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All Journal Jurnal Ilmu Pendidikan JURNAL PENDIDIKAN IPS Termometer: Jurnal Ilmiah Ilmu Kesehatan Dan Kedokteran 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 Riset Ilmu Kesehatan Umum dan Farmasi Antigen: Jurnal Kesehatan Masyarakat dan Ilmu Gizi Medical Laboratory Journal Vitamedica: Jurnal Rumpun Kesehatan Umum Corona: Jurnal Ilmu Kesehatan Umum, Psikolog, Keperawatan dan Kebidanan The Journal General Health and Pharmaceutical Sciences Research Obat: Jurnal Riset Ilmu Farmasi dan Kesehatan Jurnal Praba: Jurnal Rumpun Kesehatan Umum
Nurzahara Sihombing
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Intersectionality of Gender, Social Class, and War Trauma in the Middle East : A Multilayer Analysis Helsa Nasution; M. Agung Rahmadi; Luthfiah Mawar; Nurzahara Sihombing
Medical Laboratory Journal Vol. 3 No. 2 (2025): June : Medical Laboratory Journal
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/caloryjournal.v3i2.656

Abstract

This multilayer meta-analysis investigates the intersectionality between gender, social class, and war-related trauma in the Middle East through a systematic review of 87 studies (N = 31,459) published between 2000 and 2023. Analytical findings reveal a strong and significant correlation between gender and trauma severity (r = 0.67, p < 0.001), with women experiencing a 2.8 times higher prevalence of PTSD compared to men. Furthermore, results from hierarchical regression demonstrate that social class functions as a substantial moderator (β = 0.45, p < 0.001), with individuals from lower social class backgrounds exhibiting a 3.2 times greater risk of trauma. Further structural path analysis reveals the presence of dual mediation (CFI = 0.96, RMSEA = 0.04), with access to mental health services and social support serving as primary mediators (indirect effect = 0.38, 95% CI [0.29, 0.47]). These results expand the contributions of Al-Krenawi and Graham (2012) and Mangrio et al. (2019) by illustrating the complex interaction of the three dimensions (Gender, Social Class, and War Trauma), which had previously been examined only separately. In addition, this study identifies a new pattern termed the "spiral trauma effect," a mechanism wherein the intersectionality of gender, social class, and trauma mutually reinforce each other in a recurring cycle (effect size d = 0.89), thereby deepening the understanding of trauma dynamics in conflict zones across the Middle East. Finally, the predictive model developed in this research demonstrated an accuracy rate of 84.3% in identifying high-risk individuals. Thus, these results are considered to provide an innovative framework for the development of empirically-based trauma interventions in Middle Eastern war zones.
A Systematic Evaluation of Mental Health Policies for Middle Eastern Refugees Luthfiah Mawar; M. Agung Rahmadi; Helsa Nasution; Nurzahara Sihombing
Medical Laboratory Journal Vol. 3 No. 2 (2025): June : Medical Laboratory Journal
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/caloryjournal.v3i2.684

Abstract

This meta-review study presents a comprehensive evaluation of the effectiveness of mental health policies targeting refugees from the Middle East based on a systematic analysis of 87 policies issued across 12 refugee-hosting countries during the period from 2015 to 2023. Employing the PRISMA approach and thematic analysis, this research found that only 34.5% of all reviewed policies met the World Health Organization's minimum standards regarding mental health services for refugees. In comparison, the effective implementation rate of those policies meeting the standards reached only 28.7% (CI 95%, p<0.001). Findings from the logistic regression analysis revealed a significant correlation between the scale of mental health budget allocations and recovery rates from PTSD among refugee populations, where every 10% increase in budget allocation corresponded to a 15.3% reduction in PTSD prevalence (r=0.78, p<0.001). Furthermore, the meta-analysis results from this study demonstrated that community-based policies were 2.4 times more effective (OR=2.4, CI 95%: 1.8–3.1) than those employing institutional approaches. Hence, diverging from the conclusions posited by Turrini et al. (2019) and Sijbrandij (2017), which emphasized clinical interventions, this study has instead affirmed that integrating cultural-spiritual approaches with conventional therapy can enhance treatment success by 47.2%. Additionally, these findings expand the conceptual framework previously proposed by Watters (2001) on holistic approaches by identifying five key elements that form the foundation of effective mental health policies: universal access, cultural sensitivity, community empowerment, service integration, and program sustainability.
The Mixed-Method Approach in Research on War-Related Trauma in the Middle East Nurzahara Sihombing; M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar
The Journal General Health and Pharmaceutical Sciences Research Vol. 3 No. 2 (2025): The Journal General Health and Pharmaceutical Sciences Research
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/tjghpsr.v3i2.668

Abstract

This study conducts an in-depth examination of 87 mixed-method studies that address war-related trauma in the Middle East over the past two decades (2000–2023), employing a systematic methodological meta-synthesis approach to formulate a more comprehensive understanding of the impact of armed conflict on affected populations. Quantitative findings indicate an exceedingly high prevalence of post-traumatic stress disorder (PTSD), reaching 73.4% among war refugees (n = 12,456), accompanied by significant comorbidity rates in the form of depression (68.2%) and anxiety disorders (59.7%), both of which clinically exacerbate recovery prognosis. Meanwhile, the thematic qualitative analysis successfully identified five principal dimensions of recurrent traumatic experiences, namely direct exposure to violence (82.3%), the loss of family members (76.9%), forced displacement (71.4%), existential uncertainty regarding the future (68.9%), and the disintegration of social cohesion within affected communities (65.2%). A comprehensive integration of quantitative and qualitative data reveals a substantial correlation between the duration of conflict exposure and the severity of PTSD (r = 0.78, p < 0.001), indicating a linear association between the chronicity of war experiences and the intensity of psychological trauma. Through meta-regression, this study also identifies several statistically significant protective variables that reinforce both individual and collective resilience, including the presence of family support (β = 0.45, p < 0.001), the intensity of religiosity (β = 0.38, p < 0.01), and the strength of community resilience (β = 0.42, p < 0.001), all of which function as moderating factors of traumatic impact. In contrast to the narrow focus of Storozhuk et al. (2023) and Boeije et al. (2013), who emphasized individual trauma, this study advances a broadened paradigm by exploring the collective dimensions of war trauma made possible through an integrative methodological design. While Zerach and Solomon (2016) previously proposed three core categories of traumatic experience, the present study expands the conceptual spectrum by identifying two additional themes and unveiling the complex network of interrelations among trauma elements. The principal novelty of this study lies in the formulation of an integrative model of war trauma that not only theoretically unifies individual and collective dynamics but also constructs a new methodological framework that may serve as a reference point for trauma research in conflict-affected regions marked by the volatile and multidimensional sociopolitical context of the Middle East.
Cost-Effectiveness Analysis of Mental Health Programs in Middle Eastern Conflict Zones Helsa Nasution; M. Agung Rahmadi; Luthfiah Mawar; Nurzahara Sihombing
The Journal General Health and Pharmaceutical Sciences Research Vol. 3 No. 2 (2025): The Journal General Health and Pharmaceutical Sciences Research
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/tjghpsr.v3i2.669

Abstract

This meta-analysis evaluates the cost-effectiveness of mental health interventions implemented in conflict-affected regions of the Middle East between 2010 and 2023, compiling data from 47 programs across eight countries. Statistical analysis reveals substantial variation in program effectiveness levels (Cohen's d = 0.78, 95% CI [0.65, 0.91], p < 0.001), with cognitive behavioral therapy (CBT) demonstrating the highest cost-effectiveness ratio, registering an ICER of $2,340 per QALY gained. Multilevel regression findings indicate that community-based intervention approaches consistently prove more cost-efficient than those conducted in clinical settings (β = 0.67, p < 0.001), yielding an average savings of 43% per participant. Remote teletherapy programs exhibit significant potential, particularly in regions with limited access to services, with an ROI reaching 1.89 (95% CI [1.65, 2.13]). The economic burden analysis estimates that untreated mental health conditions incur an average annual cost of $4,623 per individual, whereas intervention expenses amount to approximately $1,876 per patient per year, resulting in a benefit-cost ratio of 2.47. This study expands upon prior research by Tol et al. (2011) and McBain et al. (2016), which were limited to clinical outcomes without addressing the economic dimension. In contrast to the study by Reed et al. (1994), which explored general health economics within conflict zones, this research specifically quantifies the cost-effectiveness of mental health interventions in Middle Eastern conflict areas. It reveals that cultural adaptation within intervention programs can enhance return on investment by up to 31%. Finally, this review uniquely demonstrates that community-based mental health programs integrated within conflict zones can meet the cost-effectiveness thresholds recommended by WHO-CHOICE while maintaining a high level of clinical efficacy.
Policy Gaps in Mental Health within Conflict-Affected Middle Eastern Countries : A Regional Synthesis Helsa Nasution; M. Agung Rahmadi; Luthfiah Mawar; Nurzahara Sihombing
VitaMedica : Jurnal Rumpun Kesehatan Umum Vol. 3 No. 3 (2025): Juli : VitaMedica : Jurnal Rumpun Kesehatan Umum
Publisher : STIKES Columbia Asia Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.62027/vitamedica.v3i3.415

Abstract

This study conducts an in-depth examination of the structural gaps in mental health policies within conflict-affected countries in the Middle East region, employing a systematic meta-synthesis approach to analyze 87 primary studies published between 2015 and 2024. Findings reveal that only 23.4% of these countries possess mental health policies that can be classified as comprehensive. In comparison, the average budget allocation for this sector accounts for merely 2.1% of total national health expenditures. In terms of affected populations, the prevalence of mental disorders is alarmingly high, recorded at 41.3% among refugees and 37.8% among residents living amidst protracted conflict. Through logistic regression analysis, a highly significant correlational relationship was identified between conflict intensity and the severity of mental disorders (r = 0.78; p < 0.001), underscoring the systemic link between structural violence and collective psychosocial vulnerability. Furthermore, meta-regression successfully identified the five most dominant policy gaps: deficits in service infrastructure (76.5%), shortages of the professional workforce (68.2%), dysfunctions in referral systems (64.7%), limitations in funding (59.3%), and lack of intersectoral service integration (52.8%). This research not only extends the conceptual framework and empirical findings previously advanced by Sihombing et al. (2025) and Akhtar et al. (2021) concerning the mental health impacts of conflict but also innovatively articulates region-specific patterns and identifies contextual moderator variables that influence policy implementation effectiveness. Thus, this study's methodological and conceptual novelty lies in formulating an evaluative framework grounded in empirical evidence, which integratively combines socio-political indicators with clinical mental health parameters, offering a comprehensive approach to assess and reform public policy in conflict-affected areas of the Middle East.
The Effectiveness of Trauma Prevention Programs in At-Risk Middle Eastern Communities Luthfiah Mawar; M. Agung Rahmadi; Helsa Nasution; 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.v3i3.5420

Abstract

This meta-analytic study systematically examines the effectiveness of trauma prevention interventions implemented in at-risk communities across the Middle East by analyzing 47 independent studies (N = 12,483) published between 2010 and 2023. Employing a random-effects model, the findings reveal that these prevention programs have a significantly positive impact on reducing trauma symptoms (g = 0.73, 95% CI [0.65, 0.81], p < .001). Moreover, programs implemented within school environments demonstrated the highest level of effectiveness (g = 0.86), followed by community-based interventions (g = 0.71), and programs involving families (g = 0.62). Further moderator analysis indicates that the duration of program implementation (β = 0.31, p < .01) and the degree of family involvement (β = 0.28, p < .01) are significant predictors of intervention success. Meanwhile, the average rate of incomplete participation (drop-out) was recorded at 18.4 percent, with substantial variation across implementation contexts (SD = 12.3 percent). Meta-regression demonstrated a significant correlation between the level of social support received by participants and the reduction in trauma symptoms experienced (R² = 0.42, p < .001). These findings significantly exceed earlier reports such as those by Peltonen and Punamäki (2010) and Marwat et al. (2025), who estimated program effects within a moderate range (g = 0.45–0.52). Beyond confirming the effectiveness of these interventions, this study highlights the crucial role of local community support and the integration of cultural values as key components in optimizing program outcomes. Accordingly, the findings broaden both the theoretical and empirical horizons of understanding regarding the dynamics of successful trauma prevention programs in Middle Eastern conflict zones, particularly through the identification of mediating mechanisms such as community resilience and the influence of socio-cultural factors as primary moderators in the effectiveness of psychosocial interventions.
The Conceptual Model of Etika Digital Ulul Albab in Reducing Cyber-Anxiety Among Generation Z : A CFA-Based Study of Data from Indonesia and Lebanon M. Agung Rahmadi; Nurzahara Sihombing; Helsa Nasution; Luthfiah Mawar; Milna Sari; Wildan Izzatul Haq
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.v3i3.5427

Abstract

This study designs and empirically tests the validity of the conceptual model of Etika Digital Ulul Albab as a form of psychological intervention aimed at reducing cyber-anxiety levels among Generation Z, drawing on data encompassing populations in Indonesia and Lebanon. Utilizing a meta-analytical approach applied to 47 online data sets (N = 12,847), this research employs Confirmatory Factor Analysis (CFA) to verify the theoretical construct proposed. The results indicate an excellent model fit (χ²/df = 2.14, CFI = 0.96, TLI = 0.95, RMSEA = 0.048, SRMR = 0.041). Additionally, the factor loading values for the Etika Digital Ulul Albab dimension range from 0.72 to 0.89, with a composite reliability of 0.93, indicating high internal consistency. Multivariate analysis reveals a significant reduction in cyber-anxiety levels by 34.2% (p < 0.001) in the Indonesian group and by 31.8% (p < 0.001) in the Lebanese group. Further mediation analysis demonstrates that Etika Digital Ulul Albab functions as a mediator in the relationship between digital literacy and cyber-anxiety (β = -0.452, p < 0.001). In the view of the researchers, these findings provide empirical support for Guryanova et al. (2020), who underscore the importance of Etika Digital Ulul Albab, while differing from Falk’s (2024) approach that places greater emphasis on technical dimensions. The principal novelty of this study lies in the integration of the Ulul Albab concept, which incorporates both spiritual and intellectual intelligence, into the Etika Digital Ulul Albab framework as a psychological foundation. This approach has not previously been explored within a cross-cultural context related to cyber-anxiety. As such, the developed model offers a novel theoretical contribution to the field of digital psychology by integrating Islamic perspectives with Western psychological paradigms.
The Psychological Construct of Islamic Moderation Based on Tafsir Ulul Albab : A Comparative Study of Indonesia and Syria in Responding to Social Polarization Nurzahara Sihombing; M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar; Romaito Nasution; Milna Sari
Medical Laboratory Journal Vol. 3 No. 3 (2025): September : Medical Laboratory Journal
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/caloryjournal.v3i3.792

Abstract

This study aims to affirm the construct validity of Islamic moderation based on the tafsir of Ulul Albab through an empirical comparison between Indonesia and Syria in responding to the social polarization that divides contemporary societies. Through a comprehensive meta-analysis of 847 journal articles indexed in Scopus, Web of Science, and PsycINFO published between 2015 and 2024, the researchers examined data from 15,428 Indonesian respondents and 12,736 Syrian respondents, integrating cross-cultural quantitative findings within a rigorous statistical framework. The results of the confirmatory factor analysis demonstrated model fit (χ²/df = 2.184; CFI = 0.947; TLI = 0.932; RMSEA = 0.041), while convergent validity indicated an AVE of 0.563 in Indonesia and 0.589 in Syria, with composite reliability values of 0.891 and 0.876 respectively, underscoring the internal consistency of the instrument. Cross-national invariance testing revealed statistically significant differences (Δχ² = 47.23; p < 0.001), with the mean score of Islamic moderation in Indonesia (M = 4.12; SD = 0.67) surpassing that of Syria (M = 3.84; SD = 0.78), indicating that distinctive sociohistorical contexts influence the implementation of moderative values. Furthermore, Islamic moderation functioned as a partial mediator of the relationship between religious literacy and social tolerance (β = 0.342; p < 0.001 for Indonesia; β = 0.287; p < 0.001 for Syria), thereby enriching Pargament's (2011) findings on religious coping and Durrheim et al.'s (2016) work on intergroup prejudice. The findings reveal that Islamic moderation encompasses cognitive, affective, and behavioral dimensions that are theoretically distinct from generic notions of tolerance, affirming the importance of the Ulul Albab approach in addressing socio-religious tensions. Lastly, the novelty of this research lies in the development of a tailored instrument that synthesizes values derived from the tafsir of Ulul Albab, going beyond conventional tolerance scales and offering a more nuanced assessment of the moderative capacity of Muslims in both countries.
Analysis of the Role of Social Media in the Collective Trauma of Middle Eastern Societies : A Digital Analysis Helsa Nasution; M. Agung Rahmadi; Luthfiah Mawar; Nurzahara Sihombing
Medical Laboratory Journal Vol. 3 No. 3 (2025): September : Medical Laboratory Journal
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/caloryjournal.v1i3.793

Abstract

This study comprehensively examines the impact of social media on the formation and intensification of collective trauma in the Middle East through a digital meta-analytical approach synthesizing 47 empirical studies, encompassing a total of 31,842 participants, published between 2015 and 2024. The results reveal a strong and statistically significant correlation between the intensity of social media use and levels of collective trauma, with a correlation coefficient of r = 0.67 and a p-value of < 0.001, indicating a consistent and substantive relationship. Furthermore, regression analysis indicates that exposure to violent content through social media accounts for 43.2 percent of the variance in communal post-traumatic stress symptoms, affirming the role of digital media as a significant catalyst in amplifying collective psychological responses to conflict in the Middle East. Daily social media use exceeding five hours was found to significantly increase the risk of experiencing collective trauma by 2.8 times, with an odds ratio of 2.84 and a 95 percent confidence interval ranging from 2.31 to 3.49. Platforms such as Facebook and Twitter demonstrated a more substantial influence in widely disseminating traumatic experiences, with a beta coefficient of 0.58, compared to Instagram, which had a relatively lower influence with a beta value of 0.34, indicating that the structural and technological logic of each platform mediates the psychological transmission effect. Thematic analysis across studies revealed three primary mechanisms through which trauma is transmitted via social media: first, the amplification of traumatic narratives, accounting for 41.3 percent of identified patterns; second, the normalization of violence at 32.7 percent; and third, the reinforcement of collective identity based on shared traumatic experiences at 26.0 percent, thereby creating a digital ecosystem prone to the social accumulation of negative emotional states. These findings substantially expand the scope of prior research, such as that conducted by Atallah in 2017 and Nasciutti and Rahbari-Jawoko in 2021, which focused more narrowly on individual trauma, by highlighting a broader collective dimension and emphasizing the specific roles of various digital platforms in reinforcing these psychosocial dynamics. This study also identifies a novel pattern of both theoretical and practical significance, namely that algorithmic content recommendation contributes significantly to the formation of closed psychological echo chambers of trauma, intensifying exposure to traumatic content and deepening the affective impact of Middle Eastern conflict within digital spaces, with a significance level of p < 0.001. Accordingly, these findings underscore the urgent need for strategically designed and contextually grounded digital interventions to mitigate the burden of collective trauma in communities affected by protracted armed conflict in the Middle East.
Transcultural Validity of Trauma Measurement Instruments in the Middle East : A Psychometric Analysis M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar; Nurzahara Sihombing
Medical Laboratory Journal Vol. 3 No. 3 (2025): September : Medical Laboratory Journal
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/caloryjournal.v3i3.794

Abstract

This meta-analytic study systematically examines the transcultural validity and psychometric characteristics of various instruments employed to measure psychological trauma in the Middle East. The analysis encompasses a total of 47 studies involving 12,487 participants, originating from twelve Middle Eastern countries and published between 2000 and 2023. Data synthesis reveals a marked variation in internal reliability coefficients, with Cronbach's alpha ranging from 0.73 to 0.92, and construct validity values spanning from 0.65 to 0.87. Meta-regression results indicate that the presence of rigorous linguistic adaptation processes significantly contributes to enhanced instrument validity, as reflected in a β coefficient of 0.43 with a significance level of p less than 0.001. Cross-cultural confirmatory factor analysis reveals an adequately fitting four-factor model, indicated by a CFI value of 0.92 and an RMSEA of 0.058. Furthermore, Differential Item Functioning analysis identifies item functioning imbalance in 23 percent of the total items, primarily related to differences in the conceptualization of somatic symptoms, as shown by a chi-square value of 127.84 and p less than 0.001. These findings expand upon the empirical scope of prior studies such as those conducted by Nasution et al (2025) and Nasution et al (2025), by introducing a new dimension concerning the influence of specific cultural factors on the construction and measurement of trauma symptoms in the Middle East. Additionally, unlike previous analyses by Rasmussen et al (2023), this study demonstrates that culturally adapted instruments exhibit more stable measurement invariance, as indicated by a CFI change of less than 0.01, compared to instruments that are merely translated literally. These results provide the first robust empirical foundation for the urgency of developing trauma measurement tools that are sensitive to cultural dimensions, particularly within the social and linguistic context of Middle Eastern populations.
Co-Authors Aisyah Umaira Andieni Pratiwi Andine Mei Hanny Annisa Ardianti Br Tarigan Ayu Anastasyah Clarisha Al Chaira Achmad Dwi Keisya Kurnia Helsa Nasution Khaila Salsabila Kiki Asnanti Lathifa Nurrahmah Luthfiah Mawar Luthfiyah Aqilah Siagian M. Agung Rahmadi Milna Sari Naila Al Madina Nur Suci Ramadhani Nurma Handayani Putri Widia Ramadhani Rambe Rasil Hakim Hasibuan Risa Ramadhani Br Panjaitan Romaito Nasution Sarah Aisyah Agusti Sasa Maghfirah Siregar Saschia Amanda Siti Nurfaiza Sri Rahayu Sukirman Wildan Izzatul Haq Zahra Aliyah Verisah Zulpiani Br Sipayung