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All Journal Jurnal Konseling dan Pendidikan Termometer: Jurnal Ilmiah 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 Tunjuk Ajar: Journal of Education and Culture International Journal of Health Science
Luthfiah Mawar
Sekolah Tinggi Ilmu Kesehatan Sehati Medan
Religion Humanities Dentistry Education Health Professions Languange, Linguistic, Communication & Media Nursing Public Health Social Sciences

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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.
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.
An Early Warning Framework for Mental Health Crises in Conflict-Affected Areas of the Middle East Luthfiah Mawar; M. Agung Rahmadi; Sri Rahayu Sukirman; Nur Suci Ramadhani; Putri Widia Ramadhani Rambe; Helsa Nasution; Nurzahara Sihombing; Annisa Ardianti Br Tarigan
Antigen : Jurnal Kesehatan Masyarakat dan Ilmu Gizi Vol. 3 No. 4 (2025): November: Antigen : Jurnal Kesehatan Masyarakat dan Ilmu Gizi
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/antigen.v3i4.886

Abstract

This study examines the effectiveness of the Early Warning System (EWS) in anticipating and responding to mental health crises in conflict-affected regions of the Middle East through a systematic review of 47 scholarly articles published between 2014 and 2024. The meta-regression findings indicate a significant contribution of EWS implementation to the reduction of post-traumatic stress disorder (PTSD) symptoms with a coefficient of β = -0.67 (p < .001), as well as depressive symptoms with a coefficient of β = -0.59 (p < .001) among populations directly affected by armed conflict. Among 12,456 respondents analysed, 73.8% reported a reduction in anxiety symptoms following the implementation of EWS, with an effect size of d = 0.82 (95% CI [0.76, 0.88]). Digitally based early warning systems demonstrated a significantly higher level of effectiveness (OR = 2.34, 95% CI [1.98, 2.70]) than conventional systems, which are more manual and reactive. Moderator analysis indicated that age (β = -0.31, p < .01) and the duration of exposure to conflict (β = 0.44, p < .001) play important roles in moderating the relationship between EWS interventions and various mental health indicators. These findings expand upon the conclusions of Fu et al. (2020) and Salesi (2023), which previously explored psychosocial interventions in conflict zones, by adding a new dimension—examining digital technology and predictive algorithms within EWS frameworks. The study explicitly demonstrates that integrating machine learning models into EWS can enhance the predictive accuracy of potential mental health crises to 84.6%, representing a novel contribution that has not been comprehensively documented in prior academic literature
The Influence of Islamic Character Education Implementation on Students’ Mental Health Helsa Nasution; M. Agung Rahmadi; Luthfiah Mawar; Nurzahara Sihombing; Ismail Saleh Lubis
Tunjuk Ajar: Journal of Education and Culture Vol. 1 No. 1 (2025): JUNE
Publisher : Tuah Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.64929/ta.v1i1.18

Abstract

Abstract: This study explores the impact of Islamic character education implementation on students’ mental health through a structural equation modeling (SEM) approach. By analyzing meta-data from 38 studies involving a total of 12,467 respondents, the results reveal a significant correlation between Islamic character education and mental health (r = 0.72, p < 0.001). Furthermore, structural model analysis indicates that Islamic character education has a direct effect on mental health (β = 0.58, p < 0.001) and an indirect effect through emotion regulation (β = 0.32, p < 0.01), yielding a total effect of 0.67. Additionally, invariance testing confirms that the model remains consistent across different age groups and genders (CFI = 0.94, RMSEA = 0.048). The SEM results validate the theoretical model’s fit (χ² = 312.45, df = 145, p < 0.001; GFI = 0.93; NFI = 0.92; TLI = 0.95). These findings extend the studies of Naqiyah (2022) and Khodijah et al. (2024), which previously only highlighted direct relationships without considering mediation variables. Furthermore, unlike the study by Yahaya et al. (2012), which found a moderate effect (β = 0.41), this research uncovers a more substantial and comprehensive impact by identifying emotion regulation as a key mediator. Lastly, the findings emphasize that integrating Islamic values into character education plays a crucial role in enhancing students’ mental health and provides new insights for developing Islamic values-based educational strategies.
Preventive Mental Health Programs for Children in Middle Eastern War Zones Luthfiah Mawar; M. Agung Rahmadi; Annisa Ardianti Br Tarigan; Kiki Asnanti; Siti Nurfaiza; Helsa Nasution; Nurzahara Sihombing; Rasil Hakim Hasibuan
Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran Vol. 3 No. 4 (2025): Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran,
Publisher : Lembaga Pengembangan Kinerja Dosen

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/termometer.v3i4.5615

Abstract

This meta-review presents a comprehensive analysis of the effectiveness of preventive mental health programs targeting children growing up in Middle Eastern conflict zones, systematically examining 47 studies (N=12,487 children) published between 2000 and 2024. The meta-analysis indicates that school-based preventive interventions produce a significant positive impact in reducing the intensity of post-traumatic stress disorder (PTSD) symptoms (d=0.72, 95% CI [0.65, 0.79]), anxiety (d=0.68, 95% CI [0.61, 0.75]), and depression (d=0.64, 95% CI [0.57, 0.71]). Furthermore, programs integrating cognitive-behavioral approaches with social support demonstrated the highest effectiveness (R²=0.83, p<0.001), with recovery rates among children reaching 73.4% compared to control groups. In addition, active parental participation in interventions significantly enhanced children's resilience (β=0.56, p<0.001) compared to programs implemented without parental involvement (β=0.34, p<0.05). These findings extend the contributions of earlier studies, particularly those by Altawil et al. (2023) and Sullivan & Simonson (2016), which primarily focused on the trauma dimension, by identifying fundamental components of effective preventive programs and their therapeutic mechanisms of change. This meta-review also affirms that integrating local wisdom, community traditions, and embedded cultural values into interventions can enhance program effectiveness by up to 47%, a crucial dimension that has not been previously examined in depth in the related literature.  
Construction of Integrated Technology for Physical and Mental Health in Conflict-Affected Middle Eastern Regions : A Confirmatory Factor Analysis of the Dimensions of Digital Innovation, Infrastructure Readiness, User Competency, and Sustainability Luthfiah Mawar; M. Agung Rahmadi; Sal Sabila; Adzra Muzhaffirah; Mutiara Rengganis; Helsa Nasution; Nurzahara Sihombing; Aisyah Umaira
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.v3i4.2114

Abstract

This study offers a comprehensive analysis of the integrated technology construct connecting physical and mental health services in conflict-affected Middle Eastern regions by employing confirmatory factor analysis within a Structural Equation Modelling approach. The research is based on 1,124 documents on digital health technology implementation published between 2017 and 2024 across fourteen countries. The measurement model demonstrates strong goodness-of-fit, evidenced by chi-square/df = 1.847, CFI = 0.971, TLI = 0.965, RMSEA = 0.041, and SRMR = 0.034, thereby confirming the structural soundness of the proposed framework. The analysis identifies four core dimensions—Digital Innovation (lambda = 0.893, CR = 13.672), Infrastructure Readiness (lambda = 0.847, CR = 12.184), User Competency (lambda = 0.819, CR = 11.453), and Sustainability (lambda = 0.865, CR = 12.738)—all significant at p < 0.001. Reliability indices are robust, with Cronbach's Alpha between 0.876 and 0.934, Composite Reliability ranging from 0.891 to 0.947, and Average Variance Extracted between 0.661 and 0.798, indicating strong internal consistency. The findings expand earlier digital health frameworks proposed by Mechael (2009) and Labrique et al. (2013) by emphasizing sustainability as a key component in conflict settings marked by limited resources. In contrast to Aranda-Jan et al. (2014), which addresses general technology adoption, this study underscores specific challenges in integrating both mental and physical health services in humanitarian contexts, thereby responding to the gap highlighted by Naslund et al. (2017) regarding fragmented digital mental health initiatives in crisis environments.
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.
Co-Authors Ade Sofyan Mulazid Adzra Muzhaffirah Agustina Bangun Aisyah Umaira Andieni Pratiwi Andine Mei Hanny Annisa Ardianti Br Tarigan Ayu Anastasyah Fairuz Azzahra Hariana Erdewi Sinaga Helsa Nasution Helsa Nasution Helsa Nasution Ismail Saleh Lubis Isnaini Fajarwati Khaila Salsabila Kiki Asnanti Luthfiyah Aqilah Siagian M. Agung Rahmadi M. Agung Rahmadi M. Agung Rahmadi M. Agung Rahmadi M. Agung Rahmadi M. Syukri Mutiara Rengganis Nafiza Fadhilatul Ulya Damanik Naila Al Madina Nazwa Aqela Saragih Nur Suci Ramadhani Nurma Handayani Nurzahara Sihombing Putri Widia Ramadhani Rambe Rasil Hakim Hasibuan Riska Wahyuni Hasibuan Sal Sabila Sasa Maghfirah Siregar Sila Tsabita Zahra Siti Nurfaiza Sri Rahayu Sukirman Suranta Ginting Winda Yulia Gitania Br Sembiring Zulpiani Br Sipayung