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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 13 Documents
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Search results for , issue "vol. 12 no. 4 (2026): july - august" : 13 Documents clear
Adaptation of Parental Perception of Uncertainty Scale (PPUS): A psychometric study in a genetic research center in Indonesia Irene Astrid Larasati; Vynda Ulvyana; Hardian Hardian; Agustini Utari; Tri Indah Winarni
Belitung Nursing Journal Vol. 12 No. 4 (2026): July - August
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4312

Abstract

Background: Parents’ inability to generate meaning in events related to their child, especially a chronic illness, leads to uncertainty. This could negatively impact the management and outcome of their child and family well-being. Nevertheless, there is no available tool to measure parental uncertainty in Indonesia. Objective: The study aimed to evaluate the validity and reliability of the Indonesian version of the Parent’s Perception of Uncertainty Scale (PPUS) using an exploratory approach. Methods: This was a psychometric properties study conducted in 2020 among parents of children with genetic conditions, i.e., congenital adrenal hyperplasia (CAH), type 1 diabetes mellitus (T1DM), and Down syndrome (DS), recruited from pediatric endocrinology clinics in secondary and tertiary hospitals, and a genetic research center in Semarang, Central Java, Indonesia. The original PPUS was translated and back-translated into Indonesian and English. Principal Axis Factoring (PAF) was performed to measure its validity and reliability. IBM SPSS version 26 and JASP version 0.18 were utilized to perform descriptive and parallel analysis, respectively. Partitioning Around Medoids (PAM) was analyzed using RStudio version 2026.05.0 on R version 4.6.0. Results: A total of 259 parents (105 fathers and 154 mothers) of 170 children with CAH, T1DM, and DS completed the questionnaire. Samples were adequate (KMO = 0.857), and factor analysis was feasible (Bartlett p < 0.01). The Indonesian version of PPUS comprised 24 items forming three subscales, i.e., Ambiguity, Unpredictability, and Lack of Clarity (α = 0.839). Conclusion: Despite requiring further refinement in a homogeneous sample, the Indonesian PPUS demonstrated potential use in research on parental uncertainty and proposing future nursing interventions aimed at improving family-centered care.
Family-centered early intervention: A concept analysis to guide pediatric and community nursing practice Mardiyanti Mardiyanti; Yeni Rustina; Nani Nurhaeni; Nur Agustini
Belitung Nursing Journal Vol. 12 No. 4 (2026): July - August
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4328

Abstract

Background: Family-Centered Early Intervention (FCEI) is increasingly recognized as a framework for promoting child development and family empowerment. However, its application in nursing practice may be limited by the lack of a clear distinction between FCEI, Family-Centered Care (FCC), and Patient- and Family-Centered Care (PFCC). Objective: To clarify the concept of FCEI and distinguish it from FCC and PFCC by identifying its defining attributes, antecedents, consequences, and empirical referents. Methods: Walker and Avant’s eight-step concept analysis method was applied. A comprehensive search was conducted across five databases (PubMed, CINAHL, Scopus, ERIC, and Taylor & Francis) for studies published between January 2010 and September 2025. After screening, 49 of 1,958 identified records were included. Results: Seven defining attributes distinguished FCEI from FCC and PFCC: family capacity building, caregiver-mediated intervention (coaching), natural environment-based delivery, routines-based intervention, timeliness and early action, orientation toward developmental and functional outcomes, and an enabling system. These attributes position families as the primary agents of developmental change and situate intervention within everyday routines and natural environments. Antecedents included developmental screening, coordinated service systems, and provider coaching competencies, while consequences encompassed improved child developmental outcomes, greater parental self-efficacy, enhanced family quality of life, and stronger service coordination. Conclusion: FCEI is a distinct developmental intervention framework that extends family-centered principles beyond clinical care toward caregiver coaching, family capacity building, and developmental support in everyday contexts. Integrating FCEI into pediatric and community nursing may strengthen early identification, family empowerment, and coordinated developmental care, particularly in low- and middle-income countries.
Factors associated with extravasation severity in Thai patients receiving noncytotoxic intravenous infusions: An observational study Thitiporn Pathomjaruwat; Borwarnluck Thongthawee; Padcha Pongcharoen; Charturong Tantibundhit
Belitung Nursing Journal Vol. 12 No. 4 (2026): July - August
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4436

Abstract

Background: Extravasation is a serious complication of peripheral intravenous (PIV) therapy. It has been linked to mechanical disruption of a PIV line due to inappropriate site selection or securement, and to the pH, concentration, and cytotoxic properties of the infused solution or drug. However, evidence on extravasation in patients receiving noncytotoxic drugs remains limited. Understanding the causes and risk factors in this population is essential for prevention, early detection, and the development of interventions. Objective: To examine demographic and clinical factors associated with extravasation severity in adult Thai patients receiving noncytotoxic drug PIV therapy. Methods: This observational study included 193 participants at high risk of extravasation during PIV therapy. They were recruited from four tertiary hospitals in four regions of Thailand between December 2019 and December 2023 using purposive sampling. Extravasation severity was assessed using an artificial deep neural network for automated screening of skin images via a smartphone application, with confirmation by a dermatologist. Demographic, clinical, and medical data were collected using standardized forms and analyzed with descriptive statistics and Spearman’s rank correlation coefficient. Results: Extravasation was mostly mild (47.67%), followed by moderate (31.09%) and severe (21.24%). Extravasation severity was strongly and negatively correlated with drug pH (r = −0.532; p < 0.01), moderately with concentration (r = 0.411), and methods of drug administration (r = 0.327) (p < 0.01). History of IV insertion showed a mild correlation with severity (r = 0.145; p < 0.05) but not with comorbidities, infusion duration, or catheter size. Conclusion: The results highlight the importance of drug administration, especially the pH and type of drug, concentration, and route of administration, which play a critical role in reducing extravasation, thereby improving PIV therapy outcomes. Nurses play a role in preventing and managing extravasation by controlling the drug’s pH and concentration, carefully monitoring early signs, and promptly initiating interventions.
Corrigendum to “The experiences of Chinese colorectal cancer survivors in marital intimacy after ostomy creation: A qualitative study” [Belitung Nursing Journal, 2024; 10(2): 222-230] Xixi Du; Suchira Chaiviboontham; Bualuang Sumdaengrit
Belitung Nursing Journal Vol. 12 No. 4 (2026): July - August
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4456

Abstract

This corrigendum corrects clerical errors regarding the data collection timeline and interview methodology in the original article (DOI: https://doi.org/10.33546/bnj.3212). The authors confirm that these administrative corrections do not affect the methodology, data analysis, results, or conclusions of the original study and sincerely apologize for any inconvenience caused.
Eye care compliance in intensive care units: A concept analysis Abdulkareem S. Iblasi; Cansu Polat Dünya; Zoelfikar Dafalla Mohamed; I Gede Juanamasta
Belitung Nursing Journal Vol. 12 No. 4 (2026): July - August
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4478

Abstract

Background: Despite the availability of evidence-based eye-care protocols, compliance among nurses in intensive care units (ICUs) remains inconsistent. Conceptual ambiguity between adherence, compliance, and protocol implementation has limited the development of valid measures and targeted interventions. Objective: To clarify and define the concept of Eye Care Compliance in ICUs through a systematic concept analysis. Methods: This concept analysis followed the eight-step framework of Walker and Avant. CINAHL Plus, PubMed, Scopus, Web of Science, and ScienceDirect were searched for studies published between 2015 and 2025. Database-specific search strings and eligibility criteria were applied, and studies were screened and selected based on predefined inclusion and exclusion criteria. Results: Of 653 records identified, 19 studies met the inclusion criteria. Eye Care Compliance was clarified as an observable nursing behavior (what nurses do), distinct from protocol compliance (following externally imposed instructions) and protocol implementation (organizational adoption of a guideline). Three defining attributes were identified: (1) consistent care: reliable, repeated delivery of all protocol-specified procedures for all at-risk patients; (2) timely care: alignment of eye-care activities with evidence-based frequency recommendations and the patient’s evolving risk profile; and (3) documented care: systematic recording of assessments, interventions, and their timing to ensure continuity and auditability. Conclusions: Eye Care Compliance is a distinct, nurse-mediated behavioral construct referring to the observable enactment of structured, evidence-based ocular protection in the ICU. This concept is operationalized as the behavior pattern in which ICU nurses systematically perform and record all protocol-specified ocular protection procedures—assessment, cleansing, eyelid closure or protection, and lubrication—for every patient meeting defined risk criterion, at the intervals required by evidence-based guidelines, with each episode documented to ensure care continuity and accountability.
Strengthening evidence-based practice culture in nursing: An ethnographic study in the central highlands of Vietnam Dang Vuong Nguyen; Apinya Jumpamool
Belitung Nursing Journal Vol. 12 No. 4 (2026): July - August
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4567

Abstract

Background: Evidence-based practice (EBP) is a vital approach to achieve Quality Improvement (QI) in healthcare services by ensuring that nursing care is grounded in the best available evidence. However, the integration of EBP into nursing in Vietnam is often lacking, presenting a significant challenge for both healthcare leaders and individual practitioners. Objectives: This qualitative study aimed to understand the workplace culture regarding EBP implementation among Vietnamese nurses, exploring the shared beliefs, values, and contextual factors that influence EBP within a tertiary hospital setting, with a particular focus on the Intensive Care Unit and other relevant departments. Method: A focused ethnographic approach was employed. Data were collected over 14 months (from late May 2024 to early July 2025) through participant observation and in-depth interviews with 30 registered nurses from various units (Nursing Department, Intensive Care Unit, Emergency Room, Neurological Department, Internal Medicine Department, and Geriatrics Department). Data analysis followed ethnographic analytic principles to identify key themes. Results: The findings revealed a complex interplay of individual, organizational, and systemic factors. Five key themes emerged: 1) Informal and experiential learning with limited research involvement; 2) Culture of task- and procedure-centered nursing practice; 3) Compliance culture; 4) Developing professional identity; and 5) Misconceptions of EBP and low-evidence conceptualization. Nurses favored experiential and peer-based learning over systematic scientific evidence. Structural constraints, including insurance policies and rigid hierarchies, further hindered EBP implementation. Conclusion: The study recommends multi-level strategies that involve policy reform, hospital management support, and enhanced nursing education to foster an environment conducive to EBP, thereby improving nursing autonomy and the quality of patient care.
Self-management-based health coaching for sustainable behavior change in chronic disease care: A concept analysis using Walker and Avant’s framework Rian Adi Pamungkas; Kathlen Potempa; Kanittha Chamroonsawasdi; Andi Mayasari Usman; Samoraphop Banharak
Belitung Nursing Journal Vol. 12 No. 4 (2026): July - August
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4575

Abstract

Background: Self-management-based health coaching is increasingly applied in chronic disease management; however, conceptual ambiguity persists regarding its defining characteristics and theoretical boundaries. A clear and consistent conceptualization is essential to strengthen its application in nursing research and practice. Objective: This study aimed to clarify the concept of self-management–based health coaching in chronic disease care. Method: A concept analysis was conducted using Walker and Avant’s framework. A systematic literature search was conducted across multiple databases (PubMed, ScienceDirect, and Google Scholar) for studies published between January 2000 and June 2025, resulting in 49 articles included in the analysis. Conceptual elements were extracted and synthesized using iterative content analysis and constant comparison. Results: The analysis identified seven core attributes (health-focused, partnership and collaboration, client-centered, goal-oriented, process-driven, enlightening, and empowering) that reflect a collaborative, client-centered, and process-oriented approach that facilitates insight and empowerment in behavior change. Antecedents included individual readiness and supportive contextual conditions, while consequences encompassed psychological, behavioral, and clinical outcomes. Model and additional cases further illustrated the concept’s application and boundaries. Conclusion: This study provides a clearer conceptual understanding of self-management–based health coaching and highlights its relevance for guiding theory-informed research and practice in chronic disease management. However, further empirical and theoretical work is needed to refine and validate the concept across diverse contexts.
Preventing iron deficiency anemia in rural Indonesia: Experiences and support needs of pregnant women and healthcare providers — a qualitative descriptive study Erli Zainal; Sri Sulistyowati; Agung Wibowo; Widiyanto Widiyanto
Belitung Nursing Journal Vol. 12 No. 4 (2026): July - August
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4588

Abstract

Background: Iron deficiency anemia remains a significant public health concern among pregnant women, particularly in rural areas of low- and middle-income countries. Despite routine antenatal care services and iron–folic acid supplementation programs, adherence to supplementation and effective anemia prevention remain challenging. Understanding how pregnant women and healthcare providers experience and respond to these challenges is essential for strengthening anemia prevention efforts in rural maternal health services. Objective: This study aimed to explore the experiences and support needs of pregnant women and healthcare providers in preventing iron deficiency anemia in rural Indonesia. Methods: A qualitative descriptive study was conducted in Seluma Regency, Bengkulu Province, Indonesia, between May and August 2025 using in-depth interviews and focus group discussions. A total of 30 participants (18 pregnant women and 12 healthcare providers, consisting of six midwives and six nutritionists) were recruited using purposive sampling through antenatal care services. Data were collected using semi-structured interview guides and analyzed using inductive thematic analysis following Braun and Clarke's approach. Results: Three themes emerged from the thematic analysis: (1) understanding anemia beyond symptoms, (2) challenges in maintaining consistent iron–folic acid supplementation, and (3) perceived structural constraints in antenatal counseling. Pregnant women demonstrated limited understanding of anemia beyond physical symptoms, which was compounded by low educational levels prevalent in the sample. Barriers to consistent supplementation included forgetfulness, side effects, and uncertainty about proper tablet intake. Healthcare providers reported that high patient volumes and limited consultation time constrained their ability to deliver comprehensive counseling and follow-up support. Conclusion: The findings demonstrate that the routine provision of iron–folic acid supplements alone are insufficient to support consistent adherence. Strengthening continuous and practical support within antenatal care through nursing- and midwifery-led education and follow-up is essential to improve anemia prevention in rural maternal health services. Strategies should be tailored to address low health literacy, daily behavioral barriers, and structural service constraints to achieve meaningful improvements in maternal anemia prevention.
Clinical and nursing correlates of severity among chronically ill adults with aspiration pneumonia in Saudi Arabia: A retrospective cross-sectional study Eman M. Gaber Hassan; Myra Cusi Britiller; Mohammad Daud Ali; May Mohammed Alshowikat; Fatimah Hassan Ahmed Alduhaim; Sarah Mohammad AlOtaibi; Asmahan Shabbab Hamad Al-Mutairi; Hassna Maquta Ali Alharthi; Dalal Sanad Almutairi; Fatimah Saleh Al Awami; Shimaa Mohammed Said
Belitung Nursing Journal Vol. 12 No. 4 (2026): July - August
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4611

Abstract

Background: Aspiration pneumonia is a major cause of morbidity and mortality in hospitalized adults, yet limited evidence exists from the Eastern region of Saudi Arabia. Objective: To identify clinical correlates of disease severity in patients with confirmed aspiration pneumonia. Methods: A retrospective cross‑sectional study was conducted using medical records of adult patients diagnosed with aspiration pneumonia across two major hospitals in Eastern Saudi Arabia (January 2018 – December 2023). A total of 294 eligible records were reviewed. Demographic, clinical, functional, and respiratory data were extracted. Bivariate and multivariable logistic regression analyses were conducted to identify factors associated with greater clinical severity, defined by respiratory compromise and treatment intensity. Results: The mean age was 63.6 years (SD 24.1); 55.1% were male, and 54.8% were fully dependent. Dysphagia or esophageal dysfunction was common, and nearly half required nasogastric feeding. In the primary multivariable model, lower oxygen saturation (aOR = 0.92, 95% CI 0.85–0.99, p = 0.035), lower Glasgow Coma Scale score (aOR = 0.81, 95% CI 0.68–0.96, p = 0.017), dysphagia/esophageal dysfunction (aOR = 2.72, 95% CI 1.15–6.40, p = 0.022), mechanical ventilation (aOR = 3.42, 95% CI 1.51–7.74, p = 0.003), and broad‑spectrum antibiotic use (aOR = 2.36, 95% CI 1.07–5.18, p = 0.033) were independently associated with greater severity. An exploratory analysis of oral hygiene was limited by sample size. Conclusions: Aspiration pneumonia in Eastern Saudi Arabia predominantly affects older, dependent adults with swallowing impairment. Independent correlates of greater severity include dysphagia, reduced consciousness, hypoxemia, and mechanical ventilation. These findings support routine dysphagia screening, structured oral care, airway protection strategies, and rehabilitative nursing interventions in chronic care pathways for at‑risk patients.
Negotiating faith in a hospital bed: A qualitative exploration of barriers to prayer (Solah) among hospitalised Muslim orthopaedic patients in Malaysia Mohd Ariff Sharifudin; Yuzana Mohd Yusop; Mai Nurul Ashikin Taib; Mohd Fitri Omar; Al Hafiz Ibrahim; Anas Mohd Yunus
Belitung Nursing Journal Vol. 12 No. 4 (2026): July - August
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4619

Abstract

Background: For Muslim patients, performing the five daily prayers (Solah) is a non-negotiable pillar of faith and a vital source of spiritual solace during illness. In Malaysia, the Ibadah-Friendly Hospital (IFH) framework was established to support this need within holistic care. However, adherence remains low, particularly among patients with physical limitations, such as orthopaedic conditions, suggesting a significant gap between policy and lived experience. Objective: This study aimed to explore in-depth the lived experiences, perceptions, and multifaceted barriers faced by hospitalised Muslim orthopaedic patients in fulfilling their obligatory prayers. Methods: A qualitative descriptive case study design was employed. Purposive sampling was used to recruit 16 Muslim patients from the orthopaedic wards of a tertiary hospital on the East Coast of Malaysia. Data were gathered via semi-structured, in-depth interviews and non-participant observations between July 2023 and February 2024. Thematic analysis was conducted using the Framework Method, facilitated by the Atlas.ti software. Trustworthiness was ensured through researcher reflexivity, audit trails, and team debriefing. Results: Three primary themes emerged from the data: (1) Negotiating Obligation and Leniency, where patients held a common misconception that religious concessions (rukhsah) permitted complete postponement rather than adaptation of prayer; (2) The Embodied Struggle of Purity and Piety, capturing profound distress over ritual impurity from medical devices (catheters, diapers) and practical hurdles with inadequate ablution facilities and missing prayer attire; and (3) The Silent Gap in Supportive Care, highlighting a systemic failure where patients perceived nurses as too busy for spiritual support, experienced gender-related discomfort, and found existing IFH facilities (e.g., prayer kits) inaccessible or unknown. Conclusion: The barriers are complex, intertwining knowledge gaps, embodied distress, and systemic shortcomings. Moving beyond infrastructural provisions, a patient-centred approach is urgently needed. This includes proactive nursing assessment of spiritual needs, tailored patient education on rukhsah, gender-sensitive assistance protocols, and training that empowers nurses to provide holistic, culturally competent care that truly supports patients’ spiritual well-being.

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