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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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Workplace environment and nurse performance: Evaluating the mediating role of self-efficacy in hospital settings Fathiyah Ma'ani; Josephina Agung; Yolla Margaretha; Bram Hadianto
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.v6i3.711

Abstract

Sustaining high-level nursing performance in complex hospital environments remains a critical determinant of healthcare delivery, clinical safety, and patient recovery outcomes. This empirical investigation evaluates the structural causal relationships among workplace environment, self-efficacy, and nurse performance within hospital settings, specifically analyzing the mediating role of self-efficacy. Data collection occurred in November 2025 at two selected healthcare facilities in Indonesia: Sumber Kasih Hospital in Cirebon and Budi Agung Juwana Hospital in Pati. Target sample size parameters were determined utilizing the Isaac and Michael formula, with a non-probability snowball sampling strategy yielding 208 completed nurse responses. Analytical procedures employed Covariance-Based Structural Equation Modeling to execute rigorous measurement validation, path analysis, and structural equation testing. Empirical findings demonstrate that both self-efficacy and the workplace environment have significant, direct positive effects on nurse performance. The quality of the workplace environment also exerts a strong, direct positive effect on nurses' self-efficacy. Mediation analysis confirms that self-efficacy partially mediates the relationship between the workplace environment and clinical performance outcomes. Multidimensional environmental support, encompassing physical gratification, psychological stability, independent competence, collaborative relationships, and structural supports, facilitates the execution of daily tasks while fundamentally reshaping nurses' perceptions of their clinical capabilities. Strengthening internal confidence enables nursing staff to maintain high standards of care under demanding operational conditions. Hospital administrators must combine structural environmental investments with psychological empowerment initiatives to optimize overall clinical care quality.
Multidimensional family support and pre-procedural anxiety in patients undergoing cardiac catheterization: A cross-sectional study Suryagustina; Putria Carolina
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.v6i3.714

Abstract

Cardiac catheterization frequently induces severe pre-procedural anxiety, necessitating effective psychosocial interventions to ensure hemodynamic stability and patient cooperation. This study investigated the relationship between multidimensional family support and anxiety levels among patients scheduled for invasive cardiac procedures. A quantitative cross-sectional design was utilized, enrolling 34 patients selected through consecutive sampling at a regional tertiary hospital in Central Kalimantan, Indonesia. Researchers measured familial assistance using a validated 20-item questionnaire encompassing emotional, informational, appraisal, and instrumental dimensions. Patient anxiety severity was concurrently assessed utilizing the standardized Hamilton Anxiety Rating Scale (HARS). Spearman's rank correlation test evaluated the statistical association between these primary psychosocial and clinical variables. The majority of participants reported adequate familial backing and experienced predominantly mild to moderate psychological distress prior to the diagnostic intervention. Statistical analysis demonstrated a significant, very strong negative correlation between family support (p = -0.888) and anxiety levels (p = 0.003). Individuals receiving comprehensive assistance from their relatives consistently exhibited significantly lower preoperative apprehension compared to those lacking robust social networks. Robust social backing effectively buffers the psychological impact of invasive cardiovascular diagnostics by enhancing internal coping resources and mitigating uncertainty. Nurses should prioritize structured educational sessions to equip families with the knowledge needed to provide effective emotional support. Healthcare institutions must integrate structured family-centered protocols into routine preoperative care to optimize patient readiness and minimize perioperative emotional turmoil.
Development and preliminary psychometric evaluation of a Tuberculosis-Specific Health Literacy Questionnaire based on the integrated model: A phase 1 pilot study in Indonesia Farida Nur Qomariyah; Lukawee Piyabanditkul
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.v6i3.715

Abstract

Tuberculosis-specific health literacy is critical for treatment adherence, yet Indonesia lacks a context-specific instrument grounded in a comprehensive framework. This pilot study aimed to develop and preliminarily evaluate a tuberculosis-specific health literacy questionnaire based on the Integrated Model of Health Literacy. A cross-sectional Phase 1 instrument-development study was conducted among former tuberculosis patients in Jember Regency, Indonesia. The 46-item questionnaire was mapped to four domains: access, understand, appraise, and apply. Content validity was assessed by five experts using Item-Level and Scale-Level Content Validity Indices. Forward-backward translation ensured semantic equivalence. Interrater reliability was evaluated by three independent raters using the Intraclass Correlation Coefficient. Internal consistency was examined using Cronbach's alpha. The instrument demonstrated excellent content validity with a Scale-Level Content Validity Index average of 0.99. Overall interrater reliability was good, yielding an Intraclass Correlation Coefficient of 0.81. Internal consistency was exceptionally high, with a total Cronbach's alpha of 0.97. Domain-specific alphas ranged from 0.89 to 0.96. Two items met the minimum Item-Level Content Validity Index threshold of 0.80 and were retained for further refinement. The newly developed tuberculosis-specific health literacy questionnaire exhibits promising preliminary psychometric properties. Subsequent large-scale validation studies must evaluate factor structure, test-retest reliability, and potential item reduction before the instrument can be utilized for routine clinical or public health decision-making.
Brief nurse-led mindfulness breathing exercises reduce stress and improve quality of life in heart failure: A quasi-experimental study Saelan; Dewi Suryandari; Aria Nurahman Hendra Kusuma; Salis Miftahul Khoeriyah
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.v6i3.727

Abstract

Psychological distress severely impacts self-care and health-related quality of life in heart failure patients. Brief nurse-led mindfulness breathing exercises offer a promising, low-cost intervention, yet clinical evidence regarding their effect sizes in low-resource settings remains scarce. This study examined the effects of a mindfulness breathing exercise program on perceived stress and heart failure-specific quality of life. A quasi-experimental pretest–posttest control group design was utilized involving 32 heart failure patients allocated into intervention (n=16) and control (n=16) groups. The intervention group performed independent mindfulness breathing exercises three times weekly for four weeks, guided by standardized instructions and logbooks. The control group received standard care. Researchers measured outcomes using the Perceived Stress Scale-10 and the Minnesota Living with Heart Failure Questionnaire. Data analysis employed the Wilcoxon Signed Rank and Mann–Whitney U tests, incorporating effect size calculations. Post-intervention analysis revealed significant between-group differences. The intervention group demonstrated substantial reductions in stress levels (p = 0.001, r = 0.58) and significant improvements in quality of life (p < 0.001, r = 0.63), yielding large effect sizes. Notably, zero participants in the intervention group remained in the high-stress or poor quality-of-life categories. The control group exhibited no significant improvements in either outcome. Mindfulness breathing exercises constitute a feasible, non-invasive, and highly effective nursing intervention for mitigating psychological distress in heart failure patients. Integrating brief mindfulness practices into routine cardiac care significantly enhances patient well-being, particularly within resource-limited clinical environments.
Humanistic Leadership and Job Satisfaction Among Health Sciences Lecturers: The Mediating Role of Meaningful Work Putria Carolina
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.v6i3.728

Abstract

Introduction: Health sciences Lecturers are increasingly confronted with complex professional demands, including the integration of teaching, research, and community service responsibilities, which place substantial pressure on their well-being and job satisfaction. In this context, job satisfaction emerges as a critical factor in sustaining academic performance, professional commitment, and institutional effectiveness. Leadership practices, particularly humanistic leadership, are considered pivotal in shaping positive work environments that acknowledge lecturers’ values, dignity, and professional contributions. This study, therefore, examines the effect of humanistic leadership on health lecturers’ job satisfaction, with meaningful work positioned as a mediating mechanism. Method: This research employed a quantitative explanatory design. Data were collected through a structured questionnaire from 105 health sciences lecturers at private higher education institutions in Palangka Raya City using purposive sampling. The data were analyzed using Structural Equation Modeling–Partial Least Squares (SEM-PLS). The findings indicate that humanistic leadership has a significant and substantial effect on lecturers’ job satisfaction. In addition, humanistic leadership positively influences meaningful work. The mediation analysis demonstrates that meaningful work partially mediates the relationship between humanistic leadership and job satisfaction, although the indirect effect is smaller than the direct effect of leadership. Result: These results suggest that leadership practices emphasizing human dignity, fair interpersonal relationships, and support for professional development contribute directly to higher job satisfaction while also fostering a more meaningful work experience. Conclusion: The study contributes to the literature by providing empirical evidence on the role of humanistic leadership and meaningful work in the context of Indonesian private higher education. Practically, the findings highlight the importance of strengthening humanistic leadership practices to enhance lecturers’ job satisfaction and support sustainable performance in health higher education institutions.
Comparative effects of room-temperature water, cold water, normal saline, and aloe vera as first aid on burn wound healing in a rat model: An experimental study Ruris Haristiani; Rondhianto; Rismawan Adi Yunanto; Baskoro Setioputro; Azkiatulfikroh; Laily Nailul Farih; Trisya Ainur Alula
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.v6i3.729

Abstract

Immediate first aid influences burn depth, infection risk, and healing. Common options include room-temperature water, cold water, normal saline, and Aloe vera, but direct comparative evidence remains limited. This study compared these interventions for burn wound healing in rats. A true experimental post-test-only control group design was used. Thirty male Wistar rats were randomly allocated to six groups (five per group). Standardized superficial partial-thickness burns were induced with a heated iron plate. Interventions comprised room-temperature water plus Burnazin, cold water plus Burnazin, normal saline plus Burnazin, room-temperature water plus Aloe vera, Aloe vera without irrigation, and room-temperature water plus vaseline. Wound diameter and macroscopic appearance were evaluated on days 1, 3, 7, and 14. Between-group differences were analyzed using one-way ANOVA (p < 0.05). Baseline wound diameter was 2.15 cm in all groups. Wound diameter increased on day 3, then decreased progressively on days 7 and 14. On day 14, the smallest mean diameters were observed in Aloe vera without irrigation (1.85 ± 0.29 cm), room-temperature water plus Burnazin (1.86 ± 0.31 cm), and room-temperature water plus vaseline (1.88 ± 0.26 cm). The largest diameter was observed in normal saline plus Burnazin (2.16 ± 0.42 cm). No statistically significant differences were found among groups on days 3, 7, or 14 (p = 0.056, 0.218, and 0.739). All interventions showed progressive wound healing. Aloe vera without irrigation showed a favorable but non-significant trend toward smaller wounds, requiring further verification.
Prognostic value of the neutrophil-to-lymphocyte ratio for predicting hospital length of stay in pneumonia patients: A cross-sectional study Henny Syapitri; Johansen Hutajulu; Amila Amila; Lasma Rina Efrina Sinurat; Janno Sinaga; Ivan Elisabeth Purba
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.v6i3.730

Abstract

Pneumonia remains a leading cause of hospitalization and mortality globally, imposing a substantial burden on healthcare systems in developing countries. The Neutrophil-Lymphocyte Ratio (NLR) has emerged as a readily accessible, cost-effective prognostic biomarker for predicting hospital length of stay (LOS). This study aimed to examine the association between NLR and LOS in patients with pneumonia at Melati Perbaungan General Hospital. A cross-sectional study was conducted using medical records of patients with pneumonia treated between January 2024 and January 2025. Of the 240 patients, 102 met the inclusion criteria. Exclusion criteria encompassed immunocompromised conditions, chronic comorbidities, surgical complications, and incomplete records. Data collected included neutrophil and lymphocyte counts, NLR, LOS, age, sex, and treatment modalities. Univariate and bivariate analyses were performed using the Chi-square test (p < 0.05). Most patients exhibited elevated neutrophil levels (64.7%) and lymphopenia (47.1%). High NLR (>3.13) was observed in 80.4% of patients. The majority (77.5%) experienced hospital stays exceeding four days. Significant associations were identified between neutrophil levels (p = 0.038), lymphocyte levels (p = 0.044), and NLR (p = 0.031) with LOS. Patients with elevated NLR demonstrated significantly higher odds of prolonged hospitalization (OR = 5.14). NLR is significantly associated with prolonged hospitalization among patients with pneumonia. This readily accessible biomarker may serve as a cost-effective prognostic indicator to support early risk stratification, optimize resource allocation, and improve patient management outcomes in clinical practice.
Financial toxicity and quality of life among hospitalized cervical cancer patients in Indonesia: A cross-sectional study Ida Maryati; Wilan Fitriana; Hesti Platini; Yanti Hermayanti; Ikeu Nurhidayah; Ai Mardhiyah; Mira Trisyani Koeryaman; Syiffa Salsabila Rausanfikra
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.v6i3.735

Abstract

Cervical cancer significantly impairs patient well-being, particularly in low- and middle-income countries where financial toxicity exacerbates the disease burden. Evidence regarding income-related quality of life (QoL) disparities among Indonesian cervical cancer patients remains limited. This study examined the association between demographic characteristics, specifically income, and QoL among hospitalized cervical cancer patients. A quantitative cross-sectional study was conducted among 60 consecutive patients recruited at a tertiary referral hospital in Bandung, Indonesia. Researchers assessed QoL using the validated EORTC QLQ-C30 instrument. Data were analyzed using descriptive statistics, bivariable tests, and multiple linear regression to identify independent predictors of QoL. Participants demonstrated a moderately favorable mean global QoL score (68.4 ± 12.5) despite experiencing a moderate symptom burden. Bivariate analyses revealed that age, education level, and marital status were not significantly associated with QoL. Income emerged as the sole significant demographic predictor. Multiple regression analysis confirmed that the higher-income group reported significantly better QoL than the lower-income group, exhibiting a mean difference of 9.3 points (β = 0.38, p = 0.008). The analysis indicated a moderate-to-large effect size (Cohen's d = 0.72). Income substantially and independently influences QoL among cervical cancer patients, highlighting the critical impact of financial vulnerability on survivorship outcomes. Integrating routine socioeconomic assessments, financial navigation services, and targeted supportive oncology nursing interventions into clinical practice is essential for mitigating financial toxicity and improving patient-centered outcomes in resource-limited settings.
Comparative diagnostic accuracy of clinical screening instruments for diabetic peripheral neuropathy against vibration perception threshold: A study in Indonesia Nunung Khairun Nissa Oper; Heri Kristianto; Laily Yuliatun; Rulli Rosandi
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.v6i3.737

Abstract

Diabetic peripheral neuropathy (DPN) is a major precursor of foot ulceration and amputation; however, validated low-cost screening tools remain limited in Southeast Asian populations. This study evaluated and compared the diagnostic accuracy of the MNSI-A, MNSI-B, DNS, and DNE against biothesiometer-defined DPN in Indonesian adults with type 2 diabetes. A cross-sectional diagnostic accuracy study recruited 140 consecutive patients with type 2 diabetes at Lavalette Hospital in Malang between August and September 2023. Two trained assessors administered the MNSI-A, MNSI-B, DNS, and DNE under double-anonymized conditions. A biothesiometer vibration perception threshold >15 V at the great toe served as the reference standard. Sensitivity, specificity, predictive values, and overall accuracy were calculated with 95% confidence intervals (CIs). DPN was detected in 55 (39.3 %) patients. MNSI-B showed the highest performance, with a sensitivity of 85.4% (95% CI 73.4–92.9), specificity of 97.6% (95% CI 91.4–99.7), positive predictive value of 95.9%, negative predictive value of 91.2%, and overall accuracy of 92.8%. The MNSI-A had a sensitivity of 76.3% (63.3–85.9) and specificity of 90.5% (82.1–95.3). The DNS yielded a sensitivity of 74.5% (61.3–84.5) and specificity of 72.9% (62.4–81.5). DNE showed a sensitivity of 83.6% (71.6–91.4) and specificity of 78.8% (68.6–86.6). The MNSI-B demonstrated excellent accuracy and may serve as a practical, low-cost first-line DPN screening instrument in Indonesian clinical settings. Symptom-based tools should not be used alone and should be integrated with objective physical examinations. These findings support the implementation of structured physical examinations in diabetes foot care programs.
Synergistic effects of coffee aromatherapy and oxytocin massage on serum prolactin levels in postpartum mothers: A quasi-experimental study Rizki Fitrianingtyas; Yuningsih; Trisna Pangestuning Tyas; Yolanda Indri Octaviani; Dinar Perbawati; Fitri Kusumasari; Dini Eka Pripuspitasari
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.v6i3.739

Abstract

Successful lactation relies on adequate secretion of prolactin and oxytocin, which postpartum stress frequently inhibits. This study evaluated the synergistic effect of combined coffee aromatherapy and oxytocin massage on serum prolactin levels in postpartum mothers. A quasi-experimental pretest–posttest control group design was conducted in Jember, Indonesia, involving 20 postpartum mothers allocated into intervention (n=10) and control (n=10) groups. The intervention group received 15 minutes of coffee aromatherapy followed by 15 minutes of oxytocin massage twice weekly for two weeks. The control group received routine postpartum care. Serum prolactin concentrations were quantified via ELISA at baseline and day 14. Baseline prolactin levels were comparable between groups. Following the intervention, the intervention group exhibited a significant increase in prolactin from 133.00 ± 6.82 ng/mL to 165.80 ± 20.82 ng/mL (mean change: +32.80 ng/mL). Conversely, the control group experienced a decline from 141.51 ± 6.16 ng/mL to 122.83 ± 14.98 ng/mL (mean change: −18.68 ng/mL). Independent t-test analysis revealed a highly significant between-group difference in prolactin change scores (mean difference: 51.47 ng/mL; 95% CI: 35.40–67.54; t = 6.73, p < 0.001), yielding a very large effect size (Cohen's d = 3.01). Integrating coffee aromatherapy with oxytocin massage significantly elevates prolactin levels, offering a potent, non-invasive complementary strategy to optimize the neuroendocrine environment for lactation. Larger randomized controlled trials are required to validate these findings and assess long-term breastfeeding outcomes.

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