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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.
Arjuna Subject : -
Articles 748 Documents
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Factors associated with health-related quality of life in older cancer survivors: A secondary analysis of data from the 8th Korea National Health and Nutrition Examination Survey (2019–2021) Yoonhee Seok
Belitung Nursing Journal Vol. 12 No. 5 (2026): September - October
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4687

Abstract

Background: The health-related quality of life (HRQoL) of older cancer survivors is emerging as an important public health issue as the older adult population continues to grow. Objective: This study aimed to identify factors affecting HRQoL among older cancer survivors and to examine age-related differences. Methods: This study used secondary data from the 8th Korean National Health and Nutrition Examination Survey (2019 and 2021). The inclusion criteria were cancer survivors aged 65 years and older. A total of 158 older cancer survivors were identified from 15,200 respondents. Participants were classified into two groups: 89 young-old and 69 old-old individuals. Linear regression analyses were conducted using sampling weights and a complex survey design to identify factors associated with HRQoL. Results: Factors affecting HRQoL differed between the two age groups. Among young-old cancer survivors, activity limitations (B = -0.09, p = 0.027), depression (B = -0.16, p < 0.001), self-rated health (B = 0.07, p = 0.019), and stress (B = -0.11, p < 0.001) were significant influencing factors. In the old-old group, significant factors included activity limitations (B = -0.07, p = 0.002), alcohol consumption (B = 0.11, p < 0.001), pronunciation problems (B = -0.08, p = 0.011), sex (B = 0.08, p = 0.003), and stress (B = -0.06, p = 0.001). Activity limitations and stress were common factors associated with reduced HRQoL in both age groups. Conclusion: HRQoL among older cancer survivors was associated with age. Age-specific nursing interventions are needed to improve HRQoL in older cancer survivors by addressing activity limitations and stress, with additional focus on psychological and oral health needs.
Common characteristics among patients with secondary osteoporosis in Oman: A retrospective descriptive cross-sectional study Nasser Al-Salmi; Abdulrahman Al-Belushi; Anas Al-Jahdhami; Dalal Al-Dhahli; Ghania Al-Ghafri; Jabeer Al-Khanbashi; Jokha Salim Al-Jahwari; Eilean Rathinasamy Lazarus; Joshua Kanaabi Muliira
Belitung Nursing Journal Vol. 12 No. 5 (2026): September - October
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4689

Abstract

Background: Secondary osteoporosis is common but remains understudied in various contexts. In Oman, public awareness of osteoporosis and its risk factors is low, and to date, few studies have specifically addressed secondary osteoporosis, despite its implications for healthcare costs, quality of life, health promotion, and well-being. Objective: To identify the common characteristics of patients with secondary osteoporosis in Oman to guide patient education and interventions for health promotion. Methods: This retrospective descriptive cross-sectional study analyzed data of patients diagnosed with secondary osteoporosis at a national referral center in Oman in February 2025. In a database of 500 patients, 112 eligible cases were included, and all met the inclusion criteria. The extracted data included demographic and lifestyle factors, laboratory results, and medical history pertinent to osteoporosis. Data were analyzed using descriptive statistics. Results: The mean age was 39.44 ± 7.50 years, and many participants reported regular physical activity and chronic conditions such as rheumatoid arthritis (17%), chronic kidney disease (14.3%), diabetes mellitus (13.4%), inflammatory bowel diseases (8.9%), and cancer (8%), among others. The commonly taken medications linked to osteoporosis were proton pump inhibitors (41%), glucocorticoids (35.7%), and thyroid hormones (12.5%). After the diagnosis of secondary osteoporosis, patients had a recorded diagnosis of chronic pain (75%), fractures (26.8%), and depression (17%). Follow-up bone mass density testing indicated low lumbar, hip, and femoral z-scores in patients with a history of cancer, chemotherapy, smokers, and thyroid hormone therapy. Conclusion: Chronic diseases were common among patients with secondary osteoporosis. Thus, patients with non-communicable diseases need comprehensive risk assessment, routine screening, and health promotion to enhance bone health maintenance. Nurses can play a critical role in providing patient education and guidance to promote bone health.
Effects of Nurse-Led Promoting Advance Care Planning (NLP-ACP) on intention to engage in advance care planning and death anxiety among patients with chronic obstructive pulmonary disease in Thailand: A randomized controlled trial Leelawadee Kloyeium; Yaowarat Matchim; Satreerat Junkroot; Parinya Raetong
Belitung Nursing Journal Vol. 12 No. 5 (2026): September - October
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4720

Abstract

Background: Patients with chronic obstructive pulmonary disease (COPD) commonly experience distressing symptoms and death anxiety. In advanced stages, many receive aggressive treatments that may not align with their preferences. Advance care planning (ACP) may facilitate goal-concordant care and reduce death anxiety. Objective: To evaluate the effects of a Nurse-Led Promoting Advance Care Planning (NLP-ACP) program on intention to engage in ACP and death anxiety among patients with COPD. Methods: A single-blind randomized controlled trial was conducted among 60 patients with COPD, randomly assigned to an experimental or control group (30 each). The experimental group received a 2-week NLP-ACP intervention plus standard care, whereas the control group received standard care alone. Outcomes were assessed at baseline, post-intervention (week 2), and at follow-up (week 4). Intention to engage in ACP was measured using the Intentions for Advance Care Planning Questionnaire and analyzed using the Mann–Whitney U test and generalized estimating equations. Death anxiety was measured using the Death Anxiety Questionnaire and analyzed using a linear mixed model. Results: Compared with the control group, the experimental group showed significantly greater increases in intention to engage in ACP immediately after the intervention and at follow-up (Z = -5.584, p < 0.001, r = 0.72; Z = -6.047, p < 0.001, r = 0.78, respectively). In addition, significant group-by-time differences in ACP intention scores were observed between the experimental and control groups (Wald χ² = 201.38, p < 0.001). The experimental group also showed significantly greater reductions in death anxiety, with significant group-by-time interactions immediately postintervention (β = 3.47, SE = 0.52, 95% CI [2.43, 4.50], p < 0.001, d = 0.70) and at follow-up (β = 6.70, SE = 0.93, 95% CI [4.84, 8.56], p < 0.001, d = 2.00). Conclusions: The NLP-ACP program shows promise in increasing intention to engage in ACP and reducing death anxiety among patients with COPD, supporting patient-centered decision-making. However, findings should be interpreted cautiously because of the short follow-up period and single-blind design. Trial Registry Number: Thai Clinical Trials Registry (TCTR20250416003)
Effectiveness of the Healthy Hearing Promoting Program (HHPP) among workers in large-scale industries: A randomized controlled trial in central Thailand Ittipol Kaewfong; Thanee Kaewthummanukul; Sumalee Lirtmunlikaporn; Orn-Anong Wichaikhum
Belitung Nursing Journal Vol. 12 No. 5 (2026): September - October
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4735

Abstract

Background: Noise-induced hearing loss remains a significant occupational health concern in industrial settings. Adherence to protective behaviors among workers remains suboptimal, leaving them at continued risk of hearing impairment. Strengthening hearing health promotion is therefore essential. Objective: To evaluate the effectiveness of the Healthy Hearing Promoting Program in promoting noise hazard protection behavior and maintaining hearing capacity among workers in large-scale industries. Methods: This single-blind parallel-group randomized controlled trial included 66 industrial workers from two large-scale factories in central Thailand, randomly assigned to an experimental group (n = 33) and a control group (n = 33). The control group continued routine occupational practices based on existing factory safety policies. Data were collected between December 2023 and July 2024. Noise hazard protection behavior was assessed at baseline, Week 10, and Week 14, while hearing capacity was evaluated at Week 34 (26 weeks after intervention completion). Statistical analyses were conducted using mixed-design ANOVA and Fisher's exact test. Results: There were no significant differences in baseline data between groups. The experimental group had significantly higher noise hazard protection behavior scores than the control group (F (1,64) = 41.67, p < 0.001, partial η² = 0.394), with significant changes over time (F(2,128) = 48.02, p < 0.001, partial η² = 0.429) and a significant group–time interaction (F(2,128) = 24.12, p < 0.001, partial η² = 0.274). Between-group mean differences in protection behavior scores were 5.91 points (95% CI: 3.6, 8.2) at Week 10 and 7.39 points (95% CI: 5.3, 9.5) at Week 14. All participants in the experimental group demonstrated hearing thresholds within the normal range across all tested frequencies at follow-up. A small proportion of control group participants exhibited abnormal thresholds at frequencies between 500 and 4000 Hz. Conclusion: The program significantly improved noise hazard protection behaviors but no significant between-group differences in hearing capacity were demonstrated. The findings provide preliminary evidence to support occupational health nurses in developing and implementing theory-driven, multilevel hearing conservation interventions aimed at improving noise hazard protection behaviors among workers in large-scale industries. Trial Registry Number: Thai Clinical Trials Registry (TCTR20251128006)
Self-directed learning readiness and its associated factors among undergraduate nursing students in Maldives: A cross-sectional correlational study Aminath Shafia; Nongkran Viseskul; Areewan Klunklin; Nonglak Chaloumsuk
Belitung Nursing Journal Vol. 12 No. 5 (2026): September - October
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4736

Abstract

Background: Self-Directed Learning (SDL) readiness is a critical competence in nursing education, as it provides students with the characteristics needed for lifelong learning in complex healthcare contexts. With the evolving healthcare landscape, cultivating SDL readiness is essential for preparing competent nursing professionals. Objective: This study aimed to determine the level of self-directed learning readiness and its related factors among undergraduate nursing students. Methods: A cross-sectional correlational design was conducted from April to December 2024. Data were collected from 182 undergraduate nursing students in the Maldives, recruited using proportionate stratified random sampling techniques. A structured questionnaire with five instruments, including the Fisher’s Self-Directed Learning Readiness Scale, Kolb’s Learning Style Inventory, Academic Motivation Scale, Dundee Ready Education Environment Measure (DREEM), and Revised two-factor version of the Study Process Questionnaire (R-SPQ-2F), was used. Descriptive statistics and Pearson’s correlation coefficient were employed to analyze the data. Results: The results revealed that nursing students exhibited SDL readiness at a high level. As for the factors related to SDL readiness, significant positive correlations were found for learning environment (r = 0.457, p < 0.01), deep learning approach (r = 0.442, p < 0.01), and academic motivation (r = 0.350, p < 0.01). In contrast, a surface learning approach was negatively correlated with SDL readiness (r = -0.201, p < 0.01). In addition, no significant correlations were observed between learning style and SDL readiness. However, abstract conceptualization demonstrated a weak positive correlation with self-management (r = 0.171, p = 0.021), while reflective observation showed a weak negative correlation with desire for learning (r = -0.165, p = 0.026). Conclusions: This study adds contextual evidence from the Maldivian undergraduate nursing education setting regarding factors related to SDL readiness. The findings support the broader body of evidence emphasizing the importance of educational environments, learning approach, and academic motivation in fostering SDL readiness in nursing education.
Development of a scale to measure empowerment approaches of visiting nurses supporting mothers of school-aged children with autism spectrum disorder Yuki Kamada; Narumi Fujino; Yuji Fujimoto; Takaomi Furuno
Belitung Nursing Journal Vol. 12 No. 5 (2026): September - October
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4751

Abstract

Background: Autism spectrum disorder (ASD) is associated with substantial challenges for children and their families. Mothers of children with ASD may experience considerable parenting-related stress, particularly when they face difficulties in understanding and responding to their children’s behavioral and communication characteristics. In home-visit nursing, empowerment-oriented approaches that support mothers’ coping abilities and self-efficacy are important; however, a scale for assessing these support practices has not yet been sufficiently developed. Objective: This study aimed to conceptualize empowerment-oriented support practices for mothers of school-aged children with ASD in the context of home-visit nursing and to develop a corresponding measurement scale. Methods: This study was conducted in two phases. Preliminary scale items were generated through semi-structured interviews with home-visit nurses, followed by expert evaluation of content validity and a nationwide questionnaire survey. Exploratory factor analysis and examinations of the reliability and validity of the scale were subsequently conducted. Results: Exploratory factor analysis identified a three-factor structure comprising 14 items: (1) educational support to enhance mothers’ sense of coping capability, (2) reframing support aimed at restoring confidence, and (3) partnership building through empathic engagement. The Kaiser–Meyer–Olkin value was 0.817, factor loadings ranged from 0.48 to 0.95, average variance extracted (AVE) ranged from 0.41 to 0.44, composite reliability (CR) ranged from 0.73 to 0.78, Cronbach’s alpha was 0.874, and cumulative variance explained was 49.2%. The AVE values were below the recommended threshold of 0.50, indicating limited support for convergent validity. Discriminant validity was also not fully supported. Conclusion: The scale developed in this study should be regarded as a preliminary measurement framework for organizing empowerment-oriented support practices provided by home-visit nurses to mothers of school-aged children with ASD, drawn from educational, cognitive, and relational perspectives. Given the limitations in convergent and discriminant validity, and the absence of confirmatory factor analysis using an independent sample, the scale should not currently be used for individual nurse evaluation, performance benchmarking, or quality assurance. Further psychometric validation using larger and more diverse samples, independent-sample confirmatory factor analysis, hypothesis testing with theoretically relevant external measures, and longitudinal studies is required.
Balancing tradition, modernity, and spirituality: A grounded theory of non-communicable disease management in the Tai Saek Ethnic Group of Thailand Amornrat Sangsaikaew; Wasana Ruaisungnoen
Belitung Nursing Journal Vol. 12 No. 5 (2026): September - October
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4761

Abstract

Background: Chronic non-communicable diseases (NCDs) are increasing among the Tai Saek ethnic minority in Thailand, yet little is known about how this community culturally interprets and manages NCDs in daily life. Objective: To develop a substantive theory explaining how the Tai Saek ethnic group perceives NCDs and manages them within changing lifestyles. Methods: A grounded theory design based on Strauss and Corbin was used. Eighteen Tai Saek adults (10 with NCDs, 8 without) were theoretically sampled from two villages in Nakhon Phanom province, Thailand. Data were collected from August 2024 to April 2025 through in‑depth interviews, field notes, and theoretical memos, and analyzed with ATLAS.ti using constant comparative analysis. Results: The core category, Cultural Perceptions and Risk Management of NCDs, describes a non-linear process where Tai Saek people balance traditional lifeways, modern influences, and spiritual beliefs. This paradigm model consists of interrelated components: (1) Contextual Conditions, characterized by a dual lifestyle involving modernized agriculture, dietary shifts, generational negotiations, and traditional “Sum Saew” gatherings; (2) Causal Conditions, where individuals construct meanings of NCDs (behavioral vs. genetic) and respond emotionally and behaviorally; (3) Action/Interaction Strategies, which selectively integrate indigenous practices (ancestor worship) with biomedical care; and (4) Consequences, which include both positive adaptation (cultural empowerment) and negative outcomes (delayed biomedical care due to reliance on rituals). Conclusion: The study demonstrates that Tai Saek people do not simply adopt biomedical advice but actively filter it through ancestral beliefs and modern constraints. Nursing care should assess cultural transitions, acknowledge spiritual rituals, and co‑design NCD management plans respecting local wisdom.
Caregiver knowledge and attitudes toward holistic family support in diabetic foot ulcer care: A cross-sectional study in Indonesia Tengku Eltrikanawati; Rizanda Machmud; Eva Decroli; Rozi Sastra Purna
Belitung Nursing Journal Vol. 12 No. 5 (2026): September - October
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4932

Abstract

Background: Family caregivers are central to home-based care for diabetic foot ulcers (DFUs), but domain-specific knowledge gaps may shape attitudes toward holistic family support. Objective: To examine caregivers’ knowledge and attitudes across physical, psychological, social, and spiritual domains of DFU support and identified predictors of total attitude. Methods: A cross-sectional study was conducted among 274 family caregivers at a tertiary referral hospital in Batam City, Indonesia, from March to July 2024. Data were analyzed using descriptive statistics, Friedman tests, Spearman correlations, and multiple regression with robust standard errors. All statistical analyses were conducted in R version 4.5.0. Results: The mean total knowledge score was 15.42 (SD = 1.44), and the mean total attitude score was 62.13 (SD = 8.51). Knowledge was highest in the physical domain (M = 86.34%, SD = 3.17) and lowest in the psychological domain (M = 17.82%, SD = 6.67). Friedman tests showed significant differences across knowledge domains, chi-square(3) = 783.668, p < 0.001, and attitude domains, chi-square(3) = 435.191, p < 0.001. Significant correlations included total knowledge with physical attitude (rho = 0.565, p < 0.001) and spiritual knowledge with total attitude (rho = 0.564, p < 0.001). The adjusted regression model explained 38.1% of the variance in total attitude score. Spiritual knowledge (B = 0.416, 95% CI [0.312, 0.520], p < 0.001), physical knowledge (B = 0.722, 95%CI [0.393, 1.052], p < 0.001), and psychological knowledge (B = 0.180, 95% CI [0.056, 0.304], p = 0.005) were significant predictors; social knowledge was not significant. Conclusion: Caregiver attitudes toward holistic DFU support were strongly associated with domain-specific knowledge. Family-centered education could usefully address the physical, psychological, social, and spiritual needs of caregivers. Nurses could consider screening for domain-specific knowledge gaps, particularly in psychological support, and offering culturally sensitive family education to strengthen caregiver readiness for home-based DFU care.

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