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Nursing and Health Sciences Journal (NHSJ)
Published by KHD Production
ISSN : 27985059     EISSN : 27985067     DOI : https://doi.org/10.53713/nhs.v1i1.1
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Medicine & Pharmacology Nursing Public Health
Nursing and Health Sciences Journal (NHSJ) is peer-reviewed and open access international journal which published by KHD Production, to accommodate researchers and health practitioners publishing their scientific articles. NHSJ accepts original papers, review articles, short communications, case reports and letters to the editor in the fields of nursing, midwifery, public health, pharmacy, medicine, nutrition, and allied health sciences. NHSJ is published four times a year, March, June, September, and December.
Arjuna Subject : Keperawatan - Keperawatan (Lain-Lain)
Articles 330 Documents
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Digital transformation in pharmacist-led services: Optimizing chronic patient management in Indonesia's primary health care facilities Yovi Pranata
Nursing and Health Sciences Journal (NHSJ) Vol. 6 No. 2 (2026): June 2026
Publisher : KHD-Production

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53713/nhsj.v6i2.689

Abstract

Primary healthcare facilities in Indonesia face persistent challenges in managing type 2 diabetes and hypertension, largely due to suboptimal medication adherence and limited telepharmacy integration. This mixed-methods quasi-experimental study evaluated a multicomponent telepharmacy intervention across ten community health centers in Depok. Using stratified random sampling, 424 chronic patients were assigned to intervention or control groups. Grounded in the Health Belief Model and Technology Acceptance Model, the intervention combined the “FarmasiKronis Depok” application with twelve virtual pharmacist consultations. Outcomes were assessed using MMAS-8, SF-36, and eHEALS. Quantitative data were analyzed via ANCOVA and multivariate regression, supplemented by thematic analysis of 45 semi-structured interviews. The intervention significantly improved medication adherence (+2.1 points; d = 1.52; p < 0.001) and quality of life (+19.2 points; d = 1.42; p < 0.001) compared with controls. Regression identified intervention exposure (β = 1.42) and digital health literacy (β = 0.12) as primary predictors. Qualitative themes highlighted digital accessibility (71%), academic institutional support (62%), and persistent digital literacy barriers (40%). Notably, university-educated participants achieved an 85% high-adherence rate. Pharmacist-led digital transformation substantially optimizes chronic disease management in primary care. Strategic integration with national health platforms, standardized telepharmacy reimbursement, and expanded digital competency training offer scalable pathways to reduce hospital readmissions by 28% and enhance health system sustainability
Factors associated with anemia among hemodialysis patients: A cross-sectional study Samsul Hadi; Heri Kristianto; Lilik Supriati
Nursing and Health Sciences Journal (NHSJ) Vol. 6 No. 2 (2026): June 2026
Publisher : KHD-Production

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53713/nhsj.v6i2.692

Abstract

Anemia substantially increases morbidity, mortality, and healthcare burden in maintenance hemodialysis (HD) patients, necessitating precise risk stratification for optimal clinical management. This study evaluated demographic and readily accessible clinical parameters as independent predictors of severe anemia in an Indonesian HD cohort. A cross-sectional design was employed, enrolling 168 maintenance HD patients at Al Huda Hospital in Banyuwangi through purposive sampling. Severe anemia was strictly defined as hemoglobin <8 g/dL versus non-severe (≥8 g/dL). Data on age, sex, HD duration, and pre-dialysis oxygen saturation were systematically collected and analyzed using chi-square tests and multivariate logistic regression. The prevalence of severe anemia was 82.7%. Multivariate analysis identified female sex as the sole independent predictor of severe anemia (adjusted odds ratio [aOR] = 4.76; 95% confidence interval [CI]: 1.83–12.40; p = 0.001). Conversely, age (p = 0.393), HD duration (p = 0.328), and pre-dialysis oxygen saturation (p = 0.648) demonstrated no statistically significant associations with anemia severity. Female sex constitutes a robust independent risk factor for severe anemia in HD populations, strongly advocating for sex-specific hematological surveillance and individualized therapeutic protocols. The lack of predictive value for routine demographic and physiological parameters underscores the critical need to integrate comprehensive assessments of iron and inflammatory biomarkers into standard anemia management protocols to improve patient outcomes.
High-calcium tuna bone meal cookies improve linear growth in stunted toddlers Rifzul Maulina; Dian Pitaloka Priasmoro; Eka Diah Kartiningrum
Nursing and Health Sciences Journal (NHSJ) Vol. 6 No. 2 (2026): June 2026
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53713/nhsj.v6i2.699

Abstract

Stunting remains a critical public health challenge in Indonesia, necessitating innovative, locally sourced nutritional interventions. Tuna fish bones represent an underutilized source of bioavailable calcium and essential nutrients. This study evaluated the efficacy of high-calcium tuna bone meal cookie supplementation in improving the nutritional status of stunted toddlers. A quasi-experimental pretest–posttest control group design was conducted in Bandungrejosari Regency, Indonesia. Thirty-two stunted toddlers aged 12–60 months were recruited through purposive sampling and allocated into intervention (n=16) and control (n=16) groups. The intervention group received tuna bone meal cookies twice daily for 60 consecutive days, while the control group received no supplementation. Anthropometric measurements were obtained at baseline and post-intervention. Data were analyzed using independent and paired t-tests, with α=0.05. The intervention group demonstrated significantly greater linear growth compared to controls, with a mean height difference of 4.53 cm (p=0.008). Post-intervention mean height was 96.00 cm in the intervention group versus 91.47 cm in the control group. Tuna bone meal cookie supplementation significantly improves nutritional status and linear growth among stunted toddlers. This cost-effective, sustainable intervention using marine by-products shows promise for integration into community-based stunting-reduction programs
Effects of deliberate practice and self-efficacy on clinical skills performance in a fundamental nursing course Erik Kusuma; Syaifuddin Kurnianto; Eko Prasetya Widianto; Mareta Deka Paraswati; Suhendra Agung Wibowo
Nursing and Health Sciences Journal (NHSJ) Vol. 6 No. 2 (2026): June 2026
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53713/nhsj.v6i2.700

Abstract

Clinical skill deficits among vocational nursing students compromise patient safety, particularly when conventional training lacks structured feedback mechanisms. This study investigated the effects of a deliberate practice intervention and self-efficacy on clinical skills performance. A quasi-experimental pretest–posttest control-group design was conducted with 60 second-semester diploma nursing students, who were allocated via matched sampling to the experimental (n=30) or control (n=30) groups. The experimental cohort completed an eight-session deliberate practice program (90 minutes per week for four weeks), while the control group received standard instruction. Blinded assessors evaluated psychomotor skills using a validated Objective Structured Clinical Examination checklist, and self-efficacy was measured with the General Self-Efficacy Scale. Intervention fidelity was rigorously maintained through protocol checklists. The experimental group demonstrated significantly superior post-intervention clinical skills scores compared to controls (mean difference = 12.47, 95% CI [8.40, 15.60], p < .001). Self-efficacy independently predicted skill performance (β = 0.29, p = .008). Combined, the intervention and self-efficacy explained 58.3% of the variance in clinical performance (adjusted R² = 0.55, p < .001). Structured deliberate practice substantially enhances clinical competency in vocational nursing students, with self-efficacy functioning as a critical complementary predictor. Nursing educators should systematically integrate deliberate practice frameworks with targeted confidence-building strategies to optimize psychomotor skill acquisition and strengthen patient safety outcomes.
Early mental health exposure and clinical readiness of nursing students: A qualitative study Bagus Dwi Cahyono; Ronal Surya Aditya; Nurul Huda; Apriana Rahmawati; Evy Aristawati
Nursing and Health Sciences Journal (NHSJ) Vol. 6 No. 2 (2026): June 2026
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53713/nhsj.v6i2.708

Abstract

Early experiential exposure is increasingly advocated to enhance psychiatric clinical readiness; however, empirical evidence regarding real-world social rehabilitation settings remains limited, particularly within low- and middle-income countries where clinical placements are often delayed. This study examined nursing students’ learning experiences and perceived clinical readiness following early exposure to individuals with mental disorders in a community rehabilitation setting. A qualitative descriptive design utilizing reflexive thematic analysis was conducted with 35 third-semester Diploma nursing students in East Java, Indonesia. Purposive sampling achieved thematic saturation at 28 interviews. Data were collected via semi-structured interviews and analyzed using reflexive thematic analysis, adhering strictly to COREQ reporting standards to ensure methodological transparency. Findings delineated a developmental trajectory from initial stigma and anxiety toward empathy, therapeutic confidence, and clinical preparedness. Four interconnected themes emerged: (1) attitudinal reconstruction regarding mental illness, (2) emerging relational agency in therapeutic communication, (3) cognitive-affective integration of theoretical constructs, and (4) transitional clinical readiness. Supervised face-to-face engagement within a supportive rehabilitation environment, facilitated stigma deconstruction, and cultivated adaptive interpersonal competencies. It contextualized abstract classroom knowledge through authentic patient interaction, thereby bridging the theory-practice divide. Early structured exposure transcends passive observation, functioning as a transformative pedagogical mechanism that synchronizes affective, cognitive, and relational development. Systematically embedding community-based experiential learning prior to acute psychiatric placements is critical to optimizing global clinical readiness, mitigating entrenched stigma, and advancing recovery-oriented nursing curricula worldwide, particularly in resource-constrained educational systems
Self-efficacy and adherence to structured lifestyle modifications in hypertension management: A cross-sectional study in Indonesian primary care I.G.A. Mayoni Renanda Putri; Ni Kadek Ayu Suarningsih; Widyanthari Desak Made; Gusti Ayu Ary Antari
Nursing and Health Sciences Journal (NHSJ) Vol. 6 No. 3 (2026): September 2026
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53713/nhsj.v6i3.537

Abstract

Hypertension remains a critical public health challenge in Indonesia, necessitating robust patient self-efficacy to sustain essential lifestyle modifications. The national CERDIK behavior program serves as a primary framework for facilitating such chronic disease self-management. This study aimed to evaluate baseline levels of self-efficacy and adoption of CERDIK behavior among hypertensive patients attending Primary Health Care II in West Denpasar. A descriptive-analytic, cross-sectional study was conducted involving 89 hypertensive patients selected via accidental sampling. Data collection utilized the validated Generalized Self-Efficacy Scale (GSES) alongside a modified CERDIK behavior questionnaire. Univariate analysis was subsequently performed to determine frequency distributions and central tendencies of the collected data. Findings revealed that a substantial proportion of respondents demonstrated high self-efficacy (46.1%) and high adherence to CERDIK behaviors (47.2%), reflecting a positive baseline for chronic disease management. A notable segment of the population exhibited moderate to low levels in both domains, indicating significant room for targeted clinical and behavioral intervention. Baseline self-efficacy and CERDIK behavior adoption are moderately favorable. Enhanced health education and consistent psychosocial support remain imperative to address these existing clinical gaps. Primary care providers must prioritize tailored educational interventions for newly diagnosed patients and individuals exhibiting low self-efficacy. Strengthening these community support systems is essential to optimize long-term hypertension management, improve overall treatment adherence, and prevent severe cardiovascular complications within the local population.
Clinical Competence Among Inpatient Nurses: A Comparative Study Across Two Indonesian Tertiary Hospitals Raul Requilmy Suprapto; Nurfika Asmaningrum; Anisah Ardiana; Dicky Endrian Kurniawan; Elok Faradisa; Thi Thu Huong Phan
Nursing and Health Sciences Journal (NHSJ) Vol. 6 No. 3 (2026): September 2026
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53713/nhsj.v6i3.638

Abstract

Clinical competence is a fundamental indicator of the quality of nursing care and patient safety. In Jember Regency, type C hospitals such as Kalisat Regional General Hospital and Balung Regional General Hospital play an important role in providing health services in their respective areas. However, differences in unit characteristics and resource management can lead to variations in nursing competence. Objective: This study aims to compare the clinical competence of inpatient nurses between RSD Kalisat and RSD Balung. Methods: This is a comparative descriptive study with a cross-sectional design. The population consisted of inpatient nurses, with a total sample of 64 respondents (32 from each hospital) through total sampling. Data were collected using the Clinical Competency Questionnaire (CCQ) and analyzed using the Independent Sample T-test and Mann-Whitney U test. Results: The findings showed no significant difference in overall clinical competence between the two hospitals (p=0.757). The same was true for each unit tested in both hospitals (general p=0.549), (surgery p=0.190), and (internal medicine p=0.626). Conclusion: In general, the clinical competence of nurses in both hospitals and between units had equivalent values and showed consistent standards. Recommendation: Hospitals should continue to provide ongoing training to maintain and improve clinical competence and other competencies.
Culturally embedded resilience in the diabetes-COVID-19 syndemic: A phenomenological study of older adults in Bali, Indonesia Putu Wira Kusuma Putra; Ni Komang Matalia Gandari; Ni Nyoman Suardani; Meriana Barreto Amaral
Nursing and Health Sciences Journal (NHSJ) Vol. 6 No. 3 (2026): September 2026
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53713/nhsj.v6i3.685

Abstract

The COVID-19–diabetes mellitus (DM) syndemic disproportionately threatened older adults with Type 2 DM globally. This study investigates the culturally embedded resilience mechanisms enabling older Balinese adults with long-standing T2DM to maintain complication-free status during this crisis, directly challenging dominant deficit narratives. A descriptive phenomenological study grounded in Husserlian principles recruited ten older adults (aged 56–70; T2DM ≥20 years) in Badung Regency, Bali, utilizing purposive sampling. Bilingual researchers conducted in-depth interviews in participants’ preferred languages. Data were analyzed employing Colaizzi’s seven-step method, with methodological rigor ensured through reflexive bracketing and biweekly peer debriefing. Analysis revealed four interconnected themes illustrating a trajectory from psychological distress to disciplined self-management: (1) spiritually mediated acceptance of syndemic threat; (2) dietary management integrating biomedical guidance with traditional Balinese Usada practices; (3) adapted physical activity with strict pandemic protocol adherence; and (4) consistent biomedical treatment compliance. The Tri Hita Karana (THK) philosophy underpinned all themes, functioning as a cohesive cultural framework that seamlessly integrated psychological, behavioral, and biomedical domains into a unified self-management ecosystem. Resilience within this syndemic context emerged as a dynamic, culturally embedded process rather than a fixed individual trait. Healthcare systems must prioritize THK-informed, strength-based nursing programs as proactive resilience infrastructure, systematically integrating indigenous health philosophies into chronic disease management strategies for future global health emergencies.
Enhancing household disaster preparedness among older adults using the N-TORM intervention: A quasi-experimental study in rural Indonesia Diki Ardiansyah; Roviatul Imaniah; Rita Fitri Yulita; Susilawati Susilawati; Asep Badrujamaludin; Khrisna Wisnusakti; Firman Sugiharto
Nursing and Health Sciences Journal (NHSJ) Vol. 6 No. 3 (2026): September 2026
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53713/nhsj.v6i3.695

Abstract

Older adults in earthquake-prone low- and middle-income countries (LMICs) face disproportionate disaster-related morbidity and mortality. Culturally adapted, nurse-led preparedness programs for this demographic in seismically active LMIC settings remain largely unexplored. This study evaluated the effectiveness of the Nurses Taking on Readiness Measures (N-TORM) intervention on household emergency preparedness (HEP) among older adults (≥ 60 years) residing near Indonesia’s Lembang Fault. A quasi-experimental, non-equivalent control-group pre-post design was implemented in April 2025 in Suntenjaya Village, West Java. Forty participants were allocated to intervention (n = 20) or control (n = 20) groups based on residential clusters to minimize contamination. The six-day N-TORM intervention comprised disaster education, booklet-guided planning, and home-visit monitoring. HEP was measured using the 32-item Household Emergency Preparedness Instrument (HEPI; score range 32–160; ≥ 112 indicates preparedness). Data were analyzed using the Wilcoxon signed-rank and Mann-Whitney U tests. Baseline assessments categorized both groups as unprepared (median HEPI score: 57). Post-intervention, the intervention group showed a significant increase in score (median: 126, p < 0.001), successfully achieving the prepared threshold. The control group exhibited no significant change. Between-group comparisons at post-test revealed a highly significant difference (Mann-Whitney U = 0.00, p < 0.001). The culturally adapted N-TORM intervention significantly enhances household emergency preparedness among older adults in earthquake-prone LMICs. Integrating such nurse-led programs into existing community health infrastructure, particularly integrated health posts, offers a scalable strategy to strengthen disaster risk reduction for vulnerable aging populations.
Determinants of menstrual hygiene management among adolescents: The interplay of school sanitation infrastructure and psychosocial support in Indonesia Putri Azzahroh; Arfiani Dean Putri; Febry Mutiariami Dahlan
Nursing and Health Sciences Journal (NHSJ) Vol. 6 No. 3 (2026): September 2026
Publisher : KHD-Production

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53713/nhsj.v6i3.703

Abstract

Suboptimal Menstrual Hygiene Management significantly increases the risk of reproductive tract infections among adolescent girls globally, representing a major public health challenge. External environmental and psychosocial determinants critically shape these vital health practices during the developmental transition. This study aimed to analyze the correlations between school sanitation facilities, peer roles, and family support regarding the menstrual hygiene behavior of female students at a vocational high school in Bekasi City. Researchers employed a quantitative analytical approach utilizing a cross-sectional design. The study population comprised 93 female students who had experienced menarche, selected through a total sampling technique. Primary data collection involved a validated structured questionnaire. Statistical analysis used the Chi-Square test to assess the significance of the relationship between the independent and dependent variables. The findings revealed that 71.0% of respondents practiced good menstrual hygiene. Bivariate analysis demonstrated statistically significant correlations between school sanitation facilities (p=0.016), peer roles (p=0.039), and family support (p=0.015) with overall hygiene behavior. School sanitation facilities emerged as a dominant enabling factor influencing the consistency of hygiene practices within the educational environment. Optimal menstrual hygiene management requires a synergistic integration of adequate gender-responsive physical infrastructure and robust psychosocial support systems. Educational institutions and public health policymakers must prioritize both ongoing facility maintenance and comprehensive community-based reproductive health education to safeguard adolescent reproductive well-being and ensure equitable health outcomes.

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