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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 WhatsApp-Based Digital Health Education on Self-Care in Diabetes Mellitus Patients: A Quasi-Experimental Study Wahyuningsih, Atik Setiawan; Ulya, Siti Imroah Layinata
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.v8i2.652

Abstract

Background: Diabetes mellitus (DM) is a chronic metabolic disorder requiring ongoing self-care behavior to prevent complications and improve quality of life. Patient compliance with self-care behavior is still suboptimal. A few facts about the effectiveness of digital health education on self-care behavior and the factors that influence it in primary health care. This study aims to determine the effectiveness of digital health education on Diabetes Mellitus self-care behavior and analyze the dominant factors in improving self-care behavior. Methods: Stage 1 with pre-experimental quantitative pretest-posttest on 106 respondents with informed consent and a simple random sampling technique from 150 Diabetes Mellitus patients. Structured digital health education for one month via WhatsApp. Self-care behavior with 13 items of the Summary of Diabetes Self-care behavior Activities (SDSCA) questionnaire was analyzed using a t-test. Stage 2, with associative quantitative methods, analyzing the effect of disease duration, gender, educational status, and previous educational exposure on self-care behavior; data were analyzed using multiple linear regression, starting with multicollinearity and heteroscedasticity tests. Results: Among the 106 participants, most had lived with diabetes mellitus for ≥5 years (88.7%), were female (71.7%), had completed primary to senior high school education (92.5%), and had never received previous diabetes health education (74.5%). The mean self-care behavior score increased significantly from 39.02 ± 7.96 before the intervention to 46.66 ± 7.60 after the intervention (mean difference = 7.64; t = 11.36; p < 0.001). Multiple linear regression demonstrated that the overall model was significant (F = 5.240, p = 0.001), explaining 17.2% of the variance in self-care behavior improvement. Previous diabetes health education (β = 0.412, p < 0.001) and educational status (β = −0.313, p = 0.002) were significant predictors, whereas duration of illness and gender were not significantly associated with the outcome. Conclusion: WhatsApp-based digital health education effectively improved self-care behavior among patients with diabetes mellitus. Previous diabetes health education and educational status were significant factors associated with greater improvements in self-care behavior. Integrating this digital education approach into routine diabetes management programs at community health centers may enhance patient engagement and support long-term self-care
Effectiveness of Mindfulness Spiritual Therapy with Murottal on Fatigue Among Hemodialysis Patients Ariyanti, Maelina; Bahtiar, Heri; Hapipah, Hapipah; Istianah, Istianah; Ernawati, Ernawati; Setiawati, Diana
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.v8i2.657

Abstract

Background: Fatigue is one of the most prevalent and debilitating symptoms experienced by patients with chronic kidney disease (CKD) undergoing hemodialysis, adversely affecting physical functioning, psychological well-being, and quality of life. Although mindfulness-based interventions and Qur’anic recitation (murottal) have individually demonstrated beneficial effects on psychological outcomes, evidence regarding their combined application for fatigue management remains limited. This study aimed to examine changes in fatigue levels following Mindfulness Spiritual Therapy with Murottal among patients with CKD undergoing hemodialysis. Methods: This study was conducted in accordance with the Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) statement using a quantitative pre-experimental one-group pretest–posttest design. The study was carried out in the Hemodialysis Unit of RSUD H. Moh. Ruslan Kota Mataram, Indonesia. Eighteen participants were recruited through purposive sampling. Mindfulness Spiritual Therapy with Murottal was administered for approximately 20 minutes per session, twice weekly for two consecutive weeks. Fatigue levels were assessed using the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F) questionnaire. Data were analyzed using the Shapiro–Wilk test and paired sample t-test. Results: Participants were predominantly middle-aged (55.6%), male (55.6%), and had undergone hemodialysis for 1–3 years (72.2%). The mean fatigue score decreased from 27.51 ± 7.17 at baseline to 21.32 ± 5.77 following the intervention. Paired sample t-test analysis demonstrated a statistically significant difference between pretest and posttest fatigue scores (mean difference = 6.194; 95% CI: 5.181–7.208; t = 12.899; p < 0.001). Participants who received Mindfulness Spiritual Therapy with Murottal experienced lower fatigue scores following the intervention. Conclusion: Mindfulness Spiritual Therapy with Murottal may help reduce fatigue among patients undergoing hemodialysis by addressing psychological and spiritual aspects of care. However, due to the one-group pretest–posttest design, the findings should be interpreted cautiously and cannot establish causality. Further multicenter randomized controlled trials with larger samples are needed to confirm these preliminary findings.
Unmet LTC Needs in Community: A Qualitative Study of Family, Cadres, and Stakeholder Perspectives Wardani, Yulia; Febriani, Dita Hanna; Amigo, Thomas Aquino Erjinyuare; Morales, Jeremy Godofredo C
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.v8i2.670

Abstract

Background: The growing older adult population in Indonesia has increased the need for community-based long-term care (LTC). However, families and community health cadres continue to face challenges in providing post-hospitalisation care, particularly in rural areas where LTC and transitional care services remain limited. This study explored the perspectives of family caregivers, cadres, and stakeholders on unmet needs and strategies to strengthen community-based LTC. Methods: A descriptive phenomenological qualitative study was conducted using purposive sampling. Fourteen participants were interviewed in face-to-face, semi-structured, in-depth interviews, and twelve stakeholders participated in a Focus Group Discussion (FGD). Data were collected in community and primary healthcare settings in Turi District, Sleman Regency, Yogyakarta, Indonesia, and analyzed using conventional content analysis with NVivo 12, and reported according to the COREQ guideline. Results: Four interconnected themes emerged from the analysis: (1) existing caregiving practices involving physical, psychosocial, and spiritual support; (2) challenges in home-based LTC related to complex health conditions, caregiver burden, and limited resources; (3) priority needs for improving LTC quality, including caregiver training, supportive equipment, and multidisciplinary collaboration; and (4) stakeholder perspectives regarding the benefits and implementation challenges of community-based transitional care services. The findings generated a conceptual framework demonstrating that caregiver empowerment, community support, accessible resources, and multidisciplinary collaboration contribute to improved LTC quality and better outcomes for older adults. Conclusion: Older adults receiving LTC in Indonesian communities experience multidimensional unmet needs that require integrated responses from families, cadres, healthcare providers, and local stakeholders. Strengthening family-centered and community-based LTC systems, caregiver education, sustainable support mechanisms, multidisciplinary collaboration, and feasible transitional care pathways is essential to improve continuity, safety, dignity, and quality of life among older adults.
Influence of Self-Efficacy, Individual Factors, and Motivation on Health Workers’ Patient Safety Performance through Competence-Based Human Resource Management: A Cross-Sectional Study Faizah, Ana; Sulastri, Endang; Ruhdiyat, Agung
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.v8i2.679

Abstract

Background: Although self-efficacy, motivation, and individual characteristics have been associated with health workers’ performance, evidence regarding the mediating role of Competence-Based Human Resource Management (CB-HRM) in patient safety implementation remains limited. This study examined the direct and indirect relationships among self-efficacy, individual factors, motivation, CB-HRM, and hospital health workers’ performance in patient safety implementation. Methods: This analytical cross-sectional survey included 98 hospital health workers at Awal Bros Hospital, Batam, Indonesia, selected using proportional random sampling. The study used a 36-item questionnaire with a five-point Likert response scale. The measurement and structural models were estimated using the path-weighting Partial Least Squares approach. Statistical inference used 5,000 nonparametric bootstrap resamples with percentile 95% confidence intervals. Reliability, convergent validity, discriminant validity, collinearity, effect sizes (f²), explained variance (R²), Q², and the Standardized Root Mean Square Residual (SRMR) were evaluated.. Results: The model explained 75.1% of the variance in CB-HRM and 80.8% of the variance in health workers’ performance. Self-efficacy (β=0.174, p=0.048), individual factors (β=0.338, p<0.001), and CB-HRM (β=0.369, p<0.001) had significant positive direct associations with performance, whereas motivation had no significant direct association (β=0.098, p=0.484). Individual factors (β=0.417, p<0.001) and motivation (β=0.396, p<0.001) were significantly associated with CB-HRM, while self-efficacy was not (β=0.109, p=0.151). CB-HRM mediated the associations of individual factors (β=0.154, p=0.007) and motivation (β=0.146, p=0.007) with performance, but did not mediate the self-efficacy association (β=0.040, p=0.145). Internal consistency was acceptable, although four HTMT ratios exceeded 0.90 and the SRMR was 0.113, indicating construct overlap and imperfect global fit. Conclusion: Seven of the ten hypotheses were supported. CB-HRM functioned as an important organizational pathway linking individual factors and motivation with patient safety performance, while self-efficacy operated mainly through a direct pathway. Hospitals should combine psychological empowerment with competency-based recruitment, placement, training, appraisal, and career development. The findings should be confirmed in larger multicenter studies using objective patient safety outcomes.
Association Between Fatigue and Basic Life Support Readiness Among Indonesian Red Cross Volunteers in Prehospital Emergency Care: A Cross-Sectional Study Sri Anik Rustini, Sri Anik x; Salsabila, Nurul Kholida; Sustrami, Dys; Widyastuti, Merina; Kristiningrum, Sifira
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.v8i2.682

Abstract

Background: Fatigue is a common challenge among humanitarian volunteers involved in pre-hospital emergency response and can reduce their readiness to perform Basic Life Support (BLS). However, evidence on the relationship between fatigue and BLS readiness among Indonesian Red Cross (PMI) volunteers is limited. This study aimed to analyze the relationship between fatigue levels and readiness to perform Basic Life Support among PMI volunteers in Surabaya, Indonesia. Methods: This quantitative analytical study used a cross-sectional design and was conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. A total of 110 Indonesian Red Cross (PMI) volunteers were recruited using total sampling. Fatigue was measured using the Subjective Self-Rating Test (SSRT), while BLS readiness was assessed using a validated and reliable 10-item questionnaire (validity coefficient ≥ 0.50; Cronbach's α = 0.845). Data were analyzed using the Shapiro–Wilk normality test and Spearman's rank correlation with a significance level of 0.05. Results: Among the 110 PMI volunteers, the majority were female (70.9%), aged 17–25 years (98.2%), and had completed high school (73.6%). Most volunteers experienced high fatigue (64.5%), while the largest proportion was categorized as almost ready to perform Basic Life Support (39.1%). Crosstabulation showed a decreasing trend in BLS readiness as fatigue levels increased. Spearman's rank correlation revealed a strong and statistically significant negative correlation between fatigue levels and BLS readiness (rₛ = −0.630, p < 0.001), indicating a large effect size. Conclusion: Fatigue is a significant factor influencing emergency preparedness and readiness to perform Basic Life Support among Indonesian Red Cross (PMI) volunteers. These findings support the integration of fatigue management into volunteer preparedness and emergency response programs to strengthen prehospital care capacity. Future longitudinal and multivariable studies are recommended further to investigate causal relationships and additional determinants of volunteer preparedness.
Biopsychosocial Determinants of Adolescent Mental Health and Risk Behaviors: A Convergent Cross-Sectional Mixed-Methods Study in West Java, Indonesia Yuliani, Indah; Aisyah, Aisyah; Nur’aliyah, Anisa; Herwansah, Diki; Salam, Ikeu Anggita; Gopur, Gopur
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.v8i2.683

Abstract

Background: Adolescent mental health disorders are an increasing public health concern in Indonesia. Although precision nursing offers a personalized approach, evidence integrating biopsychosocial, healthcare access, and cognitive-literacy factors across diverse healthcare settings remains limited. This convergent mixed-methods study aimed to identify determinants of adolescent mental health outcomes and risk behaviors while exploring how adolescents’ lived experiences complement quantitative findings to inform precision nursing interventions. Methods: A convergent cross-sectional mixed-methods study was conducted, reported in accordance with the Good Reporting of A Mixed Methods Study (GRAMMS) guideline, with 140 adolescents (aged 12–21 years) recruited across four healthcare settings in West Java, Indonesia Primary Healthcare Centers, hospital outpatient clinics, primary clinics, and community health centers (including both hospital and primary healthcare facility types). Participants were selected using proportional purposive sampling for the quantitative strand, and a purposively selected subsample (n=20) drawn from quantitative respondents was recruited for semi-structured qualitative interviews until thematic saturation was reached. Inclusion criteria were adolescents aged 12–21 years attending participating facilities who provided informed consent. Exclusion criteria included acute psychiatric crisis and severe cognitive impairment. Validated instruments included the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), WHO-5 Wellbeing Index, Perceived Stress Scale-10 (PSS-10), and Columbia Suicidality Severity Rating Scale (C-SSRS). Social, family support, healthcare access, and cognitive-literacy factors were assessed using structured questionnaires. Qualitative data were gathered through semi-structured interviews (n=20) and analyzed using inductive thematic analysis; quantitative and qualitative findings were integrated through a joint display comparing statistical results with interview themes to assess convergence and complementarity. Ethical approval was obtained from the STIKes Abdi Nusantara Ethics Committee. Data were analyzed using descriptive statistics, chi-square, and Spearman correlation with IBM SPSS Statistics Version 26. Results: Among 140 adolescents (mean age 17.2 ± 2.1 years; 54.3% male), 82.1% reported at least mild depressive symptoms (PHQ-9 ≥5), with 7.9% in the severe range. Anxiety symptoms (GAD-7 ≥5) were present in 77.9% of participants. Non-suicidal self-injury (NSSI) was reported by 14.3% (n=20). Family history of mental disorder was significantly associated with higher PHQ-9 scores (p=0.008). Low family support was present in 22.9% and correlated with greater depression severity (r=0.42, p<0.001). Poor cognitive function and health literacy were associated with higher risk behavior scores (r=0.41, p<0.01). Adolescents utilizing hospital services had significantly higher depression and anxiety scores compared to Primary Healthcare Center users (p<0.05). Three qualitative themes emerged from the interviews: (1) academic pressure and emotional burden, (2) family communication barriers, and (3) limited access to adolescent-friendly mental health services. These themes complemented and explained the quantitative findings, clarifying why low family support and poor health literacy were associated with worse mental health outcomes Conclusion: Depressive and anxiety symptoms are highly prevalent among adolescents across all healthcare settings in West Java. Family support, cognitive function, health literacy, and healthcare access are significant determinants of mental health outcomes. Integrating quantitative and qualitative findings demonstrates that family-centered and health literacy-based precision nursing interventions should be prioritized across Indonesian healthcare settings. These findings support the development of precision nursing interventions tailored to the multi-determinant profile of adolescent mental health. At the same time, future longitudinal mixed-methods studies are needed to validate these findings.
Developing an Integrative Community-Based Social Health Model to Improve Quality of Life in Indonesian Primary Care: A Scoping Review Kusumawati, Prima Dewi; Koesnadi, Koesnadi
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.v8i2.686

Abstract

Background: Quality of life (QoL) is influenced by health services and social determinants of health. However, evidence integrating community empowerment, social support, community health workers (CHWs), and primary health care (PHC) into a comprehensive QoL model remains limited, particularly in Indonesian PHC settings. This scoping review aimed to map current evidence and develop an integrative conceptual framework for a community-based social health model to improve QoL. Methods: The review followed PRISMA-ScR, the Arksey and O'Malley framework, Levac et al.'s enhancement, and Joanna Briggs Institute guidance. Using the Population-Concept-Context (PCC) framework, searches were conducted across five databases and relevant grey literature. Studies published between 2021 and 2026 were synthesized through systematic extraction, thematic coding, theoretical alignment, and evidence-to-framework development to generate an integrative community-based social health model for QoL improvement. Results: From 164 identified records, 50 sources were included. Five interconnected themes informed the proposed model: local needs assessment, community empowerment, social capital and social support, CHW-PHC integration, and quality-of-life-oriented evaluation. The framework's novelty lies in specifying how local assessment creates contextual fit, empowerment builds agency, social capital provides relational resources, CHW-PHC integration links social needs with services, and QoL-oriented evaluation functions as both endpoint and feedback loop. Evidence also indicated gaps in context-specific implementation studies from Indonesia, rural communities, and low-resource PHC settings, as well as limited validation using standardized QoL indicators. Conclusion: The proposed model integrates social and health-system determinants of QoL into a community-oriented PHC framework. However, empirical validation, pilot implementation, and effectiveness evaluation are needed before widespread adoption across diverse Indonesian community settings.
A Mixed-Methods Study of Community Health Worker Roles in Malaria Policy Implementation and Control Sulistyarini, Wahyu Dewi; Anam, Khoirul; Waluyo, Harjito Ponco
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.v8i2.688

Abstract

Background: Malaria elimination increasingly depends on effective community-based interventions, particularly in high-mobility settings such as Indonesia’s New Capital (IKN). However, limited evidence exists on how malaria cadre policies are translated into frontline practice in rapidly changing development contexts. This mixed-methods study aimed to analyze the role of malaria cadres in malaria case identification and evaluate malaria cadre policy implementation in the IKN development area by integrating quantitative performance assessment with qualitative exploration of implementation experiences. Methods: This explanatory sequential mixed-methods study followed the GRAMMS reporting guideline. A validated instrument assessed all 61 active malaria cadres using total population sampling. Quantitative findings informed qualitative interviews and focus group discussions with key stakeholders. Data were integrated during interpretation and analyzed using descriptive statistics and thematic analysis. Results: The instrument demonstrated excellent validity and reliability (Cronbach’s α = 0.86). Quantitative findings showed the highest performance in behavior change communication (mean = 1.96), environmental risk monitoring (mean = 1.91), and malaria screening (mean = 1.87), whereas malaria treatment showed the lowest performance (mean = 1.38). Qualitative analysis identified four themes, revealing that malaria cadres functioned as adaptive frontline responders with strong engagement in case detection and community interaction but limited preventive and planning roles. Integrated findings demonstrated complementarity, with qualitative evidence explaining variations in quantitative performance across cadre role domains. Conclusion: Integrated findings indicate that malaria cadres are effective frontline responders but require stronger preventive support, supervision, and policy integration to sustain malaria elimination in high-mobility settings.
Children’s Treatment Experiences in Pediatric Cancer Care Using Semi-Immersive Virtual Reality: Integrating Children’s Experiences and Parental Narratives Margaretha, Sumarti Endah Purnamaningsih Maria; Purwaningsih, Iswanti; Widiastuti, Zeni
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.v8i2.692

Abstract

Background: Childhood cancer remains a major global health challenge, with leukemia being the most common malignancy among children. Chemotherapy often causes substantial physical and psychological distress that negatively affects children's treatment experiences. Although previous studies have reported that Semi-Immersive Virtual Reality (SIVR) may reduce pain, anxiety, and procedural distress, little qualitative evidence has explored children's treatment experiences by integrating children's own perspectives with parents' narratives. Therefore, this study explored children's treatment experiences during chemotherapy using SIVR across different developmental stages. Methods: A qualitative descriptive study following the Consolidated Criteria for Reporting Qualitative Research (COREQ) guideline employed purposive sampling. Seventy children undergoing chemotherapy participated in the SIVR intervention. Children aged >6 years participated in individual semi-structured interviews, whereas parents of children aged ≤6 years participated in semi-structured Focus Group Discussions (FGDs) as proxy informants. Interviews and FGDs were audio-recorded, transcribed verbatim, and analyzed using Braun and Clarke's thematic analysis. Trustworthiness was established through member checking, data triangulation, and audit trails. Results: Five interconnected themes with several categories described children's emotional, physical, and behavioral treatment experiences: (1) treatment burden and emotional strain, (2) SIVR as emotional escape and comfort, (3) physical and ergonomic limitations, (4) treatment engagement and coping, and (5) acceptability and future expectations. Integrating children's interviews with parents' narratives provided complementary insights across developmental stages, with participants describing greater emotional comfort and coping despite ergonomic challenges. Conclusion: The findings suggest that SIVR may serve as a promising supportive intervention for enhancing children's treatment experiences during chemotherapy. Integrating children's interviews with parents' narratives provides comprehensive evidence to support child-centered pediatric oncology care. Future multicenter qualitative or mixed-methods studies should evaluate ergonomically optimized SIVR to strengthen evidence for broader clinical implementation.

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