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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 655 Documents
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Factors influencing major adverse cardiac events among people with acute coronary syndrome admitted to a tertiary hospital in Northeastern Thailand: A cross-sectional study Piwpong, Ratchanee; Plienthaisong, Bulan; Plongram, Thunsuda; Ngaosri, Wilaiwan; Narasri, Thachaiya
Belitung Nursing Journal Vol. 11 No. 2 (2025): March - April
Publisher : Belitung Raya Foundation, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3672

Abstract

Background: Acute coronary syndrome (ACS) is a severe cardiovascular condition that can lead to acute myocardial infarction (AMI), resulting in significant morbidity and elevated mortality rates. Objective: This study aimed to examine complications arising from ACS in patients admitted to a tertiary hospital and identify the influencing factors. Methods: A cross-sectional study was conducted between February and December 2021 among patients diagnosed with ACS at the tertiary hospital in Northeastern Thailand. The sample included 133 participants hospitalized for ACS. Simple random sampling was employed, with data collected from the patient registry by selecting 15 individuals at a time until the target of 1,998 patients was reached. Statistical analyses included descriptive statistics, Chi-Square test, Fisher’s exact test, and binary logistic regression to identify significant predictors of complications in this population. Results: Factors influencing the occurrence of major adverse cardiac events (MACE) included cardiac function and the need for cardiopulmonary resuscitation (CPR). Patients with New York Heart Association (NYHA) class II-IV had a significantly higher risk of MACE compared to those with NYHA class I (p <0.001; 95% CI, 2.008–10.984). Additionally, patients who received CPR were 4.15 times more likely to experience MACE than those who did not receive CPR (p <0.05; 95% CI, 1.029–16.729). Conclusions: This study demonstrated that cardiac function and the necessity for CPR significantly influence the development of MACE in patients with ACS. These findings highlight the importance of thorough evaluation and monitoring by healthcare teams during hospitalization, particularly for patients with abnormal cardiac function or a history of CPR. Prompt identification and targeted interventions for high-risk individuals can improve outcomes and reduce complications. Nurses should prioritize follow-up evaluations for ACS patients with NYHA class II-IV or those who have undergone CPR, as these individuals are at elevated risk for developing MACE.
Factors predicting delirium among hospitalized older adults in an urban area, Thailand: A prospective cohort study Kaveenuntachai, Duangrat; Prueksaanantakal, Naphatthorn; Benyapad, Pirunnapa; Chinpinkleaw, Pratin; Jiojinda, Sirichai
Belitung Nursing Journal Vol. 11 No. 2 (2025): March - April
Publisher : Belitung Raya Foundation, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3678

Abstract

Background: Delirium is a common but often underrecognized complication in hospitalized older adults. It is associated with poor outcomes, including longer hospital stays, increased mortality, and long-term cognitive decline. While numerous studies have explored factors contributing to delirium, there is a lack of research on the context of older adults in Bangkok, Thailand. Understanding the predictors of delirium is crucial for early detection and prevention, particularly in an urban hospital setting. Objective: This study aimed to determine the incidence rate of delirium and identify factors associated with its development in hospitalized older adults. Methods: A prospective cohort study was conducted in four internal medicine wards of a large urban hospital in Bangkok, Thailand. Data were collected from 168 hospitalized older adults (≥60 years) over a 7-day period following admission. The Confusion Assessment Method (CAM), the Mini-Mental State Examination (TMSE), and the Systemic Inflammatory Response Syndrome (SIRS) scores were used to assess delirium and cognitive impairment. Data were collected between January 2022 and October 2022, and participants were evaluated on Day 1 (24 hours after admission), Day 3, and Day 7 or before discharge. Descriptive statistics and multivariate logistic regression were used to analyze predictors of delirium. Results: The incidence rate of delirium among hospitalized older adults was 20.80%, with 19.00% developing delirium within the first 24-48 hours of admission. Multivariate analysis revealed that cognitive impairment (OR_adj = 7.81, p <0.001), infection (SIRS) (OR_adj = 3.80, p = 0.025), age (OR_adj = 1.09, p = 0.010), and the presence of caregivers prior to admission (OR_adj = 0.11, p = 0.008) were significant predictors of delirium. The model explained 35.30% of the variance in delirium occurrence. Conclusion: This study highlights the high incidence of delirium among hospitalized older adults and identifies key risk factors, including cognitive impairment, infection, age, and the presence of caregivers. Early delirium screening, including the use of the CAM and TMSE, should be integrated into nursing care for delirium prevention. Infection prevention and effective management strategies should also be prioritized to reduce delirium risk.
Effectiveness of using an online instructional video for preventing infections among Thai patients with cancer: A quasi-experimental study Viseskul, Nongkran; Kasatpibal, Nongyao; Suwan, Natthawan; Chaywong, Yuwalee; Pholdee, Narumon
Belitung Nursing Journal Vol. 11 No. 2 (2025): March - April
Publisher : Belitung Raya Foundation, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3681

Abstract

Background: Patients with cancer are more likely to develop infections from several factors, and an infectious complication is the leading cause of death in this population. Therefore, nurses should provide educational media to these patients for infection prevention. Objective: This study aimed to examine the effectiveness of using an online instructional video to prevent infections among patients with cancer in Thailand. Methods: A quasi-experimental design was conducted from May 2020 to March 2021 at a cancer hospital in northeast Thailand. The participants consisted of 54 patients with cancer (27 each in the experimental and control group). The experimental group participants received four weeks of online video instruction at home, while the control group received the usual education from nurses. The data collection instruments included a demographic data questionnaire, a knowledge test, an infection prevention practice questionnaire, and a video media satisfaction questionnaire. Statistical analyses included descriptive statistics, chi-square test, Fisher’s exact test, paired t-test, and independent t-test. Results: After receiving the online instruction video, the experimental group had a significantly higher score for infection prevention knowledge, increasing from 17.52 to 20.93 (t = -6.575, p <0.001), and infection prevention practice, rising from 52.07 to 61.33 (t = -3.954, p = 0.001). The control group had no significant increase in the knowledge score (17.04 to 18.04) (t = -1.328, p = 0.100) or practice score (53.41 to 54.44) (t = -0.797, p = 0.217). The experimental group showed a significantly higher mean knowledge score (t = 4.473, p <0.001, large effect size with a Cohen’s d of 1.22) and practice score (t = 3.121, p = 0.002, large effect size with a Cohen’s d of 0.85) during post-intervention than the control group. Conclusion: The findings support the use of online video as instructional media to enhance knowledge and practices regarding infection prevention among patients with cancer. This online video should be implemented for nurses and healthcare providers to promote knowledge and practices in the prevention of infections among patients with cancer in other hospitals. Trial Registry Number: Thai Clinical Trials Registry (TCTR20241030009)
The clinical decision-making of Vietnamese nursing students and related factors: A cross-sectional survey Yen Quach, Tran Binh; Lan Nguyen, Thi Phuong; Hong Huynh, Thuy Phuong
Belitung Nursing Journal Vol. 11 No. 2 (2025): March - April
Publisher : Belitung Raya Foundation, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3686

Abstract

Background: Clinical decision-making is a critical competency in nursing, influencing patient safety and career satisfaction. However, the factors shaping clinical decision-making remain underexplored, particularly in Vietnam, where research on this topic is limited. Understanding these factors is essential for enhancing nursing education and clinical practice. Objective: To assess clinical decision-making skills among nursing students, examining their relationship with students’ characteristics, perceptions of the clinical environment, and grade point average (GPA). Methods: This cross-sectional study surveyed 189 nursing students in the University of Medicine and Pharmacy at Ho Chi Minh City using an online questionnaire in June 2021. Clinical decision-making styles were assessed using the Nurses Decision-Making Instrument Revised - 2014 (NDMI-R14), and the clinical learning environment (CLE) was evaluated with the Vietnamese-CLEI. To assess differences between variables, Chi-square tests were applied, or Fisher’s exact tests where appropriate. Correlation between variables was examined using Pearson’s correlation coefficient for parametric data or Spearman’s rank correlation for non-parametric data. Results: The average clinical decision-making score was 68.6, with 67.7% of students demonstrating a quasi-rational decision-making style and 32.3% relying solely on analysis. Notably, no students reported exclusively intuitive decision-making. Significant negative correlations were identified between clinical decision-making scores and extracurricular activities (r = -0.20, p = 0.005), clinical learning environment (rs (187) = -0.16, p = 0.027), and GPA (r = -0.18, p = 0.011). These findings suggest that students with higher academic performance and greater extracurricular involvement were less likely to rely on intuitive decision-making. Conclusion: Vietnamese nursing students predominantly exhibited a quasi-rational decision-making style, combining intuition and analysis. However, students with higher GPA and extracurricular engagement showed reduced intuitive reasoning, highlighting a potential gap in their decision-making development. Nursing education programs in Vietnam should focus on fostering analytical and intuitive reasoning skills to prepare students for complex clinical environments. Further research is needed to explore the cultural, educational, and contextual factors influencing these patterns.
Community-based rehabilitation for older adults post-stroke in Thailand: An ethnographic study Somtua, Niramol; Nuntaboot, Khanitta
Belitung Nursing Journal Vol. 11 No. 2 (2025): March - April
Publisher : Belitung Raya Foundation, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3690

Abstract

Background: Stroke is a leading cause of disability among older adults, with long-term effects on their independence and quality of life. In Thailand, while previous studies have explored aspects of post-stroke rehabilitation, there remains a gap in understanding how to effectively integrate healthcare services, community resources, and cultural practices into a comprehensive, sustainable rehabilitation model. Objective: This study aimed to explore community-based rehabilitation for older adults post-stroke in Thailand. Methods: An ethnographic research design was employed to examine community-based rehabilitation practices. Participants included 88 key informants, comprising older adults post-stroke (n = 21), family members (n = 24), local administrative officials (n = 7), healthcare professionals, caregiver representatives, public health volunteers, village/sub-district headmen (n = 12), community organization members (n = 15) and general informants (neighbors and relatives) (n = 9). Data collection methods included participant observation, in-depth interviews, group discussions, and document reviews conducted from May 2023 to August 2024. Content analysis was applied, with triangulation ensuring data validity. Findings were further confirmed by informants and qualitative research experts. Results: Community-based rehabilitation for older adults post-stroke consisted of three interconnected domains: 1) Support Systems and Infrastructure, including family caregiver involvement, healthcare services, emergency care, community rehabilitation programs, and public services; 2) Social and Economic Support, encompassing community welfare initiatives, volunteer networks, financial stability measures, and legal protections; and 3) Administrative and Management Systems, comprising integrated planning for older adults, data and information management, welfare accessibility, and culturally embedded care approaches. These elements created a comprehensive and sustainable rehabilitation framework. Conclusion: The study highlights the importance of an integrated rehabilitation system that combines healthcare, socioeconomic support, and administrative mechanisms. Findings emphasize the need for advanced training in case management and coordination for community nurses and call for culturally sensitive rehabilitation protocols that merge traditional Thai healing practices with contemporary medical care. These findings align with global recommendations for sustainable rehabilitation and highlight the importance of culturally sensitive approaches. Strengthening formal and informal care networks can enhance rehabilitation outcomes and improve the quality of life for older adults post-stroke.
Factors predicting preoperative anxiety among adult patients undergoing cardiac surgery in China: A cross-sectional study Xing, Aizhen; Hengudomsub, Pornpat; Ponpinij, Panicha
Belitung Nursing Journal Vol. 11 No. 2 (2025): March - April
Publisher : Belitung Raya Foundation, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3695

Abstract

Background: Preoperative anxiety is a significant concern for patients undergoing surgery, as it can lead to adverse effects such as increased postoperative pain, delayed wound healing, prolonged hospital stays, higher incidences of postoperative complications, and even mortality. Preoperative anxiety is particularly common in patients undergoing cardiac surgery, but it is often overlooked and warrants further investigation. Objective: This study aimed to explore preoperative anxiety and its predictors, including fear of surgery, preoperative sleep quality, perception of illness severity, and perceived social support among adult patients undergoing elective cardiac surgery. Methods: A cross-sectional study was conducted with 142 adult patients undergoing elective cardiac surgery using simple random sampling. Data were collected from patients in the Class III Grade A general hospital in Wenzhou, China, between October 2023 and March 2024. Questionnaires were used to gather information about patients’ demographic characteristics, fear of surgery, preoperative sleep quality, perception of illness severity, perceived social support, and preoperative anxiety. Descriptive statistics, Pearson correlation analysis, and multiple linear regression were employed for data analysis. Results: The total score for preoperative anxiety was 15.98 ± 4.95. Fear of surgery, preoperative sleep quality, perception of illness severity, and perceived social support explained 37.3% of the variance in preoperative anxiety (Adjusted R² = 0.373, F(4,142) = 26.77, p <0.05). Fear of surgery was the strongest predictor (β = 0.539, p <0.001), followed by preoperative sleep quality (β = -0.166, p <0.05) and perceived social support (β = -0.138, p <0.05). Perception of illness severity was not a significant predictor of preoperative anxiety. Conclusion: Preoperative anxiety in adult patients undergoing elective cardiac surgery is significantly influenced by factors such as fear of surgery, preoperative sleep quality, and perceived social support. Nurses can implement targeted interventions to reduce preoperative anxiety. These interventions may include addressing the fear of surgery through health education and psychological counseling. Furthermore, improving the hospital environment to promote a calm and quiet atmosphere can enhance sleep quality. Encouraging social support to help patients build confidence in the success of their surgery and their ability to recover is also recommended.
Muslim mothers’ experiences in taking care of children with open heart surgery: A qualitative study in Southern Thailand Lohmae, Userow; Pattanasombutsook, Maneeratsami; Chantarasiripoot, Boonkanas; Chemama, Nursaheeda; Thepsao, Saowapa; Maramoh, Rusna
Belitung Nursing Journal Vol. 11 No. 2 (2025): March - April
Publisher : Belitung Raya Foundation, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3696

Abstract

Background: A child with congenital heart disease requires complex surgeries and intensive postoperative care, causing significant stress for caregivers. Muslim caregivers, in particular, rely on their faith for strength. Objective: To explore the experiences of Muslim mothers caring for children who have undergone open heart surgery due to congenital heart disease. Methods: The study used a qualitative descriptive design conducted between February and June 2023. Data were collected through in-depth interviews with 12 Muslim mothers selected through purposive sampling, and thematic analysis was employed for data analysis. Results: Three main themes identified: 1) Strengthening faith and trust in God, which includes two subthemes—embracing acceptance amidst divine attribution and utilizing faith and belief as a wellspring of spiritual shelter, 2) Cultivating patience and resilience in life, encompassing two subthemes—endurance in caring with unconditional love and fostering resilience for coping strategies, and 3) The significance of social support systems, consisting two subthemes—healthcare professionals’ support and family support. Conclusions: This study revealed the complex emotional experiences, including sadness, loss, uncertainty, and resilience, of Muslim mothers whose children face open heart surgery and highlighted the vital role of holistic support from healthcare professionals and families. Recommendations in line with holistic nursing principles include providing comprehensive information, faith-based psychological support, and involving the family’s caregiving capacity. The study also calls for further research within the holistic nursing context, including programs to enhance psychosocial support in similar situations.
Factors related to stigma among patients with cervical cancer having chemotherapy after surgery in China: A cross-sectional study Wang, Fanglin; Hengudomsub, Pornpat; Chantamit-o-pas, Chutima
Belitung Nursing Journal Vol. 11 No. 2 (2025): March - April
Publisher : Belitung Raya Foundation, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3706

Abstract

Background: Stigma is a significant issue among patients with cervical cancer undergoing postoperative chemotherapy, yet the factors contributing to stigma are not well understood. While research has explored the relationships between self-efficacy, illness perception, self-esteem, social support, and stigma, fewer studies have focused on Chinese patients, and even fewer have specifically examined stigma within this population. Objective: This study aimed to describe stigma and assess its association with self-efficacy, self-esteem, illness perception, and social support in postoperative chemotherapy patients diagnosed with cervical cancer. Methods: A total of 132 participants were recruited from the gynecology department of Wenzhou Medical University’s First Affiliated Hospital using a random sampling technique. Data were collected between December 2023 and April 2024 using validated instruments. Descriptive statistics and Spearman’s rank correlation were used for data analysis. Results: The average stigma score was 76.3 (SD = 10.84), indicating a high level of stigma. Self-efficacy, self-esteem, illness perception, and social support were negatively correlated with stigma (r = -0.085, r = -0.158, r = -0.254, r = -0.238, all p <0.05). Conclusion: All participants experienced significant stigma. The negative correlations found between stigma and self-efficacy, self-esteem, illness perception, and social support offer a theoretical basis for developing nursing interventions to reduce stigma in these patients.
Psychometric properties of the Dundee Ready Educational Environment Measure (DREEM) in a Moroccan sample of nursing students Khadija, Saka; Amarouch, Mohamed-Yassine; Miyah, Youssef; Benjelloun, Mohammed; El-Hilaly, Jaouad
Belitung Nursing Journal Vol. 11 No. 2 (2025): March - April
Publisher : Belitung Raya Foundation, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3715

Abstract

Background: The educational environment is crucial to student learning and professional development in nursing education. The Dundee Ready Educational Environment Measure (DREEM) is a widely used tool for assessing educational environments in health professions. However, its psychometric properties have not been sufficiently evaluated in the Moroccan context, particularly among nursing students. Objective: This study aimed to examine and validate the psychometric properties of the Arabic version of the DREEM scale in a sample of Moroccan nursing students. Methods: A cross-sectional study was conducted between May and July 2023 among 445 undergraduate nursing students at the Higher Institute of Nursing Professions and Health Techniques in Meknes, Morocco. Data were collected using the Arabic-translated DREEM questionnaire. Principal Component Analysis (PCA) was conducted to assess variance distribution, while Confirmatory Factor Analysis (CFA) was used to test model fit using key indices. Reliability was measured using Cronbach’s alpha, and intra-class correlation coefficients (ICCs) were calculated for test-retest reliability. Results: PCA confirmed a five-factor structure, with the first two principal components explaining 19.13% and 23.61% of the total variance. CFA results showed that the students’ perceptions of learning (SPL) and academic atmosphere (SPA) subscales had good to acceptable fit, while the students’ perceptions of teachers (SPT) and academic self-perception (SASP) subscales demonstrated moderate to marginal fit. The Arabic DREEM scale exhibited good internal consistency, with a Cronbach’s alpha of 0.87. Sociodemographic factors, including gender, scholarship status, and rural-urban background, influenced students’ perceptions of their educational environment. Conclusion: This study confirmed the reliability and validity of the Arabic version of the DREEM scale for assessing nursing students’ educational environments in Morocco. However, variability in model fit across subscales suggests the need for further refinement to enhance cultural adaptation. Findings highlight disparities in teaching quality, academic support, and student engagement, emphasizing the importance of improving teacher-student interactions, interactive teaching methods, and social support systems to enhance learning outcomes.  
Smartphone addiction and sleep quality among nursing students in Meknes, Morocco: A cross-sectional study El Haddaouy, Abdelhadi; Miyah, Youssef; Benjelloun, Mohammed; Mengad, Aziz; Blaak, Hicham; Iziki, Hayat; El Omari, Fatima
Belitung Nursing Journal Vol. 11 No. 2 (2025): March - April
Publisher : Belitung Raya Foundation, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3718

Abstract

Background: Smartphone addiction and poor sleep quality are prevalent health concerns that negatively impact students’ physical and mental well-being, which could affect their academic performance. However, research on this subject in Morocco remains limited. Objective: This study aimed to examine the impact of smartphone addiction on sleep quality and identify risk factors that moderate this relationship among nursing students. Methods: This cross-sectional study was conducted from March to July 2023, involving 451 nursing students aged 17 to 23 at the Higher Institute of Nursing Professions and Health Techniques in Meknes, Morocco. Participants completed the Mobile Phone-Related Sleep Risk Factors Questionnaire (MRSRF), the Smartphone Addiction Scale–Short Version (SAS-SV), and the Pittsburgh Sleep Quality Index (PSQI). Binary logistic regression (BLR), Receiver Operating Characteristic (ROC) curves, and Area Under Curve (AUC) analyses were used to assess the impact of smartphone addiction on sleep quality and to identify moderating risk factors. Results: The study found that 81.23% of nursing students experienced smartphone addiction, and 86.47% reported poor sleep quality. Sleep quality was significantly correlated with smartphone addiction (β = 0.174; p <0.001), use before bedtime (β = 1.018; p = 0.030), and duration of use after lights-off (β = 0.768; p = 0.047). Logistic regression analysis indicated that smartphone addiction (AUC = 0.872; p <0.001) and duration of use after lights-off (AUC = 0.668; p <0.001) were significant predictors of sleep quality. Conclusion: This study found a significant correlation between smartphone addiction and poor sleep quality, as well as a negative impact of using smartphones in bed for more than 30 minutes after lights off. Nursing students with higher smartphone addiction levels, who use their devices for extended periods without blue light filters, are more likely to experience poor sleep quality. Addressing these challenges requires an integrated, multidisciplinary approach involving healthcare professionals, educators, and community stakeholders. Health promotion programs integrated into student curricula could help reduce smartphone addiction and encourage healthier sleep hygiene practices.

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