Developing a Culturally Based Family-Centered Nursing Model for Emergency Prevention and Management among Families of Patients with Non-Communicable Diseases
DOI:
https://doi.org/10.31674/mjn.2026.v18i02.002Abstract
Introduction: Non-Communicable Diseases (NCDs) are a major cause of morbidity and mortality worldwide and may lead to emergencies requiring rapid family response. However, family preparedness for emergency prevention and management remains suboptimal and may be associated with family dynamics, individual capacity, and cultural values. Objectives: This study aimed to evaluate a proposed culturally based Family-Centered Nursing (FCN) structural model for Emergency Prevention and Management (EPM) among families of patients with NCDs. Methods: A cross-sectional analytical design was applied using Partial Least Squares Structural Equation Modelling (PLS-SEM). A total of 210 primary caregivers of patients with NCDs were selected using proportional stratified random sampling. Data were collected using a structured questionnaire measuring Family Assessment, Individual Family Members Assessment, Culture Care, and EPM. Model evaluation included measurement and structural models. Results: Family Assessment and Individual Family Members Assessments were significantly and positively associated with culture care and EPM. Culture care was also significantly and positively associated with EPM. Specific indirect effects through culture care were significant and consistent with partial mediation. The model explained 55.3% of the variance in Culture Care and 70.9% of the variance in EPM. Conclusion: The findings provide preliminary support for the proposed culturally based FCN predictive model linking family and individual factors with EPM among families of patients with NCDs. Culture Care showed significant indirect associations with EPM, consistent with a partial mediating role. These findings support culturally sensitive, family-centered approaches in nursing practice. Further longitudinal or intervention-based research is needed to validate the model and evaluate its implementation and effectiveness.
Keywords:
Culture Care, Emergency Prevention and Management, Family Centered Nursing, Non-Communicable DiseasesDownloads
References
Almeida, G. M. F., Nascimento, T. F., Silva, R. P. L., Bello, M. P., & Fontes, C. M. B. (2021). Theoretical reflections of Leininger's cross-cultural care in the context of Covid-19. Revista Gaúcha de Enfermagem, 42(Spe), e20200209. https://doi.org/10.1590/1983-1447.2021.20200209
Astuti, R. T., Fanani, M., Yusuf, M., Lestari, E., & Suminah. (2025). The role of the psychoeducation for family preparedness application on psychological preparedness and functional activities of families post-disaster: A community intervention study. Physical Therapy Journal of Indonesia, 6(2), 172–177. https://doi.org/10.51559/ptji.v6i2.312
Aza, A., Gómez-Vela, M., Badia, M., Begoña Orgaz, M., González-Ortega, E., Vicario-Molina, I., & Montes-López, E. (2022). Listening to families with a person with neurodegenerative disease talk about their quality of life: integrating quantitative and qualitative approaches. Health and Quality of Life Outcomes, 20(1), 76. https://doi.org/10.1186/s12955-022-01977-z
Barisone, M., Busca, E., Bassi, E., De Luca, E., Profenna, E., Suardi, B., & Dal Molin, A. (2023). The family and community nurses cultural model in the times of the COVID outbreak: a focused ethnographic study. International Journal of Environmental Research and Public Health, 20(3), 1948. https://doi.org/10.3390/ijerph20031948
Bautista-Gomez, M. M., Zuluaga, L. S., & Medina-Tabares, M. F. (2024). Cultural adaptation of health interventions for ethnic communities in vulnerable settings: A qualitative data synthesis. New Trends in Qualitative Research, 20(3), e920. https://doi.org/10.36367/ntqr.20.3.2024.e920
Bloemberg, D., van Zuylen, M. L., Musters, S. C., de Jong, D., Schreuder, A. M., Jamaludin, F. S., ... & Eskes, A. M. (2026). Is the active involvement of family caregivers in adult hospital care effective to improve patient outcomes? a systematic review. Journal of clinical nursing, 35(2), 565-584. https://doi.org/10.1111/jocn.70059
Castro, F. G., Barrera Jr, M., & Bautista, T. G. (2018). Evidence-Based Treatments: Adapting Behavioral Medicine Change Strategies to Meet the Needs of Integrated Care with an Appreciation of Culture. In Behavioral Medicine and Integrated Care: Efficient Delivery of Effective Treatments (pp. 89-117). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-319-93003-9_6
Çebi, A., & Reisoğlu, İ. (2023). Adaptation of self-assessment instrument for educators’ digital competence into Turkish culture: A study on reliability and validity. Technology, Knowledge and Learning, 28(2), 569-583. https://doi.org/10.1007/s10758-021-09589-0
Clodig, M., Magro, G., De Lucia, P., Prezza, M., Dussi, G., Dentice, S., Moreal, C., Chiappinotto, S., & Palese, A. (2025). Hindering and Facilitating Factors While Implementing the Family and Community Nursing Model in Italy: Findings from a Qualitative Study. Healthcare (Switzerland), 13(9), 1–18. https://doi.org/10.3390/healthcare13091001
Corbin, J. H., Oyene, U. E., Manoncourt, E., Onya, H., Kwamboka, M., Amuyunzu-Nyamongo, M., ... & Van den Broucke, S. (2021). A health promotion approach to emergency management: effective community engagement strategies from five cases. Health promotion international, 36(Supplement_1), i24-i38. https://doi.org/10.1093/heapro/daab152
Davis, J. M., Checko, T., Sumner, A., & Molinari, S. (2025). The Disaster Response Mobilization System: a community‐based disaster preparedness strategy in Puerto Rico. Disasters, 49(4), e70012. https://doi.org/10.1111/disa.70012
Dinas Kesehatan Provinsi Kalimantan Selatan. (2024). Jumlah Penyakit Jantung Koroner. Dinas Komunikasi Dan Informatika Provinsi Kalimantan Selatan [Total Coronary Heart Disease. South Kalimantan Provincial Office of Communications and Informatics]. https://data.kalselprov.go.id/dataset/data/1319/bar/y
Durmuş, M., Çiftci, N., Yildiz, M., & Yildiz, O. F. (2025). The effect of nurses’ perceptions of evidence-based attitudes on the quality of care: a cross-sectional study. BMC nursing, 24(1), 383. https://doi.org/10.1186/s12912-025-02996-z
Fauzi, M. A. (2022). Partial Least Square Structural Equation Modelling (PLS-SEM) in Knowledge Management Studies: Knowledge Sharing in Virtual Communities. Knowledge Management & E-Learning, 14(1), 103-124. https://www.kmel-journal.org/ojs/index.php/online-publication/article/view/505/501
Garcia, J. A., de Isaacs, L. G., Escalante-Barrios, E. L., & Fàbregues, S. (2025). Beliefs and socio-cultural perspectives on hantavirus in a rural community in Panama: An ethnonursing study. PLOS global public health, 5(10), e0005320. https://doi.org/10.1371/journal.pgph.0005320
Gawulayo, S., Erasmus, C. J., & Rhoda, A. J. (2021). Family functioning and stroke: Family members' perspectives. African Journal of Disability (Online), 10, 1-11. https://doi.org/10.4102/AJOD.V10I0.801
Ge, P., Zhang, J., Lyu, K., Niu, Y., Li, Q., Xiong, P., ... & Wu, Y. (2022). The current status and factors related to the preparation of home first-aid kits in China. Frontiers in public health, 10, 1036299. https://doi.org/10.3389/fpubh.2022.1036299
Giménez, V. M. M., & Manucha, W. (2021). Nanomedicine approaches for the diagnosis, treatment, and theragnosis of diabetes mellitus, hypertension, and their associated cardiovascular diseases. In Diabetes and Cardiovascular Disease (pp. 153-183). Elsevier. https://doi.org/10.1016/B978-0-12-817428-9.00006-1
Hair, J., & Alamer, A. (2022). Partial Least Squares Structural Equation Modeling (PLS-SEM) in second language and education research: Guidelines using an applied example. Research methods in applied linguistics, 1(3), 100027. https://doi.org/10.1016/j.rmal.2022.100027
Halle, M., & Münzel, T. (2025). Epidemiology and prevention. In T. F. Lüscher & U. Landmesser (Eds.), Cardiovascular system (pp. 33–47). Springer. https://doi.org/10.1007/978-3-662-70152-2_3
He, J., Chen, J., Li, Q., Yang, Z., Liang, H., Wang, L., Sun, Z., & Zhao, H. (2022). Application of family-involved smart medication management system in rural-dwelling middle-aged and older adult participants with chronic diseases: Management of chronic diseases in rural areas. Medicine (United States), 101(45), E31662. https://doi.org/10.1097/MD.0000000000031662
Hohashi, N. (2019). A Family Belief Systems Theory for transcultural family health care nursing. Journal of Transcultural Nursing, 30(5), 434-443. https://doi.org/10.1177/1043659619853017
Imanipour, M., & Kiwanuka, F. (2020). Family nursing practice and family importance in care–Attitudes of nurses working in intensive care units. International Journal of Africa Nursing Sciences, 13, 100265. https://doi.org/10.1016/j.ijans.2020.100265
Jebb, A. T., Ng, V., & Tay, L. (2021). A review of key Likert scale development advances: 1995–2019. Frontiers in psychology, 12, 637547. https://doi.org/10.3389/fpsyg.2021.637547
Jürisson, M., Pisarev, H., Uusküla, A., Lang, K., Oona, M., & Kalda, R. (2021). Prevalence of chronic conditions and multimorbidity in Estonia: a population-based cross-sectional study. BMJ Open, 11(10), 1–7. https://doi.org/10.1136/bmjopen-2021-049045
Karam, M., Chouinard, M.-C., Poitras, M.-E., Couturier, Y., Vedel, I., Grgurevic, N., & Hudon, C. (2021). Nursing care coordination for patients with complex needs in primary healthcare: A scoping review. International Journal of Integrated Care, 21(1), 16. https://doi.org/10.5334/ijic.5518
Kemenkes R. I. (2018). Riset Kesehatan Dasar. https://layanandata.kemkes.go.id/katalog-data/riskesdas/ketersediaan-data/riskesdas-2018
Kumar, S., Sirohi, V., & Pareek, N. (2025). Health Challenges Caused by Non-Communicable Diseases. In Sustainable Development Goals (SDG) and Its Intersection with Health and Well-Being (pp. 265-306). IGI Global Scientific Publishing. https://doi.org/10.4018/979-8-3693-9755-8.ch010
Kurniawatis, R., & Kusumo, M. P. (2023). Integrated care: Health promotion hospital model to improve family support for patients with chronic disease. Bali Medical Journal, 12(1), 753-760. https://doi.org/10.15562/bmj.v12i1.2991
Li, Y., Cao, G. Y., Jing, W. Z., Liu, J., & Liu, M. (2023). Global trends and regional differences in incidence and mortality of cardiovascular disease, 1990− 2019: findings from 2019 global burden of disease study. European journal of preventive cardiology, 30(3), 276-286. https://doi.org/10.1093/eurjpc/zwac285
Marques, B., Freeman, C., & Carter, L. (2022). Adapting traditional healing values and beliefs into therapeutic cultural environments for health and well-being. International Journal of Environmental Research and Public Health, 19(1), 426. https://doi.org/10.3390/ijerph19010426
McFarland, M. M., & Eipperle, M. K. (2008). Culture care theory: A proposed practice theory guide for nurse practitioners in primary care settings. Contemporary Nurse, 28(1-2), 48-63. https://doi.org/10.5172/conu.673.28.1-2.48
Mendis, S., Graham, I., & Narula, J. (2022). Addressing the global burden of cardiovascular diseases; need for scalable and sustainable frameworks. Global Heart, 17(1), 48. https://doi.org/10.5334/gh.1139
Menon, S., Entwistle, V. A., Campbell, A. V., & Van Delden, J. J. (2020). Some unresolved ethical challenges in healthcare decision-making: navigating family involvement. Asian Bioethics Review, 12(1), 27-36. https://doi.org/10.1007/s41649-020-00111-9
Nguyen, T. N. M., Saunders, R., Dermody, G., & Whitehead, L. (2024). The influence of culture on the health beliefs and health behaviours of older Vietnam‐born Australians living with chronic disease. Journal of Advanced Nursing, 80(9), 3781-3796. https://doi.org/10.1111/jan.16283
Nursalam. (2020). Metodologi Penelitian Ilmu Keperawatan Pendekatan Praktis (5th ed.). Salemba Medika. https://penerbitsalemba.com/buku/08-0284-metodologi-penelitian-ilmu-keperawatan-pendekatan-praktis-edisi-ke-5
Ocloo, J., Goodrich, J., Tanaka, H., Birchall-Searle, J., Dawson, D., & Farr, M. (2020). The importance of power, context and agency in improving patient experience through a patient and family centred care approach. Health Research Policy and Systems, 18(1), 10. https://doi.org/10.1186/s12961-019-0487-1
Opara, U. C., Iheanacho, P. N., & Petrucka, P. (2024). Cultural and religious structures influencing the use of maternal health services in Nigeria: a focused ethnographic research. Reproductive Health, 21(1), 188. https://doi.org/10.1186/s12978-024-01933-8
Parellangi, Syafar, M., Palutturi, S., Birawida, A. B., Mallongi, A., Soedirham, O., & Hijjang, P. (2023). Identification of family adaptive behavior in the Dayak tribe in an effort to prevent stroke. Pharmacognosy Journal, 15(3), 334–338. https://doi.org/10.5530/pj.2023.15.83
Perusset, M. (2025). Gender preconceptions and caregiving practices in low-income households in the villages of Copacabana and Quilino, Córdoba, Argentina. Journal of Sex-and Gender-Specific Medicine, 11(1), 13-19. https://doi.org/10.1723/4456.44508
Ruschel, K. B., Azzolin, K., & Rabelo, E. R. (2012). Home visits in cases of heart failure: reflection in the light of Leininger’s theory. Online Brazilian Journal of Nursing, 11(3), 883-892. https://doi.org/10.5935/1676-4285.20120059
Santomauro, I., Bassi, E., Busca, E., Basso, I., Ambrosi, E., Stedile, M., ... & Dal Molin, A. (2025). Perceived barriers and facilitators to family and community nurses’ care for older adults: a descriptive qualitative study. BMC nursing, 24(1), 1259. https://doi.org/10.1186/s12912-025-03890-4
Senghor, A. S. (2021). How do patients and health professionals perceive the role of family members in the decision-making process regarding the choice of a dialysis method? A qualitative study. Revue d'épidémiologie et de santé publique, 69(1), 22-29. https://doi.org/10.1016/j.respe.2020.10.006
Seniwati, T., Rustina, Y., Nurhaeni, N., & Wanda, D. (2023). Patient and family-centered care for children: A concept analysis. Belitung nursing journal, 9(1), 17. https://doi.org/10.33546/bnj.2350
Thompson, J. H., Rivelli, J. S., Gautom, P., & Coronado, G. D. (2025). Listen, empower, Co-create: adapting boot camp translation methods to create culturally responsive health messages and materials. HLRP: Health Literacy Research and Practice, 9(3), e93-e104. https://doi.org/10.3928/24748307-20250612-01
Wang, Y., Liang, J., Fang, Y., Yao, D., Zhang, L., Zhou, Y., ... & Xiao, Z. (2023). Burden of common neurologic diseases in Asian countries, 1990–2019: an analysis for the global burden of disease study 2019. Neurology, 100(21), e2141-e2154. https://doi.org/10.1212/WNL.0000000000207218
Yılmazel, G. (2023). Readiness for emergencies and disasters, and health competencies among people with epilepsy. Bangladesh Journal of Medical Science, 22(2), 341-347. https://doi.org/10.3329/bjms.v22i2.64993
Yustisia, N., Aprilatutini, T., Utama, T. A., & Masdar, M. (2023). The burden experience of family caregiver of older adults with chronic illness. Research in Community and Public Health Nursing, 34(2), 85-95. https://doi.org/10.12799/rcphn.2022.00304
Yusuf, A., Purba, J. M., Putri, D. E., Aditya, R. S., Alruwaili, A. S., & AlRazeeni, D. M. (2024). Family-centered care experiences in elderly with chronic diseases in communities: qualitative study of patients, families, nurses, and volunteers. Health Equity, 8(1), 338-350. https://doi.org/10.1089/heq.2024.0009
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 The Malaysian Journal of Nursing (MJN)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
