The Effect of Islamic Spiritual Mindfulness on Self-Efficacy in Anger Management among Schizophrenic Patients

Background: The prevalence of schizophrenia has increased in the last few years. Nevertheless, methods in assisting schizophrenic patients have not improved significantly. Islamic spiritual mindfulness is a spiritual approach that can help schizophrenic patients increase their self-efficacy in anger management. However, the application of this intervention is still not well researched.Purpose: This study aimed to determine the effect of Islamic spiritual mindfulness on self-efficacy in anger management among schizophrenic patients.Methods: This study utilized a pre-post quasi-experimental design with a control group. A total of 54 schizophrenic patients were purposively recruited and divided into two groups: the intervention group (n=27) and the control group (n=27). The intervention group received four sessions of Islamic spiritual mindfulness in two weeks, while the control group received a standard intervention from the hospital. The data were collected using the Regulatory Emotional Self-Efficacy (RESE) scale and analyzed using the t-test.Results: The results showed a significant difference in self-efficacy scores between the control and intervention groups (p=0.000) after the intervention. In the pre-test, the mean score of self-efficacy in the intervention group was lower than the control group (M=28.15 vs. M=30.26) without a significant difference. However, in the post-test, a significant difference in self-efficacy between the intervention and control groups was found (M=46.44 vs. M=46.44; p=0.000).Conclusion: Islamic spiritual mindfulness significantly affects self-efficacy among schizophrenic patients. The Islamic spiritual mindfulness can be applied as a new form of approach to increase self-efficacy in schizophrenic patients.

The Fluid Management Experience in Patients with Chronic Kidney Disease Undergoing Hemodialysis in Indonesia: A Qualitative Study

Background: Fluid management can reduce mortality, severe comorbidities, and debilitating symptoms in patients on hemodialysis. Therefore, a restricted fluid intake plan is crucial for patients with chronic kidney disease (CKD). Little evidence has been found to date on exploring the experience in fluid management of CKD patients in Indonesia.Purpose: This study aimed to explore the fluid management experience of adults with chronic kidney disease participating in hemodialysis treatment in Indonesia.Methods: A qualitative study with a phenomenological approach was conducted. Purposive sampling was used to recruit 14 adults patients with chronic kidney disease undergoing hemodialysis in a tertiary hospital in Padang between July and September 2020. Manual content analysis using the Colaizzi approach was used to identify themes.Results: Data analysis revealed four themes with 12 sub-themes. The four major themes include the challenge of thirst control, fluid/diet restriction management, inadequate information, and the support system.Conclusions: The result showed the severe suffering and sadness experienced by CKD patients who conform to fluid restrictions. It is important to provide clear information on the fluid prescription or the exact consumable amount per day. Structured education with a personal approach is recommended to ensure detailed information regarding "fluid prescribing". The support obtained from family, friends, and dialysis staff is a significant factor in promoting acceptance and adherence.

The SALT and START Triage System for Classifying Patient Acuity Level: A Systematic Review

Background: Two common triage systems have been widely used in mass casualty incidents (MCIs) and disaster situations, namely START (simple triage algorithm and rapid treatment) and SALT (sort, assess, lifesaving, intervention, and treatment/transport). There is currently controversy regarding the effectiveness of SALT over the START triage system.Purpose: This systematic review aims to compare the accuracy of the SALT and START triage systems in disaster and MCI settings.Methods: The literature was searched using a systematic search strategy for articles published from 2009 to 2020 in the Medline, CINAHL, Web of Science, Scopus, PubMed, ProQuest databases, and the grey literature. This review included simulation-based and medical record-based studies investigating the accuracy and applicability of the SALT and START triage systems in adult and child populations during MCIs and disasters. All types of studies were included. The PRISMA flowchart was used to retain the articles, and the Joanna Briggs Institute critical appraisal tools were used to assess the quality of the reviewed studies.Results: Of 1,450 articles identified in the search, 10 articles were included. It was found that the START triage system had a wide range and inconsistent levels of accuracy (44% to 94.2%) compared to the SALT triage system (70% to 83%). The under-triage error of the START triage system ranged from 2.73% to 20%, which was slightly lower than the SALT triage system (7.6% to 23.3%). The over-triage error of the START triage system (2% to 53%) was slightly higher than the SALT triage system (2% to 22%). However, the time taken to apply START triage system (70 to 72.18 seconds) was faster than for the SALT triage system (78 seconds).Conclusion: The START triage system was simpler and faster than SALT. Conversely, the SALT triage system appeared to be slightly more accurate, more consistent, and had a lower rate of under- and over-triage error than START. It appears that neither the SALT nor the START triage system is superior to the other. Further research is needed to establish the most appropriate disaster and MCI triage system, especially for the Indonesian context.

Predictors of the Willingness to Promote Advance Care Planning among Nurses in Palliative Care Settings in Yogyakarta, Indonesia

Background: While previous studies showed that oncology nurses were highly inclined to promote advance care planning (ACP), there is a limited study focusing on ACP that concerns the willingness to promote ACP among palliative nurses in Indonesia. This issue needs to be investigated to determine the causative factors so that interventions for nurses can be arranged to improve ACP in Indonesia.Purpose: This study aimed to identify predictors of the willingness to promote ACP among nurses in palliative care settings.Methods: This study used a descriptive-analytical design with a cross-sectional approach. A total of 150 registered nurses with at least one year of experience were purposively recruited. Data were collected using the Indonesian version of the willingness to promote ACP instrument (I-WPACP) with a possible score range of 24 to 120; the higher the score, the higher the willingness to promote ACP. The descriptive statistic, independent t-test, Pearson correlation test, Spearman rank correlation test, and multiple linear regression test were used to analyze the data.Results: The willingness to promote ACP showed a mean score of 84.73±9.36. The score indicates a high willingness to promote ACP. The experience of receiving palliative care education became a related factor as well as the most closely related factor to the willingness to promote ACP in the palliative care settings (β=0.184; p=0.028).Conclusion: The willingness to promote ACP among nurses is high and closely related to their experience of receiving education about palliative care. Education about palliative care and training on ACP needs to be developed so that nurses can discuss ACP with patients and family caregivers.

Psychometric Testing of the Technological Competency as Caring in Nursing Instrument – Revised (English Version Including a Practice Dimension)

Background: The middle range theory Technological Competency as Caring in Nursing (TCCN) guides nursing practices. The TCCN Instrument (TCCNI) measures perception dimension of the theory and has been revised and translated into the Japanese language (TCCNI-R). Testing the translated version of the TCCNI-R to English language with the inclusion of a practice dimension is warranted.Purpose: This study aims to determine the psychometric properties of the TCCNI-Revised English version with Practice dimension (TCCNI-RePract).Methods: A web-based cross-sectional study was conducted with data from 202 valid questionnaire copies from professional nurses in selected hospitals and nurse educators in universities. Results: The suitability for factor analysis was determined using Kaiser-Meyer-Olkin index (0.93), Bartlett's sphericity test of 3256.93, p<0.001, the anti-image correlations ranged between 0.87 and 0.96, and an average value of communalities of 0.66. In the four rotations conducted with the maximum likelihood method with a Harris-Kaiser Orthoblique rotation, four items were excluded with factor loadings less than 0.40. These results determined the final scale with 21 items and four subscales, namely: (1) Knowing the person (8 items); (2) Technological competency as Caring (6 items); (3) Technology and caring (4 items); and (4) Expression of nursing as Caring (3 items). Cronbach’s alpha coefficient for the total scale was 0.94. With two dimensions of the TCCNI-RePract, the perception dimension had significantly higher scores than the practice dimension. When comparing mean factor point among the dimensions, the perception scores were significantly higher for Factor 1 and Factor 3.Conclusion:The TCCNI-RePract is an acceptable tool that can reliably measure nurses’ perception and practice of TCCN. It is affirmed that with this tool, measuring perception and practice status of TCCN theory is possible. It is considered that the evaluation results can be used to plan in-hospital education.

The Association of Work Environments and Nurse-Nurse Collaboration: A Multicenter Cross-Sectional Study

Background: Along with the recent healthcare reform, intraprofessional collaboration in nursing is considered an essential factor for managing the challenges related to diverse roles and tasks of nurses in providing high quality care. There is lack of knowledge on how the nursing work environment could influence nurse-nurse collaboration. Purpose: The study aimed to assess the relationship between nursing work environment and nurses’ intraprofessional collaboration.Methods: A total of 300 nurses working in four teaching hospitals participated in this multicenter cross-sectional study. Data were collected using the Nurse-Nurse Collaboration Scale (NNCS) and the Practice Environment Scale of the Nursing Work Index (PES–NWI). The Pearson correlation test was used to analyze the data.Results: The results showed that the mean score of the PES–NWI was 2.65±0.32 out of 4. The highest and lowest scores belonged to the subscales of the nursing foundations for quality of care (2.86±0.31) and staffing and resource adequacy (2.24±0.49), respectively. The mean total score of nurse-nurse collaboration was 2.94±0.21 out of a score of 4. The results showed a significant positive relationship between nursing work environment and nurses’ intraprofessional collaboration (r=0.49, p<0.05).Conclusion: The nursing practice environment has a positive and significant relationship with nurse-nurse collaboration. Therefore, improving nurses’ practice environment and providing healthy workplaces could improve the intraprofessional nurse’s collaboration. Moreover, nurse managers should improve nurses’ skills in some areas of collaboration such as conflict management.

Factors Influencing Depression among Indonesians during the COVID-19 Outbreak

Background: The 2019 Coronavirus pneumonia disease (COVID-19) has gained intense attention globally, including in Indonesia. The rapid transmission and clinical effects of the virus can cause depression in Indonesian society. However, information on risk factors for depression during COVID-19 in this country is not known. Purpose: This study aimed to determine the level of depression and identify factors influencing depression in Indonesian society during the COVID-19 outbreak.Methods: An online-based cross-sectional study was conducted among Indonesian society aged ≥12 years old in April 2020. A total of 1,622 participants from 34 provinces in Indonesia were involved in this study and completed the online questionnaires on demographics, social media exposure, self-rated health, and depression levels with the WHO-Five Well-being Index (WHO-5). Ordinal logistic regression analysis was used to identify the factors associated with depression levels.Results: Of the total sample analyzed, the overall prevalence of depression levels was 28.5% mild depression, 18.4% moderate depression, and 24.8% severe depression. Social media exposure (SME), age, gender, occupation, and self-rated health (SRH) were significantly influencing depression (p<0.05). The factor that most influenced the level of depression was self-rated health (p=0.0001; OR=2.72).Conclusion: This study highlights depression in Indonesian society during the COVID-19 pandemic and provides an understanding of the effects of demographics, social media exposure, and self-rated health. The study suggests the importance of implementing a multi-disciplinary approach (e.g., a collaboration between mental health nursing and community nursing) to deal with depression.

Assessment of Interprofessional Education (IPE) in Community Settings: A Systematic Review

Background: An assessment of methods and tools in interprofessional education (IPE) needs to be conducted to guarantee that the set learning objectives (LOs) or competencies are achieved, especially in community settings. This assessment is essential since in community settings, facilitators and students are not in the same frame, while direct observation is preferable in IPE. The implementation of methods and tools for assessment varies. Mostly, the assessment does not cover all competencies of IPE. Further identification of the way the assessment is conducted as well as the IPE competencies assessed is pivotal.Purpose: This study aimed to review the implementation of IPE in community settings, especially the assessment conducted on the methods and tools used along with the assessors involved and the competencies achieved.Methods: A systematic review was employed as a method in this study. Relevant articles from Science Direct, MEDLINE, CINAHL, and Scopus were screened based on the inclusion criteria: publication between 2010–2020, research and review articles, full-text articles, conducted in community settings, and involved assessment in acquiring the competencies. This review included 12 out of 1,273 screened articles. The articles were analyzed qualitatively by identifying the keywords, categories, and themes.Results: The results showed the assessment conducted and the competencies achieved in IPE. The assessment included methods and tools as well as the assessors involved. Most existing studies used students’ perceptions or reflections as the methods and involved less assessors such as supervisors or family members. Meanwhile, the assessment tools focused on certain competencies, such as roles and responsibilities, ethics and values, teamwork, and communication. However, no study assessed all competencies.Conclusion: The analysis resulted in two large topics, i.e., the assessment, which includes the assessment methods and tools as well as assessors involved, and the competencies achieved. It is recommended to conduct further studies to develop objective assessment methods, comprehensive assessment tools, and generic competencies or learning outcomes.