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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.

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.

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.

Background This study aimed to examine individual- and health service provider-related factors that influence the self-management behavior of patients with stroke. Methods This cross-sectional study investigated a cohort of 110 ischemic stroke patients in the neurology outpatient department of Universitas Airlangga Hospital from February 2023 to May 2023. Data were obtained using the following three distinct questionnaires: the general demographic questionnaire, health care provider questionnaire, and modified stroke self-management behavior questionnaire. Results Chi-square test results indicated a significant correlation between age ( p = 0.023) and information availability ( p = 0.000) with self-management behavior in patients with stroke. However, no significant correlations were observed between gender ( p = 1.107), residence ( p = 0.859), availability of access ( p = 0.093), availability of health facilities ( p = 0.065), and collaboration among health workers ( p = 0.641) with self-management behavior in patients with stroke. Ordinal logistic regression analysis results indicated that age significantly influenced self-management behavior in patients with stroke ( p = 0.034; OR = 2.49). Discussion The presence of reliable information within the hospital setting is expectedly complemented by a strong level of literacy among patients with stroke, thereby facilitating the enhancement of their self-management practices.

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.

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.

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.

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.

Indonesia has the second-highest number of tuberculosis (TB) cases in the world. Many TB patients did not take their medicine at health care centers causing an increase in taking medication. This study aimed to develop a simple model for describing non-adherence to medication in TB patients. This study used an analytical with a cross-sectional approach. The following criteria were used in selecting the respondent: adolescent, able to read and write, and willingness to be a respondent. A total of 93 participants were recruited randomly. Data were collected through questionnaires and analyzed using logistic regression. The predisposing factors were knowledge, attitude, belief (p = 0.000), trust (p = 0.013), and values (p = 0.001). Family support (p = 0.034) and healthcare personnel support (p = 0.022) were reinforcing factors. The enabling factor was the healthcare facility (p = 0.000). This study found that the most dominant factor is knowledge (B = 56.4). The model was Logit (Pi) = 22.363 + 56.4 knowledge (1) + 22.56 belief (1) + 2.9 family support (1) + 0.577 healthcare support (1) + 0.061 healthcare facility (1). This study suggests that TB patients’ knowledge must be increased to improve their TB treatment and management.

IntroductionThe importance of health literacy in achieving optimum health is highly significant, particularly in the nursing profession where it is an integral part of the roles and functions of nurses. Therefore, this scoping review aims to describe the roles of nurses in promoting patient health literacy and identify the determinant factors of health literacy in nursing practices.MethodsAn integrative search was conducted through four databases, namely, ScienceDirect, ProQuest, SAGE Journal, and PubMed, using various keyword combinations such as “health literacy,” “health information,” “patient health literacy,” “patient literacy,” and “nurses.” Furthermore, the inclusion criteria employed were peer-reviewed articles focused on the nursing profession, explicitly discussing health literacy related to nursing, and including original studies, such as cross-sectional, quasi-experimental, and qualitative studies. The selected review articles were all published between 2017 and 2022.ResultsIn total, 13 articles met the criteria and were applied in this scoping review. Most of these discuss health literacy related to nursing practice in clinical and community settings, as well as educational institutions. Health literacy is an essential aspect of professional nursing practice. Consequently, the supportive roles of nurses include acting as caregivers, facilitators, and educators to help patients overcome their literacy limitations and attain improved wellbeing.ConclusionNurses can improve the health literacy skills of patients by making health information related to their illnesses easier to access, understand, evaluate, and use. They must also recognize various factors influencing health literacy and use the factors as opportunities to optimize health literacy improvement. A health literacy approach can be applied by nurses to solve health problems and improve the quality of care for patients.

Background: The relapse of severe mental disorders is still quite high due to the lack of family knowledge in treating schizophrenic patients. The family treats and prevents the relapse of severe mental disorder by taking the sufferer to spiritual treatment, a shaman, being shackled (pasung) because of the assumption that the cause is evil from ghosts, magic, curses, and unbelief. Objective: The purpose of this study is to explore the experience of families preventing the relapse of severe mental disorders. Materials and Methods: This study is qualitative research with a phenomenological approach. The sampling was conducted by purposive sampling with 9 participants. Data were collected using semi-structured in-depth interviews with audio-recorded, transcribed verbatim, validated, and analyzed based on Colaizzi’s method of data analysis. Results: Four themes were generated, including: i) the perception of severe mental illness; ii) the causes of relapse; iii) family prevention for severe mental disorders relapse; iv) relapse becomes helplessness and a burden on the family. Conclusions: Lack of family knowledge of severe mental disorders, prevention of relapse, and lack of social support causes helplessness and a burden on the family. Increased knowledge, coping skills, and support for families with Schizophrenia are very important to help relapse prevention and the burden that arises.

Abstract Background Task-shifting, the distribution of tasks among health workers to address health workforce shortage, has been widely used to tackle mental health treatment gaps. However, its implementation in Indonesia has still been rarely explored. This study aimed to explore stakeholders’ perspectives on the implementation of mental health task-shifting to nurses in Indonesia's primary health care. Methods An exploratory descriptive approach using in-depth interviews and focused group discussions (FGDs) was used. The study involved 19 stakeholders from the government's ministry directorates, professional organisations, and mental health practitioners. Thematic analysis was used to analyse the data. Results Three themes emerged namely, task-shifting feasibility and acceptability, shared task implementation, and nurse role enhancement issues, with 14 sub-themes. Conclusions Task-shifting on mental health issues in the eye of Indonesian stakeholders is viewed as a matter of sharing and collaboration. Implementation of task-shifting in Indonesia may require policies in place and political will across stakeholders. Further scrutiny on task-shifting implementation is needed by considering the local context and national environment.

Objective: To study the relationship between anxiety and the spiritual wellbeing of hypertensive elderly patients during the corona virus disease-2019 pandemic. Method: The cross-sectional, correlational, analytical study was conducted from March to May 2022 in Lamongan Regency, East Java, Indonesia, after approval from the Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia, and comprised elderly hypertensive subjects aged >45 years who had good cognitive skills. Data was collected using the Geriatric Anxiety Scale and the Spiritual Wellbeing Scale. Anxiety was the independent variable, while spiritual wellbeing was the dependent variable. Data was analysed using univariate and bivariate analyses. Results: Of the 200 subjects, 107(53.5%) were females and 93(46.5%) were males. Overall, 97(48.5%) were aged 45-49 years, 81(40.5%) had completed primary school, 96(48%) were farmers, 121(60.5%) had moderate anxiety and 80(40%) had moderate spiritual wellbeing. There was a significant relationship between anxiety and spiritual wellbeing (p

Objective: To assess the impact of social support on family caregivers of schizophrenia patients. Method: The cross-sectional, observational study was conducted at Menur Mental Health Hospital, Surabaya, Indonesia, from June to July 2021, and comprised family caregivers aged 20-60 years who lived with schizophrenia patients. Data was collected using the Indonesia version of Zarit Burden Interview and the social support questionnaire. Data was analysed using SPSS 25. Results: Of the 160 subjects, 87(54.4%) were males and 73(45.6%) were females, and 88(55%) were adults, while 36(22.5%) had duration of care >10 years. All the 160(100%) patients had been receiving regular treatment. There were 64(40%) respondents who reported having good social support. The correlation between social support and the family caregiver burden related to schizophrenia patients was significant (p< 0.05). Conclusion: There was a significant relationship between social support and burden on family caregivers of schizophrenia patients. Keywords: Caregiver, Schizophrenia, Burden, Psychiatric, Ambulatory care.

Objective: To explore the abuse and neglect phenomenon in long-term care facilities for the elderly population. Method: The systematic review comprised search on PubMed, CINAHL, MEDLINE and ScienceDirect databases following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The key words used were older people care, long-term care, older people and older adults. Articles published in the last 5 years between 2017 to 2021 in recognised English-language journals and whose full text was available on the websites were included. Details of the selected studies were noted and analysed. Results: Of the 336 studies initially identified, 15(4.46%) were reviewed in detail. Of them, 3(20%) had been done in North America, 6(40%) in Europe and 6(40%) in Asia. The prevalence of abuse and neglect in long-term care facilities for the elderly was generally high, with nursing home staff mostly involved due to burnout syndrome or related to personal factors, such as childhood adversity and work-related stress. Conclusion: Better understanding is critical for improving the quality of care in long-term care facilities to prevent abuse and neglect with the elderly. Keywords: Aged, Caregivers, Healthcare quality and services, Long-term care.

Objective: To develop a spiritual nursing care model to improve the quality of life of heart failure patients. Method: The cross-sectional study was conducted at two government hospitals in East Java, Indonesia, from August to November 2019, and comprised patients of either gender aged 30 years or above having classic heart failure symptoms of weariness, ankle swelling and dyspnoea. Standardised questionnaires were used to collect data regarding disease, psychosocial, spiritual, demographic and environmental factors as well as stressors, formation of meaning, coping strategy, spiritual wellbeing, and quality of life. Data was analysed using partial least squares structural equation modelling. Results: Of the 222 patients, 124(55.9%) were males and 98(44.1%) were females. The overall mean age was 57.7±9.96 years. Overall, 33(14.9) patients were suffering from heart failure for >5 years, 36(16.2) had been hospitalised >5 times, and 8(3.6%) had no health insurance cover. Psychosocial (T=2.110), spiritual (T=1,998) and environmental (T=2,019) factors had an effect on the ability to assess stressors. Disease (T=5.497), spiritual (T=3.596) and environmental (T=3.172) factors had an effect on spiritual wellbeing. Disease (T=7.553), psychosocial (T=2.230) and environmental (T=2.625) factors affected the quality of life. The ability to assess stressors affected meaning formation (T=3.293), which had an effect on coping strategies (T=3.863), which, in turn, had an effect on spiritual wellbeing (T=9.776), and that affected the quality of life (T=2.669). Conclusion: The spiritual nursing care model was found to be influenced by disease, psychosocial and environmental factors as well as by spiritual wellbeing. Keywords: Adaptation, Psychological, Heart failure, Spirituality, Structural.

Introduction: The health status of a patient is strongly influenced by the family members because they play an important role during the health care process, and in healthy living. This implies that they must be involved in decision-making and therapeutic actions at every stage of the treatment. Therefore, this study aims to determine the relationship between family support and the health status of diabetes mellitus patients in Malang. Design and Methods: This study used a descriptive correlational design with a cross-sectional approach, which was carried out by filling questionnaires to determine the relationship between family support and the health status of diabetes mellitus patients. The sample population consists of 327 diabetes mellitus patients and 327 family caregivers of patients with the disease. Meanwhile, the respondents were selected through a cluster random sampling technique. Results: The results showed that 62.7% of the caregivers provided a good family support, while 90.8% of the patients have a good health status. This indicates that there is a positive correlation between family support and the health status of people with the disease (p-value= 0,000, α

Introduction: People with severe mental disorders strain those involved, including families, societies, entire communities, and the government, due to decreased productivity. Understanding the roles to be played in caring for such people necessitates a societal adaptation process. Good adaptations boost societal resilience by caring for severe mental disorder sufferers. Therefore, this study aimed to create a societal adaptation model that would increase societal resilience in the care of people with schizophrenia. Design and Methods: An observational analytic approach was applied with 205 society members living in the working area of the Community Integrated Health Center in Malang, East Java, Indonesia. Furthermore, several questionnaires were employed and analyzed using Partial Least Squares–Structural Equation Modeling (PLS-SEM). Results: According to the results, social adaptation was a significant indicator of societal adaptation. It was discovered that coping strategies influenced adaptation (p=0.007), society problem appraisal influenced coping strategies (p=0.000), and social support (p=0.005), while societal adaptation influenced societal resilience (p=0.022). The novelty of this study is that the societal adaptation model increases societal resilience in caring for people with schizophrenia, leading to a more adaptive community by increasing social capital. Conclusions: In conclusion, the adaptation model improves societal resilience by increasing social capital and stigma prevention, thereby promoting participation in the sufferers’ recovery process.

Background Nurse–client interaction when providing nursing services is limited to optimizing treatment and self-care, with limited focus on the psychological problems of people living with HIV-AIDS. However, psychological problems manifest more often than the health risks of the disease itself. This study aimed to determine the emotional response of people living with HIV-AIDS who received limited attention from nurses from the perspective of nurse–client relationship. Patients and methods A phenomenological qualitative design was used through in-depth face-to-face interviews in a semi-structured manner, in an effort to obtain complete data. This research used purposive sampling with Participatory Interpretative Phenomenology analysis, involving 22 participants (14 males and 8 females). Results This research produces several themes, with six subcategories: 1) Difficulty of social access, 2) Forcing to accept their situation and suppressing their will, 3) Wanting to be recognized like other people in general, 4) Social stigma and self-stigmatization affecting surroundings, 5) Lacking enthusiasm for life expectancy, 6) Always lingering under the shadow "when death picks up." Conclusion The results showed that mental stress was experienced more than physical problems by people living with HIV-AIDS, thus prompting new changes to nursing services for HIV-AIDS patients that emphasize psychosocial aspects, in addition to clinical features, facilitated by satisfying relationships between nurses and clients to provide quality services.

Introduction: Suicide is a health phenomenon that is currently increasing, especially in young adults aged 15-29 years. The spiritual aspect in the form of belief in God is one way to prevent suicide. This study was conducted to determine the effect of web-based spiritual problem solving on the prevention of suicide risk in college students. Methods: The research design used a pre-experimental one-group pre-post-test. The sample was 59 respondents using the purposive sampling technique. The independent variable was web-based spiritual problem solving, and the dependent variable was suicide risk prevention. The intervention was delivered via the web using PowerPoint media, inspirational videos, and counseling for approximately one month with four sessions. Data were collected using a questionnaire and analyzed using the Wilcoxon sign rank test. Results: Web-Based Spiritual Problem Solving significantly decreases suicide risk with a p-value of 0.000 (p

Introduction: Smartphones and teenagers in the age of technology are two very close things. Uncontrolled use of smartphones can create serious problems for teenagers, namely addiction. This research aims to build a safe smartphone use model for teenagers using a health promotion theory. Methods: This study was an explanatory study with a cross-sectional approach. The study population was 11-18 year old teenagers in Surabaya, Indonesia who use smartphones actively. The respondents were 185 teens recruited by simple random sampling. Variables include teenager factors, technology factors, environmental factors, teenagers’ thinking, self-control, commitment, and the level of smartphone use. The instrument used was an on-line questionnaire distributed through social media and then analyzed with partial least squares. The statistical afforded material for focus group discussion followed by 15 teenagers, 15 parents and 5 health workers in order to improve the model. Results: The results showed that the level of smartphone use was affected by self-control (t=2.303; p=0.022) and commitment (t=2.967; p=0.003). Self-control is influenced by adolescent factors (t=3.065; p=0.002), environmental factors (t=2.934; p=0.004) and teenagers’ thinking (t=2.522; p=0.012), also self-control affects teenagers’ commitment for using smartphones (t=3.953; p=0.000). Conclusion:The model formed emphasizes the importance of establishing self-control through adolescent thinking and environment factors so that they can commit to using smartphones safely

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

Introduction: Expanding positive thoughts and narrowing the space for negative thoughts can compensate for mental attacks to reduce leprosy stress because the impact caused by leprosy can destroy the mental strength that has been built. This study aimed to examine the model of the relationship between resilience, coping resources, psychological well-being, and leprosy stress as a predictor. Methods: The perceived stress scale, coping resources scale, coping strategy scale, and psychological well-being scale were used to collect the data, with 125 participants involved in this study, consisting of women (33.60%) and men 66.40%. The structural equation model was used to test the data using the cross-sectional design. Results: The SEM test shows that there is a negative relationship between coping resources and leprosy stress, with the coefficient value (−0.294), t-test (3.647), p (0.000)

Nurses are at the forefront of being directly involved in the care of Covid-19 patients. This can put nurses in a difficult position, especially if they had lack support from the surrounding environment. The society’s negative stigma towards nurses can trigger psychological problems for them. Good coping is needed to maintain the work performance of nurses. This study aims to identify the perceived stigma, psychological response, and coping of nurses involved in caring for Covid-19 patients in Indonesia. This research was a cross-sectional study based on an electronic survey. The number of respondents was 509 nurses who came from all regions in Indonesia on 11-20 April 2020. Respondents were nurses who handled Covid-19 patients directly. The data were collected using a modified questionnaire the Berger stigma scale, DASS and Brief of Cope with a total of 27 questions. The questionnaires used have been proven valid and reliable after being tested on 30 nurses treating Covid-19 patients with a Cronbach Alpha value as follows: modified Berger Stigma Scale 0.952; modified DASS 0.928; and modified Brief of Cope 0.753. Most respondents were 26-35 years old (52.1%), female (61.5%), and worked in government-owned hospitals (48.3%). 231 respondents were stigmatized (45.4%), 274 respondents were depressed (46.2%) and 209 respondents experienced stress (41.1%). The majority of respondents chose problem focused coping (65.8%). This study shows that some respondents feel they were stigmatized by society, but they have good coping (problem focused coping) to reduce their mental burden. Negative stigma against nurses is often difficult to avoid. Support from family and colleagues was something that can ease the mental burden of nurses. Support from the government was needed to educate the public so that it does not give negative stigma to nurses and other health workers.

Introduction: Schizophrenia is a serious mental illness that affects the thinking, emotions, relationships, and decision-making. One of the positive effects of treating schizophrenia in patients is family health. The family welfare management strategies provide help for coping, care preparation, organizing meetings, and mentoring. This study focuses on family coping strategies for improving the health of members living with schizophrenia. Methods: A cross-sectional design was used by choosing 160 respondents randomly. The inclusion criteria were family members accompanying control schizophrenia patients to the Public Health Center, with a minimum age of 18. The independent variable was family coping, which consist of two sub-variables (problem-focused coping mechanism and emotion-focused coping mechanism), while the dependent variable was family health, which consists of three sub-variables (efficient, satisfaction, and happiness). The SMART PLS (2.0 Version) was used to prove the impact of the variables. Results: The results indicated that family coping had a significant impact on the health of the family. The hypothesis was taken from the value of the T-test on the structural model analysis, which shows T- statistics (13.966) > T-critical (1.96). The impact of family coping on the health is equal to 0.682 (OR). This means that if family coping is given one-unit value, it will increase the family health by 0.682 times. Conclusion: The implementation of the family coping strategy will improve the capacity of the family to clarify health issues encountered, resolve family behaviors effectively and minimize risk factors. Furthermore, the coping mechanisms chosen by families in facing stress will have an impact on the reduction of illness symptoms in the members with schizophrenia.

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.

Introduction: Mental health knowledge is a substantial part of mental health literacy. Many psychosocial problems are transient and are often not noticed. This study aimed to analyze the factors related to student self-awareness in conducting psychosocial screening. Methods: This study used a descriptive-analytic design with cross-sectional approach. The study was conducted at the Faculty of Nursing, Universitas Airlangga Surabaya. A total of 160 respondents was chosen using simple random sampling techniques. The instrument used was a questionnaire. The dependent variable in this study was students’ awareness in conducting psychosocial problems screening. The independent variables in this study were knowledge, social interaction, family support, perceived vulnerability, perceived severity, perceived benefits, perceived barriers, and self-confidence. Analysis used multiple linear regression statistical tests. Results: The results showed there was a relationship between social interaction (p=0.00), perceived vulnerability (p=0.00), perceived benefits (p=0.001) and self-confidence (p=0,000) with students’ self-awareness in conducting psychosocial screening. There was no relationship between knowledge (p=0.555), family support (p=0.720), perceived severity (p=0.070), perceived barriers (p=0.748) with students’ self-awareness in conducting psychosocial screening. Conclusion:Mental health awareness in nursing student should be enhanced and strengthened with health education. Self-awareness of mental health is important for students. This can prevent mental disorders in the future

Introduction: Managing Cancer and Living Meaningfully (CALM) is a supportive-expressive psychotherapy designed to address such barriers and to facilitate communication of mortality-related concerns in patients facing advanced disease and their primary caregivers. The study was meant to review the benefits of the CALM psychotherapy on patients with advanced or metastatic cancer and caregivers. Methods: This study was done through a systematic review with The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) approach. It broadly used Scopus, Science Direct, and ProQuest database. The search utilized the Boolean phrases “cancer”, “living meaningfully”, and “psychotherapy” throughout the title, abstract, or keywords. The consideration criteria in the literature study were: an original article, the source from journals, article in English, and available in full text. We obtained 97 articles, and 11 were considered relevant for this systematic review. Results: The findings from the results of this study are that CALM has several psychological benefits for patients with advanced cancer, including: can reduce anxiety and depression, relieve distress, promote psychological growth and well-being, and improve quality of life. Based on these findings, it can be concluded that the CALM psychotherapy has many benefits for patients with advanced cancer and their caregivers and can be used as additional therapy to improve the quality of life to face the end-of-life. Conclusion: CALM may be a feasible intervention to benefit patients with advanced cancer. It may help them overcome obstacles in communication and alleviate death-related distress.

Introduction: A growing body of literature has shed light on occupational therapy (OT) interventions and outcomes in relation to mental illness. The purpose of this article is to provide an overview of the OT interventions used with patients with schizophrenia or mental illness and their documented outcomes in relation to functional level, well-being and quality of life. Methods: The databases searched were Scopus, Proquest, Sage, and Pubmed and the time of publication was in the last ten years. This was limited by the journal source type. The search terms, truncated when relevant, were "schizophrenia," "mental illness," “work training,” “occupational therapy” and “vocational therapy”. Results: Thirteen peer-reviewed intervention studies targeting adults with mental illness or schizophrenia were reviewed and analyzed. There are 6 categories related to the occupational interventions that emerged: skill training, cognitive-based occupational treatment, psychosocial-based occupational therapy, cognitive behavior therapy-based occupational therapy, creative occupational therapy, and peer group support-based occupational intervention. Conclusion: Most of the previous literature states that there were significant effects from the occupational therapies on the level of functioning, well-being or quality of life of the patients with schizophrenia or mental illness.

Introduction: Smartphone addiction often occurs in adolescents. The purpose of this systematic review was to identify the predictors of smartphone addiction in adolescents. Methods: The method used in this systematic review consisted of 5 stages: (1) the identification of the instruments used in the literature (database search); (2) the identification of the relevant literature based on the title and abstract; (3) the inclusion and exclusion criteria; (4) getting the full-text literature and (5) grading based on the literature component and the analysis of the selected instruments. The databases used in the literature search were Scopus, PubMed, Science Direct and Springer Link from 2013 - 2018. The criteria for the included articles were that they used a cross-sectional design and involved adolescents as the sample. Results: 17 of 829 articles met the inclusion criteria. The predictors of smartphone addiction were broadly divided into 3, namely personal factors, interpersonal factors and behavioral factors. These 3 factors are related to one another. Conclusion: It is necessary to do further research within a case-control study to strengthen this systematic review.

Background: Nowadays juvenile delinquency is increasing in terms of number and type. Delinquency and criminality among teenagers are generally categorized as deviant behavior in society and can be interpreted as a form of teenage resistance to normative rules and values that apply in society. Many risk factors are related to deviant behavior. This study aimed to analyze the risk factors that influence the occurrence of juvenile delinquency. Method: This study used a cross-sectional design and a simple random sampling technique. The calculation results involved 295 samples. The independent variables were individuals, families, school environments, peer groups, coping mechanisms, lifestyles, and technologies. The dependent variable was juvenile delinquency. The data was collected using a questionnaire. The analysis used a multiple linear regression test with a significance level of α≤0.05. Results: Of the seven variables, six of them significantly influence juvenile delinquency. Technology is the variable that has the greatest influence on the occurrence of teenager wear. Conclusion: Technology is the most influential factor. These results indicate a significant shift in the causes of juvenile delinquency from family and peer factors to technological factors. This is quite reasonable because technology is a major need and is a trend for teenagers at this time.

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: The growing prevalence of schizophrenia in Indonesia requires the consideration of the families, caregivers, health care professionals, and the entire society, to serve as a support and coping resource for the patients. The process of recovery is rather difficult, especially in the absence of a decent place to live. Hence, there is the need to provide a supportive environment that facilitates recuperation from psychotic symptoms, enhances interaction with others, promotes self-expression of thoughts and feelings, and helps deal with daily stress and challenges. There are currently no studies on the framework of societal adaptation for people with schizophrenia (PWS). The aim of this research, therefore, was to explore the experiences of rural society inhabitants in adapting to PWS in Indonesia. Methods: The study uses a qualitative research design and implements an interpretive phenomenological approach. A total of ten society members were recruited from the community by purposive sampling, and the in-depth interviews conducted were audio-recorded and transcribed. In addition, thematic analysis was carried out using the interpretive phenomenological analysis method. Results: The majority of the participants assumed that PWS prompt the feeling of alertness over fear. In addition, the participants revealed a feeling of indecisiveness in related situations and emphasized the value of keeping up traditional beliefs and practices and the effectiveness of a demonstration of indifference. They explained the need to combine traditional and modern health practices as recommended by the spiritual leaders. Conclusion: Societal adaptation to PWS entails the understanding of how to deal with the disease’s uncertainty and complexity. It is important to create a supportive environment to promote mental health and wellbeing.

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.