Caring: Indonesian Journal of Nursing Science
Caring : Indonesian Journal of Nursing Science is a journal published by TALENTA Publisher, Universitas Sumatera Utara, and managed by the Faculty of Nursing Universitas Sumatera Utara. It is dedicated to interchange for articles of high quality research in the field of Nursing Science. The journal publishes state-of-art papers in fundamental theory, nursing practice in hospitals, experiments and simulation, as well as applications, with a systematic proposed method, sufficient review on previous works, expanded discussion and concise conclusion. As our commitment to the advancement of science and technology, Caring : Indonesian Journal of Nursing Science follows the open access policy that allows the published articles freely available online without any subscription. Each publication contains 5 (five) research articles which will be published online. These articles are indexed by the Indonesian Publication Index (Garuda Portal), Google Scholar, and SINTA 2. Journal title Caring : Indonesian Journal of Nursing Science Abbreviation Indones. J. Nurs. Sc. Initial IJNS Frequency 2 (two) issues per year ISSN (Online) 2685-7162 Editor-in-Chief - Managing Editor - Publisher TALENTA Publisher, Universitas Sumatera Utara Visitor Analysis Visitor Statistics (Sponsored by StatCounter) Digital Object Identifier (DOI) 10.32734 (Member of Crossref)
Effect of Creative Educational Videos on Self-Efficacy and Handwashing Knowledge among Schoolchildren
Handwashing is one of the most effective measures to prevent infectious diseases; however, compliance among school-aged children remains low. Limited knowledge and low self-efficacy in performing proper handwashing techniques often lead to inadequate hygiene practices. This study aimed to evaluate the effectiveness of a creative educational video in improving handwashing self-efficacy and knowledge among elementary school students. A pre-experimental study with a one-group pretest–posttest design was conducted in February 2024 at SDN 104190 Paluh Kurau. The participants consisted of 50 sixth-grade students selected using total sampling. Data were collected using validated and reliable questionnaires to measure self-efficacy and handwashing knowledge. Statistical analysis was performed using paired sample t-tests and correlation tests with SPSS software to assess differences before and after the intervention.The results demonstrated a significant improvement in both self-efficacy and knowledge following the educational video intervention. The proportion of students with high self-efficacy increased from 62% before the intervention to 98% after the intervention. Similarly, the proportion of students with good handwashing knowledge rose from 32% to 88%. The mean self-efficacy score significantly increased from 25.14 ± 2.43 to 36.16 ± 4.60 (p = 0.000), while the mean knowledge score increased from 7.06 ± 1.66 to 9.16 ± 1.27 (p = 0.000). In conclusion, creative educational videos are an effective and affordable method for improving handwashing self-efficacy and knowledge among elementary school children.These findings suggest that video-based health education can be a valuable tool in school health promotion programs. Keyword: Handwashing, Self-Efficacy, Health Education, Schoolchildren, Creative Video
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Stigma Experienced by Families of Children with Autism Spectrum Disorder in Urban Areas: A Phenomenological Study
Parents of a child with Autism Spectrum Disorder (ASD) may be stigmatized as families are sometimes penalised by behaviours that are different from those displayed by usually developing children. Such stigma may be link to emotional difficulties, social isolation and experienced lower family quality of life, further emphasising the need to consider the form of stigma and the factors influencing them in their context. The purpose of this qualitative phenomenological study was to make an exploration of the types of stigma that families raising children with ASD in Urban settings experience. Participants: Qualitative data were drawn from semi-structured face-to-face interviews (N = 28) of parents, siblings and grandparent(s) at home, school and a therapy center. The analysis was carried out using qualitative content analysis and the validity of the data was established through prolonged engagement, triangulation, member checking and consultation with experts. It found 5 stigma themes: Physical, internal, public, cultural and label. In summary, urban families with children diagnosed with ASD are faced with multiple persistent forms of stigma that affect their emotional health and sense of social wellbeing. Hence, there is an imminent need for intensive public education, culturally appropriate awareness drives and increased advocacy from health care providers to reduce stigmas and change social dynamics in a favourable manner. Keyword: Autism Spectrum Disorder, Family Stigma, Urban Population, Phenomenology
Health Workers' Competence in Home Blood Pressure Measurement-Based Hypertension Management in a Remote Border Region of Indonesia
Home Blood Pressure Measurement (HBPM), although strongly recommended for optimizing hypertension control and identifying white-coat and masked hypertension, remains suboptimally implemented in rural and resource-constrained border settings, primarily due to limited competence among frontline health workers. This study aimed to assess health workers’ competence related to HBPM-based hypertension management in a remote border region of Indonesia. A cross-sectional study was conducted among 331 health workers, including nurses, midwives, physicians, pharmacists, and allied health professionals. A validated 21-item questionnaire assessed three HBPM knowledge domains: fundamental concepts, clinical benefits, and technical implementation. Data were analyzed using descriptive statistics, chi-square tests, and multivariate logistic regression. Overall, 58.0% of participants demonstrated good HBPM-related knowledge. Knowledge scores were highest in the clinical benefits domain, while technical implementation showed the lowest performance. Only 14.8% correctly identified differences between home and clinic blood pressure values, and 26.6% recognized the need to discard first-day readings. Nurses (AOR = 3.5; 95% CI: 1.07–11.53) and midwives (AOR = 5.1; 95% CI: 1.44–18.15) were significantly more likely to have good knowledge compared to other professions. Gender and education level were not significant predictors. Although general awareness of HBPM among health workers was adequate, substantial gaps in technical knowledge persist. Strengthening practical HBPM training, particularly for nurses and midwives as frontline providers, is essential to improve hypertension management in underserved border regions. Keyword: Border region, Health workers, Home blood pressure measurement, Hypertension, Low-resource settings
The Multidimensional Role of Family Members in Dietary Supervision for Hypertension Patients: A Descriptive Phenomenological Study
Long-term dietary regulation, characterized by the reduction of sodium and fat intake along with increased fiber consumption, serves as a crucial non-pharmacological component for controlling blood pressure in patients with hypertension. Therefore, this study aims to identify and analyze the various dimensions of the family's role in dietary supervision for members suffering from hypertension. The study procedures were carried out at UPT Puskesmas Medan Sunggal (July-August 2025) using a qualitative design with a descriptive phenomenology approach. The participants (n=8) were selected using a purposive sampling method. Data from semi-structured interviews were analyzed using Colaizzi’s seven-step method, involving transcription, significant statement extraction, and thematic formulation. The results showed that the family's role was divided into 3 interconnected main categories. First, the family as a practical supervisor and food environment modifier, where members actively limited the use of salt, oil, and flavor enhancers during cooking and controlled the availability of fast food at home. Second, the family as motivation and emotional coping supporter, where members provided encouragement, reminded the patient using gentle language, and helped the patient cope with the frustration associated with dietary changes. Third, as a behavior model and informal educator, where members collectively adopted healthier eating patterns (low salt), preventing the patient from feeling isolated, and proactively provided nutritional information. These results recommend the empowerment of families by the primary health center to improve communication skills and the preparation of healthy meals that are acceptable to hypertensive patients. Keyword: Dietary Supervision, Family Members, Hypertension, Role
A Philosophical Perspective of Pragmatism on the Intergenerational Reminiscence Model (IRM) on Health-Related Quality of Life among Older Adults
The global increase in the older adult population necessitates the development of practical, evidence-based nursing interventions to address critical challenges to Health-Related Quality of Life (HRQoL), notably loneliness and a diminished sense of purpose. The Intergenerational Reminiscence Model (IRM), involving older adults sharing life experiences with younger generations, offers a highly promising psychosocial approach. This paper provides a conceptual analysis to philosophically ground the IRM within a pragmatist framework, arguing that this lens substantially enhances its theoretical rigor and effectively guides its future application in nursing science. Pragmatism is specifically chosen because its emphasis on action, experience, and practical consequences aligns perfectly with the IRM's primary objective of achieving measurable improvements in HRQoL. From an ontological perspective, pragmatism defines reality as dynamic, constructed actively through meaningful interactions older adults experience within their environments during intergenerational exchanges. Epistemologically, the core argument asserts that the true effectiveness of the IRM is strictly validated by its practical outcomes, specifically, its success in enhancing HRQoL. Axiologically, this framework prioritizes human flourishing, positioning observable improvements in HRQoL as the ultimate value claim. Methodologically, while this paper is philosophical, pragmatism provides robust theoretical justification for future empirical research utilizing mixed methods approaches. This is necessary to successfully capture quantitative results and the rich narratives of intergenerational experiences. Ultimately, pragmatism offers an ideal justification for a context-sensitive nursing intervention. Future research must utilize mixed methods to fully illustrate these benefits. In conclusion, pragmatism remains essential for advancing the IRM into a robust, evidence-based geriatric nursing model. Keyword: HRQoL, Intergenerational reminiscence model, Older adults, Pragmatism
Effectiveness of the PRI Model (Psycho-Religious Intervention) in Improving the Psychological Well-Being of Cancer Patients: A Randomized Controlled Trial
Cancer imposes a heavy psychological burden that significantly reduces patients’ quality of life; however, conventional psychosocial interventions often overlook the need for spiritual coping, which is of vital importance to patients in religious cultures. This study aims to examine the effectiveness of the Psycho-Religious Intervention (PRI) Model, which combines psychological education with spiritual practices such as contemplative prayer, on the psychological well-being (PWB). This study employed a single-blind, parallel-group, pre-posttest Randomized Controlled Trial (RCT) design, involving 60 homogeneous cancer patients recruited into the intervention (n=30) and control (n=30) groups. The intervention group received the PRI Model delivered over four days (two sessions per day), while the control group received standard care. The data were analyzed using independent t-test and paired t-test. The results of the study show that the PRI Model significantly improved the total PWB score (p=0.010). The intervention group recorded an average increase of 15.54 points, whilst the control group rose by only 3.74 points, representing a 14.03% increase in the total PWB score compared with the control group. The PRI model demonstrated superiority across five of the six PWB dimensions, with the greatest impact observed in the Autonomy dimension (19.41%, p=0.001), accompanied by significant improvements in the Positive Relationships, Self-Acceptance, Environmental Mastery and Life Purpose dimensions. This study provides strong evidence that the PRI Model is an effective, culturally sensitive intervention for enhancing the psychological well-being of cancer patients. Consequently, the PRI Model is recommended for validation as a standard approach in psycho-oncology care. Keyword: Cancer, Psychological Well-Being, Psycho-Religious Intervention, Randomized Control Trial
Sakura and Shifting Tides: Exploring the Deskilling and Upskilling Experiences of Indonesian Nurses in Post-COVID-19 Japan
This qualitative study explored the deskilling and upskilling experiences of Indonesian nurses working in Japan during the post-COVID-19 period, with particular relevance on professional adaptation and evolving health system needs and labor demands. An exploratory qualitative design was adopted with 41 Indonesian nurses providing care in hospitals and long-term care facilities in Chiba, Meguro, Saitama and Yokohama. Data were collected during 2023 through face-to-face semi-structured interviews. Data were analysed using Braun and Clarke's six-phase inductive thematic analysis. The analysis generated seven interrelated themes: (1) deskilling experiences, (2) upskilling and reskilling strategies, (3) post-COVID-19 workplace changes, (4) bilateral cooperation dynamics, (5) cultural and professional adaptation, (6) career transition planning, and (7) perceived benefits of working in Japan. Deskilling emerged as a dominant issue, driven by occupational downgrading, restricted clinical practice, and regulatory barriers. Yet people put into action adaptive behaviours such as: informal learning; training attendance and skill reconstruction attempts. Deskilling thus appears not as a simple linear decline but rather as a hybrid phenomenon influenced both by structural factors linked to business performance and individual actions connected to the nature of work itself. These have policy implications for the design of clinical bridging programs, with structured pre-departure preparation in Japan integrated with medical Japanese language training; clinical skill maintenance under supervision in host institutions; and re-licensure pathways for returnee Indonesian nurses. Keyword: Deskilling; Upskilling; Migrant Nurses; Career Transition; Post-COVID-19; Japan–Indonesia Cooperation
Coping Strategies in Managing Multiple Roles for Sandwich Generation Nurses: A Phenomenological Study
Sandwich generation nurses are known to experience considerable psychological pressure due to the dual responsibilities at home, alongside economic demands and heavy professional workloads. These overlapping roles often create time constraints and increased stress, underscoring the importance of effective coping strategies to maintain mental well-being. Therefore, the present study aimed to explore the coping strategies used by sandwich generation nurses to manage multiple roles. A qualitative phenomenological method was adopted, involving 10 sandwich generation nurses working at a Private Hospital in Batam. The participants were selected using the snowball sampling technique. Data were collected through in-depth interviews and reviewed using thematic content analysis. The entire analysis process identified four main themes. This included (1) managing competing professional and family responsibilities, (2) searching for interpersonal and institutional support, (3) engaging in restorative self-care activities, alongside (4) cultivating meaning and positive reframing. Occupational and emotional challenges were addressed through adaptive coping strategies that promoted emotional regulation, resilience, and psychological stability. Additionally, the results showed that effective coping strategies played a crucial role in maintaining nurses' mental well-being. The cultivation of gratitude and the maintenance of a positive mindset have evolved as significant strategies for helping sandwich generation nurses adapt to the pressures of multiple role demands. Future studies are recommended to inform the development of targeted policies and interventions to enhance the well-being of sandwich generation nurses. Keyword: Coping skills, Role conflict, Resilience, Self-care, Hospitals
Effect Of An Animated Prenatal Education Video On Intrauterine Father Attachment: A Pilot Pretest-Posttest Study
Father-fetus attachment affects maternal and fetal health, yet few interventions enhance it. Although relaxation, music, and fetal visualitation based education is recommended, evidence remains limited. Structured three-segment animated prenatal education (maternal changes, fetal development, and attachment strategies) remains rarely implemented for expectant fathers. This study aimed to determine the effect of an animated video-based prenatal health education intervention on intrauterine father–fetus attachment among expectant fathers. A pre-experimental one-group pretest-posttest study was conducted among 41 expectant fathers recruited through consecutive sampling from two primary health centers. Attachment was measured using the Intrauterine Father Attachment Scale (Cronbach’s α = 0.939). Normality was assessed using the Shapiro–Wilk test. Pre-post differences were analyzed using the Wilcoxon Signed Rank Test, and associations with participant characteristics were examined using correlation and group comparison tests as appropriate (p<0.05). Although the median intrauterine father attachment score increased from pretest to posttest [69.00 (IQR 61.50–74.00) vs 70.00 (IQR 64.00–78.50)], the difference was not statistically significant (p = 0.069). The animated video intervention did not significantly improve intrauterine father–fetus attachment. Further studies using more interactive or multi-component interventions are warranted. Keyword: Intrauterine Father Attachment, Paternal Behavior, Health Education, Video-Audio Media, Pregnancy
Predictors of Diabetes Self-Management Behaviors among Patients with Type 2 Diabetes Mellitus in Aceh, Indonesia
Patients managing Type 2 Diabetes Mellitus (T2DM) themselves are still key to reducing morbidity, mortality, and complications. T2DM blood sugar regulation is affected by several internal and environmental factors. This research aims to investigate the extent of factors related to self-management techniques in T2DM patients in Aceh Province, Indonesia. This study employed a cross-sectional predictive correlational design and was conducted in a subdistrict of Banda Aceh. This research sample has used the G*Power program, which indicated that there were 118 T2DM patients. This study utilized a purposive sampling technique. The Diabetes Self-Management Questionnaire (DSMQ), the Diabetes Mellitus Self-Efficacy Scale (DMSES), and the RAND Health Support Questionnaire (RAND SF-36). IBM SPSS Statistics 27 was used to perform the study's multiple linear regression analysis. The findings of this study showed that greater participation in the T2DM management education program was significantly associated with improved self-management behaviors (β = 0.326, p < 0.0001). In contrast, lower levels of family support (β = -0.184, p = 0.030) and self-efficacy (β = -0.172, p = 0.048) were negatively associated with T2DM self-management. The findings of this study showed that greater participation in the T2DM management education program was significantly associated with improved self-management behaviors (β = 0.326, p < 0.0001). In contrast, lower levels of family support (β = -0.184, p = 0.030) and self-efficacy (β = -0.172, p = 0.048) were negatively associated with T2DM self-management behaviors. For this research, a continuous T2DM self-management education program for families and counselor nurses is recommended. Keyword: Family Support, Self-Efficacy, Self-Management, T2DM
Quality of Nursing Work Life and Nursing Job Performance in Medan, Indonesia
Nursing Quality of Work Life (QNWL) and nursing job performance are important variables for nurses in functioning within nursing organizations. However, empirical evidence examining the relationship between these variables remains scarce in North Sumatra Province, particularly in Medan. This study aimed to assess the relationship between QNWL and nursing job performance at Chairuddin Panusunan Lubis Hospital, Indonesia. This correlational study design involved a total sample of 62 nurses working in inpatient units. The instruments used were the QNWL and nursing work performance questionnaire. The frequency distribution, percentage, and Pearson correlation test were used for data analysis. The findings showed that QNWL and nursing job performance were predominantly in the moderate category. There was a significant and positive relationship between QNWL and nursing job performance (p < 0.001 and r = 0.670), indicating that higher QNWL is associated with better nursing performance. Therefore, maintaining and improving QNWL is essential to enhance nursing job performance, enabling nurses in hospital settings to deliver high-quality care and achieve optimal and safe patient outcomes. Keyword: Nursing Work Life, Job Performance, Work Environment, Hospital
Nurses’ Perspectives on Challenges to Parental Compliance in Childhood Tuberculosis Therapy: A Clinical Study at Prof. Dr. Chairuddin P. Lubis Hospital, University of Sumatra Utara
Parental adherence is critical to the successful treatment of pediatric pulmonary tuberculosis (TB) and the prevention of drug resistance. This study explored nurses’ perspectives on barriers to parental adherence in the management of childhood TB. A qualitative phenomenological approach was employed. Semi-structured, in-depth interviews were conducted with 10 nurses who had at least five years of experience in pediatric TB care at Prof. Dr. Chairuddin P. Lubis Hospital, Universitas Sumatera Utara. Participants were recruited through purposive and snowball sampling techniques. Data were analyzed using Colaizzi’s thematic analysis framework. Three major themes emerged: challenges in the clinical management of pediatric TB, barriers to treatment adherence, and nursing interventions to address treatment obstacles. Nurses described emotional burden, fear of infection, complex treatment regimens, workload pressures, limited parental health literacy, socioeconomic difficulties, stigma, and premature discontinuation of treatment when children showed clinical improvement. Effective management of pediatric TB requires family-centered nursing approaches, clear communication, psychosocial support, and multidisciplinary collaboration. Improving nurse-to-patient ratios and strengthening nurses’ communication competencies may enhance parental adherence and contribute to better long-term treatment outcomes. Keyword: Parental Compliance, Pediatric Pulmonary Tuberculosis, Multi-Drug Resistance, Health Education, Tuberculosis
Self-Leadership and Nurses Competence in Infection Prevention and Control in Hospital
Infection Prevention and Control (IPC) is a core competency for nurses in hospital. However, several instances of infections caused by suboptimal nursing competencies in IPC are still observed, which can lead to patient safety issues. Nurse self-leadership is one way to enhance nursing competencies in IPC. This study aims to identify the relationship between self-leadership and nursing competencies in infection prevention and control in hospital. The research design used a descriptive correlation approach with a simple random sampling technique. The study was 98 nurses. This study was conducted using the Pearson correlation coefficient (r). The results of the study showed that nurse self-leadership was in the moderate category with a mean value of 3.06, and nursing competencies in infection prevention and control were also in the moderate category, with a mean value of 63.79. The study found a significant relationship between self-leadership and nursing competencies in infection prevention and control, with a r = 0.385, p-value 0.000 (< 0.05), indicating a weak relationship. The component of self-leadership that scored the highest was behavior-focused strategies. In conclusion, higher self-leadership among nurses is associated with better nursing competencies in IPC. It is recommended that ward managers develop the self-leadership skills and competencies of nurses in infection prevention and control through structured training programs. Improving self-leadership skills can enhance nursing competencies. Keyword: Hospital, Humans, Leadership, Patient Safety, Research Design
The Influence of Health Education on Knowledge about Sleep Hygiene in the Elderly: A Quasi-Experimental Study
Sleep disturbances are common among older adults and are often associated with inadequate knowledge of sleep hygiene, resulting in poor sleep quality and reduced well-being. This study aimed to determine the effect of health education on knowledge regarding sleep hygiene among elderly individuals in Hamlet III, Selemak Village, Hamparan Perak Subdistrict, Deli Serdang Regency. A quasi-experimental study using a one-group pretest-posttest design was conducted among 40 elderly participants selected through total sampling. Data were collected using a structured questionnaire consisting of 20 items assessing sleep hygiene knowledge before and after intervention. The intervention consisted of one 45-minute health education session using lectures, discussion, and leaflet media. Data were analyzed using the Wilcoxon signed-rank test. Before intervention, knowledge levels were categorized as good (5%), fair (75%), and poor (20%). After intervention, good knowledge increased to 47.5%, while fair knowledge reached 52.5%. Median knowledge scores increased from 11 to 16. Statistical analysis showed a significant improvement after intervention (Z = -4.692; p < 0.001), with a large effect size (r = 0.74). Health education was effective in improving sleep hygiene knowledge among older adults. Routine educational programs are recommended to promote healthy sleep behaviors in the elderly. Keyword: Health education, Sleep hygiene, Elderly, Knowledge
Nurses' Experiences of Burnout in the Emergency Room of a Hospital in Medan, Indonesia: A Descriptive Phenomenological Study
Burnout is a chronic state of physical and emotional exhaustion experienced by nurses as a result of prolonged exposure to work-related stress, particularly in high-demand environments such as emergency departments. Although quantitative data on its prevalence are available, the lived experiences and personal meanings that emergency nurses associate with burnout within Indonesia’s cultural and institutional context remain poorly understood. The purpose of this study was to phenomenologically explore the experiences of burnout among nurses in the emergency room of a hospital in Medan, Indonesia. The study used a descriptive phenomenological approach. Ten nurses were selected using a purposive sampling technique. Data were collected through face-to-face, in-depth interviews using an interview guide. Methodological trustworthiness was ensured through the application of explicit reflexive bracketing, prolonged engagement, and member-checking procedures. The interview transcripts were systematically analyzed using Colaizzi’s seven-step descriptive phenomenological method. The findings revealed five themes related to nurses experience on burnout in an emergency room: 1) receiving pressure and negative attitudes from patients and families, 2) undergoing high workloads and minimal appreciation, 3) experiencing negative feelings and low motivation, 4) facing internal obstacles and barriers, and 5) managing sources of stress and improving self-quality. The findings of this study indicate that burnout is a complex experience that affects nurses’ physical and emotional well-being, while also influencing their work motivation and sense of professional meaning. Hospital management should establish structured psychological support systems, ensure objective workload redistribution, and implement clear workplace violence prevention policies to protect nurses’ well-being and maintain the quality of patient care. Keyword: Burnout, Descriptive Phenomenology, Emergency Room, Nurse, Hospital
The Relationship Between Laboratory Learning and Nursing Students' Self-Confidence During Preceptorship
The gap between classroom knowledge and clinical practice remains a problem in nursing professional education. This gap creates a fear of making mistakes and a lack of self-confidence in nursing students. Laboratory learning is expected to be a solution that makes students more confident in providing health care. This correlational research design aims to analyze the relationship between laboratory learning and nursing students' self-confidence during clinical practice. The population in this study were all final-year students of the Faculty of Nursing, University of North Sumatra, totaling 196 students. The sample size was determined using the Slovin formula with α=0.05, resulting in a sample size of 132 students. The sample was selected randomly. The instrument used was developed based on theory, then validity and reliability tests were conducted to ensure its content was appropriate and suitable for use. The research data were analyzed using Spearman correlation due to the non-normal distribution of the data. The results of the data analysis showed a significant relationship between laboratory learning and student self-confidence. The coefficient value was positive (+0.417), which means that the better the laboratory learning, the higher the students' self-confidence, with a moderate strength of relationship. Keyword: Laboratory Learning, Nursing Students' Self-Confidence, Preceptorship
Factors Associated with Job Satisfaction and Self-Efficacy Among Nurses in Community Health Centers: A Cross-Sectional Study in Tanjungpinang City
Low levels of nurse’s job satisfaction and self-efficacy may reduce productivity, increase occupational stress, compromise the quality of patient care, and contribute to turnover intention. Identifying factors associated with job satisfaction and self-efficacy is therefore essential for strengthening nursing workforce management and improving healthcare outcomes. This study aimed to examine factors associated with job satisfaction and self-efficacy among nurses working in community health centers in Tanjungpinang City. A quantitative cross-sectional study was conducted among 92 nurses selected from a population of 120 using proportionate stratified random sampling based on the Slovin formula with a 5% margin of error. Data were collected using validated structured questionnaires and analyzed using Spearman’s rank correlation test. Among the 92 respondents, 70 (76.1%) reported high job satisfaction, while 67 (72.8%) demonstrated high self-efficacy. Interpersonal relationships (p < 0.001, r = 0.670) and social support (p = 0.001, r = 0.550) were significantly associated with job satisfaction, whereas workload was not significantly associated with job satisfaction (p = 0.904, r = −0.022). Verbal persuasion (p = 0.009, r = 0.447) and personal experience (p < 0.001, r = 0.690) were significantly associated with nurses’ self-efficacy. Organizational and psychological resources play a crucial role in enhancing nurses’ job satisfaction and self-efficacy. Nursing managers should prioritize evidence-based human resource management strategies that strengthen organizational support, enhance positive interpersonal relationships, expand mentoring and constructive feedback mechanisms, and promote continuous competency-based professional development to improve nurses’ performance. Keyword: Job Satisfaction, Self-efficacy, Nurses, Community Health Centers
Medication Adherence by Pill Count Method and Changes in Mean Arterial Pressure Among Community Members with Hypertension: A Pre-Experimental Study
Poor medication adherence contributes to inadequate blood pressure control and increases the risk of hypertension-related complications. The pill count method using a pill box is a simple, objective, and low-cost strategy for monitoring medication adherence in community settings. Therefore, this study aimed to evaluate medication adherence using the pill count method and explore the association with short-term changes in mean arterial pressure (MAP). A pre-experimental one-group pretest–posttest study was conducted among 33 hypertensive patients. Medication adherence was monitored for seven consecutive days using a pill box. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and MAP were measured before and after the observation period, then collected data were analyzed with the Wilcoxon Signed-Rank test. A total of 28 participants (84.8%) showed high medication adherence, with a median adherence of 100% (IQR: 86–100). Significant reductions were observed in SBP (median change: −3.0 mmHg, p = 0.014), DBP (−3.0 mmHg, p = 0.006), and MAP (−3.3 mmHg, p = 0.006). However, these reductions were modest over the seven-day observation period. High medication adherence was followed by modest short-term reductions in blood pressure parameters. These findings should be regarded as exploratory rather than confirmatory and should not be interpreted as evidence of a causal relationship because of the pre-experimental design. Nevertheless, the pill count method appears to be a practical, objective, and low-cost approach for monitoring medication adherence in community-based hypertension management. Keyword: Hypertension, Medication Adherence, Pill Count Method, Mean Arterial Pressure
Warm-Water Foot Soaking with Epsom Salt and Lower-Extremity Somatosensory Function after Ischemic Stroke: A Quasi-Experimental Controlled Study
Somatosensory impairment after ischemic stroke can reduce lower-extremity sensitivity, impair balance, and increase fall risk. Evidence for warm-water foot soaking with Epsom salt remains limited. To evaluate its association with lower-extremity somatosensory function after ischemic stroke. This non-randomized quasi-experimental pretest–posttest controlled study included 66 participants allocated sequentially to an intervention group (n = 33) or usual-care control group (n = 33). Somatosensory function was assessed using the sensory domain of the Fugl-Meyer Assessment for the Lower Extremity. The intervention comprised soaking the feet in 5 L of water at 40 °C with 250 g Epsom salt for 20 minutes, three times weekly for four weeks. Wilcoxon signed-rank and Mann–Whitney U tests were used. Median scores increased from 7.00 to 8.00 in the intervention group (p < .001) and remained 7.00 in the control group (p = .157). The between-group difference was significant (p = .038; r = 0.256). The intervention was associated with modest improvement. Non-random allocation and the absence of a warm-water-only arm prevent conclusions about efficacy or a salt-specific effect. Keywords: Complementary therapy, Epsom salt, Ischemic stroke, Somatosensory function, Warm-water foot soaking
Clarifying Nursing as a Discipline: The Case for Nursology
Nursing science has developed into a multifaceted field that integrates empirical, theoretical, and humanistic knowledge. Despite its intellectual development, questions remain regarding the conceptual clarity of its disciplinary identity, which is often positioned as an applied health science rather than an autonomous field of inquiry. In response to these ongoing debates, nursology has been proposed as a conceptual reframing that seeks to articulate the ontological, epistemological, and methodological foundations of nursing more explicitly. This paper aims to explore the conceptual and philosophical basis of nursology as a proposed disciplinary reframing of nursing science through philosophical inquiry and theoretical synthesis. A philosophical–theoretical approach was employed using conceptual analysis, disciplinary critique, and integrative synthesis. Canonical works in philosophy of science, phenomenology, hermeneutics, ethics, and caring science were critically examined to explore the conceptual foundations of nursology. The analysis identified four interrelated conceptual dimensions disciplinary differentiation, caring ontology, epistemological coherence, and methodological pluralism that collectively provide a philosophical framework for understanding nursology as a proposed conceptual orientation for nursing science rather than as an empirically established independent discipline. This paper argues that nursology may offer a coherent philosophical framework for clarifying nursing's disciplinary identity and strengthening the theoretical integration of research, education, and practice. Further scholarly dialogue and empirical inquiry are warranted to examine the usefulness and applicability of this conceptual perspective. Keywords: Caring Ontology, Integrative Epistemology, Methodological Pluralism, Nursology, Nursing Science
A Systematic Review of Delayed Umbilical Cord Clamping to Reduce Anemia among Newborn Infants
Prolonged umbilical cord clamping during labour is one method to prevent anaemia in neonates; however, limited research on this treatment exists. This review aims to comprehensively assess the effects of delayed umbilical cord cutting and clamping on the anemia status of neonates. The review methodology employs a systematic review of the PubMed, CINAHL, and ScienceDirect databases. Keywords, inclusion and exclusion criteria are explicitly defined; the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) is used to examine article selection, and critical assessment is conducted using JBI for randomised controlled trials (RCTs). A total of 11 papers from various countries were selected. The analytical results indicate that umbilical cord clamping and cutting enhance placental transfusion, augment iron reserves, diminish the risk of baby anaemia, increase red blood cell flow, and improve cardiopulmonary adaption. This measure diminishes and averts the occurrence of anemia in babies. Restricted implementation and evaluation of the efficacy of this measure in developing and multicultural nations, such as Indonesia. The socialisation and integration of this action within health services enhances the health of newborns. Keyword: Anemia, Delayed cord clamping, Newborn
Adolescent Barriers to Understanding Cancer Information:A Qualitative Study
Cancer-related information is widely accessible to adolescents through schools, families, social media, and their surrounding environment. However, adequate understanding has not necessarily been produced by increased access to information. In this study, adolescents' experiences of the barriers that are encountered in the accessing and understanding of cancer-related information were aimed to be explored. A qualitative study with a descriptive phenomenological approach was conducted. Eighteen Grade XII students from SMK Negeri 14 Medan were purposively selected and were participated in semi-structured interviews. The data were analysed manually using Colaizzi's phenomenological method. Three main themes were identified by the analysis: (1) difficulty in the understanding of complex and diverse cancer information; (2) difficulty in the filtering and prioritising of large volumes of cancer information; and (3) difficulty in the coping with uncertainty before an adequate understanding of cancer was developed. These barriers were associated with fragmented and limited information, unfamiliar medical terminology, communication that was not tailored to adolescents' level of understanding, the broad scope of cancer-related topics, challenges in the prioritising of information, confusion in the distinguishing between symptoms, prevention, and treatment, and the perception of cancer as an inevitable death sentence. It is suggested by the findings that cancer information for adolescents should be communicated using clear, age-appropriate language, be presented progressively, be tailored to their lived experiences, be delivered by trusted sources, and be designed with consideration for adolescents' psychological needs. Valuable insights for the development of school-based cancer education programmes and adolescent-centred nursing interventions are provided by these findings. Keywords: Cancer, Health literacy, Health information, Teenagers