Journal of Health Sciences

Self-Efficacy and Adherence as Predictors of Quality of Life in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study at Jemursari Islamic Hospital, Surabaya

2026-04-02T08:32:30+00:00

Type 2 diabetes is associated with a progressive decline in patients' quality of life (QoL). Self-efficacy and adherence are critical behavioral determinants that influence disease management and outcomes. This study examines the correlation between self- efficacy and adherence to quality of life in patients with type 2 diabetes mellitus. This study used a correlational analytic research design with a cross-sectional approach. The study was conducted at Islamic Hospital Jemursari, Surabaya, from August to October 2024. The population consisted of 307 patients with diabetes, and 174 respondents were selected through purposive sampling. Data were collected using validated questionnaires: the Diabetes Management Self-Efficacy Scale (DMSES), the Adherence to Diabetes Questionnaire (ADQ), and the Diabetes Quality of Life (DQOL)questionnaire. Data analysis was the Spearman's Rank correlation test. The results showed that nearly half of the respondents reported low self-efficacy, most had low adherence, and 60.3% experienced poor QoL. Spearman analysis demonstrated a significant correlation between self-efficacy and QoL (r = 0.647; p < 0.000), and between adherence and QoL (r = 0.684; p < 0.000). In conclusion, self-efficacy and adherence are strong predictors of quality of life in patients with type 2 diabetes mellitus at Jemursari Islamic Hospital, Surabaya. Future research should investigate interventions to enhance self-efficacy and adherence, particularly among patients with a poor quality of life, to develop more effective strategies for supporting diabetes care.

Factors Influencing the Incidence of Underweight in Toddlers Aged 12-23 Months in the Working Area of Cibeureum Public Health Center (PHC): A Cross-Sectional Study

2026-04-02T08:32:25+00:00

Underweight is one of the health problems in children. Data from the Ministry of Health Republic of Indonesia in 2022 stated that children under two years old who suffer from underweight in Indonesia amounted to 6.2%, while those who experience severe underweight were 1.1%. This study determines the factors influencing the incidence of underweight in children aged 12-23 months in the working area of Cibeureum PHC. The study employed a quantitative approach with an analytical design, utilizing a cross-sectional design. There were 95 respondents with purposive sampling. The instruments used were a questionnaire and nutritional status measurements, as assessed by the anthropometric weight-for-age index. Data analysis used the Chi-Square test with an α<0.05. The results showed an influence of maternal education (p = 0.000), family income (p = 0.000), maternal knowledge regarding feeding (p = 0.000), and feeding practices (p = 0.000) on the incidence of underweight. However, the history of exclusive breastfeeding did not influence the incidence (p = 0.471). In conclusion, the factors affecting the incidence of underweight in children aged 12-23 months in the working area of Cibeureum PHC include maternal education, family income, maternal knowledge, and feeding practices. Meanwhile, the history of exclusive breastfeeding did not influence the incidence.

The Effect of Tummy Time Exercise on Gross Motor Skills in Babies Aged 3-6 months

2026-04-02T08:32:18+00:00

Tummy time exercise involves positioning the baby on their stomach, allowing them to

support their body weight. The purpose of this study was to determine the effect of

tummy time exercise on gross motor skills in babies aged 3-6 months. This research

design employed analytics using a One-Group Pretest-Posttest Design approach. The

population consisted of 43 babies aged 3-6 months at the Integrated Health Service Post,

known as Posyandu, in Arjowilangun Village, Malang Regency. The sampling

technique was a total sampling. The time of intervention was 2 weeks. Data analysis

employed the Wilcoxon Signed Ranks Test. Before giving tummy time exercise

intervention, most respondents had normal gross motor skills (97.7%), and a small

proportion had delayed gross motor skills (2.3%). After intervention, all respondents

had advanced gross motor skills (100%). Based on the results of the Wilcoxon Signed

Rank Test, there was a significant influence on gross motor skills in babies aged 3-6

months before and after the intervention, as indicated by a p-value of 0.000 and a

calculated z-value of -6.487. In conclusion, tummy time exercises can significantly

increase gross motor skills in babies aged 3-6 months. Parents should apply tummy time

exercises to babies regularly to promote the development of gross motor skills in babies

aged 3-6 months, enabling them to achieve gross motor milestones more quickly.

The Spiritual Emotional Freedom Technique (SEFT) Therapy Combined with Dhikr to Overcome Thanatophobia in the Older People

2026-04-02T08:32:04+00:00

Older adults are a phase of human life accompanied by a decline in physical,

psychological, and social conditions. These changes have the potential to cause mental

health issues such as thanatophobia or an excessive and irrational fear of death. One

way to overcome is through non-pharmacological therapy, the Spiritual Emotional

Freedom Technique (SEFT) therapy, combined with dhikr. This study evaluates the

effectiveness of SEFT therapy combined with dhikr as a complementary intervention in

geriatric nursing on thanatophobia levels in older adults. It employed a pre-experimental

design with a one-group pretest-posttest design. There were 24 respondents with a total

sampling technique. The independent variable was the combination of SEFT therapy

and dhikr, and the dependent variable was the levels of thanatophobia. The instrument

was a Thanatophobia questionnaire. Therapy was conducted in four sessions over a

period of two weeks, with each session lasting between 30 and 60 minutes. Data

analysis used the Wilcoxon signed-rank test with a significance level of p < 0.05. Pre-

test results showed that most respondents experienced very high levels of thanatophobia

(70.83%), with the average score reaching 45. After intervention, the average score

dropped to 15, and most respondents (87.5%) fell into the mild thanatophobia levels.

The Wilcoxon Signed-Rank Test obtained a p-value of 0.000, indicating that the SEFT

therapy and dhikr were significantly effective in reducing thanatophobia levels in

respondents. The SEFT therapy combined with dhikr could be an alternative

complementary nursing intervention in overcoming thanatophobia among older people.

Social Cognitive Theory (SCT) Based Breastfeeding Education Model: Implications for Early Breastfeeding Practices and Maternal Self-Efficacy in Badung Regency, Bali

2026-04-02T08:32:02+00:00

Exclusive breastfeeding coverage in Indonesia, including Badung District, remains

below the national target of 67%. Maternal self-efficacy and employment status are key

barriers, often leading to early introduction of formula feeding. This study aimed to

analyze the effect of a breastfeeding education model based on Social Cognitive Theory

(SCT) on early breastfeeding practices, maternal self-efficacy, and infant growth. A

quasi-experimental study with a non-equivalent control group design was conducted

involving 76 postpartum mothers (38 in the intervention group and 38 in the control

group), recruited on the third day postpartum. The intervention group received SCT-

based breastfeeding education for six weeks, while the control group received standard

breastfeeding education. Data were analyzed using Chi-square, Mann–Whitney, and t-

tests, with a significance level set at p < 0.05. The intervention group demonstrated

significantly higher post-test scores for early breastfeeding practices (36.16 vs. 29.37; p

< 0.001) and maternal self-efficacy (52.00 vs. 38.71; p < 0.001) compared with the

control group. SCT-based breastfeeding education is effective in improving early

breastfeeding practices and enhancing maternal self-efficacy. Its integration into

breastfeeding promotion programs is recommended to optimize maternal and child

health outcomes.

Effectiveness of Ear Acupressure on Anxiety Among Primigravida Women During Labor

2026-04-02T08:32:15+00:00

Childbirth is a physiological process that is influenced by maternal, familial, and

environmental support. Primigravida women often experience heightened anxiety due to

lack of childbirth experience. Increased anxiety can stimulate cortisol release,

potentially leading to labor complications such as impaired uterine contractions and

prolonged labor. One non-pharmacological approach to reduce anxiety during labor is

acupressure. While ear acupressure has been shown to reduce labor pain, evidence

regarding its effect on anxiety remains limited. This study aimed to examine the

effectiveness of ear acupressure at the Shen Men point in reducing anxiety during the

early stage of labor. A quasi-experimental one-group pre-test–post-test design was used,

involving 31 primigravida women in early labor selected through convenience

sampling. Anxiety levels were measured before and after the intervention using the

Anxiety Assessment Scale for Women in Labor (AASWL). Before the intervention,

67.70% of participants reported anxiety levels above 50%. After ear acupressure, more

than half of the participants (54.80%) continued to report anxiety levels above 50%. The

mean anxiety score decreased from 25.71 before the intervention to 16.48 after, showing

an average reduction of 9.23 points. However, statistical analysis using the Wilcoxon

signed-rank test yielded a p-value of 0.157, indicating that the reduction was not

statistically significant. In conclusion, ear acupressure at the Shen Men point was not

shown to have a significant effect on reducing anxiety during the first stage of labor in

primigravida women.

The Differences Between Think Pair Share and Stratagem Learning Models in Improving Knowledge of Premature Sex Prevention in Students at SMA Samarinda

2026-04-02T08:32:28+00:00

Adolescent growth and development causes physical, cognitive and psychosocial changes, which are followed by sexual maturity, followed by attraction to the opposite sex, thereby triggering the potential for premarital sexual behavior. This problem requires preventive treatment efforts in the form of health education. Health education models that are suitable for upper secondary students are think-pair-share (TPS) and stratagem. This research aims to see the differences in the effectiveness of the think-pair-share and stratagem health education methods on knowledge of premarital sex prevention. This research design uses a quasi-experimental pre- and post-test with a control group design. The population in this study was 120 class X students at SMA 11 Samarinda. The sampling technique used was random sampling with a total of 42 samples each. Adolescent students' prevention knowledge was measured with a questionnaire consisting of 16 items. The research results show a change in knowledge score of 4, given the TPR model education, while the Stratagem model increases by 6. The results of the Mann-Whitney test show a p-value of 0.000 (<0.05), where there is a difference between the TPS and Stratagem models. The stratagem model is suitable for teenagers because of the teenager's character who likes relaxed and fun learning.

Analysis of Factors Affecting Non-Adherence to Treatment in Type 2 Diabetes Mellitus Patients at Jatilawang Community Health Center

2026-04-02T08:32:16+00:00

Diabetes mellitus is a chronic metabolic disorder marked by elevated blood sugar. Non-adherence to type 2 DM treatment increases risks of complications and failure of blood sugar control. This quantitative cross-sectional study used spatial and network analysis to examine factors affecting non-adherence among 114 type 2 DM patients registered as prolanis participants at the Jatilawang Community Health Center. Data collection involved questionnaires, interviews, and geospatial mapping via Google Maps. Statistical analyses included univariate, bivariate, multivariate analysis with SPSS, and network mapping with QGIS. The study found that access to health information significantly influenced non-adherence (p-value=0.006, OR=5.170), while transportation availability (p-value=0.427, OR=0.609) and family support (p-value=0.076, OR=2.622) were confounding factors. Other variables, such as knowledge, attitude, motivation, distance to the community health center, and the role of health workers, were not significant. Most respondents lived within 3 km of the community health center based on network mapping. The findings suggest that patients should actively seek health information from healthcare providers to enhance treatment adherence.

The Availability of Basic Sanitation to the Incidence of Stunting in Toddlers in the Coastal Area of Tamangapa Village, Pangkep Regency

2026-04-02T08:32:21+00:00

The problem of malnutrition, including stunting, is greatly influenced by environmental

sanitation and personal hygiene. This paper examines the influence of the availability of

trash bins, Waste Water Drainage Channels (Saluran Pembuangan Air Limbah or

SPAL), and toilets on the incidence of stunting in toddlers in the Coastal Area of

Tamangapa Village. This paper was a quantitative descriptive study. This study was

conducted in Tamangapa Village from September to November 2024. The population

was mothers with toddlers in Tamangapa Village, Pangkep Regency. The sample

consisted of 72 respondents. The data source used primary data obtained through

questionnaires. The analysis test used regression analysis. The results showed that the

availability of trash bins (p = 0.000), SPALs (p = 0.000), and toilets (p = 0.003) affected

the incidence of stunting in toddlers. In conclusion, the availability of basic sanitation

(including trash bins, wastewater disposal channels, and toilets) has a significant impact

on the incidence of stunting in toddlers in the coastal area of Tamangapa Village,

Pangkep Regency.

The Interaction Between Environmental Sanitation and Pregnant Women's Nutritional Intake on the Risk of Stunting in Toddlers

2026-04-02T08:32:06+00:00

Stunting is a chronic nutritional problem that impacts the physical growth and

development of children. Environmental sanitation factors and maternal nutritional

intake during pregnancy play a crucial role in determining toddlers' nutritional status.

This study analyzes the relationship between environmental sanitation and pregnant

women's nutritional intake on the incidence of stunting in toddlers. In addition, their

interactions with stunting incidence. The study used an analytical observational design

with a cross-sectional approach. The study population comprised families with toddlers

aged 6–59 months. A sample of 100 families was selected using a purposive sampling

technique. Data were collected through structured questionnaires, mother interviews,

sanitation observations, and height measurements for height-for-age using WHO

standards to assess stunting incidence. Data analysis used univariate analysis, the Chi-

Square Test for bivariate analysis, and logistic regression to examine variable

interactions. Results showed that 38% of toddlers experienced stunting, 45% of families

had poor environmental sanitation, and 42% of pregnant women had inadequate

nutritional intake. There was a significant correlation between environmental sanitation

and the incidence of stunting (p=0.001) and between pregnant women's nutritional

intake and stunting (p=0.003). The logistic regression analysis showed that toddlers

exposed to poor sanitation and inadequate nutritional intake during pregnancy had a 3.2

times higher risk of stunting than those exposed to only one factor. Stunting is a

multifactorial problem influenced by poor sanitation and inadequate maternal nutritional

intake during pregnancy. Therefore, efforts to prevent stunting need to be integrated

through improving environmental sanitation and enhancing the nutritional quality of

pregnant women.

Working Position, Work Duration, Ergonomics Knowledge Level on The Risk of Musculoskeletal Disorders among Informal Workers in Slipper Sponge Sandal Manufacturing

2025-06-10T23:51:55+00:00

The informal sector may be associated with an increased risk of occupational diseases or

accidents. This is due to the absence of an ergonomic workplace, insufficient attention

to occupational safety and health, and inadequate supervision. The purpose of this study

was to determine the effect of working position, work duration, and level of ergonomic

knowledge on the risk of Musculoskeletal Disorders (MSDs) among informal workers

in slipper sponge sandal manufacturing. The research design in this study was cross-

sectional. The number of respondents was 33. Data collection used field observation and

the completion of questionnaires using the REBA (Rapid Entire Body Assessment),

Nordic Body Map Questionnaires, and questionnaires measuring ergonomic knowledge.

Data analysis used bivariate and multivariate analysis. Multivariate analysis used

multiple linear regression with α=0.05. Results showed that 63.6% respondents had a

high risk of MSDs. Based on bivariate analysis, working position (X1) obtained

p=0.018, work duration (X2) p=0.018, ergonomic knowledge level (X3) p=0.023.

Multivariate analysis on X1, X2, and X3 got p=0.000. In conclusion, Working position,

work duration, and ergonomic knowledge level influence partially and simultaneously

the risk of musculoskeletal disorders among informal workers in slipper sponge sandal

manufacturing.

Modification of Papercraft Play Therapy Combined with Music Therapy on the Social- Emotional Development of Preschool Children

2025-10-01T01:53:01+00:00

The prevalence of emotional development disorders in children is still quite high. Thus,

stimulating children's social-emotional development is critical. This paper evaluates

whether children's social-emotional development improves after receiving papercraft play

therapy combined with music therapy. This study used a quasi-experimental pretest-

posttest design. The population was preschool children (5–6 years old) at TK Kristen

Dharma Mulya. The sample was 60 children selected using a purposive sampling

technique. It was divided into three groups: two intervention groups and one control

group—Group A: papercraft play therapy; Group B: papercraft play therapy combined

with music therapy; and Group C: routine play activities. The research instruments were

the Emotion Regulation Checklist (ERC). Statistical analysis used ANOVA, with α≤0.05.

In Group A, the social-emotional development of children in the pre-test was in the poor

category at 70%. Meanwhile, in the post-test, it improved to the good category at 55%. In

Group B, social-emotional development in the pre-test was in the poor category at 55%.

In the post-test, it increased to the adequate category at 45%. In Group C, 65% of children

were in the poor category at the pre-test, and 50% remained in the poor category at the

post-test. ANOVA analysis showed significant differences among the three groups

(p=0.001). Post hoc tests indicated that Group B showed greater improvement in

children's social-emotional development than the other groups. In conclusion, papercraft

therapy combined with music therapy is more effective for social-emotional development

in preschool children than papercraft therapy alone or routine play activities.

Mental Health Issues Among Indigenous Communities and the Role of Traditional Medicine

2025-06-25T08:56:31+00:00

Indigenous populations worldwide face significant mental health disparities stemming

from historical trauma, colonization, and marginalization. The World Health Organization

reports particularly concerning rates of suicide and self-harm among indigenous youth.

These communities struggle with multiple interconnected challenges, including economic

hardship, limited access to education, and identity crises. This narrative review es mental

health issues among indigenous communities and the role of traditional medicine in

addressing these challenges. This review analyzed sources from 2014 to 2024 in English

and Bahasa Indonesia, including academic papers, government reports, and grey literature

on indigenous peoples, mental illness, and traditional medicine. Using keywords related

to indigenous/aboriginal communities, mental health, and traditional/alternative medicine,

the review presented findings across 5 themes: Indigenous community challenges; health

and cultural perspectives; traditional and biomedical approaches; preservation of

traditional medicine; and new healthcare models. Traditional medicine faces challenges

from systematic marginalization and younger generations' skepticism. The review

advocates for an integrated healthcare approach that combines traditional and biomedical

practices while preserving indigenous knowledge systems. This integration requires

cultural competency, specialized training for healthcare professionals, and empowerment

of indigenous community members in healthcare roles.