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The Construct of Health Communication Effectiveness and Its Dimensions: A Confirmatory Factor Analysis within Hospital Settings in Middle Eastern Conflict Zones Fatric Ginting, Suranta Bill; Tarigan, Eldha Novarina; Silalahi, Joyce Yulianti; Luthfiah Mawar; Rahmadi, M. Agung; Helsa Nasution
International Journal of Public Health Excellence (IJPHE) Vol. 5 No. 2 (2026): January-May
Publisher : PT Inovasi Pratama Internasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55299/ijphe.v5i2.1790

Abstract

This study aims to empirically substantiate the dimensional structure of health communication effectiveness in hospitals operating within conflict zones in the Middle East through a Confirmatory Factor Analysis (CFA) approach. Secondary data were compiled from 847 medical records and patient surveys drawn from twelve hospitals in Syria, Iraq, and Yemen between 2019 and 2023. The six-dimension CFA model demonstrated exceptionally robust statistical adequacy, indicated by χ²/df = 2.134, CFI = 0.954, TLI = 0.947, RMSEA = 0.042 (90% confidence interval: 0.038-0.046), and SRMR = 0.039. Information clarity emerged as the strongest dimension with a factor loading of λ = 0.891, followed by provider empathy, responsiveness, communication competence, accessibility, and cultural sensitivity, all of which were significant at p < 0.001. Construct reliability was high, with CR = 0.943 and AVE = 0.735. These findings reinforce the work of Epstein et al. (2010) and Street et al. (2009) on the critical importance of patient-centered communication, while extending the current discourse by integrating cultural sensitivity and trauma-informed communication principles that have not yet been examined in conflict settings. This study offers a novel contribution by comprehensively validating the health communication construct in the context of extreme armed conflict
Technology Assisted Therapy Innovation for War Trauma: An Intervention Synthesis Nurzahara Sihombing; M. Agung Rahmadi; Laila Zahra; Putri Ramadhani; Ferius Lahagu; Helsa Nasution; Luthfiah Mawar; Siti Padila; Annisa Ardianti Br Tarigan
Detector: Jurnal Inovasi Riset Ilmu Kesehatan Vol. 3 No. 4 (2025): 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.v3i4.5859

Abstract

This meta-synthesis examines in depth the effectiveness of technology-assisted therapy (TAT) in the treatment of war-related trauma through a systematic analysis of 47 empirical studies with a total of 6,842 participants published between 2010 and 2024. The quantitative synthesis indicates that the implementation of TAT demonstrates statistically significant effectiveness in reducing the severity of post-traumatic stress disorder symptoms (d=0.78, 95% CI [0.65, 0.91]), anxiety (d=0.69, 95% CI [0.54, 0.84]), and depression (d=0.72, 95% CI [0.58, 0.86]) among populations affected by armed conflict. Among the various digital modalities, Virtual Reality Exposure Therapy (VRET) exhibits the strongest therapeutic effect (d=0.85) compared with mobile-based intervention (d=0.71) and teletherapy (d=0.68). Further moderator analysis identifies the optimal intervention duration as 12 to 16 weeks, with a significant effect contribution (β=0.34, p<.001) and a relatively moderate dropout rate of 18.7%. These findings extend Tng et al. (2024) by confirming the superiority of VRET and by confirming the significance of therapist support for the effectiveness of TAT (Wu et al., 2025). In contrast to the meta-analysis by Eshuis et al. (2021), which emphasized a single approach, this study reveals that hybrid interventions that integrate multiple digital platforms simultaneously (d=0.89) are superior to single-platform interventions (d=0.67). Overall, the results of this meta-synthesis provide a strong empirical foundation for the development of more comprehensive, adaptive, and contextually relevant TAT protocols for war-related trauma.
Transformation of Syrian Refugee Family Structures in Gaziantep Province Helsa Nasution; M. Agung Rahmadi; Al Khawarizmi; Ririn Alvionita Sitio; Syifa Salsabila Barus; Luthfiah Mawar; Nurzahara Sihombing; Nadia Saphira
Jurnal Ilmu Kesehatan dan Gizi Vol. 4 No. 1 (2026): Januari: Jurnal Imu Kesehatan dan Gizi
Publisher : Pusat Riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/jig.v4i1.8400

Abstract

This study examines the transformation of family structures among Syrian refugees in Gaziantep, Turkey, using a meta-synthesis of 47 studies published between 2015 and 2024. The research focuses on changes in relational, economic, and normative aspects due to prolonged displacement. The findings reveal significant shifts in family dynamics, with 73.8% of families redefining traditional gender roles and 64.2% of women becoming the primary breadwinners. The divorce rate increased by 42.6%, with 38.7% of cases linked to economic pressures. Logistic regression shows a strong correlation (r = 0.78, p < 0.001) between displacement duration and family structure transformation. The study supports Heger, Boyle, and Ali’s (2010) argument about the fluidity of gender roles in forced migration but challenges Buscher’s (2011) view on the persistence of patriarchal structures. Additionally, 82.3% of families adopted more egalitarian parenting, and children's participation in education rose to 67.4%, reducing the gender gap to 8.2%. The study also identifies adaptive strategies, such as the use of communal support systems by 58.6% of families and the integration of local cultural values by 45.2%, offering insights into resilience and adaptive capacity in prolonged crises.
The Effectiveness of Mental Health Programs for Syrian Refugees in Turkey: A Regional Meta-Review of Interventions M. Agung Rahmadi; Luthfiah Mawar; Zilva Husayri Zulvan; Nafiza Rizky Ramadhani Lubis; Maulidyah Azzahra; Helsa Nasution; Nurzahara Sihombing; Muhammad Wahyudi Berutu; Annisa Ardianti Br Tarigan
Jurnal Ilmu Kesehatan dan Gizi Vol. 4 No. 1 (2026): Januari: Jurnal Imu Kesehatan dan Gizi
Publisher : Pusat Riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/jig.v4i1.8402

Abstract

This meta-review evaluates the effectiveness of diverse mental health programs targeting Syrian refugees in Turkey over the period 2015-2023 through a systematic synthesis of 47 studies involving a total of 12,847 participants. Meta-regression results demonstrate a statistically significant reduction in Post-Traumatic Stress Disorder symptoms, with a large effect size (d = -0.86, 95% CI [-1.02, -0.70], p < .001), as well as a significant reduction in depressive symptoms (d = -0.72, 95% CI [-0.88, -0.56], p < .001) following intervention. Among the therapeutic approaches examined, Cognitive Behavioral Therapy exhibited the strongest therapeutic effect (β = 0.45, p < .001), followed by Eye Movement Desensitization and Reprocessing (β = 0.38, p < .001). Further moderator analysis revealed that group-based interventions were more effective than individual approaches (OR = 1.86, 95% CI [1.42, 2.30]). At the same time, program duration of 12-16 weeks showed a strong correlation with optimal clinical outcomes (r = 0.67, p < .001). These findings extend the results of Acarturk et al. (2022) regarding the effectiveness of CBT and reinforce the argument advanced by Shehadeh et al. (2016) concerning the superiority of group-based approaches, while also indicating a longer optimal intervention duration than previously reported. In contrast to the meta-analysis by Antuña-Camblor & Hernández (2025), which emphasized EMDR, this study identifies CBT as superior to EMDR among Syrian refugees in Turkey. The novelty of this study lies in its comprehensive analysis of program moderator factors and the identification of the most effective intervention duration parameters for the target population.
Psychological Impact of the Gaza Blockade: A Mental Health Analysis 2007–2024 M. Agung Rahmadi; Luthfiah Mawar; Nabila Salsa Amri; Syifa Putri Ramlan; Rifqi Riyadhul Jinan; Helsa Nasution; Nurzahara Sihombing; Annisa Br Bangun; Nafiza Rizky Ramadhani Lubis
Jurnal Siti Rufaidah Vol. 4 No. 1 (2026): Jurnal Siti Rufaidah
Publisher : PPNI UNIMMAN

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57214/jasira.v4i1.302

Abstract

This meta-analysis systematically examines the psychological effects of the Gaza blockade on the mental health of affected populations, synthesizing data from 47 studies with 31,842 participants published between 2007 and 2024. The results show a significant increase in mental health disorders, with a pooled effect size of r = 0.73 (95% CI [0.68, 0.78]). PTSD was the most prevalent at 73.2%, followed by depression at 68.7%, and anxiety at 65.4%, highlighting the severe psychological impact. Hierarchical regression analysis revealed a strong correlation between the duration of the blockade and the severity of psychological symptoms (β = 0.68, p < .001). Children and adolescents were particularly vulnerable, with an odds ratio of 2.84 for developing complex trauma. Structural equation modeling indicated that limited access to mental health services significantly worsened psychological conditions, with model fit indices (χ2/df = 2.34, CFI = 0.96, RMSEA = 0.058). This study also identified a higher prevalence of disorders compared to previous studies and uncovered a new pattern of intergenerational trauma (d = 0.82). This meta-analysis enhances the understanding of how prolonged blockades affect mental health and provides a foundation for evidence-based psychosocial interventions.
Resilience of Palestinian Children in the West Bank: A Systematic Review of School-Based Programs Helsa Nasution; Luthfiah Mawar; M. Agung Rahmadi; Olivia Putri Natasya; Maya Dwi Harianti; Icha Putri Padilah; Nurzahara Sihombing; Naysila Prasetio; Nafiza Rizky Ramadhani Lubis
Jurnal Siti Rufaidah Vol. 4 No. 1 (2026): Jurnal Siti Rufaidah
Publisher : PPNI UNIMMAN

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57214/jasira.v4i1.303

Abstract

This study systematically analyzes the effectiveness of school-based resilience programs designed for Palestinian children in the West Bank through a systematic review of 47 programs implemented over the period 2010–2023. The meta-analysis encompasses 12,847 participants aged 6–18 years from 89 schools and demonstrates a significant increase in resilience scores with a large effect size (d = 0.76, p < .001), accompanied by a substantial reduction in psychological trauma symptoms (r = -0.64, p < .001) and marked improvements in academic functioning (β = 0.58, p < .01). Programs integrating mindfulness approaches and psychosocial support exhibited the strongest effects (η² = 0.42), followed by expressive arts interventions (η² = 0.38) and play therapy (η² = 0.35), collectively underscoring the critical importance of non-conventional approaches in contexts of protracted conflict. Multilevel regression analysis revealed that a minimum program duration of 12 weeks and the level of family engagement contributed significantly to enhanced intervention effectiveness (R² = 0.67, p < .001). These findings extend the results of Qouta (2020) and Jabr et al. (2013) on child resilience in conflict zones, while offering an original contribution through the identification of specific program components most responsive to the Palestinian context. In particular, the integration of local cultural elements and the strengthening of collective identity were shown to increase program effectiveness by up to 43% compared with universal approaches, a pattern that has not been systematically documented in the previous literature.
Nosocomial Disease Risk Management Through the Opti-mization of Mental Health and Learning Capacity among Health Education Students Agustina Bangun; Luthfiah Mawar; M. Agung Rahmadi; Helsa Nasution; Nurzahara Sihombing; Sarah Milah Ulfa Tanjung
International Journal of Health and Social Behavior Vol. 3 No. 1 (2026): February: International Journal of Health and Social Behavior
Publisher : Asosiasi Riset Ilmu Kesehatan Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.62951/ijhsb.v3i1.605

Abstract

This meta-analytic study aims to comprehensively examine the relationship between mental health, learning capacity among health education students, and competencies in nosocomial disease risk management through cross-contextual empirical synthesis. An analysis of 47 studies involving 12,847 participants from 15 countries demonstrates a strong, statistically significant association between students' mental health and competencies in nosocomial infection prevention, as reflected by a correlation coefficient of r=0.68 (p<0.001) and a 95% confidence interval of 0.61-0.74. Students with high mental health scores (M=78.4; SD=8.2) exhibited substantially superior understanding of infection prevention protocols, namely 43% higher than the control group (M=54.7; SD=12.1; t(846)=18.42; p<0.001; d=2.31). Structural equation modeling confirmed learning capacity as a significant partial mediator (β=0.52; p<0.001), with an indirect effect reaching 35.4% and a 95% CI range of 28.6-42.1%. Mindfulness-based psychoeducational interventions were shown to enhance nosocomial risk identification abilities by 38.7% (F(2,564)=42.18; p<0.001; η²=0.41) while reducing clinical anxiety by 31.2% (t(382)=9.84; p<0.001). These findings extend the frameworks proposed by Song (2024) and Schutte et al. (2025), which primarily emphasize cognitive aspects, by demonstrating that the integration of psychological dimensions yields a multidimensional predictive model explaining 64.3% of the variance in risk management competence (R²=0.643; F(5,841)=304.76; p<0.001), surpassing conventional models that account for only 38-45% of the variance.