Conclusions: Adequate information from health services regarding both the patient's condition and family counseling can help to meet the demands of care, which stimulates families to be more empowered to carry out care responsibilities and has an impact on the ability to care better

Keywords: counseling, empowerment, family, mental disorder, responsibility, schizophrenia

Psychosocial factors affecting the adherence of chronic kidney disease patients to undergo a hemodialysis program: a cross-sectional study

Rondhianto Rondhianto, Murtaqib Murtaqib, Nila Nabila Yonda — Sat, 31 Aug 2024 00:00:00 +0700

Introduction: This study aims to analyze the effect of psychosocial factors on hemodialysis program adherence.

Methods: The study was cross-sectional, with a sample size of 90 respondents, obtained through simple random sampling. The study’s dependent variable was hemodialysis program adherence and the independent variables were knowledge, motivation, coping, depression, perceived family support and health worker support. Data were collected using a questionnaire and analyzed using multiple linear regression.

Results: Most respondents adhered to the hemodialysis program (90%). The level of knowledge, motivation, coping, family support, and health worker support was in the good category (93.3%; 100%; 91.1%; 90%; 88.9%, respectively), and did not experience depression (90%). The independent variables (knowledge, motivation, coping, family support, health worker support) simultaneously significantly affected the dependent variable, namely adherence to the hemodialysis program by 94.5% (R2 = 0.945; F = 236.613; p = 0.001). Partially, the factors of knowledge, motivation, coping, family support, health workers support, and depression also had a significant effect on hemodialysis program adherence (t = 2.234, t = 5.344, t = 3.473, t = -4.190, t = 6.457, t = 4.887, t = 4.190, respectively; p = 0.001).

Conclusions: The study results showed that psychosocial factors (knowledge, motivation, coping, family support, health worker support, and depression) simultaneously or partially influenced the adherence of CKD patients to undergo a hemodialysis program, with the most dominant factor affecting adherence to hemodialysis as perceived family support.

Keywords: Adherence, Hemodialysis, Psychosocial

Spiritual needs throughout childbirth: a cross-sectional study among working women at the largest university in Brunei

Sat, 31 Aug 2024 00:00:00 +0700

Introduction: This study evaluates spiritual needs throughout childbirth of women who are working in higher education setting.

Methods: Healthcare professionals have fundamental roles in ensuring the spiritual needs of women throughout childbirth are met. This concurs with the World Health Organization’s definition of health that holistically comprises of physical/biological, psychological/mental, social and spiritual aspects. This study evaluates spiritual needs throughout childbirth of women who are working in higher education setting.

Results: A total 80 female staff participated in the study. Three out of the five domains of the spiritual needs scale were found to be the most frequently addressed as interpreted from the mean score. These are: “Finding meaning and purpose” 4.2 (0.6) followed by “Religious needs” 4.1 (0.7) and “Seeking peace” 4.0 (0.6). Those aged 40 and above scored 4.3 (0.8), which is significantly higher (P = 0.048) for “Finding meaning and purpose” compared to other age groups. Those who had four or more children had significantly higher spiritual needs for “Finding meaning and purpose” 4.2 (0.6) and “Seeking peace” 4.4 (0.7) compared to those having one to three children.

Conclusions: The findings of this study suggest that spiritual needs are essential during childbirth. “Finding meaning and purpose” and “Seeking peace” were identified to be the most common spiritual needs during childbirth. As women age and have more children, their spiritual needs increase. This study contributes positively toward the improvement of care, particularly spiritual aspects where evidence is scarce.

Keywords: Assessment, Brunei, Childbirth, Women, Spiritual

Experience of transcultural nursing for migrant workers in covid-19 field hospitals: a qualitative study in Samut Sakhon Province, Thailand

Sat, 31 Aug 2024 00:00:00 +0700

Introduction: This study aimed to explore Thai nurses’ experiences of caring for migrant workers with COVID-19 in a field hospital.

Methods: This is a qualitative study. An in-depth interview was used to collect data from nine nurses between May and September 2022. The data were transcribed verbatim and content analysis was performed to analyze the data. Interviews with interpreters and co-workers of participants in the field hospital were used to examine data triangulation.

Results: Three themes described the transcultural nursing experiences of nurses caring for COVID-19 migrant patients: 1) the role of nurses in a field hospital caring for migrant patients with COVID-19, 2) care delivery through the nursing process, and 3) cultural competence and transcultural nursing approach under mask and personal protective equipment for migrants with COVID-19 in the field hospital.

Conclusions: Nurses' experiences highlighted the crucial role of managing patient care resources, coordinating with other healthcare professionals, and providing direct patient care in various situations in a field hospital. Despite mental and cultural care challenges, nurses still embrace transcultural nursing for migrant patients, addressing cross-cultural communication and basic needs and respecting beliefs related to religion to provide optimal care.

Keywords: transcultural nursing, covid-19 field hospital, migrant workers, migrant patients

Changes in paternal perinatal depression and its predictors from third trimester of pregnancy to one-year post-partum: a longitudinal study

Kumiko Kido, Akemi Mitani, Yuko Uemura — Sat, 31 Aug 2024 00:00:00 +0700

Introduction: Paternal depression is not as widely recognized as maternal depression. Studies in Japan have examined the factors associated with paternal depression, but these have been limited to specific regions rather than conducted on a nationwide scale. This study aimed to examine changes in paternal perinatal depression from the last trimester of pregnancy to one year postpartum. Additionally, we explored the relationship between paternal perinatal depression and fathers' feelings toward their infants.

Methods: This study used a longitudinal design. We initially planned to collect data from over 384 cases based on sample size calculations, and successfully collected data from 494 men in the first survey. However, more than half of the participants dropped out in the second and subsequent surveys, resulting in 201 men completing the longitudinal survey over a one-year period.

Results: The mean Edinburgh Postnatal Depression Scale, Japanese version (EPDS-J) score in the last trimester of pregnancy was 9.274 (95% confidence interval [CI] 8.413-10.134), which was the highest throughout the study period. The mean EPDS-J score was lowest at 3-5 months postpartum, with a score of 7.682 (95% CI 6.816-8.547). At all time points, occupational stress and partner relationships were associated with EPDS-J scores.

Conclusions: Reducing paternal perinatal depression requires controlling for occupational stress and maintaining good marital relationships. The findings suggest that addressing work-life balance is crucial for Japanese fathers to enhance their whole-family well-being.

Keywords: fathers, marital relationship, occupational stress, perinatal depression

Determinants of parents’ readiness for face-to-face learning among elementary school children during the new normal

Sat, 31 Aug 2024 00:00:00 +0700

Introduction: This study aimed to identify factors influencing the readiness of parents with elementary school-age children for face-to-face learning using the Health Promotion Model (HPM).

Methods: This was a cross-sectional study. The study population consisted of parents of elementary school students in Surabaya. A purposive sampling method was used to select 395 respondents. The independent variables included motivation, parental knowledge, perceived benefits, perceptions of barriers, self-efficacy, interpersonal factors, situational factors, and commitment. The dependent variable was parental behavior in face-to-face learning readiness. Data were collected using a validated and reliable questionnaire. Data analysis was conducted using a logistic regression test, with a significance level of α ≤ 0.05.

Results: Most parents were 37 years old, and children in the 5th grade of elementary school. Most of the parents' motivation was in the sufficient category (57%). The parents’ knowledge of COVID-19 was good (66.8%). Most parents had a good perception of benefits (68.4%), and the perception of barriers was sufficient (59.7%). Good self-efficacy was observed in only 49% of cases, and interpersonal and situational factors accounted for 99.7% and 100%, respectively. Meanwhile, regarding parental readiness for face-to-face learning, the majority exhibited good behavior (96.2%). The factors that influenced parental behavior in face-to-face learning readiness were parental knowledge (0.010), perceived benefits (0.019), and commitment (0.029).

Conclusions: Good knowledge, perceived benefits, and parental commitment are factors that influence parents' readiness to participate in face-to-face learning.

Keywords: COVID-19, face-to-face learning, good health and well-being, Health promotion model (HPM), parents

Factors influencing modern contraceptive usage among women aged 15-49 years: a cross-sectional study

Hawri Yaba Mohammed-Amen, Suhailah Mohammed Ali — Sat, 31 Aug 2024 00:00:00 +0700

Introduction: This study aimed to examine the factors that influence modern contraceptive use among married women of reproductive age in Kirkuk City, Iraq.

Methods: A cross-sectional study was conducted to gather data from a convenience sample of 500 married women of reproductive age attending family planning units at 10 healthcare facilities, Azadi, Kirkuk Teaching Hospital, and private gynecological and obstetric clinics. Data were collected using a structured questionnaire from October 1st, 2023, to February 1st, 2024. The statistical analysis involved descriptive and inferential techniques.

Results: The prevalence of contraceptive use among participants was 74.6%, with about (21%) reporting condom use and (16.0%) withdrawal usage. However, intrauterine devices were reported in (12.6%). Side effects were significantly (p<0.001) associated with contraceptive method choices, with 52% of the users experiencing adverse effects. External pressures to have additional children or become pregnant significantly (p=0.037) influenced contraceptive method choices. There were fewer modern contraceptive methods due to unsafety (30.9%), discomfort (23.6%), and side effects, such as headache (18%), weight gain (16%), and irregular bleeding (14%).

Conclusions: Modern contraceptive use is affected by healthcare, safety, side effects, reproductive health, and personal choices. Providing complete knowledge and access to modern contraceptives helps couples make informed reproductive health decisions, empowers women to regulate their fertility, supports their personal and reproductive objectives, and promotes their health and well-being.

Keywords: birth control, childbearing age, Iraq, modern contraceptive, side effects

Self-efficacy in increasing physical activity of coronary heart disease patients: a cross-sectional study

Sat, 31 Aug 2024 00:00:00 +0700

Introduction: This study aimed to determine the association of physical activity and self-efficacy in patients with coronary heart disease.

Methods: A cross-sectional study was conducted among outpatients of coronary heart disease at a cardiovascular center. A total of 238 coronary heart disease patients were included in the study using a purposive sampling technique. The self-efficacy was measured using the cardiac self-efficacy scales (CSE), and the physical activity was measured using the long form International Physical Activity Questionnaire (IPAQ). Data analysis used the Chi-square test, Spearman correlation test and multivariate linear regression.

Results: Self-efficacy was strongly positively correlated with physical activity in coronary heart disease patients (r = 0.956; p = 0.001). Domain-specific correlations included domestic (r=0.419, p<0.001), work (r=0.383, p<0.001), leisure time (r=0.296, p<0.001), and transport (r=0.247, p<0.001). Multiple linear regression analysis showed that employment status had the most significant negative impact on physical activity (B = -246.477), while age (B = 123. 889) and self-efficacy (B = 93.513) were positively associated with physical activity. These results indicate that higher self-efficacy and older age are linked to increased physical activity, whereas employment status is associated with decreased physical activity.

Conclusions: In this population, self-efficacy, remaining working status and age are important factors of physical activity in coronary heart disease patients.

Keywords: coronary heart disease, good health and well-being, physical activity, self-efficacy

FRONT MATTER VOL 19 ISSUE 3

Admin Jurnal Ners — Sat, 31 Aug 2024 00:00:00 +0700

The landscape of mental health care landscape in asia: issues and challenges

Shawn Yong-Shian Goh — Sat, 31 Aug 2024 00:00:00 +0700

Caregiving experiences among parents of children with physical and intellectual disabilities: a qualitative systematic review

Sat, 31 Aug 2024 00:00:00 +0700

Introduction: This study aimed to identify caregiver experiences encountered by parents of children with physical and intellectual disabilities.

Methods: The study used a systematic review method with the guidelines of Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) and PRISMA 2020. The review focused on parents caring for children with physical and intellectual disabilities. The literature was searched for relevant studies from five electronic databases including PubMed, CINAHL, Web of Science (core collection), Cochrane, and Scopus. This systematic review examined 14 articles out of a total of 63,400 articles found. The study used a thematic analysis method to analyze the study.

Results: Providing care for children with physical and intellectual disabilities requires addressing a variety of challenges. It is critical to have a comprehensive understanding of these intricacies to ensure that families receive the necessary support and interventions. Our synthesis identified seven themes: (1) gendered and emotional experiences, (2) compromising quality of life: physical and psychological impact, (3) lack of knowledge about disabilities, (4) lack of social support, (5) stigma, (6) uncertain future of the recipient, and (7) unavoidable caregiving responsibility.

Conclusions: The results of this study provide recommendations that health professionals and researchers further explore these challenges and strive to build a supportive and inclusive environment that recognizes the unwavering dedication of parents and prioritizes the optimal care and development of children with disabilities.

Keywords: children, disability, parent, qualitative systematic review