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Belitung Nursing Journal
ISSN : 2528181x     EISSN : 24774073     DOI : -
Core Subject : Health,
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 700 Documents
Nurses’ perspectives on emergency room healthcare constraints in implementing family-centered care: A qualitative study in Indonesia Rakhmawati, Windy; Mufida; Mediani, Henny Suzana; Fitri, Siti Yuyun Rahayu; Mardhiyah, Ai; Rhamelani, 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.4243

Abstract

Background: Children with acute conditions that suddenly worsen need immediate care in the Emergency Room (ER). Family-Centered Care (FCC) is considered the best approach in pediatric nursing, but its implementation in the ER is still limited. This is due to various challenges that can increase child and family anxiety and decrease the quality of nursing care. Objective: This study aimed to explore nurses’ perspectives on the constraints of the health service system in implementing FCC in child care in the ER. Methods: The study used a qualitative descriptive design. Eleven nurses working in the ER at Mokopido Tolitoli Regional Hospital participated in the study, which were chosen through purposive sampling. Data were collected using semi-structured interviews conducted from July 11 to July 23, 2023. Data were analyzed manually using a thematic approach. Results: The thematic analysis revealed two main interrelated themes regarding barriers to FCC in the ER: human resource constraints and organizational constraints. Human resource constraints include limited nursing staff, varying educational levels, lack of training or outreach on FCC, lack of competency, and communication barriers. Meanwhile, organizational constraints include high ER workloads, limited nurse time, and a focus on emergency medical procedures rather than a holistic approach. These various barriers lead to suboptimal family involvement in the care of children in the ER. Conclusion: The implementation of FCC in the ER still faces major challenges. These findings highlight the need for a strategic approach and supportive policies to improve nurse capacity and foster a collaborative and responsive hospital environment for patients’ families.
Phone-based motivational interviewing intervention among patients undergoing cardiac rehabilitation: A randomized controlled trial in China Wang, Yu; Wacharasin, Chintana; Masingboon, Khemaradee
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.4258

Abstract

Background: Maintaining regular physical activity (PA) is a critical challenge for patients undergoing cardiac rehabilitation (CR), as inadequate adherence can lead to adverse outcomes, including disease recurrence. Enhancing motivation is key to improving PA adherence. Motivational interviewing (MI) has been shown to overcome psychological barriers by building intrinsic motivation. However, there is a need to explore how to integrate MI techniques with digital technology to enhance intervention accessibility and leverage the strengths of both approaches. Objective: This study aimed to evaluate the effects of a hybrid intervention model integrating phone-based motivational interviewing with mobile phone-based management on motivation and physical activity in patients undergoing CR. Methods: This pilot randomized controlled trial was conducted in China between January and June 2024, involving 52 patients undergoing cardiac rehabilitation. The intervention group (n = 25) received usual care plus a 4-week phone-based motivational interviewing intervention, which included a face-to-face session, weekly phone MI sessions (OARS technique), and personalized support via WeChat. The control group (n = 27) received only usual cardiac rehabilitation guidance. Outcomes measured were steps/day (using a smart band) and motivation, assessed using the Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2). Two-way repeated-measures ANOVA was used for data analysis. Results: Compared with the control group, the intervention group showed a significant interaction effect of Group*Time on both steps/day (p <0.001, ηp2 = 0.706) and the BREQ-2 (RAI) (p <0.001, ηp2 = 0.349). The intervention group’s daily steps significantly increased from 3582.80 ± 649.59 to 9444.79 ± 1413.72 (p <0.001). Conclusion: This study indicates that a phone-based motivational interviewing intervention delivered by trained researchers can effectively increase physical activity levels and enhance autonomous motivation for PA in CR patients. This approach provides a scalable model for the routine care of cardiac rehabilitation patients, especially in resource-limited settings. For nursing practice, the findings highlight the importance of incorporating MI as a core skill and utilizing a hybrid, technology-supported care model to extend continuous professional support into patients’ homes. Trial Registry Number: Chinese Clinical Trial Registry (ChiCTR2400079877)
Associations between family care, organizational support, psychological resilience, and professional quality of life of emergency department nurses in China: A cross-sectional study Liu, Gang; Hu, Shaohua; Ding, Peipei
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.4272

Abstract

Background: Emergency department nurses face substantial occupational stress due to frequent exposure to high-risk, unstable, and unpredictable clinical environments. However, research on nurses’ professional quality of life (ProQOL) has largely focused on other specialties, leaving ED nurses underrepresented. Addressing this gap is essential to improving professional well-being and job satisfaction. Objective: This study aimed to examine the associations between family care, organizational support, psychological resilience, and ProQOL among emergency department nurses. Methods: A cross-sectional study was conducted from July 6 to July 31, 2024, involving 441 emergency department nurses from 18 tertiary hospitals in 16 cities in Anhui Province, China. Data were collected using anonymous paper-based questionnaires and analyzed using descriptive statistics, t-tests, one-way ANOVA, Kruskal–Wallis H tests, Pearson’s correlation analysis, and multiple linear regression. Results: Compassion satisfaction differed significantly by sex (Z = -2.677, |d| = 0.231, p = 0.007), professional level (H = 17.675, η² = 0.035, p < 0.001), and number of night shifts (H = 10.571, η² = 0.022, p = 0.005). Burnout scores varied significantly by professional level (H = 8.861, η² = 0.016, p = 0.012), number of night shifts (H = 8.357, η² = 0.021, p = 0.015), and presence of chronic illness (Z = -2.029, |d| = 0.437, p = 0.042). Secondary traumatic stress differed significantly according to chronic illness history (Z = -2.232, |d| = 0.341, p = 0.026). Family care, organizational support, and psychological resilience were positively correlated with compassion satisfaction (r = 0.382, 0.549, and 0.562, respectively; all p < 0.001) and negatively correlated with burnout (r = -0.333, -0.405, and -0.497, respectively; all p < 0.001). Regression analyses indicated that family care, organizational support, and psychological resilience significantly predicted compassion satisfaction (adjusted R² = 0.458), while burnout was significantly associated with intention to leave the ED, family care, organizational support, and psychological resilience (adjusted R² = 0.358). Conclusion: The findings provide evidence that family care, organizational support, and psychological resilience are associated with the ProQOL of nurses working in emergency departments. In China, these results offer useful references for regions facing similar emergency care pressures (e.g., high workloads in tertiary hospitals, nurse shortages) to optimize nurse well-being interventions. They also provide a foundation for developing targeted strategies to enhance nurses’ professional well-being and job satisfaction.
Determinants of loneliness and quality of life among rural community-dwelling older adults in Egypt: A cross-sectional descriptive study Abdel Aziz, Hassanat Ramadan; El-Ashry, Ayman Mohamed; Ibrahim, Ateya Megahed; Mohammed , Safia Gomaa
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.4293

Abstract

Background: Loneliness in later life is common and is strongly associated with poorer quality of life (QoL). However, evidence from rural Egypt remains limited, particularly community-based studies that concurrently examine loneliness and QoL and their health, social, religious, and leisure-related determinants. This gap limits the development of culturally appropriate nursing and community interventions for rural older adults. Objective: To assess the levels of loneliness and QoL and to identify their determinants among community-dwelling older adults in a rural Egyptian setting. Methods: A cross-sectional descriptive study was conducted between July and September 2023 in a randomly selected rural village in Sharkia Governorate, Egypt. Using multistage probability sampling, 143 community-dwelling adults aged 60 years and older were recruited. Data were collected using structured and validated questionnaires. Descriptive statistics, Pearson correlation coefficients, and multiple linear regression analyses were performed. Results: Participants had a mean age of 70.87 ± 8.50 years, and 52.4 percent were women. High loneliness was reported by 43.4 percent of participants, while 73.4 percent had low overall quality of life. Loneliness was strongly and inversely correlated with quality of life and was positively correlated with age and disease burden, while quality of life was negatively associated with age and number of chronic diseases and positively associated with education, income, social support, religious rituals, and leisure activities in bivariate analyses (all p <0.001). In exploratory multivariable analyses, quality of life was independently associated with age, education, current employment, number of chronic diseases, social support, and loneliness (R² = 0.743), while loneliness was associated with age, number of visitors, religious rituals, and leisure activities (R² = 0.451). Conclusion: Loneliness and low quality of life are highly prevalent among community dwelling older adults in rural Egypt and are closely linked to aging, chronic disease burden, social resources, and engagement in meaningful activities. For nursing practice, these findings support the routine screening of loneliness and quality of life in primary and chronic care settings, the integration of social support and activity-based interventions into care plans, and collaboration with community and faith-based organizations to deliver culturally appropriate strategies aimed at reducing loneliness and enhancing quality of life among rural older populations.
Complementary and alternative medicine use and pain characteristics in older Vietnamese adults with chronic pain: A cross-sectional study Trieu, Nguyen Thi Thu; Hoai, Nguyen Thi Yen; Thuy, Pham Thi; Dung, Phan Thi An; Ninh, Do Thi
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.4317

Abstract

Background: Chronic pain is a common and burdensome condition among older adults, significantly impacting their quality of life and increasing interest in complementary and alternative medicine (CAM) approaches to pain management. Objectives: This study aimed to describe the prevalence of CAM use and attitudes toward CAM for self-managing chronic pain among older adults, and to examine the associations between chronic pain characteristics, CAM use, and attitudes toward CAM. Methods: A cross-sectional study was conducted among 289 hospitalized patients aged ≥60 years with chronic pain at a general hospital in Da Nang, Vietnam, in 2025. Data were collected using a structured questionnaire that included the Pain Disability Index (PDI) and the Attitudes towards CAM scale. Statistical analyses included t-tests, ANOVA, chi-square tests, and Pearson’s correlation. Results: CAM use was reported by 92.7% of participants, with biologically based therapies (e.g., herbal remedies) being the most common (81.3%). The average attitude score toward CAM was 28.7 (SD = 3.2), indicating generally favorable views. CAM use was more frequently reported among participants experiencing pain in specific anatomical locations, including the arm/hand, neck, upper back, and lower back (all p <0.008 after Bonferroni correction). Attitudes toward CAM were modestly associated with perceived pain control ability (p = 0.031) and with the impact of chronic pain on daily life (r = 0.206; p <0.001), while other pain characteristics showed no significant associations. Conclusion: CAM is widely used and positively perceived among older Vietnamese adults with chronic pain. Associations were observed between certain pain characteristics and CAM use, as well as between pain-related interference and attitudes toward CAM. These findings highlight the importance of routinely assessing CAM use in older adults and providing guidance on safe, evidence-based options within comprehensive pain management, while recognizing the observational nature of the data.
Low birth weight among neonates in rural areas of Indonesia: A secondary data analysis Nelwati, Nelwati; Malini, Hema; Efendi, Ferry; Kuswanto, Heri; Has, Eka Misbahatul Mar’ah; Sampurna, Mahendra Tri Arif
Belitung Nursing Journal Vol. 12 No. 2 (2026): March - April
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4163

Abstract

Background: Low birth weight (LBW) is a major global health concern because of its strong association with infant mortality, morbidity, and impaired long-term development. The determinants of LBW among neonates in rural areas of Indonesia remain underexplored. Objective: To examine the prevalence of LBW and determine its associated factors among neonates in rural areas of Indonesia.   Methods: A cross-sectional study used secondary data sources from the 2017 Indonesian Demographic and Health Survey. A total of 6,701 mothers who lived in rural areas were included. Explanatory variables were maternal age, maternal education, smoking status, parity, birth interval, twin history, antenatal care (ANC), husband support, wealth quintile, region of residence, and complications during pregnancy. The outcome variable was the prevalence of LBW. Data were analyzed using bivariate analysis with a Chi-square test (χ2) and multivariable logistic regression. Results: The prevalence of LBW was 6.65%. First birth [AOR = 1.486; 95% CI: 1.126-1.959], twin history [AOR = 27.165; 95% CI = 13.006-56.738], fewer than four ANC visits [AOR = 2.193; 95% CI = 1.519-3.164], and complications during pregnancy [AOR = 1.890; 95% CI = 1.427-2.503] were significantly associated with the prevalence of LBW. Conclusion: This study revealed the prevalence of LBW among neonates in rural areas of Indonesia. First birth, twin history, ANC visits, and complications during pregnancy were significantly associated with LBW. It is suggested that health professionals should strengthen the quality of antenatal care and improve health promotion and education during pregnancy for rural mothers to reduce the prevalence of LBW.
The relationship between nurses’ speaking up about patient safety and nursing work environment in Saudi Arabia: A cross-sectional study Albalawi, Rawan; Gheith, Nirvana Abdelrahman; Felemban, Ebaa
Belitung Nursing Journal Vol. 12 No. 2 (2026): March - April
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4233

Abstract

Background: Despite nurses’ proximity to patient care, many remain reluctant to voice safety concerns. A significant gap exists in understanding how the professional work environment influences these behaviors within the Saudi Arabian context, where specific cultural and hierarchical norms may impact communication. Objective: This study examined the relationship between nurses’ speaking up regarding patient safety and the nursing work environment in Saudi Arabia. Methods: A cross-sectional descriptive correlational design was used. Data were collected from 270 nurses between August and September 2024 using the Speaking Up About Patient Safety Questionnaire (SUPS-Q) and the Practice Environment Scale of the Nursing Work Index (PES-NWI). Statistical analyses were conducted using SPSS version 28, including descriptive statistics, Spearman’s rank correlation, and ANCOVA. Results: The nursing work environment showed a significant correlation with the speak-up climate. Weak but statistically significant negative correlations were found between perceived concerns and nurse participation (r = -0.210, p = 0.001), quality foundations (r = -0.155, p = 0.011), staffing adequacy (r = -0.184, p = 0.002), and nurse–physician relations (r = -0.156, p = 0.010). Withholding voice also negatively correlated with quality foundations (r = -0.149, p = 0.014) and nurse–physician relations (r = -0.138, p = 0.023). Psychological safety and an encouraging environment showed strong positive correlations with all work environment dimensions (p < 0.001). ANCOVA indicated that education level significantly predicted speaking up (p = 0.042), and experience influenced perceptions of the work environment (p = 0.002), while age and nationality were not significant. Conclusion: Strengthening the work environment is a clinical necessity for safety. Organizations should prioritize “Just Culture” initiatives, systemic learning, and visible responses to raised concerns. Practice protocols should include “safe zones” for voicing concerns away from patients. Professional development must focus on communication skills for addressing high-authority figures. Finally, adequate staffing is essential to empower nurses to prioritize safety advocacy over basic tasks.
Predictors of health literacy among older adults with hypertension in Bali, Indonesia: A cross-sectional study Krisnayanti, Putu Mega; Promnoi, Chantra; Chinnawong, Tippamas
Belitung Nursing Journal Vol. 12 No. 2 (2026): March - April
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4270

Abstract

Background: The prevalence of hypertension in Indonesia continues to increase, particularly in Bali. However, existing research focusing on health literacy in Indonesia, especially among older adults with hypertension, is still limited and outdated. Objective: This cross-sectional predictive design study aimed to examine the level of health literacy among older adults with hypertension and its associated factors. Methods: Two hundred ninety-six eligible older adults with hypertension were purposively selected from two regencies in Bali. Data were collected from March to April 2025 using the Demographic Characteristic Questionnaire, the Short-Form Health Literacy Survey (HLS-SF12), the Perceived Severity of Illness Questionnaire (PSIQ), and the Multidimensional Scale of Perceived Social Support (MSPSS). The data were analyzed using descriptive statistics and multiple regression. Results: The findings showed an adequate level of health literacy among older adults with hypertension. The regression model explained 47.80% of the variance in health literacy (R² = 0.478). Significant associated factors of health literacy included perceived severity of illness (β = 0.353, p < 0.001), social support (β = 0.347, p < 0.001), and social activity engagement (β = 0.166, p < 0.001). However, use of media (β = 0.039, p = 0.375) and access to healthcare services (β = 0.001, p = 0.977) were not statistically significant predictors of health literacy among older adults with hypertension. Conclusion: Perceptions of illness severity, along with social support and social activity engagement, play a fundamental role in shaping the health literacy of older adults with hypertension in Bali. These findings can guide nurses in developing a tailored education program to help older adults better understand illness severity and promote social integration.
The relationship between leadership styles of nurse managers, nurse motivation, and turnover intention among nurses in Saudi Arabia: A descriptive correlational study Aldhafeeri, Nouf Afit; Alshutwi, Sitah S.; Alotaibi, Ahoud Mofareh; Alanaza, Albandre Eid; Jaber, Amirah Hussain; Alharbi, Asrar Saleh; Alowais, Raghad Khalid
Belitung Nursing Journal Vol. 12 No. 2 (2026): March - April
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4297

Abstract

Background: Nurses’ perceptions of their nurse managers’ leadership styles influence work motivation and turnover intention. However, limited evidence is available from Middle Eastern healthcare settings, particularly in Saudi Arabia. Objective: This study aimed to examine the relationships between nurse managers’ leadership styles, nurses’ work motivation, and turnover intention, and assessed whether work motivation moderates the association between leadership styles and turnover intention. Methods: A cross-sectional survey was conducted among 377 nurses working in governmental hospitals in Riyadh, Saudi Arabia, between January and March 2024. Leadership styles were measured across four dimensions: directive, supportive, participative, and achievement-oriented leadership. Data were analyzed using descriptive statistics, Pearson correlation analysis, and multivariate linear regression, followed by moderation analysis. Results: The mean scores for supportive, participative, directive, and achievement-oriented leadership were 5.3 ± 1.0, 5.1 ± 1.0, 5.0 ± 1.0, and 4.9 ± 1.0, respectively. The mean scores for work motivation and turnover intention were 3.5 ± 0.9 and 3.1 ± 0.8. Correlation analysis indicated that all leadership styles were positively associated with work motivation, whereas only directive leadership was negatively associated with turnover intention. In multivariable regression analyses, after adjustment for sociodemographic and professional factors, achievement-oriented leadership remained significantly associated with higher work motivation (β = 0.51, p = 0.034), while directive leadership was independently and negatively associated with lower turnover intention (β = -0.15, p = 0.022). Nationality, educational level, years of experience, and working area were also significantly associated with turnover intention in adjusted models, while educational level and years of experience were associated with nurses’ perceptions of leadership styles. Moderation analysis showed that work motivation did not significantly moderate the relationship between directive leadership and turnover intention. Conclusion: Leadership styles were significantly associated with nurses’ work motivation and turnover intention. Achievement-oriented leadership was linked to higher work motivation, while directive leadership was associated with lower turnover intention. These findings highlight the importance of strengthening nurse managers’ leadership competencies to enhance nurses’ motivation and potentially reduce turnover intentions in hospital settings.  
Maternal guilt in the lives of female ICU nurses in South Kalimantan, Indonesia: A qualitative study Hairina, Yulia; Hartini, Nurul; Nursalam
Belitung Nursing Journal Vol. 12 No. 2 (2026): March - April
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4329

Abstract

Background: Maternal guilt is a common emotional experience among working mothers, often associated with challenges in fulfilling both professional and caregiving roles. Female nurses, especially those working in intensive care units (ICUs), encounter pressures due to heavy workloads, irregular schedules, and the emotional intensity of patient care. These conditions make them particularly vulnerable to feelings of guilt when family responsibilities are perceived as being neglected. Objective: This study aimed to explore how maternal guilt is experienced in the personal and professional lives of female ICU nurses in South Kalimantan, Indonesia. Methods: A qualitative descriptive design using thematic analysis within a constructivist paradigm was employed. Ten married female ICU nurses who were mothers and had at least five years of ICU experience were purposively recruited through nurse managers from three regional public hospitals. Data were collected through in-depth semi-structured interviews, with member checking and researcher triangulation used to enhance credibility. Interviews were conducted between March and June 2024, transcribed, translated, and analyzed following Braun and Clarke’s six-phase framework. Results: Three themes were identified: (1) the internal burden of perceived inadequacy, reflected in persistent feelings of inadequacy, emotional exhaustion, cognitive overload, anxiety and sadness, and self-blame; (2) relational strain and compensatory parenting, including disrupted parent–child bonding, compensatory parenting behaviors, and increased emotional dependence on spouses; and (3) professional strain and competing care responsibilities, characterized by reduced work focus and distraction, fatigue and thoughts of resignation, and role conflict between professional and maternal responsibilities. These findings indicate that maternal guilt emerged as a multidimensional experience permeating both personal and professional domains. Conclusion: Maternal guilt emerged as a salient experience shaping nurse mothers’ emotional well-being, family relationships, and professional functioning. The findings suggest that collectivist cultural expectations and idealized motherhood norms may contribute to shaping the experience of guilt among Indonesian ICU nurses.  These insights underscore the need for supportive workplace policies, flexible scheduling, and accessible psychosocial services to sustain nurses’ well-being and retention in high-demand clinical environments.

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