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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 379 Documents
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Effectiveness Of Non-Pharmacological Coping Strategies For Labor Pain Management In Women: A Systematic Review Rejeki, Sri; Ariska, Siti Linda; Khayati, Nikmatul; Dhamanik, Reina
Journal of Applied Nursing and Health Vol. 8 No. 2 (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.v8i2.591

Abstract

Background: Labor is a natural physiological process often accompanied by severe pain, which varies among mothers. Uncontrolled pain may increase catecholamine levels, inhibit uterine contractions, prolong labor, and affect fetal well-being. Non-pharmacological approaches offer an important alternative for pain management. This review aims to synthesize evidence on the effectiveness of non-pharmacological coping strategies in reducing labor pain intensity. Methods: This study is a Systematic Literature Review referring to the PRISMA 2020 guidelines. Article searches were conducted in Google Scholar, Semantic Scholar, PubMed, ScienceDirect, and ProQuest databases for the 2021–2025 period using the keywords “coping,” “managing,” and “labor pain.” Inclusion criteria included RCTs, quasi-experimental studies, observational studies, and systematic reviews in English or Indonesian discussing non-pharmacological coping strategies. A total of 11 articles met the criteria and were analysed using the PICOT framework. Results: Identification through database searching (n =150),  articles screened based on title and abstract (n= 110). Remaining relevant articles: 70, Full-text articles reviewed (n =30), and Articles meeting inclusion criteria and synthesized in the final review (n = 11). The synthesis shows that various non-pharmacological coping strategies, such as breathing exercises, music therapy, back massage, use of a birth ball, aromatherapy, acupressure, and emotional support, are effective in reducing pain intensity and anxiety during labor. Conclusion: Non-pharmacological coping strategies are proven effective, safe, and empowering for mothers. Implications for practice may consist of Multimodal coping strategies that improve maternal outcomes, Non-pharmacological methods that reduce reliance on analgesics, and Interventions feasible in low-resource settings
Clinical Variables Associated with Quality of Life Among Women with Breast Cancer: A Cross-Sectional Study Anna, Anastasia; Trisyani , Yanny; Nuraeni, Aan; Priambodo, Ayu Prawesti; Sugiharto, Firman
Journal of Applied Nursing and Health Vol. 8 No. 2 (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.v8i2.615

Abstract

Background: Breast cancer is a major public health concern in Indonesia. Clinical factors such as disease duration, cancer stage, treatment type, and comorbidities may affect patients’ quality of life (QoL), but evidence in Indonesia remains limited. This study aimed to examine the correlation between clinical variables and QoL among breast cancer patients. Methods: This cross-sectional study was conducted between November 2025 and January 2026 at a referral hospital in West Java, Indonesia, and followed the STROBE guidelines. A total of 53 breast cancer patients were recruited using convenience sampling. The independent variables included clinical characteristics such as duration of illness, cancer stage, treatment received, treatment frequency, comorbidities, body mass index (BMI), and family history of cancer, while the dependent variable was QoL. QoL was assessed using the Indonesian version of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), a validated instrument for evaluating functional status, symptoms, and global health status among cancer patients. QoL is categorised into poor, moderate, and good. Bivariate analysis was performed using Fisher’s exact test and the chi-square test. Results: Among the 53 breast cancer patients, the majority had been diagnosed for less than one year (45.3%), underwent surgery combined with chemotherapy (41.5%), and received treatment every three weeks (64.2%). Most patients reported moderate global health status (49.1%), while 35.8% had poor QoL. Significant associations were found between duration of illness (p < .001; Cramer’s V = 0.467), treatment received (p = .030; Cramer’s V = 0.434), and treatment frequency (p = .034; Cramer’s V = 0.396) and global health status. No significant associations were identified between cancer stage, comorbidities, BMI category, or family history of cancer and QoL. Conclusion: Duration of illness and treatment-related factors were significantly associated with quality of life among breast cancer patients. These findings suggest that the illness trajectory and treatment burden may be substantially related to patients’ overall well-being, supporting the need for targeted supportive care and routine QoL monitoring to improve patient-centred outcomes.
Association Between Nurses' Workload and Compliance with Digital NEWS Documentation: A Cross-Sectional Study Widiastuti, Linda; Atrie, Utari Yunie; Wati, Liza; Sugiharto, Firman
Journal of Applied Nursing and Health Vol. 8 No. 2 (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.v8i2.622

Abstract

Background: Deterioration in a patient's clinical condition can occur suddenly during hospitalization, making early detection essential to prevent delayed interventions and reduce mortality risk. Patient deterioration requires early detection using the National Early Warning Score (NEWS). However, its implementation is often reported to be associated with nurses' high workload. Furthermore, limited evidence exists on how workload influences digital NEWS documentation, particularly in resource-constrained settings. This study aimed to determine the relationship between workload and the implementation of digital NEWS documentation. Methods: This quantitative, cross-sectional study followed the STROBE guidelines and involved 72 nurses selected via convenience sampling at a Type A private hospital in Indonesia. The independent variable was workload, and the dependent variable was digital NEWS documentation. Data were collected using a validated workload questionnaire and a digital NEWS documentation checklist based on Royal College of Physicians (2017) standards, and analyzed using Jamovi software via Chi-square tests. Results: 76.4% of respondents experienced a non-heavy workload, and 65.3% implemented digital NEWS documentation. The analysis revealed a significant relationship between workload and the implementation of digital NEWS documentation (p = 0.003; OR = 0.186; CI95% = 0,058-0,597), indicating that a heavier workload was associated with a lower likelihood of completing NEWS documentation. Conclusion: These findings highlight that workload is significantly associated with clinical documentation compliance. To enhance patient safety, hospital administrators must move beyond general evaluations and implement targeted interventions, including staffing adjustments to balance nurse-to-patient ratios, workflow redesign to minimize administrative burden, and digital optimization of the digital NEWS system to streamline data entry.
Implementation and Effectiveness of Gender-Responsive Occupational Health and Safety for Female Workers in Waste Processing Industries: A Systematic Review Hutabarat, Dewi Sartika; Ginting, Siska Suci Triana; Zebua, Audry Marselina; salmah, umi; Rochadi, kintoko; Silaban, Gerry; Mardiana, Arfah
Journal of Applied Nursing and Health Vol. 8 No. 2 (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.v8i2.628

Abstract

Background: Female workers in waste processing industries are highly vulnerable to occupational hazards, including biological, chemical, ergonomic, and reproductive risks. Despite the implementation of Occupational Health and Safety (OHS) programs, evidence regarding gender-responsive OHS practices for female workers remains limited, particularly in low- and middle-income countries (LMICs). This systematic review aimed to synthesise evidence on the implementation and effectiveness of gender-responsive Occupational Health and Safety (OHS) programs among female workers in waste processing industries Methods: A systematic review was conducted following the PRISMA 2020 guidelines. Literature searches were performed in Scopus, PubMed, ScienceDirect, Web of Science, and CINAHL for studies published between 2014 and 2024. Two independent reviewers conducted study screening through title, abstract, and full-text assessment. Methodological quality was evaluated using the Joanna Briggs Institute (JBI) critical appraisal tool. Eighteen studies met the eligibility criteria. Due to heterogeneity in study designs, outcomes, and measurement indicators, meta-analysis was not feasible; therefore, the data were synthesised using a thematic narrative analysis. Results: The PRISMA process identified 1,246 records, of which 18 studies were included in the final synthesis. Studies were predominantly conducted in LMIC settings and involved cross-sectional, qualitative, and mixed-method designs. Three major themes emerged: (1) occupational hazard exposure among female waste workers, (2) implementation of OHS interventions and personal protective equipment (PPE), and (3) barriers to gender-responsive occupational health protection. Most studies reported inadequate PPE utilisation, limited reproductive health protection, and weak institutional OHS policies. The quality of evidence ranged from low to moderate due to methodological heterogeneity and limited longitudinal studies. Conclusion: Gender-responsive OHS implementation in waste processing industries remains suboptimal, particularly in LMICs. Strengthening workplace policies, reproductive health protection, PPE compliance, and gender-sensitive occupational programs is essential to improve worker safety. Future studies should employ longitudinal and intervention-based designs to evaluate the effectiveness of OHS programs among female workers.
Association Between Cyberbullying Exposure and Suicide Risk Among Undergraduate Students: A Cross-Sectional Study Hidayati, Laili Nur; Anggelica, Dhella; Sarkarsi, Rosnani Binti
Journal of Applied Nursing and Health Vol. 8 No. 2 (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.v8i2.632

Abstract

Background: The increasing use of the internet and social media among undergraduate students has contributed to the growing prevalence of cyberbullying. Exposure to cyberbullying may negatively affect students’ mental health and increase the risk of suicidal ideation and suicidal behavior. However, limited evidence exists regarding the relationship between cyberbullying and suicide risk among college students in low- and middle- income countries, including Indonesia. Therefore, this study aimed to examine the relationship between cyberbullying exposure and suicide risk among undergraduate students. Methods: This cross-sectional study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines and involved 392 undergraduate students recruited via convenience sampling. Cyberbullying exposure was treated as the independent variable, while suicide risk was the dependent variable. Data were collected using the Cyberbullying Behavioral Scale and the Beck Scale for Suicide Ideation (BSS). Statistical analysis was performed using the Spearman rank correlation test. Results: Most respondents reported low levels of cyberbullying exposure, 359 (91.6%), and low suicide risk (82.7%). Spearman rank analysis demonstrated a statistically significant positive relationship between cyberbullying exposure and suicide risk (r= 0.141, p = 0.005), indicating a weak positive correlation. Conclusion: Cyberbullying exposure was associated with suicide risk among undergraduate students. However, this finding should be interpreted cautiously and not considered evidence of a causal relationship. These results highlight the importance of mental health screening, cyberbullying prevention, and suicide risk assessment programs within university settings.
Effectiveness of a Family Unit Empowerment Model in Improving Diabetes Management, Family Empowerment, and Family Support among Adults with Type 2 Diabetes Mellitus: A Quasi-Experimental Study Trisnadewi, Ni Wayan; Adiputra, I Made Sudarma; Oktaviani, Ni Putu Wiwik
Journal of Applied Nursing and Health Vol. 8 No. 2 (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.v8i2.634

Abstract

Background: Diabetes mellitus (DM) remains a major public health challenge in Indonesia, with its prevalence continuing to increase. Although incurable, effective long-term management can maintain patients' quality of life. Family involvement is essential in supporting adherence to diabetes management, yet evidence on structured family-unit empowerment interventions, particularly in community settings, remains limited. Therefore, this study aimed to evaluate the effectiveness of the Family Unit Empowerment Model in improving diabetes management, family empowerment, and family support among patients with type 2 diabetes mellitus (T2DM). Methods: This study employed a quasi-experimental one-group pre-test–post-test design and followed the TREND (Transparent Reporting of Evaluations with Nonrandomized Designs) reporting guideline. A total of 140 patients with T2DM registered at the Blahbatuh 2 Gianyar Community Health Center were recruited through purposive sampling between December 2022 and July 2023. Inclusion criteria included a confirmed T2DM diagnosis, residence with family, ability to communicate effectively, and provision of informed consent. The independent variable was the Family Unit Empowerment Model; dependent variables were diabetes management, family empowerment, and family support, measured using the Summary of Diabetes Self-Care Activities (SDSCA), the Family Empowerment Scale (FES), and the Diabetes Family Support Scale, respectively (all Cronbach’s α ≥ 0.70). The intervention consisted of four structured weekly family-based health education sessions delivered over one month. Data were analyzed using the Wilcoxon Signed-Rank Test, with a significance level of p < 0.05. Results: Statistically significant improvements in median scores were observed for all three outcome variables following the intervention. The proportion of families in the good empowerment category increased from 37.1% to 55.7% (p < 0.001, r = 0.54). For family support, the proportion reporting high support increased from 44.3% to 49.3%, with a significant rise in median scores (p < 0.001, r = 0.49). Diabetes management improved, with poor-category cases decreasing from 40.7% to 27.9% (p < 0.001, r = 0.33). Conclusion: Participation in the Family Unit Empowerment Model was associated with statistically significant improvements in diabetes self-management behaviors, family empowerment, and family support among patients with T2DM. Because the single-group design and reliance on self-reported outcomes preclude causal attribution, these findings should be interpreted as preliminary. They provide promising support for family-centered empowerment approaches in community-based diabetes care and a rationale for evaluation in adequately powered, controlled, multicenter trials that incorporate objective clinical outcomes before broad implementation is recommended.
Effectiveness of Code Stroke Activation Models on Clinical Decision-Making Quality: A Scoping Review Purwandi, Purwandi; T, Pahria,; H., Pratiwi, S.; H., Fauzan, N.
Journal of Applied Nursing and Health Vol. 8 No. 2 (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.v8i2.635

Abstract

Background: Traditional medicine is widely used worldwide, particularly in rural communities of developing countries. Cultural beliefs, cost, accessibility, and social factors influence its use. This study aims to identify factors associated with the use of traditional medicine for Ear, Nose, and Throat (ENT) conditions among patients in Kumasi. Methods: This scoping review was conducted in accordance with PRISMA-ScR guidelines and used the PCC (Population, Concept, Context) framework and the Arksey & O’Malley approach. A systematic literature search was conducted in the PubMed, ScienceDirect, Scopus, and EBSCOhost databases for the period 2021–2026. Inclusion criteria included studies on the Code Stroke activation model in the prehospital and ED settings. In contrast, exclusion criteria included in-hospital activation in the ICU or wards without ED involvement. The screening phase was conducted independently by four reviewers using the PRISMA protocol. Data were mapped through a documentation process using the JBI critical appraisal tools, and data synthesis was performed via thematic analysis to group activation models. Results: Of the 1,690 identified records, the literature was found to be dominated by single-center studies or those conducted in high-income countries with advanced technological infrastructure. In contrast, evidence regarding the effectiveness of these activation models in Low- and Middle-Income Countries (LMICs) and the specific context of Indonesia remains very limited. The synthesis results identified four main themes of activation models: (1) nurse-based activation, (2) AI-based models (such as automated LVO detection), (3) pre-hospital activation via ambulance notifications, and (4) workflow optimization through a “pit-crew” model that transforms sequential processes into simultaneous parallel ones. Although these models have proven effective at accelerating time metrics such as door-to-needle time, a research gap remains: a lack of direct comparative analysis between models in resource-limited settings. Conclusion: The integration of nurse leadership, parallel task delegation, and advanced technological support is critical to minimizing permanent neurological damage. Practice and policy implications include the need to implement a “no-fault” activation system for triage nurses and standardize AI reporting. Future research should focus on validating these models in geographically challenging contexts, such as in Indonesia, and conducting multicenter comparative studies to determine the optimal balance between diagnostic accuracy and hospital resource availability.
Diagnostic and Metastatic Predictive Value of Urinary Exosomal miR-26b-3p in Prostate Cancer: A Prospective Observational Study Sufriyudi, Muhammad; Danarto, HR
Journal of Applied Nursing and Health Vol. 8 No. 2 (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.v8i2.636

Abstract

Background: Prostate cancer (PCa) remains challenging to diagnose due to the limited accuracy of PSA testing. Urinary exosomal miR-26b-3p is a promising non-invasive biomarker, but evidence across PCa metastatic stages is limited, particularly in LMICs. This study evaluated miR-26b-3p expression in BPH, non-metastatic PCa, and metastatic PCa (M1b and M1c), and assessed its diagnostic and metastatic discrimination potential. Methods: This prospective, observational, single-center study was conducted at Dr Sardjito General Hospital, Yogyakarta, Indonesia, from January 2023 to December 2023, and reported in accordance with the STROBE guidelines. A total of 40 male participants (12 BPH and 28 PCa) were enrolled using consecutive sampling. Inclusion criteria were men aged ≥40 years with histopathologically confirmed BPH or PCa who provided written informed consent. Exclusion criteria were prior pelvic radiotherapy, urinary tract infection, hematuria, or incomplete urine specimens. The independent variable was the clinical diagnostic group; the dependent variable was relative urinary exosomal miR-26b-3p expression. Urinary exosomes were isolated, and miR-26b-3p was quantified by quantitative real-time PCR (qPCR). Group comparisons used one-way ANOVA with post-hoc analysis, and diagnostic performance was evaluated by Receiver Operating Characteristic (ROC) analysis with Area Under the Curve (AUC) and 95% confidence interval (CI). Results: miR-26b-3p expression differed significantly among the four groups (p = 0.002). Mean ± SD expression was 6.6 ± 3.4 in BPH, 44.2 ± 25.4 in non-metastatic PCa, 46.7 ± 41.1 in M1b PCa, and 35.1 ± 21.3 in M1c PCa. ROC analysis demonstrated excellent diagnostic performance for differentiating BPH from PCa (AUC = 0.982; 95% CI: 0.943–1.000; p < 0.001). Conclusion: Urinary exosomal miR-26b-3p shows strong diagnostic discrimination between BPH and PCa and is associated with metastatic status, supporting its potential as a non-invasive biomarker for prostate cancer screening and metastatic risk stratification. Multicenter validation in larger, ethnically diverse cohorts is needed before clinical implementation.
Effectiveness of Hindmilk Feeding on Weight Gain Among Low-Birth-Weight Infants Abiyoga, Aries; Meihartati, Tuti; Kristiani, Denny; Bandung, Murti
Journal of Applied Nursing and Health Vol. 8 No. 2 (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.v8i2.637

Abstract

Background: Low Birth Weight (LBW) infants are at high risk of morbidity and growth problems. Hindmilk, which is rich in fat and calories, is proposed to improve weight gain, but evidence remains limited. This study examined the effect of hindmilk feeding on weight gain in LBW infants. Methods: This pre-experiment design and was reported in accordance with the TREND guideline. A total of 15 LBW infants admitted to the Perinatology Unit of Malinau Hospital were recruited using purposive sampling. The independent variable was hindmilk feeding, while the dependent variable was infant weight gain. Data were collected using the Standardised Human Observation Sheet (SHOS) and analysed using the paired sample t-test. Results: The findings showed a significant increase in infant body weight after the hindmilk intervention compared with baseline measurements. The mean body weight after intervention was higher than before intervention, with a statistically significant difference (p = 0.001). These results indicate that hindmilk feeding contributed positively to weight gain among LBW infants. Conclusion: Hindmilk feeding significantly improved weight gain among LBW infants at Malinau Hospital. Therefore, hindmilk feeding may be recommended as an effective nutritional intervention for the management of LBW infants, particularly in resource-limited and remote healthcare settings.
Association Between Nurses’ Demographic Characteristics and Knowledge of Healthcare-Associated Infection Prevention: A Cross-Sectional Study Sulistyowati, Arlina Dhian; Rahmawati, Eka; Agustina, Nur Wulan; Handayani, Sri
Journal of Applied Nursing and Health Vol. 8 No. 2 (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.v8i2.638

Abstract

Background: Healthcare-Associated Infections (HAIs) significantly impact patient safety and healthcare costs. While general knowledge is often reported, evidence regarding how nurses’ demographic characteristics influence HAI knowledge remains inconsistent, particularly in specialised psychiatric settings. This study aims to analyse the relationship between nurses’ characteristics and their knowledge of HAI prevention and control. Methods: This cross-sectional study followed STROBE guidelines. Data were collected from 125 nurses using a total sampling approach. Independent variables included age, gender, education, and length of service, while the dependent variable was knowledge of HAI prevention, measured by a validated 15-item Guttman-scale questionnaire. Data were collected using a validated and reliable structured questionnaire (Cronbach’s alpha > 0.60). Data were analysed using the Contingency Coefficient. Results: Most respondents were aged 30–50 years (84%), female (58.4%), held a Diploma in Nursing (71.2%), and had more than 5 years of service (86.4%). The majority demonstrated good knowledge (94.4%). There were significant relationships between age (p<0.001), education (p<0.001), and length of service (p<0.001) and knowledge of HAI prevention and control. However, no significant association was found between gender and knowledge (p > 0.001). Conclusion: Nurses’ characteristics, specifically age, education, and length of service, are significantly associated with knowledge of HAIs prevention and control, while gender does not show a significant association. These findings emphasise the importance of infection prevention education strategies tailored to nurses’ professional profiles.

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