Journal Of Nursing Practice https://thejnp.org/index.php/jnp <p><strong>Journal Of Nursing Practice</strong>&nbsp;is an open access journal (e-journal) which publishes the scientific works for nurse practitioners and researchers. The focus and scopes of the journal include <span style="text-decoration: underline;">Pediatric and Maternity Nursing</span>, <span style="text-decoration: underline;">Adult Nursing</span>, <span style="text-decoration: underline;">Emergency Nursing</span>, <span style="text-decoration: underline;">Community and Mental Health Nursing</span>, <span style="text-decoration: underline;">Education and Management in Nursing</span>.&nbsp;</p> <p>The articles of this journal are published every six months, that is on April and October (2 issues per year), and developed by the <strong>Institut Ilmu Kesehatan STRADA Indonesia</strong>.</p> <p>The JNP Editorial team welcome and invite researchers from around the world to submit their papers (original research article, systematic review, and case study) for publication in this journal. All papers are published as soon as they have been accepted.</p> <p><a href="http://creativecommons.org/licenses/by-nc-sa/4.0/" rel="license"><img style="border-width: 0;" src="https://i.creativecommons.org/l/by-nc-sa/4.0/88x31.png" alt="Creative Commons License"></a><br>The<a href="http://thejnp.org/index.php/jnp" target="_blank" rel="noopener"> Journal of Nursing Practice</a>, its website, and the articles published there in are licensed under a <a href="http://creativecommons.org/licenses/by-nc-sa/4.0/" rel="license">Creative Commons Attribution-NonCommercial-ShareAlike 4.0 </a>International License.</p> en-US <p><a href="http://creativecommons.org/licenses/by-nc-sa/4.0/" rel="license"><img src="http://i.creativecommons.org/l/by-nc-sa/4.0/88x31.png" alt="Creative Commons License"></a><br>This work is licensed under a&nbsp;<a href="http://creativecommons.org/licenses/by-nc-sa/4.0/" rel="license">Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License</a>.</p> jnpstrada@gmail.com (Prima Dewi Kusumawati) jnpstrada@gmail.com (Yuli Anita, S.M) Sat, 29 Oct 2022 00:00:00 +0000 OJS 3.3.0.11 http://blogs.law.harvard.edu/tech/rss 60 The Level of Independence and Social Activity with the Life Satisfaction of the Elderly at Panti Bhakti Luhur Sidoarjo https://thejnp.org/index.php/jnp/article/view/258 <p><strong>Background: </strong>Many factors are related to life satisfaction in the elderly, one of which is the level of independence and social activity. This study aims to determine the level of independence and social activity with the life satisfaction of the elderly at Panti bhakti Luhur Sidoarjo.</p> <p><strong>Purpose:</strong> The purpose of the study was to determine the independence and social activities with the life satisfaction of the elderly at Panti bhakti Luhur Sidoarjo.</p> <p><strong>Method</strong><strong>s:</strong> The sampling technique used non-probability sampling with accidental sampling. The population of this study was 108 people and the research sample obtained was 85 elderly people aged over 60 years at Panti Bhakti Luhur Sidoarjo. To assess the level of independence using a Katz Index questionnaire, to assess social activity using a social activity questionnaire, to assess life satisfaction using the SWLS (Satisfaction With Life Scale) questionnaire. The data is then tested using Spearmen Rho Correlation.</p> <p><strong>Results:</strong> Research shows that there is a relationship between the level of independence and life satisfaction of 0.001 (?&lt;0.05) and social activities with life satisfaction of 0.000 (?&lt;0.05). <strong>Conclusion:</strong> The level of independence and social activities related to the life satisfaction of the elderly requires support from the family and related agencies in developing elderly activities to increase life satisfaction by motivating and helping the elderly to be able to train the level of independence and social activities.</p> Sri Anik Rustini, Raudatul Jannah, Astrida Budiarti, Ninik Ambar Sari, Ceria Nurhayati, Merina Widyastuti Copyright (c) 2022 Journal Of Nursing Practice https://creativecommons.org/licenses/by-nc-sa/4.0 https://thejnp.org/index.php/jnp/article/view/258 Sat, 29 Oct 2022 00:00:00 +0000 A Qualitative Study on Parents with Smartphone Addiction Children in Banda Aceh: Phenomenological Approach https://thejnp.org/index.php/jnp/article/view/262 <p><strong>Background:</strong> The need for smartphones in children not only as a communication tool but also as a school learning media so that there is a risk of smartphone addiction. Weak parenting patterns have resulted in many children experiencing smartphone addiction.</p> <p><strong>Purpose:</strong> This study aims to explore the experience of role-based parents with smartphone addiction in child.</p> <p><strong>Methods:</strong> This study used qualitative design with a phenomenological approach. There were ten participants in this study. The data collection method used in-depth interviews with guidelines that had been prepared based on a theoretical framework and related literature studies. Data collection tools used in this study consisted of interview guidelines and field notes.</p> <p><strong>Results:</strong> Based on the results of data collection conducted by researchers, there are four themes that represent the results of the study, parent's role as mentoring, parent's role as modelling, parent's role as organizing and parent's role as teaching.</p> <p><strong>Conclusion:</strong> Parents need to provide time and affection for their children so that the diversion of children towards smartphones decreases.</p> Amir Hidayat, Nurjannah, Irwan Saputra, Said Usman, Muhammad Yani Copyright (c) 2022 Journal Of Nursing Practice https://creativecommons.org/licenses/by-nc-sa/4.0 https://thejnp.org/index.php/jnp/article/view/262 Sat, 29 Oct 2022 00:00:00 +0000 The Head Room Experience in Implementing the Nursing Management Function during the Covid-19 Pandemic in General Hospital Sabang: A Phenomenology Study https://thejnp.org/index.php/jnp/article/view/271 <p><strong>Background:</strong> Nursing is one of the important services for hospital to maintain the quality of services that ensure patient safety. Good nursing services can be seen from the nursing management function carried out by the head of the room, especially in the inpatient room.</p> <p><strong>Purpose:</strong> This study explored in depth the experience of the head of the inpatient ward in implementing the nursing management function during the COVID-19 pandemic.</p> <p><strong>Methods:</strong> This study used qualitative design with a phenomenological approach. There were six participants in this study. The data collection method used in-depth interviews with guidelines. Data collection used the interview guidelines and field notes in this study.</p> <p><strong>Results:</strong> The results of this study consisted of five themes, namely planning not according to needs, organizing according to conditions, staffing improvements, optimized the directing and follow-up the controlling.</p> <p><strong>Conclusion:</strong> Hospital need to provide training to ward heads and nurses as well as make improvements to evaluate and develop strategies for hospital during a pandemic based on the obstacles the ward head encountered while managing inpatient room.</p> Amanda Zuliani, Maimun, Yadi, Saiful, Urip Copyright (c) 2022 Journal Of Nursing Practice https://creativecommons.org/licenses/by-nc-sa/4.0 https://thejnp.org/index.php/jnp/article/view/271 Sat, 29 Oct 2022 00:00:00 +0000 Factors Affecting the Interest of Pregnant Women to Conduct PPIA Examination (Prevention of Mother-to-Child Transmission) in Senggreng Village, Sumberpucung District, Malang Regency https://thejnp.org/index.php/jnp/article/view/284 <p><strong>Background: </strong>The government's policy that requires all pregnant women to undergo PPIA (Prevention of Mother-to-Child Transmission) examination is one of the prevention of HIV/AIDS and hepatitis transmission from mother to child, but PPIA (Prevention of Mother-to-Child Transmission) visits to pregnant women in Senggreng village are still low.</p> <p><strong>Purpose: </strong>The purpose of this study was to analyze the factors that influence the interest of pregnant women in the PPIA (Prevention of Mother-to-Child Transmission) examination in Senggreng Village, Sumberpucung District, Malang Regency.</p> <p><strong>Methods:</strong> The design of this research is quantitative with correlative analytic type. The population of this study were all third trimester pregnant women in Senggreng Village, as many as 31 people. By using the total sampling technique obtained a sample of 31 people. Analysis of the data used is multiple logistic regression.</p> <p><strong>Results: </strong>The results showed that the parity factor with a value of p = 0.034 and the level of knowledge with a value of p = 0.040 had an effect on the interest of pregnant women in the PPIA (Prevention of Mother-to-Child Transmission) examination. And the dominant factor that influences the request for pregnant women in the PPIA (Prevention of Mother-to-Child Transmission) examination is the parity factor with the Exp(?) value of 6.153.</p> <p><strong>Conclusion: </strong>Increasing the knowledge of pregnant women about the importance of PPIA (Prevention of Mother-to-Child Transmission) as well as accurate information related to the schedule for the implementation of the PPIA (Prevention of Mother-to-Child Transmission) examination should be improved. The cooperation of all parties, including cadres, families, and health workers, is needed to increase the achievement of PPIA(Prevention of Mother-to-Child Transmission) visits.</p> Suci Anggraeni, Atriyani Awaru Copyright (c) 2022 Journal Of Nursing Practice https://creativecommons.org/licenses/by-nc-sa/4.0 https://thejnp.org/index.php/jnp/article/view/284 Sat, 29 Oct 2022 00:00:00 +0000 The Effect of Self-Care on the Severity of Disability of Leprosy Patients in the Work Area Galis Health Center https://thejnp.org/index.php/jnp/article/view/274 <p><strong>Background:</strong> People with leprosy tend to have dry skin due to damage.</p> <p><strong>Purpose:</strong> This study aims to analyze differences in the severity of disability in patients before and after self-care in the treatment group and the control group.</p> <p><strong>Methods:</strong> This research used a Quasy experiment pretest posttest with a control group design. The population was 52 respondents, with a sample of 34 respondents. The sampling technique used purposive sampling.</p> <p><strong>Results:</strong> The results of the study using the Wilcoxon test showed that there was a difference in the severity of disability in the treatment group with a p-value of 0,00 &lt; 0.05 and no difference in the severity of disability in the control group with a p-value of 0,105 &gt; 0.05. Based on the results of the Mann-Whitney test, it was found that there were differences in the severity of disability in the treatment group and the control group before and after self-care with a p-value of 0,00 &lt; 0,05.</p> <p><strong>Conclusion:</strong> The researcher suggests that sufferers can continue to improve efforts to prevent the severity of leprosy disability by taking regular self-care.</p> Mufarika, Nicky Citra Auliya, Merina Widyastuti Copyright (c) 2022 Journal Of Nursing Practice https://creativecommons.org/licenses/by-nc-sa/4.0 https://thejnp.org/index.php/jnp/article/view/274 Sat, 29 Oct 2022 00:00:00 +0000 The Analysis of Verbal Abuse within Socialization Ability of Preschoolers in Playproup Al Fattah Malang https://thejnp.org/index.php/jnp/article/view/290 <p><strong>Background:</strong> Preschoolers are children with a phase of developing and learning new things quickly. The development phase begins with interacting with family and socializing with playmates in the social environment. The social environment can affect the development process of pre-school age children, for example the occurrence of verbal abuse in the social environment that has an impact on children's social development.</p> <p><strong>Purpose:</strong> The purpose of this study was to determine the relationship between verbal abuse and the socialization ability of preschool children.</p> <p><strong>Methods: </strong>The research design was cross sectional study and the sampling method was carried out by the total sampling method. The sample in this study was all 50 students of Playgroup Al Fattah Malang. Data analysis used SPSS program with Chi Square test.</p> <p><strong>Results:</strong> It was found that 46% of children received verbal abuse in the low category, 38% in the medium category and 16% received verbal abuse in the high category and 76% of children had good socialization skills and 24% of children had poor socialization skills and through Chi Square test analysis with In the SPSS program, the value of Asymptotic Significance (2-sided) = 0.001 &lt; 0.05, it means that H1 is accepted, or it is clear that there is a relationship between verbal abuse and the socialization skills of preschoolers in Playgroup Al Fattah Malang.</p> <p><strong>Conclusion:</strong> It can be concluded that verbal abuse can result in barriers and disruptions to the socialization development of preschool children. Parents and teachers are expected to provide the right parenting to improve socialization skills in preschool age children.</p> Prima Dewi Kusumawati, Nadya Risky Aini Nasution Copyright (c) 2022 Journal Of Nursing Practice https://creativecommons.org/licenses/by-nc-sa/4.0 https://thejnp.org/index.php/jnp/article/view/290 Sat, 29 Oct 2022 00:00:00 +0000 Nursing Implementation of Acute Pain Management in Post Mastectomy Surgery Patients https://thejnp.org/index.php/jnp/article/view/281 <p><strong>Background:</strong> Surgery is a potential or actual threat to a person's integrity, both biopsychosocial and spiritual. One of the treatments for breast cancer is surgery, either tumor removal or mastectomy. The problem that often arises in postoperative patients is pain, which can affect the patient's overall condition.</p> <p><strong>Purpose:</strong> The purpose of this study was to determine the effect of pain management with deep breath relaxation therapy on the post operative mammae pain scale.</p> <p><strong>Methods:</strong> This case study design uses a descriptive method. The sampling method used was purposive sampling with 2 respondents, namely post-mastectomy patients in the Surgical Room of Muhammadiyah Hospital Palembang, in March 2022. The case study data were taken using interviews, observations and physical examinations carried out descriptively and presented in a narrative manner</p> <p><strong>Results:</strong> After implementing acute post-mastectomy pain management with deep breathing relaxation therapy in both case study subjects for 3 days there was a 3 point reduction in pain scale, in patient 1 from pain scale 6 to pain scale 3, in patient 2 from pain scale 5 to a pain scale of 2, and both case study subjects were able to move and fulfill basic needs independently.</p> <p><strong>Conclusion: </strong>Acute pain management with deep breathing relaxation therapy can reduce pain scale and help patients move quickly.</p> Ismar Agustin, Azwaldi, Muliyadi, Sri Endriyani; Vina Annisa Dilianasari Copyright (c) 2022 Journal Of Nursing Practice https://creativecommons.org/licenses/by-nc-sa/4.0 https://thejnp.org/index.php/jnp/article/view/281 Sat, 29 Oct 2022 00:00:00 +0000 Psycoeducation of the Resilience of the Family of Patients with Mental Disorders in Overcoming Psychosocial Problems in the Transition of the Covid-19 Pandemic in the Region Buleleng Regency of Bali https://thejnp.org/index.php/jnp/article/view/277 <p><strong>Background:</strong> The Covid-19 pandemic affects all aspects of human life, physically, economically and psychosocially. This pandemic situation also affects the mental state of the families of ODGJ patients. This situation not only threatens overall health but also threatens the resilience of the family in dealing with the situation. <strong>P</strong><strong>urpose</strong><strong>:</strong> The study was to determine the effect of psychoeducation on the resilience of families of patients with mental disorders in overcoming psychosocial problems during the transition period of the COVID-19 pandemic in the Buleleng-Bali Regency area.<strong>M</strong><strong>ethod</strong><strong>s:</strong> The methods uses a true experiment using a one group pre-posttest approach. This research activity was carried out in two stages, namely field activities and activities to provide counseling and education about ODGJ care during the transition period.<strong>R</strong><strong>esults</strong><strong>:</strong> This study indicate that before being given psychoeducation to families of ODGJ sufferers, most of the family toughness was in the less category as many as 57 respondents (57%) and after being given psychoeducation the family was mostly in the good toughness category as many as 67 respondents (67%). The results of the paired T test show the value of = 0.000 with = 0.05. The results of this test show that the value of &lt; then H1 is accepted, meaning that there is an influence of psychoeducation on the resilience of the family of ODGJ patients in Overcoming Psychosocial Problems During the Transition Period of the Covid-19 Pandemic in the Buleleng Regency –Bali.<strong>Conclusion:</strong> Providing psychoeducation can help families become more resilient in dealing with psychosocial problems in treating DOGJ patients during the transition period of the COVID-19 pandemic.</p> Eka Lutfiatus Solehah, Nyoman Sri Ariantini Copyright (c) 2022 Journal Of Nursing Practice https://creativecommons.org/licenses/by-nc-sa/4.0 https://thejnp.org/index.php/jnp/article/view/277 Sat, 29 Oct 2022 00:00:00 +0000 Fulfillment of Sleep Needs in Elderly Insomnia in South Sibolga District, Sibolga City https://thejnp.org/index.php/jnp/article/view/196 <p><strong>Background:</strong> Insomnia is one of the most common sleep problems in older adults (elderly). Insomnia in the elderly is caused by several factors, namely health status factors, drug use, environmental conditions, psychological stress, diet/nutrition.</p> <p><strong>Purpose:</strong> overcoming insomnia in the elderly by combining two theories, namely Comfort and Environmental.</p> <p><strong>Methods:</strong> The type of research used in this study is qualitative with a phenomenological approach. the number of participants who participated in this study were fifteen people. Collecting data using Focus Group Discuss (FGD), Observation, and in-depth interviews, the results of data collection in this study using analysis techniques Triangulation method (Focus Group Discuss, in-depth interviews, and observation).</p> <p><strong>Results:</strong> This study produced five main themes, namely: 1) physical, 2) psychology, 3) religion, 4) social, 5) environment.</p> <p><strong>Conclusion:</strong> In achieving the quality and quantity of sleep for the elderly who experience insomnia, it is expected that the elderly can fulfill their comfort and cleanliness in their surrounding environment.</p> Anggi Hanafiah Syanif, Joni Haryanto, Elida Ulfiana Copyright (c) 2022 Journal Of Nursing Practice https://creativecommons.org/licenses/by-nc-sa/4.0 https://thejnp.org/index.php/jnp/article/view/196 Sat, 29 Oct 2022 00:00:00 +0000 The Analysis of Services Quality and Satisfaction of BPJS Patient at X Public Health Center Counter Kediri City https://thejnp.org/index.php/jnp/article/view/294 <p><strong>Background:</strong> There are still many people who do not know about the National Health Insurance itself, the ease of treatment using the National Health Insurance has not been fully successful, because of the length of bureaucracy and the lack of facilities and infrastructure to support the National Health Insurance program.</p> <p><strong>Purpose:</strong> The purpose of this study was to see correlation between services quality and satisfaction BPJS Patients.</p> <p><strong>Methods:</strong> A correlational study methodology was used with a group of BPJS Patients. To obtain 30 individuals, a consecutive sampling procedure was used. The data was analyzed using the Spearman rho statistical test, with a significance threshold of = 0.05.</p> <p><strong>Results:</strong> The data revealed that, of the 30 respondents, the majority, 26 respondents (80 percent), stated that the services quality was good, and the majority had adequate satisfaction, 25 respondents (83 percent ). The results of the analysis of the spearman rho test obtained a p-value = 0.000 which is less than the value of alpha (0.05) so it can be concluded that H0 is rejected, meaning that there is a relationship between the services quality and the satisfaction of BPJS patients at X Public Health Center Kediri City.</p> <p><strong>Conclusion:</strong> Based on the study's findings, it is possible to conclude that there is a link between the services quality and the satisfaction of BPJS patients. The study's findings also suggest that services quality can increase satisfaction because patient will have loyalty if public health center can ensure services quality to BPJS patient.</p> Mohamad As’ad Efendy, Elon Bora Bili Copyright (c) 2022 Journal Of Nursing Practice https://creativecommons.org/licenses/by-nc-sa/4.0 https://thejnp.org/index.php/jnp/article/view/294 Sat, 29 Oct 2022 00:00:00 +0000 Behavioral Counseling of Theory of Planned Behavior-Based to Increase Tuberculosis Patients` Obedience in Medication Nutrition, and Prevention of Transmission: Randomized Control Trial https://thejnp.org/index.php/jnp/article/view/207 <p><strong>Background:</strong> Adherence behavior of tuberculosis patients become the most crucial factor in achieving success treatment, including adherence to compliance with medication, prevention of transmission, and nutritional compliance.</p> <p><strong>Purpose:</strong> This study aims to determine the effect of behavioral counseling based on Theory of Planned Behavior (TPB) in improving adherence of TB patient.</p> <p><strong>Methods:</strong> Quasy-experiment pre-post-test with control group were conducted on 108 patients with pulmonary tuberculosis at a Puskesmas located in Subang with simple random sampling technique. This study was conducted by behavioral counseling of TPB-Based in the treatment groups for 2 months. The statistical test used was the independent t test and chi-square.</p> <p><strong>Results: </strong>There were significant differences (p&lt;0,05) between treatment and control groups on attitude toward behavioral variables (ATB), subjective norm (SN), perceived behavior control (PBC), intention, medical adherence, prevention of transmission and nutritional compliance.</p> <p><strong>Conclusion:</strong> There were significant differences (p&lt;0,05) between treatment and control groups on attitude toward behavioral variables (ATB), subjective norm (SN), perceived behavior control (PBC), intention, medical adherence, prevention of transmission and nutritional compliance. Behavioral counseling of TPB-Based proven to have an effect in improving the ATB, SN, PBC, intention, medical adherence, prevention of transmission, and nutrition compliance of TB patients.</p> Novian Mahayu Adiutama, Wardah Fauziah Copyright (c) 2022 Journal Of Nursing Practice https://creativecommons.org/licenses/by-nc-sa/4.0 https://thejnp.org/index.php/jnp/article/view/207 Sat, 29 Oct 2022 00:00:00 +0000 The Future of Post-Covid-19 Health Services using Metaverse Technology https://thejnp.org/index.php/jnp/article/view/295 <p><strong>Background:</strong> The development of the metaverse technology of the next generation of the Internet, which consists of a virtual environment, Augmented Reality online which is decentralized and stable and can be widely used in the health field. Due to the growth of Metaverse technology in various fields and the importance of using it in healthcare, this study was conducted to review and identify areas of application of metaverse technology in healthcare.</p> <p><strong>Purpose: </strong>The purpose of this study is to analyze the writings that examine the metaverse in health care.</p> <p><strong>Method</strong><strong>s:</strong> In this scoping review, an electronic search is done through publish or perish to get an overview by combining keywords related to the topic without a time limit. Two authors independently collected data by data extraction tables.</p> <p><strong>Results:</strong> The 50 articles found through the initial search, nine studies were eligible for inclusion in the review. Most of the studies (55.55%) were published in 2021, and South Korea was the country with the most research (44.44%). The main services for using Metaverse include educational services, intervention services, and communication services. Also, medical imaging is the most practical aspect of the Metaverse used in healthcare.</p> <p><strong>Conclusion:</strong> The use of Metaverse in various health fields is growing rapidly. It is now widely used in other fields, such as medical intervention and health care provision; in medical imaging, it has many applications due to fundamental changes in the nature and quality of imaging.</p> Joko Prasetyo, Masruroh Copyright (c) 2022 Journal Of Nursing Practice https://creativecommons.org/licenses/by-nc-sa/4.0 https://thejnp.org/index.php/jnp/article/view/295 Sat, 29 Oct 2022 00:00:00 +0000 Implementation of Islamic Spiritual Guidance in Reducing the Anxiety Level of CVA (Cerebro Vascular Accident) Patients at Muhammadiyah General Hospital in Bandung Tulungagung https://thejnp.org/index.php/jnp/article/view/296 <p><strong>Background:</strong> The incidence of stroke is still high and contributes to high mortality and disability rates. Stroke attacks cause malfunctions such as paralysis and difficulty communicating so that patients will experience anxiety, fear, sadness and even despair in the face of the disease they are suffering from.</p> <p><strong>Purpose:</strong> The purpose of this study was to analyze the effect of providing Islamic spiritual guidance on the anxiety level of CVA (Cerebro Vascular Accident) patients.</p> <p><strong>Methods: </strong>This research was conducted in the Inpatient Room at RSU Muhammadiyah Bandung Tulungagung using a quasi experimental design with a one group pre post test design approach, 122 respondents were taken using purposive sampling technique. The independent variable is the provision of Islamic spiritual guidance and the dependent variable is the level of anxiety using a questionnaire and Wilcoxon test analysis.</p> <p><strong>Results:</strong> The results of the Wilcoxon test analysis value negative ranks N: 91, Mean: 49.23, Sum of ranks: 4480.00, so it can be concluded that there is a decrease in the value of the anxiety level before to after Islamic spiritual guidance. Based on statistical tests obtained p value: 0.001 &lt;0.05, meaning that there is effectiveness after Islamic spiritual guidance in reducing the anxiety level of stroke patients. Islamic spiritual guidance is effective in reducing anxiety in stroke patients, so hospitals need to make a formulation to form a spiritual guidance team that can provide spiritual services to all patients in the hospital.</p> <p><strong>Conclusion: </strong>Islamic spiritual guidance can reduce anxiety in stroke patients so hospitals need to make formulations to create teams or increase the ability of health workers about spiritual guidance given to all patients in the hospital.</p> Agustin Widyowati, Yudit Violitha, Anik Nurhidayah Copyright (c) 2022 Journal Of Nursing Practice https://creativecommons.org/licenses/by-nc-sa/4.0 https://thejnp.org/index.php/jnp/article/view/296 Sat, 29 Oct 2022 00:00:00 +0000