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The Relationship Between Stress, Depression, and Suicidal Ideation among Adolescents in Gresik Regency
Background: Mental health disorders have become a serious concern due to their wide-ranging impacts, including the rising incidence of suicide. Suicide is an intentional act to end one’s life, influenced by both internal factors such as psychological and biological conditions, and external factors such as economy, environment, and technology. Adolescents and young adults represent vulnerable groups prone to stress and depression triggered by academic and social demands. When left unaddressed, these conditions may lead to the emergence of suicidal ideation. This situation underscores the need for mental health awareness and early prevention efforts among adolescents and young adults. Purpose: This study aimed to determine the relationship between stress and depression with suicidal ideation among adolescents in one of the districts of Gresik Regency. Methods: This study employed quantitative cross-sectional design. Data was collected using the Depression Anxiety Stress Scale (DASS-42) to assess stress and depression levels, and the Mini Plus 5.0.0 Questionnaire to measure suicidal idea. The study population consisted of 462 adolescents, with 215 respondents selected through simple random sampling. Ethical approval was obtained under No. 005/KET/II.3.UMG/KEP/A/2024. Data was analyzed using the Spearman Rank correlation test. Results: The correlation analysis between stress and suicidal ideation yielded a significance value of 0.01 (r=0.358, p-value < 0.05). Similarly, the correlation between depression and suicidal ideation also showed a significant value of 0.01 (r= 0.376, p-value < 0.05). Conclusion: The findings indicate that both stress and depression are significantly correlated with suicidal ideation among adolescents in Gresik Regency. Mental health problems, particularly stress and depression, can severely affect daily functioning among adolescents and young adults, leading to discomfort and vulnerability to suicidal thoughts due to inadequate coping mechanisms and environmental support.
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Differences in Triage Accuracy for Respiratory Emergency Cases between Academic and Professional Level Nursing Students Using the Early Warning System Score (EWSS)
Background: EWSS functions as a cumulative scoring framework that standardizes the clinical assessment of acute illness severity through systematic evaluation of vital sign measurements. Purpose: EWSS is a simple scoring system utilizing the Track & Trigger method based on patients' vital signs to detect early signs of clinical deterioration. It employs physiological parameters to identify patients with severe infections and facilitate triage decisions based on the severity level. Methods: The objective of this study is to compare the accuracy of triage determination in respiratory emergency cases between two groups of students: academic-level nursing students and professional-level nursing students, using the Early Warning System Score (EWSS) instrument. The research was implemented at nursing undergraduate education institutions in Malang City and Malang Regency. The sample consisted of 100 nursing students, divided into two groups: 50 academic-level students and 50 professional-level students. Each respondent was given 10 respiratory emergency vignette cases and performed triage assessments using the EWSS instrument. Results: The analysis showed that the Mann-Whitney test has a significance value 0.45, indicating no significant difference in triage accuracy using EWSS between academic-level and professional-level students. Almost all respondents were able to accurately determine triage for both groups using the EWSS method. Conclusion: EWSS can be broadly utilized by both academic and professional-level nursing students. The triage instrument based on patients' clinical signs and symptoms, EWSS is expected to be widely adopted, including by the general public.
Immune Response Indicators in Term and Preterm Premature Rupture of Membranes: A Leukocyte Profile Evaluation
Background: Premature rupture of membranes (PRM) occurs when membranes rupture spontaneously before delivery. PRM is categorized into preterm PRMor preterm premature rupture of membranes (PPROM), occurring before and at 37 weeks of gestation, and term PRM or premature rupture of membranes (PROM), occurring after 37 weeks. Objective: This study aimed to determine differences in leukocyte profiles between term and preterm PRM cases at RSD dr. Soebandi Jember. Methods: This research used an observational analytic design. This research involved two groups of pregnant women with term and preterm PRM. A total of 55 participants were included, with 28 in the preterm PRM group and 27 in the term PRM group. Data were collected from medical records between January 2023 and July 2024 using a purposive sampling technique. Normality tests were conducted using the Shapiro-Wilk Test. For normally distributed data (p > 0.05), the Independent T-Test was applied, while the Mann-Whitney Test was used for non-normally distributed data (p < 0.05). Results: The results showed no significant differences in lymphocyte (p-value=0,725) and neutrophil (p-value=0,893) levels. Similarly, no significant differences were found in leukocyte, monocyte, eosinophil, and basophil levels (p-values=0,987, 0,666, 0,949, and 0,979, respectively). Conclusion: The study showed no significant differences in the leukocyte profiles between term and preterm PRM. However, increased neutrophil counts in preterm cases may suggest an ongoing infection, highlighting the importance of monitoring leukocyte levels in PRM for potential infection risk management. Further studies are needed to assess how factors such as occupation and daily fatigue affect the incidence of PRM, especially in the preterm group.
Analysis of Hemodialysis Duration as a Determining Factor of Quality of Life in Patients with Chronic Kidney Disease : A Cross-Sectional Study at Regional General Hospital, Bandung Regency, 2024
Background: Chronic kidney disease (CKD) is a progressive global health problem, with hemodialysis serving as a vital life-sustaining therapy. The therapy duration potentially impacts patients’ quality of life due to physical, psychological, and social challenges. Purpose: This study aimed to investigate the relationship between the duration of hemodialysis and quality of life among CKD patients at Regional General Hospital, Bandung Regency, Indonesia. Methods: A cross-sectional correlational design was employed in May 2024 involving 80 CKD patients undergoing hemodialysis, recruited by accidental sampling. Duration of hemodialysis was obtained from medical records, while quality of life was measured using the validated Kidney Disease Quality of Life Short Form (KDQOL-SF36). Data were analyzed using descriptive statistics and the Chi-Square test, with significance set at α = 0.05. Results: The mean age of participants was 46.3 ± 8.9 years; 56.3% were male. Patients undergoing hemodialysis for more than 24 months constituted 45.0% of the sample. Quality of life was reported as good by 57.5% of respondents, moderate by 30.0%, and poor by 12.5%. A significant association was found between hemodialysis duration and quality of life (p < 0.001), with longer treatment durations correlating with better quality of life 86.1% of patients treated over 24 months reported good quality of life compared to 35.5% in those treated under 12 months. Conclusion: Longer duration of hemodialysis is significantly associated with improved quality of life among CKD patients, potentially reflecting enhanced coping and adaptation mechanisms. These findings highlight the necessity for holistic nursing care programs tailored to treatment duration to optimize patient outcomes.
Screening Mental, Social, and Health Readiness Among Prospective Brides and Grooms
Background: Entering marriage is a crucial developmental phase, requiring thorough preparation to achieve the goals of marriage. The mental, social, and health readiness of prospective brides and grooms is crucial for the well-being of future generations. Purpose: The purpose of this study was to screen prospective brides and grooms for their mental, social, and health readiness. Methods: This observational study was conducted on 30 prospective brides and grooms in the Pare District Office of Religious Affairs (KUA) area, the samples take by with accidental sampling without inclusion and exclusion criteria. The variables included mental and social readiness, healthy lifestyle habits, blood pressure, and upper arm circumference for prospective brides and grooms. Results: The results showed that the prospective brides and grooms' mental and social readiness was relatively good. Regarding health readiness, two prospective brides had a low upper arm circumference (MUAC) and three prospective grooms had high blood pressure. Regarding smoking habits, the majority of the 15 prospective grooms, except for two, were smokers. Conclusion: The conclusion of this study are expected to provide important information in identifying issues in the health readiness of prospective brides and grooms that require strengthening.
Cognitive Behavioral Therapy to Reduce Academic Stress among Nursing Students: A Quasi-Experimental Study
Background: Academic stress was commonly experienced by university students as a result of high academic demands and workload. Cognitive Behaviour Therapy (CBT) is one of the methods that can help individuals identify irrational thought and replace them with adaptive cognitions so they can assess academic situation more realistically and rationally. Purpose: The purpose of this study was to analyze the effectiveness of CBT in reducing academic stress among nursing students. Methods: A quasi-experimental pre–post-test design was applied with 141 participants selected through simple random sampling, consisting of 70 respondents in the experimental group and 71 in the control group. The intervention group received a two-week CBT program based on the ABCDE model and cognitive restructuring techniques. The Student Life Stress Inventory (SSI) was administered before and after the intervention. Data were analyzed using the Wilcoxon Signed Rank Test and Mann–Whitney U Test. All procedures of this study were approved by the Research Ethics Committee of STIKes Hang Tuah Surabaya Number PE/50/II/2025/KEP/SHT Results: The Wilcoxon test showed a significant reduction in stress levels in the experimental group (Z = –3.088, p = 0.002), while no significant difference was found in the control group (Z = –0.765, p = 0.444). The Mann–Whitney U Test revealed a significant difference in post–pre score changes between groups (U = –3.017, p = 0.003), indicating that CBT was effective in decreasing stress levels. Conclusion: CBT effectively reduced academic stress among nursing students.CBT also can be used as an effective non-pharmacological nursing intervention in stress management.
Relationship between Food Availability and Nutritional Status of Children Aged 6–24 Months
Background: The growth and development period is the golden phase for toddlers; thus, providing adequate and balanced nutrition is essential to optimize their nutritional status. One of the factors influencing poor nutritional status is limited food availability. Purpose: This study aims to analyse the relationship between food availability and the nutritional status of children aged 6–24 months in the Bulak Banteng Subdistrict, Surabaya. Methods: This study employed a descriptive analytic design with a cross-sectional approach. The population consisted of all children aged 6–24 months in Bulak Banteng Subdistrict, totalling 146 toddlers. A total of 107 respondents were selected using simple random sampling. Food availability, was measured using the Household Food Insecurity Access questionnaire, and nutritional status, was assessed using anthropometric measurements. Data were analysed using the Spearman’s rho test. Results: The findings showed that most households were categorized as food secure, and most children had a good nutritional status. Statistical analysis revealed a significant relationship between food availability and nutritional status (p =0.001, ρ <0 .05). Conclusion: Food availability is significantly associated with the nutritional status of toddlers. Parents demonstrated the ability to maintain good nutritional status in their children; however, they are encouraged to actively participate in nutrition education programs, enhance their knowledge and skills in preparing nutritious meals, and regularly monitor their children’s nutritional status.
Implementation of Digital based Handover as an Effort to Improve Safety and Continuity of Patient Care
Background: Digital-based handover systems have emerged as an innovative approach to standardize communication, support clinical decision-making, and enhance the integration of patient information across shifts and care units. Purpose: this study was to evaluate the implementation of a digital weighing system as an effort to improve safety and continuity of service for patients. Methods: This study used a non-experimental quantitative design with a cross-sectional approach. The sample for this study was the entire population, consisting of 220 respondents. Data collection was conducted using a standardized questionnaire with a Cronbach's alpha value of 0.88 and a Likert scale of 1–5. The data were then analyzed using descriptive statistics, normality tests, Pearson's correlation test, and simple/multiple linear regression to see the strength of the relationship and the contribution of independent variables to the dependent variable. Results: Base on result the implementation of digital weighing, the higher the safety and continuity of patient care. The r value is in the strong relationship category, indicating that the variables in this study have a strong relationship. Conclusion: The implementation of a digital-based handover system is not only a technological innovation, but also a strategic intervention in efforts to improve patient safety and continuity of service.
Mitigating Strategies for Nurses' Emotional Exhaust based on Technology-Based Assessment: A Systematic Review
Background: Most nurses report experiencing emotional exhaustion due to high job demands, a condition that not only affects individuals but also impacts the overall healthcare system. The utilization of health information systems offers significant potential in detecting, measuring, and managing emotional exhaustion among healthcare professionals through comprehensive data analysis, thus improving individual well-being and the quality of healthcare services. Purpose: The objective of this systematic review is to explore indicators of emotional exhaustion and strategies to address it. Methods: This review was developed based on the Joanna Briggs Institute (JBI) methodology and presented according to PRISMA. Three databases, PubMed, ScienceDirect, and ProQuest, were used as sources to search for studies in English. The research obtained with the criteria of discussing health information systems and emotional exhaustion, original research, full text, and published between 2019-2024. Out of 1,782 identified articles, 15 articles were selected for in-depth analysis. Results: Through this systematic review, it was found that HIS can be used to measure emotional exhaustion through behavioural, performance, and organizational dimensions. These indicators can be identified through the analysis of data stored in HIS. In addition, HIS can also support mitigation efforts through increased work efficiency, employee health management, and organizational support. Conclusion: Detecting the condition of emotional exhaustion and understanding how to mitigate it are competencies required to support the smooth and quality delivery of nursing care.
A School-based Suicide Prevention Programme with Peer Support to Prevent Suicidal Ideation in Adolescents: A Cross-Sectional Study
Background: Suicide is a significant public health concern among school-aged adolescents. Suicidal ideation (SI) in adolescents are robustly associated with greater risk of concurrent and succeeding suicide attempts. Evidence suggests that suicidal ideation in adolescents is influenced by peer support at school. Purpose: Our aim was to investigate the influence of peer support on school-based suicidal ideation in adolescents. Methods: A cross-sectional study was conducted in Malang, Indonesia. A total of 179 Adolescents aged 13-15 years were recruited from six classes at junior high schools in Malang by stratified random sampling. An anonymous self-report questionnaire was used to collect demographic characteristics, suicidal ideation, and peer support. Logistic regression was used to test the hypotheses. Results: The results of the multiple logistic regression showed that peer support and protection against suicidal ideation had a significance value of 0.008. This means that peer support influences protection against suicidal ideation. The results also showed that peer support and suicide vulnerability had a significance value of 0.840. This means that peer support did not influence vulnerability to suicidal ideation. Conclusions: Suicide vulnerability is a risk factor for suicidal ideation. Peer support can enhance protective factors against suicidal ideation. Public health nurses can collaborate with school nurses to regularly detect symptoms of suicidal ideation and provide early intervention. Educating peers and teachers about methods to enhance protective factors in adolescents can be beneficial in reducing suicidal ideation.
Effectiveness of Foot Exercise on Improving Ankle-Brachial Pressure Index (ABPI) in Young Adults at Risk of Peripheral Artery Disease (PAD)
Background: Peripheral artery disease (PAD) is a vascular complication associated with cardiovascular disease or diabetes mellitus and, if not adequately managed, may progress to severe morbidity and increased mortality risk. The prevalence of PAD, based on an Ankle-Brachial Pressure Index (ABPI) value of ≤ 0.89, among students of the Faculty of Medicine at Mulawarman University is approximately 44.7%. Foot exercise is a simple physical activity that, when performed sequentially and regularly, can enhance peripheral blood circulation and improve lipid metabolism, including increasing HDL cholesterol and reducing total cholesterol and triglyceride levels. Purpose: To evaluate the effectiveness of foot exercise in improving the Ankle-Brachial Pressure Index (ABPI) among young adults at risk of peripheral arterial disease. Methods: This study employed a quasi-experimental design using a pre-test and post-test non-equivalent control group approach. Forty respondents with an ABPI value of ≤ 0.89 were randomly assigned to two groups (intervention and control), with 20 participants in each group. The intervention group performed foot exercises three times per week for one month, while the control group did not receive any intervention. Data analysis was conducted using the paired t-test. Results: The mean ABPI value increased after foot exercise, from 0.75 (SD = 0.83) to 0.97 (SD = 0.70). This difference was statistically significant (p < 0.05). Conclusion: Foot exercise is effective in increasing ABPI values among young adults at risk of peripheral artery disease (PAD).
Analysis of the Influence of Community Cultural Factors on the Movement of Dengue Haemorrhagic Fever Mosquitoes in Malang Regency
Background: Dengue Haemorrhagic Fever (DHF) remains a serious threat in tropical regions, including Indonesia, with a significant increase in cases. Purpose: The spread of this disease is influenced by community cultural factors and behaviours related to environmental sanitation. Cultural differences between rural and urban communities affect dengue prevention efforts. Through the measurement of the House Index (HI) and Container Index (CI), the relationship between community behaviour and mosquito density can be determined. Methods: This study analysed the influence of community cultural factors on the movement and breeding behaviour of Aedes aegypti mosquitoes in Malang Regency. Using a quantitative analytical observational design (cross-sectional), the research was conducted in three subdistricts with the highest DHF cases: Dau, Kepanjen, and Singosari. Results: The results showed that family support for DHF prevention was generally positive but not significantly related to mosquito density (p = 0.796). Conversely, community leader support showed a significant effect (p = 0.044), as residents were more obedient to local leaders’ guidance. Community leaders play a crucial role in dengue control, while family involvement needs to be strengthened through education and active participation. Conclusion: Nurses are advised to empower families and collaborate with community leaders in implementing the 3M Plus movement and culturally based education to reduce mosquito density and Dengue Haemorrhagic Fever cases.
The Length of Use of Panty Liner with the Incidence of Vaginal Discharge in Adolescent Girls
Background: The phenomenon in women and adolescent girls has experienced vaginal discharge in 60% of adolescents (15-22 years old) and 40% of women (23-45 years old); if left, vaginal discharge can have bad impacts on health, one of which is cervical cancer, it was found that the main cause of cervical cancer in Indonesia is poor quality sanitary napkins. Physiological vaginal discharge usually occurs before and after menstruation, and abnormal vaginal discharge is called pathological vaginal discharge, which occurs due to an infection in the vagina. Purpose: The purpose of the study was to determine the relationship between the length of wearing panty liners and the incidence of vaginal discharge in adolescent girls. Methods: The quantitative method with the correlation analysis method and using a cross-sectional design, the research instrument used a questionnaire. The population was 95 students, and the number of samples was 79 people with purposive sampling techniques; the data were analyzed with univariate and bivariate analysis. Results: The results showed that there was a relationship between the length of wearing panty liners and the incidence of vaginal discharge in adolescent girls. The results showed that there was a significant relationship between the duration of panty liner use and the incidence of vaginal discharge among adolescent girls. A total of 44 respondents (55.7%) used panty liners in the abnormal category, while 35 respondents (44.3%) were in the normal usage category, with a p-value of 0.001 < 0.05. Conclusion: This indicates that wearing panty liners for an extended period can increase the risk of vaginal discharge in adolescent girls. It is recommended that the use of panty liners be limited and replaced periodically to prevent vaginal discharge and maintain the health of the intimate organs.
Influence Rational Emotive Behavior Therapy (REBT) & Acceptance Commitment Therapy (ACT) on Self-Efficacy of HIV Patients
Background: Self-efficacy is a determining factor and predictor of successful treatment for HIV patients. Self-efficacy contributes to a person's ability to overcome the challenges they face. Efforts to manage self-efficacy in HIV patients are needed to support treatment success. One approach is to use a combination of Acceptance Commitment Therapy (ACT) and Rational Emotive Behavior Therapy (REBT). Purpose: The aim of this study was to determine the effect of providing combination therapy of ACT and REBT on increasing self-efficacy in HIV patients. Methods: This study used a quantitative, semi-experimental, one-group pre-test and post-test method. The study population consisted of 31 respondents. The sampling method was total sampling. The study was conducted on 31 HIV patients with at least adequate self-efficacy scores. The Wilcoxon test was used for analysis because the data used were ordinal. Results: There was an effect of combined ACT and REBT therapy on improving self-efficacy in HIV patients, as indicated by a significant value of 0.00. Respondents experienced an increase in efficacy values before and after with an average increase of 16 with a sig value of 0.00 where the value is less than 0.05, which means there is a difference in value between the efficacy values before and after. There is an effect of administering ACT and REBT therapy on the efficacy level of HIV patients. Conclusion: ACT and REBT therapy have been shown to improve self-efficacy in HIV patients. Self-efficacy in HIV patients is influenced by several factors, including patient demographics and stigma. The development and implementation of therapy, particularly for vulnerable groups, is needed, taking into account each patient's characteristics.
Cognitive behavioral Therapy Based on Local Wisdom Culture to Increase Happiness and Slow Degradation of Cognitive Function in the Elderly Post-Stroke
Background: Stroke in the elderly often leads to physical, psychological, and quality of life deterioration, which can hinder post stroke rehabilitation. Although Cognitive Behavioural Therapy (CBT) has been widely applied, the use of Cognitive Behavioural Therapy (CBT) integrated with local wisdom remains limited, particularly among elderly stroke survivors. Purpose: This study aimed to explore the lived experiences of elderly individuals after stroke who received local wisdom based Cognitive Behavioural Therapy (CBT) using sulthon prayer as a therapeutic medium. Methods: This study employed a qualitative phenomenological design. A total of 25 elderly post stroke participants were selected through purposive sampling and participated in in depth interviews. Data were analysed using thematic analysis following Braun and Clarke’s approach. Results: The findings revealed three main themes, namely biological experiences, psychosocial experiences, and spiritual experiences, reflecting participants’ perceptions of physical comfort, emotional regulation, and enhanced spiritual meaning during the recovery process. In conclusion, local wisdom based Cognitive Behavioural Therapy (CBT) using sulthon prayer provides meaningful biological, psychosocial, and spiritual support for elderly individuals after stroke. Conclusions: These findings imply that integrating culturally and spiritually sensitive Cognitive Behavioural Therapy (CBT) interventions may enhance holistic nursing care and rehabilitation outcomes for elderly stroke survivors.
The Effectiveness of M-Health on Self-Efficacy, Self-Management, and Self-Care of Patients Undergoing Maintenance Hemodialysis: A Systematic Review and Meta-Analysis
Background: M-Health is the use of mobile digital technology to support health and well-being by extending education, communication, health interventions, and research beyond the reach of traditional clinical care. Research has developed and tested M-Health, demonstrating its effectiveness in enhancing the self-efficacy of cancer patients. However, there has been no synthesis on the effectiveness of M-Health in enhancing self-efficacy in patients with chronic kidney disease. Purpose: The purpose of this systematic review and meta-analysis is to determine the effectiveness of M-Health on self-efficacy, self-management, and self-care in chronic kidney disease patients undergoing maintenance hemodialysis. Methods: The study method is a systematic review and meta-analysis reported according to PRISMA guidelines. We conducted this systematic review across six databases. We included randomized controlled trials, quasi-experimental studies, and cohort studies evaluating self-efficacy, self-management, and self-care in patients with chronic kidney disease. We performed the critical appraisal using the Joanna Briggs Institute Critical Appraisal Checklist. Review Manager version 4.5 synthesized the data. Results: In this study, a database search was conducted to obtain 1,115 articles. Then, 46 duplicates were identified, and 1,109 articles were excluded for not meeting the inclusion criteria, leaving 6 articles for review. After reviewing the six articles, M-Health was found to be effective for self-efficacy and self-management, but not for self-care, due to the study's short duration. Conclusion: The conclusion of this study is that M-Health intervention can improve self-efficacy and self-management in patients with chronic kidney disease. However, the effectiveness of self-care results is reduced due to the relatively short observation time. Therefore, it is essential to take into account the duration of the intervention to achieve more optimal outcomes.
The Relationship between Parenting Styles and Adolescents Social Development
Background: The Relationship between Parenting Styles and Adolescent Social Development. Adolescent social development is the process of growing the ability to interact and understand social rules. Parenting styles play an important role in shaping children's attitudes and behavior in their social environment. This study aims to analyze the relationship between parenting styles and adolescent social development. Purpose: This study aims to analyze the relationship between parenting styles and adolescents’ social development. Methods: The research is a quantitative descriptive study with a cross-sectional approach. A sample of 165 students from class 11 at SMA Hang Tuah 5 Sidoarjo was selected using simple random sampling technique. The research was conducted on January 23-30, 2025. The questionnaire exploring Parenting styles were measured using the Parenting Styles and Dimensions Questionnaire-Short Version (PSDQ), and Adolescent Social Development Questionnaire (Rahmawati, 2021) for measured the social development. Data analysis used the Spearman rank correlation with alpha 5%. Results: The results showed that most parents applied democratic parenting styles (49.70%) and the majority of adolescents had fairly good social development (55.15%). The Spearman Rho test showed r = 0.323 with ρ = 0.01 (ρ < 0.05), indicating a weak relationship between parenting styles and adolescent social development. Conclusion: Adolescent social development does not always follow the same pattern because it is influenced by various factors, such as parenting styles, stimulation, health conditions, and child motivation. The ideal parenting style is one that balances supervision and freedom, supported by fulfilling needs and good communication. Therefore, parents are advised to apply a balanced parenting style to support optimal social development in adolescents.
Strategic Model of Mental Health Nurse Competence and Caregiver in Preventing Relapse Risk in Schizophrenia Patients
Background: The competences under consideration include clinical knowledge, clinical skills, communication competence, crisis and safety management, professional growth, management of care, and recommendations. Purpose: Analyzing the Strategic Model of Mental Health Nurse Competence and Caregiver in Preventing Relapse Risk in Schizophrenia Patients. Methods: The study used a quantitative design with a cross-sectional methodology and included 110 participants, including nurses and caregivers from five community health clinics in East Java Province. The data were obtained using a Likert-scale instrument that was previously validated and reliable. The data was analyzed using the Structural Equation Modeling (SEM) approach using the SmartPLS tool. Results: All competency characteristics of psychiatric nurses and caregivers have a substantial and essential relationship to the prevention of relapse risk in schizophrenia patients, with a very high model commitment in producing variations in variables which are dependent variables. Conclusion: Thoroughly enhancing the competence of psychiatric nurses and caregivers is an effective method for lowering relapse rates among schizophrenia patients. Suggestions include enhancing the psychiatric nurse education curriculum, providing competency-based continuing training, and incorporating collaborative care models into health care organizations.
Resilience and Spiritual well being in Rural and Urban Communities: A Community Nursing Perspective
Background: Resilience and spiritual well-being are essential aspects of life in both rural and urban settings. Rural communities are more closely connected to nature, yet they face limitations in accessing health care services. In contrast, urban communities experience stress related to social life, but they benefit from more access to health. Purpose: This study aims to examine differences in resilience and spiritual well-being in rural and urban communities in Jember Regency. Methods: The researchers employed a cross sectional approach for analyzing the study. The sample consisted of 210 respondents living in rural and urban communities in Jember Regency. The researchers selected the samples using a purposive sampling technique. Data collection was carried out using a digital questionnaire through validity and reliability tests. Data were analyzed using independent sample t-test. Results: Univariate test results indicate that the mean resilience score for rural communities is 64.70, whereas for urban communities it is 64.81. The mean spiritual well-being score for rural communities is 22.35, compared to 22.86 for urban communities. The difference test for resilience between rural and urban communities yields a p-value of 0.92, while the spiritual well-being difference test shows a p-value of 0.11. Conclusion: The conclusion of this study is that there is a relationship between resilience and spiritual well-being in rural and urban communities in Jember Regency. Meanwhile, the results of the difference test for resilience and spiritual well-being showed no difference between rural and urban communities.
The Psychological Response to Menarche in Elementary School Students is Influenced by Age, Perception, Knowledge, and Information Sources
Background: Menarche causes anxiety in some teenagers, because they consider menstruation to be a disease and dirty blood. Purpose: The aim of the research is to determine the factors related to the psychological response during menarche at Khadijah Elementary School, Surabaya. Methods: This research is an analytical observational study with a cross-sectional approach. It was conducted at SD Khadijah Surabaya on May 3, 2024. The sample consisted of 47 female students who had experienced menarche. The sampling technique used was stratified random sampling. The research instruments included questionnaires on age at menarche, sources of information, knowledge and perceptions about menstruation and menarche, as well as psychological responses during menarche. The data were analyzed using the Chi-square test with a significance level of α = 0.05. Multivariate analysis was not performed to avoid overfitting due to the small sample size. Results: The results of the Chi-square test showed significant associations between psychological responses at menarche and the following variables: age at menarche (p = 0.001), knowledge (p = 0.000), perception (p = 0.000), and source of information (p = 0.035). Conclusion: Based on the results of the research and discussion that have been described, it can be concluded that there is a relationship between the age of menarche, knowledge, perception and sources of information with the psychological response during menarche at Khadijah Elementary School Surabaya.
Cost-Effectiveness of Maternal Tetanus Toxoid and Tetanus Diphtheria in Developing Countries: Systematic Review
Background: Maternal and neonatal tetanus (MNT) remains a public health threat in low- and middle-income countries due to suboptimal coverage of complete-dose maternal immunization. Although TT and Td vaccines are clinically effective, their cost-effectiveness in different country contexts needs systematic assessment. Purpose: To evaluate the cost-effectiveness of maternal tetanus toxoid (TT) and tetanus-diphtheria (Td) vaccination in developing countries, focusing on economic outcomes and contextual variations. Methods: This systematic review followed PRISMA 2020 guidelines. Literature was searched in PubMed, Scopus, ScienceDirect, Wiley, and Crossref. Inclusion criteria comprised CEA/CUA studies on maternal TT/Td immunization in developing countries. Reporting quality was assessed using the CHEERS 2022 checklist. Results: From 2,040 records, four studies met inclusion criteria. All reported maternal TT/Td vaccination as highly cost-effective, with ICERs ranging from USD 3.61 to 15,600 per DALY or life-year saved. Key uncertainties included vaccine effectiveness and distribution costs, while program efficiency varied by local health system conditions. Conclusion: Complete-dose maternal TT/Td immunization is a highly cost-effective public health intervention in resource-limited settings. However, policy implementation must be adapted to local contexts and supported by robust sensitivity analysis and reliable primary data.
Prevalence of Hypertension and Risk Factors among Adolescent High School Girls
Background: The health of adolescent girls is important. Teenage girls have a vital role in giving birth to a new generation (future mothers). Purpose: The research aimed to determine the description of blood pressure in adolescent girls and to analyze what factors were associated with the incidence of hypertension in adolescent girls. Methods: This research used a cross-sectional method with a descriptive approach. The sample of this research, a total of 1,193 adolescent girls at Jembrana Regency, Bali, Indonesia, from 5 high schools and vocational schools, was selected using purposive sampling. The adolescent girls were 15 to 19 years old with an average age of 16.5 years old. Blood pressure was categorized in children and adolescents by using four categories: normal, pre-hypertension, hypertension I, and hypertension II. Results: The research results on 1,193 adolescent girls showed that the majority of respondents had blood pressure in the normal category, totaling 1,031 individuals (86%). A total of 149 adolescent girls (12%) were in the pre-hypertension category, while stage 1 and stage 2 hypertension were found in 13 respondents (1%). The average systolic blood pressure of respondents was 116.3 mmHg (SD ±12.3), and diastolic blood pressure was 71.3 mmHg (SD ±9.8). The average age of respondents was 16.5 years (SD ±0.7). Bivariate analysis results showed that nutritional status based on BMI and mid-upper arm circumference (MUAC) had a significant relationship with the incidence of hypertension in adolescent girls (p < 0.05). Adolescents with overweight, obesity, and chronic energy deficiency (CED) status were more frequently found in the pre-hypertension and hypertension groups. Conclusions: It was concluded in this research that the majority of adolescent girls at Jembrana Regency, Bali-Indonesia had normal blood pressure. To prevent hypertension, adolescent girls have to maintain their health and change risk factors by optimizing their nutritional status.
The Effect of Training on First Aid for Cardiac Arrest on Knowledge and Readiness of Cadres to Provide Emergency Aid to Cardiac Arrest Victims in the Community
Background: The incidence of cardiac arrest or Sudden Cardiac Arrest (SCA) in the community that cannot be saved increases every year. This is because they do not get the right and fast action due to the community's ignorance and inability to assist. Objective: This study aimed to evaluate health education on increasing knowledge and readiness of respondents in helping cardiac arrest victims. Methods: This study used a pre-experimental design with a one-group pre-post test approach to 52 respondents, namely the general public. The research sample was recruited using convenience sampling techniques. The sample was given health education on basic life support (BLS) and cardiac arrest management directly with several interactive sessions using visual aids such as posters and presentation slides. Data collection used a valid and reliable questionnaire (Knowledge and Readiness to Help). Data were analyzed univariately through frequency distribution, central tendency, mean difference, and bivariate tests using paired sample t-tests. Results: There was an increase in respondents' BLS knowledge from 6.87 to 11 (p<0.001) and readiness to help, with an average score increasing from 60.4 to 63.3 (p=0.002). These results indicate that health education can increase knowledge about BLS and readiness to help respondents. Research results show that readiness to act in emergencies depends on more than theoretical understanding; it also requires practical training, self-confidence, and direct experience. Conclusion: Health education significantly improved public knowledge and readiness to provide first aid for cardiac arrest victims. These findings indicate that structured Basic Life Support (BLS) education is effective in strengthening community preparedness and timely emergency response. Integrating regular and practical BLS training into community health programs may further enhance public capacity to respond to cardiac arrest events.
Health Education for Increasing Knowledge and Skills of Caring Family in Post Stroke at Poncokusumo Community Health Center, Malang
Background: The lack of knowledge and skills among family members in caring for post-stroke patients can make prolong recovery time and increase the risk of complications. Health education is essential to enhance understanding and optimize caregiver skills. Purpose: This study aims to examine the effect of health education on family knowledge and skills in post stroke care at Poncokusumo Community health center in Malang regency. Methods: This research employs pra experimental with one group pre-post test design with a total population of 35 family with the post stroke patients in Poncokusumo Community Health Center , from which 32 participants were selected using purposive sampling. The research instrument consists of a questionnaire, and data were analyzed using the Wilcoxon test. Results: The results show that before the health education intervention, half of the participants had a moderate level of knowledge (16 people, 50.0%). After the intervention, nearly all participants demonstrated good knowledge (28 people, 87.5%). In terms of skills, before the intervention, the majority of participants had poor caregiving skills (19 people, 59.4%). After the intervention, most participants improved to a moderate skill level (19 people, 59.4%). There was a significant effect of health education on family knowledge regarding post-stroke care at Poncokusumo Community Health Center, with a p-value of 0.000 (<0.05). Conclusion: Health education is effective in improving family knowledge and skills in caring for post-stroke patients. With structured education, families understand how to care for patients, from mobilization, prevention of complications, to psychosocial support. Direct training and educational media help them apply skills with more confidence. This increased understanding contributes to better quality of care, accelerates patient recovery, and reduces the risk of complications.
Assessing the Knowledge, Attitude and Practices of Nurses in Implementing Infection Control Measures for Tuberculosis in Hospital: Literature Review
Background: Tuberculosis (TB), caused by Mycobacterium tuberculosis, remains a major global health concern, particularly for healthcare workers (HCWs) who are at increased risk due to occupational exposure. This study evaluates nurses’ knowledge, attitudes, and practices (KAP) in implementing TB infection control measures in hospital settings across Ethiopia, Zimbabwe, Nepal, Saudi Arabia, India, Gabon, and Malaysia. Despite the availability of preventive measures, their inconsistent application due to inadequate training, resource shortages, and systemic challenges continues to hinder effective TB control. Identifying these gaps is crucial for improving infection prevention strategies. Purpose: This study aims to assess nurses' KAP regarding TB infection control, identify critical gaps in their understanding and practices, and highlight the need for targeted interventions such as in-service training, resource allocation, and stigma-reduction efforts. Methods: A literature review was conducted on studies published between 2020 and 2024 using the PubMed, ProQuest, and Scopus databases. The inclusion criteria focused on studies involving nurses in hospital settings that discussed knowledge, attitudes, and practices related to TB prevention. The 340 articles identified, 29 articles met the eligibility criteria after applying strict exclusion criteria for duplicate and non-empirical publications and studies that did not specifically focus on nurses in hospitals. To ensure accuracy and credibility, the included studies were assessed using the critical appraisal tool from the Joanna Briggs Institute (JBI) to minimize the risk of bias. Results: Findings revealed substantial gaps in nurses' knowledge and infection control practices, despite generally positive attitudes. For instance, many incorrectly relied on surgical masks instead of N95 respirators. Inconsistencies in infection control were linked to inadequate training, resource limitations, and high workloads. Conclusion: Addressing these deficiencies through structured training, improved resource distribution, and stigma-reduction strategies is essential to enhance TB prevention efforts in hospital settings.