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Malahayati International Journal of Nursing and Health Science
Published by Universitas Malahayati
ISSN : 26209152     EISSN : 26214083     DOI : https://doi.org/10.33024/minh.v7i10
Core Subject : Health,
Health Professions Nursing Public Health
Malahayati International Journal of Nursing and Health Science is a peer-reviewed journal and provides a platform to publish areas of nursing and health science. The journal also seeks to advance the quality of research by publishing papers introducing or elaborating on new methods in nursing and health science, subject areas for publication include nursing and health science core
Arjuna Subject : Keperawatan - Keperawatan (Lain-Lain)
Articles 217 Documents
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Clinical pathways in patients with ischaemic stroke: Estimating mean length of stay and hospital costs Yuwono, Reinaldo Bobby; Zulfikar, Taufik; Malik, Rahadian
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 10 (2025): Volume 8 Number 10
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i10.1543

Abstract

Background: Effective and efficient healthcare services have become one of the priorities in the global health system, including in Indonesia. In an effort to improve quality and efficiency of care, various initiatives have been implemented by hospitals, one of which is the application of Clinical Pathways (CP). A Clinical Pathway is a systematic approach designed to provide evidence-based guidelines in managing patients with specific conditions, with the goal of improving quality, efficiency, and patient safety. Purpose: To analyze the effectiveness of clinical pathways on length of stay (LOS) and its implications for hospital costs in ischemic stroke patients. Method: This quantitative, analytical, observational study used a cross-sectional approach. Data collection was conducted retrospectively using secondary data from patient medical records, Clinical Pathway documents, and the Hospital Information System (SIMRS). This included all inpatients with ischemic stroke treated by the Social Security Administration at Hermina Hospital Solo during 2024. The sample size was determined using the Slovin formula with a 5% margin of error, resulting in a sample of 170 respondents. Results: Regression analysis showed that CP significantly affects LOS, with a regression coefficient indicating that increased adherence to CP can reduce LOS. LOS also has a significant effect on hospital costs, with a positive regression coefficient, meaning the longer the LOS, the higher the hospital cost. However, CP does not have a direct effect on hospital costs. Path analysis revealed an indirect effect of CP on hospital costs through LOS, indicating that improved CP adherence can reduce hospital costs by shortening LOS. Conclusion: That higher adherence to CP can shorten LOS and indirectly lower hospital costs. Hospital management is expected to conduct regular socialization, evaluation, and monitoring of CP implementation to achieve optimal service efficiency and cost control.
Optimising modern wound care to improve the quality of life and self-confidence of patients with diabetes mellitus Fatmawati, Fatmawati; Barangkau, Barangkau; Yammar, Yammar; Asnuddin, Asnuddin
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 10 (2025): Volume 8 Number 10
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i10.1741

Abstract

Background: Diabetes Mellitus (DM) remains a prevalent global health challenge, with significant incidence rates observed in Indonesia, particularly within South Sulawesi. Current data records 10.64 million cases in 2024, with projections estimating a rise to 40.7 million by 2045. A substantial number of these patients suffer from diabetic ulcers, a complication that severely compromises quality of life and self-confidence. Purpose: To evaluate the efficacy of optimized modern wound care interventions in enhancing the quality of life and self-confidence of patients with Diabetes Mellitus. Method: A pre-experimental design. A total sampling technique was employed to select 25 registered DM patients at the Masagena Independent Wound Care Practice. Statistical analysis was conducted using paired t-tests with a significance threshold of p < 0.05. Results: The analysis revealed significant differences in patient outcomes following the intervention (p < 0.05). The mean quality of life score improved markedly from a baseline of 8.72 ± 2.85 to 94.20 ± 3.41 post-intervention. Similarly, the mean self-confidence score increased from 8.36 ± 2.69 (pre-test) to 93.92 ± 2.88 following the implementation of modern wound care optimization. Conclusion: The optimization of modern wound care significantly positively impacts type 2 DM patients, resulting in a demonstrated increase in both quality of life and self-confidence.
The Android mobile application to assess mothers' knowledge, attitudes, and behaviors related to the prevention of stunting in children under two years old Gustina, Mely; Yorita, Epti; Sari, Aplina Kartika; Utama, Feranita; Haryono, Haryono
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 10 (2025): Volume 8 Number 10
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i10.1945

Abstract

Background: Stunting remains a major public health problem in Indonesia, with prevalence rates that exceed the World Health Organization threshold. In Bengkulu Province, particularly in the Kampung Melayu Subdistrict, stunting is exacerbated by limited access to health services, low maternal knowledge, unfavorable attitudes, and inadequate sanitation-related preventive behaviors. These factors contribute to recurrent infections and impaired nutrient absorption in children under two years old. The use of digital-based educational media is considered a promising strategy to improve health literacy and promote positive behavioral change among mothers. Purpose: To evaluate the effectiveness of the Android mobile application to assess mothers' knowledge, attitudes, and behaviors related to the prevention of stunting in children under two years old in the Kampung Melayu Subdistrict, Bengkulu City. Method: A quasi-experimental design with a control group. A total of 80 participants were selected using purposive sampling and divided into an intervention group (n = 40) and a control group (n = 40). The intervention group received health education through the SESAMA Android application, while the control group received conventional health promotion. Data were analyzed using Wilcoxon test, Paired T-test, Mann–Whitney test, ANCOVA, and MANCOVA. Results: The intervention group showed a significant improvement in knowledge, attitudes, and preventive behaviors related to stunting (p = 0.000). Mean knowledge scores increased from 5.60 to 8.23, attitude scores from 35.58 to 39.50, and behavior scores from 11.18 to 15.73. In contrast, the control group showed a significant improvement only in knowledge (p = 0.041), with no significant changes in attitudes (p = 0.172) or behaviors (p = 0.083). MANCOVA analysis confirmed that the SESAMA application had a significant effect on knowledge (p = 0.000; R² = 0.298), attitudes (p = 0.000; R² = 0.166), and behaviors (p = 0.000; R² = 0.584), with the strongest effect observed on preventive behavior. Conclusion: The SESAMA Android-based educational application is effective in improving maternal knowledge, attitudes, and behaviors related to stunting prevention and demonstrates greater effectiveness compared to conventional health promotion methods. The SESAMA model has strong potential to support digital health education strategies and may be considered for broader implementation in stunting prevention programs.
Kegel exercises and perineal wound healing among postpartum mothers: A qualitative study Yunitasari, Eva; Saragih, Septina Boru; Nursanti, Indah; Yetiani, Novin
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 11 (2026): Volume 8 Number 11
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i11.1996

Abstract

Background: Perineal wounds following childbirth are common, particularly among women who experience vaginal or perineal tears. When healing is delayed, these wounds may lead to serious postpartum complications, including infection, bleeding, and increased maternal morbidity. Kegel exercises are widely recognized as a simple, non-pharmacological intervention that strengthens pelvic floor muscles and may support the healing process of perineal wounds. However, limited attention has been given to postpartum mothers’ personal experiences in performing these exercises during the recovery period. Purpose: To explore postpartum mothers’ experiences in practicing Kegel exercises as part of perineal wound healing at the Gadingrejo Community Health Center. Method: A qualitative study with a phenomenological approach was employed to capture mothers’ lived experiences. Participants were selected through purposive sampling, involving eight postpartum mothers who met the inclusion criteria. Data were collected through in-depth interviews and direct observation. Thematic analysis was conducted to identify recurring patterns and meanings related to the implementation of Kegel exercises. Results: The findings revealed five main themes: (1) timing of Kegel exercise initiation, (2) initial physical complaints after childbirth, (3) perceived benefits of the exercises, (4) vaginal care practices, and (5) dietary patterns during the postpartum period. Observations of wound healing using the REEDA assessment showed a gradual improvement from day one to day seven. Initially, most participants demonstrated poor wound healing characteristics, which progressed to good wound healing by the end of the observation period. Conclusion: Postpartum mothers who practiced Kegel exercises experienced better perineal wound healing compared to their initial condition. These findings suggest that Kegel exercises may contribute to accelerating the perineal wound healing process. In addition, proper vaginal care and adequate nutritional intake appear to play supportive roles in promoting recovery among postpartum women.
Strategy for implementing segmentation, targeting, and positioning to increase the utilization of outpatient services in hospitals Sukarjiyah, Waritsah; Wiliyanarti, Pipit Festi; Sukardiono, Sukadiono
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 10 (2025): Volume 8 Number 10
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i10.2003

Abstract

Bckground: Hospitals have a responsibility to provide quality, affordable, and accessible healthcare services to all levels of society. Varied patient needs and characteristics often pose challenges in optimizing visits and maintaining service quality, particularly in outpatient care. Implementing a segmentation, targeting, and positioning (STP) strategy can be an effective service management approach to tailoring services to patient profiles, thereby supporting increased service utilization and enhancing patient satisfaction. Purpose: To systematically review the application of STP strategies in hospital settings and to identify their role in enhancing the utilization of outpatient services, with a focus on patient-centered care and health service accessibility. Method: A systematic review was conducted following PRISMA 2020 guidelines. Literature was searched through the Scopus database. A total of 20 articles that met the inclusion criteria were analyzed. Results: Hospitals apply segmentation strategies (demographic, psychographic, behavioral), targeting (specific patient groups, medical tourism, service-based targeting), and positioning (faith-based service values, patient-centered care, experience-based branding). These approaches have been shown to increase patient satisfaction, loyalty, and particularly the utilization of outpatient services. Conclusions: This review demonstrates that segmentation, targeting, and positioning (STP) strategies, although traditionally applied in hospital service strategies can be effectively adapted to optimize outpatient healthcare services. The novelty of this study lies in reframing STP as a health service management approach that enhances patient-centered care, increases service utilization, and supports broader public health outcomes.
Hospital-based rehabilitation services for drug disorders: Challenges and policy implications Fitriani, Arifah Devi; Febriantika, Febriantika; Meliala, Sri Agustina; Yanti, Fitri
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 10 (2025): Volume 8 Number 10
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i10.2029

Abstract

Background: Substance use disorder (SUD) imposes a complex, multidimensional burden that necessitates comprehensive and integrated rehabilitation services. Hospitals play a pivotal role in the delivery of rehabilitation; however, implementation remains constrained by limited specialized human resources, inequitable access to services, fragmented intersectoral policy coordination, and persistent stigma toward individuals with SUD. Purpose: To examine hospital-based rehabilitation for substance use disorders, with particular attention to service availability and conditions, program effectiveness, and the roles of key stakeholders. Method: A qualitative case study was conducted between April and June 2025 at Prof. Ildrem Psychiatric Hospital, selected primary health centers, and related institutions, including the Provincial National Narcotics Agency of North Sumatra, the Health Office, National and Political Unity Agency, Regional Research and Innovation Agency, the police, and community-based organizations. Fifteen key informants and ten triangulation informants were purposively recruited. Data were collected through in-depth interviews, non-participant observations, and document review, and were analyzed thematically using NVivo 12 through open, axial, and selective coding processes. Results: Seven major themes were identified: workforce capacity and competence, access to rehabilitation services, social vulnerability, program effectiveness, post-rehabilitation and community reintegration, policy processes, and stigma. Key barriers included shortages of addiction-trained professionals, complex and bureaucratic referral mechanisms, high non-medical costs, weak cross-sector collaboration, and insufficient aftercare services and community support systems. Conclusion: The findings indicate that hospital-based rehabilitation alone is inadequate to address the complex needs of individuals with substance use disorders. An integrated rehabilitation model that combines medical treatment, psychosocial interventions, community-based support, and coherent policy frameworks is essential. Enhancing professional capacity, streamlining referral pathways, expanding community-based aftercare, and implementing systematic stigma-reduction initiatives are critical to improving rehabilitation outcomes and promoting sustainable recovery.
Resilience-focused interventions for post- stroke depression: A systematic review Hariyani, Liberti; Kariasa, I Made; Maria, Riri
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 10 (2025): Volume 8 Number 10
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i10.2044

Abstract

Background: Stroke is one of the leading causes of long-term disability and morbidity worldwide. Post-stroke depression (PSD) is a common psychological complication that negatively affects recovery, functional outcomes, and quality of life. Psychological resilience is considered a key factor in helping patients adapt to post-stroke challenges; however, evidence regarding effective interventions to strengthen resilience in patients with PSD remains limited. Purpose: To evaluate the effectiveness of interventions that potentially enhance resilience-related components in patients with post-stroke depression and to provide evidence-based recommendations for nursing and clinical practice. Method: A systematic review was conducted in accordance with the PRISMA 2020 guidelines. Literature searches were performed across five databases such as PubMed, Scopus, ScienceDirect, ProQuest, and Wiley using the keywords post-stroke depression, resilience, and intervention. Randomized controlled trials published in English that involved PSD patients and reported psychological outcomes related to resilience were included. Of 9,241 identified records, nine studies involving 779 participants met the inclusion criteria and were analyzed using narrative synthesis. Results: Psychological interventions, including Acceptance and Commitment Therapy (ACT) and Mindfulness-Based Interventions (MBI), showed significant improvements in psychological flexibility (25–35%), mindfulness (20–32%), and coping ability (15–25%), alongside a significant reduction in depressive symptoms (p < 0.001). Physical-based interventions such as Tai Chi and Yijinjing Qigong were associated with improved emotional regulation and reductions in depressive symptoms of up to 45%. Technology-assisted approaches, particularly Virtual Reality interventions, reduced depressive symptoms by up to 22%. Pharmacological treatments demonstrated faster mood improvement but showed limited effects on strengthening psychological resilience. Conclusion: ACT, MBI, and structured physical exercise appear to be the most effective interventions for enhancing resilience-related components and alleviating depressive symptoms in patients with post-stroke depression. Future studies are recommended to directly measure resilience outcomes and examine the long-term sustainability of these interventions.
Nursing leadership training: A scoping review Yanthi, Kadek Ayu Purnama; Eka, Ni Gusti Ayu; Manalu, Enjelika Putri; Paiuk, Erica Dorelia; Sinurat, Kyela Friska Br
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 12 (2026): Volume 8 Number 12
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i12.1630

Abstract

Background: Nursing leadership training is essential for preparing nurses to lead teams, make strategic decisions, and adapt to rapidly evolving healthcare environments. Despite its critical role, the effectiveness of leadership programs is often undermined by various challenges, including limited institutional support, high workload demands, resource constraints, and cultural or psychological barriers. These issues can impact program outcomes and the long-term development of nursing leadership capacity. Purpose: To explore the design and implementation challenges of nursing leadership training programs. Method: This scoping review followed the Joanna Briggs Institute (JBI) guideline. Searching was conducted using three databases including Medline (Ebsco), ScienceDirect (Elsevier), and PubMed. Inclusion and exclusion criteria guided study selection. Data from 14 peer-reviewed articles published between 2021 and 2024 were extracted and synthesized using content analysis and descriptive statistics. Results: Four major themes were identified organizational barriers, individual barriers, non-interventional programs, and interventional programs each with sub-themes. Effective leadership interventions have emerged across several forms: mentorship, simulation, empowerment programs, and structured curricula. Conclusion: Nursing leadership training must shift from conceptual frameworks to evidence-based, context-specific interventions. Strengthening organizational infrastructure, promoting inclusivity, and enhancing program clarity and evaluation are critical for building effective, scalable, and sustainable leadership pathways in nursing.
Lifestyle interventions for blood pressure reduction and hypertension prevention in adolescents: A systematic review Siregar, Hasbunsyah; Permatasari, Henny; Nursasi, Astuti Yuni
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 12 (2026): Volume 8 Number 12
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i12.1686

Abstract

Background: Hypertension in adolescents is an emerging public health concern, often linked to poor lifestyle habits formed early in life. Lifestyle interventions have been recommended as first-line, non-pharmacological strategies for blood pressure control and hypertension prevention. Purpose: To evaluate the effectiveness of lifestyle interventions in reducing blood pressure and preventing hypertension among adolescents. Method: A systematic literature review was conducted on June 30, 2025, using the PICO framework. Databases searched included PubMed, Sage Journals, ScienceDirect, and Google Scholar. Keywords included Lifestyle Interventions, Hypertension, and Adolescents. Inclusion criteria were original studies (RCTs, cohort, quasi-experimental) focusing on adolescents with lifestyle-based interventions. Articles in English or Indonesian were included if full-text was available and outcomes reported changes in blood pressure, BMI, or lifestyle practices. Results: The reviewed studies consistently demonstrated that lifestyle interventions such as increased physical activity, dietary modification, and health education effectively reduced both systolic and diastolic blood pressure. Several interventions also resulted in improved BMI, physical fitness, and healthier lifestyle practices.  Multicomponent and early interventions, particularly those implemented in schools and supported by family or community involvement, showed the most promising results. However, some adolescents with severe obesity or resistant hypertension may require complementary medical treatment. Conclusion: Lifestyle interventions are effective, scalable, and evidence-based strategies for lowering blood pressure and preventing hypertension in adolescents. These findings support their integration into public health initiatives aimed at reducing long-term cardiovascular risk from an early age.
Intervention strategies to improve adherence to the five pillars of diabetes management among patients with type 2 diabetes mellitus: A literature review Megawati, Putu Vera; Agustini, Ni Luh Putu Inca Buntari; Megayanti, Sri Dewi; Sari, Ni Made Candr Citra
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 12 (2026): Volume 8 Number 12
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i12.1690

Abstract

Background: Diabetes mellitus is a metabolic disease that is a global problem, with the number of sufferers increasing annually. Adherence to the five pillars of diabetes management is the cornerstone of preventing and reducing morbidity and mortality from diabetes. Purpose: To analyze how to improve adherence in type 2 diabetes patients in implementing the five pillars of diabetes management. Method: The research method used a literature review approach to map and identify interventions for implementing the 5 pillars of diabetes management. Results: The study found 20 articles describing interventions for people with diabetes mellitus through educational and informational delivery mechanisms. The types of interventions included: mobile phone application interventions, physical exercise interventions, audiovisual interventions, flipchart interventions, and peer leader interventions. Conclusion: Five types of interventions improve adherence in patients with type II diabetes mellitus to implementing the 5 pillars of diabetes management.

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