Jurnal Keperawatan Indonesia

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Jurnal Keperawatan Indonesia — Tue, 31 Mar 2026 00:00:00 +0000

A Systematic Review of Implementing IoT Healthcare Systems: Technological, Organizational, and Ethical Barriers in Rural Settings

Tue, 31 Mar 2026 00:00:00 +0000

The implementation of Internet of Things (IoT) technologies holds transformative potential for healthcare delivery in rural and underserved regions. This systematic review focuses on technological, organizational, and ethical barriers. A comprehensive literature search across six major academic databases yielded eleven empirical studies published between 2015 and 2025. The review adhered to PRISMA protocols, with data synthesized using the Synthesis Without Meta-Analysis (SWiM) guidelines. Findings revealed that technological challenges—such as unreliable internet connectivity, lack of device interoperability, and power supply issues—are widespread across rural implementations. Organizational limitations included inadequate training, resistance to workflow changes, and financial constraints. Ethical concerns primarily involved informed consent, data security, and privacy, often exacerbated by weak regulatory structures and digital illiteracy. Despite these obstacles, successful implementation efforts were marked by community engagement, phased integration strategies, and culturally adapted frameworks. The review underscores the necessity of comprehensive approaches that combine infrastructure development, workforce preparedness, and locally contextualized ethical safeguards. These findings provide a critical foundation for policymakers, system designers, and healthcare practitioners aiming to scale digital health solutions in low-resource settings.

Association of Central Obesity and Hypertension in an Urban Area

Chandrayani Simanjorang, Diva Anita, Ulya Qoulan Karima — Tue, 31 Mar 2026 00:00:00 +0000

Hypertension is one of the non-communicable diseases in Indonesia that is closely related to obesity. Therefore, this study aimed to determine the association between central obesity and hypertension in a cohort study group in Bogor City from 2011 to 2021. A retrospective cohort study design was employed, with multivariate Cox regression analysis performed using secondary data from the Risk Factors for Non-Communicable Diseases (FRPTM) Cohort Study. Among 3,586 samples, 879 incident cases of hypertension were observed by the end of follow-up, accounting for 24.5% of the at-risk population. The incidence rate of hypertension was 28 cases per 1000 people per year, with a cumulative incidence rate of 25%. Multivariate analysis found that people with central obesity (RR: 1.415; 1.181-1.694) had a higher risk of developing hypertension. Other covariates were present, including age (p = 0.000), obesity (p = 0.000), light smoking (p = 0.000), moderate smoking (p = 0.011), and heavy smoking (p = 0.035). The control of central obesity through routine waist circumference screening in primary health care can serve as an important opportunity to prevent hypertension.

Factors Affecting Older Adult Adjustment at A Health Promoting Hospital in Nakhon Phanom, Thailand

Tue, 31 Mar 2026 00:00:00 +0000

Elderly adjustment influences quality of life and well-being and informs appropriate health promotion, holistic care, and health services. This study aimed to investigate the factors influencing the adaptation of older adults by focusing on a study conducted at Dong Kwang Health Promoting Hospital in Nakhon Phanom Province, Thailand. A cross-sectional design was used for the study. The sample consisted of 100 older adults and were selected for data collection from March 22, 2023, to April 20, 2023. The research instruments consisted of questionnaires assessing personal information, spiritual well-being, stress, perceived self-care abilities of older adults, quality of life, and older adult adjustment. The results indicated that the majority of the participants exhibited moderate levels of adjustment, with a mean score of 63.40 (SD = 8.99). A statistically significant correlation was found between stress and adjustment among older adults (r = .381, p = .001). Moreover, stress accounted for 11.00% of the variance in adjustment (p = .001). Nurses are recommended to reduce stress among older adults to enhance their adaptive capacity. Stress reduction interventions for older adults should be prioritized as they can enhance adaptive capacity and improve adjustment and quality of life in early old age.

Prevalence of Fall among Elderly in Rural Sabah and Its Associated Factors

Tue, 31 Mar 2026 00:00:00 +0000

Falls are a leading cause of injury among older adults, often resulting in significant physical, psychological, and social consequences. This study aims to determine the factors that contribute significantly to fall risks among the older adults in rural Sabah. A cross-sectional community study was conducted in the Kudat Division, Sabah, Malaysia from January to June 2021. Using multistage random sampling, 700 adults aged ≥60 years were recruited, excluding those with severe disability, mental illness, or institutionalized. Data were collected through face-to-face interviews with a structured questionnaire adapted from the validated Japanese Gerontological Evaluation Study (JAGES) tool, and anthropometric measures were taken to calculate body mass index (BMI). Logistic regression was performed in SPSS version 27 to identify factors associated with falls. The prevalence of falls among the elderly is 19%. The significant factors include the age ≥80 years old: higher adjusted odds ratio (AOR) for falls (AOR = 2.01); overweight: significantly higher risk (AOR = 4.17); walking difficulty: elevated risk (AOR = 1.69); and poor current health status: increased likelihood of falls (AOR = 1.88). In conclusion, these findings highlight key demographic and health-related factors associated with falls among the rural elderly population, contributing to a clearer understanding of fall risk in non-urban settings.

The Effectiveness of Psychoeducation and Mind Mapping in Preventing Early Marriages in Central Java, Indonesia

Tue, 31 Mar 2026 00:00:00 +0000

During the COVID-19 pandemic, the number of early marriages increased. Early marriage causes biological and psychological problems in the mother and her baby. The combination of psychoeducation and mind mapping emerged as a preventive effort against early marriage. The aim of this study was to analyze the effectiveness of this combination in preventing early marriage in West Java, Indonesia by influencing adolescents’ knowledge and intentions. This study was conducted using a convergent mixed-methods design. For the quantitative phase, the pre-test – post-test control group experimental design was used, while in the qualitative phase, a thematic analysis was performed using focus group discussion (FGD) as an additional evaluation. A total of 32 participants with a history of risky sexual activity and moderate-to-high early marriage intentions were recruited from a Senior High School in West Java during the COVID-19 pandemic using Proportional Random Sampling. Classically, the control group in this study was given standard interventions with education through socialization in one session. The intervention group was given psychoeducation and mind mapping in a 3-hour face-to-face session with an FGD. The data collected were analyzed using a paired-samples t test. This study shows that the provision of psychoeducation interventions combined with mind-mapping techniques was effective in influencing the knowledge and early marriage intentions of adolescents in West Java. The intervention succeeded in increasing the adolescents’ level of knowledge about marriage by 6.78% (ΔMean, 9.89) and reducing their early marriage intentions by 46.29% (ΔMean, 4.31), with significant differences from those of the adolescents in the control group (p = 0.004 and p = 0.001, respectively). Therefore, the combination of psychoeducation and mind mapping can reduce adolescents’ intentions to get married early and increase their knowledge about marriage. This study demonstrates that it can be used as an alternative preventive effort against early marriage.

The Predictive Ability of Child Characteristics and Parenting Factors on Four Developmental Domains in Toddlers

Tue, 31 Mar 2026 00:00:00 +0000

Stunting is a chronic condition that has a significant impact on child development. This phenomenon is primarily caused by prolonged nutritional deficiency, especially during the first 1,000 days of life. In addition, as family factors also play a crucial role in children’s development, this study aims to analyze the influence of child and family characteristics, mother–child attachment, parenting practices, and the nutritional status of children (stunted/non-stunted) on children’s gross motor, fine motor, language, and personal–social skills. This study used a quantitative design with an explanatory approach involving 202 mother–child pairs with children aged 12–36 months. The findings show that healthcare practices (p = 0.016) and male gender (p = 0.050) significantly affected gross motor development (AR² = 0.068), while toddler age (p < 0.001), stunting status (p < 0.001), and healthcare practices (p = 0.042) affected fine motor development (AR² = 0.213). Healthcare practices (p = 0.021) significantly affected language development (AR² = 0.038), while toddler age (p < 0.001), mother–child attachment (p = 0.025), and healthcare practices (p = 0.010) significantly affected personal–social development (AR² = 0.138). Thus, addressing stunting requires cooperation from various stakeholders—including the government, healthcare professionals, the community, and parents—to focus on child- and family-centered approaches.

The Role of Health Workers in Interprofessional Collaboration for Cancer Patient Navigators: A Scoping Review

Tue, 31 Mar 2026 00:00:00 +0000

Cancer remains a leading cause of death worldwide. The complexity of cancer care demands strong interprofessional collaboration (IPC), particularly within cancer patient navigator (CPN) programmes. However, research examining IPC in the context of CPN implementation is still limited. This scoping review aims to explore the various roles of healthcare workers in the IPC process within cancer navigator programme interventions. The review was conducted using four databases: PubMed, Clinical Key, EBSCOhost, and ScienceDirect. The Arksey and O'Malley framework was used to address the research question: “What is the role of health workers in interprofessional collaboration within cancer patient navigation?” Study selection followed the PRISMA-ScR 2020 guidelines, using the following criteria: Population (P): health workers; Concept (C): interprofessional collaboration; and Context (C): hospital and community settings. The inclusion criteria consisted of original articles published between 2019 and 2024, written in English, and discussing interprofessional collaboration in cancer navigation. Review articles, protocols, pilot studies, editorials, and books were excluded from the study. Quality assessment was conducted using the JBI Critical Appraisal tool. Out of 1,150 articles, 13 met the inclusion criteria. The identified roles of health workers included communicator, care provider, care coordinator, service provider, educator, documenter, emotional support provider, and facilitator. These roles appear across the early detection, diagnosis, treatment, and survivorship phases. IPC also has a distinct function within CPN and plays a critical role throughout all phases of cancer care. Future researchers are encouraged to identify barriers to IPC within CPN to support more effective implementation.

Transforming Nursing Clinical Education: The Power of Environment, Student Motivation, and Clinical Instructors

Lia Mulyati, Nur Wulan, Abdal Rohim — Tue, 31 Mar 2026 00:00:00 +0000

Clinical learning is an important component in the formation of nursing students’ professional competence. The clinical environment, student motivation, and the role of clinical instructors are factors that influence the achievement of learning outcomes in nursing clinical practice. However, the relationship between these factors is still not fully understood. This study aims to examine the relationship between the clinical environment, student motivation, and the role of clinical instructors, and to determine how these three factors contribute to learning outcomes in nursing clinical practice. A quantitative design with a cross-sectional survey approach was used. The sample consisted of 117 nursing students, and data were collected through questionnaires. Data analysis was conducted using the Partial Least Squares Structural Equation Modeling (PLS-SEM) method. The results showed that the clinical environment significantly contributed to learning outcomes (p-value 0.001) and student motivation (p-value 0.040). The role of clinical instructors influenced perceptions of the clinical environment (p-value 0.001) and student motivation (p-value 0.001), but did not directly affect learning outcomes. Student motivation contributed significantly to learning outcomes (p-value 0.029). The research model demonstrated a fairly good fit with the data. The clinical environment and student motivation are essential for achieving learning outcomes in nursing clinical practice. The role of clinical instructors contributes indirectly by enhancing student motivation. Educational institutions and hospitals should collaborate to create a conducive learning environment and provide effective training for clinical instructors.

Ventilator Weaning Through Spontaneous Breathing Trials in Children with Tetralogy of Fallot in the PICU: A Case Report

Megah Fitrian, Kadek Ayu Erika, Muhammad Yunus — Tue, 31 Mar 2026 00:00:00 +0000

Tetralogy of Fallot (TOF) is a congenital heart defect that causes chronic low oxygen levels, increased right ventricular workload, and a higher risk of complications. Weaning mechanical ventilation in patients with TOF is particularly challenging due to right ventricular dysfunction, muscle weakness, and the risk of heart failure. This study evaluates the use of a spontaneous breathing trial (SBT) strategy with pressure support ventilation (PSV) mode for mechanical ventilation weaning in pediatric patients with TOF. An observational study was conducted on a six-year-old pediatric patient with TOF and a cerebral abscess who underwent mechanical ventilation weaning using the SBT technique with PSV mode. The patient’s vital signs (heart rate and respiratory rate) and oxygen saturation were monitored 24 h before, during, and 24 h after the trial. Weaning was successfully completed within 11 h without signs of failure, such as hypoxemia or muscle fatigue. The rapid shallow breathing index measured prior to weaning was within an acceptable range. The patient’s physiological parameters remained stable throughout the process, and no Tet spells were observed. These findings suggest that SBT combined with PSV mode is a viable weaning strategy in pediatric TOF cases, particularly when a longer trial duration is used. However, because this report is based on a single case, the results should be interpreted with caution and cannot be generalized to all patients with TOF.

Front Matter (Title Page, Table of Content, General Information, and Editorial Team)

Jurnal Keperawatan Indonesia — Tue, 31 Mar 2026 00:00:00 +0000