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I Ketut Andika Priastana
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Babali Nursing Research
Published by Babali Health
ISSN : 27766993     EISSN : 27215989     DOI : https://doi.org/10.37363/bnr
Core Subject : Health,
Nursing
The Babali Nursing Research provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy and research methods relevant to nursing, midwifery and other health related professions. The BNR aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The journal particularly welcomes studies that aim to evaluate and understand complex health care interventions and health policies and which employ the most rigorous designs and methods appropriate for the research question of interest. The journal also seeks to advance the quality of research by publishing methodological papers introducing or elaborating on analytic techniques, measures, and research methods.
Arjuna Subject : Keperawatan - Keperawatan (Lain-Lain)
Articles 282 Documents
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NGS-Based Insights into the Oral Microbiome and Glycemic Control in Pediatric Type 1 Diabetes Mellitus: A Literature Review Maharsi, Eri Dian; Sudarmono, Pratiwi Pudjilestari; Mukhtar, Diniwati; Fadilah, Fadilah
Babali Nursing Research Vol. 6 No. 4 (2025): October
Publisher : Babali Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37363/bnr.2025.64513

Abstract

Introduction: Type 1 Diabetes Mellitus (T1DM) in children is associated with significant alterations in the oral microbiome that can influence glycemic control and oral health. This study aimed to synthesize current evidence on the composition of the oral microbiome in children with T1DM using Next-Generation Sequencing (NGS) and its association with glycemic parameters. Methods: A structured literature review was conducted on studies published between 2020 and 2025 that utilized 16S rRNA sequencing to compare the oral microbiome of children with T1DM and healthy controls. Results: Across the included studies, dysbiosis was consistently observed, characterized by increased pathogenic taxa (Prevotella, Veillonella) and decreased protective genera (Streptococcus), which correlated with elevated HbA1c levels and poor metabolic control. These findings suggest that hyperglycemia-driven shifts in the oral microbiome may exacerbate inflammation and oral disease risk, potentially forming a bidirectional relationship between glycemic regulation and microbial imbalance. Conclusion: Oral microbiome profiling shows promise as a non-invasive indicator of glycemic status in children with T1DM. Further standardized, longitudinal studies in local populations, particularly in Indonesia, are recommended to validate these findings and support the integration of oral microbiome monitoring into pediatric diabetes management.
Enhancing Family Awareness of Stroke Warning Signs through Supportive Education in a Community Setting Latipah, Siti; Sofiani, Yani
Babali Nursing Research Vol. 6 No. 4 (2025): October
Publisher : Babali Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37363/bnr.2025.64514

Abstract

Introduction: Health education is a key nursing intervention for individuals, groups, or communities to address health issues and promote behavior change for better outcomes. In stroke management, it increases family knowledge of stroke signs and symptoms, helping prevent recurrence. Supportive education further strengthens understanding and awareness of early stroke warning signs, which is crucial to reducing the risk and severity of recurrent strokes. This study examined the relationship between the effectiveness of supportive education and family awareness of warning signs and symptoms in post-stroke patients. Method: A quantitative quasi-experimental pre- and post-design was applied without a control group and a cross-sectional approach. Purposive sampling was used based on inclusion and exclusion criteria. Using G*Power 3.1.9.4 with an effect size of 0.55 and 80% power, 22 participants were recruited. Data were analyzed using inferential statistics, including univariate analysis (frequency distribution) and bivariate analysis (Wilcoxon signed-rank test). The Stroke Recognition Questionnaire (SRQ) showed strong content validity, with a CVI of 0.90 for symptom items and 1.00 for risk factors. Ethical approval was obtained under reference number Un.01/F.10/KP.01.1/KE.SP/05.08.054/2025. Results: Among 22 stroke patients, 40.9% were aged over 65 years, and 72.7% were male. Hypertension was the most common risk factor (86.4%), and 68.2% had a prior stroke. The Wilcoxon test produced a p-value < 0.001, indicating significant improvement in family awareness after supportive education. Conclusion: Effective stroke care requires long-term, comprehensive family involvement with strong self-care skills to support recovery and prevent recurrence.
The Role of Cultural Values in Feeding Practices among Children with Stunting in Jembrana Regency: A Qualitative Approach Agustina, Komang Srititin; Kesumawati, Ketut Anom Sri
Babali Nursing Research Vol. 6 No. 4 (2025): October
Publisher : Babali Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37363/bnr.2025.64515

Abstract

Introduction: Stunting remains a public health problem in Jembrana Regency, Bali. Despite a decline in prevalence, persistent cases suggest that cultural and nutritional factors influence feeding practices. This study aimed to explore cultural meanings and practices shaping feeding behaviors among children with stunting. Methods:  This study employed a qualitative approach with an ethnographic design. The subjects of this study were 10 mothers or caregivers of children aged 12 - 59 months with stunting, residing in Jembrana Regency, and one healthcare worker was selected using a purposive sampling technique. Data were collected through an in-depth interview guide, an observation sheet, documentation, and field notes. The collected data were then analyzed using a thematic analysis approach. Data validity was ensured through triangulation, peer debriefing, and member checking.          Results: The study identified four main themes that reflect how cultural values shape feeding behaviors in children with stunting. These themes include: (1) Snacks as substitutes that reduce appetite for main meals; (2) Normalization of small body size; (3) Flexibility expressed as "as long as the child wants to eat"; and (4) Collective caregiving culture (allomothering). Conclusion: Stunting in Jembrana is influenced by cultural values and family dynamics, so effective interventions must be culturally sensitive and target snack habits, parental misconceptions, dietary diversity, and caregiving coordination, including the role of grandmothers, to reduce stunting risk. Providing culturally sensitive nutrition education involving extended family and child caregivers is necessary in nursing.
Influence Culture on Perceptions, Behaviors, and Risk of Repeat Attacks Patients with Heart Disease: A Literature Review Based on Transcultural Nursing Trisna, Made Oktaviani Bulan; Suyasa, I Gede Putu Darma; Israfil; Suantika, Putu Inge Ruth
Babali Nursing Research Vol. 6 No. 4 (2025): October
Publisher : Babali Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37363/bnr.2025.64517

Abstract

Introduction: Differences in values, norms, and customs across societies shape how patients understand their illness, make decisions about seeking care, and undergo treatment and recovery. Based on a transcultural nursing approach, this study aims to synthesize findings from various literatures that identify cultural influences on heart disease management and their implications for preventing recurrent heart attacks. Methods: This study was a narrative literature review with the PICO framework, using PubMed, ScienceDirect, Google Scholar, and relevant sources (2016–2025) with the keywords “Coronary heart disease” AND “transcultural nursing” AND “culture.” Inclusion criteria included qualitative and quantitative primary research on the role of “culture” OR, “ethnicity” OR, “spirituality” OR, “gender” OR,  OR “access to healthcare in heart disease.” Did not address the transcultural context, focused only on biological factors, review/meta-analysis, single case report, and inadequate methodology were excluded. Of the 1,539 articles identified, 15 met the criteria and were analyzed narratively. Results: The study identified six aspects of the role of culture in heart disease: disease perception (local beliefs and spirituality), coping and treatment seeking (family norms, traditional practices, access), ethnic and gender inequalities, immigrant acculturation (Western lifestyle), collectivism and family roles (compliance vs. delay of help), and local environmental factors/traditions (e.g., solid fuels). Culture can be both a risk and a protective factor through family support, spirituality, and community. Conclusion: Culture is important in preventing and managing heart disease, particularly in reducing the risk of recurrent heart attacks. Transcultural nursing sensitive to cultural diversity is needed to improve health literacy, medication adherence, and reduce cardiovascular inequalities across populations.
The Relationship Between Self-Criticism and Hemoglobin A1c Levels in Patients with Type 2 Diabetes Mellitus Kristanti, Erva Elli; Sari, Dyah Ayu Kartika Wulan
Babali Nursing Research Vol. 6 No. 4 (2025): October
Publisher : Babali Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37363/bnr.2025.64518

Abstract

Background: Until now, Type 2 DM is still one of the metabolic diseases with a prevalence that continues to increase globally, including Indonesia. The problem that arises is that psychosocial factors, including distress due to diabetes, self-compassion, and self-criticism, have been identified as factors that can affect glucose regulation and quality of life of Type 2 DM patients. The Purpose of this Study is to Identify the Relationship Between Self-Criticism and Hemoglobin A1c Levels in Patients with Type 2 Diabetes Mellitus Methods: This study employed a correlational design to examine the relationship between self-criticism with the glucose index in patients with type 2 Diabetes Mellitus at the Pesantren I Primary Health Center, Kediri City. The Self-criticism was assessed using the Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (FSCRS), and Hemoglobin A1c levels were examined using a Portable Analyzer.  The collected data were analyzed using the regression test (α < 0.05)Bottom of Form. Results: The study showed that the self-criticism of Type 2 DM sufferers was mostly high (66%), with the results of the Hemoglobin A1c Levels being mostly abnormal (67%). There is no relationship between Self-Criticism and Hemoglobin A1c Levels of Type 2 DM sufferers (p = 0.96). Conclusion: Self-criticism does not directly affect the hemoglobin A1c levels. The findings emphasize that Hemoglobin A1c Levels in patients with diabetes mellitus are predominantly influenced by biological factors (such as dietary adherence, physical activity, pharmacological therapy, and metabolic conditions), rather than by a single psychological factor such as self-compassion.
Effect of Disaster Mitigation Education on Earthquake Preparedness Knowledge among Children with Special Needs Astuti, Vitaria Wahyu; Richard, Selvia David; Aryanti, Putu Indraswari
Babali Nursing Research Vol. 6 No. 4 (2025): October
Publisher : Babali Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37363/bnr.2025.64520

Abstract

Introduction: Earthquakes are natural disasters that frequently occur around us, an event that can be recognized or not recognized by the public, both in general and vulnerable populations, one of which is children with special needs. Children with special needs are at high risk of becoming victims of disasters. This condition can be caused by physical or mental limitations, which affect their knowledge about disasters and how to survive earthquakes. Methods: This study employed a pre-experimental one-group pretest–posttest design involving 39 children with special needs at SLB-B Putera Asih, selected through purposive sampling based on inclusion criteria. Data were collected using a 14-item knowledge questionnaire on earthquake disaster mitigation. The intervention consisted of earthquake disaster mitigation education through role-play simulations and interactive video with sign language support. Data were analyzed using the Wilcoxon Signed Rank Test with a significance level of α = 0.05. Results: After receiving earthquake disaster mitigation education, most children with special needs demonstrated improved knowledge, with 26 students showing an increase, only two students showing a decrease, and 11 students remaining the same. The significance value was p = 0.000, indicating that disaster mitigation education significantly enhanced earthquake preparedness knowledge among children with special needs at SLB-B Putera Asih. Conclusion: Providing earthquake disaster mitigation education through role-play and interactive video significantly increased the knowledge of children with special needs and enhanced their ability to practice self-rescue measures during an earthquake.
Bibliometric Performance Analysis for Online Assessment in Health Education Ahmad, Rahwan; Hariawan, Hamdan; Ratna; Prasetyawati
Babali Nursing Research Vol. 6 No. 4 (2025): October
Publisher : Babali Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37363/bnr.2025.64522

Abstract

Background: Online assessment has become a crucial component of health professional education, a trend significantly accelerated by the COVID-19 pandemic. This study presents a comprehensive bibliometric analysis of scientific publications on online assessment in health education indexed in Scopus from 2004 to 2024. Methods: The data were cleaned using OpenRefine and analyzed with Biblioshiny. Results: Findings from 339 selected articles revealed that the United States was the leading country in publication output. Gary M. Velan and Rakesh K. Kumar were identified as the most productive authors, while BMC Medical Education emerged as the top journal. Keyword analysis highlighted the prominence of terms such as “health education,” “online assessment,” and “e-learning,” indicating the evolving research focus in this field. Furthermore, the mapping demonstrated strong international collaboration networks, particularly between the United States and the United Kingdom. Conclusion: This study provides valuable insights into the developmental trajectory and dynamics of research on online assessment in health education and identifies key opportunities for future exploration. It recommends integrating cross-database analyses (e.g., WoS, PubMed) and employing mixed bibliometric approaches to capture a broader research landscape.
Integrating the MERDEKKA Intervention into Palliative Care for Tuberculosis Patients: A Mixed-Methods Study Astuti, Ni Luh Seri; Rismayanti, I Dewa Ayu; Pratama, Aditha Angga
Babali Nursing Research Vol. 6 No. 4 (2025): October
Publisher : Babali Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37363/bnr.2025.64523

Abstract

Introduction: In Indonesia, pulmonary tuberculosis causes more than 95% of mortality. WHO has established a target for treating tuberculosis that is aligned with Asta Cita 4, which specifies that Indonesia would be TB-free by 2030. Palliative care does not only mean end-of-life care. Methods: mixed methods sequential explanatory design. Quantitative data was first collected using a one-group pre- and post-test design, and the qualitative analysis using in depth interview. Merdekka Intervention using RESPECT instrument and 80 sample in pre post test. also 15 participant to explore the experience after doing MERDEKKA intervention. Result: The majority of respondents (35.8%) were aged 62 to 72, largely male (96.1%), and had completed junior high school (43.5%). The majority of respondents were farmers (48.7%), had tuberculosis in their family (96.1%), and had been on treatment for at least 6 months. The MERDEKKA intervention had a substantial impact on TB patients' knowledge and attitudes, with a p-value of 0.001 for knowledge and 0.003 for attitudes. The effect size value was larger than 1.0, indicating a very powerful influence. Patients' experiences after the MERDEKKA intervention are described in three themes: Developing good trust between the patient and the nurse, providing proper and necessary care, and being enthusiastic about healing within six months Conclusion: The palliative care model, including the MERDEKKA intervention, is critical in the care of TB patients. Even though it is not in the terminal phase, its presence in the initial phase of therapy can improve the patient's health in all aspects of need.
Analysis of Factors Affecting Response Time in the Management of Heart Attacks Based on Pecalang (Buleleng Skilled Ambulance Officers) Made Martini; Aryawan
Babali Nursing Research Vol. 6 No. 4 (2025): October
Publisher : Babali Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37363/bnr.2025.64524

Abstract

Background: A heart attack is commonly caused by acute coronary syndrome, which may be asymptomatic yet lead to sudden cardiac arrest, particularly outside a hospital setting. Ambulance personnel serve as frontline responders in delivering lifesaving interventions. This study analyzed the factors influencing ambulance response time in heart attack cases in Buleleng. Methods: A mixed-method design was applied in Buleleng Regency, simultaneously integrating quantitative and qualitative strands. This study involved 110 ambulance officers selected purposively from hospitals and community health centers across Buleleng. The qualitative strands involved 10 key informants. Quantitative variables included personnel experience, training, travel time, type of ambulance, and communication delay. Data were collected using structured questionnaires and complemented by interviews and FGDs for qualitative insights. Quantitative data were analyzed using correlation and regression tests, while qualitative data were thematically analyzed. Results: Personnel experience (r = –0.197; p = 0.039) significantly reduced response times, highlighting the importance of clinical competence acquired in the field. Training (r = 0.104; p = 0.278) enhanced service quality but showed limited direct impact without continuous practice and operational support. Travel time (r = 0.672; p < 0.001) emerged as the primary delay factor, influenced by distance, traffic, and road conditions. Type of ambulance (r = –0.235; p = 0.014) also affected mobilization efficiency, while communication barriers (r = 0.844; p < 0.001; OR = 0.002) were the strongest determinant of delays. Conclusion: Reducing ambulance response times requires systemic improvements in communication, fleet readiness, operational management, and infrastructure, beyond individual competence alone.
Pharmacists' and Type 2 Diabetes Mellitus Patients' Perceived Barriers to Insulin Therapy at Hospital: A Qualitative Study Suastini, Ni Made; Gayatri, Ni Putu Ayu Deviana
Babali Nursing Research Vol. 6 No. 4 (2025): October
Publisher : Babali Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37363/bnr.2025.64525

Abstract

Introduction: Recent data show that Indonesia ranks fifth in the world for diabetes mellitus (DM). An increase in insulin use accompanies the increasing prevalence of DM. However, several barriers to insulin use remain among patients and healthcare professionals, impacting blood glucose control. This study explored perceptions of barriers to insulin therapy among T2DM patients and hospital pharmacists. Methods: This research was a qualitative study. The recruitment of participants used a consecutive sampling method. Eighteen in-depth interviews were conducted with T2DM patients, and nine were conducted with hospital pharmacists at a private hospital. Thematic analysis was used to generate findings in this research. Results: Barriers faced by patients in insulin therapy include fear and anxiety, insulin use practices, and misconceptions about insulin. Meanwhile, the results of the barriers faced by pharmacists on providing education and consultation on insulin therapy included patient, facility, and system barriers. These factors can impact insulin therapy and target outcomes in T2DM patients. Conclusion: Barriers from the patient and pharmacist perspectives are very important to assess, so that comprehensive therapy in the form of collaboration between health workers and patients can be implemented to achieve the target outcomes for T2DM patients.

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