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All Journal Jurnal Konseling dan Pendidikan JPGI (Jurnal Penelitian Guru Indonesia) Jurnal Riset Ilmu Kesehatan Umum dan Farmasi Antigen: Jurnal Kesehatan Masyarakat dan Ilmu Gizi Medical Laboratory Journal The Journal General Health and Pharmaceutical Sciences Research International Journal of Health Science
Nurzahara Sihombing
SD Negeri 107396 Paluh Merbau
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Administrative Resilience in Middle Eastern Healthcare within Conflict Zones Agustina Bangun; M. Agung Rahmadi; Luthfiah Mawar; Suranta Ginting; Hariana Erdewi Sinaga; Helsa Nasution; Nurzahara Sihombing
International Journal Of Health Science Vol. 5 No. 3 (2025): November : International Journal of Health
Publisher : Lembaga Pengembangan Kinerja Dosen

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/ijhs.v5i3.6206

Abstract

This study examines the construct of administrative resilience within mental and physical health service systems in Middle East conflict zones using Confirmatory Factor Analysis (CFA) within Structural Equation Modeling (SEM). Data were derived from 847 policy documents and operational reports from twelve countries (2018–2024), accessed through official online sources. The measurement model showed good fit indices (χ²/df = 2.134, CFI = 0.962, TLI = 0.955, RMSEA = 0.047, SRMR = 0.038), indicating structural stability and validity of the theoretical model. CFA confirmed four dimensions of administrative resilience with significant loadings: Adaptive Policy (λ = 0.871, CR = 12.453, p < 0.001), Cross-Sector Coordination (λ = 0.834, CR = 11.287, p < 0.001), Professional Competence (λ = 0.792, CR = 10.564, p < 0.001), and Operational Stability (λ = 0.815, CR = 11.098, p < 0.001). Reliability results were strong (Cronbach's α = 0.863–0.921; Composite Reliability = 0.879–0.934; AVE = 0.647–0.782). Findings reinforce Boin and Lodge’s (2016) concept of organizational resilience and extend Comfort et al. (2010) by integrating operational stability as a relevant dimension in conflict settings. Unlike Kruk et al. (2015), which focused on general health systems, this study identifies unique adaptive mechanisms within dual mental–physical services while addressing the fragmentation gap noted by Jawad et al. (2019) through empirical formulation of interdependent administrative dimensions.
Behavioral dynamics of halal cryptocurrency investing: cognitive and emotional mechanisms within islamic finance principles M. Syukri; Ade Sofyan Mulazid; M. Agung Rahmadi; Luthfiah Mawar; Helsa Nasution; Nurzahara Sihombing
Jurnal Konseling dan Pendidikan Vol. 13 No. 4 (2025): JKP
Publisher : Indonesian Institute for Counseling, Education and Therapy (IICET)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29210/1201700

Abstract

This study comprehensively investigates the influence of cognitive biases, emotions, and Islamic legal understanding on halal cryptocurrency investment decisions among Muslim investors. Employing a Meta-Structural Equation Modeling (MASEM) approach, the analysis is based on data from 12,780 respondents in Muslim-majority countries to identify patterns of relationships among key variables. The primary findings of this research affirm that overconfidence has a significant positive impact on investment intention (β = 0.41, p < 0.01), consistent with Shiller (2017), who highlighted that excessive confidence can drive risk-taking behavior in financial markets. Conversely, loss aversion demonstrates a significant negative effect (β = -0.53, p < 0.01), aligning with Kahneman and Tversky's (2013) findings regarding preferences for avoiding losses under uncertainty. Regarding emotional factors, anxiety about price volatility is a major deterrent to investment (β = -0.54, p < 0.01). However, a Sharia-compliant label mitigates negative perceptions among Muslim investors toward cryptocurrency investments, enhancing their sense of security and trust (β = 0.36, p < 0.05). Lastly, understanding Islamic law significantly influences confidence in halal investments (β = 0.39, p < 0.05), corroborating the findings of El-Gamal (2006) and Din (2021) while underscoring the importance of Sharia-based financial literacy. The novelty of this study lies in its multidimensional integration of psychological behavior (cognitive biases and emotions) and Islamic law, thereby expanding the horizons of prior research. Consequently, this research contributes to the foundation of a new construct and provides practical guidance for developing Sharia-compliant financial products in the digital era.
Modeling orthodox christian theological education in middle eastern conflict zones: a study of epistemological, dogmatic, hermeneutical, and ethical dimensions Murni Kasih Zebua; M. Agung Rahmadi; Luthfiah Mawar; Helsa Nasution; Nurzahara Sihombing
JPGI (Jurnal Penelitian Guru Indonesia) Vol. 10 No. 2 (2025): JPGI
Publisher : Indonesian Institute for Counseling, Education and Therapy (IICET)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29210/026806jpgi0005

Abstract

This study offers an in-depth examination of the construction of Orthodox Christian theological education in Middle Eastern conflict zones, employing Confirmatory Factor Analysis under a MASEM framework to investigate four central dimensions: patristic epistemology, dogmatic rationality, the hermeneutics of tradition, and ethics. Through a meta-analytic approach that integrates online data from 847 institutional documents and 1,523 virtual respondents across Syria, Lebanon, Jordan, Palestine, and Iraq from 2018 to 2024, the study identifies a structural model that demonstrates excellent goodness-of-fit indices, with χ²/df = 2.17, CFI = 0.946, TLI = 0.938, RMSEA = 0.054, and SRMR = 0.041. Patristic epistemology exhibits the highest loading factor (λ = 0.89, CR = 12.45, p < 0.001), with a substantial influence on academic resilience (β = 0.76, p < 0.001). In contrast, dogmatic rationality significantly strengthens theological identity stability (β = 0.68, p < 0.001). The hermeneutics of tradition reinforce communal cohesion (β = 0.71, p < 0.001), and ethics function as a significant mediator between theological constructs and altruistic behaviour in conflict zones (β = 0.63, p < 0.001). These findings extend the works of Makrides (2009), Iran (2020), and Papanikolaou (2012) by integrating psychological dimensions of education into Orthodox theology, while simultaneously generating a new empirical model that aligns patristic tradition with adaptive responses to collective trauma, resulting in an innovative theoretical framework for Orthodox theological education in conflict areas that balances doctrinal steadfastness with contextual elasticity.
Comparison of Evidence-Based Treatment Protocols for Complex Trauma in Middle Eastern Conflict Populations Luthfiah Mawar; M. Agung Rahmadi; Helsa Nasution; Nurzahara Sihombing
Jurnal Riset Ilmu Kesehatan Umum dan Farmasi (JRIKUF) Vol. 3 No. 2 (2025): April : Jurnal Riset Ilmu Kesehatan Umum dan Farmasi (JRIKUF)
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/jrikuf.v3i2.603

Abstract

This meta-analysis systematically evaluates the relative effectiveness of various empirically supported therapeutic protocols designed to address complex trauma in populations affected by armed conflict in the Middle Eastern region. From 1,284 articles identified, 47 studies (N=4,832) met the inclusion criteria and were further analyzed. The primary findings indicate that Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) produces the most significant therapeutic impact (g=0.83, 95% CI [0.76, 0.90], p<.001), followed by Eye Movement Desensitization and Reprocessing (EMDR; g=0.78, 95% CI [0.71, 0.85], p<.001) and Narrative Exposure Therapy (NET; g=0.71, 95% CI [0.64, 0.78], p<.001). Moderator analysis revealed that the duration of the intervention (β=0.42, p<.001), as well as the severity of trauma at the commencement of treatment (β=0.38, p<.001), significantly influence therapeutic effectiveness. Further network meta-analysis results demonstrated that TF-CBT holds the highest probability of being the most superior intervention (SUCRA=0.92), indicating its superior effectiveness in reducing symptoms of post-traumatic stress disorder (PTSD), with a significantly standardized mean difference compared to other approaches (SMD=-0.45, 95% CI [-0.52, -0.38]). Contrary to findings reported by Korn (2009) and Rahman et al. (2019), which positioned EMDR as the primary method, this study identifies the distinct superiority of TF-CBT specifically for individuals suffering from complex trauma due to prolonged conflict. These results broaden the horizon of prior scientific understanding by emphasizing the importance of trauma-specific characteristics as moderating variables that determine the success of therapeutic interventions.    
Integration of Indigenous Healing Approaches and Western Psychotherapy in Addressing War Trauma Post-Arab Spring M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar; Nurzahara Sihombing
Jurnal Riset Ilmu Kesehatan Umum dan Farmasi (JRIKUF) Vol. 3 No. 2 (2025): April : Jurnal Riset Ilmu Kesehatan Umum dan Farmasi (JRIKUF)
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/jrikuf.v3i2.604

Abstract

This study systematically evaluates the effectiveness of integrating indigenous healing approaches with Western psychotherapy in addressing psychological trauma experienced by populations affected by war in the aftermath of the Arab Spring. Utilizing a systematic review methodology, the analysis encompasses 47 independent studies involving 4,382 participants, published between 2011 and 2024. Meta-analytic results indicate that the combined application of both approaches yields a significantly higher effect size (d=0.86, 95% CI [0.72, 1.01]) compared to the individual application of either indigenous healing (d=0.51) or Western psychotherapy (d=0.63). Further moderator analysis reveals that the highest therapeutic effectiveness is achieved through interventions that integrate traditional healing rituals with Cognitive Behavioral Therapy techniques (β=0.41, p<.001) and Eye Movement Desensitization and Reprocessing (β=0.38, p<.001). Moreover, Indigenous healing demonstrates a significantly targeted contribution to the recovery of collective identity (r=0.72, p<.001) and enhancement of social reintegration capacity (r=0.68, p<.001). In contrast, Western psychotherapy proves more effective in reducing the intensity of post-traumatic stress disorder (PTSD) symptoms (r=-0.59, p<.001). These findings substantially expand upon previous research by Okasha et al. (2012) and Erickson & Al-Tamimi (2001), which primarily focused on the isolated effectiveness of each approach. The empirical evidence presented in this study supports the conclusion that an integrated therapeutic model yields more comprehensive and sustainable clinical benefits for survivors of collective trauma resulting from armed conflict. Finally, the core novelty of this research lies in its successful identification of specific mechanisms that effectively facilitate the synergy between indigenous healing and Western psychotherapy in the context of complex post-conflict mass trauma following the Arab Spring.    
Impact of Displacement on Mental Health Among Elderly War Victims in Syam Nurzahara Sihombing; M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar
Jurnal Riset Ilmu Kesehatan Umum dan Farmasi (JRIKUF) Vol. 3 No. 2 (2025): April : Jurnal Riset Ilmu Kesehatan Umum dan Farmasi (JRIKUF)
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/jrikuf.v3i2.605

Abstract

This study comprehensively evaluates the impact of displacement on the mental health of the elderly population affected by armed conflict in the Syam region through a systematic review and meta-analysis of 47 empirical studies (N=12,483) published between 2011 and 2024. The meta-analytic findings indicate an exceptionally high prevalence of severe psychological disorders within this population, with PTSD recorded at 63.8% (95% CI [59.2–68.4]), major depression at 58.2% (95% CI [54.1–62.3]), and generalized anxiety disorder at 52.4% (95% CI [48.3–56.5]). Multilevel regression analysis identified the duration of displacement (β=0.42, p<.001) and the loss of family support (β=0.38, p<.001) as the most significant determinants of the elevated prevalence of these mental health disorders. In particular, elderly individuals who experienced displacement for more than three years exhibited a 2.8-fold increased risk of developing psychological disorders compared to those displaced for less than one year (OR=2.83, 95% CI [2.41–3.25]). Findings from the meta-regression further revealed that social support (r=–0.45, p<.001) and adequate access to mental health services (r=–0.38, p<.001) served as significant protective factors. Accordingly, these results not only extend the contributions of prior studies by Peconga & Høgh Thøgersen (2020) and Chung et al. (2018) but also uncover the complex interaction between the duration of displacement and the degradation of social networks as key determinants within the mental health dynamic. Furthermore, this study makes an original contribution by identifying psychosocial adaptation patterns among elderly refugees that are structurally distinct from those of the general population while simultaneously proposing a contextually designed community-based intervention framework to address the multidimensional needs of elderly war victims.      
Mental Health of Combatants vs. Non-Combatants in Middle Eastern Conflicts: A Comparative Analysis Helsa Nasution; M. Agung Rahmadi; Luthfiah Mawar; Nurzahara Sihombing
Jurnal Riset Ilmu Kesehatan Umum dan Farmasi (JRIKUF) Vol. 3 No. 2 (2025): April : Jurnal Riset Ilmu Kesehatan Umum dan Farmasi (JRIKUF)
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/jrikuf.v3i2.619

Abstract

This study aims to comprehensively evaluate the psychological impact differences between individuals who served as combatants and those classified as non-combatants within the context of armed conflicts in the Middle East, through a meta-analysis of 47 independent studies involving a total of 28,463 participants and published between 2010 and 2024. The principal findings of this quantitative synthesis indicate that the prevalence of post-traumatic stress disorder (PTSD) is significantly higher among combatants, reaching 73.8%, compared to non-combatants, who reported a rate of 52.4%, with a large effect size (d=0.89, p<.001). Furthermore, results from multilevel regression analysis reveal that the duration of exposure to conflict is the strongest predictor of PTSD symptoms (β=0.67, p<.001), followed by the intensity of combat, which also contributes significantly (β=0.54, p<.001). In addition, major depression was documented in 64.2% of individuals within the combatant group and 48.7% among non-combatants, with an odds ratio of 2.34 and a 95% confidence interval ranging from 1.98 to 2.76. Anxiety disorders were also more prevalent among combatants, at 58.9%, compared to 41.3% in non-combatants, with a relative risk of 1.78 (p<.001). Subgroup analysis revealed significant differences in coping strategy preferences, with combatants tending to rely more heavily on avoidance mechanisms, recorded at 69.5% versus 45.2% among non-combatants. This meta-analytic finding expands upon the studies by Eltanamly et al. (2021) on war-induced trauma and by Figley & Nash (2011) regarding psychological defense mechanisms, with its distinct contribution lying in the identification of specific patterns of mental disorders influenced by individual roles within conflict dynamics. Overall, this research concludes that combatants exhibit a distinctive pattern of trauma manifestation and demonstrate a higher threshold of resistance to conventional therapeutic interventions, thus making a significant contribution to the formulation of role-based trauma treatment protocols in regions affected by armed conflict.
Development of a Culturally Grounded Trauma Assessment Protocol in the Middle Eastern Context Luthfiah Mawar; M. Agung Rahmadi; Luthfiyah Aqilah Siagian; Sasa Maghfirah Siregar; Andieni Pratiwi; Helsa Nasution; Nurzahara Sihombing; Annisa Ardianti Br Tarigan
Jurnal Riset Ilmu Kesehatan Umum dan Farmasi (JRIKUF) Vol. 3 No. 4 (2025): Oktober : Jurnal Riset Ilmu Kesehatan Umum dan Farmasi (JRIKUF)
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/jrikuf.v3i4.885

Abstract

This study systematically evaluates and develops a trauma assessment protocol based on local cultural contexts through a review and meta-analysis of 87 studies published between 2000 and 2023. Using JASP 0.16.1 and Comprehensive Meta-Analysis V3, results revealed a significant effect size (d = 0.78, 95% CI [0.65, 0.91], p < 0.001), indicating that culturally grounded protocols are more valid than conventional ones. Meta-regression analysis showed that cultural sensitivity accounted for 42.3% of improvements in diagnostic accuracy (β = 0.423, SE = 0.089, p < 0.001), highlighting the importance of cross-cultural understanding in assessment design. Moderator analysis identified three key factors influencing protocol effectiveness: knowledge of local cultural contexts (Q = 24.31, df = 3, p < 0.001), use of culturally appropriate language (Q = 18.76, df = 2, p < 0.001), and involvement of community leaders (Q = 15.92, df = 2, p < 0.001). The study’s heterogeneity was moderate (I² = 68.5%, τ² = 0.142), reflecting variations in implementation. These findings build on prior work by Alarcón et al. (2009) and Jackson et al. (2017), reinforcing the importance of integrating cultural values into trauma assessments. The results demonstrate a more adaptive, systematic framework with significant improvements in predictive validity (AUC = 0.89 compared to 0.76 in non-cultural protocols). This meta-analysis contributes significantly to developing trauma assessment protocols that are more culturally responsive, offering strong empirical evidence for integrating cultural elements into clinical practice.
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.
Co-Authors Ade Sofyan Mulazid Agustina Bangun Andieni Pratiwi Annisa Ardianti Br Tarigan Dinda Nurfadhilah Hariana Erdewi Sinaga Helsa Nasution Helsa Nasution Helsa Nasution Helsa Nasution Helsa Nasution Liza Adilia Pury Luthfiah Mawar Luthfiah Mawar Luthfiah Mawar Luthfiah Mawar Luthfiyah Aqilah Siagian M. Agung Rahmadi M. Agung Rahmadi M. Agung Rahmadi M. Agung Rahmadi M. Agung Rahmadi M. Agung Rahmadi M. Syukri Milna Sari Murni Kasih Zebua Naura Aqilah Rizal Nur Suci Ramadhani Putri Widia Ramadhani Rambe Rima Melati Romaito Nasution Sarah Mawaddah Sasa Maghfirah Siregar Siti Padila Sri Rahayu Sukirman Suranta Ginting Wilda Simangunsong