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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 685 Documents
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Prevalence and associated factors of sarcopenia risk and possible sarcopenia among older homeless adults in a home for destitute, Thailand: A cross-sectional study Whaikid, Phatcharaphon; Piaseu, Noppawan; Tantiprasoplap, Sukanya; Krongthaeo, Suphanna; Srisuk, Wasana; Jitwiriyatham, Theeraphorn; Tantipongsirikul, Jirapa; Subtema, Chanokporn
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.4166

Abstract

Background: Sarcopenia threatens the functional ability of older adults and may be underdiagnosed in homeless populations. Older homeless adults face heightened risks due to malnutrition and comorbidities. However, evidence on sarcopenia in this group remains limited, particularly in institutional settings in Thailand. Understanding the prevalence and associated factors of sarcopenia in this vulnerable population is essential to guide early detection, tailored interventions, and policy development. Objectives: To investigate the prevalence of sarcopenia risk and possible sarcopenia, and to identify associated risk factors among older homeless adults. Methods: This cross-sectional study was conducted in 2023 among homeless adults aged 50 years or older residing in a home for the destitute. Participants were purposively recruited based on predetermined inclusion criteria. Sarcopenia risk and possible sarcopenia were determined according to the Asian Working Group for Sarcopenia (AWGS) 2019 guidelines. Calf circumference was measured to identify sarcopenia risk, while handgrip strength and physical performance assessed using the Five-Times Sit-to-Stand Test were used to determine possible sarcopenia. Data were analyzed using descriptive statistics and multinomial logistic regression. Results: Of the 163 participants, 74.9% were classified as having sarcopenia risk, while 71.2% had possible sarcopenia. Multinomial logistic regression analysis revealed that a low body mass index (BMI) was significantly associated with sarcopenia risk (OR = 0.538, 95% CI [0.359, 0.807], p = 0.003). Possible sarcopenia was significantly associated with older age (OR = 1.173, 95% CI [1.061, 1.298], p = 0.002), lower BMI (OR = 0.564, 95% CI [0.448, 0.710], p < 0.001), and the presence of comorbidities (OR = 5.045, 95% CI [1.025, 24.847], p = 0.047). Conclusion: Sarcopenia risk and possible sarcopenia are highly prevalent among older homeless adults. BMI was a key protective factor, while age and comorbidities significantly increased the risk. These findings highlight the need for targeted interventions focusing on nutrition and early prevention strategies to mitigate sarcopenia in this vulnerable population. Nurses play a critical role in early screening and implementing tailored interventions to support prevention and management efforts.
Gender-sensitive health service framework for women prisoners in Thailand: A qualitative study Kumtanat, Threenush; Rungreangkulkij, Somporn
Belitung Nursing Journal Vol. 12 No. 1 (2026): January - February
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4173

Abstract

Background: Prison health is increasingly recognized as part of community health, especially as the population of incarcerated women grows and presents unique health needs. Yet, evidence on how Thailand’s prison health system addresses gender sensitivity, particularly when viewed through the WHO’s Six Building Blocks framework, remains limited. This system-level knowledge gap restricts efforts to improve equitable care for women prisoners. Objective: This study explored health service delivery for women prisoners in Northeastern Thailand from September 2022 to August 2024 through the WHO’s Six Building Blocks framework, identifying barriers, enablers, and policy implications for gender-sensitive prison healthcare. Methods: A qualitative descriptive design was employed. Data were collected through participatory and non-participatory observations, in-depth interviews, and document reviews with 35 informants, and analyzed using the WHO Health System Framework. Trustworthiness was ensured by triangulation, member checking, and prolonged engagement. Results: The healthcare system encompassed all six WHO building blocks: service delivery, health workforce, health information, access to medicines and technologies, financing, and governance. However, gaps persisted in gender-sensitive services such as gynecological and trauma-informed care, nurse workload, and budget allocation. Initiatives such as telemedicine and the Pansuk Project provided support but were insufficient to address women’s specific vulnerabilities. Conclusion: While structural improvements have been achieved, strengthening gender-sensitive care is necessary. Nurses should integrate trauma-informed and gynecological competencies, supported by better shift management and telemedicine systems. Policy measures, including gender-responsive budgeting and inter-ministerial collaboration, are crucial to the sustainable integration of prison health into national public health.
Cultural recognition for women with diabetes using alternative health care in Malay Ethnic, West Kalimantan, Indonesia: A focused ethnography Parliani; Pearkao, Chatkhane
Belitung Nursing Journal Vol. 12 No. 1 (2026): January - February
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4175

Abstract

Background: The use of alternative health care among people with diabetes remains widespread, especially in rural areas of West Kalimantan, Indonesia. In the Malay ethnic community, alternative health care is not just an issue of access but also deeply rooted in cultural and spiritual practices. However, limited research has explored the symbolic meanings and socio-cultural dynamics that underlie the consistent use of alternative health care by people with diabetes. Objective: This study aimed to explore the cultural recognition and socio-cultural meanings embedded in the use of AHC among Malays with diabetes in West Kalimantan, Indonesia. Methods: A focused ethnography was conducted from July to November 2024 using in-depth interviews, focus group discussions (FGDs), observations, and field notes. A total of 45 participants took part in interviews, including people with diabetes, healthcare providers, traditional healers (Tabib), family members, healthcare volunteers, and community leaders. FGDs comprised five groups, and observations included nine participants. Data were analyzed through content, typology, and matrix analysis. To ensure trustworthiness, triangulation and member checking were employed. The study was guided by three theoretical frameworks: Symbolic Interactionism, Cultural Theory, and Critical Social Theory. Findings: Four main themes emerged: (1) cultural logic and illness meaning, in which illness was viewed as a spiritual and moral imbalance; (2) symbolic meanings in alternative health care practices, highlighting ritual healing and spiritual faith; (3) social structures as pillars of healing, where family and community roles legitimized alternative health care; and (4) social processes that created cultural recognition through intergenerational transmission and community validation. Conclusion: Recognizing AHC culturally is essential for understanding the illness experiences of people with diabetes. For nursing practice, these findings emphasize the importance of providing culturally respectful care, fostering open communication between healthcare providers and people with diabetes, and incorporating alternative healthcare approaches into safe, evidence-based health education.
Home medication review and drug-related problems in patients with chronic diseases at primary health centers in Yogyakarta, Indonesia: A cross-sectional multicenter study Ningrum, Vitarani Dwi Ananda; Yunilistianingsih; Khotimah, Muslimatul; Shintia, Nirma Atin; Efendi, Septia Rahayu; Dewani, Cindy Pramudyah; Andini, Hana Trisna; Yuantari, Rahma
Belitung Nursing Journal Vol. 12 No. 1 (2026): January - February
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4185

Abstract

Background: The high incidence of Drug-Related Problems (DRPs), including medication adherence among patients with chronic diseases, especially during no direct monitoring by health workers, becomes a challenge to therapy success. Home Medication Review (HMR) is an alternative solution in primary healthcare services to avoid further complications. Objective: This study aimed to analyze DRPs, their affecting factors, and DRP interventions for patients with chronic diseases in primary health centers (Puskesmas) through HMR. Methods: A quantitative, cross-sectional observational study using purposive sampling was conducted in several Puskesmas in Yogyakarta from February to May 2023. The collaborative HMR involved healthcare providers at each Puskesmas. DRPs were assessed based on observations and semi-structured interviews. The DRP classification followed PCNE V9.1, and medication adherence was measured using both pill counts and self-report via the MARS-10 questionnaire. Data were analyzed using SPSS 25.0 to perform logistic regression with a 95% confidence level. Results: A total of 544 patients, comprising 269 adults and 275 older patients, were involved. Older patients experienced more DRPs than the adults (94.2% vs 84.8%). The most DRP experienced by both age groups was ineffective therapies, with the two most frequent causes being related to patient factors. Among the adults, hypertension comorbidity, number of medications, and BMI factors were associated with DRPs (p < 0.05). In contrast, no factors correlated with DRPs in the older patients. There was fair agreement between pill count and MARS-10 regarding medication adherence for both adults and older patients (kappa coefficients of 0.298 and 0.355, respectively). Conclusion: Patients in primary health facilities with hypertension and using at least three medications have over a three-fold increased risk of experiencing DRPs. Healthcare providers, including pharmacists, nurses, and physicians, should collaborate to identify medication-related issues and provide personalized advice and management plans to enhance medication adherence. This study highlights the need for a standardized, structured HMR program, not merely as a patient home visit but also to better control chronic diseases.
Relationship between social participation and stigma in people affected by leprosy: A cross-sectional study in northeastern Brazil Lima, Marize Conceicao Ventin; Arruda, Gustavo Aires de; Alves, Maria Geórgia Torres; Brandão Neto, Waldemar; Albuquerque, Cássia Cibelle Barros de; Nascimento, Raphaela Delmondes do; Pereira, Emanuela Batista Ferreira e; Valença, Marilia Perrelli; Moura dos Santos, Danielle Christine
Belitung Nursing Journal Vol. 12 No. 1 (2026): January - February
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4193

Abstract

Background: Leprosy remains a persistent public health challenge, especially in endemic areas, where its historical association with stigma continues to harm social participation and psychosocial well-being. Understanding how stigma affects social participation across different life areas is crucial for developing effective care and public health strategies. Objective: To examine the association between stigma and social participation across different domains among people affected by leprosy. Methods: A cross-sectional, quantitative study was conducted in 2019 with 97 individuals affected by leprosy followed at eight municipal reference units in Recife, Pernambuco, Brazil. Sociodemographic, environmental, and clinical data were collected using structured instruments and medical records. Stigma was assessed using the Explanatory Model Interview Catalogue (EMIC), and social participation was evaluated using the Participation Scale (PS). Data were analyzed using descriptive statistics, Spearman’s correlation, chi-square tests for linear trend, and effect size estimation using Cramér’s V. Statistical significance was set at p <0.05. Results: A total of 53.6% of participants presented some degree of restriction in social participation. The mean stigma score was 16.63 (SD = 8.53), and the mean participation score was 16.58 (SD = 13.62). A statistically significant, low-magnitude correlation was observed between stigma and participation restriction scores (Spearman’s rho = 0.25; p = 0.016). Categorical analysis demonstrated a significant linear association between higher stigma tertiles and greater participation restriction (χ² for trend, p = 0.022), with a low overall effect size (Cramér’s V = 0.20; 95% CI: 0.10–0.36). Moderate effect sizes were observed in specific participation domains, including religious and community activities (Cramér’s V = 0.24; p = 0.02), visiting other people in the community (Cramér’s V = 0.26; p = 0.01), and perceived respect within the community (Cramér’s V = 0.29; p = 0.04). Conclusion: Stigma was significantly associated with restricted social participation among people affected by leprosy. Although the overall association showed low magnitude, moderate and statistically significant associations were observed in key social domains. These findings support the inclusion of stigma and social participation assessments in routine leprosy care and highlight the need for integrated clinical, psychosocial, and community-based nursing and health interventions aimed at reducing stigma and promoting social inclusion.
Corrigendum to “A cross-sectional analysis of fall risk among institutionalized older adults in Malaysia” [Belitung Nursing Journal, 2025; 11(4): 487–495] Zohari, Zahira; Rahim, Azliza; Mat Din, Hazwan; Saibul, Nurfaizah; Jafri, Asiah; Rahim, Shafikah; Nasir, Faizah; Sallehuddin, Hakimah
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.4202

Abstract

This corrigendum corrects the author name, institutional affiliation, and participant information in the article “A cross-sectional analysis of fall risk among institutionalized older adults in Malaysia” [Belitung Nursing Journal, 2025; 11(4): 487–495, https://doi.org/10.33546/bnj.3899]. The corrections do not affect the findings or conclusions of the study.
Stress levels, stressors, and coping strategies among nursing students during maternal and child health clinical rotations: A cross-sectional study in Saudi Arabia Abdelmaksoud, Amaal Samir; Fadila, Doaa El Sayed; Alhumaidi, Bandar Naffaa; Al-Sayaghi, Khaled Mohammed; Roque, Mark Yuga; Relloso, Joyce Toriente; Fadlalmola, Hammad Ali
Belitung Nursing Journal Vol. 12 No. 1 (2026): January - February
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4212

Abstract

Background: Nursing students often experience high levels of stress during clinical training, particularly in maternal and child health (MCH) rotations, which may affect learning and well-being. Understanding stress levels, stressors, and coping strategies can inform the development of supportive and culturally appropriate educational approaches. Objective: To assess perceived stress levels, identify clinical stressors, and examine coping strategies among nursing students during MCH clinical rotations in Saudi Arabia. Methods: A cross-sectional study was conducted in 2024 among 187 female nursing students enrolled in MCH clinical rotations. Data were collected using validated Arabic versions of the Perceived Stress Scale (PSS-10), the Nursing Student Clinical Stressor Scale (NSCSS), and the Brief COPE Inventory. Descriptive statistics and Spearman’s rho correlation analyses were performed using SPSS. Results: Most students reported moderate perceived stress (75.4%), with a mean PSS-10 score of 20.5 ± 5.9. The highest stressor domains were MCH-specific challenges (9.13 ± 5.00), academic pressures (8.72 ± 3.95), and the clinical environment (7.65 ± 3.64). Religion (5.20 ± 2.06) and acceptance (4.79 ± 1.80) had the highest mean scores among coping strategies, while substance use was least reported (3.04 ± 1.40). Self-blame showed the strongest association with total clinical stressors (rho = 0.501, p <0.001). Conclusion: Female nursing students experienced moderate stress during MCH clinical rotations, largely related to clinical and academic demands. Coping strategies were predominantly emotion-focused, with self-blame showing a strong association with higher stress levels. These findings highlight the importance of culturally sensitive support strategies in nursing education.
Health needs of patients with permanent colostomy in North China: A longitudinal qualitative study based on the “Timing It Right” framework Liu, Baoyu; Wang, Liyan; Li, Qingqing; Pang, Xiaoli
Belitung Nursing Journal Vol. 12 No. 1 (2026): January - February
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4214

Abstract

Background: Colostomy surgery is the most common method used for the radical treatment and prolongation of life in patients with intestinal diseases. However, patients who undergo a colostomy face various physiological, psychological, and social challenges after the procedure. This necessitates that nurses deliver targeted care tailored to the specific needs of different stages and individual patients. Objective: This study aimed to understand the experiences of health needs of patients with colostomy in order to effectively improve their quality of life across different phases. Methods: A longitudinal qualitative study was conducted. Data were collected between July 2022 and March 2023. A total of 15 patients with permanent colostomy were selected to participate in unstructured interviews, guided by the “Timing It Right” framework. Data analysis was conducted using NVivo 12 software following Colaizzi’s methods. Results: The findings were organized according to the five distinct phases of the “Timing It Right” framework. Three key themes were revealed from the analysis: (1) Meeting physiological needs is the basis for patients with colostomy to recover; (2) Satisfying psychological needs is a necessary condition for improving the quality of life of patients with colostomy; (3) Social adaptation needs are effective ways to improve the quality of life of patients with colostomy. Conclusions: Based on the “Timing It Right” framework, the health status and needs of patients with colostomy differ across the following phases: diagnosis period, perioperative period, discharge preparation period, adjustment period, and adaptation period. This study not only provides a preliminary conceptual model for in-depth investigation of these patients’ health needs at each phase but also offers directional guidance for the future development of phase-specific, patient-centered nursing intervention strategies to better address their dynamic health demands.
Effect of the Capability-Opportunity-Motivation Behavior (COM-B) model of dietary behavior program on gestational weight gain in Thailand: A randomized controlled trial Buakhai, Pantipa; Xuto, Piyanut; Klunklin, Pimpaporn; Thungjaroenkul, Petsunee
Belitung Nursing Journal Vol. 12 No. 1 (2026): January - February
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4215

Abstract

Background: Excessive gestational weight gain can adversely affect maternal and fetal health. Dietary behavior change can help control gestational weight gain and prevent adverse pregnancy outcomes. Objective: This study aimed to examine the effect of the Capability-Opportunity-Motivation Behavior (COM-B) model of dietary behavior program on gestational weight gain. Methods: This single-blind randomized controlled trial used a pre-posttest control group design and included 96 pregnant women from a northern province of Thailand. Participants were randomly assigned equally to the experimental and control groups (48 each) using permuted block randomization. The experimental group received a 14-session COM-B model of dietary behavior program, while the control group received usual care. Data were collected via questionnaires between November 2023 and October 2024, and were analyzed using SPSS version 26, employing descriptive and inferential statistical methods. Results: At 36 weeks’ gestation, pregnant women in the experimental group had a significantly lower mean difference in gestational weight gain based on the Institute of Medicine (IOM) recommendation compared with both their baseline at 20 weeks and the control group. After adjusting for maternal age and education, the experimental group continued to show significantly lower gestational weight gain than the control group. The adjusted intention-to-treat analysis indicated a mean difference of -2.227 kg (95% CI: -3.75 to -0.70; p = 0.005; partial η² = 0.084), while the adjusted per-protocol analysis showed a mean difference of -2.648 kg (95% CI: -4.31 to -0.99; p = 0.002; partial η² = 0.110). These results suggest that the COM-B model of dietary behavior program effectively limited gestational weight gain, independent of sociodemographic differences. Even modest reductions in gestational weight gain may contribute to lowering the risk of pregnancy complications such as gestational diabetes and preeclampsia. Dietary behavior change was monitored, but not a predefined secondary outcome. Conclusion: The COM-B model of dietary behavior program led to minimal but potentially clinically relevant reductions in gestational weight gain. The findings highlight the clinical relevance of nurse-led interventions, underscoring the need for nurse training to implement the program in routine antenatal care. Trial Registry Number: Thai Clinical Trials Registry (TCTR20230907001)
Exploring Indonesian fathers’ educational needs in newborn care: A qualitative study Agustina, Ayuda Nia; Pratiwi, Anggi; Mahardika, Putri
Belitung Nursing Journal Vol. 12 No. 1 (2026): January - February
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4235

Abstract

Background: Father involvement in newborn care is increasingly recognized as a key determinant of infant health and family well-being. In Indonesia, paternal roles in neonatal care are often overlooked, and father-specific educational support remains limited. Understanding fathers’ lived experiences and learning needs is essential for developing effective, culturally appropriate interventions. Objective: This study aimed to explore the experiences and educational needs of Indonesian fathers in newborn care. Methods: A qualitative descriptive study was conducted using a thematic analysis approach. Sixteen fathers of infants aged 0-12 months were recruited through purposive sampling in Jakarta and the surrounding areas. Data were collected in 2024 through in-depth semi-structured interviews and analyzed using Braun and Clarke’s six-step framework. Trustworthiness was ensured through audit trails, member checking, and peer debriefing. Results: Three major themes emerged: (1) social media as the main source of information, (2) fathers’ practical involvement and learning needs in baby care, and (3) preference for visual and practical learning media. Fathers expressed strong motivation to be involved but faced challenges accessing reliable, father-focused educational content. Their learning preferences were shaped by practicality, time constraints, and the need for culturally relevant materials. Conclusion: Indonesian fathers are eager to participate in newborn care but lack structured educational support tailored to their needs. Pediatric nurses play a critical role in developing father-inclusive, digital, and culturally responsive interventions that enhance paternal self-efficacy and caregiving competence. Future programs should integrate father-focused digital interventions, such as video-based tutorials and podcasts, into pediatric nursing practice to effectively bridge the educational gap.

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