Pediomaternal Nursing Journal
Vol. 12 No. 2 (2026): VOLUME 12 NO 2 JULY 2026

Development of a diarrhea management model based on health belief model and symptom management theory to improve mothers’ ability in home-based care of under-five children

Mariyam Mariyam (Doctoral Program of Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
Faculty of Nursing and Health Sciences, Universitas Muhammadiyah Semarang, Semarang, Indonesia)

Yuni Sufyanti Arief (Department of Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia)
Makhfudli Makhfudli (Department of Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia)
Nuzul Qur'aniati (Department of Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia)
Ilya Krisnana (Department of Pediatric and Maternity Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
Research Group of Pediatric and Maternity Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia)



Article Info

Publish Date
24 Jul 2026

Abstract

Introduction: Diarrhea remains a leading cause of mortality in children under five, often exacerbated by suboptimal home-based management and inaccurate maternal symptom evaluation. Objective: This study aims to develop and analyze a diarrhea management model based on the Health Belief Model (HBM) and Symptom Management Theory (SMT) to improve mothers' ability to care for under-five children at home. Methods: A quantitative study using a structural equation modeling (SEM) approach was conducted. Data were collected from 130 mothers of under-five children using structured questionnaires. Inclusion criteria were mothers of under-five children with acute diarrhea without dehydration or with mild to moderate dehydration; primary caregivers; and able to read and write. Exclusion criteria included mothers with hearing or visual impairments and mothers of children with comorbid conditions. The sampling was conducted using a non-probability sampling technique, specifically purposive sampling. The exogenous variables included maternal, child, environmental, and healthcare provider factors, while symptom experience and belief-based management served as mediating variables. Results: Symptom experience was directly influenced by maternal factor (t=5.254, P-value<.001), child factor (t=1.989, P-value<.001), environmental factor (t=5.185, P-value<.001), and healthcare provider factor (t=2.605, P-value=.046). Symptom experience significantly triggered belief-based management (t=10.530, P-value<.001), with symptom evaluation being the strongest indicator (t=34.116). Ultimately, belief-based diarrhea management showed a strong positive influence on mothers' ability to care for under-five children at home (t=18.027, P-value<.001). Conclusion: Maternal caregiving competence is significantly improved when diarrhea management protocols are integrated with health belief constructs. Interventions should prioritize enhancing mothers' internal health beliefs and clinical symptom evaluation skills rather than focusing solely on knowledge transfer. Keywords: diarrhea; health belief model; mothers; pediatric nursing; symptom assessment

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Journal Info

Abbrev

PMNJ

Publisher

Subject

Nursing

Description

Pediomaternal Nursing Journal is a scientific media periodically published twice a year that contains scientific articles on health and nursing specifically related to the topic of child and maternity nursing. This journal as a medium for writers from students, lecturers, and researchers to be able ...