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A Systematic Review of Educational Interventions to Improve Self-Care Behaviors in Hypertensive Patients Ni Ketut Erawati; I Gede Putu Darma Suyasa; I Kadek Nuryanto; Ni Made Manik Elisa Putri
Babali Nursing Research Vol. 6 No. 3 (2025): July
Publisher : Babali Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37363/bnr.2025.63496

Abstract

Introduction: Hypertension remains one of the most prevalent non-communicable diseases worldwide, including in Indonesia. Due to its often asymptomatic nature, the condition is frequently neglected by patients, increasing the risk of complications and negatively impacting their quality of life. While pharmacological treatment is essential, hypertension management is closely tied to self-care practices, which remain a persistent challenge. One strategy to improve self-care behavior in hypertensive patients is through education. This study aims to systematically review the effectiveness of various educational interventions in enhancing self-care behavior among hypertensive patients.Methods: This study employed the PRISMA Flowchart for article selection across three databases—ScienceDirect, PubMed, and Google Scholar—with inclusion criteria limited to articles published between 2021 and 2025. Of 394 initially identified articles, 15 met the inclusion criteria after PRISMA-based screening.Results: The review analyzed 15 studies comprising diverse educational interventions, including group-based education sessions, video-assisted learning, digital and mobile health (mHealth) tools, individualized counseling, and community-based programs. These interventions significantly improved key aspects of self-care, such as medication adherence, dietary regulation, physical activity, stress management, and regular blood pressure monitoring.Conclusion: This systematic review demonstrates that a wide range of educational interventions effectively enhance self-care behaviors among hypertensive patients. Tailoring interventions to patient needs and utilizing technology may further improve outcomes. These findings underscore the importance of incorporating structured education into hypertension management strategies.
Social Isolation and Its Impact on the Health Status of Older People in the Community: A Narrative Review Suyasa, I Gede Putu Darma
Babali Nursing Research Vol. 6 No. 3 (2025): July
Publisher : Babali Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37363/bnr.2025.63501

Abstract

Introduction: Older people often face multifaceted challenges encompassing physical, psychological, and social dimensions. Among these, social isolation is a significant concern, frequently resulting from age-related degenerative changes, the loss of loved ones, or abandonment by family members. Numerous studies have indicated that social isolation can adversely affect the health and well-being of older people. However, comprehensive syntheses of recent research examining the impact of social isolation on the health status of community-dwelling older people remain limited and insufficiently explored. This study aimed to identify and summarize the latest findings regarding social isolation's impact on older people's health status.Methods: This narrative review design used databases PubMed, Science Direct, and EBSCOhost. Keywords include "social isolation" OR "loneliness" AND "older people". Literature selection was carried out non-systematically and analyzed descriptively.Results: Our search found 87 articles; 11 met the inclusion criteria. Most studies were from China (4), the United States (3), and others from England, Brazil, and Colombia. Key finddings indicated that older people living with social isolation have a high risk of depression, cognitive decline, dementia, Alzheimer's disease, changes in biochemical parameters in blood glucose and triglycerides, physical weakness and disability, difficulties in ADL and IADL, disorders, low self-assessment of health, risk of falls, low utilization of health care facilities, poor emotional well-being, and higher risk of death.Conclusion: Social isolation has been shown to have a very negative impact on the health status of older people. Community nurses need to enhance the implementation of home visit programs to support socially isolated older people better. Future research should focus on conducting longitudinal and intervention-based studies to investigate the causal relationships between social isolation and health outcomes.
Effectiveness of home-based cardiac rehabilitation programs on health outcomes of persons with heart failure: An umbrella review Promwong, Waiyaporn; Meenongwah, Jaroonsree; Kenbubpha, Kedsaraporn; Suyasa, I Gede Putu Darma
Belitung Nursing Journal Vol. 11 No. 5 (2025): September - October
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3994

Abstract

Background: Home-based cardiac rehabilitation (HBCR) serves as a crucial alternative to center-based cardiac rehabilitation (CBCR) for patients with heart failure (HF), aiming to enhance access and adherence. However, evidence of its effectiveness is dispersed across numerous systematic reviews with varying findings, necessitating a high-level synthesis to clarify HBCR’s overall impact. Objective: To synthesize and critically evaluate evidence from systematic reviews and meta-analyses on the effectiveness of home-based cardiac rehabilitation in improving health outcomes among patients with heart failure. Design: An umbrella review of systematic reviews and meta-analyses Data Sources: A systematic search was conducted in the Cochrane Library, JBI Evidence Synthesis, PubMed, Medline, CINAHL, Epistemonikos, and ThaiJo databases for studies in English or Thai up to April 11, 2025. Review Methods: The review adhered to JBI and PRISMA guidelines. Outcomes included functional capacity, quality of life (QOL), mortality, hospital readmissions, and adverse events. Study quality was assessed using the JBI checklist. Results: Fifteen systematic reviews and meta-analyses met the inclusion criteria, all of which were of high methodological quality. The evidence consistently demonstrates that HBCR significantly enhances functional capacity compared to usual care, with outcomes comparable to those of CBCR. However, findings for other outcomes were inconsistent; HBCR’s impact on QOL and left ventricular ejection fraction (LVEF) varied due to program content and methodological heterogeneity, and it did not significantly reduce mortality or hospital readmissions compared to usual care or CBCR. No significant differences in adverse events were observed between HBCR, CBCR, and usual care. Conclusion: HBCR is a safe and effective intervention for improving functional capacity in patients with heart failure, offering a viable alternative to CBCR. However, its effects on quality of life, hospital readmissions, and mortality remain inconsistent. These findings highlight HBCR’s potential role in expanding access, though further research is needed to optimize program design. Registry: PROSPERO (CRD42023484051)
Education and Simulation of Range of Motion (ROM) for Caregivers to Improve the Quality of Life of Older People in the Community Suyasa, I Gede Putu Darma; Sutini, Ni Kadek; Israfil, Israfil; Indrayani, Ni Luh Dwi; Agustini, Ni Luh Putu Inca Buntari; Oka Putra, I Nyoman Trisna Oka Putra
Ahmar Metakarya: Jurnal Pengabdian Masyarakat Vol. 5 No. 1 (2025): Ahmar Metakarya: Jurnal Pengabdian Masyarakat
Publisher : Yayasan Ahmad Mansyur Nasirah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53770/amjpm.v5i1.509

Abstract

The aging process has caused various health problems, including limited physical mobility due to muscle weakness, joint stiffness, and certain chronic disease conditions. Efforts to maintain the health of older people can be done through Range of Motion (ROM) exercises, with the family as caregivers having an essential role in doing so. This community service activity aims to improve the knowledge of elderly caregivers by providing education and simulations on ROM exercises for older people. A total of 41 caregivers from Melinggih Village, Gianyar Regency and Pedungan Village, Denpasar City were involved in this activity in March 2025. The activity was carried out using the education and simulation method, with stages using the PARE (Preparation, Action, Reflection, and Evaluation) approach. The results of the Wilcoxon statistical test obtained a p-value < 0.001 with Z = - 3.65, which showed a significant difference in the level of caregiver knowledge about ROM exercises in older people before and after the activity. Good knowledge increased from 63% to 100%, and poor knowledge decreased from 31.7% to 0%. This shows that community service activities with education and simulation methods have successfully increased caregivers' knowledge and practical abilities in performing ROM exercises for older people. ROM exercises can be an easy choice for caregivers as an effective way to maintain the health of older people in the community, support long-term care programs, and thus improve the quality of life for the older people in the community.
Empowering Caregivers to Improve Working Posture Management for Preventing Musculoskeletal Injuries in Long Term Care Settings Indrayani, Ni Luh Dwi; Buntari, Ni Luh Putu Inca Agustini; Suyasa, I Gede Putu Darma; Sutini, Ni Kadek; Duygulu, Sergul; Portia, Vitug; Israfil, Israfil; Sagita, Ni Wayan Riska
Ahmar Metakarya: Jurnal Pengabdian Masyarakat Vol. 5 No. 1 (2025): Ahmar Metakarya: Jurnal Pengabdian Masyarakat
Publisher : Yayasan Ahmad Mansyur Nasirah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53770/amjpm.v5i1.522

Abstract

Physically demanding tasks in long-term care, such as lifting and repositioning patients, increase caregivers' risk of musculoskeletal disorders, highlighting the need for empowerment through targeted education and skills training to ensure safe practices. This community service aimed to evaluate the effectiveness of an educational training program for caregivers, focusing on working posture management and technique in transferring older people to reduce the risk of musculoskeletal injuries. A pre- and post-intervention design was used to assess cognitive improvement and participant satisfaction among 41 caregivers in community setting. Results showed a marked increase in correct responses across all questionnaire items following the training, indicating improved knowledge and satisfaction throughout the training. The increased to 95.1% after the training was found, indicating a significant gain in knowledge about the basic concepts of transfer techniques. Participants expressed high satisfaction, with simulation-based learning identified as the most effective instructional method. The findings suggest that targeted, practical training can enhance caregivers’ competencies and contribute to safer caregiving practices. Despite these positive outcomes, limitations included a participant bias, limited follow-up, or the socio-economic context of the participants in short-term evaluation. Future programs are recommended to include follow-up assessments and wider community involvement to ensure long-term impact and sustainability.
Predictors of Anxiety toward COVID-19 Delta Variant: A Cross- Sectional Study among Healthcare Providers in Java and Bali, Indonesia Swarjana, I Ketut; Putu Darma Suyasa, I Gede; Nuryanto, I Kadek
Kesmas Vol. 17, No. 3
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Health facilities are experiencing overcapacity, oxygen scarcity, and a limited number of healthcare providers due to the coronavirus disease 2019 (COVID-19), thus impacted on anxiety. This study aimed to determine predictors of anxiety among healthcare providers toward the Delta variant of COVID-19 in Indonesia. A cross-sectional study was conducted with 371 healthcare providers in Java and Bali Islands, and the snowball sampling technique was used. Data were collected using a questionnaire and distributed through social media (WhatsApp), then analyzed using univariate analysis, bivariate analysis (Chi-square test), and multivariate analysis (multiple logistic regression). The results showed that 81 (21.8%) respondents experienced anxiety. The workplace (AOR: = 0.617; p-value = 0.011), a history of confirmed positive for COVID-19 (AOR = 2.965; p-value<0.001), and the respondent's comorbidities (AOR = 8.753; p-value<0.001) were significantly associated with anxiety toward the Delta variant. Healthcare managers must regularly evaluate the psychological condition of their subordinates during the COVID-19 pandemic so that anxiety can be detected and overcome early through constructive self-adaptation and positive coping mechanisms.
Determinants of Nurse Performance in Implementation of Infection Prevention and Control Using Employee Engagement Theory in Pandemic Period: A Literature Review Dewi, Putu Sundari; Suyasa, I Gede Putu Darma; Darmini, AAA Yuliati; Wulandari, Sarah K.
Babali Nursing Research Vol. 4 No. 3 (2023): July
Publisher : Babali Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37363/bnr.2023.43252

Abstract

Nurse performance is an important parameter in improving the quality of health services. Nurse performance is influenced by several factors such as individual factors, psychological and organizational factors. The need for support for nurse performance can also be increased through an employee engagement approach. This study aims to identify the determinants factors of nurse performance in implementing infection prevention and control using the theory of employee engagement during a pandemic. This study uses the literature review method. Article search uses 4 journal databases from 2019-2023 which were reviewed including Garuda, Google Scholar, Pubmed and Scient Direct and fifteen articles met the criteria. The results showed that the determinants of nurse performance using employee engagement theory were leadership and organization. Nurse performance influences employee engagement, engaged nurses will have high work engagement and nurses who are not engaged will have low work engagement. The implementation of employee engagement during the pandemic there were still several factors that had not been widely intervened, so further research is needed to find out how the theory of employee engagement is applied to find out the performance factors of nurses in implementing infection prevention and control.
Benson Relaxation Therapy: Impact on Blood Pressure in Hypertensive Older Adults – A Literature Review Sani, Ari Wina; Suyasa, I Gede Putu Darma; Nuryanto, I Kadek; Astawa, I Gede Satria
Babali Nursing Research Vol. 5 No. 3 (2024): July
Publisher : Babali Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37363/bnr.2024.53378

Abstract

Introduction: The high incidence of hypertension can have an impact on increasing death rates in the world because it can cause heart failure and coronary heart disease and increase the risk of stroke. A strong emphasis on managing essential HTN with non-pharmacological interventions involving multiple elements of lifestyle modification, focusing on more permanent measures to help improve the overall quality of life and decrease physician dependence and hospitalizations of severe complications. This study aimed to explore the effect of Benson relaxation therapy on blood pressure in older adults with hypertension. Method: The method used in this literature review was to examine the results of previous research in published articles. Article searches were carried out via PubMed, Science Direct, and Google Scholar using the keywords "Benson Relaxation," "Blood Pressure," AND "Hypertensive Older adults," as well as combinations of these keywords such as "Benson relaxation on older adults hypertensive blood pressure." Fifteen articles were extracted based on the inclusion that Benson relaxation and other relaxation treatments significantly reduced blood pressure values in hypertension sufferers.Results: There were 15 articles focused on Benson therapy. Eleven studies were of pre-experimental study design. The remaining studies were case study groups (two) and one randomized control study. All of the articles combine deep breathing relaxation and religious relaxation. Conclusion: Benson relaxation has a significant effect on reducing blood pressure values in hypertension sufferers.
Influence Culture on Perceptions, Behaviors, and Risk of Repeat Attacks Patients with Heart Disease: A Literature Review Based on Transcultural Nursing Trisna, Made Oktaviani Bulan; Suyasa, I Gede Putu Darma; Israfil; Suantika, Putu Inge Ruth
Babali Nursing Research Vol. 6 No. 4 (2025): October
Publisher : Babali Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37363/bnr.2025.64517

Abstract

Introduction: Differences in values, norms, and customs across societies shape how patients understand their illness, make decisions about seeking care, and undergo treatment and recovery. Based on a transcultural nursing approach, this study aims to synthesize findings from various literatures that identify cultural influences on heart disease management and their implications for preventing recurrent heart attacks. Methods: This study was a narrative literature review with the PICO framework, using PubMed, ScienceDirect, Google Scholar, and relevant sources (2016–2025) with the keywords “Coronary heart disease” AND “transcultural nursing” AND “culture.” Inclusion criteria included qualitative and quantitative primary research on the role of “culture” OR, “ethnicity” OR, “spirituality” OR, “gender” OR,  OR “access to healthcare in heart disease.” Did not address the transcultural context, focused only on biological factors, review/meta-analysis, single case report, and inadequate methodology were excluded. Of the 1,539 articles identified, 15 met the criteria and were analyzed narratively. Results: The study identified six aspects of the role of culture in heart disease: disease perception (local beliefs and spirituality), coping and treatment seeking (family norms, traditional practices, access), ethnic and gender inequalities, immigrant acculturation (Western lifestyle), collectivism and family roles (compliance vs. delay of help), and local environmental factors/traditions (e.g., solid fuels). Culture can be both a risk and a protective factor through family support, spirituality, and community. Conclusion: Culture is important in preventing and managing heart disease, particularly in reducing the risk of recurrent heart attacks. Transcultural nursing sensitive to cultural diversity is needed to improve health literacy, medication adherence, and reduce cardiovascular inequalities across populations.
Determinant of functional disability in instrumental activities of daily living among elderly living in a rural area in Bali: a crosssectional study Suyasa, I Gede Putu Darma; Sutini, Ni Kadek; Kamaryati, Ni Putu; Nuryanto, I Kadek
Jurnal Ners Vol. 18 No. 2 (2023): JUNE 2023
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jn.v18i2.45700

Abstract

Introduction: Little do we understand about factors associated with functional disability in instrumental activities of daily living among the elderly living at home. This study aimed to explore the prevalence and determinant factors of functional disability in instrumental activities of daily living (IADL) among the elderly living in a rural area in Bali. Method: Using a cross-sectional design, 1,053 elderly aged 60 years and above living in a rural area in Bali were recruited. A structured interview by trained data collectors was conducted. Questionnaires used were the Lawton IADL Scale, the 5-item of Geriatric Depression Scale, and the adoption of questionnaires for vision, hearing, and communication problems from the Washington Group Short Set of Questions on Disability. A logistic regression model was applied to explore determinant factors. Results: Findings indicated that 26.1% of participants aged 75+ and 52.3% were female. Eight percent (8%) experienced functional disability in IADL, 1.9% lived alone, 11.8% indicated depression, 5.1%, 4.7%, and 1.6% of them had vision loss, hearing impairment, and communication problems, respectively. The strongest determinant factor for functional disability in IADL was depression (OR 7.869; 95% CI 4.657-13.296), followed by age (OR 4.602; 95% CI 2.764-7.663), and hearing impairment (OR 2.903; 95% CI 1.190-7.083). Conclusions: Depression is the strongest determinant factor for functional disability in IADL. Health professionals in rural areas should actively screen for depression to increase the ability of the elderly to fulfill their IADLs. Keywords: aged, depression, epidemiology, Indonesia
Co-Authors A.A. Ayu Yuliati Darmini Adnyanita, Anak Agung Istri Citra Agus Ari Pratama Agustini , Ni Luh Putu Inca Buntari Agustini, Ni Komang Tri Agustini, Ni Komang Tru Anak Agung Istri Citra Adnyanita Anak Agung Istri Wulan Krisnandari, Anak Agung Istri Wulan Anggari, Inggita Apiradee Pimsen Aries Susanti, Ni Putu Arinjaya, I Gede Eka Arnaya, I Gede Putu Suka Artsanthia, Jintana Astawa, I Gede Satria Asthadi Mahendra Bhandesa, Asthadi Mahendra Buntari, Ni Luh Putu Inca Agustini Cahyani, Kadek Indra Chi-Jane Wang Darmini, AAA Yuliati Dewa Ayu Erna Sri Rahayu Dewi, Ni Putu Ayu Ratna Dewi, Putu Ayu Laksmi Dewi, Putu Sundari Diyu, Ida Ayu Ningrat Pangruating Dr. Ni Luh Dwi Indrayani Duygulu, Sergul Edi Sanjana, I Wayan Gst Ayu Dwina Mastryagung Gusti Ayu Dwina Mastryagung I Gusti Ayu Puja Astuti Dewi I Gusti Ngurah Aryana I Gusti Ngurah Made Kusuma Negara I Kadek Doni Kusmadi I Kadek Nuryanto I Ketut Alit Adianta I Ketut Alit Adianta I Ketut Alit Adianta I Ketut Swarjana I Komang Wirayasa I Nyoman Krisna Artha Kusuma I Wayan Edi Sanjana I Wayan Remiasa Ida Ayu Suptika Strisanti Ida Bagus Putu Rai Suryawan Idah Ayu Wulandari Idyatul Hasanah IGA Rai Rahayuni Indrayani, Ni Luh Dwi Inggita Anggari Intan Julia Anastasia Israfil Israfil Israfil Israfil Israfil Israfil, Israfil Israfil, Israfil Israfil Jaya Kusuma, I Made Kadek Ayu Ananda Maharini Kadek Buja Harditya Kadek Sriasih Kenbubpha, Kedsaraporn Kesari Darmapatni, Ni Wayan ketut hendra yanti dewi Ketut Widia Komang Asrini Widya Tri Lestari Komang Ayu Purnama Dewi Komang Rosa Tri Anggaraeni komang suarningsih Luh Ari Suantari Made Dian Shanti Kusuma Made Rismawan Meenongwah, Jaroonsree Nadya Treesna Wulansari Ni Kadek Devariyani Swantari Ni Kadek Devariyani Swantari Ni Kadek Sriasih Ni Kadek Sutini Ni Kadek Sutini Ni Ketut Erawati Ni Komang Ady Tri Hapsari Ni Komang Tru Agustini Ni Luh Dwi Indrayani Ni Luh Gede Hari Nugrahini Ni Luh Putu Dina Susanti Ni Luh Putu Inca Buntari Agustini Ni Luh Putu Inca Buntari Agustini Ni Luh Putu Inca Buntari Agustini Ni Luh Putu Inca Buntari Agustini Ni Luh Putu Mira Santana Sari Ni Luh Putu Mira Santana Sari Ni Made Ari Widayani Ni Made Candra Citra Sari Ni Made Dewi Wahyunadi Ni Made Dewi Wahyunadi Ni Made Manik Elisa Putri Ni Made Milapastiniari Ni Made Nurtini Ni Made Sri Rahyanti Ni Nyoman Nuartini Ni Putu Ayu J. Sastamidhyani Ni Putu Ayu Jelantik Sastamidhyani Ni Putu Kamaryati Ni Putu Kristiani Ni Wayan Deani Ni Wayan Kesari Darmapatni Ni Wayan Kesari Dharmapatni Ni Wayan Manik Parwati Ni Wayan Sri Wahyuni Ni Wayan Sukma Antari Nugrahini, Ni Luh Gede Hari Nurhayati Nurhayati Nuryanto, Kadek Oka Putra, I Nyoman Trisna Oka Putra Pande Putu Ida Oktaviani Pangruating Diyu, Ida Ayu Ningrat Portia, Vitug Promwong, Waiyaporn Putra, I Komang Ardidhana Nugraha Putra, I Nyoman Arya Maha Putra, Kadek Andika Dwi Putra, Komang Ardidhana Nugraha Putri, Ni Made Manik Elisa Putu Adinda Saraswati Putu Awik Sirna Wardani Putu Inge Ruth Suantika Putu Mariany Purnama Sari Putu Noviana Sagitarini Ratih Comala Dewi, Ni Made Rittiruang, Amonwan Sagita, Ni Wayan Riska Sandra, Putu Yudara Sani, Ari Wina Sanjana, I Wayan Edi Sarah K Wulandari Serinadi, Desak Made Sri Ariani Sri Dewi Megayanti suarningsih, komang Suryawan, Ida Bagus Putu Rai Suyasa, Agus Baratha Swantari, Ni Kadek Devariyani Tanuparbrungson, Supawan Trisna, Made Oktaviani Bulan Wangi, Ni Luh Putu Ayu Puspita Wardana, Dewa Gede Wisnu widia, ketut Wulandari, Sarah K Wulandari, Sarah K. Wulandari, Sarah Kartika yanti dewi, ketut hendra Yoga, Sukma Wisnu Yudi Wahyu, I Made Yulistina, Putu Desi Yusniawati, Yustina Ni Putu