Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal)
Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal): A Journal of Values, Issues, Experience, and Collaboration has been a leading platform for healthcare thought leaders and innovators since its establishment in 2013. Published in collaboration with DPW PPNI Jawa Barat, the journal is dedicated to advancing nursing and healthcare knowledge through evidence-based research and practice. Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal) is a peer-reviewed journal published by STIKep PPNI Jawa Barat, quarterly publication released in January, April, July, and October each year. Each issue offers valuable insights into contemporary topics and challenges relevant to nursing professions across diverse practice settings. By fostering collaboration and sharing innovative ideas, the journal serves as a vital resource for nurses, educators, researchers, and policymakers committed to improving nursing outcomes. The dynamic and ever-evolving nature of global healthcare continues to present new challenges and raise critical questions. Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal) invites researchers, academics, practitioners, managers, and policymakers from diverse countries and backgrounds to submit papers that explore these pressing issues and advance the body of knowledge in nursing and clinical practice. Beginning July 2021, the journal will be published in English. Manuscript submissions can be made online through our website: http://journal.stikep-ppnijabar.ac.id. We look forward to receiving your contributions and fostering meaningful dialogue in the field of nursing and healthcare. Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal) has been nationally accredited based on the Decree of Minister of Research, Technology and Higher Education Number : 152/E/KPT/2023 with SINTA Score 4. JKK has p-ISSN: 2354-8428, e-ISSN: 2598-8727, and DOI: https://doi.org/10.33755/jkk Average article statistics (from early 2020 to present) 7 s.d 14 Days to First Editorial Decision 30 Days to Accept 75% Acceptance Rate 25% Rejection Rate
Effect of Intradialytic Resistance Exercise on Restless Legs Syndrome Among Hemodialysis Patients: A Pilot Randomized Controlled Trial
Background: Restless legs syndrome (RLS) is common and burdensome among patients undergoing hemodialysis (HD). Intradialytic exercise provides a pragmatic opportunity for symptom management; however, evidence on resistance exercise during HD remains limited. Objective: This pilot study evaluated the effect of intradialytic resistance exercise on RLS severity in adults receiving maintenance HD. Methods: A two-arm, parallel-group pilot randomized controlled trial was conducted in two HD units (January–April 2025). Adults on thrice-weekly HD for ≥3 months with at least moderate RLS (IRLS ≥11) were randomized 1:1 to intradialytic resistance exercise (IRE) or usual care. The IRE group performed supervised elastic-band exercises during the first 2 hours of HD, three times weekly for 8 weeks. Outcomes were assessed at baseline, week 4, and week 8. The primary outcome was the International Restless Legs Syndrome Scale (IRLS) score, analyzed using mixed-effects models. Results: Forty-two participants were enrolled (IRE n=21; control n=21), with 90.5% completing the study. A significant group×time interaction was observed (p<0.001). At week 8, the IRE group demonstrated a clinically meaningful reduction in IRLS compared with controls (mean difference −8.4; 95% CI −11.7 to −5.0; Cohen’s d=1.11). Adherence was high and no serious adverse events occurred. Conclusions: An 8-week intradialytic resistance exercise program was feasible, safe, and effective in significantly reducing RLS severity among HD patients. Larger trials are warranted to confirm long-term benefits and implementation potential.
Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0
The Meaning of Burnout in Nursing Practice: An Interpretative Phenomenological Study among Emergency Department Nurses
Background: Burnout is a multidimensional occupational phenomenon that disproportionately affects nurses working in high-intensity environments such as emergency departments (EDs). While quantitative studies have documented its prevalence and determinants, limited research has explored how nurses themselves interpret and make meaning of burnout within their professional and cultural contexts. Objective: This study aimed to explore the lived meaning of burnout among emergency department nurses in Indonesia. Methods: An interpretative phenomenological analysis (IPA) was conducted with ten ED nurses recruited through purposive sampling. Participants self-identified as experiencing burnout and had a minimum of one year of ED experience. Data were collected through in-depth semi-structured interviews and reflective field notes. Analysis followed established IPA procedures, including case-by-case examination, development of emergent themes, and synthesis into superordinate themes. Reflexivity, audit trails, peer debriefing, and member reflection were employed to ensure rigor, in line with COREQ guidelines. Results: Four superordinate themes were identified: (1) burnout as relentless moral and physical overload, (2) burnout as erosion of self and emotional presence, (3) burnout as tension between professional duty and personal life amid limited organizational support, and (4) burnout as a professional test reinterpreted through spirituality and peer solidarity. Burnout was understood not merely as exhaustion, but as a meaning-laden experience involving identity disruption, moral distress, and adaptive resilience. Conclusion: Emergency nurses interpret burnout as a complex lived experience shaped by systemic demands, cultural values, and personal meaning-making processes. Addressing burnout therefore requires organizational reform alongside interventions that acknowledge nurses’ moral, emotional, and spiritual dimensions.
Understanding Gender Patterns in Knowledge, Attitudes, and Practices of Anemia Prevention Among Junior High School Students
Background: Anemia remains a prevalent nutritional problem among adolescents, influenced by rapid growth, dietary patterns, and in females menstrual blood loss. Understanding whether gender differences exist in anemia-related knowledge, attitudes, and preventive practices is essential for designing effective school-based interventions. Objective: To describe and compare knowledge, attitudes, and preventive practices related to anemia among male and female junior high school students. Methods: A descriptive comparative study was conducted among 134 junior high school students (grades 7–9) in West Bandung, Indonesia. Participants were selected through random selection within classes at a single school. Knowledge, attitudes, and preventive practices were assessed using structured questionnaires. Gender differences were analyzed using the Mann–Whitney U test due to non-normal data distribution. Results: Female students demonstrated higher proportions in the high-knowledge category compared with males; however, the difference in knowledge scores between genders did not reach statistical significance (p = 0.060). No statistically significant gender differences were observed in attitudes (p = 0.160) or preventive practices (p = 0.285). Most students of both genders exhibited moderate attitudes and moderate anemia prevention practices. Conclusion: No statistically significant gender differences were identified in knowledge, attitudes, or preventive practices related to anemia among junior high school students. Although female students tended to show higher knowledge levels, this pattern represents a non-significant trend rather than a confirmed difference. These findings suggest that anemia prevention programs should target both male and female adolescents equally, with emphasis on translating knowledge into consistent preventive behaviors through comprehensive school-based interventions.
Usability and User Experience Evaluation of a Geriatric Care Screening Tool for Nursing Practice
Background: Population aging continues to intensify the demand for comprehensive geriatric nursing assessments, particularly in primary care and community health settings. In many contexts, these assessments are still performed manually, which can be time-consuming, prone to documentation errors, and difficult to integrate into ongoing care planning. Digital screening tools may help address these challenges; however, their effectiveness largely depends on usability and user experience among frontline nurses. Objective: This study aimed to evaluate the usability and user experience of the Geriatric Care Screening Tool, a digital application developed to support geriatric nursing assessments, from the perspective of nurse users. Methods: A usability and user experience evaluation study was conducted using a descriptive quantitative design within a user-centered development framework. Twenty nurses involved in geriatric nursing services participated in the evaluation. User needs were explored through a focus group discussion (FGD), followed by expert content validation of the application. Usability was assessed using the System Usability Scale (SUS), while user experience was evaluated using the User Experience Questionnaire (UEQ). Data were analyzed descriptively and interpreted using established benchmark standards. Results: The mean SUS score was 70.38, indicating marginally acceptable usability with a “Good” adjective rating. UEQ results showed positive user experience across all dimensions. The highest scores were observed in Clarity (1.75), Accuracy (1.20), and Stimulation (1.04). Lower scores were identified in Attractiveness (0.73), Efficiency (0.86), and Novelty (0.65), suggesting areas that require further improvement, particularly related to interface design, navigation speed, and innovative features. Conclusion: The Geriatric Care Screening Tool demonstrated acceptable usability and a generally positive user experience among nurses. While the application meets basic functional requirements for geriatric nursing assessment, further refinement—particularly in efficiency, visual design, and innovation—is needed to optimize its use in clinical and community practice.
Effectiveness of a Health Belief Model–Based “Smart Social Media” Module in Reducing Social Media Addiction Among Indonesian Adolescents: A Quasi-Experimental Study
Background: Adolescent social media addiction has become a growing public health concern in Indonesia, particularly in semi-urban areas, and is linked to negative mental health and academic outcomes. Previous intervention studies often lacked rigorous control designs and contextual relevance, limiting their generalizability. Objective: This study evaluated the effectiveness of a structured Health Belief Model (HBM)–based “Smart Social Media” module in reducing social media addiction and improving knowledge among Indonesian adolescents. Methods: A quasi-experimental non-equivalent control group design was conducted among 70 senior high school students in Sukoharjo, Indonesia. Participants were assigned to an intervention group (n = 35) or control group (n = 35). The intervention consisted of a single 45-minute session including an educational presentation, interactive HBM-based discussion with a Kahoot quiz, and completion of a social media diary worksheet. Social media addiction and knowledge were measured using a validated 20-item questionnaire (Cronbach’s α = 0.927). Data were analyzed using Wilcoxon signed-rank and Mann–Whitney U tests (α < 0.05). Results: The intervention group showed a significant increase in knowledge (median change +16.0, p < 0.001) and a significant reduction in social media addiction scores (median change −4.0, p < 0.001), with large effect sizes. The control group showed minimal changes. Between-group post-test differences were statistically significant for both outcomes. Conclusion: The HBM-based “Smart Social Media” module was effective in reducing social media addiction and improving knowledge among adolescents. Larger multi-site and longitudinal studies are recommended to assess sustained behavioral effects
The The Effect of Buerger Allen Exercise on Peripheral Tissue Perfusion in Patients with Type 2 Diabetes Mellitus: A Literature Review
Background: Type 2 diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia due to impaired insulin secretion and/or insulin resistance. One of the most common long-term complications is impaired peripheral tissue perfusion of the lower extremities, which can progress to diabetic foot ulcers and significantly increase the risk of amputation. Consequently, identifying effective and accessible non-pharmacological interventions to improve peripheral circulation is crucial. Objective: This literature review aimed to evaluate the effectiveness of Buerger Allen Exercise (BAE) in improving peripheral tissue perfusion among patients with type 2 diabetes mellitus. Methods: A literature review was conducted using Google Scholar, PubMed, ScienceDirect, ProQuest, and Elsevier databases. Articles published between 2016 and 2024 were identified using the keywords “Buerger Allen Exercise,” “BAE,” “Type 2 Diabetes Mellitus,” “Peripheral Perfusion,” and “Ankle Brachial Index,” combined with Boolean operators “AND” and “OR.” Inclusion criteria comprised intervention studies published in English or Indonesian that reported outcomes related to peripheral perfusion. Results: Ten studies met the inclusion criteria. Overall, BAE was associated with significant improvements in peripheral perfusion, evidenced by increased Ankle Brachial Index values, improved capillary refill time, enhanced skin temperature and color, strengthened peripheral pulses, and reduced lower extremity pain. Several studies also reported greater benefits when BAE was combined with adjunctive interventions such as vitamin C supplementation, foot spa therapy, or music therapy. Conclusion: Buerger Allen Exercise is a low-cost, feasible, and evidence-supported non-pharmacological intervention that effectively enhances peripheral tissue perfusion in patients with type 2 diabetes mellitus and may help prevent vascular complications and improve patient well-being.
Instrumental Activities of Daily Living and Quality of Life Among Older Adults with Hypertension: A Cross-Sectional Study in Grogol, Indonesia
Background: Global population aging is accelerating, including in Indonesia, and is accompanied by an increasing burden of chronic conditions such as hypertension. Older adults with hypertension are vulnerable to functional decline, particularly in instrumental activities of daily living (IADL), which may adversely affect their quality of life (QoL). However, empirical evidence examining the relationship between IADL and QoL in primary healthcare settings remains limited. Objective: This study aimed to examine the association between instrumental activities of daily living and quality of life among older adults with hypertension attending a primary health center. Methods: A cross-sectional study was conducted involving 382 older adults with hypertension registered at the Grogol Health Center. IADL was assessed using the Lawton Instrumental Activities of Daily Living scale, while QoL was measured using the Kualitas Kehidupan Lansia (KKHL) questionnaire. Descriptive statistics were presented as medians and interquartile ranges (IQRs) due to non-normal data distribution. The association between IADL and QoL was analyzed using Spearman’s rank correlation test. Results: The median QoL score was 56 (IQR: 50–58), indicating relatively homogeneous quality of life among participants. Most respondents demonstrated functional independence in IADL. A statistically significant but weak positive correlation was found between IADL and QoL (ρ = 0.131; p = 0.010; 95% CI: 0.03–0.23). Conclusion: Functional independence in IADL was positively associated with QoL among older adults with hypertension, although the strength of the relationship was weak. Other contributing factors should be explored to better understand determinants of QoL in this population.
Associations Between Physical Activity and Multiple Maternal Health Outcomes Among Pregnant Women: A Cross-Sectional Study
important role in maintaining maternal health. However, inappropriate activity levels may be associated with various adverse maternal outcomes. Previous studies have often focused on single health outcomes, limiting understanding of how physical activity relates to multiple maternal conditions within the same population. Objective: This study aimed to comprehensively examine the associations between physical activity levels and multiple maternal health outcomes, including constipation, low back pain (LBP), blood pressure, chronic energy deficiency (CED), and anemia, among pregnant women. Methods: This cross-sectional correlational study involved 251 pregnant women consecutively recruited from two community health centers. Physical activity was assessed using the Pregnancy Physical Activity Questionnaire (PPAQ), while constipation, LBP, blood pressure, CED, and anemia were measured using the Constipation Assessment Scale (CAS), Numeric Rating Scale (NRS), and a standardized checklist form. Data were analyzed using Chi-square and Fisher’s exact tests, with odds ratios (ORs) and 95% confidence intervals (CIs) calculated for significant associations. Results: Most respondents reported moderate levels of physical activity. Physical activity level was significantly associated with LBP severity (p = 0.020), with women engaging in vigorous activity showing higher odds of severe LBP compared with those performing sedentary to moderate activity (OR = 1.83; 95% CI: 0.94–3.54). No statistically significant associations were observed between physical activity level and constipation, blood pressure, CED, or anemia. Conclusion: Low back pain was the only maternal health outcome significantly associated with physical activity level in this study. These findings highlight the importance of antenatal care interventions that prioritize screening for LBP, assessment of physical workload patterns, and guidance on safe and balanced physical activity to prevent severe LBP during pregnancy.
The Effectiveness of a Combination of Slow Breathing Exercises and Progressive Muscle Relaxation on Anxiety Levels in Pre-elderly People with Hypertension
Background: Pre-elderly individuals often suffer from hypertension, a chronic condition that often causes anxiety due to increased sympathetic nervous system activity. By increasing parasympathetic activity and muscle relaxation, non-pharmacological techniques such as Progressive Muscle Relaxation (PMR) and Slow Breathing Exercises (SBE) have been shown to reduce anxiety levels. Objective: The purpose of this study was to determine the impact of progressive muscle relaxation and slow breathing exercises on anxiety levels in pre-elderly individuals with hypertension in Depok Village, Pakenjeng District, Garut Regency. Methods: This study used a quasi-experimental, non-randomized pre-post-test design with two groups (intervention vs. control). 100 pre-elderly participants were selected using purposive sampling. The intervention lasted for one month and consisted of two 30-minute sessions per week. The Hamilton Anxiety Rating Scale (HARS) was used to assess anxiety symptoms. Results were analyzed statistically using the paired samples t test and the independent samples t test for samples with a significance level of p < 0.05. Results: The results of the study found that after the intervention, anxiety scores in the intervention group decreased significantly from a mean of 27.88 (SD 8.47) to a mean of 12.80 (SD 4.82) (p < 0.001), with a substantial effect size (Cohen's d = 2.21). In the control group, the decrease from a mean of 28.82 (SD 9.10) to a mean of 21.94 (SD 7.18) was less pronounced. A significant difference remained between the two groups after the intervention (mean difference = 9.14; 95% CI: 6.72–11.56; p < 0.001), indicating that the combination of SBE and PMR was effective in reducing anxiety. Conclusion: The combination of slow breathing exercises and progressive muscle relaxation is effective in reducing anxiety levels in pre-elderly people with hypertension. This intervention can be recommended as a non-pharmacological supportive therapy in public health services.
Determinants of Interprofessional Collaboration Among Nurses: The Role of Demographics, Work Experience, and Workplace Culture
Background: Interprofessional Collaboration (IPC) enhances the quality and safety of healthcare by integrating the expertise of multiple health professionals; however, its implementation in hospital settings is often hindered by barriers such as ineffective communication, unclear professional roles, hierarchical dominance, and unsupportive workplace culture. Objective: This study aimed to analyze the relationship between demographic characteristics, work experience, and workplace culture and the implementation of IPC among nurses. Methods: A cross-sectional quantitative study design was employed to examine the association between demographic factors, work experience, and work culture with IPC implementation among nurses at a general hospital in Banten Province, Indonesia. Eighty nurses were recruited using stratified random sampling. Data were collected through structured questionnaires and analyzed using descriptive and inferential statistics with SPSS version 27.0. Results: IPC implementation was significantly associated with age (p = 0.048), education level (p = 0.047), work experience (p < 0.001), and work culture (p < 0.001). Work culture emerged as the most influential factor, with an odds ratio (OR) of 7.429 (95% CI: 2.703–20.419). Conclusion: Both individual demographic factors and organizational context influence nurses’ IPC implementation, with workplace culture being the most influential factor, highlighting the need to foster a collaborative work environment through interprofessional communication training, inclusive decision-making, and supportive institutional policies.
Adolescents’ Narratives of Trauma, Violence, and Identity Development: A descriptive–exploratory approach
Background: Past traumatic experiences are associated with psychosocial challenges and mental health outcomes. In nursing practice, trauma particularly sexual violence may have long-term psychological effects that shape individuals’ well-being and self-perception, including aspects of identity. Concurrently, sexual orientation diversity has become increasingly visible within Indonesian society, underscoring the need for trauma-informed, non-judgmental nursing care that supports psychological health without pathologizing sexual orientation Objective: This study aims to explore adolescents lived experiences of trauma and violent behavior and how these experiences influence their perceptions and understanding of sexual orientation. Methods: This qualitative study used a descriptive–exploratory approach. Data were collected through in depth interviews with 6 informants selected using snowball sampling. Data analysis was conducted using the Colaizzi’s method to identify emerging themes from participants lived experiences Results: Participants described past traumatic experiences, including loss of loved ones, parental separation, sexual violence, and perceived lack of parental support, as important contexts shaping their psychological well-being, interpersonal relationships, and self-understanding during adolescence. These findings reflect participants’ personal perceptions and lived experiences rather than causal changes in sexual orientation. Conclusion: This study highlights adolescents’ narratives of how traumatic experiences inform their psychosocial well-being and identity-related reflections. The findings underscore the importance of trauma-informed, non-pathologizing nursing care that acknowledges adolescents’ lived experiences and supports holistic psychological development
Quality of Nursing Work Life (QNWL): A Scoping Review of Concepts, Determinants, and Outcomes
Background: Quality of Nursing Work Life (QNWL) is increasingly recognized as a critical determinant of nurses’ well-being, retention, and performance. However, heterogeneity in conceptualization, measurement, and methodological approaches limits comparability and practical application. Objective: This scoping review aimed to map and synthesize contemporary evidence on QNWL, focusing on its definitions, measurement instruments, determinants, outcomes, and research gaps. Methods: A scoping review was conducted following the Joanna Briggs Institute (JBI) methodological framework and reported in accordance with PRISMA-ScR. Searches were performed in PubMed/MEDLINE, Scopus, Web of Science, CINAHL, and PsycINFO for studies published in English between January 2019 and February 2025. Google Scholar (first 200 results, sorted by relevance) and reference list screening were used as supplementary sources. Eligibility was defined using the Population–Concept–Context (PCC) framework. Data were charted descriptively and synthesized narratively. Methodological appraisal using JBI tools was conducted to describe study quality, not to exclude evidence. Results: Fifteen studies met inclusion criteria, encompassing cross-sectional surveys, psychometric validation studies, and contextual reviews from diverse geographic settings. The Brooks Quality of Nursing Work Life scale and the Work-Related Quality of Life instrument were most frequently used, reflecting continued conceptual heterogeneity. Key determinants of QNWL included leadership quality, workload, staffing adequacy, and organizational climate. Higher QNWL was consistently associated with greater job satisfaction, organizational commitment, and intention to stay, whereas lower QNWL was linked to burnout and turnover intention. Most studies were cross-sectional, limiting causal inference. Conclusions: QNWL is a multidimensional, context-sensitive construct shaped primarily by organizational and leadership factors. While evidence consistently links QNWL with workforce stability and well-being, methodological limitations and conceptual variability remain. Future research should prioritize longitudinal and interventional designs, standardized measurement, and broader contextual coverage to inform sustainable nursing workforce policies
The Effect of Student-Centered Learning using the Make a Match Model on Students’ Knowledge in the Nursing Management and Patient Safety Course Among Second-Year Undergraduate Program
Background: Active learning strategies are essential to improve nursing students’ understanding of Nursing Management and Patient Safety, which are critical for preventing adverse events in clinical practice. Student Centered Learning (SCL) using the Make a Match model is an interactive cooperative learning approach that promotes active engagement and conceptual understanding. However, evidence regarding its effectiveness in improving nursing students’ knowledge remains limited. Objective: This study aimed to determine the effect of Student Centered Learning using the Make a Match model on students’ knowledge in the Nursing Management and Patient Safety course among second-year undergraduate nursing students. Methods: A pre-experimental one-group pretest–posttest design was conducted involving 69 second-year undergraduate nursing students at STIKes Dharma Husada, selected through purposive sampling. Students’ knowledge was assessed using a 34-item patient safety knowledge questionnaire developed by Dhewa (2017). All enrolled participants completed both the pretest and posttest. Data normality of the pre–post difference scores was confirmed, justifying the use of a paired t-test. Statistical analysis was performed at a 0.05 significance level. Effect size was calculated using Cohen’s d, and 95% confidence intervals were estimated. Results: Prior to the intervention, most students demonstrated a moderate level of knowledge (63.8%). After the implementation of the Make a Match learning model, the majority of students achieved a good level of knowledge (91.3%). The paired t-test showed a statistically significant increase in knowledge following the intervention (p = 0.001), with a large effect size and a 95% confidence interval indicating a meaningful educational impact. Conclusion: Student Centered Learning using the Make a Match model is effective in significantly improving nursing students’ knowledge in the Nursing Management and Patient Safety course. This approach may be considered as an alternative instructional strategy to enhance learning outcomes in nursing education.
The Influence of Parental Knowledge and Experience on Behavioral Management in Child Rearing
Background: Children’s emotional reactions, such as fear or resistance, are strongly influenced by how parents manage their behavior during medical procedures. Effective behavioral management which means parenting practices in managing children’s behavior, plays a crucial role in helping children face medical procedures calmly and cooperatively. Various factors may affect implementation of behavioral management, including knowledge and experience. Objective: This study aimed to examine the association of parents’ knowledge and experience on the implementation of behavioral management in parenting. Methods: This study employed a quantitative, non-experimental design. The population consisted of parents whose children received health examinations at the Pediatric Outpatient Clinic, with a total of 70 participants selected using accidental sampling. Data were analyzed using ordinal logistic regression. Results: Respondents with poor knowledge had a 68% lower likelihood of demonstrating better behavior management compared with those with good knowledge (OR = 0.32; 95% CI: 0.10–0.96; p = 0.05), while moderate knowledge showed a similar but statistically non-significant trend (OR = 0.42; p = 0.09). Respondents with poor experience had a 70% lower likelihood of exhibiting better behavior management (OR = 0.30; 95% CI: 0.09–1.00; p = 0.05), whereas moderate experience was not significantly associated with behavior management (OR = 1.18; p = 0.73). Conclusion: Parents are expected to apply behavioral management strategies in clinical setting based on knowledge and experience to reduce fear and anxiety in children, such as preparatory communication, distraction techniques, play therapy and collaboration with health care staff.
Effectiveness of Board Game–Based Education in Enhancing Knowledge and Intention Toward HPV Vaccination Among Adolescent Girls
Background: Human papillomavirus (HPV) infection is a major cause of cervical cancer, and HPV vaccination is recommended for girls aged 11–12 years. However, HPV vaccination coverage in Indonesia remains low, partly due to limited knowledge and low intention to receive vaccination among preadolescent girls. Innovative educational strategies are needed to improve HPV vaccine acceptance. Objective: This study aimed to evaluate the effectiveness of board game–based HPV vaccine education in improving knowledge and intention to receive HPV vaccination among adolescent girls. Methods: A quasi-experimental study was conducted involving 144 girls aged 11–12 years, with 72 participants in the intervention group and 72 in the control group. The intervention group received HPV vaccine education through a board game–based approach, while the control group received conventional education. Knowledge and intention toward HPV vaccination were measured using validated questionnaires before and after the intervention. Data were analyzed using descriptive statistics, paired sample t-tests, and ANCOVA. Results: After adjustment for baseline scores and age using ANCOVA, the intervention group showed significantly higher post-test knowledge (F(1,140) = 9.65, p = 0.002, partial η² = 0.065) and intention (F(1,140) = 8.69, p = 0.004, partial η² = 0.058) compared with the control group, indicating moderate intervention effects. Conclusion: Board game–based HPV vaccine education was associated with significant improvements in knowledge and intention toward HPV vaccination among adolescent girls after controlling for baseline differences. However, these improvements were comparable to those achieved through conventional education. Interactive educational approaches may therefore serve as viable and engaging alternatives, rather than superior strategies, for supporting HPV vaccination promotion in school-based programs
Hand-Held Fan Therapy and Changes in Respiratory Parameters in Hospitalized Patients with Congestive Heart Failure: A Nursing Case Series
Background: Congestive heart failure (CHF) is a progressive clinical syndrome characterized by impaired cardiac function and reduced ability to meet metabolic demands. Dyspnea is one of the most frequent symptoms and is commonly identified in nursing practice as an ineffective breathing pattern. Supportive non-pharmacological interventions may assist in relieving respiratory distress. Hand-held fan therapy delivers airflow to the facial area and has been suggested as a simple method to reduce breathlessness. Objective: To describe changes in respiratory rate and oxygen saturation among patients with CHF following the application of hand-held fan therapy as part of inpatient nursing care. Methods: A descriptive case series was conducted using the nursing process framework. Three hospitalized CHF patients with ineffective breathing patterns were observed in a cardiovascular ward at RSUD Koja Hospital, North Jakarta. Hand-held fan therapy was applied for approximately five minutes per session. Respiratory rate and oxygen saturation were monitored before and after the intervention period. Results: All patients showed tachypnea at baseline (28 breaths/min). After repeated application of hand-held fan therapy, respiratory rates decreased consistently to 22 breaths/min. Oxygen saturation improved modestly from 93–94% to approximately 95%. Conclusion: Hand-held fan therapy was associated with improved breathing patterns and oxygenation in patients with CHF. This intervention may be considered a supportive nursing strategy for managing dyspnea
Pomelo (Citrus maxima) Peel Ethanolic Extract Mitigates Isoniazid–Rifampicin–Induced Hepatotoxicity in a Male Wistar Rat Model
Background: Tuberculosis continues to pose a substantial public health challenge in Indonesia, which currently ranks second worldwide in disease burden. Although first-line antituberculosis drugs such as isoniazid and rifampicin are highly effective, their prolonged use is frequently associated with hepatotoxicity, which may disrupt treatment continuity and compromise patient safety. Identifying adjunctive strategies capable of reducing liver injury during antituberculosis therapy therefore remains an important research priority. Objective: This study aimed to examine the concurrent hepatoprotective effect of pomelo (Citrus maxima) peel ethanolic extract in a male Wistar rat model exposed to isoniazid–rifampicin–induced liver injury. Methods: An experimental posttest-only control group design was applied using thirty-two male Wistar rats distributed into five groups: a normal control, a negative control receiving isoniazid and rifampicin, and three treatment groups administered pomelo peel ethanolic extract at doses of 100, 200, and 400 mg/kg body weight. Hepatotoxicity was induced with isoniazid and rifampicin, followed by extract administration two hours after drug exposure from day 4 to day 10. Liver function was assessed by measuring serum alanine aminotransferase (SGPT) and aspartate aminotransferase (SGOT). Phytochemical screening was conducted to identify major secondary metabolites present in the extract. Results: Phytochemical analysis revealed the presence of flavonoids, tannins, alkaloids, triterpenoids, and quinones in pomelo peel extract. Rats receiving isoniazid–rifampicin exhibited marked elevations in SGPT and SGOT levels compared with the normal control group. Concurrent administration of pomelo peel extract significantly reduced these enzyme levels across all treatment doses relative to the negative control. The 400 mg/kg body weight dose produced the greatest attenuation of hepatic enzyme elevation, indicating a dose-related protective response. Conclusion: Pomelo (Citrus maxima) peel ethanolic extract demonstrates dose-dependent hepatoprotective activity during concurrent exposure to isoniazid and rifampicin in male Wistar rats. These findings suggest that pomelo peel extract may have potential as a supportive agent to mitigate antituberculosis drug–induced liver injury, although further mechanistic, pharmacokinetic, and clinical investigations are required prior to translational application
Emotional Mental Health Among Adolescents: A Profiling Psychosocial Risk Distribution
Background: Adolescents are a vulnerable population to emotional and mental health problems due to rapid biological, psychological, and social changes. National surveys have reported increasing levels of anxiety, loneliness, and behavioral problems among adolescents; however, local evidence describing the distribution of adolescent emotional and mental health problems remains limited, particularly in school settings. Objective: This study aimed to describe the distribution and profile of emotional and mental health problems among adolescents based on school-based psychosocial screening in Bandung Regency, Indonesia. Methods: A descriptive quantitative study with a cross-sectional design was conducted involving 1,304 adolescents who participated in a school-based mental health screening program in 2025. Emotional and behavioral problems were assessed using the Strengths and Difficulties Questionnaire (SDQ), covering five domains: emotional symptoms, conduct problems, hyperactivity, peer relationship problems, and prosocial behavior. Data were analyzed descriptively using frequencies and percentages. Results: Most adolescents were classified as normal in the domains of emotional symptoms (67.9%), conduct problems (67.2%), hyperactivity (81.8%), and prosocial behavior (57.8%). However, a relatively high proportion of abnormal scores was observed in peer relationship problems (27.1%) and emotional symptoms (20.6%). Based on the total difficulties score, 3.4% of adolescents were categorized as abnormal, indicating the presence of a psychosocial risk burden within the adolescent population. These findings suggest that peer relationship difficulties and emotional problems constitute prominent areas of concern. Conclusion: This study provides a descriptive overview of emotional and mental health problems among adolescents identified through school-based psychosocial screening. The findings underscore the potential role of routine screening in supporting early identification of adolescents at risk of psychosocial difficulties. Further evaluative and longitudinal studies are needed to assess the effectiveness of screening programs and related interventions in improving adolescent mental health outcomes
Motivations and Behavioral Patterns of Sexual Harassment Perpetrators: A Qualitative Study in Bandung City, Indonesia
Background: Sexual harassment is a persistent social and public health problem, particularly in urban contexts where complex social interactions and power relations are prevalent. While existing research has largely centered on victims’ experiences, limited attention has been directed toward understanding the motivations and behavioral patterns of perpetrators, especially within the Indonesian sociocultural context. Objective: This study aimed to explore the motivations, behavioral processes, and cognitive patterns underlying sexual harassment perpetration based on perpetrators’ own perspectives in Bandung City, Indonesia. Methods: A qualitative study employing a phenomenological approach was conducted among individuals convicted of sexual harassment and currently serving sentences in a correctional facility in Bandung City. Data were collected through in-depth, semi-structured interviews. Reflexive thematic analysis was used to identify recurring themes related to motivations, behavioral development, rationalization strategies, and moral awareness. Results: Six interrelated themes emerged from the analysis. Sexual harassment behavior was driven by internal psychological factors, including sexual desire, curiosity, emotional dysregulation, and low self-control. Social and cultural environments that normalized harassment reinforced these behaviors. Power imbalances between perpetrators and victims facilitated domination and reduced resistance. Harassing behaviors typically developed gradually, starting with minor boundary violations and escalating over time. Perpetrators employed cognitive rationalization and strategic risk management to justify their actions and avoid detection. Moral awareness and remorse varied and often emerged only after legal consequences were experienced. Conclusion: Sexual harassment perpetration is shaped by a complex interaction of individual, social, and structural factors. Understanding perpetrators’ motivations and behavioral patterns is crucial for informing comprehensive prevention strategies, rehabilitation programs, and policy development. Integrating perpetrator-focused education on consent, emotional regulation, and ethical behavior alongside victim-centered approaches is essential to effectively reduce sexual harassment
Hemodialysis Adherence and Quality of Life Among Patients with Chronic Kidney Disease in Indonesia: A Cross-Sectional Study
Background: Chronic kidney disease requires long-term hemodialysis, yet adherence to treatment remains a persistent challenge that may influence patient-reported outcomes. Objective: This study aimed to examine the relationship between hemodialysis adherence and quality of life among patients with chronic kidney disease in Indonesia. Methods: A cross-sectional study was conducted from January to February 2025 in a public hospital. Fifty-two patients undergoing maintenance hemodialysis were recruited using convenience sampling. Adherence was assessed through medical record review, including session attendance and completion. Quality of life was measured using the Kidney Disease Quality of Life Short Form-36 (KDQOL-SF36). Data were analyzed using Pearson’s correlation and linear regression. Results: The mean quality of life score was 67.06 ± 9.82. Hemodialysis adherence was positively correlated with overall quality of life (r = 0.36, p = 0.05). Higher adherence was particularly associated with symptom-related and disease impact domains. Regression analysis indicated that adherence significantly predicted quality of life with (β = 0.20, p < 0.05, R² = 0.04), indicating that adherence explained 4% of the variance in quality of life scores Conclusion: Adherence to hemodialysis is significantly associated with better quality of life among patients with chronic kidney disease. These findings highlight the importance of adherence monitoring and patient-centered interventions in hemodialysis care.