Jurnal Keperawatan Komprehensif (JKK)
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Effectiveness and User Satisfaction of an ePRO-Based mHealth Application for Near Miss Reporting and Patient Safety Culture in the ICU
No full textBackground: Near miss reporting and patient safety culture are critical to quality improvement in intensive care units (ICUs), yet conventional reporting systems are often constrained by underreporting, delayed submission, and limited feedback. Mobile health (mHealth) applications integrated with electronic patient-reported outcomes (ePRO) offer a promising approach to facilitate real-time reporting and strengthen safety culture in high-risk clinical environments.
Objective: This study evaluated the effectiveness and user satisfaction of an ePRO-based mHealth application in improving near miss reporting and patient safety culture in ICU settings.
Methods: A mixed-methods study was conducted in the ICU of a level B hospital in Karawang, Indonesia, involving 250 healthcare workers, primarily nurses. The intervention was implemented over six months using a user-centered design approach. Outcomes included near miss reporting rates, reporting timeliness, and Hospital Survey on Patient Safety Culture (HSOPSC) scores. Quantitative data were analyzed using paired t-tests and multiple linear regression, while user satisfaction and implementation experiences were explored using the System Usability Scale (SUS) and focus group discussions.
Results: Near miss reporting increased 2.3-fold after implementation, and timely reporting within one hour rose from 21.4% to 68% (p < 0.001). Significant improvements were observed in patient safety culture domains, particularly non-punitive response to error and communication openness. User satisfaction was high, with a mean SUS score of 82.3. Technical challenges and initial staff resistance were identified as key barriers.
Conclusion: The ePRO-based mHealth application significantly improved near miss reporting, enhanced patient safety culture, and demonstrated high usability in ICU settings. Despite technical and cultural challenges, the intervention aligns with the WHO Global Patient Safety Action Plan 2021–2030 and underscores the importance of integrating digital innovation with safety culture initiatives in resource-limited healthcare system
Effectiveness of Ergonomic Training in Reducing Musculoskeletal Disorders Among Farmers: An Agricultural Nursing Program
No full textBackground : Musculoskeletal disorders (MSDs) represent a major occupational health concern among agricultural workers in Indonesia. These conditions commonly arise from repetitive workloads, awkward or non-ergonomic body positions, and insufficient understanding of ergonomic practices. As a result, farmers may experience ongoing discomfort, reduced work capacity, and a decline in overall well-being. Objective : The purpose of this study was to assess the effectiveness of an Ergonomics Exercise Program (EEP) in alleviating musculoskeletal complaints among farmers. Methods : This study applied a pre- and post-intervention design involving 85 farmers. Symptoms related to musculoskeletal disorders were evaluated before and after the intervention using the Visual Analog Scale (VAS) and the Nordic Body Map (NBM). The Ergonomics Exercise Program was carried out over a two-week period, with participants performing 10-minute exercise sessions each day prior to starting work. The intervention focused on flexibility training, strengthening of core muscles, and correction of working posture. Changes in MSD symptoms were analyzed statistically to determine the effect of the program. Results : Before the intervention, 54% of participants reported mild pain, while 46% experienced moderate pain levels. The most commonly affected body areas included the calves (62.3%), lower back (45.8%), arms (40%), and shoulders (28.2%). Following the implementation of the Ergonomics Exercise Program, a statistically significant reduction in musculoskeletal complaints was observed (p < 0.05), particularly in the lower back, shoulders, and calves. Conclusion : The findings indicate that the Ergonomics Exercise Program effectively reduced musculoskeletal disorder symptoms among farmers. Incorporating ergonomics-based exercise routines into agricultural nursing and occupational health initiatives may offer a practical and sustainable approach to improving worker health and preventing MSDs in rural farming populations in Indonesia
Think Aloud Testing in Usability Evaluation of the Love Your Breast Application to Enhance Self-Examination Behavior in Adolescents
Full text linkBackground: Adolescents are a key demographic for promoting early breast cancer detection through Self-Breast Examination (SADARI). Mobile health (mHealth) applications offer potential to increase awareness and encourage preventive behaviors, but their effectiveness depends on usability and user experience.
Objective: This study aimed to evaluate the usability of the Love Your Breast mobile application using the Think Aloud method and to identify design improvements to enhance its effectiveness for adolescent users.
Methods: A descriptive qualitative design was employed. Ten female high school students in Bandung participated in Think Aloud usability testing, performing seven task scenarios while verbalizing their thoughts. Quantitative data were analyzed through task success rate calculations, while qualitative data were examined using thematic analysis.
Results: The application achieved an average success rate of 86%. Thematic analysis revealed three main usability themes: (1) general observation—issues with font size, color brightness, and background images; (2) performance expectancy—users could not access the video feature; and (3) effort expectancy—some users experienced slow downloads due to poor internet access. Although the app was considered informative and easy to use, these issues negatively affected the overall user experience.
Conclusion: The Love Your Breast app shows promise as a tool for adolescent breast cancer awareness and early detection. Future updates should address visual consistency, enable offline video access, and improve performance under limited connectivity. These changes will enhance usability and align with user-centered mHealth design principles, supporting its broader adoption in adolescent health promotion
Exploring the Determinants of Multidrug-Resistant Tuberculosis in Pulmonary TB Patients at Jatisari Karawang: A Cross-Sectional Analysis
No full textAims: The aim of this study is to find out what factors contribute to the spread of Multidrug-Resistant Tuberculosis (MDR-TB) at Jatisari Karawang Hospital. It focuses on things like nutrition, patient adherence to treatment, motivation, family support, and how treatment is supervised.
Methods: This study uses a quantitative method with a cross-sectional approach, which looks at the relationship between risk factors and their effects at one time. It involves 249 patients who visited the MDR-TB clinic at Jatisari Regional Hospital in January 2024, with a sample size of 106 patients. The goal is to identify the factors that are linked to MDR-TB at the hospital in 2024.
Result: Most people in the study were under 60, and more males had MDR-TB. Many had poor nutrition (77.4%) and didn’t follow their medication (55.7%). Over half had low motivation (57.5%) and lacked family support (72.6%). About half had poor medication supervision (50.9%). These issues all played a role in the spread of MDR-TB.
Conclusion: In conclusion, most people in the study were under 60, male, had a junior high school education, and were unemployed. The study also found that factors like nutrition, taking medication correctly, motivation, family support, and medication supervision are linked to the spread of MDR-TB
Cancer Care in the Community Setting: A Mixed Method Study
No full textAims: This study evaluated palliative care services in Indonesia, focusing on proposing a community-based model to enhance cancer care.
Method: A mixed-method approach was employed, involving quantitative analysis of 200 patients’ personal and treatment factors and qualitative insights from 21 stakeholders to FGDs and in-depth interviews.
Results: The qualitative results highlight five themes: 1) illness as a subjective and culturally influenced concept, 2) family’s role in treatment decision-making, 3) perceptions of healing through multiple treatment modalities, 4) finding positive meaning in illness, and 5) hopes and aspirations for recovery. The quantitative results show that 55.5% of patients had inadequate knowledge, with 69.5% preferring modern therapy. A significant relationship was found between knowledge, perception, and treatment options, while no significant correlation was observed with self-confidence or diagnosis date.
Conclusion: An integrated community-based palliative care model tailored to Indonesia’s healthcare system is proposed to improve the quality of life for cancer patients
Health Belief as a Determining Factor in the Behavior of Complementary Therapy use in Cancer Patients Undergoing Treatment
No full textAims: Analyzing the correlation between health beliefs and the behavior of using complementary therapies in cancer patients.
Methods: The study was conducted at the Indonesian Cancer Foundation (YKI) East Java Branch, Surabaya in July 2024 using a correlation design and cross-sectional approach and added interview methods to support quantitative data results. The population of all cancer patients at YKI, 33 patients was obtained according to the inclusion criteria. The instruments used were the Health Belief Questionnaire, and the Scale for Attitudes Towards Complementary and Alternative Medicine (SACAM), and continued by in deep interview to support the quantitative data.
Results: Mean of health belief score was 77.88 + 11.467 (good health belief category), and mean of the behavior of using complementary therapies was 42.48 + 8.758 (neutral behavior category). The results of the Kendal Tau test (p < 0.05) showed a significant correlation between health beliefs and behavior of using complementary therapies (p-value = 0.000).
Conclusions: Health beliefs are an important factor for cancer survivors in determining their decision-making behavior regarding medical treatment and complementary treatments
Rehabilitative Exercise Strategies for Urinary Incontinence After TURP: A Quasi-Experimental Evaluation of Kegel and Bridging Techniques
No full textBackground: Urinary incontinence (UI) is a common issue following Transurethral Resection of the Prostate (TURP). Pelvic Floor Muscle Training (PFMT), including Kegel and Bridging exercises, is a promising non-pharmacological intervention for managing UI.
Objective: This study aimed to evaluate the effectiveness of Pelvic Floor Muscle Training, combining Kegel and Bridging exercises, in reducing urinary incontinence among post-TURP patients, and to identify factors associated with UI severity.
Methods: A quasi-experimental pre-posttest design was employed involving 44 male patients who had undergone TURP. Participants were allocated into an intervention group (n = 22), which received six sessions of PFMT over three weeks, and a control group (n = 22), which received standard care. UI severity was measured using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) before and after the intervention. Data were analyzed using paired t-tests and regression analysis.
Results: The intervention group demonstrated a significant reduction in UI scores from 15.50 (SD = 2.50) to 7.41 (SD = 4.12) (p = 0.0001), whereas the control group exhibited only minor improvement. Regression analysis identified age and body mass index (BMI) as significant predictors of UI severity (p = 0.037 and p = 0.041, respectively).
Conclusion: Pelvic Floor Muscle Training effectively decreases urinary incontinence severity following TURP surgery. Integrating PFMT into routine postoperative nursing care may enhance patient outcomes and facilitate recovery. Future research should explore long-term adherence and outcomes associated with PFMT in diverse patient populations
Cross-Cultural Adaptation, Validation, and Reliability of the Indonesian Version of Kidney Disease and Quality of Life (The KDQOL-SF™ v1.3) Instrument
No full textBackground: The Kidney Disease and Quality of Life Short Form (KDQOL-SF™ v1.3) was specifically developed to assess quality of life in individuals with kidney disease, including those not yet requiring dialysis. With the increasing burden of chronic kidney disease (CKD) in Indonesia, there is a need for culturally adapted and psychometrically sound instruments.
Objective: This study aimed to adapt, validate, and evaluate the reliability of the Indonesian version of the KDQOL-SF™ v1.3 among hemodialysis patients.
Methods: The KDQOL-SF™ v1.3 was adapted for cultural use by following international guidelines, including forward and backward translation, expert review, and interviews with patients. A total of 190 hemodialysis patients took part in the study. Construct validity was tested using factor analysis, and convergent validity was checked by comparing it with the EQ-5D-5L quality of life scale. Differences in scores between early-stage CKD patients and those on hemodialysis were used to test known-groups validity. Reliability was measured through internal consistency (Cronbach’s alpha) and a two-week test–retest method.
Results: Of the 225 patients invited, 190 (84.4%) completed the survey. The content validity index (CVI) ranged from 0.73 to 1.00 across items. Exploratory factor analysis revealed factor loadings between 0.501 and 0.872, supporting construct validity. Significant correlations between the KDQOL-SF™ v1.3 domain scores and EQ-5D-5L measures confirmed convergent validity. Known-groups validity was demonstrated by significantly lower scores in physical function, role-physical, mental health, general health, pain, and fatigue domains among hemodialysis patients compared to those with earlier-stage CKD (p < 0.05). Cronbach’s alpha values ranged from 0.710 to 0.883 across domains, indicating good internal consistency, while test-retest reliability coefficients ranged from 0.702 to 0.852.
Conclusion: The Indonesian version of the KDQOL-SF™ v1.3 is a valid and reliable tool to measure quality of life in hemodialysis patients. It can be used in both clinical practice and research to support patient-centered care and track outcomes. Future research should look at how well the tool detects changes in health and whether it works for patients with other stages of CK
Knowledge of Disease Management and Complication Prevention Among Type 2 Diabetes Mellitus Patients in Tangerang District
No full textBackground: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder with increasing prevalence. Patients\u27 knowledge about T2DM is very important to prevent complications and improve quality of life.
Objectives: The aim of this study is to assess the level of knowledge of patients with T2DM at Puskesmas Curug. Methods: The design of the study used a cross-sectional quantitative method with purposive sampling, and included 142 patients with T2DM who visited the Curug Health Center in February-April 2025. Data were collected using the Diabetes Knowledge Questionnaire (DKQ) consists of 24 items on three dimensions: baseline information, glycaemic control, and complications prevention.
Results: Results showed that 66.9% of patients had low level of knowledge, with most female respondents (69%).
Conclusions: The study concluded that the level of knowledge of patients with T2DM at Puskesmas Curug is still low. Specific educational programs need to be planned and implemented among the population for improvement in knowledge and disease management. Further research is recommended to explore factors influencing patient knowledge in order to make training interventions more effective
Effectiveness of Ginger Aromatherapy on Blood Pressure Among Hypertensive Patients in a Community Health Center in Indonesia: A Quasi-Experimental Study
Full text linkBackground: Hypertension is a disease caused by several factors including genetic factors, physical changes, unhealthy lifestyles, the presence of certain medical conditions. One way to manage hypertension in a non-pharmacological way is using aromatherapy.
Objective: This research was conducted to determine the effect of ginger aromatherapy on blood pressure in hypertensive patients at the Ngemplak II Health Center, Sleman Regency.
Methods: The research design used was quasy experimental design with a non-equivalent control pre-posttest design approach. The study population was all hypertensive patients who conducted examinations at the Ngemplak II Health Center, Sleman Regency. The number of samples in this study were 50 respondents who were divided into 2 groups, namely 25 intervention groups and 25 control groups taken by purposive sampling technique. The intervention group was given ginger aromatherapy with a duration of 30 minutes per day for 3 days using a diffuser, while the control group only measured blood pressure on the first day and the third day.
Results: The results showed that a small proportion of hypertensive patients were elderly (38%), mostly female (64%), and mostly worked as farmers (52%). Data analysed using the Mann-Whitney test showed that there was a significant difference in mean systolic blood pressure between the intervention and control groups (p value <0.001), however, between the intervention group and the control group, there is no significant difference in diastolic blood pressure(p = 0.460).
Conclusion: Ginger aromatherapy has been proven effective as a non-pharmacological therapy for controlling blood pressure in hypertensive patients. Further research with a more accurate design and stricter control of confounding factors is recommended to follow up on the results of this stud