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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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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.
Structural equation modeling of symptom clusters and health-related quality of life among patients with advanced colorectal cancer receiving chemotherapy in Bangkok, Thailand Suratako, Savitree; Matchim, Yaowarat; Griffin, Mary Quinn
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.3932

Abstract

Background: Patients with advanced colorectal cancer (CRC) receiving chemotherapy experience multiple symptoms due to both disease progression and complications of treatment. These symptoms affect the physical, psychological, and social aspects of health-related quality of life (HRQoL). Additionally, contextual variables of patients may also impact HRQoL. Objective: To test a structural equation model on symptom clusters, contextual variables, and HRQoL in patients with advanced CRC receiving chemotherapy. Methods: In this cross-sectional study, data were collected from 300 patients with advanced CRC who had received chemotherapy at five hospitals in Bangkok, Thailand, between March 2023 and July 2023. Data collection instruments included a demographic data form, Memorial Symptom Assessment Scale, Multidimensional Scale of Perceived Social Support questionnaire, Palliative Care Outcome Scale, and Functional Assessment of Cancer Therapy-Colorectal questionnaire. Structural equation modeling (SEM) was used to test the model. Results: SEM showed a good model fit, with X2/df = 1.15, p = 0.20, CFI = 0.94, TLI = 0.94, RMSEA = 0.03, and SRMR = 0.02. The symptom severity cluster dimension, symptom distress cluster dimension, social support, and palliative care outcomes predicted effects on HRQoL with 78% accuracy. The findings showed that the symptom severity and symptom distress cluster dimensions showed significant negative direct and positive indirect effects on HRQoL. Palliative care outcomes had a significant negative influence on HRQoL. Moreover, social support had direct positive and indirect negative influences on HRQoL. Conclusions: Symptom clusters, social support, and palliative care outcomes were identified as predictors of HRQoL in patients with advanced CRC receiving chemotherapy. Understanding the SEM of symptom clusters, social support, palliative care outcomes, and HRQoL may help nurses and other healthcare professionals develop effective interventions to better manage symptoms in patients with advanced CRC receiving chemotherapy.
Aesthetic experiences of patients with advanced cancer in end-of-life care in China: A phenomenological study Li, Xia; Kongsuwan, Waraporn; Barry, Charlotte D.
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.3935

Abstract

Background: For most patients with advanced cancer, an important prerequisite for quality of end-of-life care is understanding their preferences. Nurses reported the challenges in the care process, such as poor communication patterns of sensitive topics. Aesthetic experience values meaningful moments and is sensitive to the impact of different environments and situations. Aesthetic expression enables individuals to transform intuitive cognition into artistic behavior, ultimately expressing real needs through aesthetic cognition, enhanced sensibility, and reflection, thereby promoting improved care quality.  However, there is still a lack of studies exploring aesthetic experiences in end-of-life care from the perspective of patients with advanced cancer. Objective:  To explore the aesthetic experiences in end-of-life care as perceived by patients with advanced cancer during hospitalization. Methods: This study applied a hermeneutic phenomenological approach and was conducted in an oncology unit of a hospital in China. This hospital was the hospital promulgated by the local health department as a pilot hospice care program. The hospital mainly admitted patients with advanced cancer who have given up radiotherapy and chemotherapy after being treated in a higher-level hospital. Data collection spanned from August to December 2023. Ten participants were invited to engage in reflective experiences using the individual face-to-face interviews followed by the creative drawings. The data were analyzed and interpreted following van Manen’s approach. Results: The findings revealed four themes: 1) Dynamic understanding; 2) Cherished relationships; 3) Prioritizing being presentable; 4) Creating a peaceful atmosphere. Patients with advanced cancer present different states at each stage of their disease progression, which requires dynamic understanding to provide more precise care. In addition, their demands for cherished relationships, a presentable style, and a peaceful atmosphere will also increase during this process. We need to pay attention to these moments that are meaningful to them for improving the quality of end-of-life care. Conclusion:  This study explored the aesthetic experiences from the unique experiences of patients with advanced cancer in end-of-life care, thereby using aesthetic elements to create and cultivate a unique end-of-life care ideal, which will stimulate the creativity and respond to the special challenges of end-of-life care.
Knowledge, attitude, and practice regarding trauma-informed care among nursing students in Eastern China: A cross-sectional study Zhang, Di; Songwathana, Praneed; Vachprasit, Ratjai; Holroyd, Eleanor
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.3947

Abstract

Background: Patients with a history of traumatic life events who enter the healthcare system are especially vulnerable, often posing greater challenges to care delivery. However, little is known about the capacity of nursing staff, especially nursing students, to deliver trauma-informed care (TIC). Objective: This study aimed to assess the knowledge, attitude, and practice of trauma-informed care among Chinese nursing students. Methods: A cross-sectional study was employed to survey undergraduate nursing students from a medical college in eastern China. Data were collected using an established self-administered questionnaire on TIC knowledge, attitude, and practice (KAP) consisting of 21 items. The content validity scale-level CVI was 0.950, and the reliability with Cronbach’s α coefficient was 0.963. Results: A total of 118 undergraduate nursing students, ranging from first to fourth year, participated in the survey, and ultimately, 117 students were included in the study, yielding an effective response rate of 99.15%. The average scores for KAP were 70.83±14.58, 77.78±11.11, and 66.67±16.67; however, the good levels of KAP accounted for 16.2%, 45.3% and 6.0%, respectively. Additional analysis showed a weak positive correlation between knowledge and attitude (rs = 0.211, p = 0.022), while there was a moderate positive correlation between knowledge and practice, attitude and practice (rs = 0.309, p < 0.001; rs = 0.310, p < 0.001). Univariate analysis indicated that year of study and experience in caring for trauma patients were significantly related to practice (p = 0.039, p = 0.002). Conclusion: The students’ KAP on trauma-informed care was not at a good level, especially regarding practice and knowledge, and required further strengthening. The findings provide baseline information for further development of a KAP-TIC comprehensive course and exploration of practice ability-centered TIC education for nursing students. Assessing the effectiveness of the newly developed TIC course and learning outcomes in clinical practice is also recommended.
Prevalence and associated factors of emotional and behavioral problems in Indonesian early adolescents: A cross-sectional study Sundari, Ririn Isma; Sitaresmi, Mei Neni; Lusmilasari, Lely
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.3990

Abstract

Background: Emotional and behavioral problems (EBPs) in early adolescence are a growing public health concern, particularly in low- and middle-income countries like Indonesia. The COVID-19 pandemic has further disrupted adolescent development, highlighting the need to identify both internal and external contributing factors to these issues. Objective: This study aimed to assess the prevalence of emotional and behavioral problems among early adolescents in Central Java, Indonesia, and to identify internal and external factors associated with these problems during the post-pandemic transition from hybrid to offline learning. Methods: A cross-sectional study was conducted from May to June 2023 involving 256 adolescents aged 10–14 years in Central Java. Emotional and behavioral problems were measured using the Strengths and Difficulties Questionnaire – Self-Report (SDQ-SR). Internal factors were assessed using the Reduced Morningness–Eveningness Questionnaire (rMEQ) and the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA). External factors were measured through sociodemographic questionnaires and the Revised Family Communication Pattern (rFCP) Scale. Descriptive statistics were used to characterize the sample. Associations were analyzed using multiple logistic regression, and model fit was assessed using the Hosmer–Lemeshow test and Nagelkerke R². Results: The prevalence of adolescents with abnormal total difficulties scores was 15.6%. Among SDQ subscales, emotional problems showed the highest abnormal prevalence (30.1%), followed by peer problems (10.9%), conduct problems (10.5%), and hyperactivity-inattention (4.3%). Multivariate logistic regression analysis revealed that adolescents with an eveningness chronotype were significantly more likely to experience EBPs (OR = 21.11, 95% CI: 5.82–76.63, p <0.001). Similarly, low emotional regulation increased the risk (OR = 5.08, 95% CI: 2.18–11.80, p <0.001). Among external factors, low maternal education (OR = 1.34, 95% CI: 1.12–1.94, p = 0.015) and low intrafamilial communication (OR = 3.35, 95% CI: 1.45–7.74, p = 0.004) were also significant predictors. The model showed good fit (Hosmer–Lemeshow χ² = 6.050, p = 0.642) and explained 40.6% of the variance in EBPs (Nagelkerke R² = 0.406). Conclusion: Emotional and behavioral problems remain a concern among Indonesian early adolescents in the post-pandemic, with emotional symptoms being the most prevalent. Internal risk factors, such as eveningness chronotype and low emotional regulation, as well as external factors like maternal education level and intrafamilial communication, were significantly associated with these issues. These findings suggest a need for early mental health screening and targeted interventions. For nursing practice, this highlights the role of nurses in school and community settings in promoting emotional regulation, strengthening family communication, and delivering health education tailored to familial and developmental contexts.

Page 64 of 66 | Total Record : 655

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