Jurnal Keperawatan Padjadjaran
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The effect of an empowerment program on knowledge and cancer cervical screening participation among reproductive age women in Indonesia: A randomized clinical trial
No full textBackground: Cervical cancer in Indonesia is the second leading cause of death and a significant health burden, largely due to low screening coverage. Indonesia faces challenges in developing women's health due to a lack of information, studies, weak relationship between research, management, planning, and service provision, and limited resources and expertise. This study aimed to examine the effect of an empowerment-based educational intervention on improving knowledge and participation in cervical cancer screening among women of reproductive age in Indonesia.
Methods: A randomized clinical trial was conducted in Jakarta, Indonesia, from February to July 2023, involving 150 eligible women. Participants were allocated to intervention or control groups using block randomization (block size = 4) with a 1:1 ratio. The intervention group received a three-week empowerment program consisting of six educational sessions. Outcomes, including cervical cancer knowledge and screening participation, were measured at baseline and eight weeks post-intervention. Data were analyzed using t-tests, chi-square tests, and linear regression. Risk ratios and differences were estimated using marginal standardization. Analyses followed the intention-to-treat principle, with blinding applied during data analysis.
Results: A randomized study with 80 participants showed an improvement in knowledge about cervical cancer and cancer cervical screening participation at 8 weeks. The intervention group showed a mean difference of 3.91 (1.38) and 4.24 (0.45) p<0.05. More participants in the intervention group reached Minimal Clinically Important Differences (MCIDs) in knowledge about cervical cancer and cancer cervical screening participation than in the control group, with a relative risk of 2.34 (95% CI=1.08-4.36) and 2.57 (95% CI=1.21-4.90), respectively.
Conclusion: An empowerment program significantly enhances knowledge and participation in cancer cervical screening among reproductive age women in Indonesia after intervention, but further studies are needed to determine its long-term impact
Perceived stress and anxiety in government employees during remote work arrangements : A correlation study
No full textBackground: The transition to remote work has significantly reshaped workplace structures, posing unique challenges for employees. Government workers, accustomed to face-to-face interactions, faced substantial adjustments when transitioning to remote arrangements, leading to concerns about their mental health, particularly stress and anxiety.
Purpose: This study examines perceived levels of stress and anxiety among government employees in remote work arrangements and investigates the relationship between these mental health outcomes and socio-demographic factors.
Methods: A descriptive correlational study design was employed, targeting 257 government employees from 11 PhilHealth offices in the National Capital Region. Stratified random sampling recruited 173 employees completing an online self-administered survey. The Perceived Stress Scale (PSS-10) and Generalized Anxiety Disorder Assessment (GAD-7) tools were used to measure stress and anxiety levels. Descriptive statistics and Chi-Square tests were applied for data analysis.
Results: Most respondents (96.32%) reported moderate stress levels (mean PSS score = 19.51), while nearly half (49.69%) exhibited mild anxiety (mean GAD-7 score = 6.83). Severe stress and anxiety were minimal, at 3.07% and 0.61%, respectively. No significant correlations were identified between socio-demographic factors and mental health outcomes.
Conclusions: The study highlights moderate stress and mild anxiety levels among government employees during remote work. Findings emphasize the importance of mental health support and structured remote work policies to address workplace stress during periods of significant organizational change
Self-care education based on local wisdom to improve glycemic control and self-efficacy in type 2 diabetes
No full textIntroduction: Effective management of type 2 diabetes mellitus (T2DM) requires structured self-care education supported by family and cultural context. In Bali, health-related decisions are often influenced by patrilineal households where male family members act as primary decision-makers. This study evaluated a self-care education program based on Balinese local wisdom to improve glycemic control and self-efficacy among T2DM patients.
Methods: A quasi-experimental design with pre- and post-tests and a control group was conducted at Community Health Center in Bali, Indonesia from June to September 2024. .Seventy patients with T2DM living in patrilineal households were purposively recruited and randomly allocated into intervention (n=35) and control (n=35) groups.. The intervention consisted of twelve weekly sessions of culturally tailored self-care education covering diet, physical activity, monitoring, medication, and foot care, with active involvement of male household decision-makers. Outcome measures included self-efficacy (Diabetes Management Self-Efficacy Scale), HbA1C, and systolic/diastolic blood pressure, analyzed using t-tests.
Results: After 12 weeks, the intervention group demonstrated significant improvements compared to controls: self-efficacy (mean difference: 8.37, p<0.001), systolic blood pressure (-4.51 mmHg, p<0.001), diastolic blood pressure (-2.74 mmHg, p<0.001), and HbA1C (-0.61%, p<0.001). Although the HbA1C reduction was modest, it indicates a meaningful step toward better glycemic control.
Conclusion: A 12-week culturally tailored self-care education program involving patrilineal family members improved self-efficacy and glycemic control in T2DM patients. These findings highlight the importance of integrating local wisdom and family involvement into diabetes education to enhance patient empowerment and adherence
Interprofessional clinical simulation in enhancing patient centered care competency among Indonesian nursing students: A mixed methods design
No full textBackgrounds: Nursing clinical simulations to improve patient centered care (PCC) competency are currently often limited to nursing students. Interprofessional clinical simulations are designed to improve PCC competency by involving students from various health professions, including medicine, physiotherapy, nutrition, and medical laboratory technology.
Purpose: This study aimed to identify the effect of interprofessional clinical simulation on patient centered care competency.
Method: This research used a convergent parallel mixed methods design. The quantitative study involved 50 respondents, and the qualitative study involved 9 participants. Two case scenarios were given in the simulation. The instrument was used patient centered care competency scale. Quantitative data were analyzed using the Wilcoxon test, qualitative data using thematic analysis, and the two data sets were integrated using a joint display table.
Result: Quantitative results showed a significant effect of the interprofessional clinical simulation in enhancing PCC competency (p<0.001). Qualitative findings identified four themes and fourteen subthemes. The themes are valuing and honoring the patient's viewpoint, ensuring patients are fully engaged in their treatment plan, addressing the patient's discomfort for peace and well being and protecting the patient's rights and needs. The integration of the two data showed that the quantitative research results converged with the qualitative research results.
Conclusion: The results of the increase in PCC competency scores converged with most themes and subthemes from nursing student’s experiences
Factors associated with type 2 diabetes mellitus in older adults living in Coastal Areas: Implications for community nursing practice
No full textBackground: Indonesia’s growing older adult population is experiencing a rising burden of type 2 diabetes mellitus (T2DM). Coastal populations face unique risks, including limited health service access, dependence on fisheries-based livelihoods, and dietary patterns high in salt and low in fresh produce. These factors may heighten vulnerability to T2DM, yet remain underexplored.
Purpose: This study aimed to examine determinants of T2DM among older adults living in a coastal community.
Methods: A cross-sectional study was conducted with 86 older adults selected using purposive sampling between October 30 and December 14, 2024. Data were collected using demographic questionnaires, the Mini Nutritional Assessment (MNA), the Geriatric Depression Scale (GDS), and the Physical Activity Scale for the Elderly (PASE). Chi-square tests assessed associations between independent variables and T2DM, and variables with p < 0.25 were entered into multivariable logistic regression to identify significant predictors.
Results: Comorbidity (p < 0.001), nutritional status (p = 0.001), physical activity (p < 0.001), and depression (p < 0.001) were significantly associated with T2DM. In multivariable analysis, lower physical activity emerged as the strongest predictor (OR = 4.13, 95% CI: 1.18–14.48; Wald = 4.92; p = 0.027). Comorbidity (OR = 3.61), depression (OR = 3.64), and nutritional status (OR = 3.28) also remained significant independent factors.
Conclusions: T2DM among older adults in coastal areas was more likely in those with comorbidities, depressive symptoms, altered nutritional status, and especially low physical activity. These findings highlight the need for community-based nursing interventions emphasizing physical activity promotion, nutritional counseling, and depression screening to mitigate T2DM risk in vulnerable coastal population
Alcohol use and sociodemographic risk factors for severe intimate partner violence among women in Timor-Leste
No full textBackground: Intimate partner violence (IPV) remains a significant public health concern in Timor-Leste, with sociocultural norms, economic disparities, and partner behaviors contributing to its prevalence. Understanding the associated risk factors is crucial for informing prevention strategies.
Purpose: This study aimed to examine sociodemographic and behavioral factors associated with severe IPV among women in Timor-Leste
Methods: A cross-sectional analysis was conducted using data from 3,694 women aged 15–49 years who participated in the 2016 Timor-Leste Demographic and Health Survey (DHS). The outcome variable was self-reported severe IPV. Independent variables included age, marital status, education, household wealth index, place of residence, geographic region, and husband/partner’s alcohol consumption. Weighted logistic regression models were used to calculate crude and adjusted odds ratios (COR, AOR) with 95% confidence intervals (CI).
Results: Severe IPV was significantly associated with being aged 25–34 (AOR = 1.74; 95% CI: 1.19–2.52), being unmarried/widowed/divorced (AOR = 2.56; 95% CI: 1.33–4.92), and having a partner who consumed alcohol (AOR = 2.41; 95% CI: 1.85–3.11). Higher education and better economic status were protective against IPV.
Conclusions: Alcohol consumption by partners, lower education levels, and economic disadvantage are key risk factors for severe IPV in Timor-Leste. Policies targeting alcohol reduction, women’s empowerment, and tailored regional interventions are essential to mitigate IPV and its health impact
The effect of awake prone position in non-intubated patients with COVID-19: A feasibility randomized controlled trial
No full textIntroduction: The duration of discomfort and clinical benefits of lying prone in Indonesian clinical settings remain unknown, with the accumulation of prone hours potentially impacting results. The study aimed to test the effect of awake prone position in non-intubated patients with covid-19.
Methods: This study used a feasibility randomized control trial. The research was conducted at two general hospitals in Jakarta, Indonesia. This study used a computerized random number generator was used to assign patients to intervention and control groups. The sample is adult patients who admitted to the hospital with hypoxic respiratory failure due to a positive COVID-19 test. A total of 70 patients were randomly assigned to each group, with 35 individuals being included in the analysis. The intervention involved bed-side nurses encouraging patients to lie prone for at least 6 hours daily, with additional pillows provided for comfort. Significant prone position sessions were recorded if they lasted more than 30 minutes in both arms, lasting for 7 days.
Results: The intervention group of patients achieved 65.7% adherence to the intervention protocol. After 2 hours, the P/F ratio was significantly different across the groups, but no significant different between intervention and control group, in term of respiratory escalation, length of stay, or mortality. However, 5.7% of patients in intervention group and 11.4% of patients in control group died due to respiratory failure.
Conclusions: Clinical trial conditions have shown that non-intubated patients can be placed in an awake prone position without harm, and this information could be used to help design protocols for future large randomized controlled trials
Milk-sharing experiences: Perspective among Malaysian donors and rexipient mothers
No full textBackground: Shared breastmilk has been a longstanding tradition in many cultures throughout history through wet nursing, cross nursing, and the donation of expressed breastmilk to a milk bank. However, social media has introduced some new dynamics to this practice, making it more visible and accessible; and it is known as milk-sharing. Research on milk sharing is still in its infancy and focused on western perspectives. Therefore, the sociocultural dimensions of milk sharing have not been adequately explored across different settings and cultures.
Purpose: This qualitative study aims at understanding the milk-sharing experiences among donor and recipient mothers in Malaysia.
Methods: We conducted a social media analysis on milk-sharing postings from four Facebook Groups Pages. This was followed by a detailed exploration of individual experiences throughout the milk-sharing journey using a semi-structured, online interview with thirty mothers. Thematic analysis was applied in the data analysis process using ATLAS.ti 9 software.
Results: A total of 252 postings were retrieved from four Facebook Groups Pages. Of these, 151 postings referred to donating milk, 70 referred to requesting milk, and 31 focused on issues related to milk-sharing. Thirty mothers with various milk-sharing experiences were involved in this study. Fifteen donors, six recipients, and nine fell into both categories. The mothers in the study had an average age of 32.9 years and the majority were Malay. In terms of their relationship with the infants, 93.3% were biological mothers with the majority having two to five children. Thematic analysis identified five themes: 1) point of reference, 2) communication platform, 3) altruism for mutual benefit, 4) faith and 5) challenges and problem-solving methods.
Conclusions: Milk sharing is a personal and sociocultural-bounded practice where mothers negotiate their understanding of the need to breastfeed and the use of donated breastmilk. Despite its specific focus on the Malaysian context, this research offers a complementary understanding of milk sharing within a non-Western framework and transferable to similar sociocultural backgrounds. The findings are important for intercultural nursing and midwifery practice, where nurses can incorporate sociocultural perspectives into breastmilk donation initiatives to increase public acceptance
Triage in disasters: A conceptual analysis
No full textBackground: Disaster triage faces significant challenges due to definitional conflicts and ambiguities. Conducting a concept analysis of disaster triage is essential for clarifying its meaning, improving decision-making, ensuring effective training, and enhancing disaster preparedness for healthcare professionals. Thus, this study aims to define the concept of disaster triage and identify its attributes, antecedents, and consequences using Walker and Avant's framework.
Method: The methodology involved a comprehensive literature review from 2013 to 2024, focusing on nurse-related triage during emergencies and disasters. Articles were gathered from databases such as Web of Science, PubMed, Scopus, Cochrane Library, and Google Scholar. After screening the titles, abstracts, and full texts, 30 articles met the inclusion criteria.
Result: Following Walker and Avant's framework, the concept analysis revealed that disaster triage is influenced by various antecedents, attributes, and consequences. Antecedents such as education, working experience, and disaster training provide the foundation for effective triage practices, while attributes such as clinical judgment, assessment skills, and effective communication are crucial in the triage process itself. The consequences of effective disaster triage include enhanced patient safety and care delivery efficiency.
Conclusion: In conclusion, this study provides valuable insights that deepen the understanding of the concept of disaster triage and also provides valuable guidance for clinical practice and informs future research in the fields of disaster management and emergency nursing
Impact social rehabilitation program on quality of life of inmates with illicit drug use
No full textBackground: Inmates with illicit drug use have experienced various problems that affect their Quality of Life (QoL). The social rehabilitation program is expected to improve their QoL. Studies investigating the impact of social rehabilitation programs on QoL of inmates with drug abuse are limited.
Purpose: This study aims to describe the differences in the QoL of inmates with illicit drug use at the 0, 3rd, and 6th months of the program and to know the program's effectiveness in three Indonesian prisons.
Methods: This study used a secondary data analysis of comparison study with pre-post program intervention for inmates with illicit drugs in Indonesian Prisons by analyzing inmates' QoL. The instrument used the World Health Organization Quality of Life-BREF (WHOQOL-BREF). This study consists of documents from 400 male and 92 female inmates with illicit drug use who fully participate in social rehabilitation programs in three prisons. Data were analyzed by measuring the frequency and mean of QoL in the 0, 3rd, and 6th months using the One-Way Anova and the Kruskal Wallis to evaluate the program's effect on the QoL.
Results: The average QoL in physical, psychological, social relationship, and environment domains increased from the 0, to 3rd, and 6th months of the program. The rehabilitation program was effective in improving QoL (p<0.001) in Prisons A and C, but it was found no significant effect on QoL in Prison B (p=0.069).
Conclusions: The rehabilitation program was potentially effective in improving the QoL of inmates with illicit drug use. It is important for related parties to further evaluate the supporting and inhibiting factors that affect the QoL in the social rehabilitation program and overcome these inhibiting factors