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).
Factors associated with exclusive breastfeeding success among breastfeeding mothers in Ogan Komering Ulu Regency, Indonesia: A cross-sectional study
Background: Exclusive breastfeeding is an essential intervention for improving infant health, growth, and development. Despite its well-established benefits, the coverage of exclusive breastfeeding in several regions of Indonesia remains below target, including in the working area of Puskesmas Peninjauan, Ogan Komering Ulu Regency. The success of exclusive breastfeeding is influenced by multiple maternal and environmental factors, including maternal knowledge, family support, parity, and pregnancy interval. Objective: This study aimed to analyze the factors associated with the success of exclusive breastfeeding among breastfeeding mothers in the working area of Puskesmas Peninjauan, Ogan Komering Ulu Regency. Methods: This study employed an analytical quantitative design with a cross-sectional approach. The study was conducted from June to July 2025 and involved all mothers with infants aged 7–12 months in the working area of Puskesmas Peninjauan, with a total of 61 respondents selected using total sampling. Data were collected using a checklist form and structured questionnaires covering maternal knowledge, family support, parity, pregnancy interval, and exclusive breastfeeding success. Data were analyzed using univariate and bivariate analyses with the Chi-square test at a 95% significance level (α = 0.05). Results: Most respondents were aged 21–30 years (52.5%), had completed senior high school (37.7%), and were homemakers (88.5%). A total of 91.8% of mothers successfully practiced exclusive breastfeeding. Bivariate analysis showed that family support was significantly associated with exclusive breastfeeding success (p = 0.002), whereas maternal knowledge (p = 0.353), parity (p = 0.215), and pregnancy interval (p = 0.052) were not significantly associated. Conclusion: Family support was the most influential factor associated with the success of exclusive breastfeeding. Strengthening the involvement of husbands and family members in breastfeeding education and lactation support should be integrated into maternal and child health services to improve exclusive breastfeeding outcomes.
Copyright (c) 2026 Ranida Arsi, Ulva Rachmawati, Fitri Afdhal https://creativecommons.org/licenses/by-nc/4.0/
Exploring mothers’ perceptions of the role of integrated health posts (Posyandu) in stunting prevention: A qualitative study
Background: Stunting remains a public health problem with long-term consequences for child growth and development. Integrated Health Posts (Posyandu) play a strategic role as community-based health services in stunting prevention; however, their utilization is influenced by mothers’ perceptions of the role and function of Posyandu. Objective: This study aimed to gain an in-depth understanding of mothers’ perceptions of the role of Posyandu in stunting prevention in the working area of Martapura 1 Primary Health Center. Methods: This study employed a qualitative design with a descriptive phenomenological approach. The study was conducted in June 2025 in the working area of Martapura 1 Primary Health Center. Participants were recruited using purposive sampling, with inclusion criteria of mothers who had stunted children under five years of age. A total of 13 participants were involved until data saturation was achieved. Data were collected through in-depth interviews using semi-structured interview guidelines and analyzed through transcription, coding, categorization, and thematic analysis with the assistance of NVivo 12 software. Results: The findings identified four themes related to mothers’ perceptions of the role of Posyandu in stunting prevention in the working area of Martapura 1 Primary Health Center: (1) visit patterns; (2) Posyandu services; (3) perceived benefits of Posyandu; and (4) mothers’ expectations. Conclusion: Mothers primarily perceived Posyandu as a place for routine child growth monitoring, while its role in stunting prevention was not fully understood. These findings indicate a gap between the ideal role of Posyandu in stunting prevention and mothers’ perceptions at the community level.
Copyright (c) 2026 Filia Sofiani Ikasari, Iis Pusparina https://creativecommons.org/licenses/by-nc/4.0/
Strengthening palliative nursing care through integration of islamic educational values: An integrative review
Background: Spiritual care is a core component in palliative nursing, but most of the literature still discusses it in a general framework and has not systematically integrated Islamic educational values as an ethical and professional foundation. Objective: Formulating a conceptual framework for strengthening palliative nursing care through the integration of Islamic educational values. Methods: The study used an integrative literature review design following the PRISMA flow. A systematic search was conducted on PubMed, Scopus, ScienceDirect, and Google Scholar for articles from January 2010–June 2025. The final search was conducted in June 2025 using a combination of the keywords “Islamic values,” “Islamic education,” “palliative nursing,” “palliative care,” and “spiritual care.” Of the 215 articles identified, 30 met the inclusion criteria after screening and full-text review. Analysis was conducted through thematic synthesis and quality assessment using the CASP and JBI checklists. Results: Four dominant core values were identified: rahmah (compassion), patience, sincerity, and trust (relief), with trust as a key determinant of professional ethics. Rahmah emerged most frequently and contributed to improved therapeutic communication, reduced anxiety, increased emotional support, and improved quality of life for terminally ill patients. The integration of these values also impacted patient satisfaction and strengthened nurse professionalism. Conclusion: The integration of Islamic educational values strengthens the ethical, spiritual, and professional dimensions of palliative nursing practice in a holistic and evidence-based manner. Further research using quantitative or mixed methods designs is needed to increase the generalizability of the findings.
Copyright (c) 2026 Imam Ghozali, Erni Yusnita https://creativecommons.org/licenses/by-nc/4.0/
Factors influencing the nutritional status of adolescents during the COVID-19 pandemic: A cross-sectional study
Background: The COVID-19 pandemic substantially altered adolescents’ daily routines, including eating habits, physical activity, and sleep patterns, all of which may influence nutritional status. Evidence from Indonesia remains limited, particularly regarding the simultaneous contribution of these behavioral factors during periods of prolonged social restriction. Objective: This study aimed to examine the associations between dietary patterns, physical activity, sleep quality, and nutritional status among adolescents in Pekanbaru, Indonesia, during the COVID-19 pandemic. Methods: A cross-sectional study was conducted from June to November 2021 among 75 adolescents aged 15–18 years in Pekanbaru, Riau Province, Indonesia. Participants were recruited through convenience sampling using school and alumni WhatsApp groups. Data were collected online using a structured self-administered questionnaire that included a Food Frequency Questionnaire for dietary patterns, the Indonesian version of the Physical Activity Questionnaire for Adolescents (PAQ-A), and the Pediatric Daytime Sleepiness Scale (PDSS) for sleep-related problems. Nutritional status was assessed using self-reported weight and height to calculate body mass index (BMI), which was then classified into underweight, normal, and overweight categories. Descriptive statistics and chi-square tests were used for data analysis, with statistical significance set at p < 0.05. Results: Of the 75 participants, most were 17 years old (40.0%) and female (70.7%). Overall, 68.0% had normal nutritional status, 18.7% were overweight, and 13.3% were underweight. Chi-square analysis showed significant associations between dietary patterns and nutritional status (p = 0.001), sleep quality and nutritional status (p = 0.001), and physical activity and nutritional status (p = 0.001). These findings indicate that unhealthy dietary patterns, poor sleep-related functioning, and lower physical activity were associated with abnormal BMI categories among adolescents. Conclusion: Dietary patterns, physical activity, and sleep quality were significantly associated with adolescent nutritional status during the COVID-19 pandemic. These findings highlight the importance of integrated behavioral screening and adolescent health interventions targeting diet, movement, and sleep to support optimal nutritional outcomes.
Copyright (c) 2026 Riri Novayelinda, Oswati Hasanah, Syafrida Hanum https://creativecommons.org/licenses/by-nc/4.0/
Effectiveness of health belief model-based prenatal education on anemia prevention behaviors among pregnant women: A systematic review
Background: Anemia during pregnancy remains a major public health concern because it contributes to adverse maternal and fetal outcomes and is strongly influenced by modifiable health behaviors. Prenatal education grounded in behavioral theory has gained increasing attention as a strategy to improve preventive practices, particularly in primary care and community settings. The Health Belief Model offers a relevant framework because it addresses women’s perceptions of risk, benefits, barriers, and cues to action related to anemia prevention. Objective: This systematic review aimed to evaluate the effectiveness of Health Belief Model-based prenatal education on anemia prevention behaviors among pregnant women in community health centers and other primary care settings. Methods: This study applied a systematic review design. Literature searches were conducted across major electronic databases using combinations of terms related to the Health Belief Model, prenatal education, pregnant women, anemia, iron supplementation, hemoglobin, and primary health care. The main outcomes were hemoglobin level, anemia prevalence, iron-folic acid supplementation adherence, dietary intake, and behavioral determinants. Data were extracted using a structured form and synthesized narratively. Results: Eight studies were included in the final synthesis. The findings consistently showed that Health Belief Model-based or theory-based prenatal education improved anemia prevention behaviors and related health outcomes. The strongest effects were observed in iron-folic acid supplementation adherence, hemoglobin improvement, anemia reduction, and healthier dietary practices. Several studies also reported gains in maternal knowledge, attitudes, and selected Health Belief Model constructs, especially perceived susceptibility and cues to action. Interventions that combined counseling with educational media, reminder systems, or repeated follow-up produced more consistent benefits across settings. Conclusion: Health Belief Model-based prenatal education appears to be an effective strategy for improving anemia prevention behaviors among pregnant women in community and primary care settings. Integrating theory-based educational interventions into routine antenatal services may strengthen maternal anemia prevention and support better pregnancy outcomes.
Copyright (c) 2026 Febriana Soares De Araujo, Herry Susanto, Sri Wahyuni https://creativecommons.org/licenses/by-nc/4.0/
Effectiveness of health belief model-based reproductive health education on menarche preparedness: A systematic review
Background: Menarche preparedness is an important component of adolescent reproductive health because inadequate knowledge, negative perceptions, and anxiety may hinder girls’ ability to adapt to their first menstruation. Health education based on the Health Belief Model (HBM) has been increasingly used to improve adolescent readiness by addressing beliefs, perceptions, and preventive behaviors related to reproductive health. Objective: This systematic review aimed to evaluate the effectiveness of HBM-based reproductive health education on menarche preparedness among adolescent girls. Methods: Literature searches were conducted in ProQuest, Scopus, ScienceDirect, and SAGE Journals, with additional searching through grey literature and reference lists. The search covered publications from 2015 to 2025 in English and Indonesian. Eligible studies included quantitative intervention studies examining HBM-based reproductive health education in relation to menarche preparedness or closely related outcomes among adolescent girls. Data were extracted using a structured form and synthesized narratively because of heterogeneity in study design, intervention format, and outcome measures. Results: A total of 30,651 records were identified, of which 42 studies met the eligibility criteria for inclusion. The reviewed evidence consistently showed that HBM-based reproductive health education improved menstrual knowledge, increased positive attitudes, reduced anxiety, and enhanced emotional and behavioral readiness for menarche. Several studies also demonstrated improved menstrual hygiene practices and stronger preparedness when family support and culturally sensitive approaches were incorporated. Although the included studies varied in design and measurement, the overall direction of evidence indicated a beneficial effect of HBM-based educational interventions on adolescent girls’ preparedness for menarche. Conclusion: HBM-based reproductive health education is effective in improving adolescent girls’ preparedness for menarche across cognitive, emotional, and behavioral domains. The integration of theory-based, culturally appropriate, and family-supported educational strategies into school and community health programs may strengthen adolescent reproductive health outcomes.
Copyright (c) 2026 Sitti Nurhaisa, Sri Wahyuni, Herry Susanto https://creativecommons.org/licenses/by-nc/4.0/
Factors influencing family support and family burden in caring for family members with a history of violent behavior: A systematic review
Background: Family caregivers play a central role in caring for relatives with severe mental illness, particularly those with a history of violent behavior. In this context, caregivers are required to provide continuous supervision, emotional support, and practical assistance, while also managing fear, stigma, and prolonged caregiving demands. These conditions may influence both family support and family burden through a complex interaction of clinical, psychosocial, and structural factors. Objective: This study aimed to systematically identify, analyze, and synthesize the factors influencing family support and family burden in caring for family members with a history of violent behavior. Methods: This study employed a systematic review design. A comprehensive literature search was conducted in PubMed, Scopus, ProQuest, SAGE Journals, and ClinicalKey for Nursing for studies published between 2015 and 2025. Quantitative, qualitative, and mixed-method studies were included if they examined determinants of family support or caregiver burden among family caregivers of individuals with severe mental illness involving aggression or a history of violent behavior. Study selection, data extraction, and methodological quality appraisal were conducted independently by two reviewers using standardized procedures and the Joanna Briggs Institute critical appraisal tools. Results: Ten studies met the inclusion criteria. The review identified three major domains influencing family support and family burden: clinical factors, psychosocial factors, and structural factors. Patient aggression, symptom severity, relapse, and poor social functioning consistently increased caregiver burden. Psychosocial factors, particularly affiliated stigma, emotional distress, gendered caregiving roles, and family relationship patterns, further intensified burden and reduced caregiving resilience. Structural barriers, including limited access to mental health services, weak care coordination, insufficient caregiver involvement in decision-making, and economic hardship, also weakened family support capacity. Intervention evidence suggested that family psychoeducation and structured support may reduce caregiver burden, although their effectiveness varied across contexts. Conclusion: Family support and family burden in the care of relatives with a history of violent behavior are shaped by interrelated clinical, psychosocial, and structural determinants. Family-centered and context-sensitive mental health interventions are needed to reduce caregiver burden and strengthen sustainable family support.
Copyright (c) 2026 Andre Soares Dos Santos, Dwi Heppy Rochmawati, Wahyu Endang Setyowati https://creativecommons.org/licenses/by-nc/4.0/
The mediating role of sleep quality in the relationship between workload and employees’ job stress: A systematic review
Background: Workload is a major occupational factor that contributes to employees’ job stress and may also impair sleep quality. Increasing evidence suggests that sleep quality is not merely an outcome of work strain, but may function as an important mechanism through which workload influences psychological well-being. However, the mediating role of sleep quality in the relationship between workload and employees’ job stress has not been systematically synthesized across occupational settings. Objective: This systematic review aimed to examine the mediating role of sleep quality in the relationship between workload and employees’ job stress and to synthesize current evidence on how sleep quality explains or modifies this association across employee populations. Methods: This study employed a systematic review design. Literature searches were conducted in Scopus, PubMed, ScienceDirect, ProQuest, and ClinicalKey for Nursing for articles published between 2015 and 2025. Studies were included if they involved employees or workers, examined workload or work-related stress, assessed sleep quality, and reported job stress-related outcomes. Study selection, data extraction, and quality appraisal were conducted systematically, and the findings were synthesized narratively because of heterogeneity in study designs, measures, and analytical approaches. Results: The search identified 2,264 records, and 12 studies were included in the final synthesis. The included studies consistently showed that higher workload or work-related stress was associated with poorer sleep quality across diverse occupational groups. Sleep quality emerged as a recurrent mediating factor linking occupational burden with adverse outcomes, including burnout, depressive symptoms, daytime dysfunction, and reduced well-being. Additional psychological mechanisms, such as rumination, anxiety, and depression, frequently strengthened this pathway, whereas physical activity, resilience, and social support appeared to buffer the negative effects. Conclusion: Sleep quality plays a significant mediating role in the relationship between workload and employees’ job stress. Interventions to reduce job stress should therefore address not only workload management, but also sleep health and related psychological factors in the workplace.
Copyright (c) 2026 Liwingston Filemon Mona, Iskim Luthfa, Muh Abdurrouf, Dwi Heppy Rochmawati https://creativecommons.org/licenses/by-nc/4.0/
Association between family support and activities of daily living among patients undergoing hemodialysis: A cross-sectional study
Background: Patients with hemodialysis frequently experience physical limitations that may affect their capacity to accomplish Activities of Daily Living (ADL). This decline in independence increases patients’ dependence on others. Family support plays a crucial role in helping patients maintain independence and refine the quality of their lives during long-term treatment. Objective: This study aimed to determine the association between family support and Activities of Daily Living (ADL) among patients undergoing hemodialysis. Methods: A cross-sectional analytical correlational study was implemented at Muhammadiyah General Hospital. The participants were 50 patients with chronic kidney disease undergoing hemodialysis for at least three months, aged 18-60 years, selected through purposive sampling. Family support was assessed using the Perceived Social Support–Family (PSS-FA) instrument, while independence in activities of daily living (ADL) was measured using the Barthel Index. Descriptive statistics were used to summarize participants characteristics. The relationship between family support and ADL was analyzed using Somers' d test at the 5% significance level. Results: The evidence indicates that most respondents received high levels of family support (86%) and had relatively good levels of independence in performing ADL (68%). Statistical analysis indicated a critical association between family support and ADL among hemodialysis patients (p=0.001; r = 0.61). These findings imply that higher levels of family support contribute to improve patient independence in carrying out daily activities. Conclusion: Family support is significantly associated with the capacity of hemodialysis patients to perform Activities of Daily Living. Strengthening family involvement through family-centered nursing interventios may help improve patient independence and overall well-being during long-term hemodialysis treatment.
Copyright (c) 2026 Intan Kumala Sari, Dwi Soelistyoningsih, Achmad Rifa'i, Abdul Qodir https://creativecommons.org/licenses/by-nc/4.0/
Family caregivers’ perception and response to COVID-19 in caring for older adults with chronic diseases: A qualitative study
Background: The older adult is the vulnerable group to infecting COVID-19 and most of them live with their families. The family must take care of them while they face various problems during the pandemic. It will probably tend to more stress and burden so the understanding of their perception and response on dealing with older adults with chronic diseases is vital. Objective: This study explored exploring about perceptions and responses of family caregiver’s older adults with chronic diseases about COVID-19 disease. Methods: The study used qualitative descriptive phenomenology by using online semi-structured interviews with family caregivers of older adults with chronic diseases in Samarinda, Indonesia from September to November 2021. Sixteen family caregivers of older adults participated that was using purposive sampling method. The data analysis conducted by Collaizi technique and rigor process were included peer debriefing with peers, member checking of the outcome, and inquiry audit. Results: After qualitative analysis, three main themes emerged: 1) Views of older adult families on covid-19 disease (positive and negative views on Covid-19 disease); 2) Older adult family caregiver responses in facing covid-19 vaccination of older adult with chronic diseases (negative thoughts about vaccinations, family efforts to facilitate vaccination for the older adult); 3) Families facilitate traditional medicine are an option that is of interest to the older adult to prevent and deal with covid-19 disease (opinions of the older adult to consume herbal medicine, reasons for older adult consuming herbal medicine). Conclusion: This study showed that Indonesian older adult family caregivers have various perceptions and responses to older adults with chronic diseases during the pandemic. The government needs to enhance health promotion regarding COVID-19 and vaccination. Older people commonly use herbal medicine, so information about ingredients and dose must be educated properly.
Copyright (c) 2026 Bahtiar Bahtiar, Nurlaila Fitriani, Dwi Nopriyanto, Ida Ayu Kade Sri Widiastuti, Arief Andriyanto, Ikbal Fradianto, Eriyono Budi Wijoyo https://creativecommons.org/licenses/by-nc/4.0/
Effectiveness of combined ar-rahman murottal therapy and lavender aromatherapy for family anxiety reduction in intensive care unit waiting rooms: A systematic review
Background: Family members who wait for patients in intensive care units frequently experience anxiety due to uncertainty, emotional burden, and fear related to critical illness. Non-pharmacological interventions such as Qur’anic murottal therapy and lavender aromatherapy have been increasingly explored because both approaches may promote relaxation, emotional comfort, and psychological stability in stressful clinical situations. However, evidence regarding their combined effectiveness for reducing anxiety among families in ICU waiting rooms remains limited and scattered across different clinical contexts. Objective: This systematic review aimed to examine the effectiveness of combined Ar-Rahman murottal therapy and lavender aromatherapy for reducing anxiety among family members in intensive care unit waiting rooms. Methods: This study used a systematic review design and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guideline. Literature searches were conducted in ClinicalKey for Nursing, SAGE Journals, ProQuest, and Google Scholar using combinations of keywords related to murottal therapy, lavender aromatherapy, anxiety, ICU, and family health. Studies published in English or Indonesian within the last 10 years were considered. Experimental and quasi-experimental studies were included, while irrelevant studies, methodologically weak articles, grey literature, and studies outside the review focus were excluded. Study selection, quality appraisal, and data extraction were conducted independently by two reviewers. Of 1,942 records initially identified, 12 full-text articles were assessed, 2 were excluded because of high risk of bias, and 10 studies were included in the final synthesis. Results: The included studies showed that the combination of Ar-Rahman murottal therapy and lavender aromatherapy was associated with reduced anxiety across several clinical contexts. The strongest evidence came from studies involving family members in ICU waiting rooms, where the combined intervention significantly reduced anxiety levels. Indirect evidence from preoperative, inpatient, and waiting-room populations supported the anxiolytic potential of both therapies. Overall, the findings suggested a consistent positive direction of effect, although the evidence remained heterogeneous in terms of population, setting, intervention duration, and measurement instruments. Conclusion: Combined Ar-Rahman murottal therapy and lavender aromatherapy appears to be a promising complementary intervention for reducing anxiety among family members in ICU waiting rooms. Nevertheless, further rigorous studies focusing specifically on ICU family populations are needed to strengthen the evidence base and support wider implementation in family-centered critical care nursing.
Copyright (c) 2026 Sukran Suyanto, Ahmad Ikhlasul Amal, Erna Melastuti, Indah Sri Wahyuningsih https://creativecommons.org/licenses/by-nc/4.0/
Exploring cancer patients’ experiences of end-of-life care in hospital settings: A qualitative study
Background: Cancer patients in the advanced stages of illness often receive end-of-life care in hospital settings where intensive medical interventions, complex decision-making, and limited family involvement may influence their physical, emotional, and existential experiences. Hospital-based end-of-life care presents unique challenges, particularly in contexts where palliative care integration is limited and care delivery is shaped by institutional priorities. Understanding patients’ lived experiences is essential to inform patient-centered and dignity-preserving end-of-life care practices. Objective: This study aimed to explore cancer patients’ experiences of end-of-life care in hospital settings. Methods: A qualitative phenomenological design was employed to capture the lived experiences of adult cancer patients receiving end-of-life care in hospital settings in Africa. Purposive sampling was used to recruit participants who met the inclusion criteria. Data were collected through in-depth semi-structured interviews and analyzed using thematic analysis. Strategies to ensure trustworthiness included member checking, reflexive journaling, peer debriefing, and the development of an audit trail. Results: Three main themes emerged from the analysis: experiencing physical and emotional vulnerability at the end of life, navigating relationships and communication in hospital-based end-of-life care, and seeking dignity and meaning during the final stage of life. Participants described persistent physical symptoms and emotional distress as central aspects of their end-of-life experiences. Limited communication and dependence on healthcare professionals shaped patients’ sense of control and security. Participants also emphasized the importance of dignity, respectful care, and opportunities for reflection on life and death during hospitalization. Conclusion: Cancer patients experience end-of-life care in hospital settings as a complex and deeply personal process influenced by symptom burden, communication quality, family involvement, and dignity-preserving practices. Hospital-based end-of-life care should prioritize holistic, patient-centered approaches that address physical, emotional, and existential needs.
Copyright (c) 2026 Kwame Mensah, Amina Okafor, Samuel Ndlovu https://creativecommons.org/licenses/by-nc/4.0/
Exploring older adults' experiences of community-based exercise programs in community nursing interventions: A qualitative study
Background: The increasing number of older adults is a challenge for public health systems, especially in low- and middle-income countries, because the aging process is often accompanied by a decline in physical function and quality of life in the elderly. Although various studies have shown that community nursing interventions through physical exercise programs have been proven effective, an in-depth understanding of how older adults interpret and directly experience their involvement in these programs is still limited. Objective: This study aims to explore the experiences of older adults who participated in a community-based physical exercise program in Malang City using a qualitative phenomenological approach. Methods: A qualitative phenomenological study was conducted among 24 older adults living in Malang City, Indonesia, who participated in a six-week community-based exercise program. Participants were recruited using purposive sampling. Data were collected through individual, face-to-face, semi-structured interviews conducted in participants’ homes after completion of the intervention. Interviews lasted 30–60 minutes, were audio-recorded with consent, transcribed verbatim, and analyzed manually using thematic analysis. Trustworthiness was ensured through credibility, dependability, confirmability, and transferability strategies, including member checking, field notes, audit trails, and independent coding by two researchers. Results: the data was analyzed thematically and produced four main themes: (i) Rediscovering Physical Capability and Body Confidence, (ii) Exercise as a Meaningful and Enjoyable Social Experience, (iii) Growing Awareness of Health and Self-Care, and (iv) The Community Nurse as a Catalyst for Engagement and Safety. Conclusion: These findings of this study highlight that community nurses play a role not only as instructors but also as facilitators capable of fostering motivation, self-confidence, and sustained participation in older adults through an individual-centered approach. Therefore, nurse-initiated community-based physical exercise programs should be considered for more systematic integration into public health policies as part of strategies to support healthy and sustainable aging.
Copyright (c) 2026 Qory Tifani Rahmatika, Ronal Surya Aditya, Muhammad Putra Ramadhan, Achmad Masfi https://creativecommons.org/licenses/by-nc/4.0/
Association between gadget use and physical and mental health among adolescents: A cross-sectional study
Background: Gadget use has become increasingly common among adolescents and is closely integrated into learning, communication, entertainment, and daily activities. Although gadgets provide educational and social benefits, excessive or problematic use may contribute to physical complaints, including eye strain, hearing problems, and musculoskeletal pain, as well as mental health problems such as depressive symptoms. However, empirical evidence regarding the association between gadget use and adolescent physical and mental health remains limited. Objective: This study aimed to examine the association between gadget use and physical and mental health among adolescents. Methods: A cross-sectional analytic survey was conducted among students at a state vocational high school in Palembang City, Indonesia. A total sampling technique was used, resulting in 50 respondents. Gadget use was measured using an adapted Mobile Phone Problematic Use Scale, while physical health was assessed based on eye health, hearing health, and pain-related complaints. Mental health was measured using the 6-item Kutcher Adolescent Depression Scale. Data were analyzed using univariate analysis and Kendall’s tau correlation test, with a significance level of 0.05. Results: Most respondents were middle adolescents aged 16–18 years (90%) and male (68%). The majority were classified as at-risk gadget users (90%). More than half of the respondents had moderate physical health problems (56%), and most respondents were categorized as having depressive symptoms (90%). Bivariate analysis showed no significant association between gadget use and physical health among adolescents (r = 0.055; p = 0.687). Similarly, no significant association was found between gadget use and mental health (r = 0.228; p = 0.106). Conclusion: Gadget use was not significantly associated with physical or mental health among adolescents in this study. These findings suggest that adolescent physical and mental health may be influenced by multiple factors beyond gadget use, including lifestyle, social environment, family factors, academic stress, and individual coping mechanisms. Further studies with larger samples and more comprehensive assessment of confounding variables are recommended.
Copyright (c) 2026 Novita Elisabeth Daeli, Sanny Frisca, Aprida Manurung https://creativecommons.org/licenses/by-nc/4.0/
Parent-adolescent communication and adolescent mental health outcomes: A systematic review
Background: Parent-adolescent communication is an essential family process that may influence adolescent mental health outcomes, particularly during a developmental period marked by emotional, social, and behavioral transitions. Poor communication within the family may increase adolescents’ vulnerability to depression, anxiety, emotional difficulties, behavioral problems, suicidal ideation, and low psychological well-being. Objective: This systematic review aimed to synthesize current evidence on the relationship between parent-adolescent communication and adolescent mental health outcomes. Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guideline. Literature searches were conducted in Scopus, ProQuest, PubMed, and SAGE Journals, with the final search completed in March 2026. Eligible studies were primary empirical articles published between 2015 and 2026 in English or Indonesian, involving adolescents aged 10–19 years or samples predominantly composed of adolescents. Study selection, quality appraisal, and data extraction were conducted independently by two reviewers, with disagreements resolved through discussion or consultation with a third reviewer. The Joanna Briggs Institute Critical Appraisal Checklists were used to assess methodological quality. A narrative synthesis was performed because of heterogeneity in study designs, populations, communication measures, and mental health outcomes. Results: Of 10,803 records initially identified, 10 studies were included in the final synthesis. The evidence showed that positive, open, consistent, and culturally sensitive parent-adolescent communication was associated with better adolescent mental health outcomes. Poor communication was linked to higher depressive symptoms, anxiety, emotional distress, behavioral problems, family conflict, and reduced treatment engagement. Communication also supported emotional disclosure, help-seeking behavior, parental care management during suicidal crises, and engagement in family-centered mental health interventions. Cultural context, digital exposure, parental mental health literacy, and structural barriers influenced the quality of communication. Conclusion: Parent-adolescent communication is a key protective factor for adolescent mental health. Family-centered prevention and clinical interventions should strengthen parental listening, emotional validation, mental health literacy, crisis response, and culturally responsive communication.
Copyright (c) 2026 Dewa Ayu Sri Saraswati, Zakiyah Mujahidah https://creativecommons.org/licenses/by-nc/4.0/
Caregiver burden and coping strategies among family caregivers of patients with chronic kidney disease undergoing hemodialysis: A descriptive study
Background: Chronic kidney disease is a progressive condition requiring long-term hemodialysis therapy and affects not only patients but also family caregivers involved in daily care. Continuous caregiving demands may lead to physical, emotional, social, financial, and care-related burdens, requiring adaptive coping strategies to sustain caregiving roles. Objective: This study aimed to identify caregiver burden and coping strategies among family caregivers of patients with chronic kidney disease undergoing hemodialysis. Methods: This descriptive quantitative study was conducted at Regional Hospital in Tarakan from December 2025 to February 2026. A total of 133 family caregivers of patients with chronic kidney disease undergoing hemodialysis were recruited using a total sampling technique based on predetermined inclusion and exclusion criteria. The Zarit Burden Interview was used to assess caregiver burden, while the Brief COPE was used to measure coping strategies. Data were analyzed using univariate analysis with Jamovi and presented as frequency distributions, percentages, medians, minimum values, and maximum values. Results: Most respondents were adults, female, housewives, had a monthly family income of IDR 1,000,000–3,000,000, and were the patients’ children. The majority of caregivers experienced mild burden, accounting for 84 respondents (63.2%). The most dominant coping strategy was emotion-focused coping, with a median score of 24, a minimum score of 13, and a maximum score of 34. The most frequently used coping subscales were positive reframing, acceptance, and religion, each with a median score of 8. Conclusion: Most family caregivers of patients with chronic kidney disease undergoing hemodialysis experienced mild caregiver burden and tended to use emotion-focused coping as their primary strategy. Regular caregiver burden screening, education on adaptive coping strategies, and psychosocial support should be strengthened within hemodialysis care services.
Copyright (c) 2026 Shinta Nur Haliza, Hendy Lesmana, Ayuk Cucuk Iskandar https://creativecommons.org/licenses/by-nc/4.0/
Effect of basic life support education using lecture and demonstration methods on teachers’ knowledge and skills in managing drowning incidents: A pra-experimental study
Background: Drowning is a time-critical emergency that can rapidly lead to respiratory failure, hypoxic injury, cardiac arrest, and death when immediate assistance is not provided. Teachers in coastal and flood-prone school environments may act as first responders because they are often the nearest adults when drowning incidents occur among students. However, teachers frequently have limited formal exposure to Basic Life Support and drowning management procedures. Objective: This study aimed to determine the effect of Basic Life Support education using lecture and demonstration methods on teachers’ knowledge and skills in managing drowning incidents. Methods: This study employed a quantitative pre-experimental design with a one-group pre-test and post-test approach. The study involved 20 teachers from the Muhammadiyah Panjang Foundation, Bandar Lampung, selected using total sampling. The intervention consisted of one structured 120-minute educational session using lecture, mannequin-based demonstration, guided practice, and feedback. Teachers’ knowledge was measured before and after the intervention using a structured questionnaire, while skills were assessed after the intervention using a standard operating procedure-based observation checklist. Descriptive statistics were used to summarize respondent characteristics, knowledge scores, and post-intervention skill performance. The Wilcoxon signed-rank test was used to examine differences in knowledge scores before and after the intervention. Results: Most respondents were female (80.0%) and aged 21–30 years (75.0%). All respondents had no previous experience in handling drowning victims or performing Basic Life Support. The mean knowledge score increased from 5.85 ± 1.140 before the intervention to 15.80 ± 0.410 after the intervention. The Wilcoxon signed-rank test showed a significant improvement in knowledge scores after the intervention (Z = -3.965; p < 0.001). The mean post-intervention skill score was 14.80 ± 0.523, indicating good practical performance after training. Conclusion: Basic Life Support education using lecture and demonstration methods significantly improved teachers’ knowledge and supported good post-intervention skills in managing drowning incidents. Schools in high-risk areas should integrate structured Basic Life Support training into routine emergency preparedness programs.
Copyright (c) 2026 Agung Julian Pangestu, Linawati Novikasari, Riska Wandini, Setiawati Setiawati https://creativecommons.org/licenses/by-nc/4.0/
Patient family satisfaction and affective anger among families of hemodialysis patients in Lampung general hospital: A cross-sectional study
Background: Hemodialysis care creates repeated interactions between healthcare providers, patients, and family members. Families who accompany patients during hemodialysis often evaluate the quality of services while also experiencing emotional tension related to caregiving demands. However, limited evidence has examined the relationship between patient family satisfaction and affective anger among families of hemodialysis patients. Objective: This study aimed to examine the relationship between patient family satisfaction and affective anger among families of patients undergoing hemodialysis at Lampung General Hospital. Methods: This study used an analytical cross-sectional design. The study was conducted in the hemodialysis unit in Bandar Lampung. A total of 179 adult family members of patients undergoing hemodialysis were selected using purposive sampling. Patient family satisfaction was measured using an adapted SERVQUAL-based questionnaire focusing on responsiveness and reliability, while affective anger was assessed using the emotional burden subscale of the Cognitive Behavioural Assessment. Data were analyzed using descriptive statistics and the Spearman Rank correlation test because the data were not normally distributed. Results: Most respondents reported being somewhat satisfied with hemodialysis services (50.8%), followed by satisfied (29.6%), dissatisfied (10.1%), very dissatisfied (8.4%), and very satisfied (1.1%). Affective anger was mostly categorized as low (37.4%), followed by moderate (28.5%), very low (16.8%), high (10.1%), and very high (7.3%). The Spearman Rank correlation test showed a strong, significant, and negative relationship between patient family satisfaction and affective anger (rs = -0.693; p < 0.001). Higher family satisfaction was associated with lower affective anger among family members. Conclusion: Patient family satisfaction was strongly and negatively associated with affective anger among families of hemodialysis patients. Hemodialysis units should strengthen family-centered care through responsive communication, reliable service processes, structured information delivery, and early identification of family emotional distress.
Copyright (c) 2026 Nabilla Puji Lestarie, Prima Dian Furqoni, Triyoso Triyoso, Dian Asih Rianty https://creativecommons.org/licenses/by-nc/4.0/
Structured exercise interventions for reducing anxiety in older adults across settings and health conditions: A systematic review
Background: Anxiety is a common psychological problem among older adults and is often not optimally managed. Pharmacological treatment may be limited by side effects and tolerability concerns in later life. Structured exercise interventions have been proposed as feasible non-pharmacological approaches, but evidence focused specifically on anxiety reduction across different older adult populations remains fragmented. Objective: To synthesize evidence on the effectiveness of structured exercise interventions in reducing anxiety among adults aged 60 years and older across different settings and health conditions. Methods: A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. PubMed, ScienceDirect, CrossRef, Scopus, and Google Scholar were searched for studies published from 2015 to 2025, with the final search conducted on April 8, 2026. Randomized controlled trials and quasi-experimental studies involving structured exercise and validated anxiety measures were included. Study quality was appraised using Joanna Briggs Institute (JBI) tools and findings were synthesized narratively. Results: Eleven studies were included. Most studies reported reductions in anxiety after aerobic exercise, resistance training, multimodal programs, or home-based routines. Effects were reported among healthy/community-dwelling older adults, nursing home residents, and participants with chronic conditions, including those with cancer and Parkinson’s disease. Interventions lasting 6-12 weeks with 2-4 sessions per week were most frequently linked with improved anxiety outcomes. Despite heterogeneity in designs and instruments, results were generally consistent in direction. Conclusions: Structured exercise interventions are generally associated with reduced anxiety in older adults across multiple settings and health conditions. Further high-quality studies are needed to clarify the most effective exercise prescription and the long-term sustainability of benefits.
Copyright (c) 2026 Anisa Rizki Fadhilah, Aditya Denny Pratama https://creativecommons.org/licenses/by-nc/4.0/
Implementation of spiritual education and the speos method using the BEST for moms e-book in mothers with ineffective breastfeeding: A nursing case study
Background: Ineffective breastfeeding remains a common postpartum nursing problem and may be manifested by insufficient milk production, poor infant latch, low breastfeeding frequency, infant dissatisfaction after feeding, and maternal anxiety. Mothers with ineffective breastfeeding require an intervention that addresses not only physiological milk production but also maternal knowledge, confidence, emotional readiness, and spiritual meaning. Spiritual breastfeeding education combined with the Stimulation of Endorphin, Oxytocin, and Suggestive massage method and digital learning media may offer a holistic approach to support breastfeeding success. Objective: This study aimed to describe the application of spiritual breastfeeding education and the SPEOS method using the BEST for Moms e-book among mothers with ineffective breastfeeding. Methods: This study used a descriptive case study design with a nursing care approach. The study was conducted in Tanjung Baru Village, Baturaja Timur, and involved two Muslim breastfeeding mothers with infants aged 0–1 month who experienced ineffective breastfeeding and were able to access the e-book. The intervention was delivered in eight visits over four weeks and included spiritual breastfeeding education, endorphin massage stimulation, oxytocin massage, suggestive techniques, and guided use of the BEST for Moms e-book. Data were collected using an ineffective breastfeeding assessment format, a spiritual breastfeeding education questionnaire, an intervention checklist, the Breastfeeding Self-Efficacy Scale–Short Form, and standard operating procedures for the intervention. Data were analyzed descriptively by comparing breastfeeding indicators before and after the intervention. Results: Both mothers showed improvement after the intervention. Breastfeeding self-efficacy increased from 51 to 59 in the first case and from 55 to 67 in the second case. Breastfeeding frequency and infant urination frequency increased from fewer than eight times per day to more than eight times within 24 hours in both cases. Maternal anxiety decreased, maternal confidence improved, infant latch and breastfeeding position became more appropriate, and infants appeared calmer after breastfeeding. Ineffective breastfeeding was resolved on day seven in the first case and on day six in the second case. Conclusion: Spiritual breastfeeding education and the SPEOS method using the BEST for Moms e-book may improve breastfeeding effectiveness, maternal self-efficacy, and infant feeding adequacy among mothers with ineffective breastfeeding.
Copyright (c) 2026 Eni Folendra Rosa, Meilina Estiani, Suparno Suparno, Rita Kamalia, Rosdiana Rosdiana https://creativecommons.org/licenses/by-nc/4.0/
Implementation of brain gym and puzzle therapy and changes in cognitive function among elderly people with dementia in primary health care: A descriptive case study
Background: Dementia is a progressive decline in cognitive function that affects memory, thinking, behavior, and activities of daily living, particularly among older adults. The increasing proportion of the elderly population has contributed to the rising burden of cognitive impairment, emphasizing the need for accessible non-pharmacological interventions in primary healthcare settings. Brain gym and puzzle therapy are cognitive stimulation approaches that may support cognitive function among older adults with mild cognitive impairment. Objective: This study aimed to describe changes in cognitive function among older adults before and after the implementation of brain gym and puzzle therapy. Methods: A descriptive case study was conducted in the working area of Tanjung Agung Primary Health Center, Ogan Komering Ulu Regency. Two older adults were selected using purposive sampling based on the inclusion criteria: aged 60 years or older, having mild cognitive impairment based on Mini-Mental State Examination scores, and willingness to participate in the entire intervention program. The intervention was delivered by a nurse with family members acting as caregivers over four weeks. Each session was conducted daily for 30–45 minutes, consisting of 10–15 minutes of brain gym followed by 20–30 minutes of puzzle therapy. Cognitive function was assessed before and after the intervention using the Mini-Mental State Examination and the Short Portable Mental Status Questionnaire. Data were analyzed descriptively. Results: The Mini-Mental State Examination scores increased from 18 to 24 in participant 1 and from 17 to 23 in participant 2. The Short Portable Mental Status Questionnaire error scores decreased from 5 to 3 and from 6 to 3, respectively. Additional improvements were observed in the participants’ ability to follow instructions, active participation, and speed of puzzle completion. Conclusion: Brain gym and puzzle therapy may contribute to improved cognitive function among older adults with mild cognitive impairment. These interventions can be considered as feasible non-pharmacological nursing strategies in gerontological care within primary healthcare settings.
Copyright (c) 2026 Lisdahayati Lisdahayati, I Gusti Ayu Putu Desy Rohana, Saprianto Saprianto, Gunardi Pome, Umar Hasan Martadinata, Eldi Fajriansyah https://creativecommons.org/licenses/by-nc/4.0/
Relationship between husband support, maternal knowledge, and pregnancy exercise participation among pregnant women: A cross-sectional study
Background: Pregnancy exercise is a safe form of physical activity during pregnancy and contributes to maternal physical and psychological readiness for childbirth. However, pregnant women’s participation in pregnancy exercise may be influenced by several factors, including husband support and maternal knowledge regarding its benefits. A preliminary study at TPMB Bdn. Roslina, S.Keb indicated that several pregnant women had limited knowledge of pregnancy exercise and lacked adequate support from their husbands . Objective: This study aimed to analyze the relationship between husband support, maternal knowledge, and pregnancy exercise participation among pregnant women. Methods: This study employed a cross-sectional design. The sample consisted of 50 pregnant women in the second and third trimesters selected using accidental sampling. Data were collected through direct interviews using questionnaires measuring husband support and maternal knowledge of pregnancy exercise. Univariate and bivariate analyses were conducted using the Chi-square test with SPSS . Results: Of the 50 respondents, 33 pregnant women (66.0%) participated in pregnancy exercise, 29 respondents (58.0%) received husband support, and 31 respondents (62.0%) had good knowledge of pregnancy exercise. Bivariate analysis showed a significant relationship between husband support and pregnancy exercise participation (p < 0.001). Maternal knowledge was also significantly associated with pregnancy exercise participation (p < 0.001). Conclusion: Husband support and maternal knowledge were significantly associated with pregnancy exercise participation among pregnant women. Strengthening husband involvement and health education delivered by midwives may improve pregnant women’s participation in pregnancy exercise programs.
Copyright (c) 2026 Ramayani Ramayani, Tamela Zahra, Siti Yuriah https://creativecommons.org/licenses/by-nc/4.0/
Overview of nursing problems in patients undergoing hemodialysis using Virginia Henderson's nursing theory approach: A descriptive study
Background: Patients undergoing hemodialysis often experience complex nursing problems involving physiological, psychological, social, and spiritual dimensions. A comprehensive nursing assessment is therefore essential to identify patients’ basic needs and guide holistic care. Virginia Henderson’s nursing theory provides a relevant framework for assessing 14 fundamental human needs among patients with chronic kidney disease receiving hemodialysis. Objective: This study aimed to describe nursing problems among patients undergoing hemodialysis using Virginia Henderson’s nursing theory approach. Methods: This study employed a quantitative descriptive design. The study was conducted in the Hemodialysis Unit of RSUD Siti Fatimah Az-Zahrah Palembang from June to July 2025. A total sampling technique was used, involving 35 patients who met the inclusion criteria, namely undergoing routine hemodialysis twice weekly, having received hemodialysis for more than three months, and using an arteriovenous fistula. Data were collected through interviews, physical examination, and nursing documentation review using an observation sheet based on Virginia Henderson’s 14 basic human needs. Nursing problems were identified according to the Indonesian Nursing Diagnosis Standards. Data were analyzed descriptively and presented as frequencies and percentages. Results: The mean age of respondents was 52.17 years, with a standard deviation of 11.947. Most respondents were female (51.4%), and 40% had undergone hemodialysis for more than 24 months. The most prevalent nursing problem was hypervolemia, found in all respondents (100%), followed by ineffective breathing pattern (80%), fatigue (80%), impaired urinary elimination (72%), ineffective role performance (23%), hopelessness (20%), ineffective health management (17%), and disturbed sleep pattern (17%). No nursing problem was identified in relation to worship according to personal belief. Conclusion: Patients undergoing hemodialysis experience multiple nursing problems, predominantly related to fluid balance, respiratory function, fatigue, elimination, and psychosocial role performance. Virginia Henderson’s nursing theory offers a comprehensive framework for identifying basic human needs and strengthening holistic, patient-centered nursing care in hemodialysis units.
Copyright (c) 2026 Aniska Indah Fari, Veroneka Yosefpa Windahandayani https://creativecommons.org/licenses/by-nc/4.0/
Relationship between knowledge level and reproductive health behavior among adolescent girls: A cross-sectional study
Background: Adolescent reproductive health is an important aspect of adolescent girls' development because it relates to their ability to understand bodily changes, maintain reproductive hygiene, and make responsible health decisions. Adequate knowledge is needed to prevent risky behavior, reproductive tract infections, and misinformation commonly obtained from peers and digital media. Objective: This study aimed to analyze the relationship between knowledge level and reproductive health behavior among adolescent girls at SMA Sentosa Bhakti OKU. Methods: This study used an analytical quantitative design with a cross-sectional approach. The population consisted of all 30 female grade XII students at SMA Sentosa Bhakti OKU, and the sample was selected using total sampling. The independent variable was reproductive health knowledge, while the dependent variable was reproductive health behavior. Data were collected using questionnaires and analyzed using univariate and bivariate analyses. The bivariate analysis used the Chi-square test with an expected-count assessment; if the assumption was not met, the Fisher-Freeman-Halton Exact Test was used as an alternative. Results: Most respondents had a high level of knowledge (13 respondents; 43.3%), followed by moderate knowledge (7 respondents; 23.3%) and low knowledge (10 respondents; 33.3%). Reproductive health behavior was mostly categorized as good (12 respondents; 40.0%), sufficient (8 respondents; 26.7%), and poor (10 respondents; 33.3%). The analysis showed a significant relationship between knowledge level and reproductive health behavior among adolescent girls (p = 0.003). Conclusion: Knowledge level was significantly associated with reproductive health behavior among adolescent girls. Schools, school health units, and community health centers should strengthen structured, adolescent-friendly, and sustainable reproductive health education.
Copyright (c) 2026 Berta Afriani, Oca Mawadah https://creativecommons.org/licenses/by-nc/4.0/
Determinants of stunting among children under five years: A systematic review
Background: Stunting remains a major chronic nutritional problem among children under five years and reflects long-term growth failure caused by biological, maternal, socioeconomic, environmental, and child-related determinants. Although many observational studies have examined factors associated with stunting, the evidence remains dispersed across different countries, populations, and methodological designs. A systematic synthesis is therefore needed to identify recurring determinants and clarify the strength of available evidence. Objective: This systematic review aimed to identify and synthesize determinants associated with stunting among children under five years of age based on recent observational studies. Methods: A systematic review was conducted following the PRISMA 2020 reporting guideline. Literature searches were performed in PubMed, ScienceDirect, and Google Scholar for articles published between 2021 and 2026. The search combined keywords and Boolean operators related to stunting, determinants, risk factors, associated factors, and children under five. 15 studies were included in the final synthesis. Study quality was assessed using the Joanna Briggs Institute critical appraisal tools. Data were synthesized narratively and grouped into maternal, socioeconomic, environmental, and child-related determinants. Results: The most consistently reported determinants were low maternal education, poor maternal nutritional status, short maternal stature, low household income, household food insecurity, poor sanitation, limited access to clean water, low birth weight, lack of exclusive breastfeeding, and inadequate complementary feeding practices. Most included studies demonstrated moderate methodological quality, although limitations remained in confounding control, sampling procedures, and causal interpretation. Conclusion: Stunting among children under five is associated with recurring and interrelated determinants across multiple domains. Because most studies were observational and meta-analysis was not performed, findings should be interpreted as recurring associations rather than definitive causal evidence. Future longitudinal and intervention studies are needed.
Copyright (c) 2026 Fatmalina Febry, Hasyim Kadri, Trisnawarman Trisnawarman, Icon Harizon, Muhammad Hasan Azhari, Adinda Syafhira https://creativecommons.org/licenses/by-nc/4.0/
Ultra processed food consumption and childhood obesity in food-insecure settings: A systematic review
Background: Childhood obesity continues to rise globally among populations with food insecurity. Children’s reliance on ultra-processed foods (UPFs) is driven by their high energy density, affordability, and widespread accessibility. This condition contributes to the emerging paradox of the coexistence of food insecurity and childhood obesity associated with UPF consumption. Objective: This systematic review aims to systematically evaluate the association between ultra-processed food (UPF) consumption and the risk of obesity among children living in food-insecure settings. Methods: A systematic literature review was conducted using four electronic databases: ScienceDirect, PubMed, Cochrane Library, and Europe PMC, covering publications from 2016 to 2026. It was conducted from 7th April to 10th April. A total of 109 articles were identified through the initial search process, and 10 studies that met the predefined PICO framework and inclusion criteria were included in the final synthesis. Risk of bias was assessed using appraisal tools appropriate to each study design. Results: The included studies demonstrated that high consumption of ultra-processed foods (UPFs) was associated with an increased risk of overweight and obesity, poorer diet quality, and unhealthy feeding practices among children. Food insecurity was also linked to a greater likelihood of UPF consumption, lower dietary diversity, and reduced intake of fruits and vegetables. Conclusion: UPF consumption contributes to the increasing prevalence of childhood obesity in food-insecure settings. Food insecurity promotes poor-quality dietary choices and dependence on inexpensive processed foods, highlighting the need for policies aimed at improving access to healthy foods and enhancing education regarding UPF consumption among vulnerable populations.
Copyright (c) 2026 Windi Indah Fajar Ningsih, Wilma Hannie Daniel, Rhipiduri Rivanica, Roza Holilah, Fatmalina Febry, Rizma Adlia Syakurah https://creativecommons.org/licenses/by-nc/4.0/
Nursing students’ experiences of case-based learning in medical-surgical nursing courses: A phenomenological qualitative
Background: Case-Based Learning (CBL) method is interactive and utilizes actual or realistic scenarios to promote authentic learning. It is an interactive, student-centred exploration that begins with illustrating real-life situations. CBL combines a constructivist and experiential approach, developing professional skills such as problem-solving, clinical reasoning, and knowledge of theory. Objective: This study aimed to explore students' experiences in using CBL learning method in medical-surgical nursing courses at Faculty of Nursing, Universitas Andalas. Methods: This study used a descriptive phenomenological qualitative design. Twenty-three fifth-semester nursing students enrolled in medical-surgical nursing courses using CBL were selected through purposive sampling. Data were collected in July 2022 through three focus group discussions lasting 60–90 minutes, guided by semi-structured questions on students’ perceptions, benefits, challenges, and suggestions for CBL implementation. Audio recordings were transcribed verbatim and analyzed using the Stevick-Colaizzi-Keen phenomenological method. Trustworthiness was ensured through credibility, transferability, dependability, and confirmability. Results: Based on the results of the thematic analysis, several themes were found, including (1) CBL learning method develops analytical thinking students (2) Using cases in CBL learning method improves the quality of learning (3) Inappropriate standard of implementation CBL learning methods. Conclusion: This study showed some benefits of using CBL learning method. Based on the results, it is necessary to optimize the implementation of CBL in medical-surgical nursing courses and develop it in other courses in Faculty of Nursing, Universitas Andalas.
Copyright (c) 2026 Devia Putri Lenggogeni, Hema Malini, Esthika Ariany Maisa , Bunga Permata Wenny, Mahathir Mahathir https://creativecommons.org/licenses/by-nc/4.0/
Comparison of the effectiveness of beetroot juice (beta vulgaris l.) and date palm extract (phoenix dactylifera) on increasing hemoglobin levels among adolescent girls with anemia: A quasi-experimental study
Background: Anemia is a common health problem among adolescent girls and may reduce concentration, physical fitness, learning capacity, and future reproductive health. Beetroot juice and date palm extract are potential non-pharmacological nutritional interventions for increasing hemoglobin levels. However, comparative evidence between these two interventions among adolescent girls with anemia remains limited. Objective: This study aimed to compare the effectiveness of beetroot juice and date palm extract in increasing hemoglobin levels among adolescent girls with anemia at SMA Negeri 14 Bandar Lampung in 2026. Methods: This quantitative study used a quasi-experimental two-group pretest-posttest design and was reported in accordance with relevant TREND guideline items for non-randomized intervention studies. Thirty adolescent girls with anemia were selected through purposive sampling from 196 grade XI female students and allocated into two equal intervention groups. The beetroot juice group received 250 mL of beetroot juice once daily for seven consecutive days, while the date palm extract group received one tablespoon of date palm extract twice daily for seven consecutive days. Hemoglobin levels were measured before and after intervention using the EasyTouch GCHb device. Data were analyzed using the Wilcoxon signed-rank test, Mann-Whitney U test, and effect size estimation. Results: The mean hemoglobin level increased from 10.827 to 12.980 g/dL in the beetroot juice group, with a mean difference of 2.153 g/dL, and from 10.687 to 11.540 g/dL in the date palm extract group, with a mean difference of 0.853 g/dL. The Wilcoxon test showed significant increases in both groups (p = 0.001), with a large effect size in the beetroot juice group (r = 0.89) and date palm extract group (r = 0.89). The Mann-Whitney U test showed a significant difference in hemoglobin improvement between groups (p = 0.001), with a large between-group effect size (r = 0.68; Cliff’s delta = 0.80). Conclusion: Beetroot juice and date palm extract were associated with increased hemoglobin levels among adolescent girls with anemia, with a greater increase observed in the beetroot juice group. The interventions may be considered complementary food-based nutrition education strategies rather than substitutes for iron supplementation programs.
Copyright (c) 2026 Shindi Shafitri, Setiawati Setiawati, Umi Romayati Keswara https://creativecommons.org/licenses/by-nc/4.0/
Factors associated with dengue hemorrhagic fever prevention practices: A cross-sectional study
Background: Dengue Hemorrhagic Fever (DHF) remains an important public health problem in tropical regions, including Indonesia. Community prevention practices are essential because dengue transmission is closely related to household behavior, mosquito breeding sites, and routine vector control activities. This study examined knowledge, attitude, and selected environmental factors as determinants of DHF prevention practices in Laya Village. Methods: This study used a quantitative analytic design with a cross-sectional approach. The population consisted of 359 households in Laya Village. A total of 78 respondents were selected using the Slovin formula and proportional allocation across five neighborhood clusters. Data were collected using structured questionnaires measuring knowledge, attitude, environmental factors, and DHF prevention practices. Environmental factors included the presence of discarded items, the habit of hanging clothes, and the use of mosquito repellents. Data were analyzed using univariate analysis and the Chi-square test. Results: Most respondents had good knowledge (61.5%), good attitudes (52.6%), good management of discarded items (76.9%), good practice regarding hanging clothes (56.4%), and good use of mosquito repellents (83.3%). However, DHF prevention practices were mostly categorized as poor (51.3%), followed by adequate (42.3%) and good (6.4%). Bivariate analysis showed a significant relationship between knowledge and DHF prevention practices (p = 0.008). Attitude (p = 0.065), presence of discarded items (p = 0.119), habit of hanging clothes (p = 0.546), and use of mosquito repellents (p = 0.304) were not significantly associated with DHF prevention practices. Conclusion: Knowledge was significantly associated with DHF prevention practices, while attitude and the three environmental indicators were not significantly associated. Continuous health education, community empowerment, and routine mosquito breeding site control are needed to strengthen DHF prevention at the household and community levels.
Copyright (c) 2026 Toto Harto, Roni Ferdi, Desta Rahmawati https://creativecommons.org/licenses/by-nc/4.0/
Analysis of health workforce preparedness in enhancing community resilience to flood disasters: A literature review
Background: Floods are one of the most common hydrometeorological disasters in Indonesia and have a significant impact on public health. In this context, the preparedness of healthcare workers is a key factor in strengthening community resilience in the face of disaster situations. This study aims to analyze the preparedness of healthcare workers in enhancing community resilience to floods through a literature review approach. Methods: A systematic literature search was conducted using the PubMed, ScienceDirect, and Google Scholar databases covering the years 2020–2025. A total of 864 articles were identified in the initial stage. After removing duplicates and screening based on titles and abstracts, 69 articles were selected that met the criteria for further review in the full-text stage. Next, 15 articles were selected based on the inclusion criteria, namely: studies focusing on the preparedness of health workers in the context of disasters, related to floods or hydrometeorological disasters, original research articles, and available in full text in Indonesian or English. Results: The study results were synthesized thematically, yielding four main themes: individual preparedness of healthcare workers, encompassing knowledge, attitudes, and skills; support from healthcare facilities and systems, including infrastructure and resource readiness; cross-sectoral coordination in disaster management; and community education focused on strengthening resilience. These four themes contribute to enhancing the community’s adaptive capacity, accelerating emergency response, and reducing post-disaster health impacts. Conclusion: In conclusion, strengthening healthcare workers’ preparedness through continuous training, disaster simulations, and integrated policy support is essential for enhancing community resilience against flood disasters.
Copyright (c) 2026 Novrikasari Novrikasari, Febri Adriati, Akma Listiana, Riyanti Riyanti, Risa Mundari, Muhlisin Muhlisin https://creativecommons.org/licenses/by-nc/4.0/