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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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Digital devices usage barriers among community-dwelling older adults in Abha, Saudi Arabia: A cross-sectional study Hawash, Manal Mohammed
Belitung Nursing Journal Vol. 11 No. 5 (2025): September - October
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3989

Abstract

Background: Modern communities increasingly rely on technology, influencing older adults’ health and daily life. While technology can enhance quality of life and independence, various barriers limit digital adoption among older adults. Objective: This study aimed to identify barriers to digital device use among community-dwelling older adults in Abha, Saudi Arabia. Methods: This study used a cross-sectional survey of 400 adults aged 60 years and older. Data were collected from February to March 2025 on depression (Beck Depression Inventory-II), cognitive status (Saint Louis University Mental Status Examination), and technology-related barriers (Technology Usage Barriers Questionnaire). Data were analyzed using t-tests, one-way ANOVA, effect sizes (Cohen’s d, η²), and 95% confidence intervals. Results: Smartphone users reported significantly higher barriers than feature phone users in personal (8.07 ± 4.50 versus 5.70 ± 5.09; p <0.001; d= 0.50), technical (5.20 ± 4.60 versus 4.20 ± 3.02; p = 0.009; d = 0.25), and environmental domains (1.90 ± 1.30 versus 1.40 ± 1.50; p = 0.001; d = 0.36). Among smartphone users, the highest personal barriers were observed in adults aged 80 years and older (11.3 ± 4.3; η² = 0.075), females (d= 0.48), those with primary education (d = 0.84), low-income individuals (d = 0.44), unemployed participants (d = 1.23), and rural residents (d = 1.24). Education most strongly predicted technical barriers (d = 0.94), while income had the greatest impact on environmental barriers (d = 0.93). Conclusion: Older adults, especially smartphone users, women, those with lower education, low income, unemployed individuals, and rural residents, face substantial barriers to digital adoption. Tailored digital literacy programs, affordable access, and senior-friendly device design are essential to reduce the digital divide and improve autonomy, inclusion, and quality of life. For nursing practice, these findings emphasize the importance of assessing older adults’ digital skills, providing targeted education, and advocating for technology solutions that support engagement and health management.
Effectiveness of home-based cardiac rehabilitation programs on health outcomes of persons with heart failure: An umbrella review Promwong, Waiyaporn; Meenongwah, Jaroonsree; Kenbubpha, Kedsaraporn; Suyasa, I Gede Putu Darma
Belitung Nursing Journal Vol. 11 No. 5 (2025): September - October
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3994

Abstract

Background: Home-based cardiac rehabilitation (HBCR) serves as a crucial alternative to center-based cardiac rehabilitation (CBCR) for patients with heart failure (HF), aiming to enhance access and adherence. However, evidence of its effectiveness is dispersed across numerous systematic reviews with varying findings, necessitating a high-level synthesis to clarify HBCR’s overall impact. Objective: To synthesize and critically evaluate evidence from systematic reviews and meta-analyses on the effectiveness of home-based cardiac rehabilitation in improving health outcomes among patients with heart failure. Design: An umbrella review of systematic reviews and meta-analyses Data Sources: A systematic search was conducted in the Cochrane Library, JBI Evidence Synthesis, PubMed, Medline, CINAHL, Epistemonikos, and ThaiJo databases for studies in English or Thai up to April 11, 2025. Review Methods: The review adhered to JBI and PRISMA guidelines. Outcomes included functional capacity, quality of life (QOL), mortality, hospital readmissions, and adverse events. Study quality was assessed using the JBI checklist. Results: Fifteen systematic reviews and meta-analyses met the inclusion criteria, all of which were of high methodological quality. The evidence consistently demonstrates that HBCR significantly enhances functional capacity compared to usual care, with outcomes comparable to those of CBCR. However, findings for other outcomes were inconsistent; HBCR’s impact on QOL and left ventricular ejection fraction (LVEF) varied due to program content and methodological heterogeneity, and it did not significantly reduce mortality or hospital readmissions compared to usual care or CBCR. No significant differences in adverse events were observed between HBCR, CBCR, and usual care. Conclusion: HBCR is a safe and effective intervention for improving functional capacity in patients with heart failure, offering a viable alternative to CBCR. However, its effects on quality of life, hospital readmissions, and mortality remain inconsistent. These findings highlight HBCR’s potential role in expanding access, though further research is needed to optimize program design. Registry: PROSPERO (CRD42023484051)
Beyond the pandemic: Posttraumatic stress and its association with physical and mental health outcomes among older adults in Egypt – a cross-sectional study El-Sayed, Mona Metwally; Abd-Elhay, Eman Sameh; Taha, Samah Mohamed; Wafik, Wagdia; Ahmed, Hala Awad; Alharbi, Ghala Abdullah; Hawash, Manal Mohammed
Belitung Nursing Journal Vol. 11 No. 5 (2025): September - October
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4011

Abstract

Background: The COVID-19 pandemic has severely affected older adults worldwide, with the Egyptian geriatric population facing vulnerabilities due to limited healthcare access and cultural factors. Posttraumatic stress disorder (PTSD) following COVID-19 may significantly impact physical and mental health, yet data specific to older Egyptians are limited. Objective: This study aimed to assess the prevalence of PTSD and its association with physical and mental health outcomes among older adults in Egypt after COVID-19 infection. Methods: A cross-sectional study included 290 geriatric patients (≥60 years) recruited from outpatient clinics at two Egyptian university hospitals. Data collection took place over three months, from September to December 2023. PTSD symptoms were measured using the PTSD Checklist-Civilian Version (PCL-C), and physical and mental health were evaluated by the 12-item Short Form Health Survey (SF-12). Pearson correlation and multiple linear regression were used to analyze the relationships between PTSD and health outcomes, controlling for sociodemographic and clinical factors. Results: Moderate PTSD symptoms were present in 60.3% of participants, and 18.6% showed severe symptoms. Physical health (PCS mean = 31.97, SD = 6.66) and mental health (MCS mean = 32.54, SD = 13.34) scores were significantly reduced. PTSD symptom clusters, such as hyperarousal and avoidance, were negatively correlated with physical and mental health components (e.g., hyperarousal vs. PCS: r = -0.206, p <0.001). The regression model explained 59% of the variance in health outcomes (adjusted R² = 0.59). Higher PTSD symptom severity was associated with a small but statistically significant negative effect on health outcomes (B = -0.20, p = 0.033). Chronic disease status showed the largest negative association (B = -12.34, p <0.001), indicating a substantial impact on health. Age demonstrated a modest negative association (B = -0.15, p = 0.049), while gender and education were not significantly associated with health outcomes. Conclusion: Nearly four out of five older Egyptian adults experienced moderate to severe PTSD after COVID-19, and PTSD symptoms were significantly associated with poorer physical and mental health. Chronic illness emerged as the strongest determinant of health outcomes, with age showing a modest effect. These findings highlight the importance of culturally sensitive, trauma-informed nursing interventions that address both PTSD and chronic illness to improve the well-being of older adults.
Faith, fear, and disclosure: Exploring serodiscordant relationships in Indonesia’s Muslim society Ridwan, Eka Sari; Tanasugarn, Chanuantong; Benjakul, Sarunya; Kengganpanich, Mondha; Mohammadnezhad, Masoud
Belitung Nursing Journal Vol. 11 No. 5 (2025): September - October
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4054

Abstract

Background: In Indonesia’s Muslim society, serodiscordant couples navigate a complex web of faith, fear, and stigma. While HIV care efforts have advanced, understanding how religious beliefs and emotional responses shape disclosure remains limited. Objective: This study aimed to explore the lived experiences of serodiscordant couples in South Sulawesi, Indonesia, with a focus on how faith, fear, and gender roles influence HIV understanding and disclosure practices. Methods: A qualitative, phenomenological approach was employed, involving 34 participants who participated in in-depth interviews and focus group discussions conducted between February and May 2019. Data were thematically analyzed to capture emotional, cultural, and relational dimensions of HIV disclosure. Results: Two main themes emerged. (1) Faith and Fear: Navigating HIV Understanding, which includes knowledge of HIV, emotional responses to an HIV diagnosis, the role of religious teachings in shaping health decisions, and the fear of social exclusion; and (2) HIV Status Disclosure and Its Complexities, highlighting motivations for disclosure, barriers to openness, and the personal impact of revealing one’s HIV status to a partner. Disclosure was often delayed or mediated by third parties, driven by fear of rejection, shame, and limited communication skills. Conclusion: The findings revealed the dual role of faith as both a support and a barrier, and the complex interplay of gender dynamics in disclosure decisions. Community nurses in Indonesia’s primary health care settings should then play a critical role in HIV prevention by providing culturally sensitive, Islamic-faith-based counseling, gender-responsive disclosure support, and collaboration with peer support groups to foster trust, reduce stigma, and improve adherence.
Thai Burnout Assessment Tool (T-BAT): Translation, validity, and reliability testing in nurses Posai, Vachira; Srisintorn, Wisarut; Thongsuksai, Paramee; Jitpanya, Chanokporn
Belitung Nursing Journal Vol. 11 No. 5 (2025): September - October
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4086

Abstract

Background: The Burnout Assessment Tool (BAT), an instrument for measuring burnout among healthcare professionals, was originally developed in English and remains unadopted and unvalidated within the Thai healthcare context. Despite its widespread international use, cultural and linguistic variations necessitate rigorous contextual validation. Objective: This study aimed to translate the BAT into Thai (T-BAT) and evaluate its psychometric properties among Thai nurses, addressing critical gaps in cross-cultural burnout assessment. Methods: A cross-sectional survey was conducted among 1,005 nurses from two government hospitals in Thailand, employing a multistage sampling with quota-based convenience selection. Participant inclusion criteria comprised full-time nursing employment, a minimum bachelor’s degree in nursing, and at least three months of hospital work experience. The BAT underwent a back-translation process to ensure linguistic and cultural equivalence. The psychometric evaluation encompassed descriptive statistical analysis, internal consistency assessment, known-group validity testing through hypothesis, and construct validation via confirmatory factor analysis (CFA). Finally, Rasch analysis, evaluating item performance and measurement precision, was used. Results: The T-BAT exhibited robust psychometric characteristics, including internal consistency (Cronbach’s alpha = 0.93), known-group validity (significant score variations across nurse subgroups), and construct validity (confirmatory factor analysis validating the proposed four-factor model). Finally, Rasch analysis demonstrated optimal item performance, including fit statistics within acceptable ranges (Infit: 0.78-1.40; Outfit: 0.73-1.41).  Person and item reliability indices consistently exceeded 0.80, indicating high reliability of the scale. Conclusion: The study substantiates the T-BAT as a reliable and valid instrument for assessing burnout among Thai nurses. This culturally adapted tool provides a context-specific approach to understanding burnout, potentially enabling more targeted interventions by healthcare policymakers, hospital administrators, and nursing leaders.
Proportion of medication error reporting and its associated factors among healthcare workers in Indonesia: A mixed-methods study Pramesona, Bayu Anggileo; Wardani, Dyah Wulan Sumekar Rengganis; Ramdini, Dwi Aulia; Taneepanichskul, Surasak
Belitung Nursing Journal Vol. 11 No. 6 (2025): November - December
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3548

Abstract

Background: Medication errors (MEs) are among the most prevalent healthcare-related incidents. However, many institutions do not report these incidents. Objective: This study aimed to investigate the proportion of medication error reporting and the associated factors of medication error reporting among healthcare workers (HCWs) in the hospital settings. Methods: This mixed-methods study used a sequential explanatory design. The quantitative phase involved 122 HCWs, including physicians, nurses, midwives, and pharmacists/pharmacist assistants, and the qualitative phase purposively included 15 of these participants. Data were collected from June to July 2024 at a public hospital in North Lampung, Indonesia, using a self-administered questionnaire and face-to-face in-depth interviews. Quantitative data were analyzed using logistic regression, and qualitative data were analyzed using thematic analysis. Results: The proportion of medication error reporting among HCWs was found to be 64.7%. Lack of a readily available system for reporting medication errors and fear of being blamed were considered as two of the most common causes of HCWs being hindered from reporting MEs. The logistic regression analysis showed that having experienced any medication administration error and having discovered medication error cases that others committed were significantly associated with medication error reporting. From qualitative data, eight themes emerged: 1) monitoring and evaluation, 2) teamwork, 3) self-motivation, 4) organizational culture, 5) rewards and penalties, 6) lack of facilities, 7) lack of understanding about MEs, and 8) fears. Conclusion: The study found a relatively high rate of medication error reporting, indicating that HCWs have an intrinsic motivation to report. However, systemic barriers, such as the lack of a supportive infrastructure and fear of retribution, remain major challenges. Developing a user-friendly, digital medication error reporting system with an anonymous option is recommended to mitigate fear and providing institution-wide training on patient safety culture and reporting procedures to address knowledge gaps.
Cognitive function and dementia risk factors among older people in nursing homes: An observational cohort study in Medan, Indonesia Martina, Siska Evi; Fitri, Faishah Irfani; Sibero, Alexander Fernando Kawas; Amila
Belitung Nursing Journal Vol. 11 No. 6 (2025): November - December
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3784

Abstract

Background: Indonesia’s rapidly aging demographic presents significant challenges, particularly in dementia among older people in resource‐limited settings, such as nursing homes. However, there are limited reports on the deterioration of cognitive function and risk factors of dementia among older people in nursing homes. Early identification of dementia is essential for timely intervention and management. Objective: This study aimed to investigate and follow up on the cognitive function and risk factors of dementia among older people living in nursing homes. Methods: An observational cohort study was conducted over 6 months (April to October 2024) involving 162 participants from government (n = 83) and private nursing homes (n = 79). Implementation of early dementia screening was carried out using the Montreal Cognitive Assessment in the Indonesian version (MoCA INA) instrument to indicate cognitive function impairment. In addition, the Self-reporting of Physical Activity Questionnaire Indonesia (SPAQ-I) was used to identify physical activity. Descriptive statistics, McNemar, Chi-square, Fisher’s Exact, Independent t-test, and multivariate regression were then used to analyze data. Results: Older individuals did not differ in terms of gender, age, education, or length of stay. However, residents of the private nursing home had significantly higher physical activity levels (t = -2.04, p = 0.040), and a greater proportion engaged in adequate activity (65.8% vs. 50.6%, χ² = 4.23, p = 0.040). Over a six-month period, cognitive function significantly declined among residents in the government nursing home (normal: p = 0.021; mild: p = 0.012; moderate: p = 0.003), whereas no significant change was observed among residents in the private nursing home. At the endpoint, mean cognitive function scores were slightly higher in the private nursing home (20.23 ± 3.45) than in the government nursing home (19.70 ± 4.39), with a very small effect size (Cohen’s d = 0.13). Multiple regression analysis revealed that older age (β = -0.396, p <0.001) and lower levels of physical activity (β = 0.163, p = 0.030) were significantly associated with lower cognitive scores. Conclusion: Dementia screening can enhance care planning for age-related cognitive impairment by enabling early identification and management. Early detection allows nurses to implement more effective care strategies. Additionally, higher physical activity levels were associated with better cognitive function, highlighting a modifiable factor that may help maintain cognitive health among older adults in nursing homes.
Quality of life and its associated factors among patients with type 2 diabetes mellitus in East Bolaang Mongondow, Indonesia: A cross-sectional study Tumurang, Marjes Netro; Watung, Grace Irene Viodyta; Langingi, Ake Royke Calvin
Belitung Nursing Journal Vol. 11 No. 6 (2025): November - December
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3942

Abstract

Background: Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance and progressive β-cell dysfunction, leading to long-term complications that negatively affect patients’ quality of life (QoL). Various demographic, psychological, and clinical factors influence QoL. However, limited research has explored these associations within the sociocultural context of a rural regency in Indonesia, where variations in healthcare access, education, and economic conditions may uniquely affect QoL. Objective: This study aimed to examine the relationships between clinical and demographic factors and QoL among patients with T2DM. Methods: A cross-sectional study was conducted from June 2024 to February 2025 with 1,030 adult T2DM patients recruited via purposive sampling. QoL was assessed using the Diabetes Quality of Life Scale (DQOL), and anxiety was measured using the State-Trait Anxiety Inventory (STAI). Additional data on employment status, disease duration, age, and therapy type were collected via structured questionnaires. Data were analyzed using SPSS 27 with univariate, bivariate (chi-square), and multivariate logistic regression analyses. Statistical significance was set at p < 0.05. Results: Descriptively, most participants were female (90.8%), aged 51–60 years (59.7%), and had completed senior high school (84%). Overall, 61.2% reported good QoL. Anxiety was mild in 73.3% and moderate in 26.7% of participants. Multivariate logistic regression indicated that moderate anxiety (OR = 2.78; 95% CI [1.48–5.25], p = 0.041), disease duration ≥5 years (OR = 10.24; 95% CI [2.13–12.40], p = 0.027), older age (≥50 years) (OR = 8.94; 95% CI [2.15–14.73], p = 0.032), unemployment (OR = 3.66; 95% CI [1.03–13.07], p = 0.030), and insulin therapy (OR = 11.3; 95% CI [2.80–12.60], p = 0.019) were significantly associated with poor QoL. The model showed good fit (Hosmer–Lemeshow χ² = 5.32, p = 0.72) and moderate explanatory power (Nagelkerke R² = 0.24). Conclusion: Longer disease duration, older age (≥50 years), unemployment, moderate anxiety, and insulin therapy were significantly associated with lower QoL among T2DM patients. These findings emphasize the need for integrated care strategies combining educational, psychosocial, and socioeconomic interventions. Nursing practice should prioritize holistic, patient-centered approaches incorporating psychological support, individualized education, and social empowerment.
Health literacy on Mpox among Brazilian men who have sex with men: Findings from a national cross-sectional study Santos, Guilherme Reis de Santana; Ribeiro, Caíque Jordan Nunes; Cepas, Lariane Angel; Bulcão, Carolina da Silva; Nascimento, Rita de Cassia Dias; Sousa, Anderson Reis de; Fronteira, Inês; Mendes, Isabel Amélia Costa; Fernandes, Ana Paula Morais; Sousa, Álvaro Francisco Lopes de
Belitung Nursing Journal Vol. 11 No. 6 (2025): November - December
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3974

Abstract

Background: In 2022, Mpox presented significant challenges globally, particularly in Brazil, where cases surged among men who have sex with men (MSM). Health literacy (HL) is essential for promoting health within this group. Objective: To analyze the HL of MSM in the context of Mpox transmission in Brazil. Methods: This was a national cross-sectional study conducted in a virtual setting. An electronic survey was carried out from September to December 2022. A translated and adapted version of the Health Literacy Scale (HLS-14) and a questionnaire containing sociodemographic information, sexual behaviors, and knowledge and beliefs about Mpox were administered. The distribution of predictor variables across health literacy (HL) levels was explored descriptively. Associations between predictors and HL were analyzed using Pearson’s Chi-square test (p < 0.20 for inclusion in multivariate analysis). A generalized linear Poisson model with robust variance was used to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals. Model fit was assessed with the omnibus test and information criteria (AIC, deviance, log-likelihood). Significance was set at p <0.05. Results: The final sample included 1,449 MSM, with an overall prevalence of 53.83% (n = 780) for satisfactory HL. In the bivariate analysis, 15 of the 27 variables met the statistical criterion (p <0.20) for inclusion in the multivariate model, with six retained in the final model. Reporting non-adherence to treatment if diagnosed with Mpox (aPR: 1.73; 95% CI: 1.44–2.07), a prior Mpox diagnosis (aPR: 1.17; 95% CI: 1.04–1.32), having a basic education level (aPR: 1.15; 95% CI: 1.02–1.31), using apps to seek sex (aPR: 1.15; 95% CI: 1.04–1.27), and seeking sex at parties and clubs (aPR: 1.14; 95% CI: 1.04–1.26) were independently associated with a higher prevalence of satisfactory HL. Conclusion: HL levels among MSM during the Mpox public health emergency in Brazil were low, shaped by individual, economic, and social factors. The findings can guide nursing practice regarding how MSM deal with information and make decisions in contexts of episodic health events, as well as the HL strategies to be implemented in nursing therapy.
Determinants of intrinsic capacity among older adults in low- and middle-income countries: A scoping review Tang, Linxi; Binti Rasudin, Nur Syahmina; Dong, Yuan; Yusuf, Azlina
Belitung Nursing Journal Vol. 11 No. 6 (2025): November - December
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4007

Abstract

Background: Intrinsic capacity (IC), as defined by the World Health Organization (WHO), represents the composite of an individual’s physical and mental capacities and forms a cornerstone of the healthy aging framework. Understanding its determinants is essential for designing effective interventions, particularly in low- and middle-income countries (LMICs) where population aging is accelerating amid limited resources and fragmented health systems. Mapping these determinants supports evidence-based strategies that enhance functional ability and resilience among older adults. Objective: This scoping review aimed to systematically map and categorize the determinants of IC among older adults in LMICs, providing an evidence base to inform nursing practice and policy development. Methods: Following PRISMA-ScR guidelines, four databases (Web of Science, PubMed, Scopus, and EBSCOhost) were searched for peer-reviewed studies published between January 2015 and April 2025. Data were synthesized thematically and classified into four determinant domains. Results: Thirty-six studies met inclusion criteria. The determinants of IC were grouped into four domains: (1) sociodemographic (age, gender, education, marital and economic status, living arrangement, residence); (2) biological, physiological, and disease-related (chronic diseases, multimorbidity, body mass index, frailty, polypharmacy, biomarkers); (3) behavioral and lifestyle (physical activity, diet, smoking, alcohol use, sleep, health-seeking behavior); and (4) environmental (housing quality, social participation, community support, healthcare accessibility). Advancing age, chronic disease burden, frailty, and social isolation were linked to reduced IC, while education, good nutrition, physical activity, and supportive environments were protective. Conclusion: Intrinsic capacity in older adults from LMICs is shaped by interrelated social, biological, behavioral, and environmental factors. For nursing and health policy, these findings emphasize the need to shift from disease-centered to proactive, function-oriented care. Integrating IC monitoring into routine nursing practice, promoting health literacy, and creating age-friendly environments are critical for sustaining IC and promoting equitable, healthy aging. Findings from this review may serve as a valuable reference for practitioners and policymakers in LMICs. Registry: Open Science Framework (OSF) [10.17605/OSF.IO/HQ6PG]

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