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Psychospiritual care has taken many forms and approaches. In the clinical setting, the meaning, variations, and inconsistencies in the delivery of psychospiritual and its related terms persist. The purpose of the study is to identify the meaning and attributes of psychospiritual care and enhance collaborative practice by presenting a concept analysis. This review used Walker and Avant's eight-step approach to concept analysis. Psychospiritual is a broad, dynamic, and unique concept that integrates psychological and spiritual methods. In this analysis, the defining attributes of psychospiritual care are intuitive self-awareness, therapeutic use of psychological and spiritual perspective, and cultivation of psychological and spiritual environment. Providing psychospiritual care promotes positive consequences, such as therapeutic effects for patients and promoting psychospiritual awareness among psychospiritual interventionists. A comprehensive definition of psychospiritual care has been developed. The findings contribute to science by creating a platform for developing practice standards, research, and theory. Implementing psychospiritual care may improve overall occupational health and well-being, thereby improving patient care delivery.

Older adults are a group vulnerable to health problems, and cases continue to increase. One of the reasons is living in a nursing home. So far, efforts have been made to improve older adults’ care services for their Quality of Life (QoL). However, one thing that is forgotten is spiritual services for older adults. This research aims to find relevant aspects between care and spiritual services to improve the QoL for older adult people living in nursing homes. This was a cross-sectional study. The sample size was 131 older adult people living in nursing homes. Samples were taken through simple random sampling with the criteria of being able to communicate and having a good cognitive function. Care services were measured using the Services Assessment Scale (SVAS) questionnaire, spiritual services were measured using the Spiritual Assessment Scale (SAS) questionnaire, and QoL was measured using the World Health Organization Quality of Life Older (WHOQOL-OLD) questionnaire. Data analysis used the gamma test. Respondents in this study were mostly women (55.5%), aged 60-74 years (62.6%), who had an elementary school graduation education (56.5%). Most respondents received low care services (74.0%), low spiritual services (84.0%), and most of them had low QoL (82.4%). The results showed a significant correlation between care services and QoL (p=0.000 and r=0.623), and between spiritual services and QoL (p=0.000 and r=0.755). Older adults in nursing homes need spiritual services and care services to improve their QoL.

Ketidakpatuhan penderita hipertensi dalam pengobatan penyakitnya berdampak pada tidak terkontrolnya tekanan darah yang dapat memperburuk status kesehatan dan bahkan kematian. Salah satu faktor penting yang harus diperhatikan dalam upaya meningkatkan kepatuhan hipertensi adalah pengetahuan penderita tentang penyakitnya dan penatalaksanaan yang diperlukan. Tujuan penelitian ini adalah untuk mengetahui hubungan pengetahuan dalam mendukung praktik kepatuhan penderita hipertensi dalam mengkonsumsi obat anti-hipertensi. Desain penelitian yang digunakan adalah analisis deskritif cross sectional. Besar sampel penelitian ini sebanyak 220 responden, direkrut melalui teknik purposive sampling. Analisis data penelitian dilakukan dengan menggunakan uji statistik chi square. Sebanyak 51,8% penderita hipertensi memiliki pengetahuan cukup dan 65,9% penderita hipertensi mengaku tidak patuh dalam meminum obat yang dianjurkan. Nilai hasil uji < α 0,05 (p= 0,000), artinya pengetahuan berhubungan signifikan dengan kepatuhan minum obat. Pengetahuan adalah komponen terpenting yang harus dimiliki penderita agar mereka dapat terlibat aktif dalam praktik kepatuhan. Diharapkan temuan ini dapat dijadikan sebagai bahan pertimbangan dalam merumuskan intervensi pengobatan bagi penderita hipertensi kaitannya dengan upaya meningkatkan kepatuhan penderita dalam hal meminum obat anti-hipertensi.

Introduction Caring is learned through faculty role-modeling and clinical interactions, enhancing nursing students’ caring character. Relationship between caring, motivation, teacher experience, and learning environment remains uncertain. Objective The present study aimed to explore the relationship between their caring characters, motivation, lecturer experience, and learning environment among undergraduate nursing students in Indonesia. Methods A cross-sectional study was conducted between December 2022 and February 2023, recruiting 550 undergraduate nursing students from 10 universities in West Java province, Indonesia. The study included instruments such as students’ perceptions of learning, academic motivation scale, service quality assessment of instructional laboratories, and caring character learning instrument. The Bootstrap analysis was used to analyze the mediating effect of study variable. Results The study involved participants aged 20–25 years. The mean scores for caring characters, lecturer experience, motivation, and learning environment were 2.18 ± 0.97, 3.46 ± 1.20, 4.32 ± 1.53, and 5.96 ± 2.08, respectively. The results showed significant direct effects of lecturer experience on caring character, mediating effects of learning environment, motivation, and chain mediating effects of learning environment and motivation. The direct effect accounted for 44.34% of the total effect, while the indirect effect was 35.21%. Conclusions The study found that learning environment and motivation mediate the relationship between lecturer experience and caring characters among undergraduate nursing students in West Java, Indonesia. Emphasizing best practices and creating a student-friendly environment is crucial for fostering guidance and support.

Abstract Background Mother's awareness of obstetric danger signs is the degree of a pregnant woman to fully utilize her knowledge of the signs and symptoms of complications of pregnancy, which helps the mother and family to seek medical help immediately. High maternal and infant mortality rates in developing countries are due to a combination of a lack of quality, resources and access to health services coupled with mother’s lack of awareness. The purpose of this study was to collect current empirical studies to describe the pregnant women awareness about the obstetric danger sign in developing country. Method This review employed the Prisma-ScR checklist. The articles searched in four electronic databases (Scopus, CINAHL, Science Direct, Google Scholar). Variables that used to search the articles (pregnant woman, knowledge, awareness, danger signs pregnancy). The Framework used to review is PICOS. Result The results of the article found 20 studies which met inclusion criteria. The determinants were high educational status, more pregnancy experience, more ANC visit, and labour in the health facility. Conclusion The level of awareness is low to medium, only some have fair awareness, in which related to determinant. The recommended effective strategy is to improve the ANC program by assess the risk of obstetric danger sign promptly, assess the barrier of health seeking related to the family support, i.e. the husband and the elderly. Additionally, use MCH handbook or mobile application to record the ANC visit and communicate with the family.

Non-adherence in hypertensive patients is a serious challenge faced by health workers. The motivational interviewing (MI) is a patient-centered intervention and has been shown to change a person's compliance. The aim of this review is to investigate the impact of MI on adherence in hypertensive patients. This review was conducted on four databases, PubMed, Cinahl, Web of Science (WOS), and Scopus. Only randomized controlled trial (RCT) articles were used in this review, the quality assessment of the articles used the JBI critical appraisal tools, the selection and extraction of articles referred to the PRISMA guidelines. There were 5 articles that met the inclusion criteria. MI is applied with 2 methods, conventional and non-conventional. 2 articles showed an increase in medication adherence, 1 article showed adherence to dietary and physical activity recommendations, 1 article showed a change in smoking consumption patterns, and 4 articles showed a decrease in blood pressure in post-intervention hypertensive patients. MI can be an effective option in terms of improving hypertension adherence in the future. Although the evidence is currently validated, more research is needed to explore the evidence for the effectiveness of the combined MI method.

Hospitals in today’s healthcare system are under pressure to boost their competitiveness. A number of studies have shown the disconnect between corporate culture and the enhancement of healthcare professionals’ performance. While it is well accepted that an organization’s culture has a substantial impact on the performance of its health care professionals in clinical practice, the mechanisms by which culture might enhance health care professionals’ performance remain unclear. This paper draws on 22 literature reviews and database searches using keyword syntax from ScienceDirect, Pubmed, Google Scholar, and other relevant publications published between 2011 and 2021. Research in the field demonstrates that a company’s culture may influence the efficiency and effectiveness of its healthcare employees. This overarching issue was dissected into the following themes: nurse performance mediated by discipline; the existence of cultural groups; a central focus on health care professional management; and individual, organizational, and psychological aspects. The optimal performance of nurses and the outcomes of patient care are contingent on management in the health care business knowing the cultural factors that exist in the workplace.

Health systems at all levels are under pressure to provide comprehensive and high quality of care based on the best evidencebased interventions. The kangaroo mother care (KMC) is one way to care for Low Birth Weight babies (LBW) especially in developing country where the rates of preterm and LBW neonates are higher and the resources are limited. The purpose of this paper is to explore healthcare providers’ perspectives of kangaroo mother care implementation in perinatology ward in the rural surgical hospital of East Java Province, Indonesia. We conducted an in-depth interviews to identify KMC implementations. Ten healthcare providers engaged with KMC were interviewed. Data was analyzed using a thematic analysis. Healthcare providers reported positives perceptions of KMC and acknowledged their important roles to give education. The barriers in implementing the KMC including the level of knowledge and the age of the mother of LBW babies. KMC as a method of treating LBW babies is effective intervention care of preterm and LBW babies. This research provides information regarding the need of supports from all levels in KMC implementation.

Introduction: The contraceptive prevalence rate in Indonesia has not experienced much improvement, which has led to an increase in the number of pregnancies. This study aimed to analyse the barriers to contraception use among women of childbearing age in rural Indonesia. Methods: This study used a cross-sectional design with data from the Indonesian Demographic and Health Survey (IDHS) of 2017. The independent variables were age, employment status, education, marital status, wealth status, health insurance and parity. The dependent variable was the use of contraception. The statistical significance was set at p

Background: One of the efforts made to return people with severe mental illness to the community is to prepare with sufficient skills so then they can return to a productive life. The purpose of this study was to develop a vocational social rehabilitation model to increase the independence of the instrumental activity of daily living (ADL) among people with severe mental illness. Design and Methods: The study was conducted in 2 stages. Phase 1 used an observational design with a cross sectional approach. It was conducted at the Menur Mental Hospital from March to July 2020. The population of this study were all people with severe mental illness with a psychotic degree scoring ≥ 30. The total sample was 100. The data was analyzed using the Partial Least Square. The second phase was carried out by compiling modules from strategic issues and conducting expert consultations. Results: The results of phase 1 showed that the instrumental ADL independence was directly influenced by perceived behavior, memory phase, motivation phase, skills and intention. Additionally it is indirectly influenced by socio-demography, mental illness severity, attitude towards behavior, subjective norm, perceived behavioral control, attention, retention, motor reproduction, motivation and skill. The results of the phase 2 carried out were used to compile modules based on the stages of vocational rehabilitation consisting of determining eligibility, preparatory counseling, implementing rehabilitation, evaluation and ongoing support. Conclusion: The vocational social rehabilitation model is related to the independence of the Instrumental ADL among people with severe mental illness.

Background: Curiosity is a personality characteristic, which fits with wellbeing and positive functioning. The objective of this study was to assess the construct validity of the Curiosity and Exploration Inventory II (CEI-II) in Indonesia. Design and Methods: The study included 256 undergraduate students who lived in Indonesia, mean age 19.8 years old. The CEI-II measures stretching and embracing using 11 items. The English version of CEI-II was translated into Bahasa. The Cronbach’s alpha coefficient and intraclass correlation coefficient (ICC) were addressed to examine internal consistency reliability and the test-retest reliability. To evaluate construct validity, exploratory factor analysis (EFA) was used to assess factor structure and confirmatory factor analysis (CFA) was used to evaluate the structural model fit of the CEI-II Indonesia version. Results: The study showed Cronbach’s alpha for the internal consistency of the overall CEI-II Indonesia version was 0.77. The ICC for the test-retest reliability ranged between 0.753-0.829. EFA showed adequate with the Kaiser-Meyer-Olkin value of 0.86 and the Bartlett’s test of sphericity was statistically significant. CFA tested the second-order model with two-order factors and showed a model fit. Conclusions: The CEI-II Indonesia version indicated acceptable construct validity to evaluate curiosity in Indonesia.

Introduction: Attention deficit is one of three main problems of children with Attention Deficit Hyperactivity Disorder (ADHD). Children experience difficulty of paying attention and concentrating to one or more things or objects. As a results these children cannot perform the task well. Crossword puzzle is one of games that may increase attention and concentration. The aim of this study was to analyze the effect of crossword puzzle to increase attention of children with ADHD. Method: Pre-experimental design was employed in this study. The population was ADHD students in Cakra Autisme Therapy. Seven students were recruited by means of purposive sampling. The independent variable was crossword puzzle and the dependent variable was the increase of attention. Data were collected using observation sheet and analyzed using Wilcoxon Signed Rank Test with level of significance of α≤ 0.05. Result: Result showed that crossword puzzle could increase attention. Respondent’s attention improved from less to good attention, particularly in playing activities (p=0.014). Analysis: This finding suggests that there was differences of attention between pre and post-test. It can be concluded that crossword puzzle can increase attention of the students with ADHD. Discussion: It is recommended for teachers and parents of ADHD children to give them crossword puzzle game everyday at school or at home. Further studies should involve larger sample size and employs another game not only to increase attention, but also reduce hyperactivity and impulsivity of ADHD child.

Introduction: Menopause woman has higher depression level than pre and postmenopause woman. Many woman who are getting menopause will feel lonely and don’t have any friends to talk, if this situation continue it can cause menopausal depression. Peer group support is one of group therapy which gives opportunity to menopause woman to get mutual support and help them to face the problem. This aimed of this study was to analyze the effect of peer group support in the menopause woman depression level. Method: A quasy experimental pre-post test design was used in this study. There were 16 menopause women taken from Cepokomulyo Kepanjen. The independent variable was peer group support and the dependent variable was the depression level. Data were analyzed by Wilcoxon Signed Rank Test and Mann Whitney U Test with the significance level α

Introduction: Decision for cesarean section may lead to the stress for women in delivery. Stress response requires longer recovery time in post cesarean section patients. Most of patients who experience stress before and after surgical is associated with wound healing delay. When this condition continues, the wound will have a higher risk of infection. The objective of this study was to analyze correlation between stress and wound healing phase in post cesarean section patients. Method: A cross sectional design was used in this study. The population were women with cesarean section, both elective or emergency, in Delivery Room I RSU Dr. Soetomo Surabaya. Samples were recruited by using purposive sampling, with 28 samples who met to the inclusion criterias. The observed variables were stress and wound healing phase in post cesarean section patient. Stress data were collected by interview and wound healing measurement done by observation on the 3rd day post cesarean section. Result: The result showed that women with stress experience wound healing delay. The characteristic of wound healing delay was prolonged on inflammation phase, nevertheless there was presence of granulation tissue. Spearman’s rho correlation showed that correlation value r=0.675 with p=0.000. Discussion: It can be concluded that there was strong significant correlation between stress and wound healing phase in post cesarean section patients. It is important to give this information to the patients with cesarean section in order to prevent stress and delay in wound healing phase.

Introduction: Aging is a natural process in individuals. Most of the elderly have problems in dealing with this natural process. Lost of occupation, friends and loneliness may result in depression in this age group. Cognitive therapy changes pessimistic idea, unrealistic hopes and excessive self evaluation may result and justify depression. Cognitive therapy may help elderly to recognize the problem in life, to develop positive objective of life and to create more positive personality. The aimed of this study was to analyze the effect of cognitive therapy to reduce the level of depression. Method: This study was used a pre experimental pre post test design. Sample were 10 elderly people who met to the inclusion criteria. The independent variable was cognitive therapy and dependent variable was the level of depression in elderly. Data were collected by using Geriatric Depression Scale (GDS) 15, then analyzed by using Wilcoxon Signed Rank Test with significance levelα≤0.05. Result: The result showed that cognitive therapy has an effect on reducing depression with significance level p=0.005. Discussion: It can be concluded that cognitive therapy was effective in reducing depression level in elderly. Further studies are recommended to analyze the effect of cognitive therapy on decreasing anxiety in elderly by measuring cathecolamin.

Introduction: The main problem that experienced by child of mental retardation was slowness development of socialization ability especially the ability to cooperate. This disability happened because less of stimulation activity and because of the extraordinary school give more lessons to increase intelligence ability. Group Activity Therapy (GAT) Socialization is a therapy given to child of mental retardation to train their cooperate in playing group and increased their socialization ability (cooperate). Method: This study used Quasy Experimental design. The population was the students of 1-5 class at Karya Bhakti extraordinary school. The sample was recruited with purposive sampling consist of 20 respondents according the inclusions criteria and divided into treatment and control groups. The Independent variable was GAT Socialization session 6 and the dependent variable was the increased of socialization ability (cooperate). Data were collected with observation sheet and analyzed with Wilcoxon Signed Rank Test and Mann Whitney U Test with level of significance p

Introduction : Autism is a behavioral dissorder which can be identified by three factors i.e.: communication, socialize and stereotyping. Lovaas method was a structural method, having a well-composed material which can be implemented one on one with very clear instructional steps. This study was aimed to explain the correlation of lovaas method implementation with the obedience in children with autism. Method : This study used cross sectional design involved 15 respondents for children with autism and 15 respondents of therapist who met inclusion criteria, taken by accidental sampling. The independent variable was lovaas method and the dependent variable was the obedience. Data were collected by using observation and questionaire. Data were analyzed using Gamma and Somers’d test with level of significance α ≤ 0.05. Result : Results showed that there was moderate correlation between lovaas method implementation with the obedience in children with autism (p = 0.026). Analysis : It can be concluded that lovaas method has correlation with the obedience in children with autism. Discussion : Lovaas method can shape obedience with reinforcement when children can respond order from therapist which is having more authority in giving rewards. For further studies the implementation of lovaas method should be intended to reveal other possible capacity in children with autism.

Introduction: Psychological well-being is one of an important part on the positive aging process for elderly. Many older people face stressful situation such as death of family, deterioration of health, decrease of physical ability and psychological problem like loneliness, low self esteem, useless, isolation or difficulty in relationship. Religious relaxation: dzikir is one of the group therapy to fill up psychological necessary by filled up spiritual necessary so they could say thanks to God for everything what they have had now. The aimed of this study was to analyze the effect of religious relaxation: dzikir to increase the level of psychological well being of the elderly. Method: This study was used a quasy experimental pre post test design. There were 20 respondents which taken by using purposive sampling. The independent variable was religious relaxation: dzikir and the dependent variable was elderly psychological well being. Data were analyzed by using Wilcoxon Signed Rank Test and Mann Whitney U-Test with significance level a≤0.05. Result: The result showed that religious relaxation: dzikir has an effect on increasing the level of psychological well being of the elderly with Wilcoxon Signed Rank Test p=0.004 in treatment group, p=1.000 in control group and the result of Mann Whitney U-Test revealed p=0.000. Discussion: It can be concluded that religious relaxation: dzikir can increase psychological well-being. Religious relaxation: dzikir help the elderly to develop self acceptance, autonomy, positive relation with others, environmental mastery, purposive in life and personal growth. Researcher suggests the institutional to practice relaxation religious: dzikir to help elderly people to raise psychological well-being.

Introduction: Prison is societal implementer unit which accommodate care and develop the delinquent children. It was recorded that 57% of children at Blitar Child Prison undergo some self concept problems such as low self esteem. This was caused by some factors such as society’s stigmatization toward criminals, development pattern and education, and less support from family. If the self esteem problem is not being overcome soon, the children may fell useless, disable to control their self and recrime when they are back to society. The objective of this study was to analyze the influence of GAT (Group Activity Therapy) perception stimulation in increasing the children self esteem at prison. Method: A quasy experimental pre post control design was used in this study. Samples were recruited by using total sampling and there were 22 samples as on inclusion criteria. The independent variable was GAT perception stimulation and the dependent variable was increasing self esteem of these childen. Data were collected by using questionnare and analyzed by using Wilcoxon Signed Ranks Test and Mann Whitney U Test with the significance level α≤0.05.Result: The result showed that controlled group has significance level was p=0.654, it is mean there was no self esteem change before and after GAT perception stimulation was given. Whereas treatment group has significance level was p=0.001, it revealed that there was self esteem change before and after GAT perception stimulation was given. The result of Mann Whitney U Test showed p=0.000 which means was accepted. Discussion: It can be concluded that perception stimulation can increase the children self esteem at prison. Further studies are recommended to study the effect of GAT perception stimulation modified by skill therapy in increasing children self esteem in prison.

Introduction: Autism is social interaction disorder in children. They were seemingly living in their own world. ABA method was a technique to decrease behaviour disorder or social interaction in autism children. The aimed of this research was to evaluate correlation between ABA method implementation and parents role with social interaction development in children with autism. Method: This research was used a cross sectional with purposive sampling. There were 22 respondents who met to the inclusion criteria. The independent variable was ABA methode and the dependent variable was social interaction development. Data were collected by using questionnaire and observation, then analyzed by using Spearman Rho Correlation with significance level α≤0.05. Result: The result showed that there was a correlation between ABA method and social interaction development in autism children with p

Perubahan lingkungan belajar dari lingkungan akademis ke lingkungan klinik dapat memicu munculnya stres. Ketidaksiapan mahasiswa dalam praktik akan menimbulkan perilaku tidak caring terhadap pasien. Tujuan dari penelitian ini adalah untuk mengatahui pengaruh penerapan relationship centered care dengan metode preceptorship terhadap penurunan stres dan peningkatan perilaku caring mahasiswa praktik profesi Ners. Desain penelitian ini adalah quasy experimental dengan pre-post test control design. Besar sampel adalah 12 sampel untuk setiap kelompok (24 responden), dan teknik sampling yang digunakan adalah cluster sampling. Variabel independen adalah relationship centered care dengan metode preceptorship. Variabel dependen adalah stres dan perilaku caring. Pengumpulan data melalui pengisian kuesioner dan juga lembar observasi. Data yang sudah terkumpul kemudian dianalisis dengan menggunakan Mann-Whitney U test untuk mengetahui perbedaan antara kelompok kontrol dan kelompok perlakuan. Hasil penelitian menunjukkan ada perbedaan tingkat stres yang signifikan antara kelompok kontrol dan kelompok perlakuan p= 0,001. Begitu juga dengan perilaku caring p= 0,001 yang artinya terdapat perbedaan antara kelompok control dan kelompok perlakuan. Relationship centered care dengan metode preceptorship dapat diterapkan pada mahasiswa praktik profesi Ners karena dapat mengurangi tingkat stres mahasiswa dan dapat meningkatkan perilaku caring mahasiswa.

Introduction: Mental disorder remains a stigma in society, even until now. A family who have a member with mental disorder, will experience continues objective and subjective burden, experience serious stress for a lifetime, which may cause ineffective coping. Method: Design used in this study was experimental (pre post test control group design). The population was every family of patient with mental disorder in Menur Mental Hospital along the year of 2010, has been taking care there twice, in minimum, lived in Surabaya. The samples were chosen by allocation simple random. Samples were 13 persons in each treatment and control group. The intervention was given in 60–120 minute in 8 times meeting with average interval about 1 week. Data analysis was done using paired t-test and independent t-test. Result: Results in this study showed that there was significant change in total of family coping (p = 0.040), maintaining family integration, cooperation and an optimistic definition of the stuation (p = 0.009), maintaining social support, self esteem, and psychological stability (p = 0.230), understanding the medical situations through communication with other parents and concultation with medical staff (p = 0.025). Discussion: The provision of family therapy with spiritual approach (DOA) can increase family coping in taking care of patient with mental disorder.

Introduction: One of school age children may developing task is learning to interact with their peer groups. The introvert have problem with their social interaction. One ways that can increase the social skill is play activities with social situation. So social play activities: cooperative play can be one of alternative solution to increase social interaction of children with introvert symptom. This study was aimed to explain effect of social play activities: cooperative play on social interaction of children with introvert symptom. Method: Quasy experiment design was used in this study. The population was school aged children with introvert symptom in SDN Kendangsari III/278 Surabaya. Total sample was 23 respondents consist of 12 respondents as treatment group and 11 respondents as controlled group. The independent variable was social play activities: cooperative play. The dependent was social interaction of children with introvert symptom. The Data was analyzed by Wilcoxon Signed Rank Test and Mann Whitney U Test with level significance ofα ≤ 0.005. Result: Result showed that social play activities: cooperative play had significant effect on social interaction of children with introvert symptom (increased). Wilcoxon Signed Rank Test showed treatment group had p = 0.002 and controlled group had p = 1.00. Mann Whitney U Test showed p = 0.002. Discussion: It concluded that social play activities: cooperative play can be one way to change social interaction of children with introvert symptom. Further studies should involve larger respondents and better measurement tools to obtain more accurate results.

Introduction: Hypertensive disease is closely related to high cholesterol level, which may act as one of causes of death in elderly. The objective of this study was to analyze the effect of guava juice on the reduction of cholesterol level of hypertensive elderly at Community Health Center, Pacar Keling, Surabaya. Method: Quasy–experimental was used in this study. Sample comprised of 14 respondents who met the inclusion criteria. The independent variable was guava juice and the dependent variable was cholesterol level. Data were collected using questionnaire and observation. Data were analyzed by Paired t–Test and Independent t–Test with signi fi cance level of α < 0.05. Result: The result showed that guava juice gave a significant effect to cholesterol level of elderly with hypertension (p = 0.000). Discussion: It can be concluded that guava juice can reduce cholesterol level in elderly with hypertension. The reduction of cholesterol level may result from vitamin C, pectin, and potassium contained in guava juice, which have effect on cholesterol regulation in the body. Guava juice can be provided as daily diet for elderly. Further studies are suggested to investigate other variables, such as diet consumed, age, activity, and obesity.

Introduction: Diabetic treatment need a very long time that make most of patient doesn’t obey. One of the methods can be used to improve patient’s compliance is nursing care model Behavioral System by Dorothy E. Johnson with its interventions are motivation and education. The objective of this study was to analyze the differences between knowledge, attitude, practice, blood sugar fasting and 2 hours post prandial (PP) of diabetic patients. Method: This experimental research using randomized control group pretest posttest design. Sample used 30 persons divided into 2 groups. Motivation and education are given 4 times in period of 1 month by visiting to the patient’s house. Data were collected by questionnaires and observation then analyzed by wilcoxon with α < 0.05. Result: Results showed that after intervention, treatment group who haved good knowledge were 15 persons (100%), good attitude were 8 persons (53.3%), moderate were 7 persons (46.7%), good practice were 11 persons (73.3%), moderate were 3 persons (20%) and less was 1 person (6.7%). Blood sugar fasting and 2 hours post prandial (PP) decreased were 13 persons (86.7%). Analysis using wilcoxon showed that result was significant. Discussion: It can be concluded that motivation and education can improve knowledge, attitude, practice, decrease blood sugar fasting and 2 hours post prandial (PP). It was suggested to optimalized education and giving motivation due to improving support and awareness of patient to implement diabetes mellitus treatment.

Introduction: Schizophrenia is the problem with kognitive, mal-adaptive thought and behavior. Family who have a member with mental disorder can experience serious conflict, become an objective and subjective burden, blame each other, get involved in hostility among family members. Various negative effect faced by family can caused by wrong family’s health belief model about Schizophrenia, hence the failure on choosing the treatment and taking care of patient at home. Someone with severe stress will seek comfort and strength from God. But so far, the most effective spiritual models to improve the health belief model of the family in caring for patients with schizophrenia has not been found. Method: Design used in this study was experimental (pre post test control group design). The population was every family of patient with mental disorder in Menur Mental Hospital along the year of 2010, chosen by alocation simple random. Samples were 13 persons in each treatment and control group. The intervention was given in 60–120 minute in 8 times meeting with average interval about 1 week. Data analysis was done using paired t-test and independent t-test. Results: There were significant changes in total of family’s health belief model (p=0,004), there was significantly change in aspects of (1) perceptions about bene fi ts (p=0,009), (2) perception about barriers (p=0,035) and perception about self efficacy (p=0,002). There were no significant changing in perception about susceptibility and severity (p=0,052). Discussion: Family believes that all events experienced by the patient and the family is God's will, hoping the patient can be more independent, and believe mental disorders can be changed for the better. The conclusion of this study is that family therapy with a spiritual approach can improve the health belief model of the family in caring for patients with mental disorders.

Introduction: Patient with nasopharynx cancer may experience emotional distres. Emotional distres and anxiety may lead to decrease self-efficacy. Clients with a negative perception of the health or low self-efficacy would become apathetic and disability in soluns problem as compensation of getting that disease. The purpose of this study was the relaxation affirmations techniques in order to increase self-efficacy patient with nasopharynx cancer. Methode: This study used pra-experiment pre-post test design. Population was taken from patient with nasopharynx cancer of Ear Nose and Throat (ENT) Patient Departement Dr. Soetomo Hospital at Surabaya. Sample comprised of 19 respondents who selected based on inclusion criteria. Independent variable was the relaxation affirmations. Dependent variable was self efficacy of nasopharyngeal cancer patients. Data were collected using the observation sheet. Result: The results showed that there was a significant influence of relaxation affirmation in increased self-effi cacy patient with nasopharynx cancer, with p = 0.008. Discussion: Based on that results, it can be concluded that relaxation affirmations help patients nasopharyngeal cancer in THT Patient Departement Dr. Soeotomo Hospital at Surabaya in improving self-efficacy so that they would have ability to accept reality and belief in health pattern for optimalizing quality of life. Relaxation affirmations techniques including diaphragma breathing and affirmation decrease sympatic nerve activity and increase positive firm belief in patient.

Introduction: The degradation of cognitive function present early dementia in elderly. Brain gym is one of the alternative implementation to improve the cognitive function of elderly. The objective of this study was to analyze the effect of brain gym to the improvement of cognitive function in elderly. Method: This study used Quasy Experimental design. The populations were elderly in Social Service Unit Tresna Werdha Lamongan. The samples were recruited using purposive sampling, consist of 30 respondents, taken according to the inclusion criteria. Samples then divided into 2 groups, experimental groups and control groups. The independent variable of research this study was brain gym and the dependent variable was cognitive function at elderly. Data were collected by using MMSE score and then analyzed using Wilcoxon Signed Rank Test and Mann Whitney Test with level of significance α ≤ 0.05. Result: Result showed that there is an effect of brain gym to the improvement of cognitive function in elderly (p = 0.001). The difference of cognitive function also seen between experimental groups and control groups (p = 0.001). Discussion: The conclusion of this research is brain gym improve cognitive function in elderly. The simple movement of brain gym able to coordinate the brain function so the brain activity become more optimal hence the improvement of memory function, recall and concentration.

Anxiety is common among adolescents. Self-report anxiety scales are needed to screen and prevent adolescents sinking into worse mental health. The purpose of this study was to assess the psychometric properties of Indonesia Zung Self-rating Anxiety Scale (SAS), including translation, validity, reliability and receiver operating characteristics (ROC). We used cross-sectional study and correlational design in this study. Total sample was 1,000 adolescents in junior and senior high school. The SAS was translated into Bahasa Indonesia based on World Health Organization guidelines. SAS and the Indonesia version of Beck Depression Inventori-(BDI) II questionnaires were used to develop construct validity. Correlation between item score and total score was used to establish convergent validity. Cronbach’s alpha was used to calculate reliability and ROC curves were used to examine cut-off point of SAS. Construct validity showed positive correlation between the SAS and Indonesia version of BDI II scores. Convergent validity showed positive correlation between each item and total score. Cronbach’s alpha 0.691 and the ROC 36.5. Thus, the Indonesia version of SAS provides a reliable and valid tool to screen anxiety among adolescents.

Introduction: Human Immunodeficiency Virus (HIV) is a retrovirus that infects cells of the immune system, destroying or damaging the function of cells of the immune system. This makes the immune system becomes weaker, and people become more liable to infection. A lot of new detected HIV transmission source comes from former workers who work abroad. The challenge in dealing the number of transmission performed comprehensive care of patients and their family empowerment and peer support groups. The aimed of this study was to develop the ability of a family of Indonesian Workers who are infected with HIV and Peer Support Group in independence of care. Methods: This study was used an explanatory design and quasy-experimental. Population in this study were the closest family who care for patients infected with HIV during work abroad as migrant workers in East Java. Samples were selected using simple random sampling technique. The independent variable was the peer group and family support, the dependent variable is the level of independence of care on the respondent. Data were collected using a questionnaire that has been tested for validity and reliability and results were tested using the Wilcoxon Signed Rank Test with alpha ≤0.05. Results: The results showed that this method can improve the independence of the family of the HIV-infected client care during labor as migrant workers abroad with a significance value of p=0.004. Conclusion: Empowerment of family and peer group support can be used to increase the independence of families and patients in the treatment of HIV-infected patients during work abroad as migrant workers. Future studies are expected to use a larger sample. Keywords: empowerment of the family, peer group support, independence treatment, TKI (Indonesian Labor), Human Immunodeficiency Virus (HIV)

Schizophrenia is a chronic brain disorder that affects about one percent of the population which is also commonly found in Indonesia. Based on the medical records taken from Surabaya Menur Mental Hospital in July until September 2016, the number of patients diagnosed with this disease is 439 patients. The increasing case of schizophrenia is resulted from the lack of support and role of family and their ability in taking care of patients with schizophrenia. This study used quasi-experimental design (pre-post test controlgroup design), purposed to prove the effects of video-based discharge planning using family-centered nursing on the ability of family in taking care of patients with schizophrenia. This study involved the family members of schizophrenic clients as the population in which half of them were taken as the samples: 15 repondents were chosen as the control group, whereas 15 respondents were taken as the treatment group using consecutive random sampling technique. The independent

Emergency nursing is a part of competences of profession program aimed to encourage the students to think critically to overcome the nursing problems which threaten the clients' lives. The learning method used in this stage is the experiential clinical learning. However, problems in achieving the learning outcomes still occur recently to result in low outcomes of clinical learning. This study used explanative method to describe the causal relationship among variables. This study involved all nursing students of the Faculty of Nursing and Midwifery of Unusa. 72 students were taken as the samples by using simple random technique. The endogenous variables were the students' characteristics, observation factors, thinking process, learning behaviors, and experiential clinical learning. The exogenous variables, on the other hand, were the outcomes of clinical learning in emergency nursing in ners students. The results of statistic test with Partial Least Square showed that all indicators and constructs variable were valid and significant. the significance test using structural model (t > 1,96), showed that the students' characteristics affected the observation factor, thinking process, and experiential clinical learning. The variable of observation factor affected the thinking process and learning behaviors. The variable of thinking process affected learning behaviors. The variable of learning behaviors affected experiential clinical learning. In addition, the variable of experiential clinical learning influenced the outcomes of clinical learning in emergency nursing in ners students. Experiential clinical learning model is categorized as a good model and has a prediction value if applied can improve learning achievement of clinical learning in emergency nursing in ners students. The dominant factors of successful experiential clinical learning are the characteristics of the students and learning behavior in ners students.

Spirituality is one of the most influential dimensions in adolescent development. Adolescent with good spiritual sees life with optimism, clean mind and soul. Environment will affect the spiritual development of adolescents. This research aimed to understanding the adolescent spirituality living around ex-localization. This research used qualitative research design of phenomenology with in-depth interview with semi structured interview and observation. Participants were junior high school teenagers, Moslems living around exlocalization, Kota Surabaya, choose by purpossive sampling. The data analysis in this study using thematic analysis with nine steps Collaizzi. result of this research got 18 theme that is adolescent perception, adolescent behavior, adolescent relationship with parents, interaction of adolescent with society, interaction of adolescent with opposite sex, adolescent knowledge, adolescent relationship with self, autonomy, feeling during worship, SWT, the purpose of human creation, religious analysis, Allah's incomprehension, the timeliness of worship, obstacles, life goals, hopes, spiritual experiences, ways of dealing with problems, lifestyles, self-image. Adolescents who live in an ex-localization will interact with peers and the surrounding community in the neighborhood. These reciprocal relationships affect the spiritual values in teenagers. The existence of the control of parents can control the interaction process that occurs between adolescents with the surrounding community who live in ex-localization so that formed the spiritual character of adolescents.

Indonesia bebas pasung bagi pasien gangguan jiwa merupakan program prioritas yang harus dicapai pemerintah pada tahun 2019. Saat ini upaya bebas pasung telah dilaksanakan dengan baik, permasalahan baru muncul setelah masa pengobatan selesai dan harus kembali kepada keluarga dan masyarakat. Keluarga tidak menghendaki pasien kembali kepada keluarga, diabaikan, kembali kambuh atau menjadi gelandangan psikotik. Penelitian ini bertujuan untuk memperoleh gambaran dukungan keluarga terhadap pasien gangguan jiwa pasca pasung. Penelitian ini menggunakan desain kualitatif fenomenologi, jumlah partisipan sebesar 9 orang dipilih dengan purposive sampling, pengumpulan data dilakukan dengan wawancara mendalam, data dianalisis secara tematik. Hasil penelitian menunjukkan dukungan keluarga terhadap pasien gangguan jiwa pasca pasung diperoleh 2 (dua) tema besar yaitu; fenomena pasung terhadap pasien gangguan jiwa dan dukungan keluarga. Fenomena pasung meliputi; alasan, keputusan, metode, pembebasan dan dampak pemasungan. Dukungan keluarga meliputi; dukungan penilaian, instrumental, informasional dan dukungan emosional. Dukungan keluarga dibutuhkan pasien untuk dapat mencapai penyembuhan dan mencegah kekambuhan. Pengetahuan yang kurang terhadap cara perawatan pasien gangguan jiwa pasca pasung menyebabkan dukungan keluarga yang diberikan terhadap pasien tidak optimal. Pandangan keluarga dan masyarakat yang keliru terhadap pasien gangguan jiwa mempengaruhi penanganan yang tepat terhadap pasien gangguan jiwa. Kata kunci: Dukungan keluarga, gangguan jiwa, pasung. Abstract Indonesian free of pasung for mental disorders is a priority program to be achieved by the government in 2019. Currently the effort of free of pasung for mental illness has been well implemented. A new problems arise after the treatment period is over and patients must return to family and community. Families do not want patients to return to then, ignored, relapse or become psychotic homeless. This study aims to obtain a description of pasung phenomenon and family support for patients after having pasung. This research used qualitative phenomenology design, the number of participants for 9 people was chosen by purposive sampling, data collection was done by indepth interview, the data were analyzed by thematic analysis. The result of the research showed two big themes that are; pasung phenomenon and family supports after the patient having pasung. The pasung phenomenon includes; reasons, decisions, methods, exemptions and the effects of deprivation. Family support includes; support assessment, instrumental, informational and emotional support. Family support is needed for patients to achieve healing and prevent recurrence. The lack of knowledge about the way patients care for post pasung mental disorders cause the family support provided to patients is not optimal. Misrepresentation of family and community opinions on psychiatric patients affects the proper treatment of psychiatric patients. Keywords: Family support, mental disorder, pasung.

The objective of this study was to examine the correlation between parenting and social environtment with sexual behavior for adolescence (14–21 years) who lived in Putat Jaya prostitution area Surabaya. Design used in this study was cross sectional design. The population were all adolescence who lived around in Putat Jaya prostitution area Surabaya. Total sample were 104 respondents, taken according to inclusion criteria. The independen variables were parenting and social environtment and the dependent variable was sexual behavior in adolescence (14–21 years). Data were collected by using structured questionaires with multiple choice and several open questions. Data were then analyzed by using Spearman’s Rho Correlation with level of significance p=0.05 and content analyse. Result showed that parenting had a strong correlation with sexual behavior in adolescence (p=0.000 and ρ=0.691) and the social environtment had a strong correlation with sexual behavior in adolescence (p=0.000 and ρ= –0.773). Conclution: parenting and social environtment has correlation with sexual behavior in adolescence and the most factors that have strong relationship in those correlations is living in prostitution area nearby. It is recommended for nurse, parent and publics to modified the social environtment to be more condusiveness.

Older adults with hypertension often experience a low quality of life. Family support plays a critical role in maintaining and improving their well-being. This study aimed to analyze the effectiveness of a family-centered empowerment model on the quality of life of hypertensive patients. This quasi-experimental study included 70 participants with hypertension, who were divided into an intervention group and a control group. Participants were selected through a consecutive sampling technique. The study utilized the Family Empowerment Instrument and the European Quality of Life questionnaire (EQ-5D-5L) for data collection. The data analysis was performed using Levene's, Wilcoxon Signed Rank, and Mann-Whitney U tests. There were no significant differences in the participants’ characteristics between the control and intervention groups (Levene's test p-value >0.05). After the family-centered empowerment intervention, the quality of life in the intervention group was significantly higher than that of the control group (Mann-Whitney U test p-value=0.000 < 0.05). This suggests that nurses can effectively involve patients with chronic diseases, particularly hypertension, and their families in the treatment process to enhance their quality of life.

BackgroundFamily involvement in overcoming the severity of leprosy is very important in the life of leprosy sufferers in communities who experience the clinical and, psychological, social and behavioral consequences of the disease. However, this need, psychosocial, is felt to be not optimal. This study is to identify how the experiences of family members as caregivers provide assistance to individuals with leprosy in improving healing and maintaining patterns of interaction in the family.MethodsThe design uses qualitative research with in-depth, face-to-face interviews with family members in a semi-structured manner with the hope of obtaining complete data. Using purposive sampling with Participatory Interpretative Phenomenology analysis, there are 12 families with 15 family members consisting of 4 men and 11 women.ResultsThis study produced a family theme that tried to follow what would happen to individuals with leprosy, with four sub-categories: 1) Using various coping alternatives to recognize the disease, 2) Family members in the shadow of leprosy, 3) Trying to empathize with other family members. sick, 4) Caring for the emotional response of the family and seeking support.ConclusionsThis analysis shows that deficiency in cognitive aspects can be closed by maintaining a lifestyle in the family through efforts to understand, support, establish communication, increase maximum involvement in restoring self-confidence, especially in individuals with leprosy with psychosocial problems in the family. The results of this study can be used as psychosocial support in maintaining communication between family members to support treatment programs and accelerate the recovery of leprosy.

Background: The presence of psychotic symptoms in adults’ with schizophrenia need an increase in family control and support to prevent the risk of aggressive behavior. However, the issue of whether psychotic symptoms hold any clinical relevance in relatively stable outpatient samples has not been established. The purpose of this study, therefore, was to identify the relationship between family supports and adaptation mechanisms of adults’ outpatients with schizophrenia. Design and methods: The study design involves quantitative research and descriptive correlation, attained through purposive sampling approach. 101 samples were obtained from the population of schizophrenia outpatients. The questionnaires of House & Kahn were used as an instrument to evaluate family support, while Nursalam questionnaires were used to access adaptation skills. Results: Findings from Spearman’s rho test showed P

Background: Various efforts have been made by the Indonesian government to improve mental health services. In 2014, the government established Law no 18, which is about mental health and the treatment of people with mental illness covered by the universal health coverage. However, many people still experience difficulty in accessing mental health services. In Indonesia, family plays the role of a caregiver to people with mental illness. Objective: This study aims to identify the perceived barriers on mental health services by families whose members suffers from mental illness. Methods: This study is a qualitative research study with a phenomenological approach. Sampling was conducted by purposive sampling with a sample size of 12 participants. Data were collected using semistructured in-depth interviews. Thematic analysis was performed using Colaizzi steps. Results: The obtained results presented three themes. Theme 1, mental health service affordability; theme 2, mental health service availability; and theme 3, negative attitudes (stigma). Conclusion: Families whose members suffered from mental illness still experienced barriers in relation to mental health services even with universal health coverage. Improved mental health services are related to the health insurance coverage, affordability, availability of mental health services and stigma reduction in the health professionals and wide community. Keywords: Family, Mental health services, Perceived barrier, Qualitative research

Introduction: : Families of schizophrenia patients need to obtain information from health services about how to care for them. Limited information and understanding of responsibilities in caring are still obstacles to becoming an empowered family in caring for patients with schizophrenia. The study aimed to explore family needs regarding information from health services and family responsibilities when caring for patients with schizophrenia. Methods: This study used a descriptive qualitative design. The study involved families who cared for patients with schizophrenia in Surabaya, Indonesia. Twenty participants were obtained using purposive sampling techniques and the sample size was determined by data saturation. Data were collected using in-depth interviews, field notes and interview question guides. The data were processed with content analysis. Results: The results showed eight themes. Families need information about patient conditions, medication, routine control, and counseling for patient conditions as well as for families. The family describes the responsibilities carried out for the patient as providing support for patient treatment, fulfilling daily needs, helping with social skills, and providing activities in spare time. Conclusions: Adequate information from health services regarding both the patient's condition and family counseling can help to meet the demands of care, which stimulates families to be more empowered to carry out care responsibilities and has an impact on the ability to care better Keywords: counseling, empowerment, family, mental disorder, responsibility, schizophrenia

Depression occurs among the elderly, leading to increased use of medical facilities, adversely affecting quality of life (QoL), and increasing mortality. Fewer studies have been conducted to explore the factors that contribute to depression among the elderly. The purpose of this study was to identify the factors that trigger depression in this population. This research used descriptive analysis with a cross-sectional design. A total of 247 participants completed a questionnaire containing socio-demographic information and the geriatric depression scale-15 (GDS-15). The data were analyzed for correlation using the chi-square test. There was a significant relationship between insurance and occupation and depression in rural communities in Central Java, Indonesia. Insurance and occupation influence elderly individuals’ preparation for old age, ensuring they have sufficient finances through old age savings, which enables them to be financially secure. The population needs to prepare for old age by calculating their retirement fund requirements, saving and investing, and obtaining insurance for pension and health fund protection.

The elderly commonly struggle with mental health issues, especially depression. Spiritual coping is one of the factors that might prevent depression. The aim of this study is to investigate cultural involvement in spiritual coping to depression prevention among the Balinese elderly. From January to March 2021, this study was carried out on 273 elderly members of the Integrated Primary Public Health service in seven districts in Gianyar, Bali. The study used a cluster random sampling method to collect data and focused on quantitative measurements related to participant characteristics, depression prevention, and spiritual coping. The investigation into spiritual coping was based on the tri hita karana, a concept from Balinese philosophy. Bivariate analysis was used to assess the relationship between spiritual coping and depression prevention behaviour. The study comprised 146 male and 127 female participants aged between 65 and 79 years old. Among all participants, 190 (69,6%) were diagnosed with mild to moderate depression, while 83 (30,4%) with moderate to severe depression. However, for the majority, depression prevention was good 163 (59,7%), the rest was moderate 103 (37,7%), and poor 7 (2,6%). Tri hita karana spiritual coping for the majority was good 17 (53,8%). Spiritual coping has a strong correlation with depression prevention (r=0.230). Thus, spiritual coping has a strong correlation with depression prevention among the Balinese elderly. It can be concluded that the implementation of tri hita karana becomes a potent spiritual coping enhance depression prevention. Indigenous philosophy embedded in daily life supports social capital in dealing with stress.

Introduction To improve the capacity of diabetic foot ulcer (DFU) patients for self-management of wound care, there is a renewed need for self-care on their part, as well as an increase in their readiness to deal with issues and heal their wounds. Therefore, this review empirically assessed contemporary evidence on how patients with DFU can perform self-treat wound care. Methods This integrative literature review assessed how patients with DFU could perform self-treat wound care. Whittemore and Knafl integrative information literature review involved searching four databases (Scopus, PubMed, Web of Science, and Google Scholar), which resulted in 2,595 published articles, between 2010 and 2023. Nineteen articles satisfied the requirements for inclusion and quality assessment, and the PRISMA review checklist was followed. Results No research has addressed DFU patients’ self-treatment of wound care. The integration of evidence from quantitative and qualitative studies was achieved in three categories: (1) motivation, (2) self-wound care strategy, and (3) self-wound care performance by DFU patients. Conclusion To equip themselves to perform wound care independently, patients with DFU must receive training to clean wounds, apply wound medication, and perform dressings. There is a need for research that develops a self-treat wound care intervention model in patients with DFU.

Older people suffering from depression often exhibit low self-efficacy, which causes them to quickly give up on challenges caused by various problems related to ageing, such as physical, social and mental aspects, including depression, which ultimately impact their quality of life and productivity. Depression in the elderly is caused by physical, psychological, and social interactions with other people, especially caregivers in nursing homes. This study employed a phenomenological approach to analyse self-efficacy among older adults suffering from depression through qualitative inquiries. The participants who met the inclusion criteria lived in nursing homes for more than one year and experienced depression. In-depth interviews were conducted using a structured guide with a general self-efficacy scale (GSES), Indonesian version. The study was conducted in an older adult nursing home in 2022 with 14 older adults. The results were divided into four themes – accompanying performance, vicarious learning, verbal encouragement and emotional states – and indicated that older adults with depression experienced poor self-efficacy and described how to cope with poor self-efficacy.

Abstract Background Post-stroke patients often need support from their family caregivers to continue their care after hospital discharge. Family caregiver readiness in caring for stroke patients is needed to improve the patient's quality of life. This study aimed to analyze factors affecting family caregivers' readiness for post-stroke patient care after hospital discharge. Methods A cross-sectional study of family members of stroke patients admitted to the neurology inpatient unit from February to April 2023, and they were selected through purposive sampling. The general demographic questionnaire, the stroke knowledge questionnaire, and the Family Readiness for Hospital Discharge Scale (FAM-RHDS) were used to gather the data. Data analysis was performed with IBM SPSS 26 software. Data were examined through the descriptive, Pearson correlation, and multiple linear regression tests. Results Fifty-nine respondents completed the questionnaires. Factors that were significantly related to family readiness to care for stroke patients were age (p = 0.000), gender (p = 0.000), income (p = 0.000), occupation (p = 0.000), marital status (p = 0.000), and knowledge (p = 0.000). Education level was the one that didn’t correlate with family readiness (p = 0.452). Gender is the most dominant factor affecting the readiness of family caregivers to care for stroke patients (coefficient B = 10.847). Conclusion Male family caregivers should be given special attention to improve their readiness to care for post-stroke patients. Assessment of family caregivers’ readiness for discharge should be part of discharge planning and those who are unprepared may be provided with additional interventions prior to discharge.

Hypertension has been identified as a causative factor for cardiovascular disease, a leading global cause of death. The accessibility of health services plays a pivotal role in shaping community awareness and engagement in hypertension management. This research aimed to explore the availability of primary health facilities, health control practices, drug consumption, and healthy living behaviors among individuals with hypertension. Utilizing a correlation study with a cross-sectional design, the sample comprised 130 hypertensive individuals selected through purposive sampling. Statistical analysis used the Spearman rho correlation test. The findings revealed that significant correlations between primary health facility availability and health control behavior (α=0.000, r=0.310), antihypertensive drug consumption behavior (α=0.000, r=0.461), and healthy lifestyle behavior (α=0.000, r=0.478) among hypertensive patients. These results underscore the relationship between the availability of primary health facilities and the behavior of hypertensive patients in terms of health control, drug consumption, and healthy lifestyle choices within the community. While the full implementation of these behaviors among hypertensive patients may not be optimal, the observed good availability of primary health facilities serves as an initial step to promote improved behaviors in the management and prevention of hypertension complications within the community.

Introduction Caring for people with schizophrenia has consequences, one of which is stressors during care. Families as caregivers often using coping strategies that involve relationships with self, others, or the transcendent/God or nature and also may include religious/spiritual practices. Objectives This literature review aims to identify the benefit of using spiritual coping as used by a family schizophrenia caregiver. The variable is spiritual coping. Methods This literature review method used PRISMA methodology for systematic reviews. Search was conducted in March 2017, updated in August 2022 and submitted in April 2023 for the publication process, limited to English by using electronic databases: Scopus, ScienceDirect, Sage, ProQuest, and PubMed. Results Fifteen studies were included in this review. Two synthesized findings emerged: spiritual coping strategies used by family caregivers give positive effects for family. Conclusion When the stress or crisis phase is experienced while caring for people with schizophrenia, the family who acts as a caregiver reveals the meaning of life they have and that they feel hopelessness and helplessness. In an effort to overcome the family's burden as caregivers, they often use spiritual coping, which is important to increase the caregiver's wellbeing.