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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 730 Documents
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Psychometric testing of the Indonesian version of the Resourcefulness Scale for older adults Irna Kartina; Chieh-Yu Liu; Jaclene A. Zauszniewski; Chien Yu Lai
Belitung Nursing Journal Vol. 12 No. 3 (2026): May - June
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4537

Abstract

Background: Resourcefulness is the capacity to confront life’s obstacles by utilizing coping skills, adapting to new circumstances, and seeking assistance from the environment. Therefore, the geriatric field continues to emphasize the importance of older adults’ resourcefulness. The Indonesian version of the Resourcefulness Scale© (I-RS) has just been translated; it is essential to conduct this research and report the findings for its application in Indonesia. Objective: This study intended to develop the Bahasa Indonesian version of the Resourcefulness Scale© and to test its reliability and validity in older adults. Methods: The questionnaire was initially created in English and then translated by two linguistic experts. Subsequently, meaning and cultural analysis were performed by psychiatric nursing specialists. Following this, a back-translation was executed, and the Indonesian version was used for data collection. Data was collected with 331 older adults residing in 11 nursing homes from 2023 to 2024. Correlational analysis and Confirmatory Factor Analysis (CFA) were conducted using Structural Equation Modeling (SEM) in LISREL 8.8 to examine the validity of the I-RS. Reliability was assessed using Cronbach’s Alpha and Split-half reliability. Results: The internal consistency of the Indonesian version of the instrument is acceptable with Cronbach’s Alpha .79 and Split-half reliability .75. According to the results of SEM, Chi square = 253.13, the Root means square error of approximation (RMSEA = 0.04), the adjusted goodness of fit index (AGFI = 0.90), Normed Fit Index (NFI = 0.92), Parsimony Normed Fit Index (PNFI = 0.76) and Comparative fit Index (CFI = 0.97) were all accepted.  Two factors, such as personal and social resourcefulness, were identified through factor analysis using SEM. A positive and significant relationship was found between resourcefulness and spiritual health (r = 0.45, p < 0.001). Conclusion: These results confirmed the use of the Indonesian version of the Resourcefulness scale (I-RS), indicating that it has acceptable reliability and validity. This instrument is potentially useful for measuring older adults’ resourcefulness in geriatric nursing in Indonesia, across both clinical and community settings.
The perceptions and lived experiences of Indonesian nursing students in providing end-of-life care: A qualitative study Chalita Diandra Natalie; Yenni Ferawati Sitanggang; Oscar Fidel Antunez Martinez
Belitung Nursing Journal Vol. 12 No. 3 (2026): May - June
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4540

Abstract

Background: End-of-life (EoL) care is a form of service provided to patients in the terminal phase and families to meet physical, psychological, social, and spiritual needs so that patients can face death peacefully and with dignity. EoL care can be facilitated by medical personnel, but it is not uncommon for nursing students to be involved as well. Several factors influence nursing students’ ability to provide EoL care to patients. Objective: This study aimed to explore the nursing students’ perceptions and experiences regarding the provision of EoL care during clinical placements. Methods: A qualitative descriptive study was conducted using purposive sampling and in-depth interviews with 10 professional nursing students who had experience providing EoL care. Data were collected with a four-question guide between February and May 2025 and analyzed inductively using thematic analysis, including familiarization, coding, theme development, and reporting. Strategies to enhance trustworthiness included credibility, transferability, dependability, and confirmability. Results: Four main themes emerged: 1) Nursing Students’ perspective of EoL Care, 2) Providing holistic Care to Patients and Families, 3) Challenges and Opportunities in Providing EoL Care, 4) Developing Heart of Caring. Participants conceptualized EoL as a holistic, person-centered process emphasizing comfort, dignity, and compassion rather than cure. They demonstrated developing competence in identifying clinical indicators of terminal decline and addressing patients’ physical, psychosocial, and spiritual needs. Students described providing comfort through symptom management, active listening, emotional support, and the facilitation of spiritual practices aligned with patients’ beliefs. Although communication difficulties, emotional strain, and insufficient preparation were significant barriers, they were also perceived as valuable learning opportunities that fostered personal growth, empathy, and professional confidence. Spiritual faith and viewing patients as family members further inspired compassionate, value-driven care. Conclusion: Overall, the findings emphasize that experiential and reflective learning during clinical placements are essential in shaping nursing students’ moral sensitivity, resilience, and humanistic orientation. Integrating Structured EoL care education that includes emotional and spiritual dimensions is crucial to preparing future nurses to deliver dignified, compassionate, and holistic care for patients and families at EoL.
Effects of medagogy-based health literacy enhancement on self-management behaviors and functional capacity among older persons with chronic heart failure: A randomized controlled trial Saowaluk Thummak; Sirirat Panuthai; Rojanee Chintanawat; Nattaya Suwankruhasn
Belitung Nursing Journal Vol. 12 No. 3 (2026): May - June
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4542

Abstract

Background: Appropriate self-management behaviors and good functional capacity are crucial to reduce complications in older persons with chronic heart failure. Health literacy and transformative learning can be used in health education to motivate health behavior change, but limited research has examined their effects on health literacy for self-management behaviors and functional capacity in older persons with chronic heart failure. Objective: To investigate the effect of medagogy-based health literacy enhancement on self-management behaviors and functional capacity in older persons with chronic heart failure. Methods: This assessor and statistician-blinded, randomized controlled trial involved 70 older persons with chronic heart failure attending a heart clinic at a hospital in central Thailand. Permuted block randomization with a block size of four was employed to assign the participants to either the experimental group (n = 35) receiving a 5-session medagogy-based health literacy enhancement program over three weeks, or the control group (n = 35) receiving standard care. Outcomes were measured at baseline, 1 month post-intervention (self-management behavior), and 2 months post-intervention (functional capacity). Data analysis followed the intention-to-treat principle, using split-plot ANOVA and Repeated-Measures ANCOVA to adjust for imbalances in baseline functional capacity. Results: After the program, significant time and group interaction effects were found for self-management behavior (F(1,68) = 91.322, p < 0.001; ƞp2 = 0.573) and functional capacity (F(1, 67) = 5.424, p < 0.05; ƞp2 = 0.075). The experimental group demonstrated significantly higher mean scores for self-management behaviors than before the program (MD = 20.143, 95% CI = 17.561, 22.725; p < 0.001), and than the control group (MD = 18.686, 95% CI = 15.850, 21.521; p < 0.001). For functional capacity, the experimental group achieved a significant within-group improvement from baseline (p < 0.05) and a significantly higher adjusted mean capacity at post-intervention than the control group (Madj = 20.887, 95% CI = 2.986, 38.787; p < 0.05). Conclusion: The program led to improved short-term self-management behaviors and functional capacity. It can be used by nurses as a structured, patient-centered health education to promote older people’s self-management and functional capacity. However, multi-site and longitudinal follow-ups are recommended for future studies. Trial Registry Number: Thai Clinical Trials Registry (TCTR20250908004)
Effects of a transformative learning theory-based health literacy enhancement program on self-management behaviors and blood pressure in adults with uncontrolled hypertension in Thailand: A cluster randomized controlled trial Uraiwan Sasang; Decha Tamdee; Sivaporn Aungwattana; Chiraporn Tachaudomdach
Belitung Nursing Journal Vol. 12 No. 3 (2026): May - June
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4543

Abstract

Background: Uncontrolled hypertension leads to a number of complications. To achieve effective self-management, adults with uncontrolled hypertension need health literacy to promote and maintain good health. Transformative learning is a key adult learning paradigm that supports perspective transformation, self-management, and blood pressure control. Objective: This study aimed to evaluate the effects of a Transformative Learning Theory-Based Health Literacy Enhancement Program on self-management behaviors and blood pressure among adults with uncontrolled hypertension. Methods: This cluster-randomized controlled trial was conducted at two sub-district health-promoting hospitals in northeastern Thailand. Hospitals were randomly allocated to either the experimental or control group to prevent treatment contamination. A total of 58 participants (n = 29 per group) were consecutively recruited. Data were collected between February and June 2025 using a validated Self-Management Behavior Scale and digital BP monitoring. Data were analyzed using independent- and dependent-samples t-tests and repeated-measures ANOVA, and ANCOVA was used to compare groups while controlling for baseline values. Results: At 8 and 12 weeks after the program, the experimental group had significantly higher self-management scores than the control group (t = 2.117, p = 0.039; t = 3.416, p = 0.001, respectively) and than their own baseline (F = 31.958, p < 0.001). Regarding clinical outcomes, ANCOVA revealed a significant main effect of the program on mean arterial pressure (MAP) at both 8 weeks (F(1, 55) = 9.014, p = 0.004, hp2 = 0.141) and 12 weeks (F(1, 55) = 9.133, p = 0.004,  hp2 = 0.142). The adjusted mean MAP for the experimental group was significantly lower than the control group at the final follow-up (108.90 vs. 111.37 mmHg). A significant reduction was noted for systolic blood pressure (p = 0.028) but not diastolic blood pressure. Conclusion: The study highlights the effectiveness of the program for improving self-management behaviors and systolic blood pressure. Nurses can integrate adult learning theories into health education to enhance outcomes for hypertensive patients in primary care. Trial Registry Number: Thai Clinical Trial Registry (TCTR20250202009)
Network structure of multidimensional frailty among long-term care residents in China: A cross-sectional network analysis Jiaqi Zhao; Sharifah Shafinaz Sh Abdullah; Hongyu Yu; Ye Gao; Zhicui Lu; Tiantian Zhang
Belitung Nursing Journal Vol. 12 No. 3 (2026): May - June
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4577

Abstract

Background: Multidimensional frailty is highly prevalent among older adults residing in long-term care facilities (LTCFs). However, the structural interrelationships among physical, psychological, social, cognitive, and functional health domains remain insufficiently understood. Objective: To characterize the network structure of multidimensional frailty domains and related health indicators among institutionalized older adults. Methods: This cross-sectional study included 272 LTCF residents from Liaoning, China. Eleven theoretically selected health indicators were modeled using a Mixed Graphical Model with ℓ1-regularized neighborhood regression and model selection based on the Extended Bayesian Information Criterion (γ = 0.25). This approach estimates sparse conditional dependence structures among mixed data types. Strength centrality was used as the primary descriptive metric. Network accuracy and stability were evaluated using non-parametric and case-dropping bootstrap procedures. Results: The strongest conditional association emerged between age and cognitive impairment (edge weight = 0.68). Substantial associations were also observed between physical frailty and ADL dependency (edge weight = 0.43), and between psychological frailty and depressive symptoms (edge weight = 0.45). Physical frailty, ADL dependency, and depression exhibited relatively high strength centrality values; however, bootstrap difference tests indicated that these nodes were not statistically more central than several other highly connected indicators. The correlation stability coefficient for strength centrality was 0.75, indicating good stability of strength centrality estimates within this sample. Conclusion: The network revealed an interconnected pattern linking functional dependency, physical frailty, and psychosocial health among LTCF residents. Because the data were cross-sectional, the observed conditional associations should not be interpreted as causal or temporal pathways. These findings highlight the potential value of multidomain nursing assessment in long-term care settings and may inform hypothesis generation for future longitudinal or interventional nursing studies.
Evaluation of the holistic health care program to develop the capacity of prison public health volunteer leaders (PPHVs) in Thailand: A participatory action research Phannathat Tanthanapanyakorn; Sasiwimol Chanmalee; Sootthikarn Mungkhunthod; Chaninan Praserttai; Nonlapan Khantikulanon
Belitung Nursing Journal Vol. 12 No. 3 (2026): May - June
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4580

Abstract

Background: Health promotion in correctional settings faces challenges due to limited healthcare access and restricted environments. Nurses are primary healthcare providers in correctional institutions; however, evidence on nurse-led capacity-building programs for inmate health volunteers remains limited. Developing the capacity of Prison Public Health Volunteer Leaders (PPHVs) through a holistic healthcare approach can enhance their self-reliance. Objective: This study aimed to collaboratively develop, implement, and evaluate a holistic health care program to strengthen the capacity of PPHVs at the Central Correctional Institution for Young Offenders in Pathum Thani Province, Thailand. Methods: This study employed a Participatory Action Research (PAR) design. A total of 100 well-behaved inmates were purposively selected as PPHVs and actively engaged as co-participants throughout the PAR process. The intervention was collaboratively designed and implemented over five weeks, comprising ten participatory training sessions that addressed physical, mental, social, and environmental health dimensions. Quantitative data were collected using validated questionnaires assessing knowledge, attitudes, health practice skills, data management skills, and overall capacity at baseline, post-intervention, and at 1-month follow-up. Data were analyzed using repeated measures analysis of variance (ANOVA). Results: The findings revealed statistically significant improvements (p <0.001) in participants’ knowledge (F = 778.41, ηp² = 0.887), attitudes (F = 889.09, ηp² = 0.900), health practice skills (F = 1241.89, ηp² = 0.917), data management skills (F = 546.81, ηp² = 0.847), and overall capacity (F = 727.48, ηp² = 0.880). These outcomes indicate substantial enhancement in PPHVs’ ability to perform health promotion and data management roles proficiently. Conclusion: The holistic health care program significantly improved PPHVs’ capacity, suggesting promise for strengthening inmate health volunteer programs in correctional settings. These findings have significant implications for nursing practice in designing capacity-building programs, nursing education in preparing nurses for correctional care, and nursing policy in developing standards for correctional nursing in Thailand. Trial Registry Number: Thai Clinical Trials Registry (TCTR20260115003)
Corrigendum to “Assessing sexual health literacy among Thai female adolescents in non-formal education: A mixed-methods study” [Belitung Nursing Journal, 2025; 11(3): 340-348] Rapeepan Narkbupha; Atcharawadee Sriyasak; Atiya Sarakshetrin; Pailin Thungthin
Belitung Nursing Journal Vol. 12 No. 3 (2026): May - June
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4704

Abstract

This corrigendum corrects clerical errors regarding the study timeline, IRB approval dates, the instrument permission date, and adolescent age classifications in the original article (DOI: https://doi.org/10.33546/bnj.3744), which resulted from an inadvertent mistake in converting Buddhist Era (BE) dates to the Gregorian calendar. The authors confirm that these administrative corrections do not affect the methodology, data analysis, results, or conclusions of the original study and sincerely apologize for any inconvenience caused.
Adaptation of Parental Perception of Uncertainty Scale (PPUS): A psychometric study in a genetic research center in Indonesia Irene Astrid Larasati; Vynda Ulvyana; Hardian Hardian; Agustini Utari; Tri Indah Winarni
Belitung Nursing Journal Vol. 12 No. 4 (2026): July - August
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4312

Abstract

Background: Parents’ inability to generate meaning in events related to their child, especially a chronic illness, leads to uncertainty. This could negatively impact the management and outcome of their child and family well-being. Nevertheless, there is no available tool to measure parental uncertainty in Indonesia. Objective: The study aimed to evaluate the validity and reliability of the Indonesian version of the Parent’s Perception of Uncertainty Scale (PPUS) using an exploratory approach. Methods: This was a psychometric properties study conducted in 2020 among parents of children with genetic conditions, i.e., congenital adrenal hyperplasia (CAH), type 1 diabetes mellitus (T1DM), and Down syndrome (DS), recruited from pediatric endocrinology clinics in secondary and tertiary hospitals, and a genetic research center in Semarang, Central Java, Indonesia. The original PPUS was translated and back-translated into Indonesian and English. Principal Axis Factoring (PAF) was performed to measure its validity and reliability. IBM SPSS version 26 and JASP version 0.18 were utilized to perform descriptive and parallel analysis, respectively. Partitioning Around Medoids (PAM) was analyzed using RStudio version 2026.05.0 on R version 4.6.0. Results: A total of 259 parents (105 fathers and 154 mothers) of 170 children with CAH, T1DM, and DS completed the questionnaire. Samples were adequate (KMO = 0.857), and factor analysis was feasible (Bartlett p < 0.01). The Indonesian version of PPUS comprised 24 items forming three subscales, i.e., Ambiguity, Unpredictability, and Lack of Clarity (α = 0.839). Conclusion: Despite requiring further refinement in a homogeneous sample, the Indonesian PPUS demonstrated potential use in research on parental uncertainty and proposing future nursing interventions aimed at improving family-centered care.
Family-centered early intervention: A concept analysis to guide pediatric and community nursing practice Mardiyanti Mardiyanti; Yeni Rustina; Nani Nurhaeni; Nur Agustini
Belitung Nursing Journal Vol. 12 No. 4 (2026): July - August
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4328

Abstract

Background: Family-Centered Early Intervention (FCEI) is increasingly recognized as a framework for promoting child development and family empowerment. However, its application in nursing practice may be limited by the lack of a clear distinction between FCEI, Family-Centered Care (FCC), and Patient- and Family-Centered Care (PFCC). Objective: To clarify the concept of FCEI and distinguish it from FCC and PFCC by identifying its defining attributes, antecedents, consequences, and empirical referents. Methods: Walker and Avant’s eight-step concept analysis method was applied. A comprehensive search was conducted across five databases (PubMed, CINAHL, Scopus, ERIC, and Taylor & Francis) for studies published between January 2010 and September 2025. After screening, 49 of 1,958 identified records were included. Results: Seven defining attributes distinguished FCEI from FCC and PFCC: family capacity building, caregiver-mediated intervention (coaching), natural environment-based delivery, routines-based intervention, timeliness and early action, orientation toward developmental and functional outcomes, and an enabling system. These attributes position families as the primary agents of developmental change and situate intervention within everyday routines and natural environments. Antecedents included developmental screening, coordinated service systems, and provider coaching competencies, while consequences encompassed improved child developmental outcomes, greater parental self-efficacy, enhanced family quality of life, and stronger service coordination. Conclusion: FCEI is a distinct developmental intervention framework that extends family-centered principles beyond clinical care toward caregiver coaching, family capacity building, and developmental support in everyday contexts. Integrating FCEI into pediatric and community nursing may strengthen early identification, family empowerment, and coordinated developmental care, particularly in low- and middle-income countries.
Factors associated with extravasation severity in Thai patients receiving noncytotoxic intravenous infusions: An observational study Thitiporn Pathomjaruwat; Borwarnluck Thongthawee; Padcha Pongcharoen; Charturong Tantibundhit
Belitung Nursing Journal Vol. 12 No. 4 (2026): July - August
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4436

Abstract

Background: Extravasation is a serious complication of peripheral intravenous (PIV) therapy. It has been linked to mechanical disruption of a PIV line due to inappropriate site selection or securement, and to the pH, concentration, and cytotoxic properties of the infused solution or drug. However, evidence on extravasation in patients receiving noncytotoxic drugs remains limited. Understanding the causes and risk factors in this population is essential for prevention, early detection, and the development of interventions. Objective: To examine demographic and clinical factors associated with extravasation severity in adult Thai patients receiving noncytotoxic drug PIV therapy. Methods: This observational study included 193 participants at high risk of extravasation during PIV therapy. They were recruited from four tertiary hospitals in four regions of Thailand between December 2019 and December 2023 using purposive sampling. Extravasation severity was assessed using an artificial deep neural network for automated screening of skin images via a smartphone application, with confirmation by a dermatologist. Demographic, clinical, and medical data were collected using standardized forms and analyzed with descriptive statistics and Spearman’s rank correlation coefficient. Results: Extravasation was mostly mild (47.67%), followed by moderate (31.09%) and severe (21.24%). Extravasation severity was strongly and negatively correlated with drug pH (r = −0.532; p < 0.01), moderately with concentration (r = 0.411), and methods of drug administration (r = 0.327) (p < 0.01). History of IV insertion showed a mild correlation with severity (r = 0.145; p < 0.05) but not with comorbidities, infusion duration, or catheter size. Conclusion: The results highlight the importance of drug administration, especially the pH and type of drug, concentration, and route of administration, which play a critical role in reducing extravasation, thereby improving PIV therapy outcomes. Nurses play a role in preventing and managing extravasation by controlling the drug’s pH and concentration, carefully monitoring early signs, and promptly initiating interventions.

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