Jurnal Keperawatan Komprehensif (JKK)
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Effect of Roleplay Tabletop Disaster Simulation on Flood Preparedness Attitudes Among Junior High School Students
Full text linkBackground: Disaster preparedness training is essential for junior high school children as a vulnerable group to increase awareness and preparedness for disasters. RTDS is an appropriate intervention in improving disaster preparedness.
Objective: This study aims to determine the effect of tabletop roleplay disaster simulation on students\u27 flood disaster preparedness attitude at SMPN 1 Muncar in 2024.
Methods: A pre-experimental one-group pre-test and post-test design was used in this study, involving 30 respondents selected through a purposive sampling technique. A role-playing tabletop disaster simulation was used as the independent variable instrument to measure its effect on students\u27 preparedness attitudes as the dependent variable. To measure the attitude of flood disaster preparedness in junior high school students using a questionnaire on the attitude of student preparedness in facing flood disasters. The questionnaire has been tested for validity and reliability. The data analysis method used is the Wilcoxon test.
Results: The results of the analysis showed that after being given the Roleplay Tabletop Disaster Simulation (RTDS), students\u27 disaster preparedness attitudes increased significantly. Before the intervention, 63.0% of respondents were in the low category, while after the intervention, 87.0% of respondents were in the very high category. Wilcoxon test showed that this difference was significant (P = 0.000 < 0.05), indicating the effect of RTDS on students\u27 disaster preparedness.
Conclusion: RTDS helps students understand safety procedures and improves their adaptability during disaster events
Disaster Preparedness Among Hospital Nurses in a High-Risk Region: A Cross-Sectional Study from Pekalongan, Indonesia
Full text linkBackground: Disaster preparedness is an essential component of healthcare systems, particularly in high-risk regions where healthcare providers, especially nurses, are expected to respond effectively during emergencies. Their readiness depends on sufficient training, knowledge, and confidence to act under pressure.
Objective : This study aimed to assess the level of disaster preparedness among nurses working at RSI PKU Muhammadiyah Pekajangan, a hospital located in a disaster-prone area of Pekalongan, Indonesia.
Methods: A descriptive cross-sectional study design was applied, involving 142 nurses selected through total population sampling. Data were gathered using the Disaster Preparedness Evaluation Tool (DPET), which consists of 28 items covering four core domains. Descriptive statistics were used to analyze demographic information and preparedness levels.
Results: Among the respondents, 69.7% were women, and 60.6% held a Diploma III in Nursing. The majority (62.0%) were assigned to inpatient care units. Participants had an average of 10.09 years of professional experience, ranging from 1 to 34 years. Preparedness levels were classified as moderate in 64.1% of nurses and good in 35.9%; no respondents fell into the low-preparedness category.
Conclusion: Most nurses demonstrated a moderate level of disaster preparedness, regardless of their educational background or years of experience. To enhance hospital readiness, it is recommended that continuous training, simulation exercises, and regular evaluations be integrated into institutional disaster management strategies
Longitudinal Mixed-Methods Study: Impact of Social Determinants on Maternal Health Access among Women with Disabilities (Urban vs. Rural)
No full textBackground: Women with disabilities face persistent inequities in accessing maternal health services, despite legal guarantees of inclusive care. Evidence suggests amplified barriers in rural settings; however, longitudinal data capturing temporal changes and women’s lived experiences remain limited. This study investigated how social determinants shape maternal health access among women with disabilities in urban versus rural settings in Indonesia.
Methods: A longitudinal mixed-methods design was applied across two sites in West Java: Bekasi City (urban) and Garut District (rural). A total of 300 women with physical, sensory, or mild intellectual disabilities were followed from early pregnancy to six weeks postpartum. Quantitative data were collected at three time points and analyzed using Generalized Estimating Equations and multilevel logistic regression. Concurrently, 35 participants were purposively recruited for in-depth interviews and focus group discussions, analyzed thematically with NVivo. Data were integrated through triangulation and convergence to explain disparities across the maternal healthcare continuum.
Results: Significant urban–rural inequities were found. Urban participants demonstrated higher utilization of ≥4 ANC visits (from 62% to 84%), facility-based deliveries (91%), and postnatal care (77%) than rural participants (ANC from 39% to 56%; delivery 68%; postnatal 52%) (p < 0.05). Key determinants of access included maternal education (AOR = 1.46; 95% CI 1.18–1.81), health insurance (AOR = 1.50; 95% CI 1.20–1.87), family support, economic status, and transportation accessibility. Six qualitative themes revealed reinforcing relational and emotional dynamics: structural barriers, stigma and discrimination, family role, digital divide, coping strategies, and emotional experiences.
Conclusion: Women with disabilities experience compounded inequities in maternal healthcare access, particularly in rural areas, driven by intersecting structural, socioeconomic, and relational determinants. Improving accessibility, enhancing disability-sensitive and stigma-free care, and strengthening digital and community support systems are essential to achieve equitable maternal services. Findings inform a new integrative framework for inclusive maternal health, guiding targeted policy and health system interventions in Indonesia and similar low-resource contexts
Development of an AI-Based Clinical Decision Support System for Standardized Nursing Diagnoses in Indonesia
No full textBackground: The implementation of the Indonesian Nursing Diagnosis Standards (IDHS) in clinical practice continues to encounter obstacles, including limited time for assessment, documentation burden, and inconsistency in diagnostic interpretation among nurses. Advancements in artificial intelligence (AI) offer opportunities to design clinical decision support systems that may enhance the accuracy, uniformity, and efficiency of nursing diagnoses.
Objective: This study aimed to explore nurses’ experiences, challenges, and expectations regarding the use of IDHS and to assess the initial feasibility of developing an AI-based system to support standardized nursing diagnoses.
Methods: A descriptive qualitative design was employed using in-depth interviews with five nurses from diverse clinical settings, including emergency, critical care, inpatient, outpatient, and community services. Thematic analysis was conducted to identify perceptions and needs related to IDHS and AI. Content validity of the preliminary system design was evaluated by three expert validators using the Item-Level Content Validity Index (I-CVI) and the Scale-Level Content Validity Index/Average (S-CVI/Ave).
Results: Five major themes emerged: (1) varied experiences in formulating nursing diagnoses, (2) inconsistent use of IDHS in practice, (3) challenges related to documentation and diagnostic interpretation, (4) positive attitudes toward AI integration in clinical workflows, and (5) the need for features such as automated diagnostic suggestions, clarification of clinical criteria, and integration with electronic medical records. Content validity testing demonstrated strong agreement among experts, with I-CVI values ranging from 0.80 to 1.00 and an S-CVI/Ave of 0.92.
Conclusion: The study indicates that integrating AI into the IDHS-based diagnostic process holds substantial potential to improve diagnostic quality, standardization, and clinical efficiency. The content validity results support further development and prototype testing in subsequent research phase
Factors Influencing Excessive Daytime Sleepiness among Undergraduate Nursing Students: A Cross-Sectional Study from North Sulawesi, Indonesia
Full text linkBackground: Excessive daytime sleepiness (EDS) is a common yet underrecognized concern among nursing students, potentially impairing academic performance and clinical readiness. Identifying factors associated with EDS is essential to inform preventive strategies and promote optimal student functioning.
Objective: This study aimed to identify the factors influencing EDS among undergraduate nursing students in North Sulawesi, Indonesia.
Methods: A descriptive correlational, cross-sectional design was employed. This study involved 101 students from a university in North Sulawesi Province, Indonesia, selected through consecutive sampling. Data were collected using the Epworth Sleepiness Scale (ESS) and analyzed using descriptive statistics, the Mann–Whitney U test, Kruskal–Wallis H test, Spearman’s correlation, and multiple linear regression.
Results: The mean ESS score was 12.98 (SD=4.07), with 71 respondents (70.3%) classified as experiencing EDS. Caffeine consumption (B=3.458, β=0.295, 95% CI [1.232, 5.684], p=0.003) significantly predicted EDS, accounting for 14.9% of the variance.
Conclusion: These findings highlight the need to address modifiable lifestyle factors, particularly caffeine intake, to reduce EDS among nursing students. Nurse educators and academic institutions should implement sleep health education and promote healthy coping strategies to mitigate daytime sleepiness. Early intervention may enhance students’ academic performance and clinical competence, ultimately improving patient safety and quality of care in future nursing practice
Factors Associated with Depression in Elderly Patients with Hypertension
No full textBackground: Depression in elderly individuals with hypertension is a common but often underdiagnosed mental health issue that affects quality of life and treatment adherence. This study aimed to identify factors associated with depression in elderly patients with hypertension.
Design : A descriptive correlational study with a cross-sectional design was conducted.
Methods : This study involved 68 community-dwelling elderly patients with hypertension in a village of North Sulawesi selected through total sampling. Data were collected using structured questionnaires covering sociodemographic and clinical characteristics and the Geriatric Depression Scale-15 (GDS-15). Data were analyzed using the Mann-Whitney U test, Kruskal-Wallis H test, and Spearman’s rank correlation.
Results : The mean depression score was 9.43 (SD = 1.79), with nearly half of participants experiencing moderate depression (48.5%). Only the duration of hypertension was significantly correlated with depression score (r = 0.275, p = 0.023).
Conclusions : These findings highlight the need for routine depression screening among elderly hypertensive patients, particularly those with a longer history of illness. Clinical implications include adopting integrated care models that combine hypertension management with psychosocial support in primary care setting
Gethok Tular: A Source of Self-Care Knowledge for Older Women with Hypertension in Rural Areas
No full textAims: This study explores the role of gethok tular (oral tradition) in promoting self-care management among elderly Javanese women with hypertension in rural areas, where access to health information remains limited despite existing education programs.
Methods: This study employed a qualitative ethnographic approach conducted between January and June 2022. Data were collected through in-depth interviews and observations involving five elderly women in Ngrawan Village, Semarang Regency. To ensure triangulation, additional insights were gathered from midwives and posbindu (integrated healthcare posts for non-communicable diseases) cadres. The participants were Javanese women aged 60 years or older, born and residing in Ngrawan Village, diagnosed with hypertension for more than two years, and actively participating in posbindu activities. Content analysis was used to interpret the data.
Results: Gethok tular facilitates the informal exchange of hypertension-related knowledge, particularly during interactions at posbindu sessions. Despite limited understanding of hypertension, participants practiced self-care by staying active, attending check-ups, and using herbal remedies like soursop and avocado leaves to manage symptoms.
Conclusion: The gethok tular tradition offers a culturally relevant method for disseminating health information and improving self-care practices in rural communities. This approach holds potential for integration into community-based health programs
Experience of Cardiovascular Care Unit (CVCU) Nurses in Implementing Person Centered Care
No full textBackground: Nurses in the Cardiovascular Care Unit (CVCU) have a key role in delivering Person Centered Care (PCC), which focuses on respecting patient preferences and improving care quality. Despite its importance, the implementation of PCC still faces several challenges in clinical practice.
Objective: This study aimed to explore the experiences of CVCU nurses in implementing Person Centered Care in a hospital setting.
Method: A qualitative research design with a phenomenological approach was used. Six nurses working in the CVCU were selected through purposive sampling. Data were collected using semi-structured interviews and analyzed through thematic analysis based on Colaizzi’s method.
Results: The study identified five main themes: (1) Satisfaction with nursing care, (2) Involvement of patients and families, (3) Communication and collaboration between nurses and doctors, (4) Suboptimal communication patterns between nurses and patients, and (5) Time management and workload.
Discussion: The findings indicate that PCC contributes to greater satisfaction in nursing care delivery. However, several barriers, such as limited communication and workload issues, need to be addressed. These insights can inform strategies for broader PCC implementation across different hospital wards. Hospital management should support this process by addressing potential obstacles and facilitating a supportive environment for PCC
Enhancing Maternal Understanding of Infant Immunization Through Intensive and Discovery-Based Approaches: A Quasi-Experimental Study
No full textBackground: Children\u27s health issues are one of the government\u27s priorities in creating a quality generation. One effort to achieve this goal is that all children under five are given immunization. The challenge in implementing the immunization program which causes the immunization coverage target to not be achieved is the low level of knowledge. So the role of Health workers is to provide information using demonstration methods and discovery methods.
Objectives : To determine the effectiveness of the demonstration method and discovery method on mothers\u27 knowledge about the completeness of basic immunization for babies in the working area of the Cibadak District.
Method: This research used quasi-experimental research with a sample size of 36 people. Data techniques include univariate analysis using frequency distribution and bivariate analysis using paired t test.
Result: The results of this study show that there is an influence of health education methods and findings on maternal knowledge about the completeness of basic immunization, p value 0.000.
Conclusions and Suggestions: Providing education using discovery is more effective than demonstration in increasing mothers\u27 knowledge about basic immunization. It is hoped that the provision of education can be implemented to increase mothers\u27 knowledge of basic immunization
The Effect of Motivational Interviewing on Adolescent Life Skill Toward Risky Behaviors in Indonesia: A Queasy Experimental Design
No full textBackground: Adolescents are vulnerable to engaging in risky behaviors that compromise their health. Motivational interviewing (MI) is a brief intervention that can promote positive behavior changes.
Objectives: This study aimed to examine the effect of MI on adolescent life skills related to risky behavior prevention in Indonesia.
Methods: A quasi-experimental design with a pre-test/post-test control group was conducted between April and May 2021. The intervention group received five weekly MI counseling sessions (30–45 minutes each). Life skills were assessed using the Life Skill Training Questionnaire for High School Students (LSTQ-HS). An ANCOVA test was used to compare post-intervention scores between groups, controlling for baseline differences.
Results: The intervention group’s total life skills score significantly increased from 94.57 (SD=14.06) to 117.80 (SD=4.71) (p<0.001). Significant improvements were also observed across refusal skills, assertiveness, relaxation, and self-control (p<0.05). ANCOVA analysis confirmed a significant difference between the intervention and control groups post-intervention (F=94.82, p<0.001).
Conclusions: Motivational interviewing effectively enhanced adolescents\u27 life skills related to risky behavior prevention. Integrating MI into school-based life skills programs may support adolescent health. Future studies with rigorous designs and larger sample sizes are recommended to strengthen these findings