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Journal of Applied Nursing and Health
Published by Lembaga Chakra Brahmanda Lentera
ISSN : 26671609     EISSN : 28093208     DOI : 10.55018
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Chemistry Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary
Journal of Applied Nursing and Health (JANH) (Prefix DOI: 10.55018) has published its first volume with p-ISSN: 2657-1609 (SK LIPI: 0005.26571609/JI.3.1/SK.ISSN/2019.05) in 2019 and e-ISSN: 2809-3208 (SK LIPI 005.28093208/K.4/SK.ISSN/2021.12) in 2021. JANH is a health journal that publishes scientific papers for nurses, health academics, and other health practitioners. This journal is published regularly in June and December every year. The Journal of Applied Nursing and Health (JANH) is a peer-reviewed scientific journal. JANH hopes to be able to contribute to increasing evidence-based knowledge in the realm of nursing and health, JANH hopes to be useful and used by the community to improve a better quality of life which in turn has the potential and impact on the advancement of knowledge in nursing and health practice. All JANH papers have a solid, critical, and scientifically sound scientific, evidence, theoretical or philosophical basis in their approach.
Arjuna Subject : Profesi Kesehatan - Profesi Kesehatan (Lain-Lain)
Articles 311 Documents
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Cesarean Delivery and Early Breastfeeding Outcomes: A Cross-Sectional Study of EIBF and Early Postpartum Difficulties Herawati, Ita; Hermanto, Budi; Andika, Agnes; Jumsinah, Jumsinah; Widiyanti, Lia; Tika, Ocha Gries; Marlita, Yanti
Journal of Applied Nursing and Health Vol. 8 No. 1 (2026): Journal of Applied Nursing and Health
Publisher : Chakra Brahmanda Lentera Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/janh.v8i1.487

Abstract

Background: Cesarean section (CS) rates continue to increase globally, particularly in low- and middle-income countries (LMICs) such as Indonesia. While CS is often medically indicated, it may interfere with early initiation of breastfeeding (EIBF) and early postpartum lactation. However, evidence examining both EIBF and early breastfeeding difficulties within Indonesian LMIC settings remains limited. Methods: This cross-sectional study followed STROBE guidelines and was conducted among 150 postpartum mothers within the first 10 days after delivery. Participants were recruited using consecutive sampling. Eligibility criteria included mothers aged ≥18 years, live singleton birth, and clinical stability. Data were collected using a structured Breastfeeding Initiation and Early Lactation Difficulty Questionnaire adapted from validated instruments (Cronbach’s α = 0.82). Chi-square tests were used to assess associations, with assumptions verified (expected cell count ≥5). Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to estimate effect size. Results: CS was significantly associated with failure to perform EIBF (OR = 214.79; 95% CI: 27.90–1653.65; p < 0.001). Mothers undergoing CS were also more likely to experience breastfeeding difficulties during the first 10 days postpartum (OR = 17.26; 95% CI: 6.24–47.74; p < 0.001). Conclusion: CS delivery is strongly associated with delayed EIBF and increased early breastfeeding difficulties. Structured post-cesarean lactation support integrated into surgical recovery protocols is recommended, particularly in LMIC settings.
Caregiver Resilience and Burden in Long-Term Care Family of Children with Developmental Disabilities: A Cross-Sectional Study Wulandari, Sarah Kartika; Sriwahyuningsih, LG Nita; Israfil, Israfil
Journal of Applied Nursing and Health Vol. 8 No. 1 (2026): Journal of Applied Nursing and Health
Publisher : Chakra Brahmanda Lentera Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/janh.v8i1.490

Abstract

Background: A family with a child with special needs experiences a struggle to provide care and quality of life. However, empirical evidence on the relationship between resilience and caregiver burden in the long-term care of children with developmental disabilities (DDC) in low- and middle-income countries remains limited, with a family nursing perspective in Indonesia, especially in Bali. This study aimed to determine the relationship between caregiver burden and resilience in long-term care of children with developmental disabilities. Methods: This study was reported in accordance with the STROBE guidelines. A cross-sectional study was conducted online using network sampling DDC in Denpasar City. The questionnaires were the Burden Scale for Family Caregivers (BSFC) to measure the family burden as the independent variable and the Resilience Scale for Adults (RSA) used to measure the resilience of the caregiver as the dependent variable. Spearman’s rank correlation was used for data analysis. Results: As many as 102 parents or siblings of DDC joined the research online. Data showed most caregivers were mothers (67,6%), with more than one child (65,7%), and with various types of DDC. A moderate negative correlation was observed between caregiver burden and resilience (r = −0.294, p < 0.005). The higher burden experienced by siblings (mean= 13.5), when fathers have the highest resilience (mean= 99.83), as they felt less burden (mean= 8.93). Conclusion: The greater burden experienced by the family implied a lower capacity to express resilience. Coping skill training could be developed as a response to the burden to build better family coping and boost resilience.
The Effect of Barefoot Morning Walking on Blood Pressure in Adults with Hypertension Novitayanti, Eka; Proborini, Christiana Arin
Journal of Applied Nursing and Health Vol. 8 No. 1 (2026): Journal of Applied Nursing and Health
Publisher : Chakra Brahmanda Lentera Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/janh.v8i1.500

Abstract

Background: Hypertension is a health problem that affects many people and carries the risk of serious complications if not properly treated. Walking barefoot in the morning is a non-pharmacological method believed to help lower blood pressure by stimulating nerve endings and increasing body relaxation. In low- and middle-income countries, walking barefoot is common. The public felt more productive rather than having to use. This study was conducted to analyze the effect of barefoot morning walking on blood pressure in hypertensive patients. Methods: This study used a one-group pre-experimental design with a one-group pretest-posttest approach. Technique collection sample, namely purposive, n 31, which meets the inclusion criteria, namely history of hypertension, willing given barefoot morning walk intervention according to established procedures, and criteria for respondents who cannot walk. Blood pressure was measured before and after the intervention using a validated digital blood pressure monitor. Data were analyzed using the Wilcoxon test. Results: The results of the study showed that before the intervention, most respondents were in the stage I hypertension category (64.5%), while after the intervention, the majority were in the prehypertension category (67.7%). Statistical tests showed a significant decrease in blood pressure in both systolic (p < 0.00 1 ) and diastolic (p < 0.00 1 ) blood pressure, thus indicating a significant effect of barefoot morning walking on reducing blood pressure. Conclusion: Barefoot morning walking intervention can reduce blood pressure in hypertensive patients, which can be applied to help control blood pressure.
The Association Between Infant Massage Frequency, Body Mass Index, and Early Psychomotor Milestones Among Infants Aged 3–12 Months: An Analytical Observational Study in Aligned with SDG 3 Haryani, Siti; Adimayanti, Eka; Astuti, Ana Puji; Minardo, Joyo; Nurcahyo, Satria Avianda
Journal of Applied Nursing and Health Vol. 8 No. 1 (2026): Journal of Applied Nursing and Health
Publisher : Chakra Brahmanda Lentera Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/janh.v8i1.507

Abstract

Background: Infant massage is a non-invasive, low-cost intervention that supports early childhood growth and development and is increasingly promoted in community health programs. However, evidence on its relationship with Body Mass Index (BMI) and early psychomotor milestone achievement in low- and middle-income countries, particularly Indonesia, remains limited. Therefore, this study aimed to examine the effect of infant massage on BMI and early psychomotor milestones among infants aged 3–12 months in alignment with Sustainable Development Goal 3 (Good Health and Well-Being). Methods: This study used a quantitative design with multiple linear regression analysis. The population consisted of infants aged 3–12 months in Semarang Regency, Indonesia, with a purposive sample of 250 infants. Inclusion criteria were good health status, age 3–12 months, and parental consent, while infants with congenital anomalies or developmental disorders were excluded. BMI was the dependent variable, and independent variables included infant massage frequency, psychomotor milestone achievement, feeding adequacy, and parental stimulation. Data were collected using WHO-standardized BMI measurements and psychomotor milestone checklists. Infant massage followed the standardized Love Baby Massage technique. Ethical approval was obtained, and data were analyzed using multiple linear regression with p-values, confidence intervals, and effect sizes reported. Results: Descriptive analysis indicated that the majority of infants received regular massage and exhibited nutritional status within the WHO reference standards. Regression analysis demonstrated that infant massage frequency and psychomotor milestone achievement were significant predictors of BMI (p < 0.05). Feeding adequacy showed a positive association with BMI and a moderate effect size, while parental stimulation exhibited a smaller and statistically nonsignificant direct effect. Collectively, the independent variables contributed substantially to explaining variations in BMI among infants aged 3–12 months. Conclusion: Regular infant massage plays a meaningful role in improving BMI and supporting early psychomotor development. Integrating massage practices with adequate nutrition and parental engagement is recommended as a comprehensive strategy to optimize infant growth and early development, consistent with SDG 3.
Nursing Supervision and Electronic Medical Record Documentation Quality among Practicing Nurses: A Cross-Sectional Study Wahyuningsih, Luh Gde Nita Sri; Susanti, NLP Dina; Wulandari, Sarah Kartika
Journal of Applied Nursing and Health Vol. 8 No. 1 (2026): Journal of Applied Nursing and Health
Publisher : Chakra Brahmanda Lentera Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/janh.v8i1.509

Abstract

Background: Digital transformation in healthcare has promoted the use of Electronic Medical Records (EMR) as the standard for nursing documentation. Supervision is a key managerial strategy influencing its successful implementation among practicing nurses. However, empirical evidence on how supervision components affect the quality of electronic nursing documentation in low- and middle-income countries remains limited. Therefore, this study aims to analyze the strategic role of nursing supervision in strengthening EMR documentation. Methods: This analytical cross-sectional study examined the relationship between the role of supervision and the strengthening of electronic medical records. The sample included 352 practicing nurses selected through total sampling. Data were collected using a validated and reliable structured questionnaire (Cronbach’s alpha > 0.60). Analysis was conducted using Spearman’s rank correlation and binary logistic regression to assess the relationship and influence of supervision on documentation quality. Results: The results showed that the supervision variable (planning, coordination, control, monitoring, and feedback) was significantly related to electronic medical record documentation (p < 0.001), with feedback being the most dominant factor (Exp(B)=233.049; 95% CI: 15,606–3480.287). Conclusion: Nursing supervision plays a strategic role in strengthening the implementation of Electronic Medical Record documentation. From a managerial and policy perspective, these findings confirm that strengthening the supervision system, primarily through standardized and continuous feedback mechanisms, should be a priority for nursing leaders and hospital management.
Nurse Credentialing, Work Motivation, and Performance: A Cross-Sectional Mediation Study Ahsan, Ahsan; Wokas, Deyfi Christine; Yuliatun, Laily
Journal of Applied Nursing and Health Vol. 8 No. 1 (2026): Journal of Applied Nursing and Health
Publisher : Chakra Brahmanda Lentera Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/janh.v8i1.524

Abstract

Background: Nurse credentialing is intended to ensure professional competence, improve performance, and enhance work motivation. However, despite its widespread implementation, evidence regarding its actual impact on nurses’ motivation and performance remains inconsistent and inconclusive. This inconsistency reflects an unresolved gap in understanding whether credentialing directly influences nurse performance or operates indirectly through work motivation. This study aimed to examine the relationship between credentialing, work motivation, and nurse performance, with work motivation tested as a mediating variable. Methods: This quantitative cross-sectional study followed the STROBE reporting guideline. The population comprised all inpatient nurses at Dr. Sam Ratulangi Tondano Regional General Hospital (N = 176). Using purposive sampling, 122 nurses were selected based on inclusion criteria of at least one year of work experience and direct involvement in nursing care; nurses on leave were excluded. Credentialing level (PK0–PK3) was the independent variable, nurse performance the dependent variable, and work motivation the mediating variable. Motivation and performance were measured using validated Likert-scale questionnaires, while credentialing data were obtained from institutional records. Structural Equation Modeling–Partial Least Squares (SEM-PLS) was used to test direct and mediating effects. Results: Credentialing showed a negligible and non-significant effect on nurse performance (β = 0.002; p = 0.979) and work motivation (β = 0.027; p = 0.683). Conversely, nurse performance had a strong and significant effect on work motivation (β = 0.768; p < 0.001). Work motivation did not mediate the credentialing–performance relationship. Conclusion: Credentialing alone does not significantly influence nurse performance or motivation. Integrating credentialing with performance management and continuous professional development systems is essential to enhance its effectiveness
Effect of Henderson’s Need Theory–Based Nursing Care on Medication Adherence among Patients with Tuberculosis: A Quasi-Experimental Study Wahyuni, Tri; Jiu, Cau Kim; Ariyanti, Sri
Journal of Applied Nursing and Health Vol. 8 No. 1 (2026): Journal of Applied Nursing and Health
Publisher : Chakra Brahmanda Lentera Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/janh.v8i1.525

Abstract

Background: Medication adherence remains a major challenge in tuberculosis (TB) management, particularly in low- and middle-income countries where socioeconomic and health system barriers affect treatment continuity. Although educational and psychosocial interventions have shown benefits, the application of structured nursing theories in TB care is still limited. This study aimed to examine the effect of Henderson-based nursing care on medication adherence among TB patients Methods: This quasi-experimental study with a pretest–posttest control group design followed the TREND reporting guideline. A purposive sampling procedure was conducted by screening outpatient TB registries and applying predefined inclusion and exclusion criteria, resulting in 60 eligible participants (intervention n = 30; control n = 30). The independent variable was nursing care based on Henderson’s fourteen fundamental needs, while the dependent variable was medication adherence. Adherence was measured using a validated Medication Adherence Scale (Cronbach’s α = 0.87). Before parametric testing, assumptions of normality and homogeneity of variance were examined. Paired and independent t-tests were performed, and ANCOVA was used to control for age, education level, and treatment duration. Effect size (Cohen’s d) and 95% confidence intervals (CI) were calculated. Results: Baseline characteristics were comparable between groups (p > 0.05). In the intervention group, mean adherence scores increased from 68.7 ± 8.9 to 88.3 ± 6.4 (mean difference = 19.6; 95% CI: 16.1–23.1; p < 0.001), representing a large effect size (Cohen’s d = 2.52). The control group showed no significant improvement (mean difference = 2.4; p = 0.27). The adjusted mean difference between groups at posttest was 16.8 points (p < 0.001). Additionally, the proportion of patients classified as having high adherence increased substantially in the intervention group compared to the control group. ANCOVA confirmed a significant intervention effect (F = 64.82; p < 0.001), independent of demographic covariates. Conclusion: Henderson’s Need Theory–based nursing care significantly improves medication adherence among TB patients and demonstrates a large clinical effect. Integrating structured, theory-driven nursing interventions into routine TB services may strengthen adherence-focused care, enhance patient independence, and contribute to improved treatment completion rates in resource-limited settings.
Effect of a Local Food–Based Nutrition Intervention Using Moringa oleifera and Arachis hypogaea on Mid–Upper Arm Circumference among Pregnant Women with Chronic Energy Deficiency: A Quasi-Experimental Study Hernawati, Erni; Yulianti, Novita; Hidayati, Sofa Nurul
Journal of Applied Nursing and Health Vol. 8 No. 1 (2026): Journal of Applied Nursing and Health
Publisher : Chakra Brahmanda Lentera Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/janh.v8i1.526

Abstract

Background: Chronic energy deficiency (CED) among pregnant women remains a persistent public health problem in low- and middle-income countries, including Indonesia. Various nutrition programs have been implemented; however, evidence on practical, locally based food interventions—particularly those combining moringa leaves and peanuts in ready-to-consume cookie form—remains limited. This study addresses this gap by evaluating a combined local food–based intervention aimed at improving maternal nutritional status. Methods: his study used a quasi-experimental design with a non-randomized control group and a pretest–posttest approach, reported according to the TREND guideline. The sample consisted of 100 pregnant women with chronic energy deficiency recruited through consecutive sampling at a primary healthcare center. Inclusion criteria were gestational age 12–28 weeks and MUAC < 23.5 cm, while women with pregnancy complications, chronic diseases, food allergies, or multiple pregnancies were excluded. MUAC was measured using a standard non-stretchable tape by trained midwives. The intervention group received moringa leaf and peanut cookies daily for two weeks in addition to standard antenatal care, while the control group received standard care only. Data were analyzed using paired and independent t-tests, and effect size was calculated using Cohen’s d. Results: Both groups showed significant improvements in MUAC after the intervention period (p < 0.001). However, the intervention group demonstrated a greater mean increase in MUAC compared with the control group, with a moderate-to-large effect size (Cohen’s d), indicating not only statistical significance but also meaningful clinical improvement. The effect size was moderate-to-large (Cohen's d = 0.65). Conclusion: The findings indicate that a combined local food–based cookie intervention using moringa leaves and peanuts is more effective than standard antenatal care alone in improving MUAC among pregnant women with CED. This approach supports the integration of culturally appropriate, locally available food interventions into primary healthcare nutrition programs, particularly in low-resource settings.
Effectiveness of the Manori Sapuka Community-Based Adherence Program on Blood Pressure Control Among Hypertensive Patients Faisal, Faisal; Anto, Ambo; Ibrahim, Muhammad Indra
Journal of Applied Nursing and Health Vol. 8 No. 1 (2026): Journal of Applied Nursing and Health
Publisher : Chakra Brahmanda Lentera Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/janh.v8i1.527

Abstract

Background: Hypertension is a chronic disease often referred to as a "silent killer" because it frequently presents without symptoms until serious complications occur. Adherence to blood pressure control is essential for successful management and prevention of complications. However, adherence among hypertensive patients remains low in many primary healthcare settings. To address this issue, the "Ikan Manori Sapuka" program was implemented as a community-based intervention to improve patient adherence to blood pressure control. This study aims to determine the effectiveness of the Ikan Manori Sapuka program in improving adherence among hypertensive patients. Methods: This study used a pre-experimental one-group design that followed the TREND reporting guideline. The sample consisted of 84 respondents obtained through a total sampling technique. Inclusion criteria included patients aged 40–85 years who consented to participate, while exclusion criteria were a history of stroke or refusal to participate. Data analysis was performed using the McNemar test to see significant differences before and after the intervention. Results: Adherence to blood pressure control increased from 33.3% before the intervention to 82.1% after the intervention. This improvement was statistically significant (p < 0.001), with a risk difference of 48.8%, indicating a substantial magnitude of improvement following the intervention. Conclusion: The findings demonstrate that a structured, community-based intervention significantly improves adherence to blood pressure control among hypertensive patients in remote island settings. This evidence supports the use of low-cost, locally adaptable community engagement strategies to strengthen hypertension management in primary healthcare services.
Effectiveness of a Local Wisdom–Based Spiritual Intervention on Work Happiness and Caring Behavior among Nurses: A Randomized Mixed-Methods Nur, Kholid Rosyidi Muhammad; Asmaningrum, Nurfika; Wijaya, Dodi; Kurniawan, Dicky Endrian; Rondhianto, Rondhianto
Journal of Applied Nursing and Health Vol. 8 No. 1 (2026): Journal of Applied Nursing and Health
Publisher : Chakra Brahmanda Lentera Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/janh.v8i1.529

Abstract

Background: Nurses often face high job demands and emotional stress that may reduce work happiness and caring behavior. Previous studies have examined workplace well-being interventions; however, culturally grounded spiritual programs integrating local wisdom remain insufficiently tested using rigorous experimental designs, particularly in low- and middle-income countries (LMICs). This study aimed to evaluate the effectiveness of a local wisdom–based spiritual program in improving work happiness and caring behavior among inpatient nurses in Indonesia. Methods: A mixed-methods randomized controlled trial following CONSORT guidelines was conducted with 120 inpatient nurses at two hospitals in Jember, Indonesia. Eligible nurses (>1-year inpatient experience) were randomly assigned to either an intervention group (n = 60) or a control group (n = 60). The intervention group participated in a 12-week spiritual program (Pengajian and Tari Molong Kopi) that included routine activities. The independent variable was program participation, and the dependent variables were work happiness and caring behavior measured using the Oxford Happiness Questionnaire (OHQ) and Caring Behavior Inventory (CBI) at baseline, week 6, and week 12. Data were analyzed using repeated-measures ANOVA, effect sizes (Cohen’s d), correlation, and 95% confidence intervals. Qualitative responses were analyzed thematically. Results: Participants were mostly female (87%) with a mean age of 32 years. The intervention group showed significantly greater improvements in OHQ and CBI scores at weeks 6 and 12 compared with controls (p < 0.001), with moderate-to-large effects (d = 0.65–0.82). Work happiness correlated with caring behavior (r = 0.52). Themes included enhanced mindfulness, emotional release, renewed professional meaning, and stronger collegial relationships. Conclusion: Local wisdom–based spiritual programs significantly enhance nurses’ work happiness and caring behavior. Integrating culturally grounded spiritual practices into workplace well-being initiatives may strengthen the quality of nursing care in LMIC hospital settings.

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