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.
The Relationship between Pregnant Women's Knowledge and Attitude with the Implementation of the Delivery Planning and Complication Prevention Program (P4K) in the Work Area of the Grogol Community Health Center, Kediri Regency
Background: The Birth Planning and Complication Prevention Programme (P4K) aims to improve access to and the quality of maternal and newborn health services by promoting birth preparedness and preventing pregnancy-related complications. Purpose: Maternal knowledge and attitudes are important factors influencing the implementation of P4K. A preliminary survey conducted at Puskesmas Grogol found that P4K coverage had not achieved the expected target and that 70% of ten interviewed pregnant women were unaware of the P4K programme. Methods: This study employed a correlational design with a cross-sectional approach. The study included 42 third-trimester pregnant women selected using simple random sampling. Data were collected using structured questionnaires and analysed using Spearman's rank correlation test. Results: Of the 42 respondents, 54.8% had good knowledge of P4K, while 52.4% had moderately positive attitudes toward the programme. Spearman's rank correlation analysis showed a statistically significant relationship between maternal knowledge and P4K implementation (p = 0.002) and between maternal attitudes and P4K implementation (p = 0.032). Both p-values were less than 0.05. Conclusion: Maternal knowledge and attitudes were significantly associated with the implementation of the Birth Planning and Complication Prevention Programme (P4K). These findings suggest that improving maternal knowledge and fostering positive attitudes may enhance P4K implementation, thereby supporting better birth preparedness and maternal health services.
Copyright (c) 2026 Journal Of Nursing Practice https://creativecommons.org/licenses/by-nc-sa/4.0
Associations of Reproductive Health Knowledge and Attitudes with Menstrual Hygiene Behaviors among Adolescent Girls at Al Muflihun Islamic Boarding School, Malang
Background: Adolescents' emotional responses to menarche tend to vary, including anxiety, confusion, and embarrassment, often linked to their knowledge. Lack of knowledge about reproductive health can influence adolescents’ attitudes and behaviors during menstruation. For example, inadequate menstrual hygiene practices may lead to various health issues. Purpose: This study aimed to examine whether reproductive health knowledge predicts adolescents' attitudes and menstrual hygiene behaviors, and whether attitudes predict menstrual hygiene behaviors among female students at Al Muflihun Islamic Boarding School in Malang. Methods: This study used a cross-sectional design with an analytic observational approach. A total of 48 female students aged 10–17 years were selected through total sampling. Data were collected using structured questionnaires and analyzed using regression-based path analysis. Results: Results showed that 68.8% of respondents had good knowledge, 25.0% had moderate knowledge, and 6.3% had poor knowledge. Additionally, all respondents (100%) demonstrated positive attitudes and good behaviors in dealing with menstruation. Regression-based path analysis using continuous questionnaire scores showed that reproductive health knowledge significantly predicted attitude (β=0.675; p=0.000) and behavior (β=0.334; p=0.032), while attitude also predicted behavior (β=0.392; p=0.013). Conclusion: These findings support Lawrence Green’s theory, which states that predisposing factors such as knowledge and attitude affect health behavior. Therefore, more intensive and continuous reproductive health education in schools can improve awareness and menstrual hygiene practices among adolescent girls.
Differences in Stress Levels Due to Dental Pain based on Age Group in the Working Area of Jelbuk Jember Health Center
Background: Stress caused by dental pain is a common but overlooked issue affecting all age groups. The health profile of Jember Regency in 2023 recorded that there were 94,439 cases of dental problems occurred in Jember Regency, with Jelbuk District ranking third in caries prevalence. This is exacerbated by the low number of visits to dentists in Jelbuk District, resulting in toothaches not being treated immediately, which can cause serious problems in the form of stress. Purpose: This study was conducted to determine differences in stress levels due to dental pain based on age groups in the working area of Jelbuk Jember Health Center. Methods: The methodology used in this study was observational analytic with a cross-sectional approach involving 120 people consisting of children, adolescents, adults, and the elderly selected through a purposive sampling technique. Variables in this study were stress levels due to dental pain and age. Data were analyzed using IBM SPSS Statistics version 31.0 with Kruskal–Wallis and Mann Whitney test. Results: The results showed that subjects who experienced more mild stress were children (86.7%) and adolescents (66.7%), then subjects who experienced more moderate stress were adults (46.7%), and subjects who experienced more severe stress were elderly (36.7%). Analysis of the data obtained shows P-Value=0,000, meaning that there are differences in stress levels due to dental pain between age groups. Conclusion: In conclusion, children with adults, children with the elderly, adolescents with the elderly, and adults with the elderly show differences in stress levels due to dental pain, while children with adolescents and adolescents with adults do not show any differences in stress levels due to dental pain.
Understanding and Mapping Community Health Literacy on basic Life Support in Semi-Rural Indonesia
Background: Basic Life Support (BLS) is a fundamental life-saving skill whose effectiveness heavily relies on the ability of community members to act as first responders. Public health literacy regarding BLS serves as a critical link in the chain of survival, especially during the pre-hospital phase. Purpose: However, there is a lack of comprehensive spatial mapping of BLS literacy levels at the community level, particularly in rural areas such as Wajak Subdistrict, Malang Regency. This study aims to map the level of public health literacy concerning BLS, identify influencing factors, and provide an evidence-based foundation for preventive policymaking in primary healthcare settings. Methods: A descriptive quantitative cross-sectional study was conducted involving 400 respondents aged 17 years. Participants were selected using a cluster random sampling technique based on the smallest administrative units (neighborhoods or hamlets), ensuring geographic and demographic representation. The minimum sample size was determined using the Slovin formula with a 5% margin of error, resulting in a required minimum of 400 respondents to accurately reflect the target population distributionThe research instrument was a BLS literacy questionnaire encompassing. Data were analyzed using chi-square tests and spatially using QGIS software. Results: The majority of respondents (49.5%) demonstrated a moderate level of BLS literacy, while 34.5% showed low literacy and only 16% achieved a high level. Literacy levels were positively associated with educational attainment, prior BLS training, and age group. Spatial analysis revealed clusters of low literacy concentrated in the southern villages of the region. Conclusion: BLS literacy among the population in the Wajak area remains uneven, with vulnerable clusters requiring targeted, community-based interventions. These findings highlight the urgency of mainstreaming BLS training into public health outreach programs and integrating emergency literacy as an indicator of primary care readiness.
Implementing the 5-Table Posyandu Model as an Intervention for Adolescent Anemia Prevention: An Experimental Study
Methods: Using a quasi-experimental one-group pretest-posttest design, 30 adolescent girls (aged 12–18) in the Sebulu I Health Centre work area were selected using purposive sampling. Knowledge was measured using questionnaires before and after the 5-table intervention. Results: The mean knowledge score significantly increased from 5.63 (pretest) to 11.83 (posttest). Respondents in the "Good" knowledge category surged from 10.0% to 60.0%. Statistical analysis using the Paired Samples Test yielded a p-value of 0.000 (p < 0.05), confirming a highly significant improvement. The systematic integration of screening and targeted education within the 5-table framework effectively bridged information gaps regarding the causes of anaemia, its symptoms, and iron supplementation. Conclusion: The implementation of the 5-table Posyandu Remaja framework significantly enhances adolescent girls' understanding of anaemia prevention. By combining systematic screening with targeted health education, this model serves as a strategic and scalable public health tool to mitigate the risk of anaemia among Indonesian adolescents.
Emotional Intelligence, Self-Efficacy, and Clinical Decision-Making of Perioperative Nurses
Background: Clinical decision-making is an important aspect of perioperative practice because it determines patient safety and quality of care. Current phenomena show that nurses are still not sensitive to the complexity of patients' emotions, so that emotional aspects are not fully integrated into treatment considerations. Emotional intelligence helps nurses understand and manage their own emotions and those of their patients so that they can assess situations more accurately, while self-efficacy strengthens their confidence in choosing and implementing the right actions. These two factors contribute to the accuracy and consistency of clinical decision-making. Purpose: The purpose of this study was to analyze the relationship between emotional intelligence and self-efficacy with the clinical decision-making of perioperative nurses. Methods: The research method was observational with a cross-sectional approach. The sample was taken using total sampling and consisted of 31 perioperative nurses at a hospital in Batu City. Data analysis used Spearman's rank correlation test and ordinal logistic regression test. Results: The bivariate test results showed a significant relationship between emotional intelligence (p-value = 0.002; r = 0.536) and self-efficacy (p-value = < 0.001; r = 0.568) with the clinical decision-making of perioperative nurses. The correlation coefficient showed a moderate positive correlation, indicating that the higher the emotional intelligence and self-efficacy, the higher the clinical decision-making of perioperative nurses. In the multivariate test, both variables simultaneously had a significant effect on clinical decision-making (p-value = 0.002 < α 0.05). Conclusion: The results of this study contribute significantly to maintaining the quality of nursing services and care provided by nurses through the improvement of emotional intelligence and self-efficacy.
Conflict Management and Performance of Multigenerational Nurses at Haji Makassar Hospital
Background: Nurse performance plays a crucial role in the success of healthcare. However, nurses' performance can be affected by conflicts in the workplace, including intergenerational conflicts arising from differences in age, experience, and communication styles. Conflicts that are not managed properly have the potential to reduce teamwork and the quality of nursing services. Objective: This study aims to determine the relationship between conflict management and the performance of multigenerational nurses at Haji Makassar Hospital. Methods: This study used a quantitative research design with a cross-sectional approach. The variables in this study are: conflict management as an independent variable and nurse performance as a dependent variable. The sampling technique used was non-probability sampling with the total sampling method. The sample consisted of 80 nurses who met the inclusion criteria. Data were collected using a questionnaire on conflict management and nurse performance and analyzed using the Somers'D statistical test. Results: The results showed that most of the multigenerational nurses had good conflict management (62.5%), and most also showed good performance (73.8%). The Somers'D statistical test revealed a p value of 0.020 (p < 0.05), which showed a significant relationship between conflict management and the performance of multigenerational nurses at Haji Makassar Hospital. Conclusion: This study shows that effective conflict management contributes to improved performance of multigenerational nurses. Therefore, strengthening conflict management strategies through improved intergenerational communication and teamwork is needed to support the quality of nursing services.
Burnout and Patient Safety Culture among Emergency Department Nurses: A Cross-Sectional Analysis
Background: Emergency departments (EDs) in major tourist destinations face intensified patient volume and cultural diversity, posing risks to nurse well-being and patient safety. Purpose: This study examined the effects of tourism-pressure workload and intercultural nursing competence on patient safety culture among emergency nurses in Bali, testing burnout as a mediating mechanism within the Job Demands Resources (JD–R) framework. Methods: A quantitative, cross-sectional survey was conducted from May to September 2025, coinciding with Bali’s peak tourist season. Using a total-sampling (census) approach, all eligible emergency nurses in participating public and private hospitals across Bali were invited, yielding 283 fully usable responses. Data were analyzed with partial least squares structural equation modeling (PLS-SEM): measurement quality was tested via Cronbach’s α, composite reliability, average variance extracted, and Fornell Larcker/HTMT discriminant-validity criteria, and structural paths and bootstrapped indirect (mediation) effects were tested with 5,000 resamples and bias-corrected 95% confidence intervals. Results: Tourism-pressure workload strongly increased burnout (β = 0.511, p < .001) and was negatively associated with patient safety culture (β = −0.249, p < .001). Contrary to the hypothesized protective direction, intercultural nursing competence was positively associated with burnout (β = 0.336, p < .001), while directly strengthening patient safety culture (β = 0.382, p < .001) as its strongest predictor. Burnout was negatively related to patient safety culture (β = −0.314, p < .001) and partially mediated the workload–safety relationship; the indirect path from intercultural competence through burnout was small and of the opposite sign to its direct effect (competing partial mediation). The model explained 55.2% of the variance in burnout and 65.6% in patient safety culture. Conclusion: Burnout is a central pathway through which tourism-driven demands erode safety culture, and intercultural competence carries a dual character protecting safety culture directly while imposing emotional demands when organizational support is insufficient. Integrated workload management, structured intercultural training, and burnout prevention are required.
Determinants of Nursing Service Quality: The Influence of Community Health Center Management Functions
Background: The managerial capacity of community health center leaders in Indonesia remains limited, while the quality of nursing services depends heavily on how well core management functions are carried out. Purpose: This study aimed to determine the influence of community health center management functions, namely planning, mobilization and implementation, and supervision, on the quality of nursing services, and to identify the most dominant function. Methods: A quantitative observational study with a cross-sectional design was conducted at the Malinau Seberang Community Health Center, North Kalimantan, Indonesia, in 2025. A total sampling of 87 health workers completed Likert-scale questionnaires measuring the three management functions and service quality. Results: Chi-square tests showed significant associations between planning (p=0.007), mobilization and implementation (p=0.007), and supervision (p=0.006) and the quality of nursing services. Multiple logistic regression confirmed that all three functions significantly influenced service quality (p<0.001), with planning showing the largest Exp(B) value (0.0135) and identified as the most dominant determinant. These estimates should be interpreted with caution, however, since the outcome was highly skewed toward the good category and the resulting odds ratios were very small. Conclusion: These findings strengthen the evidence that integrated community health center management is key to improving nursing service quality. Health center leaders should prioritize structured, data-driven planning, supported by coordinated implementation and routine supervision, particularly in remote and border areas.
Administration of Pumpkin Seeds Herbal Capsules (Cucurbita Moschata) and Iron Supplement Tablets to Increase Serum Ferritin Levels in Pregnancy Anemia
Background: Iron deficiency anemia is the most common hematological problem, affecting approximately 38% of pregnant women globally. Pregnant women who take oral iron supplements often complain of gastrointestinal problems. The 2021 Household Health Survey (HHS) found the prevalence of iron deficiency anemia among pregnant women in Indonesia was 24.5%. Purpose: The aim of this study was to examine the effect of addition of pumpkin seed capsules (Cucurbita moschata) to increase serum ferritin levels in pregnant women with anemia. This type of research is a true ex- experimental study with a pretest-posttest with a control group. Methods: Serum ferritin test method using the ELFA method (enzyme-linked fluorescent immunoassay). The blood sample for the test is 1 ml of serum. The limit of iron deficiency anemia with a value of <9.3 µg/mL. The study period was September-October 2024. Results: The results of the Wilcoxon test showed a Significance value (Sig) in the group given pumpkin seed capsules obtained a ρ value of 0.00 1 smaller than α 0.05, thus concluding that pumpkin seed capsules (Cucurbita moschata) have an effect on increasing serum ferritin levels in pregnant women with anemia. Conclusion: Pumpkin seeds can be a non-pharmacological remedy for increasing hemoglobin levels if consumed regularly. One effort that can be made to prevent anemia in pregnant women is to utilize local plants as functional foods found around the community's residence.
Evaluation Flood Disaster Management System in Primary Health Centers in East Java
Background: Floods are the most frequent disasters in Indonesia, namely 3885 since 1815-2019. The cause of the high morbidity and mortality rates due to floods is the disruption of the continuity of Primary Health Centers services during a disaster. Primary Health Centers play a role in disaster management which includes pre-disaster, during disaster, and post-disaster. Purpose: This study examines the flood disaster management system at Primary Health Centers. Methods: This quantitative descriptive study involved 60 flood-prone Primary Health Centers in East Java. The instrument used to measure the role of Primary Health Centers is a questionnaire. The questionnaire contained 18 indicators. Seven indicators were used in the pre-disaster phase, five in the during-disaster phase, and six in the post-disaster phase. Data analysis was performed using frequency distribution and mean ± standard deviation. Results: The distribution of disaster management systems shows the highest average value in the pre-disaster stage (4.28), followed by the post-disaster stage (3.80), and the disaster stage (3.65). The three stages have the same median value, namely 4.00, with the largest data variation seen in the post-disaster stage (standard deviation 2.916). Conclusion: Practical implications for disaster preparedness policies at Primary Health Centers include developing emergency plans, routine training for health workers, and providing adequate emergency infrastructure. This policy ensures that primary health care facilities remain ready and responsive in the event of a crisis.
The Influence of Breastfeeding Self-Efficacy Education on Pregnant Women's Attitudes Towards Exclusive Breastfeeding at Aura Syifa Hospital, Kediri Regency
Background: Feeding babies only breast milk is very important for lowering health problems in infants and helping them develop properly. However, coverage remains suboptimal. Breastfeeding Self-Efficacy (BSE) plays a big role in how successful breastfeeding is. When mothers don't feel confident, they often have negative attitudes that can make breastfeeding harder. Initial research showed that 70% of pregnant women did not have positive views about exclusively breastfeeding, highlighting the need for educational programs based on BSE. Objective: This study aimed to find out how BSE education influences pregnant women’s views on exclusive breastfeeding. Methods: A study was carried out at RS Aura Syifa using a one-group pretest-posttest design, which means that we tested the same group of people before and after an intervention. A group of 50 pregnant women was chosen using No probability sampling with accidental sampling. The program included weekly video lessons given over two weeks, using both in-person and online methods. Data were analyzed using Wilcoxon. Results: The study showed that there was a noticeable change for the better in how people felt after the intervention. The statistical analysis showed a p-value of 0.000 (p < 0.05), which means that BSE education had a significant impact on the attitudes of pregnant women. Conclusion: Teaching pregnant women about breastfeeding confidence helps them have a better attitude towards exclusive breastfeeding. Health care providers should include education about Breastfeeding Self-Efficacy (BSE) in prenatal care. Future researchers should look into other factors like family support or breastfeeding practices.
A Pre Experimental Study: The Effect of Blanket Warmers on Increasing Temperature in Post Caesarean Section Hypothermia Patients
Background: Caesarean section is one of the most frequently performed surgical procedures, commonly using spinal block anesthesia. One of the common side effects of spinal anesthesia is hypothermia. Purpose: The aim of this study was to analyze the effect of using a blanket warmer on increasing body temperature in post caesarean section patients experiencing hypothermia following spinal anesthesia. Methods: This study employed a pre-experimental design with a pre-posttest approach. The population consisted of all caesarean section patients undergoing spinal anesthesia, totaling 23 individuals. The sampling technique used was non-probability purposive sampling, with a final sample size of 23 patients. Data collection was carried out using observation sheets. Statistical analysis was performed using the paired sample t-test. Results: The findings showed that the mean body temperature before intervention of the blanket warmer was 36.10 °C, and after the intervention, the mean temperature increased to 36.67°C. The paired sample t-test revealed a statistically significant difference with a p-value of 0.000, which is lower than the significance level of α = 0.05. Conclusion: Blanket warmer significantly increases body temperature in post caesarean section patients receiving spinal block anesthesia. Blanket warmers are effective in addressing hypothermia as they provide controlled heat transfer, allowing patients with hypothermia to absorb heat from the device.
Factors Associated with the Interest of IUD Contraceptive Users in Kalirong Village, Kediri Regency
Background: Population growth in Tarokan Village, Kediri, increased by 0.77% in 2021–2022 and 0.73% in 2022–2023, driven by a decline in contraceptive use. The largest decline occurred in IUD use, which fell from 46 in 2022 to 36 in 2023. Purpose: To identify factors influencing IUD contraceptive acceptors’ interest in Kalirong Village, Kediri. Methods: This study used a cross-sectional analytical survey of 82 PUS mothers aged >21–<35 years with >1 child, selected using simple random sampling. Data were collected via a questionnaire and analyzed using the chi-square test with a significance level of p = 0.1. Results: There was a significant association between the knowledge of postpartum mothers in Kalirong Village and their interest in IUD use (p = 0.000 < 0.1), whereas spousal support was not associated (p = 0.784 > 0.1). An analysis of parity was not performed because all respondents had the same parity. Conclusion: Knowledge is the dominant factor influencing interest in IUD use. Conclusion: Comprehensive education and counseling are essential to increase family planning participation, as women's knowledge significantly influences their interest in using an IUD, whereas spousal support and parity show no significant effect.
Enhancing Adolescent Mental Health: A Quasi-Experimental Study on the Impact of Combined Cognitive behavioral Therapy and Group Therapy
Background: Adolescent mental health problems remain a major public health concern. Although Cognitive Behavioral Therapy (CBT) and group therapy have individually demonstrated effectiveness, evidence regarding their combined use among adolescents remains limited. Purpose: This study aimed to evaluate the effectiveness of combined CBT and group therapy in improving adolescent mental health. Methods: This quasi-experimental pre-test–post-test control group study with a 1:1 allocation ratio was conducted among 40 adolescents in Surakarta, Indonesia, from February to March 2024. Participants were recruited using a cluster-based sampling approach followed by total sampling of eligible students. The intervention group received CBT followed by group therapy over three consecutive sessions, whereas the control group received a delayed intervention after study completion. Mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ). Data were analyzed using the Wilcoxon Signed-Rank Test and Mann–Whitney U Test, with effect sizes (r) calculated to determine the magnitude of the intervention effect Results: The intervention group demonstrated a significant improvement in SDQ scores following the intervention (Z = −3.18, p = 0.001; r = 0.71), whereas no significant change was observed in the control group (Z = −0.38, p = 0.705; r = 0.08). Post-intervention comparison showed significantly better mental health outcomes in the intervention group than in the control group (Z = −3.58, p < 0.001; r = 0.57), indicating a large intervention effect. Conclusion: The combination of CBT and group therapy significantly improved adolescents' mental health and demonstrated clinically meaningful benefits. This integrated intervention may be considered an effective early mental health strategy for adolescents and has potential for implementation in nursing practice, school mental health programs, and community mental health services when delivered by appropriately trained professionals.
A Descriptive Study of the Daily Dietary Patterns of Stunted Children
Background: Toddler age is a period of very rapid growth and development. At this time, it is important to meet the need for adequate nutritional intake in terms of quantity and quality. Malnutrition is a condition where toddlers experience nutritional deficiencies due to low energy and protein intake over a long period of time. Nutritional problems at an early age not only have an impact on impaired growth and development of children, but also increase toddler mortality rates, reduce intelligence levels, increase the risk of mental retardation, and reduce work performance and productivity. Purpose: The purpose of this study was to obtain detailed information about the daily eating patterns of stunted children. Methods: The population of this research was stunted toddlers base in the area of Publich health services of Bendo, Pare. From the all posyandu we chooce one posyandu ada the target by randomize methods. Then we find Dahlia Posyandu as the sample. Posyandu Dahlia has five stunted toddlers so we take them as our sample. Data was taken using a food recall form filled out by the toddler's mother for one week. Furthermore, the data was processed descriptively and presented in the form of a distribution table. Results: This study shows that all toddlers eat three main meals a day, in terms of daily vegetable and fruit consumption, the majority of children rarely eat vegetables and sufficient daily calorie intake, even more than the Daily Calorie Requirement Standard for fruit, In terms of snack food consumption, all children eat snacks very often and the types of snacks eaten are snacks with a strong savory taste and candy. Conclusion: The problem in the diet of stunted children is not just in the adequacy of calories, but in the diversity of sources of protein, fruit and vegetables.
Profile of Religiosity, Spirituality, Emotional Regulation, and Mental Health in Adolescents
Background: Religiosity, spirituality, and emotional regulation are some of the factors that contribute to adolescent mental health. Purpose: The purpose of this study is to describe the profile of religiosity, spirituality, emotional regulation, and mental health of adolescents. Methods: This research is a quantitative descriptive study with a cross-sectional approach. The sample of the study was 184 adolescents in high school who met the criteria, which was carried out by purposive sampling. Researchers adapted and modified questionnaires, namely the Daily Spiritual Experience Scale, Duke University Religion Index, Emotion Regulation Scale, and Mental Health Inventory. Data were analyzed descriptively and presented in frequency distribution, percentage, minimum, maximum, average, and standard deviation using SPSS. The study has been declared ethically appropriate with number 750/S.Ket/KEPK/UK/X/2025. Results: The results of the study obtained data that of the 184 adolescents, most were in the moderate category, namely religiosity 144 people (78.3%), spirituality 112 people (60.9%), emotional regulation 133 people (72.3%), and adolescent mental health 133 people (72.3%). Conclusion: Religiosity, spirituality, emotional regulation, and mental health in adolescents are important aspects that nurses must pay attention to as providers of comprehensive nursing care that includes bio-psycho-socio-spiritual aspects.
Insomnia Related with Intellectual Function in the Elderly
Background: Insomnia is a common sleep disorder among older adults that can negatively affect quality of life and intellectual function. Impaired intellectual function may reduce independence, limit daily activities, and hinder social interactions. Purpose: This study aimed to determine the relationship between insomnia and intellectual function among older adults attending the Elderly School in Bandungrejosari, Malang City. Methods: This quantitative correlational study involved 30 older adults selected through simple random sampling. Insomnia was assessed using the KSBPJ-IRS questionnaire, while intellectual function was measured using the Short Portable Mental Status Questionnaire (SPMSQ). Data were analyzed using a correlation test to examine the relationship between insomnia and intellectual function. Results: A significant relationship was found between insomnia and intellectual function (p = 0.002). Higher levels of insomnia were associated with lower intellectual function, indicating that sleep disturbances may contribute to cognitive decline in older adults. Conclusion: Insomnia was significantly associated with intellectual function among older adults at the Elderly School in Bandungrejosari, Malang City. Improving sleep quality may help preserve intellectual function and enhance the quality of life of older adults.
Implementation of Standardized Nursing Language (SNL) in Nursing Documentation: A Scoping Review
Background: Nurses play a crucial role in improving the quality of care through standardized nursing practices. Standardized Nursing Language (SNL) provides as structured and systematic approach to articulating nursing care, facilitating accurate communication and promoting consistency in nursing documentation. Purpose: This scoping review aimed to identify the implementation of SNL in nursing documentation. Methods: A scoping review was conducted using four electronic databases: Garuda, PubMed, ScienceDirect, and Wiley. Eligible studies full text-original articles published in English or Indonesian between 2020 and August 2025 that examined SNL implementation in documentation within healthcare settings. Studies conducted in educational contexts, case reports, editorial commentaries, conference proceedings, and study protocols, were excluded. Results: Across the 10 included studies, SNL implementation was associated with improvements nursing documentation quality. Five studies (50%) reported improved documentation accuracy and readability, while five (50%) reported more appropriate nursing diagnoses and interventions. The main implementation barriers were inadequate EHR support, limited nurses’ familiarity with SNL, and lack of standardized documentation formats, each reported in five studies (50%). Conclusion: SNL implementation is associated with improved quality and consistency of nursing documentation. Further research using implementation science frameworks is warranted to systematically examine context specific barriers and facilitators of SNL implementation.
Smartphone Addiction and Associated Factors among Secondary School Students in Bangladesh: A Cross-Sectional Study
Background: Smartphone addiction is a serious problem among school students worldwide. For Bangladesh, where about half of the population uses smartphones, it is linked with behaviour challenges and academic outcomes. Purpose: The present study aimed to evaluate to smartphone addiction and associated factors among secondary school students of Bangladesh. A descriptive cross-sectional study was conducted with 186 ninth- and tenth-grade students from Rayerbazar High School in Dhaka, selected via convenience sampling. Methods: The study was conducted after institutional review board approval from NIANER on December 2019 to February 2020 using a self-administered questionnaire on demographic data, usage patterns, and a validated addiction scale. Descriptive statistics, Pearson's correlation, t-tests and ANOVA were performed. The mean addiction score was 3.33 (SD=0.90). Results: The father's educational attainment level (p=0.003), socioeconomic status (p=0.002) and family living status (p=0.021) were noted as significant associations. In addition, there was a significant correlation between higher scores and the use of smartphones (p<0.001), the duration of daily smartphone use (p<0.001), social networking (p<0.001) and gaming (p=0.021). Findings are important because the cross sectional design precludes causal inferences, but it is easy to see implications. Conclusion: School nurses should include regular health screening that incorporates an assessment for addiction in all medical practices. It is recommended that guidelines be created to set limits on recreational screen time for school health. Offline social interaction and student education on digital balance are key strategies in adolescent health promotion.
Implementing OSH-MS in North Sumatra's Hospitals and Public Health Centers: Challenges and Best Practices
Background: Occupational Safety and Health Management Systems (OSH-MS) are essential for protecting healthcare workers and ensuring safe service delivery in healthcare facilities. Purpose: This study aimed to assess and compare the implementation of OSH-MS in hospitals and primary health centres using a principle-based framework. Methods: A cross-sectional assessment was conducted in six hospitals and seven primary health centres, evaluating five OSH-MS principles: establishing OHS policies, OSH plans, OHS plan implementation, OHS performance monitoring and evaluation, and OHS performance review and improvement. Data were collected through document review and verification of implementation evidence, and achievement was analysed descriptively as percentages. Results: The results reveal substantial variation in OSH-MS implementation, with overall achievement ranging from 14% to 88%. OSH planning and implementation showed relatively high achievement across most facilities, indicating that operational safety measures are generally in place. In contrast, establishing OHS policies, monitoring and evaluation, and performance review and improvement demonstrated consistently lower achievement, particularly in several primary health centres. Hospitals generally performed better than primary health centres, although variability was observed within both groups. Conclusion: In conclusion, OSH-MS implementation in healthcare facilities remains uneven and predominantly focused on operational activities, with limited emphasis on governance, monitoring, and continuous improvement. Strengthening leadership commitment, formal OHS policies, and systematic monitoring and review mechanisms is necessary to achieve comprehensive and sustainable OSH-MS implementation, especially in primary health care settings.
Delayed Initiation of Antenatal Care among Pregnant Women in Indonesia: Findings from a Multi-Centered Cross-Sectional Study
Background: Early initiation of antenatal care (ANC) is critical for optimizing maternal and neonatal health outcomes, yet late initiation remains a persistent challenge in many low- and middle-income countries. Purpose: This study aimed to investigate the magnitude and factors associated with delayed initiation of antenatal care among pregnant women in Indonesia in Malang City and Malang Regency, Indonesia. Methods: A facility-based cross-sectional study was conducted from May to July 2025 among 309 pregnant women selected using systematic random sampling from one hospital and two health centers. Delayed ANC initiation was defined as the first ANC visit after 12 completed weeks of gestation. Data were collected using a structured interviewer-administered questionnaire and medical record review, then analyzed using bivariable and multivariable logistic regression. Results: The prevalence of delayed ANC initiation was 57.3% (95% CI: 51.7-62.9), indicating suboptimal utilization of maternal health services. Multivariable analysis revealed that low maternal education (AOR = 2.31; 95% CI: 1.42-3.76), unplanned pregnancy (AOR = 1.89; 95% CI: 1.12-3.19), lack of advice from health professionals (AOR = 2.67; 95% CI: 1.58-4.51), poor knowledge (AOR = 2.45; 95% CI: 1.51-3.98), longer distance to health facilities (AOR = 2.12; 95% CI: 1.18-3.81), and cultural beliefs discouraging early pregnancy disclosure (AOR = 1.87; 95% CI: 1.12-3.12) were significantly associated with delayed initiation. Conclusion: Delayed ANC initiation is influenced by multiple socio-demographic, cognitive, behavioral, health system, and cultural factors. These findings highlight the need for policies that strengthen early pregnancy counseling, improve maternal health literacy, and enhance timely ANC initiation in Indonesia.
A Study on the Impact of Growth and Development Screening Education on Posyandu Cadres’ Knowledge
Background: Early detection of child growth and developmental problems is essential to ensure optimal child outcomes and improve human resource quality. Posyandu cadres play a crucial role in community-based screening; however, limited knowledge and technical skills may hinder effective implementation. Purpose: Educational interventions are therefore needed to strengthen cadres’ capacity in growth and developmental screening. Methods: This study employed a pre-experimental one-group pretest–posttest design conducted in the Ciwaruga Health Center working area. A total of 33 Posyandu cadres were selected using total sampling based on predetermined inclusion criteria. The intervention consisted of structured education delivered through lectures, interactive discussions, and hands-on demonstrations covering anthropometric measurements, growth monitoring charts/ KMS (Kartu Menuju Sehat), developmental screening using the KPSP (Kuesioner Pra Skrining Perkembangan), and referral procedures. Cadres’ knowledge was measured before and after the intervention using a validated and reliable questionnaire. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test. Results: Before the intervention, most cadres demonstrated low to moderate knowledge levels. Following the educational program, a substantial improvement was observed, with the majority of respondents achieving a high level of knowledge. Statistical analysis revealed a significant difference between pretest and posttest knowledge scores (p < 0.001), indicating the effectiveness of the educational intervention. Conclusions: Growth and developmental screening education significantly improves the knowledge of Posyandu cadres. Structured, practice-oriented educational approaches are effective strategies for enhancing cadre capacity and supporting the quality of community-based child health services.
Adherence, Quality of Life, and Determinant Factors among Patients with Chronic Kidney Disease Undergoing Hemodialysis: A Cross-Sectional Analysis
Background: Hemodialysis sustains life for chronic kidney disease patients but imposes heavy physical, psychological, and social burdens. Poor adherence worsens complications and reduces quality of life, emphasizing the need to explore how compliance and patient well-being interact to improve outcomes. Purpose: This study examined how quality of life and patient factors shape treatment adherence in chronic hemodialysis. Methods: A cross-sectional design was employed with 158 adult patients recruited from hospitals in Central Java. Data were collected using validated instruments: KDQOL-36 for quality of life and MMAS for adherence. Multivariable linear regression analysis was performed to examine associations between variables. Results: Moderate adherence was observed (47.66 ± 5.90), with the highest quality of life domain in the problem list (78.30 ± 9.67). Strong positive correlations were found between adherence and all QoL domains: SF-12 (r = 1.000, p < 0.001). Regression analysis showed that age, employment, education, income, dialysis duration, and CKD length negatively influenced adherence, while quality of life was a significant positive predictor (B = 0.021, p < 0.001), confirming that better adherence is strongly linked to improved quality of life across physical, psychological, and social domains, with patient-reported challenges being the most critical factor. Conclusion: Quality of life influences adherence by affecting burden, motivation, and self-management, while age and longer dialysis history weaken this link through fatigue and reduced resilience. Socioeconomic factors help only with psychosocial support, so nursing should reduce treatment burden.
Effect of Olive Oil Back Massage on Selected Fetomaternal Parameters and Maternal Satisfaction Among Primigravid Women During the First Stage of Labour: A Quasi-Experimental Study
Background: Labour is a physiological process characterised by progressive cervical dilatation, regular uterine contractions, and fetal descent. Although childbirth is a natural process, many women experience pain, anxiety, and physical discomfort during the first stage of labour. Massage is widely used as a non-pharmacological intervention to promote comfort during labour. However, limited evidence is available regarding the effect of olive oil back massage on fetomaternal physiological parameters and maternal satisfaction. Purpose: To evaluate the effect of olive oil back massage on selected fetomaternal parameters and maternal satisfaction among primigravid women during the first stage of labour. Methods: A quantitative study with a quasi-experimental pretest-posttest control group design was conducted among 60 primigravid women admitted to the labour room of Kasturba Memorial Hospital, Dindigul, Tamil Nadu, India. Participants were selected using purposive sampling and allocated to an experimental group (n = 30) and a control group (n = 30). Women in the experimental group received olive oil back massage during the active first stage of labour in addition to routine intrapartum care, while those in the control group received routine care alone. Results: Women who received olive oil back massage had significantly longer uterine contraction duration than those who received routine care (63.00 ± 8.70 vs. 57.50 ± 7.82 seconds; p < 0.05). A significant difference was also observed in uterine contraction frequency between the groups. No significant differences were found in fetal heart rate, systolic blood pressure, or diastolic blood pressure. Among women in the experimental group, 66.7% reported adequate satisfaction and 33.3% reported moderate satisfaction. Conclusion: Olive oil back massage was associated with favourable uterine contraction characteristics without adverse effects on maternal or fetal physiological parameters. The intervention was well accepted by the participants and may be considered a simple, low-cost complementary nursing intervention during the first stage of labour.