Lentera Perawat with the registered number ISSN 2830-1846 (Online), 2722-2837 (Print), and DOI prefix : 10.52235/lp is a peer-reviewed journal that provides a platform for publication of scientific research relevant to nursing and other health related professions with an Asian focus, offering regional perspectives. Lentera Perawat is open-access journal dedicated to advancing knowledge, research, and practice in the fields of nursing or other health sciences as well as with their development through interdisciplinary and multidisciplinary approach. The journal particularly welcomes studies that aim to evaluate and understand the complex nursing care interventions which employ the most rigorous designs and methods appropriate for the research question of interest. The submission process of the manuscript is open throughout the year. It is published quarterly (four times per year: March, June, September, December). Lentera Perawat is published by STIKes Al-Maarif Baturaja, has been published since 2020 (and see the history of the journal's here). Lentera Perawat being reviewed by Scopus, and has been cited in Scopus indexed publication. Lentera Perawat is indexed by SINTA (Science and Technology Index)| GARUDA (Garba Rujukan Digital) | Google Scholar | Crossref | ROAD| Dimensions Lentera Perawat is part of Open Access | Creative Commons |Committee on Publication Ethics (COPE) | Relawan Jurnal Indonesia (RJI) | Open Journal System (OJS).
Exploration of emotional and psychosocial responses following initial HIV Diagnosis: A qualitative study
Background: Receiving an initial HIV diagnosis is often accompanied by profound emotional disruption, psychosocial uncertainty, stigma-related concerns, and challenges in disclosure and early treatment engagement. Although previous studies have examined HIV adherence, stigma, and treatment outcomes, limited evidence describes the immediate emotional and psychosocial responses experienced by newly diagnosed adults during the first months of HIV care, particularly in local healthcare settings in Indonesia. Objective: This study aimed to explore emotional and psychosocial responses following an initial HIV diagnosis among individuals receiving early HIV care in urban and rural healthcare facilities in Pringsewu, Lampung Province, Indonesia. Methods: A qualitative descriptive design was used. Participants were recruited purposively from healthcare facilities providing HIV counseling, testing, and antiretroviral therapy services. Fifteen adults diagnosed with HIV within one to seven months before data collection participated in face-to-face, in-depth semi-structured interviews. Data were collected in private rooms to ensure confidentiality and emotional safety. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. Trustworthiness was strengthened through participant validation, audit trail documentation, reflective notes, team discussions, and the use of representative quotations. Results: Thematic analysis generated three major themes. The first theme, emotional shock and personal crisis after HIV diagnosis, reflected participants’ disbelief, fear of death, uncertainty about the future, guilt, and self-blame. The second theme, stigma and fear of social reactions, described fear of family rejection, concealment of HIV status as self-protection, workplace concerns, and internalized stigma. The third theme, early adaptation and emerging hope for survival, showed gradual acceptance, reliance on support from healthcare providers or significant others, and commitment to antiretroviral therapy. These findings indicate a transition from emotional crisis and social fear toward early coping, acceptance, and treatment commitment. Conclusion: Newly diagnosed individuals experience complex emotional and psychosocial responses during the early phase of HIV care. Integrating stigma reduction, emotional counseling, accurate health information, and supportive care into HIV services may strengthen adaptation, disclosure readiness, and long-term treatment engagement among people newly diagnosed with HIV.
Copyright (c) 2026 Untung Sujianto, Ikhwan Amirudin, Azizati Salmas Marsiami, Achmad Fauji https://creativecommons.org/licenses/by-nc/4.0/
Association between nurses’ perceptions of head nurse leadership style and their performance in nursing care delivery: A cross-sectional study
Background: Nurses’ performance in delivering nursing care is a key indicator of hospital service quality. Ward head leadership may shape nurses’ work behavior through direction, motivation, supervision, and feedback. However, evidence regarding how nurses’ perceptions of head nurse leadership relate to nursing care performance in specific inpatient units remains limited. Objective: This study aimed to examine the association between nurses’ perceptions of head nurse leadership style and their performance in nursing care delivery in an inpatient ward. Methods: A quantitative correlational study with a cross-sectional design was conducted in the eighth-floor inpatient ward of RSUD Siti Fatimah in 2026. A total of 17 staff nurses were recruited using total sampling. Nurses’ perceptions of head nurse leadership style were measured using a leadership style questionnaire adapted from Nursalam, while nursing care performance was assessed using a 20-item nursing performance questionnaire adapted from Bakri. Data were analyzed using descriptive statistics and Spearman’s rank correlation with a significance level of α = 0.05. Results: Most respondents perceived the head nurse’s leadership style as good (n = 12; 70.6%), and most demonstrated good performance in nursing care delivery (n = 13; 76.5%). Among nurses with good leadership perceptions, 91.7% reported good nursing care performance. Spearman’s rank correlation showed a statistically significant positive association between nurses’ perceptions of head nurse leadership style and nursing care performance (r = 0.587; p = 0.013), indicating a moderate correlation. Conclusion: Nurses who perceived the head nurse’s leadership style more positively tended to report better performance in delivering nursing care. These findings suggest that effective ward-level leadership may support nursing care quality through clear direction, supervision, motivation, and constructive feedback. Strengthening leadership practices among head nurses is therefore important to enhance staff nurses’ performance and maintain the quality of inpatient nursing care.
Copyright (c) 2026 Indra Frana Jaya KK, Maria Regina, Jamal Jamal, Frisa Anesia Amalah, Ayu Andira, Dedek Puspasari https://creativecommons.org/licenses/by-nc/4.0/
Family caregivers’ experience in providing home-based palliative care: A descriptive phenomenological study
Background: Families, as a vital part of palliative care, need to be identified and their roles and functions explored in order to improve patients’ quality of life at home following hospitalisation. Objective: This study aims to identify the current situation regarding patient care at home. Methods: The method used in this study was a qualitative approach employing a descriptive-phenomenological methodology. informants were selected based on purposive sampling criteria, with a total of nine informants. Interviews were conducted using a semi-structured interview technique, in the Sakatiga Village Health Center. Results: The results of this study indicate that experiences of caring for palliative care patients vary; families, as a vital part of patient care, must be able to provide care for patients, even though family carers are likely to face various challenges, such as a lack of knowledge regarding care provision. The findings further examine the conditions of care provided at home, including: the assessment of the patient’s and family’s condition; the patient’s complaints regarding their condition; the family’s feelings towards the patient’s condition; the family’s coping mechanisms; dilemmas in meeting the patient’s care needs; and medical information required to understand the patient’s condition. Conclusion: The results of this study indicate that families in providing palliative care need a forum to discuss, talk, and express their feelings while providing patient care at home. This is necessary because apart from being an important part of care, families are also required to always be able to carry out their functions optimally.
Copyright (c) 2026 Karolin Adhisty, Mutia Nadra Maulida, Siti Sarahdeaz F, Zesi Aprilia https://creativecommons.org/licenses/by-nc/4.0/
Improving reproductive health self-efficacy among female adolescents through audiovisual based education: A pre-experimental study
Background: Adolescent girls need reproductive health education that not only provides accurate information but also strengthens confidence in making healthy decisions. School-based audiovisual education may offer an engaging and developmentally appropriate strategy to improve reproductive health self-efficacy among junior high school female. Objective: This study aimed to examine differences in self-efficacy among female adolescents before and after receiving PERSADA, an audiovisual-based reproductive health education intervention. Methods: This quantitative study used a pre-experimental one group pretest posttest design. A total of 161 female students from grades VIII and IX at a junior high school located in the Semarang regency were selected through purposive sampling from a population of 269 students. Self-efficacy was measured using a questionnaire administered before and after the intervention. Data were analyzed using descriptive statistics and the paired sample t-test. Results: The mean self-efficacy score increased from 61.37 before the intervention to 67.32 after the intervention, with a mean difference of 5.95 points. The minimum score increased from 48 to 56, while the maximum score increased from 76 to 79. The standard deviation decreased from 7.921 to 5.664, indicating more homogeneous post intervention scores. The paired sample t-test showed p = 0.000, indicating a statistically significant difference in self-efficacy before and after PERSADA. Conclusion: PERSADA was associated with a significant improvement in reproductive health self-efficacy among female adolescents These findings suggest that audiovisual-based reproductive health education can be used as a practical school-based health promotion strategy to strengthen adolescents’ confidence in understanding and maintaining reproductive health.
Copyright (c) 2026 Alim Hidayat, Eko Mardiyaningsih https://creativecommons.org/licenses/by-nc/4.0/
Exploring the use of the transtheoretical model in psychiatric nursing counseling for women with schizophrenia experiencing intimate partner violence: A clinical case study from Indonesia
Background: Intimate partner violence (IPV) is a major global public health concern associated with severe psychological consequences, particularly among women with pre-existing mental disorders. Survivors with chronic mental illness often experience complex psychological challenges that may hinder recovery and increase vulnerability to repeated abuse. However, structured psychiatric nursing approaches addressing survivors’ readiness for behavioral change remain limited. Objective: This study aimed to explore the application of the Transtheoretical Model of Change within psychiatric nursing counseling for women with schizophrenia experiencing intimate partner violence. Methods: A qualitative clinical case study design was employed involving two female participants with schizophrenia receiving psychiatric nursing care in Indonesia. Data were collected through clinical observation, nursing assessments, therapeutic communication, counseling session documentation, and nursing care records. Counseling interventions were implemented using experiential and behavioral strategies aligned with the stages of change framework. Data were analyzed using thematic content analysis focusing on patterns of psychological responses, coping processes, and behavioral changes observed during counseling.. Results: Clinical observations indicated that experiential strategies, including consciousness raising, self-reevaluation, and dramatic relief, were associated with increased recognition of abusive experiences and reduced self-blaming responses. Behavioral strategies such as self-liberation, reinforcement management, and counterconditioning were observed alongside the development of adaptive coping behaviors, emotional regulation, and greater engagement in daily functioning. Participants demonstrated individual variations in readiness for change throughout the counseling process. Conclusion: Transtheoretical Model may provide a useful framework for tailoring psychiatric nursing counseling according to survivors’ readiness for change and clinical context. However, findings should be interpreted cautiously given the qualitative case study design and small number of participants. Further research involving larger samples and standardized outcome measures is needed to strengthen understanding of stage-based counseling approaches among survivors of intimate partner violence with chronic mental illness.
Copyright (c) 2026 Prasetyo Aji Nugroho, Somporn Rungreangkulkij, Muliantika Muliantika https://creativecommons.org/licenses/by-nc/4.0/
Nursing management strategies for optimizing SBAR-based bedside handover implementation in an inpatient unit
Background: Bedside handover is a clinical communication strategy that supports continuity of care, patient safety, and patient involvement. The initial assessment in the inpatient unit showed an implementation rate of 68%, nurse–patient interaction during handover of only 33%, non-standardized documentation, and the absence of an SBAR-based bedside handover SOP that consistently involved patients. Objective: This article aimed to evaluate nursing management strategies for optimizing SBAR-based bedside handover implementation in an inpatient unit at a hospital in Jakarta. Methods: This quality improvement study used a pre–post evaluation approach and involved 20 inpatient nurses, including 13 diploma-prepared nurses and 7 professional nurses. The initial assessment included observation, brief interviews, document review, and one FGD with unit nurses. The intervention was implemented through baseline assessment, development of an SBAR-based SOP and documentation format, socialization, training and simulation, appointment of handover champions, supervision, and three monthly audit cycles from August to October 2025. Data were analyzed descriptively. Results: Bedside handover implementation increased from 68% in August to 77% in September and 90% in October. At baseline, patient interaction during handover was 33%, form uniformity was 82%, 50% of nurses reported documentation difficulties, and leadership during handover was documented in 27% of observations. The background and assessment components improved but remained inconsistently communicated. Conclusion: Nursing management strategies involving procedure standardization, training, documentation, handover champions, supervision, and continuous audit contributed to improved SBAR-based bedside handover. Further strengthening of background, assessment, and patient involvement is required to ensure that improved compliance is accompanied by better clinical communication quality.
Copyright (c) 2026 I Dewa Ayu Rai Netrawati, Frieda Panjaitan, Ratri Ermawati, Samuel M Simanjuntak https://creativecommons.org/licenses/by-nc/4.0/
Effect of a combined woolwich massage, acupressure, and Breastfeeding Exclusive Self Training (BEST) for moms e-book intervention on ineffective breastfeeding: A case study
Background: Ineffective breastfeeding may be associated with an inadequate breast milk supply, suboptimal infant latch, breast pain, maternal anxiety, and limited access to understandable breastfeeding information. An approach combining physical stimulation and digital education may provide comprehensive support for mothers experiencing breastfeeding difficulties. Objective: This case study aimed to describe the implementation of a combined Woolwich massage, acupressure, and BEST for MOMS e-book intervention among mothers experiencing ineffective breastfeeding. Methods: A descriptive case study design was employed involving two breastfeeding mothers with infants aged 0–1 month in Sekarjaya Village, East Baturaja District, Indonesia. The intervention was delivered over six visits and comprised breastfeeding education using the BEST for MOMS e-book, demonstration and guided practice of Woolwich massage, and acupressure at the CV17 and ST18 points. Data were collected through maternal nursing assessments, observations of breastfeeding practices and outcomes, procedural checklists, and the Breastfeeding Self-Efficacy Scale–Short Form. The data were analyzed descriptively by comparing each participant’s condition before and after the intervention. Results: Following six visits, both participants demonstrated improvements in breastfeeding status. Infant feeding frequency increased from 5–6 times to more than eight times per day, while urination frequency increased from 4–5 times to eight times per day. Breast milk flow and infant latch also improved. The infants appeared calmer after feeding, whereas maternal breast pain and anxiety decreased. The participant who initially experienced more pronounced breast swelling and pain required a longer period of adaptation. Conclusion: The combination of Woolwich massage, acupressure, and education through the BEST for MOMS e-book may be implemented as a supportive intervention for mothers experiencing ineffective breastfeeding. Studies involving larger samples, comparison groups, and standardized outcome measurements are required to determine the effectiveness of this combined intervention.
Copyright (c) 2026 Eni Folendra Rosa, Rita Kamalia, Rosdiana Rosdiana, Nelly Rustiati https://creativecommons.org/licenses/by-nc/4.0/
The effectiveness of the Youth-Oriented Mental Health Education Program (Y-MIND) school-based psychoeducational program in improving mental health literacy and reducing psychological distress among adolescents in Klaten, Indonesia: A quasi-experimental study
Background: Adolescent mental health is a major public health concern, including in Indonesia, where many cases remain undetected and untreated. Limited mental health literacy may contribute to poor help-seeking behavior and adverse mental health outcomes. Psychoeducation is a promising school-based strategy to address these challenges. Objective: This study aimed to evaluate the effectiveness of the Youth-Oriented Mental Health Education Program (Y-MIND) in improving mental health literacy and reducing psychological distress among adolescents. Methods: A quasi-experimental pretest–posttest control group design was conducted among 70 eleventh-grade students at SMA Muhammadiyah 1 Klaten, Indonesia. Participants were selected using proportional stratified random sampling and assigned to an intervention group (n = 35) and a control group (n = 35). The intervention group received the four-session Y-MIND psychoeducational program. Mental health status was assessed using the Self-Reporting Questionnaire-20 (SRQ-20), and mental health literacy was measured using the Multicomponent Mental Health Literacy Measure (MMHLM). Data were analyzed using the Wilcoxon signed-rank test and Mann–Whitney U test. Results: The proportion of participants without psychological distress increased from 45.7% to 91.4% in the intervention group, compared with 60.0% to 62.9% in the control group. High mental health literacy increased from 5.7% to 74.3% in the intervention group. Between-group analysis showed significantly greater improvements in psychological distress (p = 0.001) and mental health literacy (p < 0.001) in the intervention group compared with the control group. Conclusion: The Y-MIND program effectively improved mental health literacy and reduced psychological distress among adolescents. School-based psychoeducation may be an effective strategy for promoting adolescent mental health.
Copyright (c) 2026 Astri Wahyuningsih, Lusiana Ambarsari, Leni Prasetiyani, Indah Yunita Khairunisa https://creativecommons.org/licenses/by-nc/4.0/
Effects of intradialytic exercise on physical and psychological outcomes in patients undergoing hemodialysis: A systematic review
Background: Patients undergoing maintenance hemodialysis frequently experience physical and psychological problems, including fatigue, reduced functional capacity, muscle weakness, anxiety, stress, depression, and a decline in quality of life. These conditions are influenced by chronic kidney disease, long-term hemodialysis, limitations in physical activity, and dependence on dialysis therapy. Intradialytic exercise, defined as physical exercise performed during a hemodialysis session, is a nonpharmacological intervention with the potential to improve patients' physical and psychological conditions. Objective: To evaluate the effectiveness of intradialytic exercise on physical and psychological outcomes in patients undergoing hemodialysis. Methods: This systematic review was conducted in accordance with the PRISMA guidelines and was registered in PROSPERO under registration number CRD420261386106. Literature searches were conducted in PubMed, ScienceDirect, Scopus, Web of Science, and CINAHL. Articles published from 2020 to 2026 were searched, with the final search conducted in May 2026. The included studies were quantitative studies, primarily randomized controlled trials, quasi-experimental studies, or other intervention studies that evaluated exercise performed during hemodialysis and reported physical and/or psychological outcomes. Study selection, data extraction, and quality assessment were performed independently by the reviewers. A total of 18 studies met the inclusion criteria and were analyzed in this systematic review. Results: The synthesis showed that intradialytic exercise had positive effects on physical outcomes, including improvements in functional capacity, muscle strength, activity tolerance, and physical performance, as well as reductions in fatigue. Several studies also reported improvements in psychological outcomes, including reductions in anxiety, stress, and depression and improvements in quality of life. Conclusion: Intradialytic exercise may be an effective nonpharmacological intervention for improving physical and psychological outcomes in patients undergoing hemodialysis, while taking into account each patient's clinical condition, safety, and individual capabilities.
Copyright (c) 2026 Indra Frana Jaya KK, Novi Yanti S, Ayu Prawesti Priambodo https://creativecommons.org/licenses/by-nc/4.0/
Association between sleep quality and pre-hemodialysis blood pressure among patients undergoing hemodialysis: A cross-sectional study
Background: Chronic kidney disease (CKD) is an ailment of kidney function that develops gradually and in advanced stages requires long-term hemodialysis therapy. Sleep disturbances are common among patients due to both physiological and psychological factors. Pourer sleep quality may elevate the sympathetic nervous system's responsiveness, disrupt fluid balance, and contribute to elevated blood pressure, particularly pre-hemodialysis blood pressure, which reflects the patient’s hemodynamic status prior to dialysis initiation. Objective: This study aimed to assess the association between sleep quality and pre-hemodialysis blood pressure, including systolic and diastolic, in patients undergoing hemodialysis. Methods: This research utilized a quantitative, cross-sectional methodology that was conducted in September 2025 at the Hemodialysis Unit of Universitas Muhammadiyah Malang Hospital, among 80 patients selected using purposive sampling, undergoing routine hemodialysis for at least three months at Universitas Muhammadiyah Malang Hospital, who were conscious and able to communicate verbally. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was utilized to assess quality of sleep, whereas pre-hemodialysis blood pressure including systolic and diastolic measurements was weighed prior to the dialysis procedure using a standard sphygmomanometer. Data were evaluated using the Spearman Rank test, with an established significance threshold of p <0.05. Results: Of the total respondents, 42 (52.5%) had good sleep quality, while 38 (47.5%) experienced poor sleep quality. The median pre-hemodialysis blood pressure was 130/80 mmHg, indicating stage 1 hypertension. Statistical assessment disclosed a significant association between quality of sleep and pre-hemodialysis blood pressure category (p = 0.014) with a weak positive correlation (r = 0.274), revealing that poorer sleep quality was associated with higher blood pressure category, although the effect size was small. Conclusion: Sleep quality is significantly associated with blood pressure in patients of pre-hemodialysis. Poorer sleep quality leads to be collaborated with higher blood pressure. However, the weak correlation (r = 0.274) suggests that sleep quality is one of several contributing factors to blood pressure variability in this population. These verdicts highlight the significance of assessing and managing sleep quality as part of comprehensive care in hemodialysis patients.
Copyright (c) 2026 Robiatul Adawiyah, Dwi Soelistyoningsih, Achmad Rifai, Wira Daramatasia, Angernani Trias Wulandari https://creativecommons.org/licenses/by-nc/4.0/
Comfort-oriented nursing interventions to improve quality of life in hemodialysis patients: A systematic review
Background: Patients undergoing hemodialysis frequently experience fatigue, pain, muscle cramps, and reduced functional capacity, which adversely affect their quality of life. Non-pharmacological nursing interventions using a comfort-oriented approach are believed to improve patients’ physical comfort and functional status. However, the available recent evidence remains heterogeneous and has not been systematically synthesized. Objective: This study aimed to review and synthesize recent evidence regarding the effectiveness of comfort-oriented nursing interventions in improving physical comfort, functional capacity, and quality of life among patients undergoing hemodialysis. Methods: A systematic review was conducted by searching Scopus, PubMed, ScienceDirect, Google Scholar, and relevant research registries for studies published between 2020 and April 2026. Eligible studies included randomized controlled trials, quasi-experimental studies, observational studies, and qualitative studies reporting outcomes related to comfort, functional capacity, and quality of life among adult patients undergoing hemodialysis. Methodological quality was assessed using the Cochrane Risk of Bias Tool, Newcastle–Ottawa Scale, and Critical Appraisal Skills Programme checklists. Data were extracted and narratively synthesized to describe intervention effects, underlying mechanisms, and heterogeneity across the findings. Results: Of the 801 records identified, 10 studies met the inclusion criteria. The interventions demonstrated improvements in physical comfort, muscle strength, mobility, and quality of life. Multicomponent and technology-based interventions also improved patient engagement, treatment adherence, and nutritional markers. Heterogeneity in study populations, intervention duration, and study designs affected the strength of the evidence. Nevertheless, consistent patterns indicated that nurse-delivered interventions provided beneficial outcomes within dialysis care settings. Conclusion: Comfort-oriented nursing interventions appear to be safe, feasible, and effective in improving physical comfort, functional capacity, and quality of life among patients undergoing hemodialysis. The findings support the integration of physical exercise, relaxation techniques, and multicomponent strategies into routine dialysis nursing care.
Copyright (c) 2026 Abiyyu Faqih Dhiyaus Suud Ahmad, Enny Mulyatsih, Dwi Retno Sulistyaningsih https://creativecommons.org/licenses/by-nc/4.0/
Maternal risk of chronic energy deficiency based on mid-upper arm circumference and low birth weight among term singleton births: A retrospective record-based study in Lampung, Indonesia
Background: Low birth weight remains a major neonatal health concern. Mid-upper arm circumference (MUAC) is routinely used in Indonesia to screen pregnant women for risk of chronic energy deficiency (CED), but its association with low birth weight among term births requires careful interpretation. Objective: To examine the association between maternal risk of CED based on antenatal MUAC and low birth weight among term singleton births at Dr. H. Abdul Moeloek Regional General Hospital, Lampung, Indonesia. Methods: This retrospective record-based analytic study included 93 term singleton mother-infant pairs selected consecutively from 178 eligible delivery records from January to August 2025. Maternal risk of CED was defined as the most recent documented antenatal MUAC <23.5 cm; MUAC >=23.5 cm was classified as not at risk. Low birth weight was defined as birth weight <2,500 g. Sample adequacy was reassessed using a single-proportion approach with 95% confidence, an expected proportion of 0.50, 7.5% precision, finite-population correction, and 5% allowance for incomplete records, producing a minimum of 92 records. Pearson chi-square and crude odds ratio (OR) with 95% confidence interval (CI) were calculated. Results: Forty infants (43.0%) had low birth weight, and 20 mothers (21.5%) were at risk of CED. Low birth weight occurred in 18 of 20 mothers at risk of CED (90.0%) and in 22 of 73 mothers not at risk (30.1%). Maternal risk of CED was associated with low birth weight (p < 0.001; crude OR = 20.864; 95% CI = 4.455-97.718). The wide CI indicates substantial uncertainty in the magnitude of the estimate. Conclusion: Maternal risk of CED based on MUAC was associated with low birth weight among term singleton births. The finding supports consistent antenatal MUAC screening, but it should be interpreted as an unadjusted hospital-based association that requires confirmation in larger studies with standardized MUAC timing and multivariable adjustment.
Copyright (c) 2026 Lara Putri Upatesa, Anita Anita, Rilyani Rilyani https://creativecommons.org/licenses/by-nc/4.0/
Factors associated with exclusive breastfeeding among mothers of infants aged 7–12 months in Bandar Lampung, Indonesia: A cross-sectional study
Background: Exclusive breastfeeding is an important maternal and child health practice, but coverage can vary markedly within the same administrative area. Pinang Jaya Public Health Center reported lower coverage than the Bandar Lampung city estimate, indicating a need for local evidence. Objective: To identify maternal and contextual factors associated with exclusive breastfeeding among mothers of infants aged 7–12 months in the working area of Pinang Jaya Public Health Center, Bandar Lampung, Indonesia. Methods: This cross-sectional study included all 40 eligible mothers registered in the health-center working area in November 2025. Knowledge was measured with 20 dichotomous items (score 0–20; good = 15–20). Attitude was measured with six five-point Likert items (score 6–30; positive = 23–30), and sociocultural support was measured with ten five-point Likert items (score 10–50; supportive = 38–50). Exclusive breastfeeding was determined using a structured infant-feeding history and checked against maternal and child health records when feeding information was available. Continuity-corrected Chi-square tests were used when expected cell counts were adequate; Fisher’s exact test was used for maternal age because the minimum expected count was 2.85. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for the odds of exclusive breastfeeding. Results: Exclusive breastfeeding was reported by 21 mothers (52.5%). Significant associations were observed for good knowledge (OR = 11.900; 95% CI = 2.674–52.959; p = 0.002), being unemployed compared with employed (OR = 16.800; 95% CI = 3.417–82.603; p < 0.001), high education (OR = 8.960; 95% CI = 2.140–37.522; p = 0.005), positive attitude (OR = 10.667; 95% CI = 2.308–49.306; p = 0.003), and supportive sociocultural conditions (OR = 10.667; 95% CI = 2.308–49.306; p = 0.003). Maternal age and parity were not significantly associated with exclusive breastfeeding. Conclusion: Knowledge, employment status, education, attitude, and sociocultural support were associated with exclusive breastfeeding in this small health-center population.
Copyright (c) 2026 Renata Sheilawati, Rilyani Rilyani, Riska Wandini https://creativecommons.org/licenses/by-nc/4.0/
Preliminary effects of a red ginger–honey drink on symptoms of acute respiratory infection in toddlers: A quasi-experimental study
Background: Acute respiratory infection (ARI) is a common cause of illness in children younger than five years. Red ginger and honey have anti-inflammatory, antimicrobial, antioxidant, and demulcent properties that may relieve respiratory symptoms, although pediatric evidence remains limited. Objective: To evaluate changes in body temperature, respiratory rate, cough frequency, and peripheral oxygen saturation among toddlers receiving usual care with or without an adjunctive red ginger–honey drink. Methods: A quasi-experimental nonequivalent pretest–posttest control-group study was conducted at the Labuhan Ratu Community Health Center, Bandar Lampung, in 2026. Thirty toddlers with physician-diagnosed ARI were selected purposively and allocated to an intervention group (n = 15) or a control group (n = 15). Both groups continued physician-prescribed care; the intervention group additionally received a drink prepared from 5–10 g of fresh red ginger in 150–200 mL of water plus 10 g of honey twice daily for five days. Paired-samples t tests and Wilcoxon signed-rank tests evaluated within-group changes. Results: Body temperature did not change significantly in either group (intervention p = .913; control p = .275). Respiratory rate decreased in both groups (both p = .001), cough frequency decreased in both groups (both p < .001), and oxygen saturation increased in both groups (intervention p = .002; control p = .013). The reduction in cough frequency was descriptively greater in the intervention group (mean change 8.267) than in the control group (mean change 7.200). Conclusion: Clinical improvement occurred in both groups. The red ginger–honey drink may have adjunctive potential, particularly for cough relief, but superiority over usual care cannot be established from within-group tests alone. Larger studies using randomized allocation, baseline comparability assessment, and direct between-group analyses are required.
Copyright (c) 2026 Ferri Arya Ardiyanto, Setiawati Setiawati, Linawati Novikasari https://creativecommons.org/licenses/by-nc/4.0/
Nurses ethical dilemmas in responding to requests to withdraw life-sustaining treatment: A qualitative study from bioethical and Maqashid Al-Shariah perspectives
Background: Ethical dilemmas surrounding the limitation of life-sustaining treatment in patients experiencing medical futility remain complex because they involve clinical, ethical, legal, and religious considerations. Nurses frequently encounter these situations because of their close involvement with patients and families during end-of-life care. Purpose: This study aimed to explore nurses’ ethical dilemmas in responding to the limitation of life-sustaining treatment from bioethical and maqashid al-Shari’ah perspectives. Methods: This descriptive qualitative study used purposive sampling. Eleven participants, comprising seven nursing professionals and four religious leaders from Sumedang and Bandung, Indonesia, were recruited. Data were collected through in-depth, semi-structured interviews and analyzed using the Miles and Huberman interactive analysis model. Results: Four major themes emerged: (1) limitations of nurses’ authority in decision-making; (2) nurses’ roles as patient advocates and communication mediators; (3) integration of bioethical principles and maqashid al-Shari’ah in treatment limitation under conditions of medical futility; and (4) transformation of nursing care toward palliative and spiritual approaches. Participants emphasized that nurses do not have independent authority to discontinue life-sustaining treatment but play essential roles in advocacy, communication, comfort care, and spiritual support. Treatment-limitation decisions were understood as multidisciplinary clinical decisions guided by bioethical principles and the concept of hifz al-nafs. Conclusions: Ethical dilemmas related to treatment limitation in medical futility require an integrative approach combining clinical, ethical, legal, and spiritual considerations. The findings highlight the importance of collaboration among healthcare professionals, families, and religious leaders in supporting ethical, patient-centered end-of-life care.
Copyright (c) 2026 Lulu Azizah Zahro, Alyya Dwiyulianti Pratiwi, Lugita Julian Pamungkas, Nabila Komarudin, R Intania Putri Az Zahra, Tedi Supriyadi, Akhmad Faozi https://creativecommons.org/licenses/by-nc/4.0/
Nursing interventions in the prevention of postpartum hemorrhage: A systematic review
Background: Postpartum hemorrhage (PPH) remains a major cause of preventable maternal morbidity and mortality. Nursing and midwifery interventions may contribute to risk recognition, early response, clinical monitoring, and professional preparedness; however, the available evidence is methodologically diverse. Objective: To synthesize eight eligible publications on nursing and midwifery contributions to postpartum hemorrhage (PPH) prevention and early management, including primary intervention evidence and contextual or conceptual evidence, and to examine their relevance to Wiedenbach's Need for Help theory. Methods: This systematic review was reported in accordance with PRISMA 2020. PubMed, ProQuest, SAGE Journals, and ClinicalKey for Nursing were searched for English-language publications from January 2015 to December 2025. The search identified 5,397 records, 56 full-text reports were assessed, and eight publications were included: four primary intervention studies and four contextual or conceptual publications. Design-appropriate Joanna Briggs Institute appraisal criteria were used, and findings were synthesized narratively in separate evidence strata. Results: The eight included publications comprised one randomized clinical trial, one non-randomized controlled study, two one-group pretest-posttest studies, one qualitative evidence synthesis, one integrative review, one narrative review, and one conceptual paper. Primary clinical studies reported reductions in blood-loss scores or nursing risk events, while educational studies reported improved knowledge or competency. Contextual sources highlighted physiological care strategies, objective monitoring, communication, resource readiness, and barriers to timely recognition. None of the publications directly tested Wiedenbach's theory. Conclusion: Nursing and midwifery interventions show potential to strengthen PPH prevention and early management.
Copyright (c) 2026 Jenoveva Soares, Nopi Nur Khasanah, Sri Wahyuni https://creativecommons.org/licenses/by-nc/4.0/
Nutrition-related parenting practices and child nutritional status in urban and rural settings: A systematic review
Background: Nutrition-related parenting practices operate within social and geographic environments that shape food availability, caregiving resources, and access to preventive services. Evidence linking these practices to child nutritional status across urban and rural settings remains fragmented and methodologically heterogeneous. Objective: To synthesize evidence on the association between nutrition-related parenting or caregiving practices and nutritional status among children aged 0–12 years, and to examine whether the association differs between urban and rural settings. Methods: This systematic review followed PRISMA 2020 and the Synthesis Without Meta-analysis (SWiM) framework. The last search was conducted on 31 May 2026 in Scopus, PubMed/MEDLINE, SAGE Journals, and ClinicalKey for Nursing for English-language studies published from January 2015 to May 2026. Results: Eight cross-sectional studies involving 6,062 children or caregiver–child pairs were included; two were secondary analyses of population-based surveys. Three studies were rated low risk of bias and five moderate risk. Rural children consistently had a higher burden of stunting or underweight in comparative studies, but urban–rural differences in feeding practices did not uniformly account for this gap. Delayed complementary feeding and bottle feeding were associated with malnutrition in one Indian study. Grandparenting was associated with malnutrition in rural, but not urban, Chinese children. In other studies, feeding domains showed weak or non-significant associations after adjustment, while child illness, birth weight, maternal nutritional status, household socioeconomic conditions, and service use were more consistent correlates. Conclusion: Nutrition-related parenting practices are relevant to child nutritional status, but their effects are contingent on household resources, child health, and place of residence. The evidence does not support treating urban–rural residence or parenting practice as an isolated causal determinant.
Copyright (c) 2026 Komariah Komariah, Nopi Nur Khasanah, Sri Wahyuni, Herry Susanto, Sri Tutik Rahayu https://creativecommons.org/licenses/by-nc/4.0/
Changes in self-care following a family-based care intervention among patients with type 2 diabetes mellitus: A one-group pretest–posttest study
Background: Self-care is a fundamental component of diabetes management; however, many patients with type 2 diabetes mellitus demonstrate inadequate self-care practices. Family support plays an important role in promoting adherence to medication, dietary management, physical activity, blood glucose monitoring, and foot care, thereby supporting diabetes self-management. Objective: This study aimed to evaluate changes in self-care following a family-based care intervention among patients with type 2 diabetes mellitus. Methods: A quantitative pre-experimental study using a one-group pretest–posttest design was conducted among 30 patients with type 2 diabetes mellitus recruited through purposive sampling at Mijen Primary Health Center, Semarang, Indonesia. Participants received a two-week family-based care intervention consisting of structured family education during the first week and family monitoring during the second week. Self-care was assessed before the intervention and immediately after the intervention using the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. Data were analyzed using the Wilcoxon signed-rank test. Results: Most participants were aged 56–65 years (53.3%), female (56.7%), and had completed elementary school education (40.0%). Before the intervention, most participants were categorized as having fair self-care (53.3%), whereas after the intervention, most were categorized as having good self-care (63.3%). Wilcoxon signed-rank test showed a statistically significant difference between pretest and posttest self-care scores (Z = −4.963, p < 0.001). Conclusion: Participants demonstrated higher self-care scores following the family-based care intervention than before the intervention. These findings provide preliminary evidence that involving family members may support self-care among patients with type 2 diabetes mellitus in primary healthcare settings. Further controlled studies with larger samples and longer follow-up periods are needed to confirm the effectiveness of this intervention.
Copyright (c) 2026 Chika Tiara Oktaviana, Ismonah Ismonah, Dwi Yogo Budi Prabowo https://creativecommons.org/licenses/by-nc/4.0/
Changes in low back pain intensity following red ginger warm compresses among pregnant women in the third trimester: A pre-experimental study
Background: Pregnancy is a natural process experienced by every woman, during pregnancy the mother can experience various complaints, one of which is back pain, especially in the third trimester. If not addressed, back pain can disrupt daily activities and reduce the quality of life of pregnant women. One non-pharmacological intervention to reduce back pain is the red ginger warm compress therapy. Red ginger contains essential oils that are warm, thus increasing blood flow, helping muscle relaxation, and reducing pain. Objective: This study aims to determine the effectiveness of giving a red ginger warm compress in reducing back pain in pregnant women in the third trimester. Methods: This study is a quasi-experimental study using a one-group pretest-posttest design, with a sample of 32 pregnant women in the third trimester. Sampling used non-probability sampling with purposive sampling technique. The research instrument includes an observation sheet using the Numeric Rating Scale (NRS) for pain. Results: The results show a significant decrease in back pain scores among pregnant women p<0,001, with baseline back pain scores of 4,56±1,900 and after therapy 2,47±1,344. Conclusion: The results of this study indicate that red ginger warm compress therapy is effective in reducing back pain intensity among pregnant women in the third trimester. Therefore, red ginger warm compress therapy can be recommended as a non-pharmacological intervention to help alleviate back pain intensity in this population.
Copyright (c) 2026 Popi Lya Destari, Risqina Putri, Afrilia Fazrina, Afni Yan Syah, Che Azunie Che Abdullah https://creativecommons.org/licenses/by-nc/4.0/
Association between nurses’ caring behaviors and patient satisfaction in inpatient wards of a hospital in South Tangerang city: A cross-sectional study
Background: Nursing care extends beyond clinical procedures to include interpersonal, psychological, social, and emotional support. Preliminary observations in the study setting indicated that patients generally perceived technical aspects of care positively, while gaps remained in emotional interaction and psychosocial support. Objective: To examine the association between nurses’ caring behaviors and patient satisfaction among inpatients at a hospital in South Tangerang City in 2026. Methods: This quantitative correlational study used a cross-sectional design. A total of 67 inpatients from class II and III wards were selected using purposive sampling. Nurses’ caring behaviors were assessed using the Caring Behavior Inventory (CBI-24), while patient satisfaction was assessed using SERVQUAL. Data were summarized descriptively and the association between caring behavior and patient satisfaction was tested using the chi-square test. Results: Most respondents were in the 18–59-year age category (88.1%) and were female (67.2%). More than half rated nurses’ caring behavior as low (52.2%), and 56.7% reported dissatisfaction with the services received. Among SERVQUAL dimensions, empathy had the highest dissatisfaction, with 42 of 67 respondents (62.7%) reporting dissatisfaction. Nurses’ caring behavior was significantly associated with patient satisfaction (p < 0.001). Patients who perceived low caring behavior had higher odds of reporting dissatisfaction than those who perceived high caring behavior (OR = 8.80; 95% CI: 2.91–26.63). Conclusion: Nurses’ caring behavior was significantly associated with patient satisfaction in the studied inpatient wards. Because of the cross-sectional design, the finding should be interpreted as an association rather than a causal relationship.
Copyright (c) 2026 Vebry Haryati Lubis, Devi Andriani, Afrilia Fazrina https://creativecommons.org/licenses/by-nc/4.0/