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Belitung Nursing Journal
Published by Belitung Raya Publisher
ISSN : 2528181x     EISSN : 24774073     DOI : -
Core Subject : Health,
Nursing
BNJ contributes to the advancement of evidence-based nursing, midwifery and healthcare by disseminating high quality research and scholarship of contemporary relevance and with potential to advance knowledge for practice, education, management or policy. BNJ welcomes submissions of evidence-based clinical application papers, original research, systematic review, case studies, perspectives, commentaries, letter to editor and guest editorial on a variety of clinical and professional topics.
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Articles 14 Documents
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Search results for , issue "Vol. 11 No. 4 (2025): July - August" : 14 Documents clear
Effect of life purpose program on the wellness of juvenile delinquents with a history of alcohol use detained at the juvenile detention center: A quasi-experimental study Balthip, Karnsunaphat; Phoomchaiya, Sirimas; Nudla, Palida; Suwanruangsri, Sarana; Sathirapanya, Chutarat; Buathong, Napakkawat
Belitung Nursing Journal Vol. 11 No. 4 (2025): July - August
Publisher : Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3795

Abstract

Background: Juvenile delinquency with a history of alcohol use is a growing concern with a significant impact on their holistic well-being. Life purpose (LP) has been recognized as essential for enhancing adolescent wellness. LP should therefore be useful in addressing juvenile delinquency. Objective: This quasi-experimental study investigated the effect of the life purpose program on the wellness of juvenile delinquents with a history of alcohol use in Southern Thailand. Methods: Sixty-seven delinquents, aged 15 to 19, from the Juvenile Detention Center were randomly assigned to either the intervention group (n = 35) or the control group (n = 32). The intervention group engaged in an eight-week purpose program, whereas the control group continued with routine care. Wellness outcomes were measured using the Wellness Scale (WS) and analyzed through multilevel mixed-effects modeling. Results: At baseline, there were no significant differences in wellness scores between the control and intervention groups. Following the intervention, wellness scores at weeks 16 and 24 were significantly higher in the intervention group compared to the control group (t = -6.101, p<0.001; t = -2.856, p = 0.008, respectively). The multilevel mixed effects model confirmed a significant improvement in wellness scores over time in the intervention group (β = 3.746; 95% CI = 0.22–7.27; p = 0.037). Conclusion: The program was successful in improving wellness among juvenile delinquents with a history of alcohol use and shows promise for broader application. It should be implemented by nurses and other professionals as part of efforts to promote a sense of life purpose in similar populations. However, further research is needed to evaluate its long-term impact and sustainability. Integrating the life purpose program into existing rehabilitation processes may enhance the overall well-being of juvenile detainees. Trial Registry Number: Thai Clinical Trials Registry (TCTR20241217002)
Factors influencing the implementation of Integrated Management of Neonatal and Childhood Illness (IMNCI) by nurses in Bhutan: A predictive correlational study Pelden, Sonam; Patoomwan, Autchareeya; Daramas, Tipawan
Belitung Nursing Journal Vol. 11 No. 4 (2025): July - August
Publisher : Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3816

Abstract

Background: Integrated Management of Neonatal and Childhood Illness (IMNCI) is a critical strategy aimed at improving child health outcomes. In Bhutan, nurses play a frontline role in implementing IMNCI guidelines, yet factors influencing their implementation remain underexplored. Objective: This study aimed to identify the predictors of IMNCI implementation among nurses in selected hospitals in Bhutan. Methods: A correlational predictive design was used, involving 107 nurses from nine hospitals across Bhutan. Data on demographics, supplies/resources, supervision, attitude, workload, nurse management skills, and IMNCI implementation were collected between November and December 2023 through structured questionnaires. Multiple linear regression analysis was conducted to determine factors predicting IMNCI implementation. Results: Nurse management skill was the only significant predictor of IMNCI implementation (β = 0.321, p <0.001), while other variables such as supplies/resources, supervision, attitude, years of service, training, and workload showed no significant predictive value. The model explained 16.8% of the variance in IMNCI implementation. Conclusion: Nurse management skills play a pivotal role in effective IMNCI implementation in Bhutanese hospitals. However, the modest explanatory power suggests other factors may influence implementation, warranting further research to enhance child healthcare delivery through strengthened nurse leadership and systemic support.
Exploring dementia care for community-dwelling older adults in Thailand: A qualitative descriptive study Mongklam, Parichat; Kraithaworn, Phachongchit; Piyatrakul, Sangduen
Belitung Nursing Journal Vol. 11 No. 4 (2025): July - August
Publisher : Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3835

Abstract

Background: Dementia is a growing public health concern in Thailand, placing significant demands on families, communities, and the healthcare system. Despite national policies supporting integrated care, community-based dementia services face challenges related to resource limitations, caregiver burden, and access to training. Objective: This study aimed to explore the delivery of dementia care for community-dwelling older adults in Thailand, focusing on care processes, challenges, and support systems from the perspectives of community health nurses (CHNs), village health volunteers (VHVs), and family caregivers. Methods: A qualitative descriptive approach was used. Twenty-two participants, including CHNs, VHVs, and family caregivers, were purposively selected from a metropolitan district in Thailand. Data were collected through semi-structured interviews and focus group discussions, supplemented by contextual health assessments. Thematic analysis was conducted using Sandelowski’s content analysis framework, with rigor ensured through member checking, audit trails, and peer debriefing. Results: Six categories emerged: 1) Care processes involved integrated services across prevention, promotion, treatment, and rehabilitation, with family playing a central role; 2) Conditional factors included strong cultural values of filial responsibility and provider-community trust; 3) Care outcomes reflected partial independence in older adults, with caregivers experiencing varying levels of well-being and frequent stress due to lack of support and training; 4) Successes were attributed to supportive policies, family dedication, and healthcare providers’ intrinsic motivation; 5) Barriers included staff shortages, caregiver health issues, limited training, and insufficient confidence in VHVs; 6) Model development emphasized the need for policy backing, multidisciplinary collaboration, caregiver capacity-building, and dementia-specific community services. Conclusion: Community-based dementia care in Thailand is driven by cultural commitment and dedicated local health workers but hindered by systemic constraints. Strengthening caregiver education, expanding service networks, and enhancing integrated support systems are critical for improving care quality and reducing caregiver burden. Equipping CHNs and VHVs with dementia-specific training and supporting their role in caregiver education and interdisciplinary coordination can further enhance the effectiveness and sustainability of dementia care in community settings.
Health-related quality of life in Thai patients with hepatocellular carcinoma and its influencing factors: A cross-sectional study Pathomjaruwat, Thitiporn; Matchim, Yaowarat; Armer, Jane M.
Belitung Nursing Journal Vol. 11 No. 4 (2025): July - August
Publisher : Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3853

Abstract

Background: Health-related quality of life (HRQoL) is a critical indicator in individuals with cancer. Patients diagnosed with hepatocellular carcinoma (HCC) commonly experience a decline in HRQoL due to both the progression of the disease and the adverse effects associated with treatment. Despite the high prevalence of HCC in Thailand, there is a paucity of research examining the HRQoL of Thai patients and the factors that may influence it. Objective: This study aimed to examine HRQoL in Thai patients with HCC and evaluated the relationships between disease stage, comorbidities, albumin level, functional status (FS), self-management behaviors (SMBs), and HRQoL. Methods: A correlational, cross-sectional study was conducted with 408 patients with HCC recruited from six hospitals in central Thailand between April and September 2024. Data collection included demographic and clinical information, along with the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) scale, Inventory of Functional Status-Cancer (IFS-CA), and the SMB scale for patients with HCC. All instruments were validated and reliable. Data were analyzed using descriptive statistics and multiple regression analysis. Results: Most participants were at intermediate (38.97%) or advanced (24.26%) stages of HCC. Overall HRQoL was high (mean FACT-Hep score = 147.92 ± 26.09). Disease stage, comorbidities, albumin level, FS, and SMBs were all significantly correlated with HRQoL (r = 0.771). Together, these factors explained 58.9% of the variance in HRQoL (adjusted R² = 0.589, F(5, 402) = 117.745, p <0.001). Significant predictors of HRQoL included disease stage (β = -0.116), comorbidities (β = -0.080), albumin level (β = 0.278), FS (β = 0.388), and SMBs (β = 0.296). Among these, FS was the strongest predictor. Conclusion: Improving self-management behaviors, functional status, and nutritional status shows promise for enhancing HRQoL in patients with HCC. These findings can guide nurses in developing interventions to support patients with HCC and improve their quality of life.
Translation and validation of the Saint Louis University Mental Status (SLUMS) Exam for older adults in Thailand: The SLUMS-Thai Rungruang, Komwat; Manasatchakun, Pornpun; Polsingchan, Sarinya
Belitung Nursing Journal Vol. 11 No. 4 (2025): July - August
Publisher : Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3864

Abstract

Background: The Saint Louis University Mental Status (SLUMS) Exam is a commonly used tool for screening cognitive function, particularly for detecting mild cognitive impairment (MCI) and early dementia. It was developed to overcome limitations in existing cognitive assessments by evaluating a broad range of domains, including language comprehension, executive function, memory, and attention. While effective in English-speaking populations, its use in non-English-speaking settings is limited by language and cultural differences. In Thailand, the lack of linguistically and culturally adapted cognitive screening tools can lead to inaccurate assessments. To ensure reliable and valid evaluations in older Thai adults, the SLUMS must be appropriately translated and culturally adapted. Objective: This study aimed to translate the SLUMS into Thai (SLUMS-Thai) and validate its use among older adults in Thailand. Methods: The translation process consisted of seven steps: establishing the expert team, synthesizing the translated version, forward translation, pilot testing to ensure clarity, cultural appropriateness testing, blind back-translation, and translation equivalence testing. The study involved 100 older adults. Validation was performed using descriptive statistics, Pearson’s correlations, the Index of Item-Objective Congruence (IOC), and Cronbach’s alpha coefficients. Results: The findings showed that cultural appropriateness was assessed using expert evaluations on the relevance and sensitivity of the tool to Thai cultural norms and practices, with the rate of appropriateness at the highest level (Mean = 4.97, SD = 0.71), and translation equivalence was also rated highly (Mean = 4.76, SD = 0.27). The correlation between the original SLUMS and the SLUMS-Thai was strong (r = 0.84 - 0.91). The IOC values for the 11 questions ranged from 0.80 to 1.00, and the Cronbach’s alpha coefficient was 0.83, indicating high internal consistency. The tool’s ability to differentiate between different cognitive states was proven by the Discriminant Index, which ranged from 0.23 to 0.62.  Conclusion: The SLUMS-Thai demonstrated acceptable content validity and strong psychometric properties that were linguistically and culturally appropriate. As a consequence, the SLUMS-Thai can be used to screen older persons for dementia and mild cognitive impairment in Thailand and may be helpful for modifying interventions for accurate diagnosis and cognitive function assessment.
Lived experiences of recovery among persons with schizophrenia in Thailand: A qualitative study Jundeekrayom, Surada; Soonthornchaiya, Rangsiman; King, Beth
Belitung Nursing Journal Vol. 11 No. 4 (2025): July - August
Publisher : Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3885

Abstract

Background: Schizophrenia is a chronic and disabling mental illness that presents a significant public health challenge worldwide. It affects multiple aspects of an individual’s life, often resulting in poor health outcomes, disability, and impaired daily functioning. With advances in ongoing care and relapse prevention, the focus of treatment has shifted toward promoting remission and personal recovery. However, few studies have explored the lived experiences of recovery among individuals with schizophrenia in Southeast Asia, especially within the Thai cultural context. Objective: This study aimed to explore the lived experiences of recovery among individuals with schizophrenia in Northeastern Thailand. Methods: A qualitative hermeneutic phenomenological approach was used. Twenty-three community-dwelling individuals in the recovery phase of schizophrenia were purposively selected. Data were collected through in-depth, face-to-face interviews between December 2021 and June 2022. Interviews were transcribed verbatim and analyzed using hermeneutic analysis to identify underlying themes. Results: Participants described recovery as a process of “bringing life back to normal living.” Two interrelated themes emerged: (1) Being normal through social connectedness, and (2) Living a happy and meaningful life. These themes highlight the importance of social roles, community acceptance, emotional well-being, and culturally rooted definitions of normalcy in the recovery process. Conclusion: Recovery from schizophrenia extends beyond symptom control to include social reintegration and the restoration of purpose and well-being. Psychiatric nurses play a vital role in supporting this process by developing interventions that transcend biomedical treatment, fostering social connectedness, personal meaning, and emotional resilience. Culturally sensitive, holistic care strategies are essential to help individuals achieve their own definitions of a fulfilling and “normal” life.
The effectiveness of a self-efficacy enhancement program on health behaviors and clinical outcomes in people with metabolic syndrome: A quasi-experimental study in Thailand Madsong, Chalermkwan; Lininger, Jiraporn; Terathongkum, Sangthong
Belitung Nursing Journal Vol. 11 No. 4 (2025): July - August
Publisher : Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3891

Abstract

Background: Metabolic syndrome (MetS) is a cluster of chronic conditions, including obesity, hyperglycemia, hypertension, and dyslipidemia, known to significantly increase the risk of cardiovascular diseases (CVDs). Effective interventions are needed to control the progression of MetS. Objective: This study aimed to determine the effectiveness of the Self-Efficacy Enhancement (SEE) program on health behaviors and clinical outcomes in individuals with Metabolic Syndrome (MetS). Methods: A quasi-experimental study with a two-group pretest-posttest design was conducted from September 2023 to January 2024. A purposive sample of 70 participants with MetS was recruited from two healthcare settings in Thailand. Participants were divided into two groups: an experimental group (n = 35) and a control group (n = 35). The experimental group received the SEE program based on Self-Efficacy Theory, while the control group received only routine nursing care for 12 weeks. Data were collected using a Personal Information questionnaire, a Health Behavior questionnaire, and clinical outcome assessments, including waist circumference (WC), blood pressure (BP), fasting plasma glucose (FPG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL cholesterol), and non-high-density lipoprotein cholesterol (non-HDL cholesterol), before and after the 12-week program. Data were analyzed using descriptive statistics, paired t-test, independent t-test, Wilcoxon signed-rank test, Mann-Whitney U-test, and ANCOVA. Results: Following the SEE program, the experimental group exhibited significant improvements in health behaviors (t = -12.830, p <0.001), a reduction in WC (t = 3.809, p <0.001), decreased SBP (z = -4.554, p <0.001) and DBP (t = -5.178, p <0.001), and an increase in HDL cholesterol (z= -3.193, p <0.001) compared to baseline measures. Furthermore, compared to the control group, the experimental group demonstrated significantly improved health behaviors (F = 193.86, p <0.001), lower WC (F = 19.58, p <0.001), lower FPG (F = 12.39, p <0.001), lower SBP (F = 25.04, p <0.001), lower DBP (F = 19.49, p <0.001), and lower non-HDL cholesterol (F = 8.49, p <0.01). Partial eta-squared (η²) indicated large effects for health behaviors, WC, FPG, SBP, DBP, TC, and HDL cholesterol; non-HDL cholesterol showed a medium effect. TC and HDL cholesterol showed no significant change after completing the program. Conclusion: The SEE program improved health behaviors and clinical outcomes, supporting its integration into standard MetS care in nursing practice. Through e-health, education, exercise guidance, role modeling, and support, the program can boost confidence in adopting healthier behaviors and reduce CVD risk. Future studies should explore extending the program duration, as the 12-week period may have been insufficient to observe significant changes. Trial Registry Number: Thai Clinical Trials Registry (TCTR20250218014)
Life transition stages of family caregivers for patients with chronic illness: A grounded theory study Md Khalid, Norfaezah; Sajali, Nurul Salwa; Razali, Asbah
Belitung Nursing Journal Vol. 11 No. 4 (2025): July - August
Publisher : Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3896

Abstract

Background: Family caregivers play a crucial role in providing continuous support to individuals with chronic illnesses. Their responsibilities extend beyond the well-being of patients, influencing both patient health outcomes and their own. Caregiving entails significant responsibilities and sacrifices, requiring caregivers to navigate evolving roles and care needs over time. Existing literature highlights the emotional and psychological challenges faced by caregivers, including role transitions and stress. However, most studies focus on caregiving experiences rather than the specific transitional phases caregivers undergo after assuming their responsibilities. Objective: This study aimed to explore the transitional phases experienced by caregivers of chronically ill patients using an inductive approach, specifically grounded theory methodology. Methods: This study employed a grounded theory (GT) approach involving 33 participants, including 24 caregivers and nine professional helpers. Data collection and analysis were carried out between April 2022 and January 2024. Participants were recruited through snowball sampling based on predetermined criteria. Data were collected using semi-structured interviews and memos and analyzed using NVivo 12 software. Several measures were undertaken to ensure the validity and reliability of the data. Results: Findings yielded five stages of life transition, namely, (1) confusion, (2) conflict, (3) consideration, (4) adjustment, and (5) acceptance. Conclusion: This study contributes to the literature by providing new insight into the life transition phases experienced by family caregivers. It offers meaningful implications for nursing practice, particularly in providing holistic support to family caregivers of individuals with chronic illness. It helps nurses to design more targeted, phase-specific interventions that focus on caregivers’ psychosocial needs at each phase. The final model provides a beneficial premise for the development of clinical guidelines and support frameworks that are more responsive to the real experiences of caregivers.
A cross-sectional analysis of fall risk among institutionalized older adults in Malaysia Zohari, Zahira; Rahim, Azliza; Mat Din, Hazwan; Saibul, Nurfaizah; Jafri, Asiah; Rahim, Shafikah; Nasir, Faizah; Mohammad Sallehuddin, Hakimah
Belitung Nursing Journal Vol. 11 No. 4 (2025): July - August
Publisher : Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3899

Abstract

Background: Falls among older adults in institutional care are a significant concern due to their serious consequences and are further complicated by staffing constraints. Identification of key risk factors is essential for targeted prevention and closer monitoring. Objective: To identify the fall risk factors among older adults in institutional care and evaluate their relationships with overall fall risk. Methods: This retrospective cross-sectional study analyzed data from 184 residents of a public institutional care home in Selangor, Malaysia. Data were collected from January 2023 to October 2023 through fall risk assessments and medical records. A history of falls over the past 12 months was documented. Fall risk was assessed using the Downton Fall Risk Index (DFRI). Descriptive statistics were used to summarize participant characteristics and the prevalence of falls. Ordinal logistic regression was conducted to identify factors associated with higher fall risk scores. Results: The study included 184 participants (60.3% male), with the majority aged 70–79 years (45.4%). Common comorbidities were hypertension (50.5%) and diabetes mellitus (28.8%), with sensory impairments such as visual (50.0%) and hearing (32.1%) deficits. Polypharmacy was reported in 23% of participants, and almost a quarter had a history of falls. A high fall risk was observed in 39.7% of cases. Ordinal logistic regression revealed significant predictors of higher fall risk: hypertension (OR 5.93, 95% CI 2.18–16.14), polypharmacy (OR 5.53, 95% CI 2.11–14.47), visual impairment (OR 16.28, 95% CI 3.38–78.41), hearing impairment (OR 17.64, 95% CI 3.50–88.85), cognitive impairment (OR 33.12, 95% CI 4.61–237.88), psychiatric illness (OR 4.76, 95% CI 1.23–18.44), and female sex (OR 2.61, 95% CI 1.19–5.74). Conclusion: Regular fall risk assessments and tailored intervention plans that address these factors are crucial for reducing falls and improving the quality of life for this vulnerable population. These findings provide practical guidance for healthcare professionals, including nursing staff, in institutional care to prioritize high-risk residents and implement early preventive strategies.
Psychometric properties of the Indonesian version of the Quality of Life Index (QLI-I) among family caregivers of dependent older persons with type 2 diabetes mellitus Siregar, Rinco; Kritpracha, Charuwan; Chinnawong, Tippamas; Latour, Jos M.
Belitung Nursing Journal Vol. 11 No. 4 (2025): July - August
Publisher : Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3929

Abstract

Background: The quality of life (QoL) of family caregivers supporting older persons with functional dependence due to Type 2 Diabetes Mellitus (T2DM) is a growing concern. Accurately assessing caregiver well-being requires culturally appropriate, valid, and reliable instruments. However, such tools remain limited in the Indonesian context. Objective: This study aimed to translate the Quality of Life Index (QLI) into Indonesian and evaluate the psychometric properties of the Indonesian version (QLI-I) among family caregivers of dependent older persons with T2DM. Methods: Brislin’s back-translation method was used to ensure linguistic and conceptual equivalence in the translation process. Content validity was assessed by a panel of five experts. Psychometric evaluation was conducted on a purposive sample of 394 family caregivers recruited from eleven community health centers in Medan, Indonesia. Construct validity was examined using confirmatory factor analysis (CFA), while convergent validity and construct reliability (CR) were analyzed to assess measurement accuracy. Results: The Indonesian version of the Quality of Life Index (QLI-I) demonstrated strong construct validity, with standardized factor loadings ranging from 0.707 to 0.870. CFA indicated an acceptable model fit based on the following indices: Root Mean Square Error of Approximation (RMSEA) = 0.067, ratio of chi-square to degrees of freedom (CMIN/df) = 2.779, Comparative Fit Index (CFI) = 0.906, Incremental Fit Index (IFI) = 0.906, Goodness of Fit Index (GFI) = 0.814, and Tucker-Lewis Index (TLI) = 0.898. Composite Reliability (CR) values were high across all domains: Health/Functioning (HF) = 0.957, Family (FA) = 0.876, Social/Economic (SE) = 0.924, and Psychological/Spiritual (PS) = 0.922. Average Variance Extracted (AVE) values met the recommended threshold for each domain: HF = 0.633, FA = 0.586, SE = 0.605, and PS = 0.627. All constructs demonstrated acceptable discriminant validity, confirming the distinctiveness of each domain. Conclusion: The QLI-I is a valid and reliable instrument for assessing the QoL of family caregivers of dependent older persons with T2DM. Its use in clinical and community settings can support nurses and healthcare professionals in identifying caregiver needs and developing culturally appropriate, evidence-based interventions to enhance caregiver well-being.

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