The Malaysian Journal of Nursing (MJN)

Message from the Editor in Chief

Prof. Datuk Dr. Hjh. Bibi Florina Abdullah — 2025-07-29

Depressive Symptoms among Undergraduate Nursing Students in Indonesia

Mula Tarigan — 2025-07-25

Background: Depressive symptoms and depression are mental disorders that often occur in the world, including in university students, such as in nursing. There are still limited studies on Depressive symptoms among undergraduate nursing students in Indonesia. Objective: This study aimed to estimate the prevalence and examine demographic characteristics relationship of depressive symptoms in undergraduate nursing students in North Sumatra, Indonesia. Methods: The design of the present study was descriptive. The sample size was 385 nursing students and a simple random sampling was applied to recruit respondents. The instrument was the Indonesian version of the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R). Data was collected from March to May 2024 using a Google form. The data analysis used included frequency, percentage, and Chi-square test. Results: This study found that the highest proportion was aged 17-20 years (60.3%) with a mean age of 20.1 ± 1.39 years in the first academic year (30.6%), women (91.4%), Muslims (54.8%), and Toba ethnic (48.6). The mean score was 20.36 ± 16.52, and more nursing students indicated no depression disorder (58.4%) than depression disorder (41.6%). The study found no relationship between depressive symptoms and demographic characteristics (age, academic year, and gender) with a p-value > 0.05. Conclusion: The present study shows that the prevalence of depressive symptoms among undergraduate nursing students at the university tends to be high. Therefore, students need to be given education and practice on how to deal with stress and the potential for depression and provide health assistance when students need it.

Effectiveness of Distraction Cards in Reducing Pain During Peripheral Intravenous Cannulation in School-Age Children: A Randomised Controlled Trial

Mohammed Ataallah Ahmed — 2025-07-25

Background: Following ethical and legal professional obligations, nurses should use evidence-based methods to enhance the patient experience during intravenous cannulation. Non-pharmacological pain management techniques are now used in the clinical setting and can be performed without additional cost or time. Therefore, this study targets alleviating pain during intravenous cannulation procedures. Objectives: To investigate the effects of distraction cards in reducing peripheral intravenous cannulation-related pain among school age children. Methods: A comparative and prospective randomised controlled trial was employed. The study was carried out on 148 school-age children who had Peripheral Intravenous Cannulation (PIVC). Patients were divided into two groups randomly: the Distraction Cards group (n = 71) and the control group (n = 77). Immediately after the PIVC procedure, the patients were asked to rate their level of pain by using the Wong-Baker Faces Pain Scale. Results: Pain intensity was significantly lower in the Distraction Cards group compared to the control group (p < 0.001), with a mean difference of 2.27. Conversely, the control group exhibited moderately higher pain scores (mean difference = 3.23) relative to the Distraction Cards group. Conclusion: Distraction cards are effective in relieving pain during IV cannulation. Similar experimental studies in larger children community samples are recommended to provide stronger evidence of their effectiveness.

Predictive Analysis of Clinical Status Assessment of Critical Patients Using Electronic Early Warning System Records with Machine Learning

Suhartini Ismail — 2025-07-25

Background: Rapid and accurate assessment of a patient’s clinical status in the Emergency Room (ER) is essential for timely intervention and improved outcomes. With advancements in information technology, electronic health records such as the Electronic Early Warning Score (E-EWS) have become invaluable tools in monitoring vital signs and detecting early signs of clinical deterioration. Leveraging machine learning techniques to analyse E-EWS data presents a promising approach to predict critical events including sepsis, acute respiratory distress syndrome (ARDS), cardiac arrest, and mortality. This study focuses on the application of machine learning algorithms to predict patients’ clinical status based on E-EWS records, aiming to enhance early detection and support clinical decision-making in critical care settings. Methods: The research design uses cross-sectional analysis to analyse E-EWS records with machine learning using random forest regression and random forest classification, with a total of 206 respondents, by carrying out six observations at a period of 6 hours, 12 hours, 18 hours, 24 hours, 48 hours to 72 hours. Results: The results showed that the prediction accuracy of the E-EWS record score using machine learning reached 82.26% with an MAE (mean absolute error) of 0.22, in the prediction accuracy of the patient's clinical status in 48 hours (76.19%) and 72 hours (71.43%) and the results of the accuracy of predicting hospital discharge status, the accuracy of E-EWS records and machine learning reached 97.62% with MAE 0.02 indicating that E-EWS records with machine learning with random forest algorithms have the potential to predict patient clinical status and outcomes. Conclusion: E-EWS records based on machine learning can be used to predict future patient conditions using seven EWS parameters that can predict critical patient clinical status assessment.

Exploring Gaps in Maternal Knowledge Regarding Sudden Infant Death Syndrome and Its Risk Factors

Amal Ahmed Elbilgahy — 2025-07-25

Background: Sudden Infant Death Syndrome (SIDS) remains a leading cause of infant mortality. Understanding maternal knowledge and attitudes towards SIDS is essential for prevention. This study aims to explore gaps in maternal knowledge regarding SIDS and its associated risk factors among mothers in Arar, Saudi Arabia. Methods: A cross-sectional exploratory design was employed, involving 135 mothers of infants under one year. Data was gathered over the course of one month, beginning in January 2025, through a structured questionnaire that evaluated knowledge and attitudes regarding SIDS. Results: Most mothers (74.1%) recognised the definition of SIDS, yet only 58.5% identified the highest risk age. Knowledge of preventive practices was low, with only 23.7% understanding the role of pacifiers. A significant proportion (65.2%) acknowledged smoking around infants as a risk factor. Statistical analysis revealed that higher educational attainment and maternal age positively correlated with better knowledge and attitudes towards SIDS prevention. Conclusion: There is a critical gap in maternal knowledge regarding SIDS prevention despite high awareness of the syndrome. Targeted educational interventions are necessary to enhance understanding and promote safe sleep practices among mothers.

Patients' Perspectives of Nursing Therapeutic Interventions for Diabetes in the Community: An Ethnonursing Study

Evi Karota — 2025-07-25

Background: Management of self-care through culturally informed nursing practices is essential to enhance the quality of life of patients with diabetes. This study explored patients’ views of therapeutic interventions for diabetes through ethnonursing methodologies within the community. Methods: This qualitative ethnonursing study was conducted over eight months in 2023, involving 25 informants from several ethnic groups in Indonesia. The data collection included comprehensive interviews, observations, documents and field study reports. This study utilised topic analysis incorporating four phases of ethnonursing. Results: The study delineated six themes were identified: disorders stemming from diabetes symptoms; self-care practices among diabetic patients; the significance and beliefs surrounding traditional medicine; stress-related diabetes; skin complications and non-healing wounds; and obstacle to diabetes management. The primary findings indicate that numerous patients within the community depend on traditional medicine and exhibit inconsistent adherence to medical guidance, owing to cultural beliefs and insufficient diabetes education. Conclusion: Cultural care values and beliefs based on nursing therapeutic intervention including medical treatment and nursing intervention are important to improve self-care behaviour in patients with diabetes. It should be assessing cultural sensitivity and provide comprehensive diabetes education to enhance treatment success.

Exploring Preventative Measures: The Role of Nurses in the Fight Against Cervical Cancer in Iraq

Shahad Hazim Ali — 2025-07-25

Background: Cervical cancer remains a significant public health concern globally, especially in Low- and Middle-Income Countries (LMICs) such as Iraq, where healthcare challenges and cultural barriers impede prevention efforts. Nurses, as frontline healthcare providers, play a critical role in promoting awareness, education, and prevention of cervical cancer. However, their knowledge, cultural attitudes, and behavioural intentions remain underexamined. Objectives: To assess the knowledge, cultural attitudes, and intentions of nurses toward cervical cancer prevention in Iraq using the Theory of Reasoned Action (TRA) as a guiding framework. Methods: This cross-sectional study involved 105 registered nurses working in maternal hospitals across Mosul, Iraq. Data were collected through a structured questionnaire encompassing demographic information, knowledge of cervical cancer, cultural attitudes, and intentions toward prevention. Descriptive and inferential statistical analyses, including mean, standard deviation (SD) and Pearson’s correlation, were performed using SPSS version 25 to explore interrelationships among the variables. Results: While the majority of nurses demonstrated moderate knowledge of cervical cancer, significant gaps were identified, particularly regarding the role of HPV as a primary cause. Cultural attitudes, including stigma and traditional gender roles, influenced preventive practices. Nurses expressed generally positive intentions toward cervical cancer prevention, driven by workplace expectations and peer influence, though some lacked motivation and confidence. Barriers such as limited access to screening, financial constraints, and insufficient healthcare support were significant challenges. Conclusion: The study highlights critical gaps in nurses’ knowledge and cultural attitudes toward cervical cancer prevention, emphasising the need for targeted educational campaigns, policy reforms, and systemic support to empower nurses. Addressing these gaps can enhance preventive practices and contribute to reducing the cervical cancer burden in Iraq.

Assessment of Continuity of Care Policies Implementation for Low-Birth-Weight Infants in DKI Jakarta: A Nursing Perspective

Eviana Sumarti Tambunan — 2025-07-25

Background: Despite the introduction of several policies aimed at supporting continuity of care for Low Birth Weight (LBW) infants in DKI (Daerah Khusus Ibukota) Jakarta, significant challenges remain in delivering consistent and high-quality services. Community-based care programs continue to struggle with limited coverage and suboptimal quality. Data from the Central Statistics Agency of DKI Jakarta reveals a concerning increase in LBW cases—from 1,381 in 2018 to 2,145 in 2021—highlighting persistent gaps in both prevention and care. Methods: This qualitative study employed a multi-method approach, including literature reviews, policy document analysis, and in-depth interviews with healthcare professionals across six sub-districts of Central Jakarta. The analysis focused on assessing the feasibility and acceptability of current policy implementation. Results: Findings show that although policies for continuity of care for LBW infants exist, their implementation remains suboptimal. Key issues include weak coordination between hospitals and community health centres, limited trained personnel, and inadequate parental education. Nurses face challenges due to workload and lack of access to discharge information. Despite this, nurses play a pivotal role in delivering education, conducting home visits, and coordinating follow-up care. Conclusion: To improve outcomes for LBW infants in DKI Jakarta, stronger implementation of continuity of care policies is imperative. Key strategies include building nursing capacity, enhancing inter-facility coordination, and increasing support for parents. Strengthening these components is crucial to establishing sustainable, community-based care for this vulnerable population.

Impact of Video Games on Academic Performance in School Children

Amer Abdullah Sachit — 2025-07-25

Background: There are about two billion players of video games worldwide, making them a popular pastime. Nonetheless, experts and the media have stressed the possible risks associated with playing video games too often. The purpose of the study is to ascertain how playing video games affects academic performance. Methods: A cross-sectional descriptive study was carried out at two elementary secondary schools in Karbala city with 300 students, were playing video games during a parent meeting in school and data was collected using interviewer-administered questionnaires. Results: The children aged 11-13 years old have a high percent (51%), in regard to the item socio-economic status that the middle have more than two thirds the item residency, more than 50% were live in urban areas; concerning the educational level of children’ fathers more than half had (53%) primary school graduation, on the other hand nearly one third of the mothers had (34%) secondary education (27%). Less than thirty percent of the studied children had poor school achievement for children were poor. There were found highly significant association between the socio-demographical characteristics (age, socio-economic status, level education of father, level education of mother) with school achievements of children, but the number of year's failure in school shows no significant with their school achievements. Conclusion: Poor school achievement for the studied children was found highly associated with all socio-demographical characteristics with school achievements, except the number of year's failure in school. Recommendation: The study provides information through nursing education to the parents to limit play time on electronic games for their children, which had a bad effect on their basic skills and cognitive abilities. Additionally restrict the quantity and variety of games and swap them out for instructive ones.

Strengthening Nursing SBAR Communication Compliance to Improve Patient Safety

YK Gea Nurti — 2025-07-25

Background: Medication errors and patient falls are a significant part of patient safety events, it is estimated that more than 50% of patient injuries in healthcare settings are preventable, mainly due to communication errors. Objectives: The aim of this study was to assess the correlation between nurses' compliance in using SBAR (Situation, Background, Assessment, and Recommendation) communication and patient safety in hospitals. Methods: A descriptive correlational quantitative study was conducted in a regional public hospital. With total sampling, 257 nurses in the paediatric and adult wards, Intensive Care Unit (ICU) and Paediatric Intensive Care Unit (PICU), and Neonatal Intensive Care Unit (NICU) completed a compliance checklist on the implementation of SBAR communication and a summed rating scale regarding patient safety consisting of 20 questions, which were analysed by chi-square statistical test and logistic regression. Results: 257 nurses participated, with a gender distribution of 45.5% male and 54.5% female, and the majority aged 23-33 years (39.3%). Bivariate analysis showed a significant association between SBAR adherence and patient safety, with odds ratios (OR) for each component as follows: Situation (OR 3.230, p<0.001), Background (OR 2.961, p<0.001), Assessment (OR 4.350, p=0.002), and Recommendation (OR 5.018, p=0.001). Multivariate analysis showed that adherence to SBAR significantly improved patient safety, with an overall Omnibus value of 0.000 and a variance explained of 75.60%. Conclusion: The findings of this study showed a significant positive association between adherence to the SBAR (Situation, Background, Assessment, Recommendation) communication framework and better patient safety outcomes among nurses.

Maternal And Neonatal Risk Factors Associated with Autism Spectrum Disorder for Children in Kirkuk City

Ann Abbas Hassan — 2025-07-25

Background: Autism Spectrum Disorder (ASD) is a neurological illness that impacts a child's cognitive abilities, social interactions, and communication skills. The aim was to determine the association between maternal and neonatal risk factors associated with ASD for children in Kirkuk City. Methods: A case-control study was conducted on 180 mothers as a non-probability/convenience sample involving 90 mothers of children who were diagnosed with ASD according to the criteria (DSM-5) as a case group and were compared with 90 mothers of healthy children as a control group in Kirkuk city, through the period from November 2023 to December 2024. The collected data was analysed using SPSS version 22.0. Both descriptive and inferential statistical methods were used. The significance level for statistical analysis was set at P<0.05. Results: The study found that among 90 autistic children, 80% (72) were male, with a significance level of P=0.002. Prenatal and natal factors revealed that 78.9% of mothers experienced an unhappy emotional state, significant at P=0.000. Additionally, threatened abortions and anaemia were statistically significant at P=0.000. Also, 58.9% of the children were born via caesarean section, with 42.2% being elective c/s. 56.7% of children with autism were also bottle-fed. The majority of neonates (61.1%) were affected by jaundice, and 32.2% required phototherapy, significant at P<0.01. Conclusion: The findings detected several risk factors associated with ASD in children in a case-control study from Iraq. The most important of which were the age of the child and gender, anaemia, threatened abortions and caesarean section (elective c/s), in addition to high bilirubin levels (jaundice) of the neonate and admission to the incubator.

Innovation of the M-Nursing Application to Improve Compliance with Haemodialysis Therapy and Urea-Creatinine Levels in Patients with Chronic Kidney Disease

Riris Andriati — 2025-07-25

Background: Chronic Kidney Disease (CKD) represents a prominent health concern due to soaring propensity and occurrence rate, alongside the growing demand for kidney replacement therapies among affected individuals. Objective: This research focused on improving compliance, decreasing urea and creatinine with haemodialysis therapy among chronic renal failure patients by utilising the innovative M-Nursing Application model and assessing the impact of this novel approach. Methods: This research is experimental research with one group Pretest-Posttest design. The M-Nursing Application is an alternative therapy that can be given to patients by providing a Supportive Educative System in digital form. The procedure for this study was a pre-test to measure haemodialysis compliance, urea and creatinine; then the provision of M-Nursing Application intervention for 3 months; and then a post-test to measure haemodialysis compliance, urea and creatinine again. The measurement of the effectiveness of providing the M-Nursing Application intervention was carried out with 110 kidney failure patients at the Tangerang Regency General Hospital. Results: The results showed that in the pre-test, 31 respondents (56.4%) were compliant, while the post-test showed that number raised to 100.0% (55 compliant respondents). There was a significant decrease in mean urea level from pre-test to post-test (179.709 to 79.709), while the creatinine level dropped from pre-test (5.880) to 2.572 (post-test). The average knowledge score increased from 13.854 (pre-test) to 14.945 (post-test). The average attitude improved from 50.909 (pre-test) to 55.800 (post-test). Analysis that was done statistically confirmed a notable advancement in adherence (p-value 0.000). Conclusion: The M-Nursing Application as Innovation model was a strategy for decreasing urea values and creatinine values and increasing compliance in chronic kidney failure patients. This study provides nursing care promotive and preventive aspects, namely providing health education regarding patient compliance with haemodialysis so that optimal patient health status was achieved through the M-Nursing Application.

Effects of Online Learning Packages Using Simulation of Nursing Paediatric Critical Care Unit

Juraporn Tangpukdee — 2025-07-25

Background: Online learning packages using simulation have emerged as innovative tools to enhance nursing education in Paediatric Critical Care Units, offering interactive and flexible training experiences. The purpose of this study was to compare knowledge scores before and after receiving online learning packages using simulation of nursing paediatric critical care of registered nurses working in the Paediatric Intensive Care Unit (PICU) at University Hospital in North-eastern Reginal of Thailand, whose work experiences were less than 3 years and had not completed the training course on paediatric intensive care nursing. Methods: The method is a quasi-experimental study, an online learning package using simulation of nursing paediatric critical care, and a one-group pre-post-test design. The samples in this study were professional nurses working in the paediatric intensive care unit (PICU) at University Hospital in North-eastern Reginal of Thailand. Results: The results of the 14 registered nurses who participated in this study showed that there was a statistically significant Mean Difference (MD) in the score before and after receiving the online learning package 1 (MD -7.4), and the score after the 2-week follow-up period was (MD -3.9). Also, there was a statistically significant difference in the mean score after the program and the 2-week follow-up period with the score of 3.4. For an online learning package 2, there was a statistically significant difference in the mean score before and after receiving the package (MD -9.6 points), and the score after the 2-week follow-up period was (MD -6.1 points). It was also found that there was a statistically significant difference in the mean score after the program and the 2-week follow-up period with the score of 3.4. Conclusion: To conclude, an online learning package regarding nursing competencies can improve knowledge in paediatric critical care nursing. This will affect the quality of care and patients’ safety.

Effectiveness of Lamaze Technique for Parturient on Pain Intensity and Labour Progress at Women’s Health Hospital

Safa Ali Mohammad — 2025-07-25

Background: Lamaze, as a non-pharmacological nursing technique, helps parturients physically and psychologically relax during labour, so the antenatal preparation led the parturient to relax, which decreased the pain. Labour proceeded more smoothly. Objective: Determine the effectiveness of the Lamaze technique for parturients in terms of pain intensity and labour progress. Methods: A randomised control trial. The study was conducted in the Women's Health Hospital's antenatal clinic and labour unit at Assiut University, Egypt. It started at the beginning of April 2023 and was completed by the end of March 2024 over a period of one year. A total of 150 pregnant women randomly divided equally into two groups of pregnant women enrolled based on eligibility criteria. Using three methods to collect data: The study employed a structured interviewing questionnaire, a Visual Analogue Scale, and a labour progress assessment checklist. Results: The study Findings show that there is a significant difference with a p-value of 0.021 between the study group and control group related to the level of pain, and the study group's labour progress was better than that of the control group. So, the Lamaze technique should be included in maternity nursing care to manage pain and improve labour progress. Conclusion: Applying the Lamaze technique for parturients during labour stages had a positive effect on lowering the intensity of labour pain and enhancing labour progress during labour. Applying an antenatal educational programme for all pregnant women to increase awareness and knowledge about the Lamaze technique.

Risk Factors Associated with Haemolysis, Elevated Liver Enzymes, and Low Platelets Syndrome among Pregnant Women

Ameera Mohammed Abdulwahab — 2025-07-25

Background: Haemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome is considered a part of the preeclampsia disease spectrum, affecting 0.5–0.9% of all pregnancies. Objective: To identify risk factors associated with HELLP syndrome among pregnant women at Tal Afar General Hospital. Methods: A case-control study was conducted among 125 pregnant women, including 25 cases and 100 controls. The cases included 25 women with HELLP syndrome, while the controls included 100 women with gestational hypertension. A developed interviewing questionnaire was used to collect information related to mothers. The study was conducted at Tal Afar General Hospital. Results: The study found that pregnant women who were primigravida (40% vs. 26%), nullipara (48% vs. 33%), had fewer than five antenatal care visits (68% vs. 47%), consumed a high-salt diet (64% vs. 39%), had multiple pregnancies (12% vs. 9%), had a history of chronic hypertension (36% vs. 17%), used assisted reproductive technology (24% vs. 2%), had chronic liver disease (12% vs. 2%), and had a history of preeclampsia (48% vs. 33%) were at increased risk of developing HELLP syndrome compared to those with gestational hypertension. Conclusion: The study concludes that high-risk factors associated with HELLP syndrome include a family history of preeclampsia, a history of chronic hypertension, gestational diabetes, assisted reproductive technology, chronic liver disease, and multiple pregnancies.

Implementing Self-Help Interventions in Nursing Practice for Children and Adolescents on Mental Health with Risk for Eating Disorders

Anisa Purnamasari — 2025-07-25

Background: Eating disorders are becoming increasingly prevalent among children and adolescents, significantly impacting physical health, mental well-being, social relationships, and academic performance. There is a critical need for effective and accessible interventions, particularly those that incorporate self-help strategies within nursing practice. Objectives: This study aimed to evaluate the effectiveness of a self-help intervention in addressing eating disorders and enhancing mental health among children and adolescents. Methods: A true experimental study with a pretest-post-test control group design was conducted in Kendari City, Southeast Sulawesi, Indonesia. Participants were randomly assigned to either an intervention group (n=51) or a control group (n=51). The self-help intervention comprised modules designed to improve eating behaviours and mental well-being. Data were collected using the SCOFF (Sick, Control, One, Fat, Food) Questionnaire and the Mood and Feelings Questionnaire – Self-Report (MFQ-Self), with statistical analysis performed using the Paired Wilcoxon test. Results: The intervention group showed a significant reduction in eating disorder risk, with the mean SCOFF score decreasing from 3.37 to 1.39, and a notable improvement in mental health, with the mean MFQ-Self score decreasing from 4.06 to 2.59. In contrast, the control group exhibited minimal changes in both measures. The Paired Wilcoxon test confirmed that the improvements in the intervention group were statistically significant (p < 0.001), while the changes in the control group were not. Conclusion: The self-help intervention proved effective in reducing the risk of eating disorders and enhancing mental health among adolescents. This approach represents a promising, cost-effective, and accessible strategy for integration into nursing practice.

Validation of the Bachelor of Science in Nursing Curriculum with a Measure of Achievement of Perceived Learning Outcomes and Students’ Satisfaction

Marilen Pacis — 2025-07-25

Background: As revisions were made on the nursing curriculum, it is the task of the nursing department to meet a high standard level of education to provide to students. Objective: The study aims to validate the BSN curriculum’s adequacy and how it relates to perceived learning outcome achievement and students’ satisfaction. Methods: A descriptive correlational research design was conducted, and a total of 760 nursing students participated in the study. Data were interpreted and analysed using mean distribution and Spearman’s rank order correlation coefficient (r_s). Results: Findings revealed that nursing students perceived the BSN curriculum as adequate with the different areas of the curriculum validation measures. Learning outcomes are perceived to be highly achieved at the end of levels one and two and moderately achieved under levels three and four. Nursing students are moderately satisfied with the BSN curriculum and its components. Results show statistically significant relationships between the extent of adequacy of the curriculum as perceived by the students and their level of satisfaction as to objectives (r_s = 0.480, p = <0.001), with content (r_s = 0.480, p = <0.001), as to faculty members (r_s = 0.50, p = <0.001), as to instruction (r_s = 0.53, p = <0.001), as to evaluative measures (r_s = 0.48, p = <0.001), as to enrichment (r_s = 0.50, p = <0.001), and as to other resources (r_s = 0.45, p = <0.001). Conclusion: The curriculum is effective in preparing the student for the practice of the nursing profession, and it is significantly related to perceived learning outcome achievement and to students’ satisfaction.

Effectiveness of Game-Based Education on Knowledge Levels among Hypertensive Patients at Public Health Centre in Yogyakarta

Theresia Tatik Pujiastuti — 2025-07-25

Background: Hypertension is a significant risk factor for cardiovascular and cerebrovascular diseases and is the focus of ongoing global research. In Indonesia, it is a leading cause of death and ranks among the top ten health issues in Yogyakarta. This study addresses the problem of inadequate knowledge about hypertension, which may result in poor self-care behaviour among patients. Several references suggest that using educational games enhances hypertensive patients' knowledge effectively. Therefore, this research aims to determine the effectiveness of game-based education interventions on knowledge levels among hypertensive patients. Methods: A quantitative analytical descriptive study was conducted involving forty-eight hypertensive patients who were purposively selected from a public health centre in Yogyakarta. These patients participated in an educational intervention for one week. Results: Statistical analysis using a paired t-test revealed a significant difference in the knowledge of hypertensive patients before and after the educational game intervention in the intervention group (p=0.00< 0.05). Furthermore, an independent t-test indicated a significant difference in knowledge levels of hypertensive patients after a game-based education intervention between the intervention and control groups (p=0.00<0.05). Conclusion: The study concludes that hypertension education delivered through games for at least one week can effectively enhance the knowledge levels of hypertensive patients. Therefore, it suggested that educators continually provide educational interventions to improve hypertension patients' knowledge. It has implications for hypertension self-care practices.

Parents' Opinions towards Parental Presence During their Children's Invasive Procedures in the Paediatric Emergency Department: A Descriptive Study

Nesren S. M. Bahnsawy — 2025-07-25

Background: Invasive procedures tended to be more frightening, inducing distress and anxiety in children. Parental presence during such procedures has emerged as a crucial element in paediatric care, offering emotional support and comfort to children. Objective: This study aims to explore parental opinions regarding their presence during their children's invasive procedures in the Paediatric Emergency Department (PED). Methods: A descriptive cross-sectional study design was employed, involving 377 parents from the King Abdullah Specialised Children’s Hospital (KASCH) in Riyadh. Data were collected using a structured questionnaire, the first about the parents' demographic characteristics and the second about parental opinions and expectations regarding parental presence during a child's procedure. Results: The mean age of the participants was 37.49+ 7.96. Most invasive procedures (85%) were blood sampling and peripheral venous catheterisation, while endotracheal intubation and central or arterial catheterisation were less common. Most parents (91.8%) prefer to be present for their child during invasive procedures, with 67% identifying their primary reason as the desire to support and calm their child. Furthermore, significant levels of satisfaction were reported, with 99.7% of parents 94.2% of parents reported obtaining detailed explanations of the procedures, and 77.2% reported finding the explanation very helpful. Conclusion: Most parents prefer to be with their children; the majority of parent opinions emphasise the positive impact on the child's well-being. Further benefits include encouraging relaxation and calm for the child, highlighting the necessity of maintaining togetherness, and preventing child separation anxiety.

Factors Influencing Nursing Students' Motivation to Engage in Volunteering Activities in Indonesia

Suci Tuty Putri — 2025-07-25

Background: Nursing students, equipped with specialised knowledge and skills, have historically played a pivotal role in disaster and outbreak response efforts through their volunteer contributions to the healthcare system. Objectives: This study sought to elucidate the factors influencing nursing students' motivation and preparedness for volunteer engagement in Indonesia. Methods: A cross-sectional study was conducted in the East Java region. A total of 76 students, meeting specific criteria such as being nursing students and having volunteered, were invited to complete an online survey via Google Forms. A questionnaire was used as an instrument for data collection, and data analysis was performed using descriptive statistics and bivariate analysis. Results: The results showed that academic level (p = 0.043), family income (p = 0.007), and motivation to volunteer (p = 0.025) were significantly related to students' decisions to participate as volunteers. While ethical considerations and professional responsibility (G = 0.96, p = 0.381) were the primary reasons for students' willingness to volunteer, concerns about health and safety (G = 0.607, p = 0.015) were the most significant barriers. Despite high motivation among students, certain factors influenced their final decision to volunteer. Conclusion: The study reveals that nursing students in Indonesia are motivated to volunteer in disaster response but are hindered by health and safety concerns.

Contraceptive Knowledge and Attitude of Sabah Married Women

Nor Zehan Ahmad — 2025-07-25

Background: An unplanned pregnancy was identified as a major public health concern worldwide in developed and developing countries. Since nurses are frontline healthcare providers of reproductive health counselling in Malaysia, the present study evaluated the level of knowledge and attitude toward contraception among married women in Sabah, Malaysia. Methods: A cross-sectional study was conducted among 254 women who resided in the Interior and West Coast Division of Sabah, Malaysia. Knowledge and attitude on the contraceptive questionnaire were administered to participants via convenience sampling. The instruments had high level of reliability, with a Cronbach’s alpha coefficient of 0.73 for both knowledge and attitude. Results: The participants’ mean age was 35.20 ±7.189 years. Most respondents (n=92, 36.2%) had poor knowledge of contraceptives, while (n=162, 63.8%) showed a satisfactory attitude towards contraception. Age group, residential address, monthly income, and number of children were significantly associated with women’s knowledge level (p>0.05). Meanwhile, the monthly income and number of children were significantly associated with attitude level of women residing in Sabah (p<0.05). Conclusion: A worryingly high percentage of women in Sabah demonstrated poor knowledge, despite showing a satisfactory attitude. This crucial information can guide targeted interventions to improve contraceptive awareness and uptake. Community health nurse and nurse-midwives can leverage these findings to design targeted, culturally sensitive education and counselling interventions, particularly for lower-income, multiparous, and rural women, to improve contraceptive literacy and uptake.

The Relationship between Shame and Mental Health Problems in Nursing Students Experiencing Bullying at a University in Central Java

Ma’rifatul Ngajib — 2025-07-25

Background: Bullying is a major factor contributing to mental health problems in Indonesia, including depression, anxiety, and stress. Preliminary research found a high rate of bullying among nursing students at a university in Central Java, with verbal bullying being the most common (33.33%). This study explored the relationship between shame and mental health problems in nursing students who have experienced bullying at a university in Central Java. Methods: The research employed a cross-sectional design, targeting a population of 607 students, with a total sample of 265 participants selected through random sampling. The data collection utilised two main instruments: the External and Internal Shame Scale (EISS), which included four valid items measuring internal shame (α=0.850), and the Depression Anxiety Stress Scale (DASS-21), comprising 21 valid items to assess mental health problems (α=0.85, 0.84, 0.84). Pearson’s Product Moment correlation test was applied for data analysis. Results: Results showed a significant correlation between shame and mental health problems (P=0.000, r=0.733), with stress being the most common mental health issue. Conclusion: The study revealed that nursing students who experienced bullying reported high levels of shame, with stress identified as the most prevalent mental health issue. A significant relationship was found between shame and mental health problems, underscoring the urgent need for targeted interventions.

Effect of Implementing Nursing Guidelines on Improving Local Vascular Outcomes among Patients Undergoing Primary Percutaneous Coronary Intervention

Asmaa Badr Mohamed — 2025-07-25

Background: Complications associated with cardiac catheterisation, such as vascular complications, which include haematoma and ecchymosis, are the most frequent and can worsen patient outcomes while exposing patients to longer hospital stays and increased hospital expenses. Nurses can predict complications and reduce the possibility of their occurrence. Objectives: To evaluate the effect of implementing nursing guidelines on improving local vascular outcomes among patients undergoing primary percutaneous coronary intervention. Methods: The study was carried out at a coronary care unit at Heart Hospital of Assiut University, Egypt, using a quasi-experimental research design. A purposive sampling of 150 patients was used. Three tools were utilised to collect data - patient assessment tool, predictive Vascular Complications Risk (VASCOR) score assessment and patients' outcomes tool. Results: The outcomes revealed that study populations were at high risk (78.7% and 73.3%) for developing vascular complications. The difference between study populations was statistically significant for haematoma (p=0.014), insertion site pain (p=0.001) and bleeding (p=0.016) after application of a cold compress. Regarding discharge criteria, the difference between study populations was statistically significant (P value 0.005). Length of stay at CCU was statistically significant (P value 0.001), shorter in the intervention group. Conclusion: The study confirmed that patients' outcomes can improve through early prediction of complications, and nursing guidelines were effective in improving patients' outcomes.

Factors Associated with Accelerated Stunting Reduction among Children Under Five in Designated Quality Family Villages (Kampung KB)

Susi Widiawati — 2025-07-25

Background: The national target for 2024 is that the prevalence of stunting must be achieved at 14%. The success of Jambi Province in realising the target of accelerating stunting reduction in Muaro Jambi Regency by 8.6%. Objective: To determine the factors related to the accelerated reduction in stunting in children under 5 years of age in Muaro Jambi Regency. Methods: Cross-sectional. Sample: 129 parents with children under five using a purposive sampling technique. The instruments used were questionnaires, observation sheets, and focus group discussion guidelines. The research was conducted from July to November 2023. Univariate and bivariate data analysis using the Whitney test and multivariate using the multiple linear regression test. Results: Among the 129 respondents, it was found that 64 (49.6%) respondents had normal toddlers, 77 (59.7%) respondents had a good parental role, 68 (52.7%) respondents stated that the role of the Family Welfare Empowerment (PKK) mobilisation team was good, 77 (59.7%) respondents stated that the role of nurses/midwives was good and 77 (59.7%) respondents stated that the role of posyandu cadres was good. The most significant bivariate result is the relationship between the role of posyandu cadres and the reduction in stunting, (p-value=0.000; OR=13.192) Multivariate results: the most dominant variable in reducing stunting is the role of posyandu cadres (p-value=0.000; OR=13.192). Conclusion: The acceleration of stunting reduction is more dominant in the role of posyandu cadres and is also inseparable from the role of parents, the role of the PKK driving team, and the role of nurses/midwives.

Implementation of ‘Personal Hygiene Independence Table’ in Mental Health Hospitals in Indonesia: A Case Study

Heni Nurhaeni — 2025-07-25

Background: Self-care deficits are common in mental health patients, leading to neglect of basic hygiene tasks like bathing, dressing, and brushing teeth. This neglect can worsen physical health and hinder recovery, impacting both well-being and quality of life. Objective: This study aims to improve personal hygiene among patients with self-care deficits and enhance their independence in performing daily self-care activities. Methods: This study presents a case study focusing on a single patient diagnosed with schizophrenia experiencing self-care deficits. A structured nursing care management plan was implemented, involving psychiatric nursing strategies tailored to the patient's needs. The intervention was closely monitored by a multidisciplinary team, including the medical staff and assigned nurses, who regularly assessed the patient’s progress. Strategies included step-by-step guidance, encouragement, and evaluation of readiness for independence. In the last three days before discharge, the patients showed the ability to communicate effectively and perform self-care activities on their own. Results: Post-implementation results, measured using the Katz Index, indicated marked improvement based on observed performance and daily evaluation scores using the Katz Index in self-care independence, reaching up to 85%. Patients were able to perform essential activities such as bathing, dressing, toileting, and eating. However, some still experienced nighttime continence issues, such as bedwetting. Conclusion: There was a notable increase in self-care independence following the interventions. As recognition for this improvement, the patients receive small rewards as motivation, such as candy from their family. All progress was recorded using the Client Index and reflected in the patient independence table.

Exploring the Impact of the SBAR on Nursing Handover: A Scoping Review

Nurfairy Soed — 2025-07-25

Effective communication during nursing handovers is vital for ensuring patient safety and continuity of care. The SBAR (Situation, Background, Assessment, Recommendation) communication tool offers a structured framework that enhances clarity, efficiency, and reliability during shift transitions. This scoping review assesses the impact of SBAR on nursing handovers, with a focus on its effectiveness in improving communication, reducing errors, and enhancing patient safety. The review methodology guided by the PRISMA-ScR checklist, a systematic literature search was conducted across Medline, CINAHL, EMBASE, and EBSCO databases for the period January 2021 to June 2024. Thematic analysis of the identified studies indicates that SBAR significantly improves communication quality and patient safety, reduces handover-related errors, and promotes teamwork among nursing staff. Three studies reported notable reductions in errors, while two studies documented increased satisfaction among nurses and patients. Additionally, SBAR was associated with educational benefits, including improved knowledge and confidence in the handover process. The structured nature of SBAR contributes to a decrease in sentinel events linked to miscommunication and enhances nurses’ confidence and satisfaction with the handover process, thereby supporting teamwork and overall quality of care. Despite these positive outcomes, challenges remain in its implementation and integration across diverse healthcare settings. Further research is warranted to examine the long-term benefits of SBAR, compare its effectiveness with other communication tools, and optimise its application in varied clinical contexts. Addressing these areas will support SBAR’s continued role in improving nurse performance, patient safety, and healthcare quality.