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All Journal International Journal of Public Health Excellence (IJPHE) 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 Vitalitas Medis : Jurnal Kesehatan Dan Kedokteran Quantum Wellness : Jurnal Ilmu Kesehatan Observasi: Jurnal Publikasi Ilmu Psikologi Obat: Jurnal Riset Ilmu Farmasi dan Kesehatan International Journal Of Public Health International Journal Of Health And Social Behavior International Journal of Health and Medicine Jurnal Siti Rufaidah Jurnal Praba: Jurnal Rumpun Kesehatan Umum Tunjuk Ajar: Journal of Education and Culture
Luthfiah Mawar
Unknown Affiliation
Religion Humanities Dentistry Education Health Professions Languange, Linguistic, Communication & Media Medicine & Pharmacology Nursing Physics Public Health Social Sciences Veterinary

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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.
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 Ilmu 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 Ilmu 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.
Co-Authors Abdul Rahman Shaleh Achmad Syahid Agustina Bangun Aisyah Umaira Al Khawarizmi Amanda Aulia Putri Andieni Pratiwi Andine Mei Hanny Annisa Ardianti Br Tarigan Annisa Br Bangun Asfriyati ,MKes Ayu Anastasyah Clarisha Al Chaira Achmad Dwi Keisya Kurnia Fatric Ginting, Suranta Bill Ferius Lahagu Helsa Nasution Icha Putri Padilah Ika Sandra Dewi Ismail Saleh Lubis Isnaini Fajarwati Khaila Salsabila Kiki Asnanti Laila Zahra Lathifa Nurrahmah Lisa Maharani Rizki 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 Nasution, Helsa Naysila Prasetio Nazwa Aqela Saragih Nurma Handayani Nurzahara Sihombing Olivia Putri Natasya Putri Ramadhani Rabiatul Adawiyah Nasution Rahayu Lubis Rahmadi, M. Agung Rasil Hakim Hasibuan Rifqi Riyadhul Jinan Ririn Alvionita Sitio Risa Ramadhani Br Panjaitan Riska Wahyuni Hasibuan Romaito Nasution Said Agil Husin Al Munawar Sarah Aisyah Agusti Sarah Atikah Sarah Milah Ulfa Tanjung Saschia Amanda Shely Shely Silalahi, Joyce Yulianti Siti Nurfaiza Siti Padila Syifa Putri Ramlan Syifa Salsabila Barus Tarigan, Eldha Novarina Wildan Izzatul Haq Zahra Aliyah Verisah Zilva Husayri Zulvan Zulpiani Br Sipayung