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All Journal Budapest International Research and Critics Institute-Journal (BIRCI-Journal): Humanities and Social Sciences International Journal of Public Health Excellence (IJPHE) International Journal of Medicine and Health Termometer: Jurnal Ilmiah Ilmu Kesehatan Dan Kedokteran Jurnal Ilmu Kesehatan dan Gizi Journal of Educational Innovation and Public Health Detector: Jurnal Inovasi Riset Ilmu Kesehatan Jurnal Mahasiswa Ilmu Kesehatan Jurnal An-Najat: Jurnal Ilmu Farmasi dan Kesehatan Jurnal Anestesi: Jurnal Ilmu Kesehatan dan Kedokteran Jurnal Ventilator: Jurnal Riset Ilmu Kesehatan dan Keperawatan Jurnal Medika Nusantara Vitamedica: Jurnal Rumpun Kesehatan Umum Corona: Jurnal Ilmu Kesehatan Umum, Psikolog, Keperawatan dan Kebidanan Vitalitas Medis : Jurnal Kesehatan Dan Kedokteran Quantum Wellness : Jurnal Ilmu Kesehatan Observasi: Jurnal Publikasi Ilmu Psikologi Obat: Jurnal Riset Ilmu Farmasi dan Kesehatan International Journal Of Public Health International Journal Of Health And Social Behavior International Journal of Health and Medicine Jurnal Siti Rufaidah Jurnal Praba: Jurnal Rumpun Kesehatan Umum
Helsa Nasution
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Religion Arts Humanities Dentistry Economics, Econometrics & Finance Health Professions Medicine & Pharmacology Nursing Physics Public Health Social Sciences Veterinary

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Transmisi Intergenerasi Trauma Perang di Keluarga Palestina : Analisis Sistematis pada Tiga Generasi (1948-2024) Nurzahara Sihombing; M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar
Jurnal Ventilator Vol. 3 No. 1 (2025): Jurnal Ventilator
Publisher : Stikes Kesdam IV/Diponegoro Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59680/ventilator.v3i1.1733

Abstract

This study analyzes the intergenerational transmission of war trauma across three generations of Palestinian families through a systematic meta-analysis of 47 longitudinal studies (1948–2024), comprising 12,873 participants. The findings confirm a PTSD prevalence rate of 73.4% in the first generation (n=4,291), 61.2% in the second generation (n=4,582), and 48.7% in the third generation (n=4,000). Furthermore, hierarchical regression analysis reveals a significant correlation between the severity of first-generation trauma and its manifestation in subsequent generations (r=0.68, p<0.001). The most dominant intergenerational trauma symptoms include anxiety (89.3%), depression (82.1%), and attachment disorders (76.5%). Structural equation modelling identifies three primary mediators of trauma transmission: parenting patterns (?=0.59), family trauma narratives (?=0.47), and epigenetic factors (?=0.41). Consequently, this study extends the findings of Danieli et al. (2016) on intergenerational trauma mechanisms and contributes to Kellermann's (2013) theoretical model on protective factors in trauma resilience. Unlike previous research by Hassan (2019), which focused on two generations, these findings reveal an adaptive pattern in the third generation through the development of collective resilience (82.3%) and positive coping strategies (77.8%), offering a novel perspective on the potential for intergenerational trauma healing in the context of prolonged conflict.
Psychological Profile of Middle Eastern Children Born in Refugee Settings : An Analysis of Developmental Outcomes Helsa Nasution; M. Agung Rahmadi; Luthfiah Mawar; Nurzahara Sihombing
An-Najat Vol. 3 No. 2 (2025): Mei : An-Najat : Jurnal Ilmu Farmasi dan Kesehatan
Publisher : STIKes Ibnu Sina Ajibarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59841/an-najat.v3i2.2569

Abstract

This study comprehensively analyzes the psychological and developmental impacts on children born in refugee conditions in the Middle East, utilizing a meta-analytic approach across 47 independent studies (N = 14,892 children) published between 2010 and 2024. Quantitative synthesis results reveal a high prevalence of post-traumatic stress disorder (PTSD) at 43.2% (95% CI: 38.7–47.8%), followed by anxiety at 38.6% (95% CI: 34.2–42.9%), and depression at 35.4% (95% CI: 31.8–39.1%) among refugee children. Furthermore, multilevel regression analysis identified a significant negative correlation between the duration of displacement and cognitive development (r = -0.42, p < .001), delays in language acquisition (r = -0.38, p < .001), as well as deficits in socioemotional functioning (r = -0.45, p < .001). In addition, children born and raised in refugee situations exhibited an average IQ score 11.3 points lower than normative child populations (d = 0.78, p < .001), indicating a long-term and systemic impact. The findings of this study are considered by the researcher not only to extend the empirical contributions of Blackmore et al. (2020) and Kanan (2021), who previously explored dimensions of individual trauma but also to construct a more integrative framework of understanding through the identification of developmental cascade patterns that simultaneously influence multiple developmental domains in children born into refugee conditions in the Middle East. Moreover, this study also found that early interventions based on the principles of trauma-informed care, when strategically integrated into consistent caregiving support, could reduce the risk of developmental disorders by up to 67.8%, offering a theoretical and practical contribution that has not been achieved by previous meta-analyses (novelty).
Efektivitas Cognitive Behavioral Therapy (CBT) pada Konteks Trauma Perang Timur Tengah Helsa Nasution; M. Agung Rahmadi; Luthfiah Mawar; Nurzahara Sihombing
Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran Vol. 3 No. 2 (2025): Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran
Publisher : Pusat Riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/termometer.v3i2.4955

Abstract

This study evaluates the effectiveness of culturally adapted Cognitive Behavioral Therapy (CBT) in the treatment of war trauma in the Middle East through an analysis of 47 studies involving a total of 4,628 participants from 2000 to 2024. The findings indicate that culturally informed CBT interventions have produced a significant therapeutic effect (g = 0.82, 95% CI [0.71, 0.93], p < .001) with a moderate level of heterogeneity (I² = 68%). Furthermore, culturally adapted CBT has been shown to reduce symptoms of Post-Traumatic Stress Disorder (PTSD) by 43.2% (d = 1.24, p < .001), anxiety by 38.7% (d = 0.96, p < .001), and depression by 35.9% (d = 0.88, p < .001). Additionally, moderator analysis revealed that the effectiveness of CBT significantly increases when the therapy integrates traditional healing practices (β = 0.34, p < .01) and involves family members in the intervention process (β = 0.29, p < .01). These findings expand upon previous research by Almoshmosh et al. (2020) and Al-Krenawi & Graham (2000), which merely addressed the effectiveness of standard CBT, and complement the study by Çınaroğlu et al. (2024) by emphasizing the importance of cultural adaptation in trauma psychotherapy practices in the Middle East. Furthermore, the main novelty of this research lies in identifying specific cultural components that enhance the effectiveness of CBT in the Middle East, including the integration of religious values (β = 0.31, p < .01) and the use of local cultural narratives in therapeutic approaches (β = 0.27, p < .01). The researchers assert that this study represents the first empirical affirmation that culturally adapted CBT is more effective than standard CBT in addressing war-related trauma in the Middle East.
Kontribusi Modal Sosial pada Resiliensi Mental Komunitas di Zona Konflik Timur Tengah Nurzahara Sihombing; M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar
Jurnal Anestesi Vol. 3 No. 2 (2025): Jurnal Anestesi: Jurnal Ilmu Kesehatan dan Kedokteran
Publisher : Stikes Kesdam IV/Diponegoro Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59680/anestesi.v3i2.1798

Abstract

This study examines the relationship between social capital and community mental resilience in conflict zones of the Middle East through a meta-analysis of 47 studies involving 31,842 participants from 2010 to 2024. Utilizing a random-effects meta-analysis approach, the findings reveal a significant positive correlation between social capital and mental resilience (r = 0.64, p < .001, 95% CI [0.58, 0.70]).
Psychological Impact of Conflict on Women and Girls in Middle Eastern War Zones: A Gender-Specific Analysis M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar; Nurzahara Sihombing
Jurnal Anestesi Vol. 3 No. 2 (2025): Jurnal Anestesi: Jurnal Ilmu Kesehatan dan Kedokteran
Publisher : Stikes Kesdam IV/Diponegoro Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59680/anestesi.v3i2.1808

Abstract

This study evaluates the psychological impact of conflict on women and girls in Middle Eastern war zones through a systematic meta-analysis of 87 published studies conducted between 2010 and 2024, encompassing 24,583 participants.
Mental Health of Healthcare Professionals in the Conflict Zone of Syam : an Analysis of Burnout and Secondary Trauma Nurzahara Sihombing; M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar
Detector: Jurnal Inovasi Riset Ilmu Kesehatan Vol. 3 No. 2 (2025): Mei: Jurnal Inovasi Riset Ilmu Kesehatan
Publisher : Pusat Riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/detector.v3i2.5005

Abstract

This study investigates the profound impact of the protracted humanitarian crisis in the conflict zone of Syam on the mental health of healthcare professionals, employing a systematic meta-analytical approach across 47 independent studies (N = 12,487) published between 2011 and 2023. The findings reveal an alarmingly high prevalence of burnout, reaching 78.3% (95% CI [75.2–81.4]), with emotional exhaustion recorded as the most dominant dimension (M = 3.89; SD = 0.76). Additionally, secondary trauma was identified in 65.7% of all respondents (95% CI [62.4–69.0]), with the primary symptoms manifesting as post-traumatic stress disorder (PTSD) at 44.2% and depression at 39.8%. Meta-regression analysis demonstrated that the duration of exposure to conflict (β = 0.42; p < 0.001) and the intensity of workload (β = 0.38; p < 0.001) served as significant predictors of burnout. Meanwhile, the lack of psychosocial support (OR = 2.34; 95% CI [1.89–2.79]) and critical resource scarcity (OR = 1.98; 95% CI [1.65–2.31]) were strongly correlated with the emergence of secondary trauma among healthcare professionals. Furthermore, diverging from the more individualistic frameworks employed in the studies of Bdaiwi et al. (2020) and Bou-Karroum et al. (2020), this research explores the intricate entanglement of organizational and situational determinants that concurrently shape the mental health landscape of medical personnel operating in the Syam conflict zone. Moreover, the study's original contribution lies in identifying resilience adaptation patterns observed in 34.2% of participants, revealing that endurance capacity was cultivated through collective coping strategies and close peer support. According to the researchers, this study offers a new lens for designing community-based psychological interventions that are both sustainable and contextually grounded for healthcare providers affected by the protracted armed conflict in Syam.
The Role of Extended Family Structure in Moderating the Impact of War Trauma in the Middle East: A Cultural Analysis M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar; Nurzahara Sihombing
Detector: Jurnal Inovasi Riset Ilmu Kesehatan Vol. 3 No. 2 (2025): Mei: Jurnal Inovasi Riset Ilmu Kesehatan
Publisher : Pusat Riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/detector.v3i2.5033

Abstract

This meta-analysis systematically and comprehensively examines the structural and functional roles of the extended family in moderating the psychological impact of war trauma in the Middle East by compiling data from 47 independent studies involving 12,483 participants published between 2000 and 2023. An analytical approach using a random-effects model revealed that the presence and involvement of the extended family demonstrated a statistically significant moderating effect on the reduction of PTSD symptoms, anxiety, and depression, with an association strength of r = .42 (p < .001). Further meta-regression results indicated that support from the extended family contributed to a 37.8% reduction in PTSD symptoms (β = -.378, SE = .042, p < .001), a 29.4% decrease in anxiety levels (β = -.294, SE = .038, p < .001), and a 31.2% reduction in depressive symptoms (β = -.312, SE = .040, p < .001). Analysis of moderator variables showed that the protective effect of the extended family structure was more pronounced among children (r = .48) compared to the adult population (r = .38) and more salient among females (r = .45) than males (r = .39), indicating demographic sensitivity to the type of collective support received. Moreover, the high heterogeneity across studies (I² = 76.3%) indicated significant contextual and methodological diversity, though it did not obscure the core findings. These results contradict the theoretical emphasis advanced by Nakeyar and Frewen (2016) and Atallah (2017), who prioritized the role of the nuclear family in post-war healing contexts. In contrast, this study found that the extended family configuration has provided a more comprehensive and multidimensional form of psychological protection rooted in the distinct collectivistic values of Middle Eastern societies. Ultimately, these findings expand the conceptual horizon for understanding resilience mechanisms to trauma within non-Western cultural landscapes and open new possibilities for developing extended family-based interventions in the context of post-conflict psychosocial reconstruction.
Coordination of Mental Health Services in Humanitarian Crises : A Systematic Policy Review Nurzahara Sihombing; M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar
Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran Vol. 3 No. 3 (2025): Juli : Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran
Publisher : Pusat Riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/termometer.v3i3.5393

Abstract

This study examines the effectiveness of coordination mechanisms within mental health service delivery during humanitarian crises through a systematic review of 127 policies from 43 countries issued between 2010 and 2023. The analysis reveals that only 37.8% of policies containing coordination mechanisms can be classified as structured, while the effective implementation rate reaches 28.3% (χ²=24.67, p<.001). A subsequent meta-analysis demonstrates a significant correlation between the existence of integrated coordination systems and improved access to mental health services (r=0.73, p<.001), as well as a reduction in the severity of psychological disorders (d=0.82, 95% CI [0.76, 0.88]). Regression findings identify four primary determinants contributing to the success of coordination: centralized and directive leadership (β=0.45, p<.001), the use of integrated and real-time information systems (β=0.38, p<.001), systematically designed resource allocation strategies (β=0.35, p<.01), and the active engagement of stakeholders across sectors (β=0.31, p<.01). This study expands upon key findings by Van Long et al. (2005) concerning service fragmentation, and Martinez (2016) regarding coordination barriers, by presenting an empirically grounded model that integrates technical elements and sociocultural dimensions into the structure of coordination. Coordination effectiveness increases by up to 43% when policies adopt an adaptive and contextual approach, marking a substantial departure from conventional coordination models traditionally dominated by bureaucratic and rigid frameworks. The conceptual novelty of this study lies in developing a dynamic coordination framework that explicitly considers system complexity and the heterogeneity of crisis contexts across different global regions.
A Comprehensive Evaluation of PTSD Measurement Tools for Arab Populations : An Analysis of Validity Helsa Nasution; M. Agung Rahmadi; Luthfiah Mawar; Nurzahara Sihombing
Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran Vol. 3 No. 3 (2025): Juli : Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran
Publisher : Pusat Riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/termometer.v3i3.5396

Abstract

This study presents a highly comprehensive meta-analysis of the validity of various Post-Traumatic Stress Disorder (PTSD) measurement instruments that have been implemented within the context of Arab populations. By synthesizing data from 47 studies involving 12,384 participants published between 2000 and 2023, this review employed a multilevel meta-analytic approach based on a random-effects model to ensure estimation accuracy that accounts for cultural and methodological heterogeneity. The main findings indicate that PTSD instruments adapted into Arabic generally exhibit an adequate level of internal reliability (α = 0.88, 95% CI [0.85, 0.91]), although construct validity demonstrates significant variability (r = 0.72, 95% CI [0.67, 0.77]). Among the instruments analyzed, the Post-traumatic Diagnostic Scale (PDS) was found to have the highest level of validity (r = 0.83, p < 0.001), followed by the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) with r = 0.79 (p < 0.001), and the PTSD Checklist for DSM-5 (PCL-5) with r = 0.76 (p < 0.001). Moderator analysis revealed significant contributions from the translation strategies employed (Q = 18.42, p < 0.001), as well as demographic and psychosocial characteristics of the sample (Q = 15.67, p < 0.01), to fluctuations in instrument validity. When compared to the findings of Alqahtani et al. (2021), which highlighted the low validity of several Arabic-language psychological instruments due to a lack of cultural sensitivity in the adaptation process, and the study by Alhalal et al. (2017), which reported construct validity for the five-factor model of the Arabic version of the PCL-C, the present research successfully identifies a substantial overall increase in validity, particularly in instruments that integrate a deep cultural adaptation approach. Furthermore, one of the distinctive contributions of this study lies in its identification of specific patterns in PTSD symptom manifestation unique to Arab populations, significantly characterized by a tendency toward somatization (β = 0.45, p < 0.001) and the expression of distress in collective forms (β = 0.38, p < 0.001), as two dimensions that have been previously underexplored in cross-cultural psychometric validation studies.
Standardization of Research Methodology on War Trauma in the Middle Eastern Context Luthfiah Mawar; M. Agung Rahmadi; Helsa Nasution; Nurzahara Sihombing
Jurnal Praba : Jurnal Rumpun Kesehatan Umum Vol. 3 No. 2 (2025): Juni : Jurnal Praba : Jurnal Rumpun Kesehatan Umum
Publisher : STIKES Columbia Asia Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.62027/praba.v3i2.373

Abstract

This meta-methodological study evaluates 127 research articles on war-induced trauma in the Middle East, published between 2000 and 2023, with the aim of developing a methodological standardization framework capable of addressing the region-specific contextual complexity. The findings reveal a marked degree of heterogeneity in the methodological approaches employed (χ² = 78.45, p < .001), with 42.5% of the studies utilizing cross-sectional designs, 28.3% employing longitudinal methods, and 29.2% adopting mixed-methods approaches. Meta-regression analysis indicates a highly significant correlation between methodological rigor and the validity of research findings (r = .78, p < .001), reinforcing the importance of consistency in study design. The evaluation of instrument reliability reveals significant variation (α = .65–.92), with instruments based on DSM-5 criteria demonstrating the highest level of internal consistency (M = .86, SD = .08). Further analysis identifies five core components as critical in the methodological structuring of trauma studies within Middle Eastern conflict zones, namely cultural validation of instruments (β = .45, p < .001), data source triangulation (OR = 2.34, 95% CI [1.87–2.81]), contextualization of traumatic experience (R² = .56), sensitivity to conflict dynamics (κ = .82), and the application of ethics tailored to the local context (ICC = .79). These findings extend the work of Bush and Duggan (2013) on methodological biases rooted in Western epistemologies. Additionally, they advance the conclusions of Patel and Hall (2021) regarding the absence of cultural validity in cross-conflict studies, as this research introduces an integrated methodological framework that systematically synthesizes local perspectives with international scientific standards. The primary contribution of this study lies in the development of the Trauma Research Standardization Index (TRSI), a newly designed instrument intended to assess methodological alignment with the specific conflict context of the Middle East. The TRSI demonstrates verified construct validity (construct = .88) and high test-retest reliability (.92), making it a potentially valuable tool in standardizing trauma research across Middle Eastern contexts.
Co-Authors Abdul Rahman Shaleh Achmad Syahid Agustina Bangun Aisyah Umaira Al Khawarizmi Amanda Aulia Putri Andieni Pratiwi Andine Mei Hanny Annisa Ardianti Br Tarigan Annisa Br Bangun Asfriyati ,MKes Ayu Anastasyah Clarisha Al Chaira Achmad Dwi Keisya Kurnia Fatric Ginting, Suranta Bill Ferius Lahagu Icha Putri Padilah Ika Sandra Dewi Isnaini Fajarwati Khaila Salsabila Kiki Asnanti Laila Zahra Lathifa Nurrahmah Lisa Maharani Rizki Luthfiah Mawa Luthfiah Mawar M. Agung Rahmadi Maulidyah Azzahra Maya Dwi Harianti Milna Sari Muhammad Wahyudi Berutu Nabila Salsa Amri Nabila Sita Nadia Saphira Nafiza Rizky Ramadhani Lubis Naila Al Madina Nanda Liana Lubis Naysila Prasetio Nazwa Aqela Saragih Nurma Handayani Nurzahara Sihombing Olivia Putri Natasya Putri Ramadhani Rabiatul Adawiyah Nasution Rahayu Lubis Rahmadi, M. Agung Rasil Hakim Hasibuan Rifqi Riyadhul Jinan Ririn Alvionita Sitio Risa Ramadhani Br Panjaitan Riska Wahyuni Hasibuan Romaito Nasution Said Agil Husin Al Munawar Sarah Aisyah Agusti Sarah Atikah Sarah Milah Ulfa Tanjung Saschia Amanda Shely Shely Silalahi, Joyce Yulianti Siti Nurfaiza Siti Padila Syifa Putri Ramlan Syifa Salsabila Barus Tarigan, Eldha Novarina Wildan Izzatul Haq Zahra Aliyah Verisah Zilva Husayri Zulvan Zulpiani Br Sipayung