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/