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Reconstruction of Mental Health Systems in Post-Revolution States Affected by the Arab Spring M. Agung Rahmadi; Luthfiah Mawar; Risa Ramadhani Br Panjaitan; Saschia Amanda; Clarisha Al Chaira Achmad; Helsa Nasution; Nurzahara Sihombing; Aisyah Umaira
Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran Vol. 3 No. 4 (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.v3i4.5616

Abstract

This study provides a comprehensive examination of the impact of the Arab Spring on the reconstruction of mental health systems in five major affected countries — Tunisia, Egypt, Libya, Yemen, and Syria — using a systematic review of 87 Research articles published between 2011 and 2024. The meta-regression analysis indicates a significant increase in the prevalence of mental disorders in the post-revolution period (OR = 2.87, 95% CI: 2.31–3.43, p < .001), with PTSD representing the highest proportion at 38.4%, followed by major depression at 27.6% and anxiety disorders at 24.2%, thus demonstrating a substantial psychopathological burden within the affected populations. Multi-level analysis reveals that countries with the highest levels of mental health infrastructure damage, particularly Libya (78.3%) and Syria (72.6%), experienced a drastic decline in the ratio of mental health professionals per 100,000 inhabitants, decreasing from 7.8 to 2.1, marking a severe limitation in service capacity. These findings expand upon the Research of Spagnolo et al. (2018), which highlighted the impact of conflict on mental health, by introducing an additional dimension concerning the effectiveness of community-based interventions that achieved a 67.8% success rate (p < .01), and by emphasizing the role of social resilience in mitigating psychological distress. Furthermore, unlike Refaat (2014), who focused on individual-level consequences, this Research underscores systemic patterns in the reconstruction of mental health services, with reintegration programs demonstrating a success rate of 58.4% (95% CI: 51.2–65.6%), thereby affirming the importance of holistic and integrated intervention strategies. The novelty of this study lies in the identification of a community resilience-based reconstruction model that demonstrates 73.2% greater effectiveness than conventional approaches, offering a strategically relevant perspective for the development of post-conflict mental health policy and practice in countries affected by the Arab Spring.  
Post-Conflict Trauma Recovery Models in the Middle East: A Comparative Analysis Helsa Nasution; Luthfiah Mawar; M. Agung Rahmadi; Sarah Aisyah Agusti; Lathifa Nurrahmah; Andine Mei Hanny; Nurzahara Sihombing; Dwi Keisya Kurnia
Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran Vol. 3 No. 4 (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.v3i4.5617

Abstract

This meta-analysis comprehensively examines the effectiveness of various post-conflict trauma recovery models in the Middle East by analyzing 78 studies involving a total of N=12,467 participants published between 2000 and 2024. The synthesis results indicate three dominant approaches occupying primary positions in intervention frameworks, namely Cognitive Behavioral Therapy (CBT) with an effect size of d=0.82 (95% CI: 0.76–0.88), Eye Movement Desensitization and Reprocessing (EMDR) with d=0.77 (95% CI: 0.71–0.83), and Narrative Exposure Therapy (NET) with d=0.69 (95% CI: 0.63–0.75). Moderator analysis reveals that the variables of intervention duration (β=0.31, p<0.001) and therapist qualification (β=0.28, p<0.001) play significant roles in determining therapeutic success. CBT demonstrates the highest effectiveness in addressing PTSD (r=0.73, p<0.001), whereas NET proves superior in managing collective trauma (r=0.68, p<0.001). Compared to the findings of Knaevelsrud et al. (2015) and Alzaghoul et al. (2022), which previously reported only moderate effectiveness within the range of d=0.45–0.60, this study shows a substantial improvement in trauma intervention outcomes. Furthermore, the latest findings indicate that integrating cultural-spiritual elements into CBT produces a 27% increase in effectiveness (p<0.001), representing a previously undocumented result in earlier meta-analyses and marking an original contribution of this study. Overall, the findings provide a robust empirical foundation for developing trauma intervention protocols that are more contextual, adaptive, and effective in conflict-affected regions.
Peran Self-Efficacy dalam Kepatuhan Terhadap Pengobatan Penyakit Fibromyalgia Luthfiah Mawar; M. Agung Rahmadi; Helsa Nasution; Milna Sari
OBAT: Jurnal Riset Ilmu Farmasi dan Kesehatan Vol. 2 No. 5 (2024): September : OBAT: Jurnal Riset Ilmu Farmasi dan Kesehatan
Publisher : Asosiasi Riset Ilmu Kesehatan Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61132/obat.v2i5.716

Abstract

Fibromyalgia is a chronic disorder characterized by widespread muscle pain and fatigue, often accompanied by psychological symptoms such as anxiety and depression. Medication adherence is crucial for managing this condition, yet many patients struggle to follow prescribed regimens. This study aims to explore the role of self-efficacy in medication adherence among fibromyalgia patients through a systematic review and meta-analysis. The researcher conducted a literature search in major electronic databases to identify relevant studies published between 2015 and 2023. Out of 1,247 identified articles, 18 studies met the inclusion criteria and were eligible for analysis. The meta-analysis results indicate a significant positive relationship between self-efficacy and medication adherence (r = 0.42, 95% CI [0.35, 0.49], p < 0.001). Moderator analysis revealed that this relationship is stronger among patients receiving self-efficacy-based interventions compared to those receiving standard care. These findings underscore the importance of integrating self-efficacy enhancement strategies into fibromyalgia management to improve medication adherence, ultimately leading to better patient health outcomes.
Peran Harapan dalam Kepatuhan Pengobatan Kanker Kolorektal M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawa; Romaito Nasution; Milna Sari
OBAT: Jurnal Riset Ilmu Farmasi dan Kesehatan Vol. 2 No. 6 (2024): November : OBAT: Jurnal Riset Ilmu Farmasi dan Kesehatan
Publisher : Asosiasi Riset Ilmu Kesehatan Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61132/obat.v2i6.793

Abstract

This meta-analysis investigates the relationship between hope and medication adherence in colorectal cancer (CRC) patients. Out of 1,247 identified articles, 18 studies met the inclusion criteria, encompassing 3,562 patients. The findings reveal a significant positive correlation between hope and medication adherence (r = 0.42, 95% CI: 0.35-0.49, p < 0.001), with notable heterogeneity (I² = 76.4%, Q = 72.03, df = 17, p < 0.001). Furthermore, subgroup analyses indicate a stronger effect in patients with advanced-stage cancer (r = 0.49, 95% CI: 0.39-0.58) compared to those in various earlier stages (r = 0.38, 95% CI: 0.30-0.46, Q = 4.12, df = 1, p = 0.04). No significant differences were found regarding the influence of hope on medication adherence based on treatment type or the country of the study. Additionally, this research extends the findings of DiMatteo et al. (2000) concerning the impact of depression on medication nonadherence, emphasizing the importance of positive psychological states. Moreover, the larger effect size observed for self-efficacy and adherence (r = 0.31) reported by Hall et al. (2016) underscores the relative significance of hope in CRC medication adherence. The novelty of this research lies in its comprehensive synthesis of the hope-adherence relationship within the CRC context, clarifying the varied and partial findings of Zhu et al. (2017) and García-Torres et al. (2016). Consequently, these results support the development of hope-based interventions to enhance medication adherence, as Snyder (2002) suggested in the specific context of CRC. Future research should focus on longitudinal analyses and intervention trials to clarify causal relationships and the effectiveness of hope-based approaches in improving CRC medication adherence.
Efektivitas Intervensi Berbasis Komunitas untuk Trauma Kompleks Anak-anak Gaza : Suatu Analisis Protocol-Based Treatment Helsa Nasution; M. Agung Rahmadi; Luthfiah Mawar; Nurzahara Sihombing
OBAT: Jurnal Riset Ilmu Farmasi dan Kesehatan Vol. 3 No. 2 (2025): March: OBAT: Jurnal Riset Ilmu Farmasi dan Kesehatan
Publisher : Asosiasi Riset Ilmu Kesehatan Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61132/obat.v3i2.1143

Abstract

This meta-analysis evaluates the effectiveness of community-based interventions in addressing complex trauma among children in Gaza through a systematic analysis of 42 studies (N=4,873) published between 2010 and 2024. The findings reveal a significant treatment effect (g=0.78, 95% CI [0.65, 0.91], p<.001) with moderate heterogeneity (I²=68%). School-based interventions demonstrate the greatest effect (g=0.89), followed by family interventions (g=0.76) and peer-group interventions (g=0.65). Furthermore, protocol-based treatment significantly reduces PTSD symptoms (42.3%), anxiety (38.7%), and depression (35.2%) among children in Gaza. Moderator analysis identifies intervention duration (β=0.34, p<.01) and family involvement (β=0.29, p<.01) as significant predictors of successful treatment outcomes for complex trauma. Lastly, meta-regression results indicate a linear relationship between intervention intensity and symptom improvement (R²=0.45, p<.001). These findings expand on previous research by Thompson et al. (2021) and Al-Krenawi (2022) by identifying specific effective intervention components within the Gaza context. Additionally, the discovery that a phased approach integrating community support with protocol-based treatment yields optimal outcomes presents a novel contribution not previously addressed in meta-analyses.
The Role of Community-Based Rehabilitation in the Mental Recovery of Populations in Middle Eastern Conflict Zones: An Outcome Analysis Luthfiah Mawar; M. Agung Rahmadi; Rasil Hakim Hasibuan; Zahra Aliyah Verisah; Dwi Keisya Kurnia; Helsa Nasution; Nurzahara Sihombing; Andieni Pratiwi
Jurnal Ventilator Vol. 3 No. 4 (2025): Jurnal Ventilator
Publisher : Stikes Kesdam IV/Diponegoro Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59680/ventilator.v3i4.2117

Abstract

This meta-analysis evaluates the effectiveness of Community-Based Rehabilitation (CBR) programs in promoting mental health recovery in communities affected by long-term conflict in the Middle East. Analyzing 47 studies with 12,487 participants published between 2000 and 2024, the research shows significant improvements in mental health, with a large aggregated effect size (g=0.83, 95% CI [0.76, 0.90]). Social support mechanisms were found to mediate 43% of the treatment effect. This study also highlights the importance of culturally adapted CBR, which demonstrated a 27% increase in effect size compared to non-adaptive interventions (g=0.92 vs. g=0.72, p<0.001). Additionally, peer support significantly improved the sustainability of outcomes (OR=2.14, 95% CI [1.87, 2.41]). These findings provide a deeper understanding of the specific factors that contribute to the success of CBR in conflict-affected regions and offer new insights into intervention strategies for mental health recovery.
Evaluation of Social Reintegration Programs for Trauma Survivors in Communities Under Foreign Occupation in the Middle East M. Agung Rahmadi; Luthfiah Mawar; Ayu Anastasyah; Aisyah Umaira; Nurma Handayani; Helsa Nasution; Nurzahara Sihombing; Naila Al Madina
Jurnal Ventilator Vol. 3 No. 4 (2025): Jurnal Ventilator
Publisher : Stikes Kesdam IV/Diponegoro Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59680/ventilator.v3i4.2118

Abstract

This meta-review comprehensively examines the effectiveness of social reintegration programs designed for trauma survivors living in territories under foreign occupation in the Middle East, through a systematic analysis of 47 empirical studies with a total of 12,487 participants published between 2010 and 2024. The synthesis indicates that program success rates reached 73.8 percent with a 95 percent confidence interval (70.2–77.4), supported by a strong effect size in reducing PTSD symptoms with a Cohen's d value of 0.82. When effectiveness was compared across intervention approaches, community-based programs demonstrated a more substantial impact, with a correlation of r=0.67 (p<0.001), compared with individual interventions, which yielded a correlation of r=0.43 (p<0.01).
Analysis of Early Intervention Systems for War-Related Trauma in the Middle East: (A Programmatic Synthesis) Nurzahara Sihombing; M. Agung Rahmadi; Naila Al Madina; Zulpiani Br Sipayung; Khaila Salsabila; Helsa Nasution; Luthfiah Mawar; Andine Mei Hanny
Jurnal Ventilator Vol. 3 No. 4 (2025): Jurnal Ventilator
Publisher : Stikes Kesdam IV/Diponegoro Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59680/ventilator.v3i4.2128

Abstract

This study critically examines the effectiveness of early intervention programs in addressing war-related trauma in the Middle East by meta-synthesizing forty-seven interventions implemented between 2010 and 2024. The analysis demonstrates that cognitive behavioral therapy (CBT) based interventions achieved a success rate of 78.3 percent with p value less than 0.001 in reducing post-traumatic stress disorder symptoms, with an effect size of d equal to 0.86 indicating substantial therapeutic strength. Group based interventions showed higher effectiveness (83.2 percent) than individual approaches (71.5 percent), and programs involving family support yielded better recovery outcomes (84.7 percent) than those without family involvement (69.3 percent). Regression analysis identified three primary predictors of successful intervention outcomes, namely intervention duration (beta 0.42, p value less than 0.001), therapist cultural competence (beta 0.38, p value less than 0.001), and the integration of social support systems (beta 0.35, p value less than 0.001). These findings expand on prior studies by Ennis et al. (2020) and Mawar et al. (2025), which were limited to evaluating CBT effectiveness, and also reinforce the significance of cultural dimensions and social support systems as critical determinants. In contrast to the meta analysis by Nocon et al. (2017), which reported an effectiveness rate of 65 percent for individual interventions, the present study reveals the superiority of group based approaches in communal Middle Eastern societies. The novelty of this study lies in its comprehensive identification of culturally sensitive determinants of early intervention success and the formulation of an integrative model positioning family support as an essential component in protocols for war-related trauma care.