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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 700 Documents
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Current situation and influencing factors of emergency department visits by non-urgent young and middle-aged patients in China: A retrospective study Wu, Lizhen; Feng, Xiaowei; Dai, Huihua
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.4363

Abstract

Background: Escalating emergency department overcrowding poses a serious threat to healthcare delivery, leading to reduced quality of care, increased risk of infection transmission, and heightened tension between medical staff and patients. Objective: This study aimed to investigate the status of emergency department visits by young and middle-aged patients triaged as non-urgent and to explore the influencing factors. Methods: This study retrospectively analyzed clinical data from 55,578 young and middle-aged patients who visited the emergency department of a tertiary class A hospital in Guangdong Province between January 1 and December 31, 2024. Patients were grouped into urgent and non-urgent based on triage classification. The differences in the clinical indicators between the two groups were compared. Logistic regression analysis was conducted to identify the factors associated with non-urgent triage classification. Results: Among the included young and middle-aged patients, 35,314 (63.5%) were classified as non-urgent cases, while 20,264 (36.5%) were classified as urgent. Binary logistic regression analysis revealed that non-urgent triage classification was significantly associated with the following factors (p < 0.05): visiting Emergency Fever (OR = 1.513) and Emergency Gastroenterology (OR = 4.278) compared to Emergency Internal Medicine and Surgery; arriving on foot or by other modes (OR = 6.073) compared to ambulance transport; visiting during the afternoon shift (OR = 1.110) compared to morning shift, on weekends (OR = 1.111), and during the autumn (OR = 1.140) and winter seasons (OR = 1.083) compared to spring. Conclusion: The rate of non-urgent triage among young and middle-aged patients is high. Triage nurses should be particularly vigilant in assessing patients presenting to departments with a higher likelihood of non-urgent classification, such as the Emergency Fever and Emergency Gastroenterology, as well as those arriving without ambulance transport, during non-working hours and peak flu seasons. These findings can inform nurse-led strategies, such as dynamic staffing and guiding appropriate patients to alternative services, such as internet hospitals, thereby mitigating emergency department overcrowding. It should be noted that in this study, non-urgent status was defined solely by the triage system and was not validated against clinical outcomes; therefore, the findings describe patterns of triage classification rather than objective patient acuity.
Unseen burden: Prevalence and determinants of possible sarcopenia in Indonesian older adults – a secondary data analysis Halilintar, Via Dolorosa; Pujiyanto
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.4368

Abstract

Background: Indonesia is experiencing rapid population aging, raising concern about muscle weakness in later life; possible sarcopenia offers early identification through low handgrip strength. Objective: To estimate the prevalence of possible sarcopenia and its determinants among older adults in Indonesia. Methods: This secondary analysis used baseline data from the Indonesian Longitudinal Aging Survey 2023 and included adults aged sixty years or older with valid handgrip measurements. Possible sarcopenia followed the Asian Working Group for Sarcopenia 2019 thresholds using the maximum of two trials per hand. Covariates included sociodemographic, behavioral, functional, and clinical factors. We applied descriptive statistics, bivariate tests, and multivariable logistic regression, with probit average marginal effects. Sampling weights were unavailable in the public-use microdata; we treated enumeration areas as the primary sampling units, with available stratification and no weights; estimates were unweighted, and standard errors were design-based (survey-corrected). Results: Among 1,598 participants, the prevalence of possible sarcopenia was 51.1%. Older age, low physical performance, and urban residence were associated with higher odds. Higher body mass index and better cognition were associated with lower odds. A prespecified sex-by-body mass index interaction suggested attenuation of the protective association of body mass index among women. Conclusion: Possible sarcopenia is common among older Indonesians and is patterned by age, body composition, cognition, functional status, and residential context. Community health services, including community nursing services, can integrate routine handgrip assessment with brief interventions on strength activities, nutrition, and cognitive engagement to identify risk early and inform preventive care.
Transition to fatherhood among first-time expectant fathers having couvade syndrome in northern Thailand: A grounded theory study Sritawan, Piyawan; Sansiriphun, Nantaporn; Deeluea, Jirawan; Chaloumsuk, Nonglak; Krikitrat, Preeyakamon
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.4372

Abstract

Background: Transitioning to fatherhood for the first time is a significant milestone in a man’s life, especially among first-time expectant fathers having couvade syndrome, which causes them to experience changes both physically and psychologically. However, there is a lack of existing research on the process of transition to fatherhood among first-time expectant fathers having couvade syndrome. Objective: This study aimed to explore the process of transition to fatherhood among first-time expectant fathers having couvade syndrome. Methods: This study adopted a constructivist grounded theory methodology. Participants included 20 first-time expectant fathers having couvade syndrome who were purposively selected from antenatal clinics of two hospitals in northern Thailand. Data were collected between March 2021 and October 2023 using in-depth interviews following Charmaz’s steps. Data were corrected and analyzed until theoretical saturation. Results: “Evolving new father’s role over couvade syndrome” emerged as the core category representing their transition into fatherhood. This process consisted of three phases. Phase I was experiencing couvade syndrome that involved confirming couvade syndrome and responding to couvade syndrome. Phase II focused on handling couvade syndrome by accepting it and adapting behaviors. Phase III was stepping into the father’s role as couvade syndrome symptoms resolved, encompassing freaking out about the new father’s role, dealing with it, and planning for raising the baby. Conclusion: This study generated new knowledge regarding the transition to fatherhood among first-time expectant fathers experiencing couvade syndrome that involves three phases: in early pregnancy, around the middle of pregnancy, and towards the end of pregnancy. The insights can be used to inform nursing interventions to provide comprehensive, phase-specific antenatal care for these fathers.
Factors predicting the 7-day period prevalence of low back pain among female undergraduate nursing students in an online learning environment: A multi-center cross-sectional study across Thailand Summart, Ueamporn; Butsripoom, Benjamaporn; Polpanadham, Panicha; Palanupat, Thippawan; Piwpong, Ratchanee; Wittayapun, Yuwadee
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.4377

Abstract

Background: Most nursing students are female and represent a high-risk group for low back pain (LBP) before entering the workforce. However, the prevalence and specific predictors for LBP in this population remain poorly defined. Objective: This study investigated the prevalence and predictive factors of LBP among a nationally representative sample of Thai female nursing students. Methods: A cross-sectional online survey was conducted in 2022 among 3,490 female students from 18 nursing schools across Thailand. Data collected included demographics, online learning habits, psychological health, and LBP perceptions. Binary logistic regression was used to identify predictors of LBP. A p < 0.05 was deemed significant. Results: The seven-day period prevalence of LBP after six months of online learning was 39.5% (95% CI = 37.3-40.6). Factors significantly predicting LBP included anxiety [mild-to-moderate (AOR = 1.54, 95% CI = 1.31–1.82) and severe-to-extremely severe (AOR = 1.47, 95% CI = 1.13–1.91)], prolonged sitting (AOR = 1.52, 95% CI = 1.14–2.04), smartphone use for learning (AOR = 1.44, 95% CI = 1.23–1.68), bent posture (AOR = 1.33, 95% CI = 1.16–1.61), fatigue (per 10-point increase; AOR = 1.27, 95% CI = 1.11–1.46), and participation in online learning classes (AOR = 1.07, 95% CI = 1.02–1.12). Likewise, the final model demonstrated modest discriminatory power (AUC = 0.68, 95% CI = 0.63–0.74; p < 0.001). While the model significantly differentiates between students with and without LBP, its clinical utility is constrained by the condition’s multi-factorial nature. Conclusions: LBP is common among female nursing students and is driven by a combination of ergonomic and psychological factors. Nursing education programs should implement routine screening for both physical and mental well-being, alongside targeted preventive interventions to manage these modifiable risk factors before students enter professional practice.
Degree of burnout and leadership efficacy among nurse managers in a tertiary maternity hospital in Qatar: A sequential explanatory mixed-methods study Tapawan, Ana Mari Karla; Silang, John Paul Ben Tabar; Vallesteros, Liwayway T.; Jesus, David Hali de; Fabros, Marietta; Rosa, Ronnell Dela; Tomy, Jim; Ibrahem, Rana Aatif Salim; Al-Lenjawi, Badriya
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.4386

Abstract

Background: Nurse managers play a critical role in maintaining effective clinical operations and staff performance. However, research examining burnout and leadership efficacy in maternity care settings remains limited. Objective: To examine burnout and leadership efficacy among nurse managers. Methods: A sequential explanatory mixed-methods study was conducted at a tertiary maternity hospital in Doha, Qatar. In Phase I, 125 nurse managers were recruited through convenience sampling and completed the Maslach Burnout Inventory–Human Services Survey for Medical Personnel and the Leadership Efficacy Questionnaire. In Phase II, eight participants were purposively selected for in-depth interviews. Quantitative and qualitative findings were integrated using a joint display approach. Results: Participants reported moderate emotional exhaustion (M = 22.85, SD = 12.69) and depersonalization (M = 7.40, SD = 5.31), alongside high personal accomplishment (M = 42.19, SD = 5.75). Leadership efficacy scores indicated moderate confidence across leader action, leader means, and self-regulation domains. Emotional exhaustion and depersonalization were negatively correlated with all domains of leadership efficacy, whereas personal accomplishment was positively correlated with them. Qualitative findings identified workload, staff management demands, and personal stressors as key contributors to burnout, while resilience, support systems, and adaptive coping strategies were associated with leadership efficacy. Integration indicated that burnout and leadership efficacy co-occur, with inverse associations suggesting that higher burnout is associated with lower leadership confidence, despite sustained functional performance. Conclusion: Burnout and leadership efficacy are significantly associated among nurse managers. Although leadership functioning appears to be maintained, emotional strain is related to reduced leadership confidence. Organizational strategies that address workload demands, strengthen support systems, and promote resilience may help mitigate burnout and support leadership effectiveness.
Risk factors and outcomes of healthcare-associated infections in a Brazilian intensive care unit: A cross-sectional study Sousa Moura, Andressa Maria de; Sousa, Álvaro Francisco Lopes de; Carvalho, Herica Emilia Félix de; Madeira, Maria Zélia de Araújo; Freitas, Daniela Reis Joaquim de; Lima, Ana Carolina de Macedo; Carneiro, Liliane Moretti; Valim, Marilia Duarte; Junior, Aires Garcia dos Santos; Batista, Odinéa Maria Amorim
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.4399

Abstract

Background: Healthcare-associated infections (HAIs) in intensive care units (ICUs) are frequent and are associated with sepsis, antimicrobial resistance, and high mortality, reinforcing the need for early risk stratification at admission. Objective: To analyze risk factors and clinical outcomes associated with HAIs in ICU patients. Methods: This cross-sectional study was conducted in the ICU of a public hospital with 141 patients (182 HAI cases). Medical records covered ICU admissions from August 1, 2022, to August 31, 2024, and data collection occurred from November 2024 to February 2025. Data were extracted from medical records and the Hospital Infection Control Committee database. Risk factors were assessed at admission using the Rodríguez-Almeida-Cañon (RAC) Scale, which stratifies HAI risk using intrinsic and extrinsic factors and classifies patients as low, moderate, or high risk. Clinical outcomes monitored during hospitalization included hospital discharge, sepsis, septic shock, and death. Results: By RAC, 53.9% were moderate risk and 45.4% high risk; lower educational level was associated with higher risk (p = 0.016). Ventilator-associated pneumonia predominated (44.4%). Predominant pathogens were Pseudomonas (28.1%), Acinetobacter (19.1%), and Klebsiella (17.4%), with 34.3% showing carbapenem resistance. Sepsis occurred in 18.5% and septic shock in 30.2%; mortality was 62.9%. Compared with the reference group, odds of discharge were higher among patients aged 20–39 years (OR = 12.48; 95% CI: 4.89–102.90; p = 0.002) and 40–59 years (OR = 4.33; 95% CI: 3.89–35.78; p = 0.019). Conclusion: RAC screening revealed a high burden of predisposing factors at ICU admission, particularly among patients with lower educational levels, which was associated with worse outcomes. RAC-guided admission screening can support risk-proportional nursing surveillance and targeted prevention bundles, while institutional policies should reinforce microbiological surveillance and antimicrobial stewardship tailored to social vulnerability.
The moderating role of psychological capital in the relationship between workplace bullying and job burnout among nurses in Saudi Arabia: A cross-sectional study Abou Zeid, Mennat Allah G.; Ibrahim, Ibrahim Abdullatif
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.4404

Abstract

Background: Workplace bullying remains a pervasive problem in nursing, adversely affecting nurses’ well-being and professional functioning. Prolonged exposure to bullying is associated with emotional exhaustion and job burnout. However, the potential buffering role of internal psychological resources, particularly psychological capital, has not been sufficiently examined. Objective: This study aimed to explore the association between workplace bullying and job burnout among hospital nurses and examined whether psychological capital moderates this relationship. Methods: A cross-sectional study was conducted with 209 nurses from two hospitals between July and September 2025. Data were collected using the Short Negative Acts Questionnaire, the Work-Related Burnout subscale of the Copenhagen Burnout Inventory, the Psychological Capital Questionnaire, and a demographic and professional characteristics form. Data analysis included descriptive statistics, independent t-tests, one-way ANOVA, Pearson’s correlation coefficients, and moderation analysis using PROCESS macro (Model 1). Results: Nurses reported moderate levels of workplace bullying (M = 2.31, SD = 1.12) and job burnout (M = 2.44, SD = 0.91). Psychological capital was relatively high (M = 4.89, SD = 1.08), including optimism (M = 4.93, SD = 1.09), hope (M = 4.96, SD = 1.13), self-efficacy (M = 4.77, SD = 1.19), and resilience (M = 4.89, SD = 1.17). Job burnout differed significantly across age groups (p = 0.043). Workplace bullying and job burnout varied by educational level (p = 0.019 and p = 0.021, respectively), and workplace bullying differed by gender (p = 0.001). Moderation analysis indicated that workplace bullying was positively associated with job burnout (B = 0.472, p < 0.001), whereas psychological capital was negatively associated with burnout (B = -0.135, p < 0.01). The interaction between workplace bullying and psychological capital was significant (B = 00.106, p < 0.01), indicating that psychological capital attenuated the positive association between workplace bullying and job burnout. Conclusion: Psychological capital functions as a protective factor that buffers the adverse impact of workplace bullying on nurses’ job burnout. These findings highlight the importance of strengthening nurses’ psychological resources through organizational strategies and resilience-enhancing interventions to promote well-being and reduce burnout risk.
Integration of competency needs and continuity of care learning for midwifery students based on mobile applications in Indonesia: A mixed-methods study Susanti, Ari Indra; Mandiri, Ariyati; Novitasari, Anis; Silmi, Harridhil; Didah; Adnani, Qorinah Estiningtyas Sakilah; McKenna, Lisa
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.4446

Abstract

Background: Strengthening the quality of midwifery education is crucial to equip future midwives with the competencies required for contemporary practice. Continuity of Care (CoC) learning requires structured learning strategies, appropriate media, and effective evaluation mechanisms based on students’ needs. In this context, mobile applications can support CoC learning through flexible documentation and reporting systems. Objective: This study aimed to identify learning and competency needs for technology-enhanced CoC education among midwifery students. Methods: A convergent mixed-methods design was employed with midwifery students in the Bandung Metropolitan Raya region, West Java, Indonesia, in 2024. Purposive sampling was used to select 310 students for quantitative analysis using STATA 16.0. Qualitative data from online focus group discussions (FGDs) with 34 students were analyzed using NVivo 1.6.1. Results: Quantitative analysis identified learning strategy as the strongest predictor of CoC competency (r = 0.790, p < 0.001). Qualitative findings revealed two main themes: CoC Competencies (with subthemes of CoC Competency Objectives and CoC Core Competencies) and integrated CoC learning components (learning strategy, learning media, and learning evaluation). Conclusion: This study identified four essential components of mobile-based CoC learning, with learning strategies emerging as the strongest predictor of competency. These findings indicate that, although mobile technology enables efficient recording and reporting, it must be integrated with structured learning strategies to effectively strengthen midwifery competencies.
A hierarchical analysis of predictors of perioperative competency in Chinese operating room nurses Fu, Cong; Abhicharttibutra, Kulwadee; Lertwatthanawilat, Wanchai; Wichaikhum, Orn-Anong
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.4451

Abstract

Background: Perioperative competency among operating room (OR) nurses is essential for ensuring patient safety and effective surgical care. Guided by Bronfenbrenner’s bioecological model, particularly the Person component, this study examined how key individual characteristics contribute to perioperative competency among nurses working in tertiary hospitals in China. Objective: This study aimed to hierarchically examine the predictive power of key person characteristics (including demographics, specialized resources, and force characteristics) on perioperative competency. Methods: A cross-sectional survey was conducted among 287 OR nurses from five tertiary hospitals in Hebei Province, China. Data were collected between September 1 and November 30, 2024. Using a predictive correlational design, hierarchical multiple regression analysis was performed. Demographics (gender, marital status, educational level, professional job title) were entered in Block 1, followed by core predictors (years of experience, specialized training, empowerment, self-efficacy, and resilience) in Block 2, using the enter method for each block. Key constructs were measured with validated scales: perioperative competency, resilience, individual empowerment, and work self-efficacy. Results: The final regression model was significant, explaining 77.3% of the total variance in perioperative competency (Adjusted R² = 0.773, F = 88.449, p < 0.001). Special OR training (β = 0.534, p < 0.001) and years of OR experience (β = 0.395, p < 0.001) were the strongest predictors. Among force characteristics, individual empowerment (β = 0.233, p < 0.001), resilience (β = 0.199, p < 0.001), and work self-efficacy (β = 0.197, p < 0.001) all demonstrated significant positive effects. Conclusion: Both specialized resources and force characteristics significantly contribute to perioperative competency. Strategies that strengthen professional training, clinical experience, and positive psychological attributes may help enhance competency among OR nurses.
Exploring the perspectives of people who use drugs living with hepatitis C on interactions with case managers: A qualitative study in Taiwan Hsu, Pei Chen; Wu, Hung-Chi; Chen, Wan-Ling; Wang, Jing-Jy
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.4472

Abstract

Background: Comorbidity treatment for people who use drugs with hepatitis C should be integrated with addiction treatment. Case management plays a crucial role in enhancing treatment motivation and improving treatment completion rates. Previous studies have focused on outcomes, disease, or treatment experiences. However, studies exploring the perspectives of people who use drugs living with hepatitis C on their interactions with case managers remain limited. Objective: To explore the perspectives of people who use drugs with hepatitis C receiving case management services on their interactions with case managers. Methods: This exploratory qualitative study was conducted in a psychiatric hospital in southern Taiwan that provides addiction treatment services for individuals with substance use disorders. Purposive sampling was used to recruit participants who had received case-managed HCV treatment and completed the full course of care. Semi-structured, in-depth interviews were conducted with nine participants in a private space within the hospital’s outpatient clinic between September 2022 and December 2023 and analyzed using a qualitative content analysis. Results: Four themes were identified: (a) feeling empowered through respectful communication and shared decision-making, (b) transformation in health literacy and understanding of hepatitis C, (c) increased engagement in treatment facilitated by case management support, and (d) Diverse views of the importance of case managers’ professional backgrounds. These perspectives reflected how case-managed HCV care shaped participants’ experiences and engagement, underscoring the essential role of communication, education, and supportive relationships within addiction treatment settings. Conclusion: The findings of this study highlight patients’ perspectives on addiction case management and underscore the importance of trust-based communication, continuity of care, and tailored education in enhancing engagement in HCV care. These results provide practical implications for developing core competencies among addiction case managers in addressing the comorbidities of substance use and hepatitis C.

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