Jurnal Keperawatan Komprehensif (JKK)
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Quality of Nursing Work Life (QNWL): A Scoping Review of Concepts, Determinants, and Outcomes
No full textBackground: Quality of Nursing Work Life (QNWL) is increasingly recognized as a critical determinant of nurses’ well-being, retention, and performance. However, heterogeneity in conceptualization, measurement, and methodological approaches limits comparability and practical application.
Objective: This scoping review aimed to map and synthesize contemporary evidence on QNWL, focusing on its definitions, measurement instruments, determinants, outcomes, and research gaps.
Methods: A scoping review was conducted following the Joanna Briggs Institute (JBI) methodological framework and reported in accordance with PRISMA-ScR. Searches were performed in PubMed/MEDLINE, Scopus, Web of Science, CINAHL, and PsycINFO for studies published in English between January 2019 and February 2025. Google Scholar (first 200 results, sorted by relevance) and reference list screening were used as supplementary sources. Eligibility was defined using the Population–Concept–Context (PCC) framework. Data were charted descriptively and synthesized narratively. Methodological appraisal using JBI tools was conducted to describe study quality, not to exclude evidence.
Results: Fifteen studies met inclusion criteria, encompassing cross-sectional surveys, psychometric validation studies, and contextual reviews from diverse geographic settings. The Brooks Quality of Nursing Work Life scale and the Work-Related Quality of Life instrument were most frequently used, reflecting continued conceptual heterogeneity. Key determinants of QNWL included leadership quality, workload, staffing adequacy, and organizational climate. Higher QNWL was consistently associated with greater job satisfaction, organizational commitment, and intention to stay, whereas lower QNWL was linked to burnout and turnover intention. Most studies were cross-sectional, limiting causal inference.
Conclusions: QNWL is a multidimensional, context-sensitive construct shaped primarily by organizational and leadership factors. While evidence consistently links QNWL with workforce stability and well-being, methodological limitations and conceptual variability remain. Future research should prioritize longitudinal and interventional designs, standardized measurement, and broader contextual coverage to inform sustainable nursing workforce policie
The Effect of Student-Centered Learning using the Make a Match Model on Students’ Knowledge in the Nursing Management and Patient Safety Course Among Second-Year Undergraduate Program
No full textBackground: Active learning strategies are essential to improve nursing students’ understanding of Nursing Management and Patient Safety, which are critical for preventing adverse events in clinical practice. Student Centered Learning (SCL) using the Make a Match model is an interactive cooperative learning approach that promotes active engagement and conceptual understanding. However, evidence regarding its effectiveness in improving nursing students’ knowledge remains limited.
Objective: This study aimed to determine the effect of Student Centered Learning using the Make a Match model on students’ knowledge in the Nursing Management and Patient Safety course among second-year undergraduate nursing students.
Methods: A pre-experimental one-group pretest–posttest design was conducted involving 69 second-year undergraduate nursing students at STIKes Dharma Husada, selected through purposive sampling. Students’ knowledge was assessed using a 34-item patient safety knowledge questionnaire developed by Dhewa (2017). All enrolled participants completed both the pretest and posttest. Data normality of the pre–post difference scores was confirmed, justifying the use of a paired t-test. Statistical analysis was performed at a 0.05 significance level. Effect size was calculated using Cohen’s d, and 95% confidence intervals were estimated.
Results: Prior to the intervention, most students demonstrated a moderate level of knowledge (63.8%). After the implementation of the Make a Match learning model, the majority of students achieved a good level of knowledge (91.3%). The paired t-test showed a statistically significant increase in knowledge following the intervention (p = 0.001), with a large effect size and a 95% confidence interval indicating a meaningful educational impact.
Conclusion: Student Centered Learning using the Make a Match model is effective in significantly improving nursing students’ knowledge in the Nursing Management and Patient Safety course. This approach may be considered as an alternative instructional strategy to enhance learning outcomes in nursing education
Hand-Held Fan Therapy and Changes in Respiratory Parameters in Hospitalized Patients with Congestive Heart Failure: A Nursing Case Series
No full textBackground: Congestive heart failure (CHF) is a progressive clinical syndrome characterized by impaired cardiac function and reduced ability to meet metabolic demands. Dyspnea is one of the most frequent symptoms and is commonly identified in nursing practice as an ineffective breathing pattern. Supportive non-pharmacological interventions may assist in relieving respiratory distress. Hand-held fan therapy delivers airflow to the facial area and has been suggested as a simple method to reduce breathlessness.
Objective: To describe changes in respiratory rate and oxygen saturation among patients with CHF following the application of hand-held fan therapy as part of inpatient nursing care.
Methods: A descriptive case series was conducted using the nursing process framework. Three hospitalized CHF patients with ineffective breathing patterns were observed in a cardiovascular ward at RSUD Koja Hospital, North Jakarta. Hand-held fan therapy was applied for approximately five minutes per session. Respiratory rate and oxygen saturation were monitored before and after the intervention period.
Results: All patients showed tachypnea at baseline (28 breaths/min). After repeated application of hand-held fan therapy, respiratory rates decreased consistently to 22 breaths/min. Oxygen saturation improved modestly from 93–94% to approximately 95%.
Conclusion: Hand-held fan therapy was associated with improved breathing patterns and oxygenation in patients with CHF. This intervention may be considered a supportive nursing strategy for managing dyspne
Adolescents’ Narratives of Trauma, Violence, and Identity Development: A descriptive–exploratory approach
No full textBackground: Past traumatic experiences are associated with psychosocial challenges and mental health outcomes. In nursing practice, trauma particularly sexual violence may have long-term psychological effects that shape individuals’ well-being and self-perception, including aspects of identity. Concurrently, sexual orientation diversity has become increasingly visible within Indonesian society, underscoring the need for trauma-informed, non-judgmental nursing care that supports psychological health without pathologizing sexual orientation
Objective: This study aims to explore adolescents lived experiences of trauma and violent behavior and how these experiences influence their perceptions and understanding of sexual orientation.
Methods: This qualitative study used a descriptive–exploratory approach. Data were collected through in depth interviews with 6 informants selected using snowball sampling. Data analysis was conducted using the Colaizzi’s method to identify emerging themes from participants lived experiences
Results: Participants described past traumatic experiences, including loss of loved ones, parental separation, sexual violence, and perceived lack of parental support, as important contexts shaping their psychological well-being, interpersonal relationships, and self-understanding during adolescence. These findings reflect participants’ personal perceptions and lived experiences rather than causal changes in sexual orientation.
Conclusion: This study highlights adolescents’ narratives of how traumatic experiences inform their psychosocial well-being and identity-related reflections. The findings underscore the importance of trauma-informed, non-pathologizing nursing care that acknowledges adolescents’ lived experiences and supports holistic psychological developmen
Emotional Mental Health Among Adolescents: A Profiling Psychosocial Risk Distribution
No full textBackground: Adolescents are a vulnerable population to emotional and mental health problems due to rapid biological, psychological, and social changes. National surveys have reported increasing levels of anxiety, loneliness, and behavioral problems among adolescents; however, local evidence describing the distribution of adolescent emotional and mental health problems remains limited, particularly in school settings.
Objective: This study aimed to describe the distribution and profile of emotional and mental health problems among adolescents based on school-based psychosocial screening in Bandung Regency, Indonesia.
Methods: A descriptive quantitative study with a cross-sectional design was conducted involving 1,304 adolescents who participated in a school-based mental health screening program in 2025. Emotional and behavioral problems were assessed using the Strengths and Difficulties Questionnaire (SDQ), covering five domains: emotional symptoms, conduct problems, hyperactivity, peer relationship problems, and prosocial behavior. Data were analyzed descriptively using frequencies and percentages.
Results: Most adolescents were classified as normal in the domains of emotional symptoms (67.9%), conduct problems (67.2%), hyperactivity (81.8%), and prosocial behavior (57.8%). However, a relatively high proportion of abnormal scores was observed in peer relationship problems (27.1%) and emotional symptoms (20.6%). Based on the total difficulties score, 3.4% of adolescents were categorized as abnormal, indicating the presence of a psychosocial risk burden within the adolescent population. These findings suggest that peer relationship difficulties and emotional problems constitute prominent areas of concern.
Conclusion: This study provides a descriptive overview of emotional and mental health problems among adolescents identified through school-based psychosocial screening. The findings underscore the potential role of routine screening in supporting early identification of adolescents at risk of psychosocial difficulties. Further evaluative and longitudinal studies are needed to assess the effectiveness of screening programs and related interventions in improving adolescent mental health outcome
The Influence of Parental Knowledge and Experience on Behavioral Management in Child Rearing
No full textBackground: Children’s emotional reactions, such as fear or resistance, are strongly influenced by how parents manage their behavior during medical procedures. Effective behavioral management which means parenting practices in managing children’s behavior, plays a crucial role in helping children face medical procedures calmly and cooperatively. Various factors may affect implementation of behavioral management, including knowledge and experience.
Objective: This study aimed to examine the association of parents’ knowledge and experience on the implementation of behavioral management in parenting.
Methods: This study employed a quantitative, non-experimental design. The population consisted of parents whose children received health examinations at the Pediatric Outpatient Clinic, with a total of 70 participants selected using accidental sampling. Data were analyzed using ordinal logistic regression.
Results: Respondents with poor knowledge had a 68% lower likelihood of demonstrating better behavior management compared with those with good knowledge (OR = 0.32; 95% CI: 0.10–0.96; p = 0.05), while moderate knowledge showed a similar but statistically non-significant trend (OR = 0.42; p = 0.09). Respondents with poor experience had a 70% lower likelihood of exhibiting better behavior management (OR = 0.30; 95% CI: 0.09–1.00; p = 0.05), whereas moderate experience was not significantly associated with behavior management (OR = 1.18; p = 0.73).
Conclusion: Parents are expected to apply behavioral management strategies in clinical setting based on knowledge and experience to reduce fear and anxiety in children, such as preparatory communication, distraction techniques, play therapy and collaboration with health care staff
The The Effect of Buerger Allen Exercise on Peripheral Tissue Perfusion in Patients with Type 2 Diabetes Mellitus: A Literature Review
No full textBackground: Type 2 diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia due to impaired insulin secretion and/or insulin resistance. One of the most common long-term complications is impaired peripheral tissue perfusion of the lower extremities, which can progress to diabetic foot ulcers and significantly increase the risk of amputation. Consequently, identifying effective and accessible non-pharmacological interventions to improve peripheral circulation is crucial.
Objective: This literature review aimed to evaluate the effectiveness of Buerger Allen Exercise (BAE) in improving peripheral tissue perfusion among patients with type 2 diabetes mellitus.
Methods: A literature review was conducted using Google Scholar, PubMed, ScienceDirect, ProQuest, and Elsevier databases. Articles published between 2016 and 2024 were identified using the keywords “Buerger Allen Exercise,” “BAE,” “Type 2 Diabetes Mellitus,” “Peripheral Perfusion,” and “Ankle Brachial Index,” combined with Boolean operators “AND” and “OR.” Inclusion criteria comprised intervention studies published in English or Indonesian that reported outcomes related to peripheral perfusion.
Results: Ten studies met the inclusion criteria. Overall, BAE was associated with significant improvements in peripheral perfusion, evidenced by increased Ankle Brachial Index values, improved capillary refill time, enhanced skin temperature and color, strengthened peripheral pulses, and reduced lower extremity pain. Several studies also reported greater benefits when BAE was combined with adjunctive interventions such as vitamin C supplementation, foot spa therapy, or music therapy.
Conclusion: Buerger Allen Exercise is a low-cost, feasible, and evidence-supported non-pharmacological intervention that effectively enhances peripheral tissue perfusion in patients with type 2 diabetes mellitus and may help prevent vascular complications and improve patient well-being
Effect of Intradialytic Resistance Exercise on Restless Legs Syndrome Among Hemodialysis Patients: A Pilot Randomized Controlled Trial
No full textBackground: Restless legs syndrome (RLS) is common and burdensome among patients undergoing hemodialysis (HD). Intradialytic exercise provides a pragmatic opportunity for symptom management; however, evidence on resistance exercise during HD remains limited.
Objective: This pilot study evaluated the effect of intradialytic resistance exercise on RLS severity in adults receiving maintenance HD.
Methods: A two-arm, parallel-group pilot randomized controlled trial was conducted in two HD units (January–April 2025). Adults on thrice-weekly HD for ≥3 months with at least moderate RLS (IRLS ≥11) were randomized 1:1 to intradialytic resistance exercise (IRE) or usual care. The IRE group performed supervised elastic-band exercises during the first 2 hours of HD, three times weekly for 8 weeks. Outcomes were assessed at baseline, week 4, and week 8. The primary outcome was the International Restless Legs Syndrome Scale (IRLS) score, analyzed using mixed-effects models.
Results: Forty-two participants were enrolled (IRE n=21; control n=21), with 90.5% completing the study. A significant group×time interaction was observed (p<0.001). At week 8, the IRE group demonstrated a clinically meaningful reduction in IRLS compared with controls (mean difference −8.4; 95% CI −11.7 to −5.0; Cohen’s d=1.11). Adherence was high and no serious adverse events occurred.
Conclusions: An 8-week intradialytic resistance exercise program was feasible, safe, and effective in significantly reducing RLS severity among HD patients. Larger trials are warranted to confirm long-term benefits and implementation potential
Instrumental Activities of Daily Living and Quality of Life Among Older Adults with Hypertension: A Cross-Sectional Study in Grogol, Indonesia
No full textBackground: Global population aging is accelerating, including in Indonesia, and is accompanied by an increasing burden of chronic conditions such as hypertension. Older adults with hypertension are vulnerable to functional decline, particularly in instrumental activities of daily living (IADL), which may adversely affect their quality of life (QoL). However, empirical evidence examining the relationship between IADL and QoL in primary healthcare settings remains limited.
Objective: This study aimed to examine the association between instrumental activities of daily living and quality of life among older adults with hypertension attending a primary health center.
Methods: A cross-sectional study was conducted involving 382 older adults with hypertension registered at the Grogol Health Center. IADL was assessed using the Lawton Instrumental Activities of Daily Living scale, while QoL was measured using the Kualitas Kehidupan Lansia (KKHL) questionnaire. Descriptive statistics were presented as medians and interquartile ranges (IQRs) due to non-normal data distribution. The association between IADL and QoL was analyzed using Spearman’s rank correlation test.
Results: The median QoL score was 56 (IQR: 50–58), indicating relatively homogeneous quality of life among participants. Most respondents demonstrated functional independence in IADL. A statistically significant but weak positive correlation was found between IADL and QoL (ρ = 0.131; p = 0.010; 95% CI: 0.03–0.23).
Conclusion: Functional independence in IADL was positively associated with QoL among older adults with hypertension, although the strength of the relationship was weak. Other contributing factors should be explored to better understand determinants of QoL in this population
Pomelo (Citrus maxima) Peel Ethanolic Extract Mitigates Isoniazid–Rifampicin–Induced Hepatotoxicity in a Male Wistar Rat Model
No full textBackground: Tuberculosis continues to pose a substantial public health challenge in Indonesia, which currently ranks second worldwide in disease burden. Although first-line antituberculosis drugs such as isoniazid and rifampicin are highly effective, their prolonged use is frequently associated with hepatotoxicity, which may disrupt treatment continuity and compromise patient safety. Identifying adjunctive strategies capable of reducing liver injury during antituberculosis therapy therefore remains an important research priority.
Objective: This study aimed to examine the concurrent hepatoprotective effect of pomelo (Citrus maxima) peel ethanolic extract in a male Wistar rat model exposed to isoniazid–rifampicin–induced liver injury.
Methods: An experimental posttest-only control group design was applied using thirty-two male Wistar rats distributed into five groups: a normal control, a negative control receiving isoniazid and rifampicin, and three treatment groups administered pomelo peel ethanolic extract at doses of 100, 200, and 400 mg/kg body weight. Hepatotoxicity was induced with isoniazid and rifampicin, followed by extract administration two hours after drug exposure from day 4 to day 10. Liver function was assessed by measuring serum alanine aminotransferase (SGPT) and aspartate aminotransferase (SGOT). Phytochemical screening was conducted to identify major secondary metabolites present in the extract.
Results: Phytochemical analysis revealed the presence of flavonoids, tannins, alkaloids, triterpenoids, and quinones in pomelo peel extract. Rats receiving isoniazid–rifampicin exhibited marked elevations in SGPT and SGOT levels compared with the normal control group. Concurrent administration of pomelo peel extract significantly reduced these enzyme levels across all treatment doses relative to the negative control. The 400 mg/kg body weight dose produced the greatest attenuation of hepatic enzyme elevation, indicating a dose-related protective response.
Conclusion: Pomelo (Citrus maxima) peel ethanolic extract demonstrates dose-dependent hepatoprotective activity during concurrent exposure to isoniazid and rifampicin in male Wistar rats. These findings suggest that pomelo peel extract may have potential as a supportive agent to mitigate antituberculosis drug–induced liver injury, although further mechanistic, pharmacokinetic, and clinical investigations are required prior to translational applicatio