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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 15 Documents
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Search results for , issue "Vol. 12 No. 2 (2026): March - April" : 15 Documents clear
Low birth weight among neonates in rural areas of Indonesia: A secondary data analysis Nelwati, Nelwati; Malini, Hema; Efendi, Ferry; Kuswanto, Heri; Has, Eka Misbahatul Mar’ah; Sampurna, Mahendra Tri Arif
Belitung Nursing Journal Vol. 12 No. 2 (2026): March - April
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4163

Abstract

Background: Low birth weight (LBW) is a major global health concern because of its strong association with infant mortality, morbidity, and impaired long-term development. The determinants of LBW among neonates in rural areas of Indonesia remain underexplored. Objective: To examine the prevalence of LBW and determine its associated factors among neonates in rural areas of Indonesia.   Methods: A cross-sectional study used secondary data sources from the 2017 Indonesian Demographic and Health Survey. A total of 6,701 mothers who lived in rural areas were included. Explanatory variables were maternal age, maternal education, smoking status, parity, birth interval, twin history, antenatal care (ANC), husband support, wealth quintile, region of residence, and complications during pregnancy. The outcome variable was the prevalence of LBW. Data were analyzed using bivariate analysis with a Chi-square test (χ2) and multivariable logistic regression. Results: The prevalence of LBW was 6.65%. First birth [AOR = 1.486; 95% CI: 1.126-1.959], twin history [AOR = 27.165; 95% CI = 13.006-56.738], fewer than four ANC visits [AOR = 2.193; 95% CI = 1.519-3.164], and complications during pregnancy [AOR = 1.890; 95% CI = 1.427-2.503] were significantly associated with the prevalence of LBW. Conclusion: This study revealed the prevalence of LBW among neonates in rural areas of Indonesia. First birth, twin history, ANC visits, and complications during pregnancy were significantly associated with LBW. It is suggested that health professionals should strengthen the quality of antenatal care and improve health promotion and education during pregnancy for rural mothers to reduce the prevalence of LBW.
The relationship between nurses’ speaking up about patient safety and nursing work environment in Saudi Arabia: A cross-sectional study Albalawi, Rawan; Gheith, Nirvana Abdelrahman; Felemban, Ebaa
Belitung Nursing Journal Vol. 12 No. 2 (2026): March - April
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4233

Abstract

Background: Despite nurses’ proximity to patient care, many remain reluctant to voice safety concerns. A significant gap exists in understanding how the professional work environment influences these behaviors within the Saudi Arabian context, where specific cultural and hierarchical norms may impact communication. Objective: This study examined the relationship between nurses’ speaking up regarding patient safety and the nursing work environment in Saudi Arabia. Methods: A cross-sectional descriptive correlational design was used. Data were collected from 270 nurses between August and September 2024 using the Speaking Up About Patient Safety Questionnaire (SUPS-Q) and the Practice Environment Scale of the Nursing Work Index (PES-NWI). Statistical analyses were conducted using SPSS version 28, including descriptive statistics, Spearman’s rank correlation, and ANCOVA. Results: The nursing work environment showed a significant correlation with the speak-up climate. Weak but statistically significant negative correlations were found between perceived concerns and nurse participation (r = -0.210, p = 0.001), quality foundations (r = -0.155, p = 0.011), staffing adequacy (r = -0.184, p = 0.002), and nurse–physician relations (r = -0.156, p = 0.010). Withholding voice also negatively correlated with quality foundations (r = -0.149, p = 0.014) and nurse–physician relations (r = -0.138, p = 0.023). Psychological safety and an encouraging environment showed strong positive correlations with all work environment dimensions (p < 0.001). ANCOVA indicated that education level significantly predicted speaking up (p = 0.042), and experience influenced perceptions of the work environment (p = 0.002), while age and nationality were not significant. Conclusion: Strengthening the work environment is a clinical necessity for safety. Organizations should prioritize “Just Culture” initiatives, systemic learning, and visible responses to raised concerns. Practice protocols should include “safe zones” for voicing concerns away from patients. Professional development must focus on communication skills for addressing high-authority figures. Finally, adequate staffing is essential to empower nurses to prioritize safety advocacy over basic tasks.
Predictors of health literacy among older adults with hypertension in Bali, Indonesia: A cross-sectional study Krisnayanti, Putu Mega; Promnoi, Chantra; Chinnawong, Tippamas
Belitung Nursing Journal Vol. 12 No. 2 (2026): March - April
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4270

Abstract

Background: The prevalence of hypertension in Indonesia continues to increase, particularly in Bali. However, existing research focusing on health literacy in Indonesia, especially among older adults with hypertension, is still limited and outdated. Objective: This cross-sectional predictive design study aimed to examine the level of health literacy among older adults with hypertension and its associated factors. Methods: Two hundred ninety-six eligible older adults with hypertension were purposively selected from two regencies in Bali. Data were collected from March to April 2025 using the Demographic Characteristic Questionnaire, the Short-Form Health Literacy Survey (HLS-SF12), the Perceived Severity of Illness Questionnaire (PSIQ), and the Multidimensional Scale of Perceived Social Support (MSPSS). The data were analyzed using descriptive statistics and multiple regression. Results: The findings showed an adequate level of health literacy among older adults with hypertension. The regression model explained 47.80% of the variance in health literacy (R² = 0.478). Significant associated factors of health literacy included perceived severity of illness (β = 0.353, p < 0.001), social support (β = 0.347, p < 0.001), and social activity engagement (β = 0.166, p < 0.001). However, use of media (β = 0.039, p = 0.375) and access to healthcare services (β = 0.001, p = 0.977) were not statistically significant predictors of health literacy among older adults with hypertension. Conclusion: Perceptions of illness severity, along with social support and social activity engagement, play a fundamental role in shaping the health literacy of older adults with hypertension in Bali. These findings can guide nurses in developing a tailored education program to help older adults better understand illness severity and promote social integration.
The relationship between leadership styles of nurse managers, nurse motivation, and turnover intention among nurses in Saudi Arabia: A descriptive correlational study Aldhafeeri, Nouf Afit; Alshutwi, Sitah S.; Alotaibi, Ahoud Mofareh; Alanaza, Albandre Eid; Jaber, Amirah Hussain; Alharbi, Asrar Saleh; Alowais, Raghad Khalid
Belitung Nursing Journal Vol. 12 No. 2 (2026): March - April
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4297

Abstract

Background: Nurses’ perceptions of their nurse managers’ leadership styles influence work motivation and turnover intention. However, limited evidence is available from Middle Eastern healthcare settings, particularly in Saudi Arabia. Objective: This study aimed to examine the relationships between nurse managers’ leadership styles, nurses’ work motivation, and turnover intention, and assessed whether work motivation moderates the association between leadership styles and turnover intention. Methods: A cross-sectional survey was conducted among 377 nurses working in governmental hospitals in Riyadh, Saudi Arabia, between January and March 2024. Leadership styles were measured across four dimensions: directive, supportive, participative, and achievement-oriented leadership. Data were analyzed using descriptive statistics, Pearson correlation analysis, and multivariate linear regression, followed by moderation analysis. Results: The mean scores for supportive, participative, directive, and achievement-oriented leadership were 5.3 ± 1.0, 5.1 ± 1.0, 5.0 ± 1.0, and 4.9 ± 1.0, respectively. The mean scores for work motivation and turnover intention were 3.5 ± 0.9 and 3.1 ± 0.8. Correlation analysis indicated that all leadership styles were positively associated with work motivation, whereas only directive leadership was negatively associated with turnover intention. In multivariable regression analyses, after adjustment for sociodemographic and professional factors, achievement-oriented leadership remained significantly associated with higher work motivation (β = 0.51, p = 0.034), while directive leadership was independently and negatively associated with lower turnover intention (β = -0.15, p = 0.022). Nationality, educational level, years of experience, and working area were also significantly associated with turnover intention in adjusted models, while educational level and years of experience were associated with nurses’ perceptions of leadership styles. Moderation analysis showed that work motivation did not significantly moderate the relationship between directive leadership and turnover intention. Conclusion: Leadership styles were significantly associated with nurses’ work motivation and turnover intention. Achievement-oriented leadership was linked to higher work motivation, while directive leadership was associated with lower turnover intention. These findings highlight the importance of strengthening nurse managers’ leadership competencies to enhance nurses’ motivation and potentially reduce turnover intentions in hospital settings.  
Maternal guilt in the lives of female ICU nurses in South Kalimantan, Indonesia: A qualitative study Hairina, Yulia; Hartini, Nurul; Nursalam
Belitung Nursing Journal Vol. 12 No. 2 (2026): March - April
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4329

Abstract

Background: Maternal guilt is a common emotional experience among working mothers, often associated with challenges in fulfilling both professional and caregiving roles. Female nurses, especially those working in intensive care units (ICUs), encounter pressures due to heavy workloads, irregular schedules, and the emotional intensity of patient care. These conditions make them particularly vulnerable to feelings of guilt when family responsibilities are perceived as being neglected. Objective: This study aimed to explore how maternal guilt is experienced in the personal and professional lives of female ICU nurses in South Kalimantan, Indonesia. Methods: A qualitative descriptive design using thematic analysis within a constructivist paradigm was employed. Ten married female ICU nurses who were mothers and had at least five years of ICU experience were purposively recruited through nurse managers from three regional public hospitals. Data were collected through in-depth semi-structured interviews, with member checking and researcher triangulation used to enhance credibility. Interviews were conducted between March and June 2024, transcribed, translated, and analyzed following Braun and Clarke’s six-phase framework. Results: Three themes were identified: (1) the internal burden of perceived inadequacy, reflected in persistent feelings of inadequacy, emotional exhaustion, cognitive overload, anxiety and sadness, and self-blame; (2) relational strain and compensatory parenting, including disrupted parent–child bonding, compensatory parenting behaviors, and increased emotional dependence on spouses; and (3) professional strain and competing care responsibilities, characterized by reduced work focus and distraction, fatigue and thoughts of resignation, and role conflict between professional and maternal responsibilities. These findings indicate that maternal guilt emerged as a multidimensional experience permeating both personal and professional domains. Conclusion: Maternal guilt emerged as a salient experience shaping nurse mothers’ emotional well-being, family relationships, and professional functioning. The findings suggest that collectivist cultural expectations and idealized motherhood norms may contribute to shaping the experience of guilt among Indonesian ICU nurses.  These insights underscore the need for supportive workplace policies, flexible scheduling, and accessible psychosocial services to sustain nurses’ well-being and retention in high-demand clinical environments.
Current situation and influencing factors of emergency department visits by non-urgent young and middle-aged patients in China: A retrospective study Wu, Lizhen; Feng, Xiaowei; Dai, Huihua
Belitung Nursing Journal Vol. 12 No. 2 (2026): March - April
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4363

Abstract

Background: Escalating emergency department overcrowding poses a serious threat to healthcare delivery, leading to reduced quality of care, increased risk of infection transmission, and heightened tension between medical staff and patients. Objective: This study aimed to investigate the status of emergency department visits by young and middle-aged patients triaged as non-urgent and to explore the influencing factors. Methods: This study retrospectively analyzed clinical data from 55,578 young and middle-aged patients who visited the emergency department of a tertiary class A hospital in Guangdong Province between January 1 and December 31, 2024. Patients were grouped into urgent and non-urgent based on triage classification. The differences in the clinical indicators between the two groups were compared. Logistic regression analysis was conducted to identify the factors associated with non-urgent triage classification. Results: Among the included young and middle-aged patients, 35,314 (63.5%) were classified as non-urgent cases, while 20,264 (36.5%) were classified as urgent. Binary logistic regression analysis revealed that non-urgent triage classification was significantly associated with the following factors (p < 0.05): visiting Emergency Fever (OR = 1.513) and Emergency Gastroenterology (OR = 4.278) compared to Emergency Internal Medicine and Surgery; arriving on foot or by other modes (OR = 6.073) compared to ambulance transport; visiting during the afternoon shift (OR = 1.110) compared to morning shift, on weekends (OR = 1.111), and during the autumn (OR = 1.140) and winter seasons (OR = 1.083) compared to spring. Conclusion: The rate of non-urgent triage among young and middle-aged patients is high. Triage nurses should be particularly vigilant in assessing patients presenting to departments with a higher likelihood of non-urgent classification, such as the Emergency Fever and Emergency Gastroenterology, as well as those arriving without ambulance transport, during non-working hours and peak flu seasons. These findings can inform nurse-led strategies, such as dynamic staffing and guiding appropriate patients to alternative services, such as internet hospitals, thereby mitigating emergency department overcrowding. It should be noted that in this study, non-urgent status was defined solely by the triage system and was not validated against clinical outcomes; therefore, the findings describe patterns of triage classification rather than objective patient acuity.
Unseen burden: Prevalence and determinants of possible sarcopenia in Indonesian older adults – a secondary data analysis Halilintar, Via Dolorosa; Pujiyanto
Belitung Nursing Journal Vol. 12 No. 2 (2026): March - April
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4368

Abstract

Background: Indonesia is experiencing rapid population aging, raising concern about muscle weakness in later life; possible sarcopenia offers early identification through low handgrip strength. Objective: To estimate the prevalence of possible sarcopenia and its determinants among older adults in Indonesia. Methods: This secondary analysis used baseline data from the Indonesian Longitudinal Aging Survey 2023 and included adults aged sixty years or older with valid handgrip measurements. Possible sarcopenia followed the Asian Working Group for Sarcopenia 2019 thresholds using the maximum of two trials per hand. Covariates included sociodemographic, behavioral, functional, and clinical factors. We applied descriptive statistics, bivariate tests, and multivariable logistic regression, with probit average marginal effects. Sampling weights were unavailable in the public-use microdata; we treated enumeration areas as the primary sampling units, with available stratification and no weights; estimates were unweighted, and standard errors were design-based (survey-corrected). Results: Among 1,598 participants, the prevalence of possible sarcopenia was 51.1%. Older age, low physical performance, and urban residence were associated with higher odds. Higher body mass index and better cognition were associated with lower odds. A prespecified sex-by-body mass index interaction suggested attenuation of the protective association of body mass index among women. Conclusion: Possible sarcopenia is common among older Indonesians and is patterned by age, body composition, cognition, functional status, and residential context. Community health services, including community nursing services, can integrate routine handgrip assessment with brief interventions on strength activities, nutrition, and cognitive engagement to identify risk early and inform preventive care.
Transition to fatherhood among first-time expectant fathers having couvade syndrome in northern Thailand: A grounded theory study Sritawan, Piyawan; Sansiriphun, Nantaporn; Deeluea, Jirawan; Chaloumsuk, Nonglak; Krikitrat, Preeyakamon
Belitung Nursing Journal Vol. 12 No. 2 (2026): March - April
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4372

Abstract

Background: Transitioning to fatherhood for the first time is a significant milestone in a man’s life, especially among first-time expectant fathers having couvade syndrome, which causes them to experience changes both physically and psychologically. However, there is a lack of existing research on the process of transition to fatherhood among first-time expectant fathers having couvade syndrome. Objective: This study aimed to explore the process of transition to fatherhood among first-time expectant fathers having couvade syndrome. Methods: This study adopted a constructivist grounded theory methodology. Participants included 20 first-time expectant fathers having couvade syndrome who were purposively selected from antenatal clinics of two hospitals in northern Thailand. Data were collected between March 2021 and October 2023 using in-depth interviews following Charmaz’s steps. Data were corrected and analyzed until theoretical saturation. Results: “Evolving new father’s role over couvade syndrome” emerged as the core category representing their transition into fatherhood. This process consisted of three phases. Phase I was experiencing couvade syndrome that involved confirming couvade syndrome and responding to couvade syndrome. Phase II focused on handling couvade syndrome by accepting it and adapting behaviors. Phase III was stepping into the father’s role as couvade syndrome symptoms resolved, encompassing freaking out about the new father’s role, dealing with it, and planning for raising the baby. Conclusion: This study generated new knowledge regarding the transition to fatherhood among first-time expectant fathers experiencing couvade syndrome that involves three phases: in early pregnancy, around the middle of pregnancy, and towards the end of pregnancy. The insights can be used to inform nursing interventions to provide comprehensive, phase-specific antenatal care for these fathers.
Factors predicting the 7-day period prevalence of low back pain among female undergraduate nursing students in an online learning environment: A multi-center cross-sectional study across Thailand Summart, Ueamporn; Butsripoom, Benjamaporn; Polpanadham, Panicha; Palanupat, Thippawan; Piwpong, Ratchanee; Wittayapun, Yuwadee
Belitung Nursing Journal Vol. 12 No. 2 (2026): March - April
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4377

Abstract

Background: Most nursing students are female and represent a high-risk group for low back pain (LBP) before entering the workforce. However, the prevalence and specific predictors for LBP in this population remain poorly defined. Objective: This study investigated the prevalence and predictive factors of LBP among a nationally representative sample of Thai female nursing students. Methods: A cross-sectional online survey was conducted in 2022 among 3,490 female students from 18 nursing schools across Thailand. Data collected included demographics, online learning habits, psychological health, and LBP perceptions. Binary logistic regression was used to identify predictors of LBP. A p < 0.05 was deemed significant. Results: The seven-day period prevalence of LBP after six months of online learning was 39.5% (95% CI = 37.3-40.6). Factors significantly predicting LBP included anxiety [mild-to-moderate (AOR = 1.54, 95% CI = 1.31–1.82) and severe-to-extremely severe (AOR = 1.47, 95% CI = 1.13–1.91)], prolonged sitting (AOR = 1.52, 95% CI = 1.14–2.04), smartphone use for learning (AOR = 1.44, 95% CI = 1.23–1.68), bent posture (AOR = 1.33, 95% CI = 1.16–1.61), fatigue (per 10-point increase; AOR = 1.27, 95% CI = 1.11–1.46), and participation in online learning classes (AOR = 1.07, 95% CI = 1.02–1.12). Likewise, the final model demonstrated modest discriminatory power (AUC = 0.68, 95% CI = 0.63–0.74; p < 0.001). While the model significantly differentiates between students with and without LBP, its clinical utility is constrained by the condition’s multi-factorial nature. Conclusions: LBP is common among female nursing students and is driven by a combination of ergonomic and psychological factors. Nursing education programs should implement routine screening for both physical and mental well-being, alongside targeted preventive interventions to manage these modifiable risk factors before students enter professional practice.
Degree of burnout and leadership efficacy among nurse managers in a tertiary maternity hospital in Qatar: A sequential explanatory mixed-methods study Tapawan, Ana Mari Karla; Silang, John Paul Ben Tabar; Vallesteros, Liwayway T.; Jesus, David Hali de; Fabros, Marietta; Rosa, Ronnell Dela; Tomy, Jim; Ibrahem, Rana Aatif Salim; Al-Lenjawi, Badriya
Belitung Nursing Journal Vol. 12 No. 2 (2026): March - April
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4386

Abstract

Background: Nurse managers play a critical role in maintaining effective clinical operations and staff performance. However, research examining burnout and leadership efficacy in maternity care settings remains limited. Objective: To examine burnout and leadership efficacy among nurse managers. Methods: A sequential explanatory mixed-methods study was conducted at a tertiary maternity hospital in Doha, Qatar. In Phase I, 125 nurse managers were recruited through convenience sampling and completed the Maslach Burnout Inventory–Human Services Survey for Medical Personnel and the Leadership Efficacy Questionnaire. In Phase II, eight participants were purposively selected for in-depth interviews. Quantitative and qualitative findings were integrated using a joint display approach. Results: Participants reported moderate emotional exhaustion (M = 22.85, SD = 12.69) and depersonalization (M = 7.40, SD = 5.31), alongside high personal accomplishment (M = 42.19, SD = 5.75). Leadership efficacy scores indicated moderate confidence across leader action, leader means, and self-regulation domains. Emotional exhaustion and depersonalization were negatively correlated with all domains of leadership efficacy, whereas personal accomplishment was positively correlated with them. Qualitative findings identified workload, staff management demands, and personal stressors as key contributors to burnout, while resilience, support systems, and adaptive coping strategies were associated with leadership efficacy. Integration indicated that burnout and leadership efficacy co-occur, with inverse associations suggesting that higher burnout is associated with lower leadership confidence, despite sustained functional performance. Conclusion: Burnout and leadership efficacy are significantly associated among nurse managers. Although leadership functioning appears to be maintained, emotional strain is related to reduced leadership confidence. Organizational strategies that address workload demands, strengthen support systems, and promote resilience may help mitigate burnout and support leadership effectiveness.

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