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
Pain Scale Reduction After a Morning Walking Program among Older Adults with Osteoarthritis: A One-Group Pretest-Posttest Study at Tlogosadang Health Center
Background: Osteoarthritis is a common degenerative joint condition in older adults and is frequently accompanied by pain, stiffness, limited mobility, and reduced quality of life. Exercise is recommended in osteoarthritis management, and walking is a low-cost activity that may be feasible in community and primary health service settings. However, evidence from small primary-care-based morning walking programs remains limited, particularly when pain medication use and the absence of a control group are considered. Objective: This study aimed to examine changes in osteoarthritis knee pain scores after a structured morning walking program among older adults in the working area of Tlogosadang Health Center, Paciran District, Lamongan Regency, Indonesia. Methods: This quantitative pre-experimental study used a one-group pretest-posttest design. The sample included 35 older adults with knee osteoarthritis selected by consecutive sampling from February to March 2026. Eligible participants were aged over 60 years, had controlled knee joint pain and limited knee movement, were able to walk, and provided informed consent. The morning walking program was delivered for 15 minutes, twice weekly for 3 weeks. Pain intensity was measured before and after the program using the Numeric Rating Scale (NRS). Data analysis treated NRS as paired ordinal pain data. The Shapiro-Wilk test was used as a distributional check, and the Wilcoxon signed-rank test was selected as the primary inferential test. Results were reported with Z statistic, p-value, and effect size r. Results: Before the program, 22 participants (62.9%) reported mild pain, 12 (34.3%) reported moderate pain, and 1 (2.9%) reported severe pain. After the program, 2 participants (5.7%) reported no pain, 28 (80.0%) reported mild pain, and 5 (14.3%) reported moderate pain. The number of respondents with moderate-to-severe pain decreased from 13 (37.2%) to 5 (14.3%). The mean NRS score decreased from 3.17 ± 1.38 to 1.86 ± 1.31, with a 1.31-point absolute reduction and an approximate 41.3% relative reduction from baseline. The Wilcoxon signed-rank test showed a statistically significant within-participant reduction (Z = -4.372, p < 0.001), with a large effect size (r = 0.74). Conclusion: Older adults with osteoarthritis showed a statistically significant reduction in pain scores after the 3-week morning walking program. Because this study had no control group and 25 participants (71.4%) reported using pain or anti-inflammatory medication, the findings should be interpreted as an observed pre-post reduction rather than definitive evidence of an independent intervention effect. Morning walking may be considered as a feasible supportive activity for older adults with osteoarthritis when safety screening and individual physical capacity are considered, but controlled studies with medication monitoring, adherence data, and adverse-event reporting are needed.
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Determinants of Quality of Nursing Work Life among Staff Nurses at a Public Hospital in Indonesia: A Cross-Sectional Study
Background: The quality of nurses’ work life has received increasing attention because it is associated with workforce sustainability, nurse well-being, and healthcare outcomes. In Indonesian public hospitals, nurses may face resource constraints, high service demands, and organizational pressures that can affect their work experiences. Evidence on the simultaneous contribution of individual, organizational, and psychological factors to Quality of Nursing Work Life (QNWL) in public-hospital nurses remains limited. Objective: This study aimed to identify factors associated with Quality of Nursing Work Life among staff nurses at Karawang General Hospital, Indonesia. Methods: An analytical cross-sectional study was conducted from November 2025 to April 2026 among 100 staff nurses working in inpatient wards, intensive care units, emergency departments, and outpatient services. Participants were selected using proportional stratified random sampling across service units. Data were collected using self-administered questionnaires, including the Brooks Quality of Nursing Work Life Survey and adapted instruments assessing workload, managerial support, reward system, work environment, job satisfaction, and organizational commitment. Data were analyzed using descriptive statistics, bivariate tests appropriate to variable type, and multiple linear regression with SPSS version 25. Results: More than half of the participants reported moderate QNWL (57%), followed by high QNWL (28%) and low QNWL (15%). QNWL was significantly associated with age (p = 0.041), educational attainment (p = 0.032), and length of employment (p = 0.018). Organizational factors were also significantly associated with QNWL, including workload (p = 0.001), managerial support (p < 0.001), reward system (p = 0.005), and work environment (p = 0.003). Psychological factors, namely job satisfaction (p < 0.001) and organizational commitment (p = 0.001), were significantly associated with QNWL. In the adjusted regression model, managerial support had the largest standardized coefficient (β = 0.524, p < 0.001), followed by job satisfaction (β = 0.411, p = 0.001), workload (β = −0.321, p = 0.002), and work environment (β = 0.298, p = 0.004). Conclusion: Organizational and psychological factors were important correlates of QNWL among staff nurses. Managerial support showed the strongest association in the adjusted model, suggesting that leadership development, structured feedback, workload review, and supportive work-environment initiatives may help create conditions for improved nurses’ work life. Because of the cross-sectional design, the findings should be interpreted as associations and not as causal effects
The Relationship Between Family Support and Quality of Life Among People Living with HIV/AIDS (PLHIV) At WPA Turen Foundation
Background: HIV/AIDS is a progressive chronic disease that adversely affects the physical, psychological, social, and spiritual dimensions of an individual's life. People living with HIV/AIDS (PLHIV) are particularly vulnerable to a decline in quality of life due to opportunistic infections, stigma, discrimination, and inadequate social support, including limited support from their families. Objective: This study aimed to analyze the relationship between family support and quality of life among PLHIV at the WPA Turen Foundation, Malang Regency. Methods: A descriptive quantitative study with a cross-sectional design was employed. Thirty PLHIV respondents were recruited through purposive sampling from a total population of 59 PLHIV at the WPA Turen Foundation. Data were collected using validated family support and quality of life questionnaires adapted from Kusuma (2011). Bivariate analysis was conducted using the Spearman rho test at a significance level of α = 0.05. Results: The majority of respondents received non-supportive family support (60%) and reported a good quality of life (53.3%). The Spearman rho test yielded p = 0.005 (p < 0.05) with a correlation coefficient of r = 0.355, indicating a statistically significant positive relationship of moderate strength between family support and quality of life among PLHIV. Conclusion: A significant relationship exists between family support and quality of life among PLHIV at the WPA Turen Foundation. The more supportive the family, the better the individual's quality of life. Family-based interventions, including HIV/AIDS education and family counseling, are recommended to sustainably improve the quality of life of PLHIV.
CKD-Associated Pruritus and Dermatology-Related Quality of Life Among Hemodialysis Patients in Two Indonesian Hospitals: A Cross-Sectional Study
Background: Chronic kidney disease (CKD) is a progressive condition that often requires maintenance hemodialysis. CKD-associated pruritus (CKD-aP), also known as uremic pruritus, is a distressing itching condition that remains under-recognized and may contribute to physical discomfort, sleep disturbance, psychological burden, and poorer dermatology-related quality of life. Objective: To examine the association between CKD-aP severity and dermatology-related quality of life among chronic kidney disease patients undergoing hemodialysis. Methods: This descriptive correlational cross-sectional study used purposive sampling. Data were collected from 72 hemodialysis patients at RSU Haji Surabaya and RSUD Sidoarjo during April-May 2019. Eligible participants were aged 18-65 years, received hemodialysis twice weekly, and reported pruritus within the previous month. Patients with primary dermatological conditions such as atopic dermatitis were excluded. CKD-aP severity was measured using the 5-D Itch Scale, and dermatology-related quality of life was measured using the Dermatology Life Quality Index (DLQI). Spearman's rank correlation was used for bivariate analysis. Results: The mean 5-D Itch Scale score was 14.83 +/- 4.224, and the mean DLQI score was 10.69 +/- 4.141. Because higher DLQI scores indicate poorer dermatology-related quality of life, the positive association between 5-D Itch Scale score and DLQI score indicated poorer outcomes with more severe pruritus. CKD-aP severity was significantly associated with dermatology-related quality of life (Spearman's rho = 0.588, p = 0.001, n = 72). Exploratory domain-level analysis suggested that pruritus degree (3.34 +/- 1.02) and duration (3.12 +/- 0.94) were the highest 5-D Itch Scale domains, while DLQI symptoms/feelings (3.11 +/- 1.38) and daily activities (2.41 +/- 1.21) were the most affected quality-of-life domains. Conclusion: This cross-sectional study found a significant moderate, approaching strong, positive association between CKD-aP severity and poorer dermatology-related quality of life among hemodialysis patients. Causality cannot be inferred. The findings support routine pruritus assessment and careful symptom management in hemodialysis nursing care
The Relationship Between Parenting Style and Depression Levels in Early Adolescents
Background: Depression among early adolescents can affect social, academic, and psychological development. Parenting style is one family-related factor associated with adolescent depressive symptoms. This study focused on early adolescents at SMP Negeri 3 Satu Atap Sumberlawang. Objective: This study aimed to examine the relationship between parenting style and depression levels among early adolescents. Methods: This quantitative cross-sectional study was conducted among students aged 12–14 years at SMP Negeri 3 Satu Atap Sumberlawang. A total of 146 students were included using a total sampling technique. Eligible participants were students in grades VII, VIII, and IX who provided assent and had parental/guardian consent; students who refused participation or were older than 14 years were excluded. Parenting style was assessed using the Parental Authority Questionnaire (PAQ), and depression levels were assessed using the Patient Health Questionnaire-9 (PHQ-9). PHQ-9 total scores range from 0 to 27 and were categorized as not depressed/minimal, mild, moderate, moderately severe, and severe depression. Data were analyzed using the Chi-square test. Results: Most respondents had a democratic parenting style (75/146; 51.4%). The largest depression category was not depressed/minimal (41/146; 28.1%). Parenting style was significantly associated with depression levels, χ²(8) = 49.80, p < 0.001, Cramer’s V = 0.413, indicating a moderate association. Conclusion: Democratic parenting style was associated with lower depression levels, whereas authoritarian and permissive parenting styles were associated with higher depression levels. Because this study used a cross-sectional design, the findings indicate an association and do not establish causality. Parents and schools should support adolescent mental health through appropriate communication, supervision, and emotional support.
Women's Experiences of Living with Adenomyosis: A Scoping Review through the Lens of Levine's Conservation Model
Background: Uterine adenomyosis (UA) is a chronic gynaecological condition characterised by the presence of endometrial tissue within the myometrium, causing dysmenorrhoea, abnormal uterine bleeding, dyspareunia, infertility, and reduced quality of life. Although its physical and psychosocial burden is well recognised, women’s lived experiences have not been comprehensively synthesised using a nursing theoretical framework. Objective: To systematically identify, map, and synthesise evidence on women’s experiences of living with adenomyosis using Levine’s Conservation Model. Methods: A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology and reported according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Literature searches were performed in PubMed/MEDLINE, CINAHL Plus, and ScienceDirect, supplemented by grey-literature searching and hand-searching of reference lists. Eligibility criteria were developed using the Population–Concept–Context (PCC) framework. Data were analysed using inductive content analysis and deductively mapped to the four conservation principles of Levine’s Conservation Model. Results: Twelve sources met the inclusion criteria, comprising five primary empirical studies, four secondary or contextual sources, and three grey-literature patient narratives. Women with adenomyosis experienced multidimensional challenges across all four conservation domains. These included energy depletion caused by chronic pain and fatigue, structural compromise related to pelvic pain, dyspareunia, and infertility, threats to personal integrity arising from stigma and delayed diagnosis, and disruption of social integrity through impaired relationships, occupational limitations, and financial burden. Conclusion: Adenomyosis profoundly affects women’s physical, psychological, and social well-being across all four domains of Levine’s Conservation Model. This review provides a theory-informed framework to guide holistic nursing assessment and person-centred care while highlighting the need for further research on diagnostic experiences and nursing-specific interventions
Autogenic Relaxation as a Supportive Nursing Intervention in Type 2 Diabetes Mellitus: A Single-Patient Case Study
Background: Type 2 diabetes mellitus is often accompanied by unstable blood glucose levels and is closely related to daily self-care. Psychological stress may activate sympathetic and counter-regulatory hormonal responses that can worsen glycemic control, supporting stress management as one component of comprehensive diabetes care. Objective: This case study aimed to describe the application of autogenic relaxation as a supportive nursing intervention for a patient with type 2 diabetes mellitus and unstable blood glucose levels. Methods: A descriptive single-patient case study, reported with reference to the CARE guideline, was conducted in the Tawang Alun inpatient ward of Blambangan Banyuwangi Regional General Hospital in 2025. The case was selected because the patient had type 2 diabetes mellitus with hyperglycemia, symptoms of glucose instability, and willingness and ability to follow relaxation instructions. Nurse-guided autogenic relaxation was provided once daily for three consecutive days (10–15 minutes/session) using a consistent sequence. Blood glucose, subjective complaints, vital signs, peripheral perfusion, and wound condition were observed descriptively alongside insulin therapy, dietary management, glucose monitoring, wound care, and health education. Written informed consent for publication of anonymized clinical information was obtained from the patient. Formal research ethics approval was not sought because the report retrospectively describes routine, non-experimental nursing care; the intervention formed part of care and no additional research procedure was performed. Results: At the initial nursing assessment, the patient reported weakness, dizziness, thirst, nocturia, and tingling in both feet, with blood glucose of 378 mg/dL. Documented pre-/post-session values were 329/320 mg/dL (day 1), 303/296 mg/dL (day 2), and 160/150 mg/dL (day 3). These changes occurred during comprehensive inpatient care that included insulin, dietary management, wound care, education, and monitoring; therefore, the contribution of relaxation cannot be isolated. The patient reported feeling stronger and no longer dizzy by day 3. Conclusion: Autogenic relaxation was feasible and completed as a supportive nursing intervention in this single case. Effectiveness cannot be inferred from one uncontrolled case, and the observed improvement cannot be attributed to relaxation alone. Medication, dietary control, glucose monitoring, wound and foot care, education, and follow-up remain central to comprehensive diabetes management.
Nurse Champions as Change Agents for Bedside Handover Compliance: A Case Study
Background: Bedside handover is an essential element of effective nurse-to-nurse communication to ensure patient safety. A preliminary assessment at Hospital X, supported by previous literature, identified limited knowledge, heavy workloads, and the absence of evaluation and appreciation systems as key barriers to optimal bedside handover implementation. Objective: This study aimed to identify the implementation of the Nurse Champion role in improving nurses' compliance with bedside handover at Hospital X using Kurt Lewin's Three-Step Change Model (Unfreeze–Move–Refreeze). Methods: This case study was conducted in the medical-surgical inpatient unit of Hospital X from 8 September to 1 October 2025 using Kurt Lewin's Three-Step Change Model. Baseline observations were conducted from 8–14 September 2025, followed by semi-structured interviews with four Primary Nurses on 19 September 2025. The intervention included bedside handover socialization (24 and 26 September), appointment of a Nurse Champion (24 September), checklist-based monitoring integrated into the shift workflow (24–30 September), implementation of reminder stickers, and a reward program (1 October). Nurses' compliance with bedside handover was evaluated at the end of the intervention. Results: Following the intervention, compliance across the 9P bedside handover components varied. The highest compliance was observed for Plan and Partnership (98.76%) and Patient Comfort (92.28%), whereas Personal Hygiene and Environment showed the lowest compliance (26.44%), indicating that these aspects were less consistently addressed during bedside handover. Conclusion: Therefore, the implementation of Nurse Champions based on Kurt Lewin’s Change Model was associated to improved compliance with 9P bedside handover and fostered sustainable behavioural change through enhanced motivation, appreciation, and a collaborative work culture in nursing practice
Exercise Interventions for Reducing Low Back Pain During Pregnancy: A Scoping Review of Randomized Controlled Trials
Background: Low Back Pain (LBP) can have a negative impact on physical and psychological conditions, so that treatment of these symptoms requires attention. There is a lot of literature stating the positive effects of exercise activity, but evidence related to the type and duration of activity is not clear. Objective: This study aims to find out the type and duration of exercise that can reduce LBP during pregnancy. Methods: Scoping review using the framework from Arksey & O'Malley consisting of: identifying research questions; identifying relevant studies; study selection; charting the data; and collating, summarizing and reporting the results. Searching for articles using databases from Sciencedirect, Pubmed, Springer link, Scopus, Clinicalkey, Oxford Academic .The inclusion criteria: full text in English, published in 2020 until 2025, experimental RCT research design, nursing scope. Article appraisal using CONSORT from the Joana Briggs Institute (JBI) independently by each author. Results: Five randomized controlled trial articles were included according to the criteria. Physical activities that can be done to reduce LBP symptom include pilates (2 times a week for 60 minutes); aerobic exercise (3 times a week for 60 minutes); lumbar stabilization exercise (2 times a week for 50 minutes) and pelvic floor muscle (3 times a week for 60 minutes). All of the above activities have a positive effect on reducing pain felt by pregnant women at various gestational ages. Conclusion: In conclusion, LBP during pregnancy can be reduced by physical activity exercises such as Pilates, aerobics, lumbar stabilization exercises or pelvic muscle floor exercises with an average duration of 2 times a week for 60 minutes
Adherence to Patient Identification Procedures Among Healthcare Professionals in an Indonesian Hospital: A Cross-Sectional Study
Background: Accurate patient identification is essential for preventing wrong-patient errors during diagnostic, therapeutic, and administrative procedures. Despite established hospital safety protocols, adherence to identification procedures may remain inconsistent across healthcare professions. Objective: This study examined adherence to standardized patient identification procedures among healthcare professionals at Pasundan Hospital. Methods: A descriptive cross-sectional study was conducted involving 41 healthcare professionals selected through simple random sampling. Adherence was assessed using an observation checklist based on the hospital’s patient identification procedures. Each participant was observed on three separate occasions. Data were summarized using frequencies and percentages. Results: Of the 41 participants, 36 (87.8%) were categorized as adherent and 5 (12.2%) as partially adherent. Physicians demonstrated the lowest adherence, with 11 of 16 physicians (68.8%) meeting the required standard. All nurses and other participating healthcare professional groups were classified as adherent. Conclusion: Adherence to patient identification procedures was generally high but remained below the hospital’s expected standard. Profession-specific audit, feedback, and reinforcement strategies are needed, particularly for physicians, to promote consistent implementation of identification procedures
Effectiveness of Active Cycle of Breathing Technique on Peak Expiratory Flow Following Cardiac Surgery
Introduction: Pulmonary dysfunction is a common complication following cardiac surgery, resulting from reduced lung expansion, postoperative pain, secretion retention, and impaired ventilation. These complications may delay recovery and increase the risk of pulmonary morbidity. The Active Cycle of Breathing Technique (ACBT) has been recommended as a pulmonary rehabilitation strategy to improve airway clearance and restore lung function; however, evidence regarding its effectiveness in Indonesian postoperative cardiac patients remains limited. Objective: To evaluate the effectiveness of the Active Cycle of Breathing Technique (ACBT) in improving peak expiratory flow (PEF) among patients after cardiac surgery. Methods: A quasi-experimental study with a one-group pretest–posttest design was conducted among 114 adult patients who underwent cardiac surgery at the General Intensive Care Unit of Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Participants were recruited using accidental sampling. ACBT was administered for four consecutive postoperative days. Peak expiratory flow was measured using a peak flow meter before the intervention on postoperative day 1 and after completion of the intervention on postoperative day 4. Data were analyzed using descriptive statistics and paired t-test. Results: The mean peak expiratory flow increased significantly from 228.30 ± 32.6 L/min before the intervention to 442.32 ± 43.7 L/min after four days of ACBT. Paired t-test analysis demonstrated a statistically significant improvement in PEF following the intervention (p < 0.001). A strong positive correlation was observed between pretest and posttest measurements (r = 0.786, p = 0.001). Conclusion: ACBT significantly improved peak expiratory flow in patients after cardiac surgery. Incorporating ACBT into routine postoperative pulmonary rehabilitation may facilitate recovery of lung function and support early postoperative respiratory management.
Effectiveness of Spiritual Care in Reducing Death Anxiety Among Patients Receiving Palliative Care: An Integrative Literature Review
Background: Death anxiety is a common psychological and existential concern among patients with chronic, terminal, and palliative illnesses, adversely affecting emotional well-being, quality of life, and coping ability. Spiritual care has been increasingly recognized as an essential component of holistic palliative care; however, evidence regarding its effectiveness in reducing death anxiety remains fragmented. Objective: This integrative literature review aimed to synthesize current evidence on the effectiveness of spiritual care in reducing death anxiety among patients receiving palliative care. Methods: An integrative literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. Six electronic databases (PubMed, ScienceDirect, SAGE Journals, ProQuest, SpringerLink, and Wiley Online Library) were searched for English-language studies published between 2021 and 2026. Eligible studies included randomized controlled trials, quasi-experimental studies, and analytical cross-sectional studies involving adults with chronic, terminal, or palliative illnesses. Methodological quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tools, and findings were synthesized narratively using thematic analysis. Results: Eight studies met the eligibility criteria, comprising two randomized controlled trials, one quasi-experimental study, and five analytical cross-sectional studies. Three overarching themes emerged: (1) spirituality as a protective factor against death anxiety, (2) the effectiveness of spirituality-based interventions in reducing death anxiety, and (3) mechanisms through which spiritual care enhances psychological adaptation. Higher levels of spiritual well-being, meaning in life, and fulfillment of spiritual care needs were consistently associated with lower death anxiety. Structured interventions, including spiritual counseling, nurse-led spiritual care, and spirituality-oriented palliative care, significantly reduced death anxiety while improving resilience, psychological well-being, and quality of life. Conclusion: Spiritual care is an effective non-pharmacological intervention for reducing death anxiety and supporting psychological adaptation among patients receiving palliative care. Integrating evidence-based spiritual care into routine nursing practice may enhance holistic, person-centered care. Further multicenter randomized controlled trials using standardized interventions are needed to strengthen the evidence base
Effectiveness of Digital Health Interventions in Improving Medication Adherence Among Individuals with Schizophrenia: A Systematic Literature Review
Background: Medication non-adherence remains a major challenge in the long-term management of schizophrenia and is associated with relapse, psychiatric hospitalization, poor clinical outcomes, and increased healthcare costs. Digital health interventions have emerged as promising strategies to improve medication adherence; however, the available evidence remains heterogeneous across intervention types and healthcare settings. Objective: This systematic literature review aimed to synthesize and critically evaluate current evidence regarding the effectiveness of digital health interventions in improving medication adherence among individuals with schizophrenia and related severe mental illnesses. Methods: A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Electronic searches were performed in PubMed, Scopus, ScienceDirect, ProQuest, and Google Scholar for studies published between January 2022 and June 2026. Eligible studies evaluated digital health interventions designed to support medication adherence among individuals with schizophrenia or related severe mental illnesses. Methodological quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tools, and findings were synthesized using a narrative thematic approach. Results: The search identified 1,186 records, of which 20 studies met the eligibility criteria and were included in the review. The interventions included smartphone applications, mobile health (mHealth), telehealth, electronic medication monitoring systems, digital medicine systems, SMS reminders, and remote monitoring technologies. Overall, digital health interventions were associated with improved medication adherence, enhanced patient engagement, strengthened treatment monitoring, and better communication between patients and healthcare professionals. Nevertheless, the magnitude of these benefits varied according to intervention characteristics, study design, outcome measures, and healthcare settings. Common implementation barriers included limited digital literacy, inadequate technological infrastructure, and unequal internet access. Conclusion: Digital health interventions demonstrate considerable potential to improve medication adherence among individuals with schizophrenia and may strengthen continuity of care in mental health services. However, the heterogeneity of the available evidence highlights the need for further high-quality implementation research and pragmatic randomized controlled trials to evaluate long-term effectiveness and support sustainable integration of digital health into routine nursing practice.
Effectiveness of a Short Education Movie on Family Knowledge of Pulmonary Tuberculosis Transmission: A Quasi-Experimental Study
Background: Household members of patients with pulmonary tuberculosis are at increased risk of infection because of prolonged exposure and often have inadequate knowledge regarding disease transmission. Health education using audiovisual media, such as a Short Education Movie (SEM), may improve understanding of tuberculosis transmission; however, evidence regarding its effectiveness among family members in primary healthcare settings remains limited. Objective: This study aimed to evaluate the effect of Short Education Movie (SEM)–based health education on family members' knowledge of pulmonary tuberculosis transmission at a primary healthcare center. Methods: A quantitative quasi-experimental study with a one-group pretest–posttest design was conducted at Mantup Community Health Center, Lamongan, Indonesia, from May to June 2026. Fifty-four family members of patients with pulmonary tuberculosis were recruited using accidental sampling. Participants completed a researcher-developed 15-item knowledge questionnaire before and immediately after receiving a single SEM-based educational intervention. Descriptive statistics were used to summarize participant characteristics and knowledge scores. Differences between pretest and posttest scores were analyzed using the Wilcoxon Signed-Rank Test, with statistical significance set at p < 0.05. Results: The mean knowledge score increased from 8.59 ± 2.54 before the intervention to 12.87 ± 1.69 after the intervention. The proportion of participants with good knowledge increased from 13.0% at baseline to 70.4% following the intervention, whereas the proportion with poor knowledge decreased from 59.3% to 3.7%. The Wilcoxon Signed-Rank Test demonstrated a statistically significant improvement in knowledge after the intervention (p < 0.001). Conclusion: Short Education Movie–based health education significantly improved family members' knowledge of pulmonary tuberculosis transmission. SEM represents a practical and effective educational strategy for strengthening family-centered tuberculosis prevention and may support the integration of standardized audiovisual education into community nursing practice and primary healthcare tuberculosis control programs
Exploring Older Adults' Experiences and Coping Strategies for Loneliness: A Case Study
Background: Older adults are a vulnerable to physical, psychological, and social changes associated with aging, including loneliness. As loneliness can affect their psychological well-being and quality of life, understanding the coping strategies they use is essential. Objective: This study aims to explore the experiences and coping strategies of an older adult residing in a nursing home in dealing with loneliness in old age. Methods: This qualitative descriptive case study included one purposively selected older adult living in a nursing home. Data were collected using a semi-structured and non-participant observation through face-to-face interview, transcribed verbatim, and analyzed using thematic analysis by generating codes, grouping them into categories, and developing themes. This study was conducted as part of nursing care while adhering to ethical principles. Results: The findings identified three themes: feelings of loneliness and helplessness, emotional coping strategies, and social support from the shelter community. Intervies were conducted in Indonesian and Sundanese and subsequently translated into English for this manuscript. Conclusion: Participants’ experiences of loneliness were influenced by limited family interaction, nursing home living conditions, and age-realted physical and social decline. Participants used emotional regulation, self-acceptence, spiritual coping, and solitary behavior to cope with loneliness. Social support from fellow residents, staff, students, and the community helped reduce participants’ loneliness by providing emotional support and social interaction. These findings highlight routine psychosocial assessment and psychosocial interventions to reduce loneliness among older adults
Association Between Spousal Loss and Depression Among Older Adults: A Cross-Sectional Study in Geulanggang Teungoh Village, Aceh, Indonesia
Background: The growing elderly population has increased the number of older adults experiencing spousal loss, a major life event that may adversely affect psychological well-being and increase the risk of depression. Evidence from rural communities with strong cultural and family support systems, such as those in Aceh, Indonesia, remains limited. Objective: This study aimed to examine the association between spousal loss and depression among older adults in a rural Acehnese community. Methods: A quantitative analytical study with a cross-sectional design was conducted among 48 older adults who had experienced spousal loss, selected through total sampling. Data were collected using structured interviews, a respondent characteristics questionnaire, a researcher-developed spousal loss questionnaire, and the Geriatric Depression Scale (GDS-15). Descriptive statistics summarized participant characteristics, while the association between spousal loss and depression was analyzed using the Lambda contingency coefficient with a significance level of 0.05. Results: Most participants were women (87.5%), aged 60–74 years (56.2%), and had experienced spousal loss for more than two years (70.8%). Mild depression was the most common condition (47.9%), followed by moderate depression (37.5%), whereas most participants had normal cognitive function (79.2%). A statistically significant association was found between spousal loss and depression (p = 0.026). Conclusion: Spousal loss was significantly associated with depression among older adults in this rural community. Although the cross-sectional design precludes causal inference, the findings highlight the need for early depression screening, family-centered support, psychosocial interventions, and community-based gerontological nursing programs to promote the psychological well-being of bereaved older adults
Effect of Oral Health Education Using Poster Media on Knowledge Levels Among Elementary School Children in Surakarta, Indonesia
Background: Oral health is an essential component of a child's overall health, playing a vital role in physical growth, psychological well-being, and quality of life. School-aged children are highly susceptible to dental caries due to inadequate oral hygiene practices and limited knowledge. Health education using visual media, such as posters, is recognized as an effective strategy for improving children's understanding and awareness regarding oral health behaviors. Objective: This study aimed to determine the effect of oral health education using posters on the knowledge levels of elementary school students. Methods: This quantitative study employed a quasi-experimental, one-group pretest-posttest design and was conducted at Setabelan Christian Elementary School in Surakarta, Indonesia. The study involved 48 students selected via total sampling. Participants completed a validated oral health knowledge questionnaire before and after receiving the poster-based education. Data were analyzed using descriptive statistics and a paired t-test with a significance level of p < 0.05. Results: The mean knowledge score increased from 12.25 ± 1.57 prior to the intervention to 14.48 following the intervention. Before the educational session, 77% of participants demonstrated good knowledge, whereas after the intervention, all participants (100%) achieved the "good knowledge" category. The paired t-test results indicated a statistically significant improvement in oral health knowledge following the educational intervention (p = 0.001). Conclusion: Poster-based oral health education significantly improves the knowledge of elementary school students. Posters represent an effective, practical, and affordable educational approach for school-based oral health promotion programs
The Relationship Between Immunization Status and Infectious Diseases in Children: A Literature Review
Background: Infectious diseases remain the leading cause of morbidity and mortality among children. WHO data from 2023 indicate that approximately 14.5 million children worldwide are not immunized, including a significant number in Indonesia. Objective: This study aims to analyze the relationship between immunization status and the incidence of infections in children through a literature review. Methods: This study employed a systematic literature review approach. The literature search focused on publications from the past 10 years that were available in full text. Most of the analyzed studies used an analytical observational design. Data were collected from primary studies. Data analysis in the reviewed studies generally employed statistical tests such as the chi-square test, logistic regression, and multivariate analysis to determine the relationship between immunization status and the incidence of infections. Several large-scale studies also used logistic regression and multilevel models to control for confounding factors such as nutritional status, parental education, and access to health care. Results: The findings indicate that the majority of studies report an association between immunization status and the incidence of infectious diseases. Children with incomplete immunizations have a higher risk of developing infections such as acute respiratory infections (ARIs) and pneumonia. Variations in results are influenced by other factors such as nutritional status, environment, and access to health care. The conclusions indicate that immunization status plays a crucial role in reducing the incidence of infectious diseases in children, although this association is influenced by various other factors. Conclusion: The results of this analysis underscore the importance of increasing immunization coverage and adopting a comprehensive approach to the prevention of infectious diseases in children