Holistic Nursing PLUS
Vol. 4 No. 2 (2026): Holistic Nursing Plus

Implementation of a Nola J. Pender-Based Health Promotion E-Module to Improve Knowledge and Treatment Adherence Among Patients with Pulmonary Tuberculosis

Khaireza Rindang Kamudi (universitas muhammadiyah surakarta)
ani syafriati (Universitas Muhammadiyah Surakarta)



Article Info

Publish Date
31 Oct 2026

Abstract

Background: Pulmonary tuberculosis (TB) remains a major public health concern, requiring effective educational strategies to improve patient knowledge and treatment adherence. Purpose: This study evaluated the effectiveness of a Nola J. Pender’s Health Promotion Model-based educational e-module in improving knowledge and treatment adherence among patients with pulmonary TB. Methods: A quasi-experimental pretest–posttest control group study was conducted at RSUP Surakarta, Central Java, Indonesia. Fifty participants were included, comprising 26 in the intervention group and 24 in the control group. The intervention group received e-module-based education, while the control group received routine education. Data were analyzed using the Wilcoxon signed-rank and Mann–Whitney U tests. Results: Knowledge improved significantly in the intervention group (Z = −4.309, p < 0.001), with 24 participants improving. Treatment adherence also improved significantly (Z = −3.651, p < 0.001), with 21 participants improving. Between-group differences were significant for knowledge (U = 172.000, p = 0.006) and treatment adherence (U = 156.000, p = 0.002), with higher mean ranks in the intervention group. Conclusions: The Health Promotion Model-based e-module may improve knowledge and treatment adherence among patients with pulmonary TB. Further studies with larger samples and longer follow-up are recommended.

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Journal Info

Abbrev

HCN

Publisher

Subject

Health Professions Nursing

Description

Holistic Nursing PLUS (HNP) focuses on publishing articles that advance knowledge and scientific progress while promoting holistic nursing and health care practice through the fundamental Pillars, Longevity, Ubiquity, and Solitude in the fields of nursing, such as complementary and alternative, ...