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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 407 Documents
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Early Clinical Outcomes, Comfort, and Satisfaction With Customized 3D-Printed PLA Transtibial Sockets: A Prospective Pilot Study Rachmat, Nur; Syafii, M.; Septiani , Anissa Eka
Journal of Applied Nursing and Health Vol. 8 No. 3 (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.v8i3.755

Abstract

Background: Fused Deposition Modeling (FDM) using Polylactic Acid (PLA) may support transtibial socket fabrication, but evidence remains limited regarding short-term patient-centered responses, wear time, and safety. This study evaluated socket comfort, residual-limb pain, satisfaction, wear time, and adverse events over 28 days. Methods: This single-arm, uncontrolled, pre-experimental repeated-measures pilot study purposively recruited 30 adults with unilateral transtibial amputation in Central Java, Indonesia. The primary outcome was Socket Comfort Score (SCS); secondary outcomes included residual-limb pain, satisfaction with the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0), wear time, and adverse events. SCS and residual-limb pain were assessed at T0 and days 7, 14, 21, and 28. Inferential analyses used 29 complete cases; descriptive and safety summaries included 30. Friedman and Wilcoxon signed-rank tests were used. Results: Median SCS increased from 5.3 (interquartile range [IQR] 4.7-6.2) at T0 to 6.1 (IQR 5.4-7.3) at day 28 (W = 60; p < 0.001; r = 0.63). Residual-limb pain decreased from 3.5 (IQR 2.8-4.2) to 3.0 (IQR 1.7-3.8) (W = 58; p < 0.001; r = 0.61). Day-28 QUEST 2.0 satisfaction was 3.98 ± 0.36/5 and wear time was 8.49 ± 1.68 hours/day. Nine participants experienced mild observed clinical adverse events; all resolved with conservative management. Inferential analyses used 29 complete cases, whereas descriptive and adverse-event summaries included all 30 participants. Conclusion: Customized FDM-printed PLA transtibial sockets demonstrated promising short-term clinical feasibility and tolerability over 28 days, with improved socket comfort, reduced residual-limb pain, substantial wear time, and no observed serious clinical adverse events. These findings do not establish causal effectiveness, superiority, mechanical or structural safety, durability, or long-term safety, and the satisfaction findings require cautious interpretation because a validated Indonesian-language QUEST 2.0 was not available.
Multi-Stakeholder Governance and HIV Service Effectiveness Across Global Contexts: A Scoping Review of Governance Mechanisms and Outcomes Maulidah, Robiatul; Rifai, Ahmad; Wuryaningsih, Emi Wuri; Dlamini, Siphosethu Veronica
Journal of Applied Nursing and Health Vol. 8 No. 3 (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.v8i3.756

Abstract

Background: Human Immunodeficiency Virus (HIV) service delivery involves governments, healthcare providers, non-governmental organizations, community organizations, peer actors, and other stakeholders, but the contribution of multi-stakeholder governance remains difficult to interpret because stakeholder participation, service-delivery interventions, and governance arrangements are often reported together. This scoping review mapped how governance functions, stakeholder roles, contextual conditions, and HIV service outcomes are connected across diverse settings. Methods: This scoping review followed PRISMA-ScR guidance and used the Population, Concept, Context (PCC) framework within an Arksey and O’Malley approach. Five electronic information sources PubMed/MEDLINE, DOAJ, Scopus, ScienceDirect, and SpringerLink were searched for English-language publications from 1 January 2021 to 6 March 2026. Eligible studies documented a governance-relevant function, governance-linked stakeholder process, or governance-responsive service interface within HIV services and reported, assessed, or planned a service or implementation outcome. Three reviewers screened and charted the evidence, with disagreements resolved by consensus. Evidence was analytically separated into completed empirical studies and protocols, and outcomes were classified as observed, perceived/implementation, or planned. Results: Of 867 records identified, 68 duplicates were removed, 799 records underwent title and abstract screening, 91 full texts were assessed, and 15 studies were included. Eleven were completed empirical studies and four were protocols. The synthesis distinguished three governance mechanisms (1) institutional/intersectoral coordination, (2) participatory co-design and shared prioritization, and (3) community-mediated governance and service intermediation and two governance-responsive service interfaces: differentiated service delivery (DSD) and digital health. Observed service or clinical outcomes included HIV testing, ART initiation, and service engagement, whereas provider capacity, feasibility, acceptability, and coordination were treated as implementation or perceived outcomes. Protocols contributed planned intervention and evaluation pathways only. Conclusion: Evidence of a causal link between multi-stakeholder governance and HIV service effectiveness remains limited. Its impact depends on contextual factors, while DSD and digital health function as delivery interfaces. Future research should assess governance mechanisms and outcomes longitudinally.
Nurses’ Experiences of Caring for People Living with HIV/AIDS in Karo, North Sumatra: A Qualitative Study Sinulingga, Elysabeth; Siswadi, Yakobus; Watania, Lani Natalia
Journal of Applied Nursing and Health Vol. 8 No. 3 (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.v8i3.759

Abstract

Background: As HIV cases rise in Karo Regency, nurses face challenges including fear of infection, care barriers, and stigma. Despite this, no international studies examine nurses’ experiences through Karo culture-based spiritual interventions. This study explores nurses’ experiences, challenges, motivations, and culturally informed care within Karo cultural and spiritual values. Methods: A descriptive phenomenological qualitative study was conducted using purposive sampling. Researchers conducted face-to-face, semi-structured, in-depth interviews with 15 participants. Data were collected in hospital and primary healthcare settings in Kabanjahe District, Karo Regency, North Sumatra, Indonesia, and analyzed manually using conventional content analysis, then reported in accordance with COREQ standards. Results: Six themes emerged: Fear in Caring for People Living with HIV/AIDS; Meaning and Motivation in Caring for People Living with HIV/AIDS; Barriers in Caring for People Living with HIV/AIDS; Family and Community Support in HIV Care; Knowledge and Skills in HIV Nursing Care; and Cultural Context and Its Impact on HIV Care. Despite fears of infection and stigma, nurses remained committed to providing compassionate care. Challenges included limited protocols, heavy workloads, and persistent stigma, while family, church support, and Karo cultural values shaped care practices. Conclusion: Nurses' lived experiences highlight complex interactions among professional duties, cultural values, and institutional challenges. Integrating Karo cultural values and spiritual support offers pathways for culturally responsive care that may potentially support person-centered care and inform strategies to address barriers to treatment adherence
Short-Term Changes in Childbirth Readiness Following Srikandi Model Training Among Village Health Volunteers and Family Companions Agustini, Fenty; Sumartini, Erwina; Rahayu, Novita Tri
Journal of Applied Nursing and Health Vol. 8 No. 3 (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.v8i3.769

Abstract

Background: Maternal health emergencies may be exacerbated by inadequate childbirth preparation, delayed decision-making, and limited community capacity for early risk recognition. Evidence remains limited on structured interventions that jointly strengthen childbirth readiness among family companions and community health volunteers in rural Indonesia. This study aimed to assess short-term changes in knowledge, attitudes, and self-reported practical readiness after SRIKANDI Model training and to describe the training's preliminary feasibility. Methods: We conducted a pre-experimental one-group pretest–posttest study, reported according to the Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) statement, among 30 participants, 15 village health volunteers and 15 family companions, selected through purposive sampling in Tasikmalaya, Indonesia. The intervention was an eight-hour SRIKANDI Model training focused on identifying early maternal danger signs, decision navigation, and monitoring workflows. We measured knowledge, attitudes, and self-reported practical readiness immediately before and after training using an adapted Knowledge, Attitude, and Practice (KAP) questionnaire. We also observed volunteers' performance once in simulated scenarios during the final training simulations using the LOKA-SRIKANDI checklist (no baseline observation). Pre–post differences were analyzed with the Wilcoxon signed-rank test; a Bonferroni-adjusted threshold of α = 0.05/6 = 0.0083 was applied across the six comparisons. Results: All participants reported no previous formal childbirth-preparation training. Immediately after training, family companions' scores increased for knowledge (8.20 ± 0.86 to 9.13 ± 0.74), attitude (81.67% ± 6.22% to 89.78% ± 4.85%), and self-reported practical readiness (69.56% ± 8.14% to 81.89% ± 5.30%). Among health volunteers, knowledge increased from 7.80 ± 0.94 to 9.20 ± 0.68, attitude from 66.78% ± 7.45% to 74.11% ± 5.12%, and self-reported practical readiness from 54.93% ± 9.30% to 74.40% ± 6.20%. All six pre–post differences were statistically significant at the adjusted threshold (p = 0.001–0.004; effect sizes r = 0.53–0.62). In the post-training observation, the mean LOKA-SRIKANDI implementation score was 88.41% ± 3.48%, and all 15 volunteers (100.0%) met the a priori benchmark of ≥75%; because no baseline observation was conducted, this describes post-training performance in simulated scenarios and does not indicate change. Feasibility indicators included 100% attendance and completion, and 98.5% adherence to the training protocol. Conclusion: SRIKANDI Model training was associated with short-term improvements in knowledge, attitudes, and self-reported practical readiness among family companions and village health volunteers measured immediately after training, and appeared feasible to deliver in one rural village. These preliminary findings do not establish competency retention, changes in real-world emergency decision-making or referral behavior, or clinical impact. Controlled studies with longitudinal follow-up are needed to evaluate retention, real-world referral behavior, and maternal and neonatal outcomes.
Culturally Adapted Digital Education to Improve Self-Care Among Patients With Heart Failure: A Quasi-Experimental Study Sulastini, Sulastini; Rissaadah, Siti; Widadi, Sri Yekti; Nugraha, Bambang Aditya
Journal of Applied Nursing and Health Vol. 8 No. 3 (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.v8i3.770

Abstract

Background: Heart failure self-care remains suboptimal, while conventional education may be limited by time constraints and insufficient attention to patients’ cultural contexts. Evidence remains limited on digital education specifically adapted to local cultural values to improve self-care among patients with heart failure. This study examined changes in self-care among patients with heart failure who received local culture-based digital educational media compared with those who received standard hospital education. Methods: This quasi-experimental study used a non-equivalent pretest–posttest control group design and followed the TREND reporting guideline. A total of 140 patients with heart failure were selected using purposive sampling and allocated without randomization to intervention and control groups, each comprising 70 participants. The intervention group received local culture-based digital educational media in a single individual session, with video access via WhatsApp for independent repeat viewing as needed until posttest. In contrast, the control group received standard hospital education. Self-care was measured using the Self-Care of Heart Failure Index version 7.2 before education and 14 days after the initial education session. Within-group changes were analyzed using the Wilcoxon signed-rank test, and between-group differences in score changes were analyzed using the Mann–Whitney U test. Results: The median self-care score increased from 68.0 (Q1–Q3: 64.0–80.5) to 85.0 (78.0–99.8) in the intervention group, with a median change of 14.0 (9.0–20.5). In the control group, the median score changed from 69.5 (67.0–77.8) to 70.5 (67.3–77.8), with a median change of 0.0 (0.0–1.0). The between-group difference in change scores was statistically significant (U = 23.0; p < 0.001), with an estimated difference of 13.0 points (95% CI: 12.0–15.0) and an absolute rank-biserial correlation of 0.991. Conclusion: Local culture-based digital educational media were associated with greater improvement in self-care than standard hospital education among patients with heart failure. The intervention may complement nurse-led education by providing culturally relevant, understandable, and reviewable information to support continued self-care.
Mindfulness-Based Nursing and Changes in Stress, Self-Care, and Blood Glucose in Type 2 Diabetes: Quasi-Experimental Study Hartono, Dodik; Salam, Ainul Yaqin; Handayani, Erna
Journal of Applied Nursing and Health Vol. 8 No. 3 (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.v8i3.773

Abstract

Background: Stress may limit self-care and glycaemic management in type 2 diabetes mellitus (T2DM), but Indonesia has few nurse-led programmes that address stress, self-care, and blood glucose together. This study compared these outcomes after mindfulness-based nursing (MBN) and routine care. Methods: A quasi-experimental pretest-posttest study with a non-equivalent control group (TREND Statement) was conducted at a nursing clinic in Probolinggo, Indonesia (June 2026). We purposively recruited 58 adults aged 35–60 years with T2DM, excluding those with psychiatric disorders or regular mindfulness practice. We allocated them non-randomly to four weekly 50-minute MBN sessions (n = 29) or routine care without matched contact time (n = 29). Stress and self-care were measured by questionnaire and blood glucose by a single point-of-care reading. We used Wilcoxon signed-rank tests to assess within-group change; because baselines differed, we used Welch’s t-test to compare change from baseline between groups (dppc2)—ethics approval: 272/KEPK-UNHASA/V/2026. Results: With MBN, median stress fell from 50 to 21, self-care rose from 46 to 69, and blood glucose from 210 to 168 mg/dL; control-group stress rose from 57 to 66. Change from baseline favoured the intervention for stress (−25.48; 95% CI −36.36 to −14.60; dppc2 = −1.47), self-care (19.00; 6.56 to 31.44; dppc2 = 1.07), and blood glucose (−23.82 mg/dL; −42.58 to −5.06; dppc2 = −0.82). Conclusion: MBN was associated with greater improvement in stress, self-care, and blood glucose than routine care. Non-random allocation and unmatched contact time preclude causal or mindfulness-specific attribution, and glycaemic control was not assessed. Randomised trials with attention-matched controls and HbA1c are needed.
Development and Multidisciplinary Expert Appraisal of NersCare-ICU: Rule-Based Clinical Decision Support for Loneliness Assessment and Nurse-Family Education in Intensive Care Setiawan, Deris Riandi; Rejeki, Yunita Fitri; Yulianti, Mona; Sesilia, Fitri; Fadillah, Rifana Purnama
Journal of Applied Nursing and Health Vol. 8 No. 3 (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.v8i3.775

Abstract

Background: Loneliness may be overlooked among conscious and communicative intensive care unit (ICU) patients. This study developed NersCare-ICU, a web-based, rule-based clinical decision-support prototype that integrates loneliness assessment, predefined supportive recommendations, and nurse-family education; experts descriptively appraised its clinical, psychosocial, and technical features. Methods: A research and development approach adapted from the ADDIE framework was used. During the 2026 development period, three purposively selected experts (one each in critical care nursing, psychosocial nursing, and IT/web development) independently completed different researcher-developed, domain-specific four-point appraisal forms on 21–25 August 2026. The prototype applies established 11-item De Jong Gierveld Loneliness Scale (DJGLS) dichotomous scoring and published total-score categories; a separate researcher-defined 15-percentage-point profile rule selects predefined support options. We summarized item ratings descriptively as means and percentages of the maximum possible scores. Results: The single-expert appraisals were 90/96 (93.75%; mean 3.75/4), 94/100 (94.00%; mean 3.76/4), and 160/172 (93.02%; mean 3.72/4), respectively. These percentages summarize scores on different forms and do not demonstrate expert consensus or formal content validity. All 10 predefined IT scenarios passed as recorded in the expert form; this finding establishes concordance only with those test scenarios, without measured reliability, usability, security, or clinical outcomes. Conclusion: Three domain-specific expert appraisals and 10 predefined functional tests identified strengths and refinement needs for NersCare-ICU. ICU-specific DJGLS measurement properties, the researcher-defined profile rule, end-user usability, software reliability and security, and clinical effectiveness remain unestablished. The prototype requires targeted technical and clinical evaluation before implementation.
Positive Teacher Communication and Bullying Prevention Understanding Associated with Teacher-Student Social Relationships: A Cross-Sectional Study Asnuriyati, Wahyu; Indrayadi, Indrayadi; Asih, Hastin Atas; Panambayan, Jovanka Angelina Rahmah
Journal of Applied Nursing and Health Vol. 8 No. 3 (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.v8i3.776

Abstract

Background: Bullying remains a significant concern in high schools, while supportive teacher-student relationships may contribute to a safer school environment. However, quantitative evidence examining positive teacher communication and teachers’ understanding of bullying prevention strategies together in relation to teacher-student relationships remains limited. This study examined the associations of these two factors with teacher-student social relationship quality among high school students. Methods: This cross-sectional observational study followed the STROBE reporting guideline and included 261 students from a population of 748 students in grades 10–12 selected through stratified random sampling. Data were collected using a 1–5 Likert-scale questionnaire assessing positive teacher communication, understanding of bullying prevention strategies, and teacher-student social relationship quality; validity was assessed using Pearson’s correlation and reliability using Cronbach’s alpha in a pilot study of 20 students from another school. Supplementary semi-structured interviews with seven teachers and guidance counsellors explored communication practices and challenges in addressing bullying. Quantitative data were analyzed using Pearson’s correlation and multiple linear regression at a significance level of 0.05, while interview data were analyzed thematically. Results: Among 261 students, mean scores were 4.2 for positive teacher communication, 4.1 for understanding of bullying prevention strategies, and 4.3 for teacher-student social relationship quality. Positive teacher communication was positively correlated with relationship quality (r = 0.68; p < 0.05), as was understanding of bullying prevention strategies (r = 0.82; p < 0.05). Together, the two predictors explained 79% of the observed variance in relationship quality (R² = 0.79; p < 0.05). Conclusion: Positive teacher communication and teachers’ understanding of bullying prevention strategies were significantly associated with teacher-student social relationship quality. The findings indicate that both factors warrant consideration in school-based approaches to strengthening supportive teacher-student interactions and bullying prevention.
Factors Associated with Risky Sexual Behavior among Tenth-Grade Vocational High School Students in Semarang, Indonesia: A Cross-Sectional Study Wijayati, Sugih; Hidayatullah, Wahyu; Riyadi, Ahmad; Megasari, Anis Laela
Journal of Applied Nursing and Health Vol. 8 No. 3 (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.v8i3.777

Abstract

Background: Risky sexual behavior among adolescents may be influenced by cognitive, social, and contextual factors. This study examined associations of reproductive health knowledge, peer role, and sociodemographic factors with risky sexual behavior among tenth-grade vocational students in Semarang, Indonesia. Methods: A cross-sectional study included 84 tenth-grade students selected by proportional random sampling from 522 students. Reproductive health knowledge, peer role, sociodemographic characteristics, and risky sexual behavior were assessed using instruments adapted from previously validated Indonesian questionnaires. Data were analyzed using Spearman rank correlation, Chi-square or Fisher’s exact tests, and binary logistic regression with adjusted odds ratios (ORs). Results: Among 84 respondents, 71.4% had good reproductive health knowledge and 82.1% reported non-risky sexual behavior. Knowledge (r = 0.118, p = 0.285) and peer role (r = 0.137, p = 0.215) were not significantly associated with risky sexual behavior. No significant associations were detected for the examined sociodemographic factors. Current dating status showed the largest adjusted association (OR = 0.22, 95% CI 0.04–1.08, p = 0.062), while the overall logistic regression model was not significant (p = 0.325; McFadden pseudo R² = 0.088). Knowledge and peer-role scores were negatively correlated (r = −0.261, p = 0.017). Conclusion: This study did not demonstrate statistically significant associations between reproductive health knowledge, peer role, or the examined sociodemographic factors and risky sexual behavior in this sample. Current dating status remained statistically inconclusive. Larger, adequately powered, multi-site studies are needed to determine whether these factors are associated with risky sexual behavior and to examine behavioral, family, relationship, and contextual factors.
Perioperative Outcomes of Holmium Laser Enucleation of the Prostate (HoLEP) in Octogenarians Versus Younger Patients with Benign Prostatic Hyperplasia: A Systematic Review and Meta-analysis Naufal, Muhammad; Maulana, Akhada; Nandana, Pandu Ishaq
Journal of Applied Nursing and Health Vol. 8 No. 3 (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.v8i3.778

Abstract

Background: Benign prostatic hyperplasia (BPH) is highly prevalent among aging men, and holmium laser enucleation of the prostate (HoLEP) is increasingly used in very elderly patients. However, comparative evidence regarding perioperative outcomes remains inconsistent. This systematic review and meta-analysis compared perioperative and postoperative outcomes of HoLEP between patients aged ≥80 years and those aged <80 years. Methods: This systematic review and meta-analysis followed PRISMA 2020 guidelines and searched PubMed/MEDLINE, ScienceDirect, Google Scholar, and Epistemonikos from database inception to June 2026. Eligible retrospective comparative cohort studies included patients undergoing HoLEP for BPH and compared patients aged ≥80 years with those aged <80 years. The exposure was age group, and the outcomes were 30-day readmission, perioperative blood transfusion requirement, operative time, and length of hospital stay. Risk of bias was assessed using the Newcastle–Ottawa Scale (NOS) for retrospective cohort studies, and certainty of evidence was rated using the GRADE approach. Pooled risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI) were calculated in RevMan 5.4; heterogeneity was quantified with the I² statistic, and fixed-effect or random-effects models were selected according to the degree of heterogeneity. Results: Five retrospective comparative cohort studies comprising 10,258 patients were included. Patients aged ≥80 years had higher risks of 30-day readmission (2 studies; RR 2.40, 95% CI 1.14–5.08; P = 0.02; I² = 83%) and blood transfusion requirement (2 studies; RR 4.36, 95% CI 2.86–6.63; P < 0.00001; I² = 0%) than patients aged <80 years. Operative time did not differ significantly between groups (2 studies; MD 12.44 minutes, 95% CI −1.24 to 26.11; P = 0.07; I² = 87%), nor did length of hospital stay (3 studies; MD 0.12 days, 95% CI −0.06 to 0.31; P = 0.17; I² = 74%). The absence of a statistically significant difference for these two outcomes should not be interpreted as evidence of equivalence, as no formal equivalence testing was undertaken. Overall risk of bias was low in three studies and moderate in two. Conclusion: HoLEP demonstrated comparable operative time and length of hospital stay between patients aged ≥80 years and younger patients, while octogenarians had higher risks of 30-day readmission and perioperative blood transfusion. These findings, derived from observational data, support individualized perioperative risk assessment and close postoperative monitoring when HoLEP is performed in very elderly patients, rather than using chronological age alone to determine surgical eligibility.

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