Aris Citra Wisuda
Sekolah Tinggi Ilmu Kesehatan Bina Husada, Palembang, Indonesia

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PRECISION HOLISTIC NURSING CARE FOR CARDIOVASCULAR DISEASE: ENHANCING PSYCHOLOGICAL WELL-BEING, SPIRITUAL HEALTH, AND CLINICAL OUTCOME Aris Citra Wisuda; Citra Suraya; Dilgu Meri; Atma Deviliawati; Santi Rosalina; Heriziana Hz
Journal Of Nursing Science Research Vol. 3 No. 1 (2026): Journal of Nursing Science Research
Publisher : Institut Citra Internasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33862/zpcac092

Abstract

Cardiovascular disease is a major cause of morbidity and is frequently accompanied by psychological and spiritual distress, adversely affecting clinical stability, treatment adherence, and quality of life. Precision Holistic Nursing Care, an individualized nursing approach integrating psychological support, Islamic spiritual care, clinical education, relaxation therapy, hemodynamic monitoring, and therapeutic assistance tailored to patient needs, may help address these multidimensional challenges. This study aimed to examine changes in psychological, spiritual, and clinical outcomes following the implementation of Precision Holistic Nursing Care among patients with cardiovascular disease. Aquasi-experimental pretest–posttest study without a control group was conducted at Siti Khadijah Islamic Hospital Palembang from January to April 2026. Forty-four patients were recruited through purposive sampling. Anxiety, depression, and spiritual well-being were assessed using the Hamilton Anxiety Rating Scale (HARS), Beck Depression Inventory-II (BDI-II), and Spiritual Well-Being Scale (SWBS). Clinical outcomes included blood pressure, pulse rate, respiratory rate, sleep quality, and treatment adherence. Data were analyzed using paired t-tests (p < 0.05). Following the intervention, anxiety scores decreased from 28.91 ± 5.84 to 18.77 ± 4.96 (p < 0.001; d = 1.74), while depression scores declined from 22.45 ± 6.18 to 14.36 ± 5.21 (p < 0.001; d = 1.39). Spiritual well-being improved, with spiritual calmness increasing from 38.6% to 84.1% and confidence in coping with illness from 43.2% to 79.5%. Clinical indicators also improved, including blood pressure (152.6 ± 14.8 to 139.4 ± 12.7 mmHg), pulse rate (96.2 ± 10.5 to 84.7 ± 8.9 beats/minute).
NURSE-LED PREDICTIVE PERFORMANCE OF INTEGRATED PEWS–TRIAGE SYSTEMS IN PEDIATRIC EMERGENCY DETECTION Citra Suraya; Aris Citra Wisuda; Rinda Suciarti
Journal Of Nursing Science Research Vol. 3 No. 1 (2026): Journal of Nursing Science Research
Publisher : Institut Citra Internasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33862/6x214241

Abstract

Delayed detection of pediatric emergencies in emergency departments may increase the risk of clinical deterioration, intensive care admission, and mortality. The integration of the Pediatric Early Warning Score (PEWS) with nursing-based triage systems has emerged as a strategic approach to improve the accuracy of identifying emergency conditions in children. This study aimed to analyze the predictive performance of Nurse-Led Integrated PEWS–Triage Systems in detecting pediatric emergency conditions. A prospective analytical observational design was conducted at RS Islam Siti Khadijah Palembang from January to March 2026. A total of 48 pediatric patients were recruited using consecutive sampling. Data were collected through direct nurse observation during triage assessment using the Integrated PEWS–Triage instrument, including respiratory, cardiovascular, neurological, and triage category parameters.  Instrument validity was tested using Pearson Product Moment correlation (r > 0.361), and reliability showed a Cronbach’s alpha of 0.87.Data were analyzed using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Receiver Operating Characteristic (ROC) analyses. The findings revealed that the Nurse-Led Integrated PEWS–Triage Systems demonstrated a sensitivity of 85.0%, specificity of 78.6%, PPV of 73.9%, NPV of 88.5%, and an Area Under the Curve (AUC) ROC value of 0.87, indicating good predictive performance in detecting pediatric clinical deterioration. However, the relatively small sample size represents a study limitation and the findings should therefore be interpreted cautiously. Nurse-Led Integrated PEWS–Triage Systems have the potential to serve as effective early detection tools to support clinical decision-making and optimize pediatric emergency nursing response.