Journal title : Journal Of Nursing Practice Initials : JNP Frequency : 4 issues per year (April, July, October and January) DOI : Prefix 10.30994 Print ISSN : 2614-3488 Online ISSN : 2614-3496 Editor-in-chief : Fajar Rinawati Publisher : Universitas STRADA Indonesia in collaboration with PPNI Journal Of Nursing Practice is an international open access journal (e-journal) which publishes the scientific works for nurse practitioners and researchers. The focus and scopes of the journal include Pediatric Nursing, Maternity Nursing, Adult Nursing, Emergency Nursing, Community Nursing, Mental Health Nursing, Management in Nursing, Basic of Nursing and Education in Nursing. The JNP Editorial team welcome and invite researchers from around the world to submit their papers (original research article, systematic review, and case study) for publication in this journal. Submitted papers must be written in English for initial review stage by editors and further review process by minimum two reviewers. Finally, accepted and published papers will be freely accessed in this website and the following abstracting & indexing databases: Directory of Open Access Journals (DOAJ) SINTA GARUDA: Garba Rujukan Digital Google Scholar Dimensions Crossref Search Index Copernicus International (ICI) OCLC Worldcat Indonesia One Search BASE Bielefeld search engine The journal has been listed in LOCKSS Archieving system ROAD ISSN Sherpa/Romeo Policy OAI Address Journal Of Nursing Practice has OAI address : https://thejnp.org/index.php/jnp/oai Before submission, You have to make sure that your paper is prepared using the JNP paper TEMPLATE, has been carefully proofread and polished, and conformed to the Author guidelines. Online Submissions Already have a Username/Password for Journal Of Nursing Practice Informatics? GO TO LOGIN Need a Username/Password? GO TO REGISTRATION Forget your password? Please contact us Registration and login are required to submit items online and to check the status of current submissions.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Diagnostic Accuracy of the Roll Over Test (ROT) and Mean Arterial Pressure (MAP) for Early Detection of Preeclampsia in Pregnant Women
Background: Preeclampsia remains a leading cause of maternal mortality. Early identification of pregnant women at risk is essential to prevent severe maternal and fetal complications. While Mean Arterial Pressure (MAP) and the Roll Over Test (ROT) are used for early detection, there is a need to compare their diagnostic performance in low-resource clinical settings to optimize screening protocols. Purpose: This study aimed to determine the sensitivity and specificity of ROT and MAP in screening for preeclampsia among pregnant women. Methods: This diagnostic observational study used a prospective approach involving 46 pregnant women (gestational age >30 weeks at the Puhjarak Community Health Center, Kediri District. Participants were selected using simple random sampling from a population of 52 eligible pregnant women. Screening was conducted using MAP and ROT, and the occurrence of preeclampsia was evaluated at ≥36 weeks of gestation based on clinical diagnosis. Data were analyzed to calculate sensitivity, specificity, and predictive values. Results: The prevalence of preeclampsia in this study was 17.3%. Both MAP and ROT showed a sensitivity of 75%. However, ROT showed higher specificity (94%) compared to MAP (63%). The PPV for ROT (75%) was also higher than for MAP (30%), Conclusion: There The findings suggest that the ROT may have higher specificity than MAP in screening for preeclampsia. However, further studies with larger samples are needed to confirm these findings.
Copyright (c) 2026 Journal Of Nursing Practice https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Peer Verbal Aggression on Automatic Negative Thoughts in Adolescent Bullying Victims
Background: Adolescence is a crucial period for psychosocial development, with peer acceptance playing a central role. Peer verbal aggression, manifested through threats, offensive language, and insults, can act as a stressor for adolescents. These experiences may shape dysfunctional cognitive schemas. Recurrent and persistent negative thoughts can impact long term psychological development. Purpose: This study aims to analyze the relationship between peer verbal aggression and automatic negative thoughts in adolescent victims of bullying. Methods: This study employed a quantitative design with a cross-sectional approach. The sample consisted of 92 adolescents who were victims of bullying, selected through purposive sampling. Data were collected using a verbal victimization questionnaire adapted from an indicator of the Multidimensional Peer Victimization Scale (MPVS) and the Children’s Automatic Thoughts Scale (CATS). Data analysis was performed using the Spearman rank correlation test. Results: Most respondents were adolescents aged 15-17 years (91.3%), with 42.4% experiencing bullying for more than six months. Bivariate analysis revealed a significant correlation between peer verbal violence and automatic negative thoughts (p=0.001), encompassing physical threat (r=0.524), social threat (r=0.788), personal failure (r=0.703), and hostility (r=0.500). This suggests that higher exposure to peer verbal aggression is associated with a higher prevalence of automatic negative thoughts in bullying victims, which can disrupt their cognitive processes. Conclusion: Peer verbal aggression is a strong predictor of automatic negative thoughts in adolescent victims of bullying. The implications of this study underscore the need for psychological interventions, such as cognitive restructuring therapies, to reduce automatic negative thoughts.
The Effectiveness of Buerger Allen Exercise and Hydrotherapy on Changes in Peripheral Blood Circulation and Neuropathic Pain Intensity in Preventing Diabetes Mellitus Complications in the Elderly
Background: Type 2 Diabetes Mellitus (T2DM) is a major health problem in the elderly, often leading to complications, including impaired peripheral circulation, often accompanied by neuropathic pain. Therefore, foot activity therapy, including Buerger Allen exercises and hydrotherapy, is necessary to improve peripheral blood circulation. Purpose: This study aims to prevent complications of T2DM by improving peripheral blood circulation, as indicated by changes in Ankle Brachial Index(ABI) valuesand the intensity of neuropathic pain in the elderly. Methods: This quantitative study used a True Experimental Design with a pretest-posttest control group design. The study was divided into three groups: Buerger Allen exercise, hydrotherapy, and a control group. The sample consisted of 45 elderly individuals with type 2 diabetes mellitus (T2DM), selected using a simple random sampling method. This study was conducted in the Tempe District, Wajo Regency. Data analysis used a paired t-test to determine the effect of the three foot activity therapies. Data were analyzed using SPSS with a significance level of p < 0.05. Results: The study showed that the Buerger Allen exercises and hydrotherapy groups experienced significant changes in ABI valuesand neuropathic pain intensity before and after therapy (p-value 0.000). Meanwhile, the control group showed no significant changes in ABI values or neuropathic pain intensity from the pretest to the posttest (p-value 1.000). Conclusion: It can be concluded that the Buerger Allen exercises and hydrotherapy groups can improve peripheral blood circulation compared to the control group, thereby preventing complications associated with type 2 diabetes in the elderly.
The Effectiveness of Nurses’ Independent Interventions: Benson Relaxation and Five-Finger Hypnosis in Reducing Anxiety among Elderly Individuals in the Service Area of UPT. Puskesmas Lawawoi, Sidenreng Rappang Regency
Background: The growing elderly population has increased concerns regarding geriatric mental health, particularly anxiety disorders. Anxiety in older adults is often associated with declining physical function, chronic illness, social isolation, and reduced social support, which can negatively affect psychological well-being and quality of life (Beard et al., 2016; World Health Organization, 2022). If untreated, anxiety may worsen physical health conditions and reduce functional independence. Non-pharmacological nursing interventions are therefore needed due to their safety and accessibility. The novelty of this study lies in integrating Benson relaxation and five-finger hypnosis as nurse-led complementary interventions to reduce anxiety among community-dwelling elderly individuals. Purpose: This study aimed to analyze the effectiveness of Benson relaxation and five-finger hypnosis in reducing anxiety levels among elderly individuals in the service area of UPT Puskesmas Lawawoi, Sidenreng Rappang Regency, Indonesia. Methods: A quasi-experimental study with a pretest–posttest design was conducted among 54 elderly participants selected through simple random sampling. Participants were assigned to Benson relaxation (n = 27) and five-finger hypnosis (n = 27) groups. Anxiety levels were measured using a standardized instrument and analyzed using paired t-tests. Results: The findings showed a significant reduction in anxiety levels after the interventions (p < .001). This study provides evidence that combining relaxation response therapy with hypnosis-based techniques can effectively reduce anxiety among older adults. Conclusion: Benson relaxation and five-finger hypnosis are effective nurse-led complementary interventions that can be applied in community nursing programs to improve mental health among the elderly.
Effect of Mindfulness-Based Stress Reduction with 40 Hz Music on Anxiety and Quality of Life in Prolanis Patients with Diabetes Mellitus
Background: Anxiety is a common psychological problem experienced by patients with Diabetes Mellitus and can negatively affect disease management and quality of life. Mindfulness-Based Stress Reduction (MBSR) combined with 40 Hz music frequency is that may help reduce anxiety and improve quality of life in patients with chronic diseases. Purpose: This study aimed to analyze the effectiveness of MBSR with 40 Hz music frequency on anxiety and quality of life among Prolanis patients with Diabetes Mellitus. Methods: Study design used a quasi-experimental pretest–posttest control group. The sample consisted of 60 respondents, divided into intervention and control groups. The intervention group received an 8-week MBSR program combined with 40 Hz music frequency, while the control group received standard Prolanis care. Anxiety levels using the DASS-21 questionnaire, and quality of life was assessed using WHOQOL-BREF. Data were analyzed using Wilcoxon and Mann–Whitney tests. Results: The anxiety levels significantly decreased in the intervention group (mean difference = −10.15; p < 0.001), while no significant change was observed in the control group (p > 0.05). In addition, quality of life significantly improved in the intervention group (median increase = +16; p < 0.001), whereas the control group showed only a slight and non-significant improvement (p > 0.05). Conclusion: Mindfulness-Based Stress Reduction combined with 40 Hz music frequency is effective in reducing anxiety and improving quality of life among Prolanis patients with Diabetes Mellitus. This intervention can be integrated into primary healthcare services as a complementary nursing intervention to support holistic diabetes management.
Stroke Rehabilitation Trends: A Bibliometric Analysis
Backround: Stroke is one of the leading causes of irreversible brain damage and functional disability. Purpose: Explore stroke rehabilitation research trends through bibliometric analysis. Methods: Publication searches from 1997 to 2024 were conducted using the Scopus database. Furthermore, the data obtained was analyzed bibliometrically using VOSviewer version 1.6.20. This analysis includes visualization analysis, co-occurrence analysis, and stroke rehabilitation publication trend analysis. Results: The results of the bibliometric analysis identified 247 publications that met the search criteria in the field of stroke rehabilitation trends. The distribution of publications by country shows that the United States dominates with 83 publications (33.6%), followed by China with 29 publications (11.74%), and Canada with 19 publications (7.69%). This distribution pattern indicates that research on stroke rehabilitation trends remains concentrated in developed countries with high research capacity. These findings confirm that stroke rehabilitation is a topic receiving significant academic attention and continues to evolve globally; therefore, further studies on research trends in this field are considered important to provide direction for the development of more effective stroke rehabilitation interventions in the future. Conclusion: this article provides a comprehensive overview of stroke rehabilitation trends.
Cognitive Development in Children Aged 2-3 Years with Stunting in Kediri
Background: In the first 1,000 days of life, children are vulnerable to chronic malnutrition, known as stunting, which impacts cognitive development. An initial survey in Blabak Village, Kediri City, on several stunted children showed language delays, difficulty concentrating, motor delays and understanding commands, which means they tend to experience cognitive disorders. Purpose: The study aim is to analyze the relationship between stunting and cognitive development in children aged 2–3 years. Methods: This research using correlation analytical research design with cross-sectional approach. Sample of 54 children aged 2-3 years, selected using proportionate stratified random sampling. The research was conducted at 6 integrated health service post (posyandu), Blabak Village, Kediri City in September 2024. Stunting as an independent variable, while cognitive development as a dependent variable. Data were analyzed using Spearman rho test. Results: The results of Spearman's rho between stunting and cognitive development in learning and problem solving category, logical thinking, symbolic thinking sequentially have P values of 0.000; 0.000; and 0.005. The correlation coefficient between Stunting and Cognitive Development in Learning and Problem Solving Category, Logical Thinking, Symbolic Thinking sequentially is 0.651; 0.650; 0.374. Conclusion: There is a significant relationship between stunting and cognitive development in learning and problem solving category (strong relationship), logical thinking (strong relationship), symbolic thinking (quite strong relationship).
The Asosociation between Consumptive Behavior and Depresion Levels among Students Enggaging in Online Loan (Pinjol) Service
Background: High consumptive behavior among students can influence their decision to use online loan services, which are often used to meet consumptive needs. Uncontrolled use of online loans can lead to financial stress and trigger psychological disorders. Purpose: This study aims to determine the relationship between consumptive behavior affecting online loans (pinjol) and the depression levels among students Methods: This study uses an analytical observational design with a cross-sectional approach. The study population consists of 256 students. A simple random sampling technique was used with the Slovin formula, resulting in 156 respondents. The independent variable is consumptive behavior affecting online loans (pinjol), measured using a consumptive behavior instrument, while the dependent variable is depression level, measured using a depression level instrument. Data analysis was performed using the chi-square test. Results: The results show that 140 participants (89.7%) exhibit high consumptive behavior affecting online loans (pinjol), while 86 participants (55.2%) have severe depression. The chi-square test results indicate a significant relationship between consumptive behavior affecting online loans (pinjol) and depression levels among students, with a p-value of (0.000) and ρ-value < 0.05. Conclusion: This study indicates that consumptive behavior affecting online loans (pinjol) is a factor influencing depression levels among students. Therefore, it requires attention from lecturers, educators, and students to address this issue.
Predictors of Turnover Intention among Nurses in Private Hospitals: A Cross-Sectional Study Using Logistic Regression Analysis
Background: Turnover intention among nurses remains a critical workforce challenge, particularly in private hospitals where staffing instability directly affects service quality, patient safety, and organizational costs. Despite extensive research, evidence integrating multiple psychosocial work factors within a single multivariate model in the Indonesian private hospital context remains limited. This study addresses this gap by simultaneously examining key determinants of turnover intention and identifying the most influential predictors. Purpose: This study aimed to identify independent predictors associated with turnover intention among nurses in a private hospital setting. Methods: A cross-sectional study was conducted among nurses at a private hospital in Indonesia in 2025. A total of 70 respondents were selected using purposive sampling from a population of 81 nurses. Data were collected using a validated and reliable structured questionnaire. Turnover intention was dichotomized into high and low categories for logistic regression analysis. Data were analyzed using descriptive statistics, bivariate analysis (chi-square), and multivariate logistic regression. Although the sample size was relatively small, the number of predictors included in the final model was limited to ensure model stability. Results: Bivariate analysis showed that work motivation, work stress, burnout, work–life balance, job demands, and job satisfaction were significantly associated with turnover intention (p < 0.05). Multivariate logistic regression identified high work stress (POR = 31.62; 95% CI: 3.65–273.55; p = 0.002), high burnout (POR = 12.35; 95% CI: 1.78–85.58; p = 0.011), and low work motivation (POR = 9.02; 95% CI: 1.24–65.60; p = 0.030) as independent predictors of turnover intention. Conclusion: Turnover intention among nurses is primarily driven by high work stress, burnout, and low work motivation. These findings highlight the need for targeted organizational interventions focusing on stress management, burnout prevention, and motivation enhancement to improve nurse retention in private hospitals.
Differences in the Effectiveness of Video and Booklet Education on Early Detection, Prevention, and Management of Preeclampsia in Pregnant Women among Health Workers
Background: Preeclampsia is one of the leading causes of preventable maternal and fetal deaths in Indonesia if detected early. Lack of understanding about the symptoms, risk factors, and early treatment of preeclampsia remains a challenge at the community level, especially in areas with limited access to information and health services. Purpose: The purpose of this study was to analyze the differences in the effectiveness of video and booklet education on cadres' understanding of early detection, prevention, and management of preeclampsia in pregnant women. Methods: The research design was quasi-experimental, in which the researcher divided the respondents into two groups, namely video intervention and booklet intervention. The research sample consisted of 58 health cadres in Manisrenggo Village, using total sampling technique. The measurement tool used was a questionnaire on understanding early detection, prevention, and management of preeclampsia in pregnant women, which had been tested for validity and reliability. The research media used were videos and booklets. The research analysis was univariate, paired t-test, and independent t-test using SPSS 23. Results: The results showed that the mean score for cadres' understanding before the booklet intervention was 40.17, which increased to 43.41 after the booklet intervention. The p-value was 0.000, indicating that the booklet intervention had an effect on cadres' understanding of early detection, prevention, and management of preeclampsia in pregnant women among health cadres before and after the intervention. Conclusion: There is a difference in the effectiveness of video and booklet education on early detection, prevention, and management of preeclampsia in pregnant women among health cadres. Based on the mean value, video intervention is more effective than booklet intervention.
The Relationship between Bullying Victimization and Academic Achievement among Adolescents in Malang
Background: Adolescents who experience bullying may face various psychological and social consequences that can potentially affect their learning process at school. Being a victim of bullying may lead to fear, discomfort, and decreased learning motivation, which may ultimately influence students' academic achievement. Purpose: This study aimed to examine the relationship between bullying victimization and students’ academic achievement. Methods: The study was conducted in 2019 at SMP Negeri 5 Kepanjen, East Java, Indonesia. This study employed a cross-sectional design with a total sample of 283 respondents selected using purposive sampling based on predetermined criteria. The bullying victim instrument used in this study is a modified version of the Revised Cyber ​​​​Bullying Inventory (RCBI) and the Adolescent Peer Relations Instrument (APRI) to measure bullying victimization and the midterm examination scores to assess students’ academic achievement. Descriptive analysis was conducted to describe the characteristics of bullying victimization and students’ academic achievement, while the correlation analysis was performed using Spearman Rank. Results: The results showed that most respondents experienced low levels of bullying victimization with moderate academic achievement, accounting for 99 respondents (34.9%). The Spearman Rank correlation test indicated a statistically significant but weak negative correlation between bullying victimization and academic achievement (r = −0.174, p = 0.003), indicating that higher exposure to bullying is associated with slightly lower academic performance. Conclusion: The findings indicate that bullying victimization is associated with students’ academic achievement. Therefore, schools are expected to strengthen supervision, create a safe and supportive learning environment, and provide assistance for students who experience bullying in order to minimize its negative impact on the learning process.
Factors Influencing Pre-Hospital Delay in Acute Coronary Syndrome Patients
Background: Acute Coronary Syndrome (ACS) is a major cause of morbidity and mortality worldwide, with delayed hospital presentation contributing to poor outcomes. Pre-hospital delay, defined as the time from symptom onset to seeking definitive care, is influenced by patient, symptom, and system-related factors. Evidence from Indonesia on determinants of such delays remains limited. Purpose: This study aimed to analyze factors associated with pre-hospital delay among ACS patients in the Emergency Department of Dr. Wahidin Sudiro Husodo Regional Hospital, Mojokerto City. Methods: An observational, analytic, cross-sectional study was conducted in 2024, with 70 adult ACS patients recruited through consecutive sampling. Data were collected via standardized questionnaires and medical record review, including demographic, clinical, transportation, attack type, symptom onset timing, health insurance, and ACS knowledge. Bivariate and multivariate logistic regression analyses were performed to identify predictors of pre-hospital delay. Results: The mean age of respondents was 61.67 years, with 60% male and 61.4% lacking knowledge of ACS. Most arrived by private vehicle (87.1%) and experienced a new attack (77.1%). Pre-hospital delay occurred in 77.1% of respondents. Multivariate analysis showed that the type of attack had the highest odds ratio (OR = 5.55) for pre-hospital delay, although not statistically significant (p = 0.115). Transportation, time of onset, and ACS knowledge did not demonstrate significant associations but suggested potential confounding effects. Conclusion: Pre-hospital delay is highly prevalent among ACS patients in this setting. No significant predictors were identified, suggesting delays reflect complex behavioral and system factors. Given the limited sample size, the findings should be interpreted with caution. Improving public awareness and emergency access remains essential.
Phenomenological Study of Occupational Stress among Nurses in the Perinatology Unit at RSUD Dr. Iskak Tulungagung
Aeni, N., Rahmawati, D., & Putri, A. (2024). Neonatal intensive care and nursing challenges in perinatology units. Jurnal Keperawatan Neonatal, 6(1), 45–53. https://doi.org/10.1234/jkn.v6i1.2024. Aurellia, F., & Prihastuty, R. (2022). The development of nursing professionalism in Indonesia in the era of globalization. Jurnal Ilmu Keperawatan Indonesia, 12(2), 101–110. Hangewa, A., Bawotong, J., & Katuuk, M. (2020). Hubungan stres kerja dengan kinerja perawat di rumah sakit. Jurnal Keperawatan Klinik, 4(2), 89–97. Hasbi, M., Fatmawati, A., & Alfira, N. (2019). Faktor-faktor yang berhubungan dengan stres kerja pada perawat. Jurnal Kesehatan Masyarakat, 14(1), 55–62. Kementerian Kesehatan Republik Indonesia. (2023). Profil Kesehatan Indonesia 2022. Jakarta: Kemenkes RI. Labrague, L. J., & De Los Santos, J. A. A. (2020). COVID-19 anxiety among frontline nurses: Predictive role of organizational support, personal resilience, and social support. Journal of Nursing Management, 28(7), 1653–1661. https://doi.org/10.1111/jonm.13121. Maslach, C., & Leiter, M. P. (2016). Understanding the burnout experience: Recent research and its implications. World Psychiatry, 15(2), 103–111. https://doi.org/10.1002/wps.20311. National Library of Medicine. (2024). Occupational stress and mental health outcomes among healthcare workers. Retrieved from https://www.ncbi.nlm.nih.gov. Persatuan Perawat Nasional Indonesia. (2022). Laporan survei stres kerja perawat di Indonesia. Jakarta: PPNI. Rizki Amalya, S., Nugroho, A., & Wulandari, E. (2020). Analisis pelayanan kesehatan di RSUD dr. Iskak Tulungagung sebagai rumah sakit rujukan. Jurnal Administrasi Rumah Sakit Indonesia, 6(3), 210–218. Sulistyawati, D., Handayani, S., & Putra, Y. (2019). Stres kerja dan dampaknya terhadap kualitas pelayanan keperawatan. Jurnal Keperawatan Indonesia, 22(1), 33–40. World Health Organization. (2020). State of the world’s nursing 2020: Investing in education, jobs and leadership. Geneva: WHO.
Health Education Interventions to Improve Cervical Cancer Screening Behavior: A Scoping Review
Background: Cervical cancer is one of the most common cancers and the fourth leading cause of death among women worldwide. Several factors influencing cervical cancer screening behavior include knowledge and attitudes toward screening, relationships between patients and health care providers, and fear of test results. Purpose: This study aimed to identify the provision of health interventions in improving cervical cancer screening behavior. Methods: The method used in this study was a scoping review of 11 selected articles. The findings showed that six articles reported health education using audio visual media, which significantly increased cervical cancer screening behavior. Three articles examined the use of social media, although one study found that social media did not significantly improve screening behavior. In addition, three articles used conventional educational methods and demonstrated significant improvements in cervical cancer screening behavior. Results: Overall, the review indicates that increasing knowledge is a key factor in encouraging women to participate in cervical cancer screening. Conclusion: Adequate understanding can improve awareness, willingness, and ability to undergo screening. Future studies are recommended to compare the effectiveness of various health education media to support their implementation in health services. Nurses, as educators and counselors, have an important role in providing sufficient information and influencing the community regarding the importance of cervical cancer screening.
Non-Pharmacological Management of Sleep Disorders in the Older Adults: The Role of Aromatic Footbath-Hydrotherapy
Background: The increase in physiological symptoms in the elderly has an impact on reducing the quality of sleep. This decrease in sleep quality has an impact on health both physically and psychologically. One of the psychological impacts is depression. Various studies explain that depression can lead to distortion of thoughts, decreased memory, increased risk of suicide, and death. Purpose: The aimed to determine the effectiveness of the complementary therapy, especially aromatic footbath-hydrotherapy in reducing sleep disorders among the elder adults. The potential harming of the study were allergic and foot-wound, however the researcher select the participants based on inclusions and exclusions criteria. Methods: The method used was quasi experiment with pre-post control group. The group was divided into three with the number of respondents, there was 39 elderly consumptions of Sahdu tea, 38 elderly consumptions of "wedhang uwuh", and 30 elderly aromatic footbath hydrotherapy. The inclusions were elderly (>= 55 years old), independent activities, good verbal communication. The exclusions were allergic with the herbal’s composition, severe dementia, and severe cardiovascular disease. The data was located in Candibinangun, Ambarketawang, and Balecatur D.I. Yogyakarta in 2024. The data were scattered abnormally so using non- parametric tests to see the effectiveness of therapy. The questionnaire used PSQI. The one-way ANOVA test was implemented in the study. Results: Based on Wilcoxon test, Sahdu tea had effectively in latency and the total PSQI score; Wedhang Uwuh Javanese Drink had only effectively in sleep disorders, and the latest therapy, aromatic footbath hydrotherapy had effectively in quality, latency, duration, sleep disorder, dysfunctional, and total score of PSQI. One way ANOVA found that aromatic footbath hydrotherapy was most effective in reducing elderly sleep disorders (p: 0.000). Conclusion: Aromatic footbath hydrotherapy (AH) was most effective in reducing elderly sleep disorders. However, the weakness of this study is that researchers cannot control the stability of water temperature during therapy.
Association between Iron Tablet Adherence and Anemia among Adolescent Girls
Background: Anemia in adolescent girls can impair growth and development, and iron tablet supplementation is a key strategy to meet iron requirements beyond dietary intake. In this study, respondents were given four iron tablets over one month, taken once weekly. Purpose: The purpose of this research was to examine the relationship between adherence to iron tablet consumption and the incidence of anemia among students at SMPN 1 Wates. Methods: A correlational analytical design with a cross-sectional approach was used, involving a population of 180 individuals and a sample of 124 participants selected through proportional random sampling. Data were collected using observation sheets to assess adherence to iron tablet consumption and to measure hemoglobin levels, and analyzed using a contingency table statistical test. Results: The results showed that the highest proportion of normal hemoglobin levels occurred in the compliant group (92 individuals, 74.2%), while the highest incidence of anemia was found in the non-compliant group (20 individuals, 22.6%). The chi-square test yielded a p-value of 0.000, which is less than α=0.05, indicating a significant relationship between adherence to iron tablet consumption and the incidence of anemia. Conclusion: In conclusion, regular consumption of iron tablets can help adolescent girls prevent anemia, improve learning ability, and enhance nutritional status and overall health, especially when combined with vitamin C–rich foods or beverages that enhance iron absorption.
Media Documentary Films First Aid for Willpower Enhancement First Aid Burn Case
Background: Burns are one of the injuries that can affect children. Children aged 5-14 years are the age in growth and development to develop gross motor skills that have a high risk of injury. School-age children aged 6 years have higher assumptions about their physical abilities while for ages 7-12 years have limitations in understanding related to personal safety, even though adolescent children should be able to perform first aid. Purpose: to identify students' willpower to giving first aid for burns before the documentary film is screened, to identify students' willpower to giving first aid for burns after the documentary film is screened and analyze the difference on students' willpower to giving first aid for burns before and after screened of the Documentary Film giving first aid for burns. Methods: The study used the quasi experimental method with one group pretest-post test design. The sample of this study was 96 grade eight students of SMPN 1 Kalisat using a simple random sampling technique. Instrument of the research used questionnaire and media audiovisual. The questionnaire used to measure willpower variables. Media audiovisual used documentary film. The duration of the documentary film is 10 minutes and this is shown 3 times for 1 hour. Results: Data analysis using the Mc Nemar test with a P Value of 0.00 means that there is a difference on students' willpower to giving first aid for burns before and after screened documentary films. Conclusion: Before the documentary film was screened, most students hadn't had the willpower to giving first aid for burns, After the documentary film was screened, most students had the willpower to giving first aid for burns, and there was a difference on students' willpower to giving first aid for burns before and after screened documentary films.
Family Caregiving Behavior and its Correlation with Stroke Severity among Patients with Stroke
Background: Stroke is a disease that requires intensive family care. Suboptimal family care can worsen a stroke patient's condition. Purpose: This study aimed to determine family caregiving behaviours, based on the severity of the stroke, at PHC Hospital Surabaya. Methods: The study design employed analytical observation using a cross-sectional method, with a study population of 170 respondents and a sample of 120 selected via simple purposive sampling. The independent variable in this study was family behavior, and the dependent variable was tingkat keparahan pasien stroke. The instruments used were National Institutes of Health Stroke Scale (NIHSS) Questionnaire and the Family Behaviour Questionnaire. Data analysis utilised the Spearman rank test. Results: The results of the study showed that almost half (49.2%) had adequate behavior in caring for stroke patients and nearly half (44.2%) had severe stroke severity with a value of ρ = 0.014 correlation coefficient of 1.000, which means there is a relationship between family behavior in caring for stroke patients and the severity of stroke patients at PHC Hospital Surabaya with a robust correlation. Conclusion: Family caregiving behavior is significantly associated with stroke severity. Improving education and guidance for families of stroke patients is crucial to supporting successful patient care and rehabilitation.
How Demographic and Academic Factors Relate to Critical Thinking Skills among Indonesian Nursing Students
Background: Critical thinking is a core competency for nursing students because it supports clinical judgment, evidence-based practice, and patient safety. However, evidence on critical thinking among nursing students in Indonesia remains limited, and findings on the influence of demographic and academic factors are inconsistent. Purpose: This study aimed to examine the relationship between demographic and academic characteristics and critical thinking levels among Indonesian nursing students. Methods: This cross-sectional study was conducted at the largest private health education institution in Riau Province, Indonesia. Of the 400 eligible students, 365 completed the survey, resulting in an analyzable response rate of 91.3%. Data were collected using the Nursing Critical Thinking in Students Questionnaire (N-CT-4 Students), which consists of 109 items across four dimensions of the 4-Circle Critical Thinking Model. Data were analyzed using descriptive statistics, the Kruskal–Wallis test, and the chi-square test of independence. Results: Nearly half of the respondents had a moderate level of critical thinking (48.2%). Inferential analysis showed that gender (χ² = 7.997; p = 0.018), educational program (χ² = 10.886; p = 0.004), academic year (χ² = 12.352; p = 0.015), and semester level (χ² = 12.352; p = 0.015) were significantly associated with critical thinking level. Age was not significantly associated with critical thinking level (H = 4.398; p = 0.111). Conclusion: Most nursing students demonstrated a moderate level of critical thinking. Critical thinking was associated with gender and academic characteristics, whereas age was not. Nursing educators may strengthen critical thinking through case-based, reflective, and structured clinical learning strategies across the curriculum.
Multilevel Analysis of Socioeconomic and Cultural Factors on Chronic Energy Deficiency among Pregnant Women in Madura
Background: Chronic Energy Deficiency (CED) is one of the health problems that often occurs in pregnant women in various countries, especially in regions with low economic levels and vulnerable communities. Purpose: The purpose of this study is to examine the influence of socioeconomic and cultural contextual factors on the occurrence of CED in pregnant women. Methods: The research design is explanatory research with a cross-sectional approach. The research sample consists of 200 pregnant women with CED and 200 pregnant women without CED in Madura. The dependent variable in this study is the incidence of CED, while the independent variables are regional conditions, access to health services, parity, food availability, and CED preventive behavior. Data analysis in the study is univariate and linear regression with a multilevel approach using SPSS 23. The research ethics certificate 001867/EC/KEPK/I/II/2024. Results: Level 1 is rural and urban areas, access to health services, parity, food availability, and preventive behavior for CED. Level 2 is the subdistrict level. Subdistrict conditions have a contextual influence on the variation in the occurrence of CED in pregnant women, namely significant values in rural and urban areas (p=0.009), significant values in access to health services (p=0.013), significant values for parity (p=0.022), significant values for food availability (p=0.049), and significant values for CED preventive behavior (p=0.029). Conclusion: The highest prevalence of CED was found in coastal areas, followed by villages, and the lowest in cities. Women with low parity (primiparas) are not entirely free from the risk of CED. Conversely, pregnant women in urban areas tend to have better access to health facilities, nutritional information, and a variety of foods, resulting in a relatively lower risk of CED.
The Effect of Bawang Dayak Tea on Sleep Quality in Patients With Type 2 Diabetes Mellitus
Background: Sleep disturbances are common among patients with Type 2 Diabetes Mellitus and are associated with poor metabolic control and reduced quality of life. Effective non-pharmacological and culturally relevant interventions are needed to improve sleep quality in this population. Purpose: This study aims to determine the effect of Bawang Dayak tea on sleep quality in patients with Type 2 Diabetes Mellitus. Methods: A quasi-experimental study with a pretest–posttest control group design was conducted in the working area of Community Health Center Wonorejo, Samarinda, from December 1 to 31, 2025. A total of 50 patients with Type 2 Diabetes Mellitus were assigned to an intervention group or a control group. The intervention received routine diabetes care and Bawang Dayak tea, while the control received routine care alone. Sleep quality was assessed before and after the intervention using a standardized sleep quality questionnaire. Data were analyzed using paired and unpaired statistical tests, with a significance level of < 0.05. Results: Paired analysis revealed a significant improvement in sleep quality in the intervention group following the intervention (p < 0.001), whereas the control group demonstrated a smaller but statistically significant change (p = 0.032). Unpaired analysis revealed that post-intervention sleep quality scores were significantly better in the intervention group compared with the control group (p < 0.001). Conclusion: Bawang Dayak tea significantly improves sleep quality in patients with Type 2 Diabetes Mellitus when used as a complementary intervention in diabetes care, supporting its potential integration into nursing practice for holistic diabetes.
Effect of Positive Affirmation on Breastfeeding Outcomes among Mothers at Risk of Preeclampsia: A Quasi-Experimental Study
Background: Preeclampsia is associated with increased risk of breastfeeding difficulties, including delayed lactogenesis and reduced exclusive breastfeeding. Psychological factors may influence breastfeeding outcomes, and simple psychosocial interventions such as positive affirmations may offer potential benefits. Purpose: To evaluate the effectiveness of a positive-affirmation intervention on breastfeeding outcomes among mothers at risk of preeclampsia. Methods: A quasi-experimental study with a non-equivalent control group design was conducted in Sumenep from November 2025 to January 2026. A total of 98 mothers were recruited using purposive sampling and allocated into intervention (n = 49) and control (n = 49) groups. The intervention consisted of positive affirmations delivered for 10 minutes per session, twice weekly for four weeks. Outcomes included early initiation of breastfeeding, onset of lactogenesis, and exclusive breastfeeding at one month postpartum. Data were analyzed using independent t-tests and Chi-square tests. Effect sizes were reported as odds ratios (OR) with 95% confidence intervals (CI), and multivariate logistic regression was performed to control for confounders. Results: The intervention group showed a higher rate of successful early initiation of breastfeeding (77.6% vs 55.1%; OR = 2.82; 95% CI: 1.20–6.62; p = 0.018), earlier onset of lactogenesis (42.3 ± 10.5 vs 50.8 ± 12.1 hours; mean difference = −8.5 hours; 95% CI: −13.2 to −3.8; p = 0.001), and higher exclusive breastfeeding rates at one month postpartum (71.4% vs 51.0%; OR = 2.40; 95% CI: 1.08–5.33; p = 0.038). After adjustment, the intervention remained significantly associated with improved breastfeeding outcomes (adjusted OR = 2.40; 95% CI: 1.10–5.50; p = 0.030). Conclusion: Positive-affirmation intervention is associated with improved breastfeeding outcomes among mothers at risk of preeclampsia. Given its simplicity and feasibility, this intervention may be integrated into postpartum care to support breastfeeding practices in high-risk populations.
Integrating the Early Warning Scoring System (EWSS) into Nursing Students’ Assessment to Enhance Critical Thinking and Optimize Patient Care in Inpatient Settings
Background: High-quality nursing care begins with an accurate and comprehensive patient assessment. The Early Warning Scoring System (EWSS) is a vital tool in inpatient units for monitoring vital signs and detecting early signs of clinical deterioration, enabling timely intervention. However, field observations indicate that nursing students often lack a practical understanding and the ability to apply EWSS, leading to passivity and uncertainty in clinical decision-making. Therefore, the development of EWSS-based initial assessments within nursing care reports is essential to enhance students' critical thinking and rational intelligence in clinical practice.Purpose: This study aims to develop and implement an EWSS-based initial assessment model that enables students to integrate assessment findings, scoring values, and appropriate clinical interventions. Through the interpretation of EWSS scores, students are expected to improve their clinical reasoning and decision-making skills within inpatient nursing services.Methods: This study employed a comparative analytical quantitative design. The research was conducted in the inpatient wards of a hospital in East Java. The population consisted of all nursing profession students (Ners) undergoing clinical practice in 2024, with a total sample size of 28 respondents. The independent variable was the nursing care report integrated with EWSS indicators, while the dependent variable was the students' rational intelligence in clinical decision-making related to EWSS outcomes. Data were collected using initial assessment observation sheets supplemented with EWSS. Statistical analysis was performed using the Wilcoxon test to determine differences before and after the intervention.Results: The integration of EWSS parameters into nursing students' assessment instruments significantly improved their ability to accurately interpret patients' clinical conditions and guided them in determining interventions, thereby enhancing rational intelligence. Conclusion: Early exposure to EWSS among students ultimately supports the creation of safer (patient safety) and more effective nursing care across all clinical practice settings.
Mental Health Self-Movement through Group Activity Therapy to Improve Self-Leadership in People with Mental Disorders
Background: Decreased self-leadership in individuals with mental disorders is a common consequence of psychological impairment and requires serious attention. A preliminary study conducted at Mental Health Center in Bangkalan revealed reduced motivation, limited communication skills, and difficulties in establishing social relationships among patients. Purpose: This study aimed to analyze differences in self-leadership among patients before and after receiving Group Activity Therapy. Methods: This study employed a pre-test–post-test experimental design with a control group. The population consisted of individuals with mental disorders, with a total sample of 34 participants, divided into a control group (n = 17) and an intervention group (n = 17), selected using purposive sampling. The independent variable was Group Activity Therapy, while the dependent variable was self-leadership. Data were collected using a self-leadership observation sheet. Statistical analysis was conducted using the Paired t-test and Mann–Whitney test with a significance level of α = 0.05. Results: The intervention group showed a significant improvement in self-leadership (p < 0.001), while the control group also demonstrated a smaller but significant change (p = 0.041). A significant difference between groups was found (p < 0.001), indicating that Group Activity Therapy had a positive effect on improving self-leadership. Conclusion: Group Activity Therapy is effective in enhancing self-leadership among individuals with mental disorders. Continuous implementation of this therapy is recommended to support recovery and improve patient outcomes.
Social Support for Parents of Children with Disabilities: A Scoping Review
Background: Raising children with disabilities can be a heavy burden for families which ultimately has a negative impact on the child. Many studies recommend the need for social support for parents. Although the need for social support has been widely reported, the impact of social support for parents with disabilities children in the literature is very diverse. Purpose: This study aims to map and synthesize the existing evidence on the impact of social support for parents of children with disabilities, particularly in identifying its effects on parents, families, and children, as well as to provide a comprehensive understanding that can inform future interventions and support strategies. Methods: Therefore, a scoping review was conducted to identify the impact of social support for parents of children with special needs in international studies. A comprehensive search strategy was employed across multiple electronic databases, including PubMed, Taylor and Francis, Wiley Online library, dan Google Scholar. Results: The database search identified a total of 423 potentially relevant articles. After screening titles and abstracts, 28 potentially relevant articles were identified. All 28 articles were assessed at full-text level, resulting in 10 relevant articles for analysisTen studies were included in the review, from which positive impacts of social support for parents with disability children were identified on parents themselves, families, and children. The positive impacts of social support on parents were increasing resilience, coping skill, parenting efficacy, parenting mental health literacy and decreasing psychological distress and depression-anxiety symptoms. The impacts for parents are also buffering effect on parenteral stress-depression, parenteral stress-efficacy and parents’ satisfaction, positive affect, and depression. The positive impacts on the family increasing family psychological health and family quality of life, and decreasing family burden. Social support is also buffering the effect on family burden-psychological health and resilience. The positive impacts on children are decreasing the emotional and behavioural problem, Conclusion: Social support for parents of children with disabilities has many positive impacts on the parents themselves, the family, and the child. Through identifying the benefits of social support, direction can be provided for interventions by enabling professionals to detect and address available social support.