The Malaysian Journal of Nursing (MJN)

Toward a Unified Framework of Burnout and Workload in Emergency Care Nursing: A Systematic Review and Conceptual Integration

Hery Wibowo — 2026-05-25

Background: Due to the urgent and unpredictable nature of their clinical settings, emergency care nurses are frequently exposed to high work demands. These persistent pressures can contribute to emotional exhaustion, reduced job satisfaction, and, ultimately, burnout, which significantly impacts their mental health and overall performance. Objectives: This study aims to synthesize the existing theory of burnout and workload in emergency nursing and integrate it into a framework model, addressing gaps in the existing literature. Methods: A systematic literature review was conducted using PRISMA guidelines. A total of 900 relevant articles published between 2022 and 2024 from the Scopus and Science Direct databases were analyzed. This review includes studies on burnout and workload models relevant to emergency nursing. Results: This review identified 11 relevant articles highlighting the link between burnout and workload. It deliberately prioritized studies that concurrently address validated theoretical models of burnout, operational definitions or measurements of workload, and empirical data from emergency department nurses. This tripartite criterion ensured conceptual coherence and contextual relevance, aligning with our aim to develop an integrated framework. Conclusions: This review underscores that burnout among emergency nurses is inextricably linked to multidimensional workload drivers ranging from shift intensity and patient acuity to environmental stressors and cannot be effectively mitigated through isolated interventions. By synthesizing empirical evidence into a unified theoretical framework, this study provides a foundation for context-sensitive, system-level strategies that simultaneously address structural demands and enhance psychological resilience, ultimately safeguarding both workforce well-being and patient care quality in high-acuity settings.

Nurse-Led Interventions in the Comprehensive Management of Patients Undergoing Percutaneous Coronary Intervention (PCI): A Systematic Review

Fadiyatun Naja — 2026-05-25

Background: Nurses play an important role in monitoring and early detection of complications, as well as in managing patients after Percutaneous Coronary Intervention (PCI) to improve clinical outcomes. Previous randomized reviews have mainly focused on physician-led or multidisciplinary PCI care, with limited attention to nurse-led management. Therefore, this review evaluated whether nurse-led interventions across the PCI care continuum provide additional clinical and patient-reported benefits compared with usual care. Methods: This study employed systematic review design and was conducted using four databases: ProQuest, ScienceDirect, EBSCO, and PubMed. The PICO framework was adopted to guide the search strategy, and the PRISMA guidelines were followed. All selected articles were assessed in terms of quality using the Joanna Briggs Institute critical appraisal tools. Results: Based on the search results, 1,412 articles were identified. After removal of duplicates and screening of titles, abstracts, and full texts, 25 articles were included in the final synthesis, comprising 7 articles from ScienceDirect, 14 articles from ProQuest, 2 articles from EBSCO, and 2 articles from PubMed. These articles consisted of randomized controlled trials, cohort studies, and cross-sectional studies. They were categorized into interventions during assessment, pre-PCI procedures, post-PCI procedures, and follow-up care and rehabilitation. Conclusion: This study shows that structured, evidence-based nurse-led interventions significantly improve outcomes in patients undergoing PCI. The findings demonstrated that this model generated was associated with low Major Adverse Cardiovascular Events (MACE) (1.52%) and mortality (0.46%) through structured assessment, reduced anxiety, enhanced procedural readiness (p < 0.05), improved self-care behaviors (p < 0.05), and promotion of recovery and quality of life. Further multicenter studies with long-term follow-up are recommended to validate and generalize these findings across diverse healthcare settings.

Message from the Editor in Chief

Prof. Datuk Dr. Hjh. Bibi Florina Abdullah — 2026-06-03

Effects of an Entrustable Professional Activities (EPA) based Curriculum on the Teaching Performance of Clinical Nursing Instructors

Hsiao-Fang Chen — 2026-05-25

Background: Traditional time-based nursing training may not ensure clinical competence. Therefore, the competency-based Entrustable Professional Activities (EPAs) teaching model has been introduced to help determine a medical trainee’s readiness for independent practice. This study aimed to evaluate the effectiveness of an EPAs measure on clinical instructors and novice nurses. Methods: From November 2023 to January 2025, a structured EPA-based curriculum comprising basic training, expert workshops, and lesson plan development was completed by 30 clinical nursing instructors. The Kirkpatrick four-level model was used for evaluation. Data collection included satisfaction surveys, self-assessment questionnaires, and EPAs entrustment level ratings for novice nurses. The trained instructors subsequently applied the EPA framework to supervise 9 novice nurses, generating 108 entrustment assessments across six biweekly evaluation cycles. Statistical analyses included paired-sample t-tests and the Friedman test. Between December 2024 and March 2025, 9 novice nurses demonstrated significant improvement in entrustment levels across six assessment cycles, with a concurrent downward trend in patient safety incidents. Results: Participants’ satisfaction averaged 4.81 on a 5 point scale. Significant improvements were observed in knowledge, confidence, and teaching skills (p < 0.001). Ten EPA-based lesson plans were developed and implemented in clinical practice. Conclusion: The EPA-based curriculum enhanced teaching effectiveness, novice nurse competence, and patient safety. This model has potential for broader adoption and future digital integration in nursing education.

Nursing Care Guidelines for Nasogastric Tube-Related Hospital-Acquired Pressure Injuries: A Quasi-Experimental Pilot Study

Fatma Soliman AbdElrhman — 2026-05-25

Background: Medical Device–Related Pressure Injuries (MDRPI), including Nasogastric Tube-Related Hospital-Acquired Pressure Injuries (NGT-HAPI), represents a preventable yet frequently overlooked complication in critically ill patients. Appropriate placement, securement, and ongoing monitoring of Nasogastric Tubes (NGT) are essential to minimize associated risks. Objectives: The primary objective is to examine the preliminary effects of implementing nursing care guidelines on the incidence of NGT-HAPI and selected patient outcomes. Methods: A quasi-experimental, non-randomized pilot study was conducted in the intensive care units of Assiut University Hospital, Egypt. A purposive sample of 60 adult patients was allocated into intervention and control groups based on bed availability and clinical flow. Data collection proceeded through three tools: baseline patient assessment, NGT assessment and monitoring, and evaluation of NGT-related pressure injury incidence. Results: There is a statistically significant difference (p-value 0.001) between the study group's 90% of patients who have no stage of NGT-HAPI and the control group's 66.6% who have first-degree and 26.7% who have second-degree NGT-HAPI, and about a quarter (26.7%) in the control group have skin breakdown with a statistically significant difference (p-value 0.004*). Conclusion: Implementation of structured nursing care guidelines was associated with a lower incidence of NGT-HAPI. While findings indicate a positive effect, causal interpretations should be made cautiously due to the quasi-experimental design.

A Nursing Framework for Adolescent Type 2 Diabetes Prevention Based on an Integrated Health Behavior Theory

Indah Puspitasari — 2026-05-25

Background: The increasing prevalence of Type 2 Diabetes Mellitus (T2DM) among adolescents necessitates the development of a nursing-oriented theoretical framework to guide preventive practices addressing lifestyle-related risk behaviors. Existing health behavior theories, including the Health Belief Model, Theory of Planned Behavior, Social Cognitive Theory, and stage-based models, provide valuable insights but remain limited when applied independently. This study proposes the Adolescent Diabetes Prevention Integrated (ADPI) Model as a comprehensive framework integrating rational, emotional, social, behavioral, and ecological dimensions across three motivational phases: pre-motivational (awareness), motivational (intention), and post-motivational (action and maintenance). Methods: This study employed a methodological research design with an embedded cross-sectional empirical validation phase. The model was developed through a structured theoretical synthesis, including narrative review, conceptual analysis, and integrative model construction. The model was empirically tested on 200 senior high school students. Content validity was evaluated through expert judgment, while construct validity and reliability were assessed using Exploratory Factor Analysis (EFA) and internal consistency testing. Structural relationships among variables were analyzed using Structural Equation Modeling (SEM). Results: The model identified four key domains: cognitive–motivational determinants, social–environmental influences, behavioral regulation, and emotional reactivity and support. Content validity was excellent (S-CVI/Ave = 0.94). EFA confirmed a four-factor structure (KMO = 0.89; variance explained = 71.7%). Reliability was high (α = 0.83–0.89; overall α = 0.91). Conclusion: The ADPI Model demonstrates strong validity and reliability, offering a comprehensive, theory-based framework to support evidence-based adolescent T2DM prevention interventions.

Effect of Integrated Palliative Care on Outcomes of Patients with Gynecologic Cancer

Safaa Hegazi Kamel — 2026-05-25

Background: Palliative care nurses typically need to balance symptoms and pain relief. Making the patient as comfortable as possible is the primary responsibility of nurses. Furthermore, they provide essential emotional support to patients and their families, while also educating them on effective symptom-management strategies, including techniques to alleviate anxiety and manage treatment-related side effects. The early involvement of palliative care provides comprehensive care, improving patient outcomes, notably in symptom management, quality of life, and family satisfaction. Objectives: The aim of the study was to evaluate the process of integrated palliative care and its effect on the health of patients with gynecologic cancer. Methods: A quasi-experimental (pre–posttest) design was used. The study was conducted on 70 patients with gynecologic cancer at the Women Health Hospital's gynecologic oncology unit at Assiut University. Two tools were used for data collection: a structured interview and the EORTC-C30 questionnaire, which included 30 items assessing health-related quality of life (Global health status / QoL), functioning scale (cancer patients' role, cognitive, physical, social, and emotional), and symptoms scale. Results: A significant increase in the score of the functioning scale, a decrease in the symptom scale score, and better health-related QoL during the follow-up was observed. Conclusion: The health status of gynecological cancer patients improved after providing palliative care. Recommendations: All patients with gynecologic cancer should receive palliative care beginning with their diagnosis.

Psychological Determinants and their Outcomes among Children with Hearing Impairment

Nabaa Hussein Eidan — 2026-05-25

Background: Children with hearing impairments face numerous challenges in their psychosocial development. Making it essential to study the psychological determinants that shape their experiences and psychological outcomes. Among these determinants are self-esteem and self-efficacy, which may be linked to various aspects of mental health, such as emotional symptoms and behavioral problems. Objectives: This study aims to assess the psychological determinants and their outcomes among hearing-impaired children and to identify the relationship between certain demographic characteristics in children with hearing impairment. Methods: A cross-sectional study was conducted on a sample of 100 children with hearing impairment and their parents enrolled in hearing and speech centers at Al-Hilla city. The study used modified and developed questionnaires for the purpose of study. Data was collected through interviews and analyzed electronically by using SPSS 27. Results: The results indicate that more than half of the children showed moderate levels of psychological determinants. Psychological outcomes were also at a moderate level. Furthermore, the psychological outcomes were moderate level. The study found a strong correlation between variables and a strong association with specific demographic data such as parental education, occupation, economic status, and residency at a p-value of 0.05. Conclusion: This study emphasizes the importance of integrating psychiatric and pediatric nursing within multidisciplinary care teams and the necessity of developing specialized psychological support programs based on a holistic approach that includes the child, family, and surrounding environment. It also recommends conducting future longitudinal studies to monitor psychological changes across developmental stages, focusing on the effectiveness of nursing interventions in improving the mental health of this group.

Nurses’ Roles in Empowering Mothers of Low Birth Weight Infants: A Phenomenological Study

Iis Aisyah — 2026-05-25

Background: Low Birth Weight (LBW) infants are highly vulnerable to hypothermia, infection, and developmental complications, requiring comprehensive nursing care. However, the integration of maternal empowerment into neonatal care in hospital settings, particularly in Sumedang District, Indonesia, remains underexplored due to contextual and systemic challenges. Objectives: This study aimed to explore nurses’ experiences, challenges, and strategies in assisting mothers of LBW infants. Methods: A qualitative phenomenological design was employed in a hospital-based neonatal setting. Participants were selected using purposive sampling, involving 15 participants (eight nurses, four head nurses, and three mothers for triangulation). Data were collected through in-depth interviews, observations, and document analysis and analyzed using thematic analysis. Credibility was ensured through triangulation and member checking, with ethical approval obtained prior to the study. Results: Five themes emerged: holistic accompaniment, psychological and cultural challenges, institutional supports and barriers, adaptive communication strategies, and impacts on maternal readiness. Nurses acted as educators and emotional supporters, although constrained by limited resources and lack of structured guidelines. Conclusion: Flexible, empathetic, and context-sensitive accompaniment enhances maternal confidence and readiness. The findings support the development of training programs, family-centered care, and institutional policies to strengthen neonatal care in resource-limited settings. This study also contributes to the achievement of the United Nations, particularly SDG 3 (Good Health and Well-Being) and SDG 10 (Reduced Inequalities) through improved and equitable maternal and neonatal healthcare services.

Understanding Patient Satisfaction: The Predominant Influence of Professionalism over Emotional Intelligence in Nursing Students’ Clinical Performance

Abdulhakeem Jamil Ahmed — 2026-05-25

Background: Professionalism and emotional intelligence (EI) are essential attributes in nursing that significantly shape patient care experiences. While these traits are well-studied among practicing nurses, limited research has explored their impact when demonstrated by nursing students during clinical training. Objectives: This study aimed to investigate the relationship between nursing students' emotional intelligence and professionalism and patients' perceptions of professionalism and treatment satisfaction in a clinical education setting. Methods: A descriptive correlational cross-sectional design was employed. The study involved 100 final-year nursing students from Ninevah University, Iraq and 100 patients who had received care from these students. Standardized self-report tools were used to assess students' emotional intelligence and professionalism. Patients evaluated their perceptions of students' professionalism and their satisfaction with care. Descriptive statistics, Pearson correlation, and multiple linear regression analyses were conducted using SPSS version 25. Results: Emotional intelligence and professionalism were both positively and significantly correlated with patient-perceived professionalism (r = 0.42 and 0.53, respectively; p < 0.001) and patient satisfaction (r = 0.36 and 0.47, respectively; p < 0.01). Regression analysis further demonstrated that emotional intelligence (β = 0.28, p = 0.002) and professionalism (β = 0.44, p < 0.001) were significant predictors of patient satisfaction, with professionalism exerting a stronger influence. Although patients rated students in surgical wards and female students slightly higher in satisfaction and perceived professionalism, these differences were not statistically significant. Conclusion: Nursing students' emotional intelligence and professionalism play an important part in determining patients' perceptions of care and satisfaction, even during their training. These findings highlight the importance of integrating emotional and professional competency development into nursing education to promote patient-centered care.

The Paradox of Nursing Informatics Competencies: Implications for Nursing Care Quality in Ghana

Eric Kanyire Bachiere — 2026-05-25

Introduction: Nursing Informatics Competencies (NIC) have become essential for effective healthcare delivery in the digital era. They encompass informatics skills, computer skills, and informatics knowledge, all of which support accurate documentation, decision-making, and patient-centered care. Despite their importance, limited research has examined how NICs influence the quality of nursing care in Ghana, where digital health integration is still evolving. Methods: This study employed a quantitative cross-sectional survey design, involving 354 registered nurses in the Sekondi-Takoradi Metropolitan Area, Ghana. A structured questionnaire measured NIC domains and quality of nursing care. Data analysis was performed using descriptive statistics, correlation, and multiple regression, with significance set at p ≤ 0.05. Results: Nurses reported high perceptions of quality nursing care (M = 4.13, SD = 0.749). NIC levels were moderate, with informatics skills rated higher than computer skills and informatics knowledge. Correlation analysis revealed significant negative associations between NIC domains and quality of nursing care: informatics skills (r = –0.36, p <0.001), computer skills (r = –0.459, p <0.001), and informatics knowledge (r = –0.511, p <0.001). Regression analysis showed that NIC collectively explained 28.2% of the variance in care quality (R² = 0.282, F(3,353) = 45.796, p ≤0.001). Informatics skills had a positive effect, while computer skills and informatics knowledge negatively predicted care quality. Conclusion: This study shows that while practical informatics skills enhance nursing care, inadequate integration of theoretical and basic computer skills and knowledge may hinder bedside practice. Nursing education should emphasize experiential, competency-based training, and policies must strengthen digital infrastructure to ensure informatics supports rather than disrupts quality care in Ghana.

Exploring the Relationship between Work–Life Balance and Work Engagement among Staff Nurses at a Tertiary Care Centre: A Cross-Sectional Study

Kalaiyarasi Balakrishnan — 2026-05-25

Background: Work-life balance is the balance between work and personal life that is important for employee health and productivity. Nursing is a very stressful job, so keeping this balance helps nurses provide better care, stay healthy, and make their clients happier by doing better work and being more involved. Objectives: To identify the correlation between work-life balance and work engagement among the nursing staff in a tertiary care center. Methods: A cross-sectional descriptive correlational study was performed among 250 staff nurses chosen through convenience sampling from a tertiary care hospital. Data were gathered using the Work–Life Balance Scale and the Utrecht Work Engagement Scale (UWES-17) and analyzed using descriptive and inferential statistics methods. Results: The study determined that 48.8% of nurses reported a high level of work-life balance, and 32.8% had a moderate level. As for work engagement, 28.4% were very highly engaged and 23.6% highly engaged. The mean ± standard deviation of the work-life balance score was 62.58 ± 14.95, whereas the average work engagement score was 3.59 ± 1.71. There was a statistically significant moderate positive correlation between work-life balance and work engagement (r = 0.427, p < 0.001). Family type (p = 0.008) and number of children (p = 0.019) were significantly related to work-life balance, whereas gender was significantly associated with work engagement (p = 0.039). Conclusion: The findings highlight the importance of promoting organizational policies and interventions, flexible scheduling, adequate staffing, and psychological support, which may enhance work-life balance and engagement, improve job satisfaction, and ensure quality care delivery.

Healthcare Workers’ Knowledge and Attitudes toward Elderly Care in Malaysian Public Hospitals: A Single-Centre Cross-Sectional Study

Azura Abdul Halain — 2026-05-25

Background: Aging is a natural part of life, and the number of elderly people is rapidly increasing globally and in Malaysia. Many elderly individuals experience chronic health problems that require specialized nursing care. Healthcare workers, particularly nurses, who lack sufficient knowledge or positive attitudes toward elderly care may deliver suboptimal care, affecting both patients and the healthcare system. Objectives: This study aimed to assess healthcare workers’ knowledge and attitudes toward elderly care in a Malaysian public hospital and discuss nursing implications to improve gerontology practice. Methods: This cross-sectional study was conducted in a single public hospital between September 2018 to June 2019. Using convenience sampling, a total of 304 healthcare workers, including doctors, nurses, dentists, and allied health professionals, were recruited, yielding a response rate of 92.12%. Data was collected using validated self-administered questionnaires: the Facts on Aging Quiz 2 (FAQ-2) to assess knowledge and Kogan’s Attitude toward Old People Scale (KOP) to evaluate attitudes. Data analysis was performed using SPSS version 22.0. Results: The mean ± SD score for knowledge on aging was 9.16 ± 1.03, while the mean ± SD score for attitudes toward the elderly was 38.00 ± 5.14. A significant association was found between the highest educational qualification and both knowledge (p=0.011) and attitude (p<0.001) scores. Conclusion: Educational level significantly influences healthcare workers’ knowledge and attitudes toward elderly care, with exposure to elderly care also playing a role. Enhancing awareness and understanding of aging among healthcare workers is essential to fostering empathy and improving attitudes, ultimately improving the quality of care for elderly patients.

Effect of Staff Wellness Programs on Nurses’ Perceptions of Supporting Healthy Behaviors in R2 Healthcare Settings, Riyadh, Kingdom of Saudi Arabia

Premalatha Jayachandra — 2026-06-03

Background: Nurses commonly experience high levels of occupational stress that can negatively influence their emotional health, job performance, and the quality of patient care. Workplace wellness programs that include interventions such as counseling support, recreational activities, creative therapies, and lifestyle coaching have been introduced to improve well-being; however, evidence on their effectiveness in hospital nursing populations remains limited. Objectives: This study aimed to assess the impact of a Staff Wellness Program on reducing psychological distress and enhancing nurses’ perceptions of organizational support for healthy behaviors. Methods: A quantitative pretest–posttest design was carried out among registered nurses working across 12 hospitals in the Riyadh Second Healthcare Cluster (R2), Kingdom of Saudi Arabia, administered by King Fahad Medical City (KFMC). Participation was voluntary following institutional invitations. Due to logistical arrangements, baseline assessment and program implementation were conducted at PIMA Hospital during a Staff Wellness Day. Data were collected at baseline and three months post-intervention using a structured electronic questionnaire accessed via QR code with online informed consent. Psychological distress was measured using the General Health Questionnaire-12 (GHQ-12), while perceptions of healthy behavior support were assessed using a validated scale. Data analysis included paired t-tests, McNemar test, and Pearson correlation, with reliability confirmed using Cronbach’s alpha and intraclass correlation coefficients. Results: There was a statistically significant reduction in GHQ-12 scores after the intervention (mean difference = -3.88, p < 0.001), indicating improved psychological well-being. Healthy behavior perception scores showed a significant increase (mean difference = 9.14, p < 0.001), corresponding to a 16.22% improvement. Post-intervention findings demonstrated a transition from moderate to higher levels of positive perception, with an increase in the “very high” category (32.8%) and a reduction in the “low” category (6.8%). A significant inverse correlation was found between psychological distress and healthy behavior perception (r = −0.37, p = 0.01). Age emerged as the only demographic factor significantly associated with post-test distress levels. Conclusion: The Staff Wellness Program demonstrated effectiveness in reducing psychological distress and improving nurses’ perceptions of workplace wellness support. These results highlight the value of structured wellness initiatives in enhancing nurses’ psychological well-being and promoting positive workplace behaviors. Continued implementation of such programs is recommended to strengthen resilience, support well-being, and improve the quality of patient care.

Impact of Seasonal Variation on Health-Related Quality of Life and Lung Function among Patients with Bronchial Asthma

Shahinda Ahmed Hosny — 2026-05-25

Background: Seasonal variations may affect asthma symptoms, lung function, and patients’ health-related quality of life (HRQoL). Objectives: This study aimed to examine the association between seasonal variation, HRQoL, and lung function among patients with bronchial asthma. Methods: A descriptive cross-sectional study was conducted among 497 patients attending inpatient and outpatient clinics at the Chest Department of Assiut University Hospital, Egypt. Data were collected through structured interviews, the Mini Asthma Quality of Life Questionnaire (Mini AQLQ), the Lung Function Questionnaire, and spirometry measurements, including forced expiratory volume in one second (FEV₁) and forced vital capacity (FVC). Seasonal variation data were categorized, and both descriptive statistics and bivariate analyses were used to assess the relationships between seasons, respiratory symptoms, lung function, and HRQoL. Results: Respiratory symptoms, including wheezing, cough, and nocturnal breathlessness, were more prevalent during colder seasons. HRQoL scores were lower in winter, while lung function demonstrated modest seasonal variation, with relatively better values observed during warmer months. Conclusion: Seasonal variation is associated with changes in asthma symptoms, lung function, and HRQoL. These findings highlight the importance of considering seasonal environmental factors in the management of bronchial asthma. This study provides novel evidence on the seasonal impact on both physiological and quality-of-life outcomes among asthma patients in Upper Egypt.

Lifestyle Characteristics among Women Experiencing Spontaneous Abortion: A Nursing Perspective from Mosul, Iraq

Noor Qassim Yehya — 2026-05-25

Background: Spontaneous abortion (miscarriage) is a common early pregnancy complication influenced by modifiable lifestyle factors. Recognizing these factors is vital for developing nursing interventions to improve maternal outcomes. Objectives: This study aimed to investigate the distribution of selected lifestyle factors among women with spontaneous abortion attending teaching hospitals in Mosul City, Iraq. Methods: A descriptive cross-sectional study was conducted from November 2023 to June 2024 involving 200 women with clinically confirmed spontaneous abortion at three major teaching hospitals in Mosul. Data was collected using structured face-to-face interviews based on a validated questionnaire. Statistical analysis was performed using SPSS version 26, with a significance level set at p<0.05. Results: This study found significant associations between spontaneous abortion and poor nutrition (p=0.037), low physical activity (p=0.030), high psychological stress (p = 0.007), and irregular sleep patterns (p=0.027). However, no significant associations were observed with smoking, drug use, or environmental exposure. Only 26.7% of participants demonstrated good lifestyle adherence, while 73.3% exhibited fair to poor adherence. Conclusion: The findings underscore the critical influence of modifiable lifestyle factors on pregnancy outcomes and highlight the essential role of nursing professionals in providing lifestyle-based education and support. Integrating lifestyle assessment and counseling into maternal care may contribute to the reduction of preventable pregnancy losses.

Modified Dry Cupping for Back Pain in Older Adults: A Nursing Innovation in Complementary Therapy

Lisnawati Lisnawati — 2026-05-25

Background: Back pain is a common musculoskeletal problem among older adults, leading to reduced mobility, loss of independence, and decreased quality of life. Although dry cupping therapy has been shown to alleviate pain, its conventional application requires therapist supervision, limiting accessibility for the elderly. Objectives: This study aimed to evaluate the effectiveness of a modified dry cupping therapy device with an automatic control system as an innovative complementary nursing intervention for reducing back pain and promoting self-care in older adults. Methods: A quasi-experimental two-group pretest–posttest design was conducted with 102 elderly participants in Kendari City, divided equally into an intervention and control group (n = 51 each); the analysis used a paired-sample t-test. Results: At baseline, both groups reported moderate back pain (intervention: mean = 5.12 ± 0.52; control: mean = 5.10 ± 0.36). Following the intervention, the intervention group demonstrated a significant reduction in pain intensity (mean = 2.76 ± 0.65, p < 0.001, Cohen's d = 4.01), with 98% of participants reporting mild pain. In contrast, the control group showed no significant change (mean = 5.10 ± 0.36, p = 1.000). The between-group comparison confirmed a significant difference (mean difference = 2.34, 95% CI: 2.13-2.55, p < 0.001). Conclusion: Modified dry cupping therapy with an automatic control system is an effective, safe, and practical complementary nursing intervention for reducing back pain in older adults. This innovation supports self-care independence and may be integrated into community and gerontological nursing practices.

Investigating the Relationship between the Proximity of Cell Phone Towers to Residential Areas and Health Symptoms in Adolescents: A Study from Maysan Governorate

Mahdi Abed Neamah AL Musawi — 2026-05-25

Background: The proliferation of cell phone towers in residential areas has prompted concerns about potential health effects, particularly on adolescents who may be more susceptible to Electromagnetic Fields (EMF). Objectives: This study aimed to investigate the health impacts of EMF emitted by cell phone towers on adolescents in Missan Province. Methods: Conducted from (January 2024 and June 2024), this study involved 150 adolescents aged 12-18 years. Participants were categorized based on their proximity to cell phone towers (100-200m, 201-350m, and 351-500m). Results: Adolescents living within 100-200 meters of cell phone towers reported significantly higher rates of headaches (60%), sleep disturbances (52%), and difficulty concentrating (44%) compared to those living further away. Conclusion: This study suggests a potential association between proximity to cell phone towers and increased prevalence of certain health symptoms among adolescents, particularly headaches, sleep disturbances, and difficulty concentrating. Recommendations: These findings highlight the need for further research into the long-term health effects of EMF exposure on this vulnerable age group. Given the widespread use of mobile technology, understanding these impacts is crucial for informing future health guidelines and regulatory policies.