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All Journal Jurnal Ilmu Pendidikan JURNAL PENDIDIKAN IPS 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 Quantum Wellness : Jurnal Ilmu Kesehatan Obat: Jurnal Riset Ilmu Farmasi dan Kesehatan Jurnal Siti Rufaidah Jurnal Praba: Jurnal Rumpun Kesehatan Umum
Nurzahara Sihombing
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Arts Dentistry Education Environmental Science Health Professions Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Nursing Physics Public Health Social Sciences Veterinary

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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.
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.
Reconstruction Strategies for Mental Health Services in Post-Conflict Middle Eastern Regions: (A Policy Synthesis) Helsa Nasution; M. Agung Rahmadi; Nazwa Aqela Saragih; Isnaini Fajarwati; Riska Wahyuni Hasibuan; Luthfiah Mawar; Nurzahara Sihombing; Annisa Ardianti Br Tarigan
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.v3i4.2129

Abstract

This study presents a comprehensive analysis of reconstruction strategies for mental health services in post-conflict regions of the Middle East, based on a meta-synthesis of 87 policies and intervention programs issued between 2010 and 2023. The findings indicate that 73.4 percent of initiatives did not meet their intended targets due to infrastructural limitations, resulting in a service dropout rate of 62.8 percent. The implementation of the Stepped Care Model shows a 47.2 percent improvement in service access (p = 0.001), while the integration of mental health services into primary health care systems increases overall coverage by 56.3 percent (p = 0.001). Task shifting to community health workers enhances efficiency by 38.9 percent (p = 0.01) with a cost-effectiveness ratio of 1 to 2.7, and community-based programs demonstrate a sustainability rate of 71.2 percent compared to 43.5 percent in conventional approaches. These findings build upon the work of Hamamra et al. (2025) and Werner et al. (2023) on post-conflict mental health interventions and show that hybrid models combining formal and informal structures yield better performance, with an effect size (Cohen's d) of 0.82. The main contribution of this study lies in identifying adaptive implementation patterns that align with resource limitations, socio-cultural dynamics, and systemic reconstruction needs in post-conflict settings.
Effectiveness of Digital Mental Health Intervention in Middle Eastern Conflict Zones: (A Technology-Based Meta-analysis) Nurzahara Sihombing; M. Agung Rahmadi; Sarah Atikah; Nanda Liana Lubis; Lisa Maharani Rizki; Helsa Nasution; Luthfiah Mawar; Rasil Hakim Hasibuan
Jurnal Medika Nusantara Vol. 4 No. 1 (2026): Jurnal Medika Nusantara
Publisher : Stikes Kesdam IV/Diponegoro Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59680/medika.v4i1.2180

Abstract

This meta-analysis evaluates the effectiveness of digital mental health interventions in post-conflict regions of the Middle East by synthesizing findings from 47 studies (N = 8,427) published between 2015 and 2024. Using a random-effects model, the results demonstrate that digital interventions consistently produce significant reductions in symptoms of PTSD (g = 0.82, 95% CI [0.74, 0.90], p < .001), depression (g = 0.76, 95% CI [0.68, 0.84], p < .001), and anxiety (g = 0.71, 95% CI [0.63, 0.79], p < .001). Moderator analyses show that mobile application–based interventions (g = 0.88) outperform web-based platforms (g = 0.69). The optimal duration falls within the 8 to 12 week range (g = 0.85) with a retention rate of 76.4 percent. These findings confirm Maalouf et al.'s (2019) argument about the accessibility of digital technologies in conflict settings, yet indicate stronger effects for mobile interventions than those reported by Kamali et al. (2020). In contrast to the meta-analysis by Al Dweik et al. (2024), which examined general interventions, this study identifies the specific effectiveness of artificial intelligence–driven personalized treatment (g = 0.91) and encrypted peer-to-peer support (g = 0.87). The results reinforce that digital interventions can serve as a strategic alternative when conventional mental health services are difficult to access.
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 Ilmu Kesehatan dan Gizi
Publisher : Lembaga Pengembangan Kinerja Dosen

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.
Co-Authors Aisyah Umaira Al Khawarizmi Amanda Aulia Putri Andieni Pratiwi Andine Mei Hanny Annisa Ardianti Br Tarigan Annisa Br Bangun Ayu Anastasyah Clarisha Al Chaira Achmad Dwi Keisya Kurnia Ferius Lahagu Helsa Nasution Icha Putri Padilah Isnaini Fajarwati Khaila Salsabila Kiki Asnanti Laila Zahra Lathifa Nurrahmah Lisa Maharani Rizki 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 Olivia Putri Natasya Putri Ramadhani Rabiatul Adawiyah Nasution Rasil Hakim Hasibuan Rifqi Riyadhul Jinan Ririn Alvionita Sitio Risa Ramadhani Br Panjaitan Riska Wahyuni Hasibuan Romaito Nasution Sarah Aisyah Agusti Sarah Atikah Saschia Amanda Shely Shely Siti Nurfaiza Siti Padila Syifa Putri Ramlan Syifa Salsabila Barus Wildan Izzatul Haq Zahra Aliyah Verisah Zilva Husayri Zulvan Zulpiani Br Sipayung