Journal of Public Health Sciences

Effectiveness of Sajie Care Application in Reducing Stress: A Quasi-Experimental Study

Isymiarni Syarif — 2026-05-14

This study evaluated the effectiveness of the Sajie Care mobile application in reducing stress among caregivers of individuals with schizophrenia. A quasi-experimental pretest–posttest control group design was conducted with 64 caregivers in Labakkang Sub-district, South Sulawesi, Indonesia. Participants were divided into an intervention group using the Sajie Care app (n = 32) and a control group receiving leaflet-based psychoeducation (n = 32). The three-month intervention integrated stress management education, Spiritual Emotional Freedom Technique (SEFT) therapy, medication reminders, and peer support. Stress levels were assessed using the Indonesian version of the Perceived Stress Scale (PSS-10). The intervention group showed a significant reduction in mean stress scores from 17.84 to 13.06 (p < 0.001), while the control group showed a smaller, non-significant change (16.84 to 15.75; p = 0.070). Between-group analysis confirmed significant differences at posttest 3 (p = 0.014). These findings indicate that Sajie Care effectively reduces caregiver stress and enhances coping capacity compared to conventional psychoeducation. The study demonstrates the potential of culturally adapted mobile health interventions as accessible, sustainable tools to strengthen community-based mental health services in low-resource settings.

Evaluating the Quality of Health Services for BPJS Nasional Indonesia Beneficiaries Using the Servqual Model

Sudirman — 2026-05-15

Evaluating the quality of health services for BPJS participants is essential to ensure the effectiveness and sustainability of the National Health Insurance program. Although patient visits at the Tinggede Community Health Center have continued to rise, this increase has not been matched by improvements in service quality, highlighting the need for a structured assessment of patient needs. This study aims to evaluate patient perceptions of service quality using the ServQual model, which consists of five key dimensions: Reliability, Responsiveness, Assurance, Empathy, and Tangible. A quantitative cross-sectional design was employed involving 96 BPJS beneficiary respondents. Data were collected through a Likert scale–based questionnaire and analyzed using the Friedman test to compare perceptions across dimensions. Results show that Assurance and Responsiveness received the highest ratings, while Tangible scored the lowest and differed significantly from the top two dimensions. These findings indicate that non-physical elements, particularly competence, trustworthiness, and timely responses from healthcare workers, play a greater role in shaping patient satisfaction than physical facilities. The study contributes empirical evidence on priority areas for improving service quality in primary health care settings. Practical implications include enhancing staff competencies, streamlining service flow to reduce waiting times, and strengthening empathetic communication. The study concludes that efforts to improve service quality should prioritize non-physical dimensions that have the strongest influence on patient experience. Recommendations include ongoing quality evaluations, broader adoption of digital services, and expanding future studies to different regions and populations to deepen understanding of service quality determinants.

The Relationship between the Albumin-Bilirubin Ratio and Frailty in Patients with Liver Cirrhosis

Triyanta Yuli Pramana — 2026-05-22

Patients with liver cirrhosis are at risk of impaired liver function, characterized by disturbances in albumin synthesis and bilirubin secretion. The Albumin-Bilirubin (ALBI) score has been reported to be associated with the prognosis of liver cirrhosis patients. This study aimed to analyze the relationship between the ALBI score and frailty in patients with liver cirrhosis. A cross-sectional study was conducted at Dr. Moewardi General Hospital from May to September 2024. A total of 68 patients with liver cirrhosis were included. The dependent variable was frailty, while the independent variable was the ALBI score. Data were collected via a questionnaire and laboratory results, and analyzed using logistic regression. This study found a significant association between a higher ALBI score and frailty in patients with liver cirrhosis. After correcting for data entry errors, the re-analyzed data showed a significant association. A one-unit increase in the ALBI score was associated with a significant increase in the odds of frailty (OR = 13.32; 95% CI = 1.31 to 135.48; p = 0.029). These findings suggest a significant relationship between the ALBI score and frailty in patients with liver cirrhosis, indicating that patients with more severe liver dysfunction (reflected by a higher ALBI score) are more likely to be frail.

Biopsychosocial Determinants of Depressive Symptoms among Middle-Aged Adults in Indonesia

Sylivia Lugereka — 2026-05-23

Depression has been recognized as a major public health issue that affects middle-aged people in developing countries. The research explored how diabetes mellitus and stroke history affected depressive symptoms in Indonesian among middle-aged adults. This is a cross-sectional study that used data from the IFLS-5, which included 7,503 participants. Weighted descriptive, bivariate, and multivariable logistic regression analyses were performed. The prevalence of depressive symptoms was 17.72%, while 5.62% reported diabetes and 1.00% reported stroke. In adjusted analysis, diabetes only ((AOR = 0.77; 95% CI: 0.57–1.03; p= 0.082)), stroke only (AOR = 1.32; 95% CI: 0.70–2.52; p= 0.387), and combined diabetes and stroke (AOR = 0.91; 95% CI: 0.18–4.50; p= 0.912) were not significantly associated with depressive symptoms. Female (AOR = 1.20; 95% CI: 1.05–1.39; p= 0.009), unhealthy self-rated health (AOR= 2.48; 95% CI: 2.17–2.84; p= 0.001), and lack of community participation (AOR = 0.86; 95% CI: 0.74–0.99; p= 0.043) were significant. However, BMI had lower odds of depressive symptoms. Marital status, education, residence, smoking status, and physical activity were not significantly associated with depressive symptoms. These findings suggest that psychosocial and perceptual factors play a more prominent role in midlife depressive symptoms than chronic disease status. Integrated public health strategies addressing self-perceived health, social engagement, and gender disparities are necessary.

Earphone Use Patterns and Hearing Loss Risk Affecting Quality of Life

Lina Marliana — 2026-05-23

In today's modern life, most people are constantly exposed to noise every day, potentially disrupting their hearing function. One such factor is the use of hearing devices, namely earphones. Approximately 1.1 billion young adults and adolescents are at risk of experiencing hearing loss in their lifetime. If someone is at risk of hearing loss, it can undoubtedly impact their quality of life. Participants in this study were students at the Christian University of Indonesia in 2019, 2020, and 2021. The purpose of this study was to determine whether risky earphone use patterns are associated with quality of life. Data for this study were collected using a cross-sectional observational analytical methodology with a consecutive sampling technique. The study sample was assessed with a questionnaire created using Google Forms. The questionnaire, which is divided into two parts: the Earphone Use Pattern Questionnaire (PPE) and the Hearing Handicap Inventory for Adults (HHIA), to determine the patient's quality of life, was then analyzed using the Chi-Square and Spearman tests. Of the 225 respondents, there were 62.2% risky earphone usage patterns and 37.8% non-risky earphone users. According to the HHIA score findings, 74.2% of people had no disabilities, 9.8% had mild to moderate disabilities, and 16.0% had severe disabilities, with p = 0.015 (p <0.05) obtained through the use of the Chi-Square statistical test. There is a relationship between earphone usage patterns and the risk of hearing loss, which affects the quality of life of students of the Faculty of Medicine, Universitas Kristen Indonesia, Class of 2019, 2020, and 2021.

Predictive Statistical Modeling of Unemployment-Related Lack of Health Insurance Coverage among US Adults

Emmanuel Thompson — 2026-05-23

The study aimed to develop an accurate predictive model to identify individuals without health insurance due to unemployment. The study participants comprised 2,496 individuals who lacked general health insurance coverage in the United States for the period 2020-2023. Microdata records from the National Health Interview Survey available in the Integrated Public Use Microdata Series (IPUMS) served as the data source. The response variable was a binary variable indicating whether an individual had no health insurance (uninsured) due to unemployment. Statistical analyses involved descriptive measures: frequencies, percentages, and quartiles and inferential tests: Pearson’s chi-squared test, Wilcoxon rank-sum test, and Goodman and Kruskal’s measures. For predictive analysis, data were partitioned into training and testing sets, with class imbalance addressed using the Synthetic Minority Over-sampling Technique (SMOTE). Binary logistic regression and probit models were applied, and model performance was assessed using accuracy, precision, recall, and F1 score. Most participants reported being in good, very good, or excellent health. The demographic and health-related factors in this study had limited standalone predictive values. However, Probit and Logit models identified obesity, age, lower education, and lack of healthcare access as critical risk factors. Furthermore, the prediction performance metrics for both Logit and Probit models were identical.

Community Health Worker Empowerment and Pregnant Women’s Compliance with the P4K Program in Penfui Timur, Nusa Tenggara Timur

Serlyansie Boimau — 2026-07-07

This article reports an analysis of the relationship between the level of cadre empowerment and pregnant women’s compliance with the implementation of the Birth Planning and Complication Prevention Program (P4K). The study employed a cross-sectional survey design conducted in Penfui Timur Village, Kupang Regency, involving 30 community health cadres. Cadre empowerment was assessed through dimensions of knowledge, skills, support, and participation, while pregnant women’s compliance served as the dependent variable. Data were collected using structured questionnaires and analyzed using univariate analysis, bivariate analysis with the Chi-square test, and multivariate analysis using logistic regression. The results showed a significant association between cadre empowerment and pregnant women’s compliance with P4K implementation (p = 0.012). Cadres with a high level of empowerment were more effective in assisting compliant pregnant women compared to those with lower levels of empowerment. Participation in P4K training also had a significant effect on improving pregnant women’s compliance (p = 0.021). These findings indicate that cadre empowerment and training are key factors in enhancing pregnant women’s compliance with the P4K program. Strengthening cadre capacity through continuous training and institutional support is therefore necessary to optimize program implementation at the community level.

Association Between Body Mass Index and Serum Urea Levels Among Women of Reproductive Age in Waihaong Village, Maluku, Indonesia

Syah Mutiara — 2026-07-11

Chronic kidney disease (CKD) is a growing global health concern, highlighting the importance of identifying modifiable risk factors that affect renal function. Nutritional status, commonly reflected by Body Mass Index (BMI), is one such factor, while serum urea serves as a key biomarker of kidney function. This study examined the relationship between BMI and serum urea levels among women of reproductive age in Waihaong Village. Using a cross-sectional analytical design, 75 participants were selected through purposive sampling. Data collection included informed consent, 10–12 hours fasting, BMI measurement, venous blood sampling, and serum urea analysis. Data were processed with SPSS using the Spearman correlation and multiple regression tests. Results revealed a significant positive correlation between BMI and serum urea levels (r = 0.259, p = 0.025). The median serum urea concentration was 18.3 mg/dL (range: 12.8–37.4 mg/dL), remaining within normal limits. The Kruskal–Wallis test showed no significant difference among BMI categories (χ² = 7.792, p = 0.100), although mean rank values indicated a trend of increasing urea with higher BMI. Multiple linear regression indicated that BMI significantly influenced serum urea (β = 1.045, p = 0.031) after adjusting for diet and physical activity, while other variables showed no significant associations (p > 0.05). The model’s stability was confirmed (VIF < 2). In conclusion, higher BMI is associated with increased serum urea levels, suggesting the need for routine BMI screening to help detect early kidney dysfunction in women of reproductive age.

Effect of Date Fruit Consumption on Hemoglobin Levels in Anemic Adolescent Girls

Indryani — 2026-07-12

Anemia among adolescent girls remains a persistent public health problem, particularly in low- and middle-income countries, where increased nutritional requirements and menstrual blood loss elevate the risk of iron deficiency. Although iron supplementation is the primary preventive strategy, low adherence among adolescents necessitates complementary approaches. This study aimed to evaluate the effect of date fruit consumption on hemoglobin levels among anemic adolescent girls. A quantitative pre-experimental study with a one-group pretest–posttest design was conducted in a school setting in South Sulawesi, Indonesia. Hemoglobin screening was performed on 70 adolescent girls, and 10 anemic participants were selected using purposive sampling. The intervention consisted of consuming 100 g of date fruit (approximately 7–8 fruits) daily for seven consecutive days. Hemoglobin levels were measured before and after the intervention using a portable hemoglobin analyzer. Data were analyzed using descriptive statistics and the Wilcoxon Signed-Rank Test, with statistical significance set at p < 0.05. Mean hemoglobin levels increased significantly from 11.09 g/dL at baseline to 13.38 g/dL after the intervention, with an average increase of 2.29 g/dL (p = 0.005). These findings suggest that short-term date fruit consumption significantly improves hemoglobin levels among anemic adolescent girls. In conclusion, date fruit represents a feasible, culturally acceptable, food-based nutraceutical intervention that may complement existing anemia prevention programs. Further randomized controlled studies with larger samples and longer follow-up are recommended to confirm these findings and evaluate their long-term effectiveness.

Psychological and Sensory Determinants of Fall Risk among Older Adults

Lina Safarina — 2026-07-13

Falls represent a significant health issue among the elderly worldwide, particularly those residing in long-term care institutions. Although physical and environmental causes have been widely examined, there is limited research within Indonesian settings that investigates how psychological and sensory factors contribute to fall risk in institutionalized older adults. This study explores the association between psychological and sensory factors with the risk of falls among elderly individuals living in Indonesian care facilities. A cross-sectional analytical study was carried out involving 100 individuals aged 60 years and older in various long-term care homes across Indonesia. Data were obtained through structured interviews using standardized tools. Bivariate analyses were then analyzed using multivariable logistic regression to determine independent predictors. Out of all participants, 46% were found to have a heightened risk of falling. Multivariate analysis showed that higher levels of fear of falling (OR = 1.15; 95% CI: 1.04–1.28; p = 0.006), anxiety (OR = 2.97; p = 0.005), depression (OR = 2.85; p = 0.008), poor sleep quality (OR = 3.81; p = 0.001), visual problems (OR = 2.14; p = 0.038), hearing challenges (OR = 2.50; p = 0.022), and advancing age (OR = 1.04; p = 0.049) were all significantly linked to fall risk. This study highlights that psychological and sensory health significantly impact fall vulnerability among elderly residents in care institutions. Incorporating these often-overlooked dimensions into routine fall risk assessments may enhance preventative care approaches.

The Effectiveness of Combined Hatha Yoga and Tandem Walking Exercise on Sleep Quality

Nikmatur Rosidah — 2026-07-13

To improve sleep quality, the use of a combination of relaxation techniques and physical fitness training has been suggested. This study aimed to assess the impact of a combined Hatha Yoga and Tandem Walking program on improving the quality of sleep in older adults in Malang, Indonesia. A one-group pre-post experimental design was used in this study. A total of 30 elderly participants participated and received a combination of Hatha yoga and tandem walking exercise for 30–45 minutes, for a total of 12 sessions. Pittsburgh sleep quality index used to measure the quality of sleep of the participants. Wilcoxon signed-rank test used for data analysis, and statistically significant set at 0.05. This study resulted in a substantial enhancement in sleep quality after 6 weeks of combined Hatha Yoga and Tandem Walking exercise, with the mean PSQI score decreasing from 9.32 ± 1.70 to 4.24 ± 0.75 and 81% of the participants experiencing good sleep quality (p = 0.001) after the intervention. The combination of Hatha Yoga and Tandem Walking is an effective and safe non-pharmacological intervention to improve sleep quality in older adults and support healthy aging. For optimal results, this intervention can be practiced regularly and incorporated into a program for senior communities.

The Effect of Storytelling Intervention on the Mental Health of Preschool Children

Chatarina Suryaningsih — 2026-07-14

Every year, around 24.6% of children aged 0-17 years in the world experience mental health problems. One of the efforts to improve mental health is the introduction of reading from an early age through storytelling. The purpose of this study is to analyze the effect of storytelling intervention on mental health in preschool children. This research uses a Quasi-experimental design through the Nonequivalent Control Group Design approach. Sampling used the total sampling technique with a total of 61 children enrolled in Kartika VIII-42 Cimahi Kindergarten. Data were obtained using the Strength Difficulties Questionnaire. The tests used were the dependent t-test and the independent t-test. The results of the study were obtained in the intervention group; the mean before the intervention was 8.88 and the mean after the intervention was 6.69. In the control group, the mean before the intervention was 10.41 and the mean after the intervention was 10.69. The results of the independent t-test obtained a p-value after intervention in both groups of 0.002 (α < 0.05); there was a difference in mental health after intervention in the intervention group and the control group. It is hoped that storytelling will be used as a promotional effort in improving children's mental health, and the school will make storytelling activities a routine activity in helping children to improve their mental health from an early age.

The Correlation of Family Support on Blood Sugar Levels in Diabetes Mellitus (DM) Sufferers

Nandang Jamiat — 2026-07-18

Diabetes Mellitus (DM) is closely linked to unhealthy dietary habits and sedentary lifestyles. Despite the efforts of the Indonesian government to manage DM through its chronic disease management program, many patients continue to experience poor glycemic control. Families, particularly primary caregivers, play a critical role in supporting patients with DM. This study aimed to analyze the correlation between family members' knowledge and attitudes toward family health tasks and glycemic control (fasting blood glucose levels) in DM patients participating in the Chronic Disease Management Program (CDMP) at a public health center in Bandung, Indonesia. A cross-sectional correlational study was conducted using a quantitative design. The study involved 65 family members who served as primary caregivers for DM patients, selected through a total sampling technique. Data were gathered using structured questionnaires to assess family members' knowledge and attitudes, along with clinical data on the patients' glycemic control. The relationship between variables was analyzed using the Spearman Rank Correlation test. The findings revealed no significant relationship between family members' knowledge and attitudes regarding caregiving tasks and the glycemic control of DM patients. Specifically, family knowledge and attitudes were not significantly associated with patients' glycemic control (p > 0.05). This study concluded that family members' knowledge and attitudes do not significantly influence glycemic control in patients with DM. These findings suggest that other factors may affect blood sugar levels, indicating the need for further research on family-based interventions and additional variables that could impact glycemic management.

The Relationship between Individual Characteristics and Safety Climate with Safety Behavior of Loading and Unloading Workers

Idharsyah Termanu Dasi — 2026-07-19

Occupational safety is a crucial aspect of loading and unloading activities at ports, which inherently carry high levels of risk. This study aimed to analyze the relationship between individual characteristics and safety climate with safety behavior among loading and unloading workers at Tenau Port, Kupang City. A quantitative study with a cross-sectional design was conducted among loading and unloading workers at Tenau Port. The study population consisted of all active workers registered in the TKBM Cooperative, and a sample of 73 respondents was selected using a random sampling technique. Data were collected using structured questionnaires and analyzed using Chi-Square and logistic regression tests. The results showed that most respondents had good individual characteristics (82.2%) and perceived a strong safety climate (74.0%). Bivariate analysis indicated a significant relationship between individual characteristics and safety behavior (p = 0.029) as well as between safety climate and safety behavior (p = 0.008). Multivariate analysis showed that safety climate was the most dominant factor associated with safety behavior (p = 0.038; Exp(B) = 5.312; 95% CI = 1.101–25.634). Workers who perceived a stronger safety climate were more likely to demonstrate compliant safety behavior than those who perceived a weaker safety climate. In conclusion, individual characteristics and safety climate were significantly associated with safety behavior among loading and unloading workers at Tenau Port, Kupang City. Strengthening workplace safety culture and improving workers’ competencies are recommended to enhance safety compliance.

Effectiveness of the "CEPAT" (Smart and Compliant) Health Promotion Model on Blood Pressure Control in Hypertensive Patients

Dewi Hartinah — 2026-07-19

The necessity for efficient non-pharmacological methods to supplement medical therapy is highlighted by the fact that hypertension remains a major global public health concern. In Kudus Regency, Indonesia, this study looked at how well the CEPAT health promotion model worked to lower blood pressure in hypertensive individuals. Purposive sampling was used to choose 32 individuals from PRM 02 Pasuruhan Lor for a quasi-experimental study with a pre-test–post-test control group design. Participants were split equally between a control group (n = 16) and an intervention group. While the control group got standard care, the intervention group participated in a four-week CEPAT health promotion program. Following the intervention, the diastolic blood pressure decreased from 103.71 ± 1.03 mmHg to 93.13 ± 0.93 mmHg (p = 0.001) and the systolic blood pressure decreased significantly from 167.81 ± 32.19 mmHg to 135.63 ± 16.43 mmHg (p < 0.001). On the other hand, the control group showed no statistically significant changes. A substantial difference between the two groups was also shown by post-intervention analysis (p < 0.001). These results imply that the CEPAT health promotion model is a useful community-based intervention for improving blood pressure control and could be a useful tactic for managing hypertension.

Determinants of Pregnant Women’s Compliance with the Triple Elimination Programme in Bandung City, Indonesia

Reynie Purnama Raya — 2026-07-19

The Triple Elimination Programme was first introduced in 2017 to standardise screening for pregnant women nationwide. Moving into 2025, however, coverage rates in several regions—including Bandung City—remain below national targets, pointing to an ongoing struggle with programme compliance. This study examined the association between knowledge, information sources, and family support with pregnant women’s compliance in the Triple Elimination programme. A cross-sectional study was conducted among 132 pregnant women attending health facilities in Arcamanik Sub-district, Bandung City. Participants were selected using purposive sampling, and data were collected using structured questionnaire. Univariate analyses described the frequency and distribution of variables, whilst bivariate analyses using Chi-squared and Mantel-Haenszel odds ratio (95% CI) assessed associations between knowledge, information sources, and family support with the pregnant women’s compliance. The results showed that most respondents had high knowledge (66.7%), adequate access to information (71.2%), and positive family support (67.4%), while 56.1% were compliant with the programme. Knowledge (OR [95% CI] = 10.99 [4.59–26.32], p<0.01), information sources (5.97 [2.57–13.87], p<0.01), and family support (15.66 [6.10–40.18], p<0.01) were all significantly associated with compliance, with family support being the strongest determinant. These findings highlight the importance of involving families in health education to strengthen pregnant women’s participation and improve the success of the Triple Elimination Programme.

Understanding Women's Participation in Visual Inspection with Acetic Acid Screening

Zaim Anshari — 2026-07-19

The level of community health is shaped by four main determinants: environment, behaviour, health care, and heredity. Visual inspection with acetic acid (VIA) is a simple, low‑cost method that can be used for early detection of cervical cancer in primary care settings, yet uptake among women of reproductive age in Indonesia remains suboptimal. This analytic observational case–control study was conducted at Puskesmas Teladan, Medan, in 2025. A total of 102 women of reproductive age were enrolled, comprising 51 women who had undergone VIA (case group) and 51 women who had never undergone VIA but had heard about the test (control group). Data on socio‑demographic characteristics (age, education, occupation), behavioural factors (knowledge, attitude, practice), and psychological factors (perception, motivation) were collected using a structured questionnaire and analysed using chi‑square tests and multiple logistic regression. In the multivariable model, good knowledge (adjusted odds ratio [AOR] 8.25; 95% confidence interval [CI] 2.32–29.36; p=0.001) and high motivation (AOR 15.92; 95% CI 5.35–47.42; p<0.001) were independently associated with undergoing VIA, whereas age, education, occupation, attitude, practice, and perception were not statistically significant. Women of reproductive age with better knowledge about VIA and stronger motivation are substantially more likely to undergo VIA screening. Strengthening knowledge and intrinsic motivation through health promotion and counselling at primary health centres and via Posyandu cadres may increase uptake of VIA as an early detection strategy for cervical cancer.

The Importance of Hospital Image, Service Trust Level, and Physiotherapy Service Satisfaction on Patient Loyalty

Gabrina Selvi Yanuarista — 2026-07-19

Patient loyalty is essential for sustaining physiotherapy services, where prolonged treatment and discomfort often lead to high drop-out rates. This mixed-methods observational study examined how hospital image and patient trust shape satisfaction and loyalty among physiotherapy outpatients at KS Hospital between March and May 2025. A total of 160 outpatients were recruited through accidental sampling and completed a structured questionnaire, analyzed using partial least squares structural equation modeling (PLS-SEM). Qualitative data were gathered through in-depth interviews with a service manager, a specialist, and patients, triangulated to validate and enrich the quantitative findings. Hospital image significantly predicted satisfaction (β = .544, p < .001) and indirectly influenced loyalty through satisfaction (β = .202, p < .001). Patient trust showed both direct (β = .274, p < .001) and satisfaction-mediated (β = .294, p < .001) effects on loyalty. Satisfaction was the central mediating variable, explaining 70% of the variance in loyalty (R² = .695), with word-of-mouth emerging as its strongest indicator. Interview findings reinforced that service uniqueness and facility quality strengthen image and trust, which in turn foster satisfaction and encourage patients to return. These results underscore satisfaction's pivotal role in translating hospital image and trust into patient loyalty. Hospital management should prioritize improving service responsiveness and distinctiveness while ensuring equitable, empathetic care to strengthen long-term patient commitment to physiotherapy services. As a result, patient visit numbers can be maintained or even improved.

Having a Primary Care Physician: Individual and Community Characteristics in Japan

Ryosuke Sugiura — 2026-08-07

Primary care is vital for disease prevention, but factors influencing access to primary care physicians (PCPs) in Japan are not well understood. Using data from 28,481 respondents in the 2023 JACSIS survey, we analyzed demographic, health, and community characteristics associated with having a PCP. The proportion of individuals with a PCP was lowest in the early thirties and increased with age. Employment demands, child-rearing responsibilities, living alone, and weak community ties were Primary care is vital for disease prevention, but factors influencing access to primary care physicians (PCPs) in Japan are not well understood. Using data from 28,481 respondents in the 2023 JACSIS survey, we analyzed demographic, health, and community characteristics associated with having a PCP. The proportion of individuals with a PCP was lowest in the early thirties and increased with age. Employment demands, child-rearing responsibilities, living alone, and weak community ties were associated with a lower likelihood of having a PCP, while older age, chronic conditions, health-conscious behaviors, and strong community relationships increased PCP access. Mental health issues and a history of drug use were associated with lower PCP proportions. Our findings suggest that improving PCP access in vulnerable groups requires attention to health literacy, time availability, and community support, rather than focusing solely on income or education. Targeted efforts may help increase PCP utilization among those most in need.associated with lower likelihood of having a PCP, while older age, chronic conditions, health-conscious behaviors, and strong community relationships increased PCP access. Mental health issues and a history of drug use were associated with lower PCP proportions. Our findings suggest that improving PCP access in vulnerable groups requires attention to health literacy, time availability, and community support, rather than focusing solely on income or education. Targeted efforts may help increase PCP utilization among those most in need.

Nurses’ Readiness to Manage Patients Following Suicide Attempts in Hospital Settings

Anggit Dwi Retno Murni — 2026-07-07

Suicide remains a major public health concern worldwide, and nurses play a critical role in managing patients following suicide attempts. Nurses’ readiness is essential to ensure patient safety and prevent recurrent suicidal behaviors. However, evidence suggests that preparedness among nurses varies widely. This systematic review aimed to identify, critically appraise, and synthesize available evidence regarding nurses’ readiness in hospital settings to manage patients following suicide attempts. A systematic review was conducted following PRISMA guidelines. Electronic searches were performed in PubMed, Scopus, and ProQuest databases for articles published between 2021 and 2025. Studies examining nurses’ readiness and related factors in hospital settings were included. Methodological quality was assessed using JBI critical appraisal tools. Data were synthesized narratively. A total of 103 records were identified, and nine studies met the inclusion criteria. Most studies employed quantitative cross-sectional designs, while one study used a quasi-experimental approach. The findings indicated that nurses’ readiness varied considerably and was influenced by multiple factors. Higher readiness was associated with suicide prevention training, clinical experience, positive attitudes, and self-efficacy. Common barriers included high workload, lack of structured training programs, limited organizational support, and absence of clear clinical guidelines. However, the predominance of cross-sectional studies and heterogeneity of outcome measures limited quantitative comparison across studies. Nurses’ readiness to manage patients following suicide attempts remains inconsistent across hospital settings. These findings highlight the importance of implementing regular suicide prevention training programs, establishing clear clinical guidelines, and strengthening organizational support to improve nurses’ readiness in hospital settings and enhance patient safety.

The Effect of Telenursing on the Quality of Life of Chronic Kidney Disease Patients Undergoing Hemodialysis

Fatimatus Zahron Faizin — 2026-07-18

Chronic Kidney Disease (CKD) is a growing global health issue that significantly impacts renal function and patients' quality of life, particularly those undergoing hemodialysis. Patients' quality of life is influenced by clinical, psychological, and environmental factors, where limited access to healthcare services often presents a barrier. Telenursing has emerged as a health technology innovation to provide remote nursing care to support disease management. This study aims to synthesize the effect of telenursing on the quality of life of CKD patients undergoing hemodialysis. The method used was a literature review searching articles via international databases Scopus, ProQuest, and PubMed. The search was limited to full-text English articles published between 2019 and 2024 using the keywords "hemodialysis", "telenursing", and "quality of life”. The selection process yielded 9 articles meeting the inclusion criteria. The review results indicate that telenursing interventions significantly improved quality of life scores, self-efficacy, and medication adherence compared to standard care. In conclusion, telenursing is effective as a holistic intervention model to enhance the quality of life for hemodialysis patients, although its implementation still faces challenges regarding infrastructure and digital literacy.

Multifaceted Roles of Nurses in Mitigating Climate Change-Related Health Impacts

Nadia Rohmatul Laili — 2026-07-19

Climate change is increasingly amplifying global morbidity and mortality, disproportionately affecting vulnerable populations and placing sustained pressure on health systems. Nurses, as the largest segment of the healthcare workforce, are strategically positioned to mitigate climate change-related health impacts; however, the scope and empirical basis of these roles remain insufficiently consolidated. This scoping review aimed to map and critically examine the multifaceted roles of nurses in addressing climate-related health consequences. A comprehensive search of SCOPUS, PubMed, ProQuest, and ScienceDirect identified 15 articles eligible for inclusion in this review. Four core nursing roles were identified: (1) integrating climate change into nursing curricula and community health education, (2) advancing research on planetary health, (3) influencing climate-related health policies, disaster preparedness, and resilience strategies, and (4) providing climate-responsive care to vulnerable populations. A key finding was the predominance of normative and conceptual literature, revealing a substantial gap between expected nursing roles and empirically supported practices, particularly in direct caregiving interventions.