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Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal)
Published by Sekolah Tinggi Ilmu Keperawatan PPNI Jawa Barat
ISSN : 23548428     EISSN : 25988727     DOI : 10.33755
Core Subject : Health, Science,
Health Professions Medicine & Pharmacology Nursing Physics Public Health
Jurnal Keperawatan Komprehensif (JKK) of STIKep PPNI Jawa Barat has mission to provide information regarding nursing science for students, teachers, and for public community who have concern in nursing. Jurnal Keperawatan Komprehensif published twice a year on every July and Januari.
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Articles 778 Documents
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The Relationship Between Parenting Style and Depression Levels in Early Adolescents Lintang Putri Pramudita; Estin Yuliastuti; Suyatno Suyatno
Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal) Vol. 12 No. 3 (2026): JURNAL KEPERAWATAN KOMPREHENSIF (COMPREHENSIVE NURSING JOURNAL)
Publisher : STIKep PPNI Jawa Barat

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Abstract

Background: Depression among early adolescents can affect social, academic, and psychological development. Parenting style is one family-related factor associated with adolescent depressive symptoms. This study focused on early adolescents at SMP Negeri 3 Satu Atap Sumberlawang. Objective: This study aimed to examine the relationship between parenting style and depression levels among early adolescents. Methods: This quantitative cross-sectional study was conducted among students aged 12–14 years at SMP Negeri 3 Satu Atap Sumberlawang. A total of 146 students were included using a total sampling technique. Eligible participants were students in grades VII, VIII, and IX who provided assent and had parental/guardian consent; students who refused participation or were older than 14 years were excluded. Parenting style was assessed using the Parental Authority Questionnaire (PAQ), and depression levels were assessed using the Patient Health Questionnaire-9 (PHQ-9). PHQ-9 total scores range from 0 to 27 and were categorized as not depressed/minimal, mild, moderate, moderately severe, and severe depression. Data were analyzed using the Chi-square test. Results: Most respondents had a democratic parenting style (75/146; 51.4%). The largest depression category was not depressed/minimal (41/146; 28.1%). Parenting style was significantly associated with depression levels, χ²(8) = 49.80, p < 0.001, Cramer’s V = 0.413, indicating a moderate association. Conclusion: Democratic parenting style was associated with lower depression levels, whereas authoritarian and permissive parenting styles were associated with higher depression levels. Because this study used a cross-sectional design, the findings indicate an association and do not establish causality. Parents and schools should support adolescent mental health through appropriate communication, supervision, and emotional support.
Determinants of Quality of Nursing Work Life among Staff Nurses at a Public Hospital in Indonesia: A Cross-Sectional Study Lilis Suryani
Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal) Vol. 12 No. 3 (2026): JURNAL KEPERAWATAN KOMPREHENSIF (COMPREHENSIVE NURSING JOURNAL)
Publisher : STIKep PPNI Jawa Barat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33755/jkk.v12i3.1022

Abstract

Background: The quality of nurses’ work life has received increasing attention because it is associated with workforce sustainability, nurse well-being, and healthcare outcomes. In Indonesian public hospitals, nurses may face resource constraints, high service demands, and organizational pressures that can affect their work experiences. Evidence on the simultaneous contribution of individual, organizational, and psychological factors to Quality of Nursing Work Life (QNWL) in public-hospital nurses remains limited. Objective: This study aimed to identify factors associated with Quality of Nursing Work Life among staff nurses at Karawang General Hospital, Indonesia. Methods: An analytical cross-sectional study was conducted from November 2025 to April 2026 among 100 staff nurses working in inpatient wards, intensive care units, emergency departments, and outpatient services. Participants were selected using proportional stratified random sampling across service units. Data were collected using self-administered questionnaires, including the Brooks Quality of Nursing Work Life Survey and adapted instruments assessing workload, managerial support, reward system, work environment, job satisfaction, and organizational commitment. Data were analyzed using descriptive statistics, bivariate tests appropriate to variable type, and multiple linear regression with SPSS version 25. Results: More than half of the participants reported moderate QNWL (57%), followed by high QNWL (28%) and low QNWL (15%). QNWL was significantly associated with age (p = 0.041), educational attainment (p = 0.032), and length of employment (p = 0.018). Organizational factors were also significantly associated with QNWL, including workload (p = 0.001), managerial support (p < 0.001), reward system (p = 0.005), and work environment (p = 0.003). Psychological factors, namely job satisfaction (p < 0.001) and organizational commitment (p = 0.001), were significantly associated with QNWL. In the adjusted regression model, managerial support had the largest standardized coefficient (β = 0.524, p < 0.001), followed by job satisfaction (β = 0.411, p = 0.001), workload (β = −0.321, p = 0.002), and work environment (β = 0.298, p = 0.004). Conclusion: Organizational and psychological factors were important correlates of QNWL among staff nurses. Managerial support showed the strongest association in the adjusted model, suggesting that leadership development, structured feedback, workload review, and supportive work-environment initiatives may help create conditions for improved nurses’ work life. Because of the cross-sectional design, the findings should be interpreted as associations and not as causal effects
CKD-Associated Pruritus and Dermatology-Related Quality of Life Among Hemodialysis Patients in Two Indonesian Hospitals: A Cross-Sectional Study Risyda Ma&#039;rifatul Khoirot; Tobi Pitora; Rahmawati Dian Nurani; Eva Riantika Ratna Palupi; Retno Tri Astuti Ramadhana; Sartika Rajagukguk
Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal) Vol. 12 No. 3 (2026): JURNAL KEPERAWATAN KOMPREHENSIF (COMPREHENSIVE NURSING JOURNAL)
Publisher : STIKep PPNI Jawa Barat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33755/jkk.v12i3.1023

Abstract

Background: Chronic kidney disease (CKD) is a progressive condition that often requires maintenance hemodialysis. CKD-associated pruritus (CKD-aP), also known as uremic pruritus, is a distressing itching condition that remains under-recognized and may contribute to physical discomfort, sleep disturbance, psychological burden, and poorer dermatology-related quality of life. Objective: To examine the association between CKD-aP severity and dermatology-related quality of life among chronic kidney disease patients undergoing hemodialysis. Methods: This descriptive correlational cross-sectional study used purposive sampling. Data were collected from 72 hemodialysis patients at RSU Haji Surabaya and RSUD Sidoarjo during April-May 2019. Eligible participants were aged 18-65 years, received hemodialysis twice weekly, and reported pruritus within the previous month. Patients with primary dermatological conditions such as atopic dermatitis were excluded. CKD-aP severity was measured using the 5-D Itch Scale, and dermatology-related quality of life was measured using the Dermatology Life Quality Index (DLQI). Spearman's rank correlation was used for bivariate analysis. Results: The mean 5-D Itch Scale score was 14.83 +/- 4.224, and the mean DLQI score was 10.69 +/- 4.141. Because higher DLQI scores indicate poorer dermatology-related quality of life, the positive association between 5-D Itch Scale score and DLQI score indicated poorer outcomes with more severe pruritus. CKD-aP severity was significantly associated with dermatology-related quality of life (Spearman's rho = 0.588, p = 0.001, n = 72). Exploratory domain-level analysis suggested that pruritus degree (3.34 +/- 1.02) and duration (3.12 +/- 0.94) were the highest 5-D Itch Scale domains, while DLQI symptoms/feelings (3.11 +/- 1.38) and daily activities (2.41 +/- 1.21) were the most affected quality-of-life domains. Conclusion: This cross-sectional study found a significant moderate, approaching strong, positive association between CKD-aP severity and poorer dermatology-related quality of life among hemodialysis patients. Causality cannot be inferred. The findings support routine pruritus assessment and careful symptom management in hemodialysis nursing care
Pain Scale Reduction After a Morning Walking Program among Older Adults with Osteoarthritis: A One-Group Pretest-Posttest Study at Tlogosadang Health Center Nadia Nasywa Candraningtyas; Dadang Kusbiantoro; Masunatul Ubudiyah
Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal) Vol. 12 No. 3 (2026): JURNAL KEPERAWATAN KOMPREHENSIF (COMPREHENSIVE NURSING JOURNAL)
Publisher : STIKep PPNI Jawa Barat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33755/jkk.v12i3.1025

Abstract

Background: Osteoarthritis is a common degenerative joint condition in older adults and is frequently accompanied by pain, stiffness, limited mobility, and reduced quality of life. Exercise is recommended in osteoarthritis management, and walking is a low-cost activity that may be feasible in community and primary health service settings. However, evidence from small primary-care-based morning walking programs remains limited, particularly when pain medication use and the absence of a control group are considered. Objective: This study aimed to examine changes in osteoarthritis knee pain scores after a structured morning walking program among older adults in the working area of Tlogosadang Health Center, Paciran District, Lamongan Regency, Indonesia. Methods: This quantitative pre-experimental study used a one-group pretest-posttest design. The sample included 35 older adults with knee osteoarthritis selected by consecutive sampling from February to March 2026. Eligible participants were aged over 60 years, had controlled knee joint pain and limited knee movement, were able to walk, and provided informed consent. The morning walking program was delivered for 15 minutes, twice weekly for 3 weeks. Pain intensity was measured before and after the program using the Numeric Rating Scale (NRS). Data analysis treated NRS as paired ordinal pain data. The Shapiro-Wilk test was used as a distributional check, and the Wilcoxon signed-rank test was selected as the primary inferential test. Results were reported with Z statistic, p-value, and effect size r. Results: Before the program, 22 participants (62.9%) reported mild pain, 12 (34.3%) reported moderate pain, and 1 (2.9%) reported severe pain. After the program, 2 participants (5.7%) reported no pain, 28 (80.0%) reported mild pain, and 5 (14.3%) reported moderate pain. The number of respondents with moderate-to-severe pain decreased from 13 (37.2%) to 5 (14.3%). The mean NRS score decreased from 3.17 ± 1.38 to 1.86 ± 1.31, with a 1.31-point absolute reduction and an approximate 41.3% relative reduction from baseline. The Wilcoxon signed-rank test showed a statistically significant within-participant reduction (Z = -4.372, p < 0.001), with a large effect size (r = 0.74). Conclusion: Older adults with osteoarthritis showed a statistically significant reduction in pain scores after the 3-week morning walking program. Because this study had no control group and 25 participants (71.4%) reported using pain or anti-inflammatory medication, the findings should be interpreted as an observed pre-post reduction rather than definitive evidence of an independent intervention effect. Morning walking may be considered as a feasible supportive activity for older adults with osteoarthritis when safety screening and individual physical capacity are considered, but controlled studies with medication monitoring, adherence data, and adverse-event reporting are needed.
Autogenic Relaxation as a Supportive Nursing Intervention in Type 2 Diabetes Mellitus: A Single-Patient Case Study Hirdes Harlan Yuanto; Ahmad Rosuli; Fajri Andi Rahmawan; Novita Putri Lestari
Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal) Vol. 12 No. 3 (2026): JURNAL KEPERAWATAN KOMPREHENSIF (COMPREHENSIVE NURSING JOURNAL)
Publisher : STIKep PPNI Jawa Barat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33755/jkk.v12i3.1026

Abstract

Background: Type 2 diabetes mellitus is often accompanied by unstable blood glucose levels and is closely related to daily self-care. Psychological stress may activate sympathetic and counter-regulatory hormonal responses that can worsen glycemic control, supporting stress management as one component of comprehensive diabetes care. Objective: This case study aimed to describe the application of autogenic relaxation as a supportive nursing intervention for a patient with type 2 diabetes mellitus and unstable blood glucose levels. Methods: A descriptive single-patient case study, reported with reference to the CARE guideline, was conducted in the Tawang Alun inpatient ward of Blambangan Banyuwangi Regional General Hospital in 2025. The case was selected because the patient had type 2 diabetes mellitus with hyperglycemia, symptoms of glucose instability, and willingness and ability to follow relaxation instructions. Nurse-guided autogenic relaxation was provided once daily for three consecutive days (10–15 minutes/session) using a consistent sequence. Blood glucose, subjective complaints, vital signs, peripheral perfusion, and wound condition were observed descriptively alongside insulin therapy, dietary management, glucose monitoring, wound care, and health education. Written informed consent for publication of anonymized clinical information was obtained from the patient. Formal research ethics approval was not sought because the report retrospectively describes routine, non-experimental nursing care; the intervention formed part of care and no additional research procedure was performed. Results: At the initial nursing assessment, the patient reported weakness, dizziness, thirst, nocturia, and tingling in both feet, with blood glucose of 378 mg/dL. Documented pre-/post-session values were 329/320 mg/dL (day 1), 303/296 mg/dL (day 2), and 160/150 mg/dL (day 3). These changes occurred during comprehensive inpatient care that included insulin, dietary management, wound care, education, and monitoring; therefore, the contribution of relaxation cannot be isolated. The patient reported feeling stronger and no longer dizzy by day 3. Conclusion: Autogenic relaxation was feasible and completed as a supportive nursing intervention in this single case. Effectiveness cannot be inferred from one uncontrolled case, and the observed improvement cannot be attributed to relaxation alone. Medication, dietary control, glucose monitoring, wound and foot care, education, and follow-up remain central to comprehensive diabetes management.
The Relationship Between Family Support and Quality of Life Among People Living with HIV/AIDS (PLHIV) At WPA Turen Foundation Muhammad Rias Kurnia Sandi; Sih Ageng Lumadi; Ridwan Sofian
Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal) Vol. 12 No. 3 (2026): JURNAL KEPERAWATAN KOMPREHENSIF (COMPREHENSIVE NURSING JOURNAL)
Publisher : STIKep PPNI Jawa Barat

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Abstract

Background: HIV/AIDS is a progressive chronic disease that adversely affects the physical, psychological, social, and spiritual dimensions of an individual's life. People living with HIV/AIDS (PLHIV) are particularly vulnerable to a decline in quality of life due to opportunistic infections, stigma, discrimination, and inadequate social support, including limited support from their families. Objective: This study aimed to analyze the relationship between family support and quality of life among PLHIV at the WPA Turen Foundation, Malang Regency. Methods: A descriptive quantitative study with a cross-sectional design was employed. Thirty PLHIV respondents were recruited through purposive sampling from a total population of 59 PLHIV at the WPA Turen Foundation. Data were collected using validated family support and quality of life questionnaires adapted from Kusuma (2011). Bivariate analysis was conducted using the Spearman rho test at a significance level of α = 0.05. Results: The majority of respondents received non-supportive family support (60%) and reported a good quality of life (53.3%). The Spearman rho test yielded p = 0.005 (p < 0.05) with a correlation coefficient of r = 0.355, indicating a statistically significant positive relationship of moderate strength between family support and quality of life among PLHIV. Conclusion: A significant relationship exists between family support and quality of life among PLHIV at the WPA Turen Foundation. The more supportive the family, the better the individual's quality of life. Family-based interventions, including HIV/AIDS education and family counseling, are recommended to sustainably improve the quality of life of PLHIV.
Effectiveness of Active Cycle of Breathing Technique on Peak Expiratory Flow Following Cardiac Surgery Susy Puspasari; Nyayu Nina Putri Calisanie; Nunung Nurhayati; Septa Permana; Indriyani Lestari
Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal) Vol. 12 No. 3 (2026): JURNAL KEPERAWATAN KOMPREHENSIF (COMPREHENSIVE NURSING JOURNAL)
Publisher : STIKep PPNI Jawa Barat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33755/jkk.v12i3.1031

Abstract

Introduction: Pulmonary dysfunction is a common complication following cardiac surgery, resulting from reduced lung expansion, postoperative pain, secretion retention, and impaired ventilation. These complications may delay recovery and increase the risk of pulmonary morbidity. The Active Cycle of Breathing Technique (ACBT) has been recommended as a pulmonary rehabilitation strategy to improve airway clearance and restore lung function; however, evidence regarding its effectiveness in Indonesian postoperative cardiac patients remains limited. Objective: To evaluate the effectiveness of the Active Cycle of Breathing Technique (ACBT) in improving peak expiratory flow (PEF) among patients after cardiac surgery. Methods: A quasi-experimental study with a one-group pretest–posttest design was conducted among 114 adult patients who underwent cardiac surgery at the General Intensive Care Unit of Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Participants were recruited using accidental sampling. ACBT was administered for four consecutive postoperative days. Peak expiratory flow was measured using a peak flow meter before the intervention on postoperative day 1 and after completion of the intervention on postoperative day 4. Data were analyzed using descriptive statistics and paired t-test. Results: The mean peak expiratory flow increased significantly from 228.30 ± 32.6 L/min before the intervention to 442.32 ± 43.7 L/min after four days of ACBT. Paired t-test analysis demonstrated a statistically significant improvement in PEF following the intervention (p < 0.001). A strong positive correlation was observed between pretest and posttest measurements (r = 0.786, p = 0.001). Conclusion: ACBT significantly improved peak expiratory flow in patients after cardiac surgery. Incorporating ACBT into routine postoperative pulmonary rehabilitation may facilitate recovery of lung function and support early postoperative respiratory management.
Women's Experiences of Living with Adenomyosis: A Scoping Review through the Lens of Levine's Conservation Model Yayu Handayani
Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal) Vol. 12 No. 3 (2026): JURNAL KEPERAWATAN KOMPREHENSIF (COMPREHENSIVE NURSING JOURNAL)
Publisher : STIKep PPNI Jawa Barat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33755/jkk.v12i3.1033

Abstract

Background: Uterine adenomyosis (UA) is a chronic gynaecological condition characterised by the presence of endometrial tissue within the myometrium, causing dysmenorrhoea, abnormal uterine bleeding, dyspareunia, infertility, and reduced quality of life. Although its physical and psychosocial burden is well recognised, women’s lived experiences have not been comprehensively synthesised using a nursing theoretical framework. Objective: To systematically identify, map, and synthesise evidence on women’s experiences of living with adenomyosis using Levine’s Conservation Model. Methods: A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology and reported according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Literature searches were performed in PubMed/MEDLINE, CINAHL Plus, and ScienceDirect, supplemented by grey-literature searching and hand-searching of reference lists. Eligibility criteria were developed using the Population–Concept–Context (PCC) framework. Data were analysed using inductive content analysis and deductively mapped to the four conservation principles of Levine’s Conservation Model. Results: Twelve sources met the inclusion criteria, comprising five primary empirical studies, four secondary or contextual sources, and three grey-literature patient narratives. Women with adenomyosis experienced multidimensional challenges across all four conservation domains. These included energy depletion caused by chronic pain and fatigue, structural compromise related to pelvic pain, dyspareunia, and infertility, threats to personal integrity arising from stigma and delayed diagnosis, and disruption of social integrity through impaired relationships, occupational limitations, and financial burden. Conclusion: Adenomyosis profoundly affects women’s physical, psychological, and social well-being across all four domains of Levine’s Conservation Model. This review provides a theory-informed framework to guide holistic nursing assessment and person-centred care while highlighting the need for further research on diagnostic experiences and nursing-specific interventions
Effectiveness of Digital Health Interventions in Improving Medication Adherence Among Individuals with Schizophrenia: A Systematic Literature Review Hafidz Al Qodri
Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal) Vol. 12 No. 3 (2026): JURNAL KEPERAWATAN KOMPREHENSIF (COMPREHENSIVE NURSING JOURNAL)
Publisher : STIKep PPNI Jawa Barat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33755/jkk.v12i3.1035

Abstract

Background: Medication non-adherence remains a major challenge in the long-term management of schizophrenia and is associated with relapse, psychiatric hospitalization, poor clinical outcomes, and increased healthcare costs. Digital health interventions have emerged as promising strategies to improve medication adherence; however, the available evidence remains heterogeneous across intervention types and healthcare settings. Objective: This systematic literature review aimed to synthesize and critically evaluate current evidence regarding the effectiveness of digital health interventions in improving medication adherence among individuals with schizophrenia and related severe mental illnesses. Methods: A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Electronic searches were performed in PubMed, Scopus, ScienceDirect, ProQuest, and Google Scholar for studies published between January 2022 and June 2026. Eligible studies evaluated digital health interventions designed to support medication adherence among individuals with schizophrenia or related severe mental illnesses. Methodological quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tools, and findings were synthesized using a narrative thematic approach. Results: The search identified 1,186 records, of which 20 studies met the eligibility criteria and were included in the review. The interventions included smartphone applications, mobile health (mHealth), telehealth, electronic medication monitoring systems, digital medicine systems, SMS reminders, and remote monitoring technologies. Overall, digital health interventions were associated with improved medication adherence, enhanced patient engagement, strengthened treatment monitoring, and better communication between patients and healthcare professionals. Nevertheless, the magnitude of these benefits varied according to intervention characteristics, study design, outcome measures, and healthcare settings. Common implementation barriers included limited digital literacy, inadequate technological infrastructure, and unequal internet access. Conclusion: Digital health interventions demonstrate considerable potential to improve medication adherence among individuals with schizophrenia and may strengthen continuity of care in mental health services. However, the heterogeneity of the available evidence highlights the need for further high-quality implementation research and pragmatic randomized controlled trials to evaluate long-term effectiveness and support sustainable integration of digital health into routine nursing practice.
Nurse Champions as Change Agents for Bedside Handover Compliance: A Case Study Aisyah Rohie; Andi Amalia Wildani; Hanny Handiyani; Lia Setyarini
Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal) Vol. 12 No. 3 (2026): JURNAL KEPERAWATAN KOMPREHENSIF (COMPREHENSIVE NURSING JOURNAL)
Publisher : STIKep PPNI Jawa Barat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33755/jkk.v12i3.1036

Abstract

Background: Bedside handover is an essential element of effective nurse-to-nurse communication to ensure patient safety. A preliminary assessment at Hospital X, supported by previous literature, identified limited knowledge, heavy workloads, and the absence of evaluation and appreciation systems as key barriers to optimal bedside handover implementation. Objective: This study aimed to identify the implementation of the Nurse Champion role in improving nurses' compliance with bedside handover at Hospital X using Kurt Lewin's Three-Step Change Model (Unfreeze–Move–Refreeze). Methods: This case study was conducted in the medical-surgical inpatient unit of Hospital X from 8 September to 1 October 2025 using Kurt Lewin's Three-Step Change Model. Baseline observations were conducted from 8–14 September 2025, followed by semi-structured interviews with four Primary Nurses on 19 September 2025. The intervention included bedside handover socialization (24 and 26 September), appointment of a Nurse Champion (24 September), checklist-based monitoring integrated into the shift workflow (24–30 September), implementation of reminder stickers, and a reward program (1 October). Nurses' compliance with bedside handover was evaluated at the end of the intervention. Results: Following the intervention, compliance across the 9P bedside handover components varied. The highest compliance was observed for Plan and Partnership (98.76%) and Patient Comfort (92.28%), whereas Personal Hygiene and Environment showed the lowest compliance (26.44%), indicating that these aspects were less consistently addressed during bedside handover. Conclusion: Therefore, the implementation of Nurse Champions based on Kurt Lewin’s Change Model was associated to improved compliance with 9P bedside handover and fostered sustainable behavioural change through enhanced motivation, appreciation, and a collaborative work culture in nursing practice

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