Belitung Nursing Journal最新文献

{"title":"The relationship between leadership styles of nurse managers, nurse motivation, and turnover intention among nurses in Saudi Arabia: A descriptive correlational study.","authors":"Nouf Afit Aldhafeeri, Sitah S Alshutwi, Ahoud Mofareh Alotaibi, Albandre Eid Alanaza, Amirah Hussain Jaber, Asrar Saleh Alharbi, Raghad Khalid Alowais","doi":"10.33546/bnj.4297","DOIUrl":"10.33546/bnj.4297","url":null,"abstract":"<p><strong>Background: </strong>Nurses' perceptions of their nurse managers' leadership styles influence work motivation and turnover intention. However, limited evidence is available from Middle Eastern healthcare settings, particularly in Saudi Arabia.</p><p><strong>Objective: </strong>This study aimed to examine the relationships between nurse managers' leadership styles, nurses' work motivation, and turnover intention, and assessed whether work motivation moderates the association between leadership styles and turnover intention.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 377 nurses working in governmental hospitals in Riyadh, Saudi Arabia, between January and March 2024. Leadership styles were measured across four dimensions: directive, supportive, participative, and achievement-oriented leadership. Data were analyzed using descriptive statistics, Pearson correlation analysis, and multivariate linear regression, followed by moderation analysis.</p><p><strong>Results: </strong>The mean scores for supportive, participative, directive, and achievement-oriented leadership were 5.3 ± 1.0, 5.1 ± 1.0, 5.0 ± 1.0, and 4.9 ± 1.0, respectively. The mean scores for work motivation and turnover intention were 3.5 ± 0.9 and 3.1 ± 0.8. Correlation analysis indicated that all leadership styles were positively associated with work motivation, whereas only directive leadership was negatively associated with turnover intention. In multivariable regression analyses, after adjustment for sociodemographic and professional factors, achievement-oriented leadership remained significantly associated with higher work motivation (<i>β</i> = 0.51, <i>p</i> = 0.034), while directive leadership was independently and negatively associated with lower turnover intention (<i>β</i> = -0.15, <i>p</i> = 0.022). Nationality, educational level, years of experience, and working area were also significantly associated with turnover intention in adjusted models, while educational level and years of experience were associated with nurses' perceptions of leadership styles. Moderation analysis showed that work motivation did not significantly moderate the relationship between directive leadership and turnover intention.</p><p><strong>Conclusion: </strong>Leadership styles were significantly associated with nurses' work motivation and turnover intention. Achievement-oriented leadership was linked to higher work motivation, while directive leadership was associated with lower turnover intention. These findings highlight the importance of strengthening nurse managers' leadership competencies to enhance nurses' motivation and potentially reduce turnover intentions in hospital settings.</p>","PeriodicalId":42002,"journal":{"name":"Belitung Nursing Journal","volume":"12 2","pages":"158-167"},"PeriodicalIF":2.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Degree of burnout and leadership efficacy among nurse managers in a tertiary maternity hospital in Qatar: A sequential explanatory mixed-methods study.","authors":"Ana Mari Karla Tapawan, John Paul Ben Tabar Silang, Liwayway T Vallesteros, David Hali de Jesus, Marietta Fabros, Ronnell Dela Rosa, Jim Tomy, Rana Aatif Salim Ibrahem, Badriya Al-Lenjawi","doi":"10.33546/bnj.4386","DOIUrl":"10.33546/bnj.4386","url":null,"abstract":"<p><strong>Background: </strong>Nurse managers play a critical role in maintaining effective clinical operations and staff performance. However, research examining burnout and leadership efficacy in maternity care settings remains limited.</p><p><strong>Objective: </strong>To examine burnout and leadership efficacy among nurse managers.</p><p><strong>Methods: </strong>A sequential explanatory mixed-methods study was conducted at a tertiary maternity hospital in Doha, Qatar. In Phase I, 125 nurse managers were recruited through convenience sampling and completed the Maslach Burnout Inventory-Human Services Survey for Medical Personnel and the Leadership Efficacy Questionnaire. In Phase II, eight participants were purposively selected for in-depth interviews. Quantitative and qualitative findings were integrated using a joint display approach.</p><p><strong>Results: </strong>Participants reported moderate emotional exhaustion (<i>M</i> = 22.85, <i>SD</i> = 12.69) and depersonalization (<i>M</i> = 7.40, <i>SD</i> = 5.31), alongside high personal accomplishment (<i>M</i> = 42.19, <i>SD</i> = 5.75). Leadership efficacy scores indicated moderate confidence across leader action, leader means, and self-regulation domains. Emotional exhaustion and depersonalization were negatively correlated with all domains of leadership efficacy, whereas personal accomplishment was positively correlated with them. Qualitative findings identified workload, staff management demands, and personal stressors as key contributors to burnout, while resilience, support systems, and adaptive coping strategies were associated with leadership efficacy. Integration indicated that burnout and leadership efficacy co-occur, with inverse associations suggesting that higher burnout is associated with lower leadership confidence, despite sustained functional performance.</p><p><strong>Conclusion: </strong>Burnout and leadership efficacy are significantly associated among nurse managers. Although leadership functioning appears to be maintained, emotional strain is related to reduced leadership confidence. Organizational strategies that address workload demands, strengthen support systems, and promote resilience may help mitigate burnout and support leadership effectiveness.</p>","PeriodicalId":42002,"journal":{"name":"Belitung Nursing Journal","volume":"12 2","pages":"261-272"},"PeriodicalIF":2.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A hierarchical analysis of predictors of perioperative competency in Chinese operating room nurses.","authors":"Cong Fu, Kulwadee Abhicharttibutra, Wanchai Lertwatthanawilat, Orn-Anong Wichaikhum","doi":"10.33546/bnj.4451","DOIUrl":"10.33546/bnj.4451","url":null,"abstract":"<p><strong>Background: </strong>Perioperative competency among operating room (OR) nurses is essential for ensuring patient safety and effective surgical care. Guided by Bronfenbrenner's bioecological model, particularly the Person component, this study examined how key individual characteristics contribute to perioperative competency among nurses working in tertiary hospitals in China.</p><p><strong>Objective: </strong>This study aimed to hierarchically examine the predictive power of key person characteristics (including demographics, specialized resources, and force characteristics) on perioperative competency.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 287 OR nurses from five tertiary hospitals in Hebei Province, China. Data were collected between September 1 and November 30, 2024. Using a predictive correlational design, hierarchical multiple regression analysis was performed. Demographics (gender, marital status, educational level, professional job title) were entered in Block 1, followed by core predictors (years of experience, specialized training, empowerment, self-efficacy, and resilience) in Block 2, using the enter method for each block. Key constructs were measured with validated scales: perioperative competency, resilience, individual empowerment, and work self-efficacy.</p><p><strong>Results: </strong>The final regression model was significant, explaining 77.3% of the total variance in perioperative competency (<i>Adjusted R²</i> = 0.773, <i>F</i> = 88.449, <i>p</i> < 0.001). Special OR training (<i>β</i> = 0.534, <i>p</i> < 0.001) and years of OR experience (<i>β</i> = 0.395, <i>p</i> < 0.001) were the strongest predictors. Among force characteristics, individual empowerment (<i>β</i> = 0.233, <i>p</i> < 0.001), resilience (<i>β</i> = 0.199, <i>p</i> < 0.001), and work self-efficacy (<i>β</i> = 0.197, <i>p</i> < 0.001) all demonstrated significant positive effects.</p><p><strong>Conclusion: </strong>Both specialized resources and force characteristics significantly contribute to perioperative competency. Strategies that strengthen professional training, clinical experience, and positive psychological attributes may help enhance competency among OR nurses.</p>","PeriodicalId":42002,"journal":{"name":"Belitung Nursing Journal","volume":"12 2","pages":"138-147"},"PeriodicalIF":2.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal guilt in the lives of female ICU nurses in South Kalimantan, Indonesia: A qualitative study.","authors":"Yulia Hairina, Nurul Hartini, Nursalam","doi":"10.33546/bnj.4329","DOIUrl":"10.33546/bnj.4329","url":null,"abstract":"<p><strong>Background: </strong>Maternal guilt is a common emotional experience among working mothers, often associated with challenges in fulfilling both professional and caregiving roles. Female nurses, especially those working in intensive care units (ICUs), encounter pressures due to heavy workloads, irregular schedules, and the emotional intensity of patient care. These conditions make them particularly vulnerable to feelings of guilt when family responsibilities are perceived as being neglected.</p><p><strong>Objective: </strong>This study aimed to explore how maternal guilt is experienced in the personal and professional lives of female ICU nurses in South Kalimantan, Indonesia.</p><p><strong>Methods: </strong>A qualitative descriptive design using thematic analysis within a constructivist paradigm was employed. Ten married female ICU nurses who were mothers and had at least five years of ICU experience were purposively recruited through nurse managers from three regional public hospitals. Data were collected through in-depth semi-structured interviews, with member checking and researcher triangulation used to enhance credibility. Interviews were conducted between March and June 2024, transcribed, translated, and analyzed following Braun and Clarke's six-phase framework.</p><p><strong>Results: </strong>Three themes were identified: (1) the internal burden of perceived inadequacy, reflected in persistent feelings of inadequacy, emotional exhaustion, cognitive overload, anxiety and sadness, and self-blame; (2) relational strain and compensatory parenting, including disrupted parent-child bonding, compensatory parenting behaviors, and increased emotional dependence on spouses; and (3) professional strain and competing care responsibilities, characterized by reduced work focus and distraction, fatigue and thoughts of resignation, and role conflict between professional and maternal responsibilities. These findings indicate that maternal guilt emerged as a multidimensional experience permeating both personal and professional domains.</p><p><strong>Conclusion: </strong>Maternal guilt emerged as a salient experience shaping nurse mothers' emotional well-being, family relationships, and professional functioning. The findings suggest that collectivist cultural expectations and idealized motherhood norms may contribute to shaping the experience of guilt among Indonesian ICU nurses. These insights underscore the need for supportive workplace policies, flexible scheduling, and accessible psychosocial services to sustain nurses' well-being and retention in high-demand clinical environments.</p>","PeriodicalId":42002,"journal":{"name":"Belitung Nursing Journal","volume":"12 2","pages":"232-241"},"PeriodicalIF":2.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and outcomes of healthcare-associated infections in a Brazilian intensive care unit: A cross-sectional study.","authors":"Andressa Maria de Sousa Moura, Álvaro Francisco Lopes de Sousa, Herica Emilia Félix de Carvalho, Maria Zélia de Araújo Madeira, Daniela Reis Joaquim Freitas, Ana Carolina de Macedo Lima, Liliane Moretti Carneiro, Marilia Duarte Valim, Aires Garcia Dos Santos Junior, Odinéa Maria Amorim Batista","doi":"10.33546/bnj.4399","DOIUrl":"10.33546/bnj.4399","url":null,"abstract":"<p><strong>Background: </strong>Healthcare-associated infections (HAIs) in intensive care units (ICUs) are frequent and are associated with sepsis, antimicrobial resistance, and high mortality, reinforcing the need for early risk stratification at admission.</p><p><strong>Objective: </strong>To analyze risk factors and clinical outcomes associated with HAIs in ICU patients.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in the ICU of a public hospital with 141 patients (182 HAI cases). Medical records covered ICU admissions from August 1, 2022, to August 31, 2024, and data collection occurred from November 2024 to February 2025. Data were extracted from medical records and the Hospital Infection Control Committee database. Risk factors were assessed at admission using the Rodríguez-Almeida-Cañon (RAC) Scale, which stratifies HAI risk using intrinsic and extrinsic factors and classifies patients as low, moderate, or high risk. Clinical outcomes monitored during hospitalization included hospital discharge, sepsis, septic shock, and death.</p><p><strong>Results: </strong>By RAC, 53.9% were moderate risk and 45.4% high risk; lower educational level was associated with higher risk (<i>p</i> = 0.016). Ventilator-associated pneumonia predominated (44.4%). Predominant pathogens were <i>Pseudomonas</i> (28.1%), <i>Acinetobacter</i> (19.1%), and <i>Klebsiella</i> (17.4%), with 34.3% showing carbapenem resistance. Sepsis occurred in 18.5% and septic shock in 30.2%; mortality was 62.9%. Compared with the reference group, odds of discharge were higher among patients aged 20-39 years (OR = 12.48; 95% CI: 4.89-102.90; <i>p</i> = 0.002) and 40-59 years (OR = 4.33; 95% CI: 3.89-35.78; <i>p</i> = 0.019).</p><p><strong>Conclusion: </strong>RAC screening revealed a high burden of predisposing factors at ICU admission, particularly among patients with lower educational levels, which was associated with worse outcomes. RAC-guided admission screening can support risk-proportional nursing surveillance and targeted prevention bundles, while institutional policies should reinforce microbiological surveillance and antimicrobial stewardship tailored to social vulnerability.</p>","PeriodicalId":42002,"journal":{"name":"Belitung Nursing Journal","volume":"12 2","pages":"148-157"},"PeriodicalIF":2.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between social participation and stigma in people affected by leprosy: A cross-sectional study in northeastern Brazil.","authors":"Marize Conceição Ventin Lima, Gustavo Aires de Arruda, Maria Geórgia Torres Alves, Waldemar Brandão Neto, Cássia Cibelle Barros de Albuquerque, Raphaela Delmondes do Nascimento, Emanuela Batista Ferreira E Pereira, Marilia Perrelli Valença, Danielle Christine Moura Dos Santos","doi":"10.33546/bnj.4193","DOIUrl":"10.33546/bnj.4193","url":null,"abstract":"<p><strong>Background: </strong>Leprosy remains a persistent public health challenge, especially in endemic areas, where its historical association with stigma continues to harm social participation and psychosocial well-being. Understanding how stigma affects social participation across different life areas is crucial for developing effective care and public health strategies.</p><p><strong>Objective: </strong>To examine the association between stigma and social participation across different domains among people affected by leprosy.</p><p><strong>Methods: </strong>A cross-sectional, quantitative study was conducted in 2019 with 97 individuals affected by leprosy followed at eight municipal reference units in Recife, Pernambuco, Brazil. Sociodemographic, environmental, and clinical data were collected using structured instruments and medical records. Stigma was assessed using the Explanatory Model Interview Catalogue (EMIC), and social participation was evaluated using the Participation Scale (PS). Data were analyzed using descriptive statistics, Spearman's correlation, chi-square tests for linear trend, and effect size estimation using Cramér's V. Statistical significance was set at <i>p</i> <0.05.</p><p><strong>Results: </strong>A total of 53.6% of participants presented some degree of restriction in social participation. The mean stigma score was 16.63 (SD = 8.53), and the mean participation score was 16.58 (SD = 13.62). A statistically significant, low-magnitude correlation was observed between stigma and participation restriction scores (Spearman's rho = 0.25; <i>p</i> = 0.016). Categorical analysis demonstrated a significant linear association between higher stigma tertiles and greater participation restriction (χ² for trend, <i>p</i> = 0.022), with a low overall effect size (Cramér's V = 0.20; 95% CI: 0.10-0.36). Moderate effect sizes were observed in specific participation domains, including religious and community activities (Cramér's V = 0.24; <i>p</i> = 0.02), visiting other people in the community (Cramér's V = 0.26; <i>p</i> = 0.01), and perceived respect within the community (Cramér's V = 0.29; <i>p</i> = 0.04).</p><p><strong>Conclusion: </strong>Stigma was significantly associated with restricted social participation among people affected by leprosy. Although the overall association showed low magnitude, moderate and statistically significant associations were observed in key social domains. These findings support the inclusion of stigma and social participation assessments in routine leprosy care and highlight the need for integrated clinical, psychosocial, and community-based nursing and health interventions aimed at reducing stigma and promoting social inclusion.</p>","PeriodicalId":42002,"journal":{"name":"Belitung Nursing Journal","volume":"12 1","pages":"49-57"},"PeriodicalIF":1.4,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complementary and alternative medicine use and pain characteristics in older Vietnamese adults with chronic pain: A cross-sectional study.","authors":"Nguyen Thi Thu Trieu, Nguyen Thi Yen Hoai, Pham Thi Thuy, Phan Thi An Dung, Do Thi Ninh","doi":"10.33546/bnj.4317","DOIUrl":"10.33546/bnj.4317","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain is a common and burdensome condition among older adults, significantly impacting their quality of life and increasing interest in complementary and alternative medicine (CAM) approaches to pain management.</p><p><strong>Objectives: </strong>This study aimed to describe the prevalence of CAM use and attitudes toward CAM for self-managing chronic pain among older adults, and to examine the associations between chronic pain characteristics, CAM use, and attitudes toward CAM.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 289 hospitalized patients aged ≥60 years with chronic pain at a general hospital in Da Nang, Vietnam, in 2025. Data were collected using a structured questionnaire that included the Pain Disability Index (PDI) and the Attitudes towards CAM scale. Statistical analyses included <i>t</i>-tests, ANOVA, chi-square tests, and Pearson's correlation.</p><p><strong>Results: </strong>CAM use was reported by 92.7% of participants, with biologically based therapies (e.g., herbal remedies) being the most common (81.3%). The average attitude score toward CAM was 28.7 (SD = 3.2), indicating generally favorable views. CAM use was more frequently reported among participants experiencing pain in specific anatomical locations, including the arm/hand, neck, upper back, and lower back (all <i>p</i> <0.008 after Bonferroni correction). Attitudes toward CAM were modestly associated with perceived pain control ability (<i>p</i> = 0.031) and with the impact of chronic pain on daily life (<i>r</i> = 0.206; <i>p</i> <0.001), while other pain characteristics showed no significant associations.</p><p><strong>Conclusion: </strong>CAM is widely used and positively perceived among older Vietnamese adults with chronic pain. Associations were observed between certain pain characteristics and CAM use, as well as between pain-related interference and attitudes toward CAM. These findings highlight the importance of routinely assessing CAM use in older adults and providing guidance on safe, evidence-based options within comprehensive pain management, while recognizing the observational nature of the data.</p>","PeriodicalId":42002,"journal":{"name":"Belitung Nursing Journal","volume":"12 1","pages":"113-120"},"PeriodicalIF":1.4,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146054212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of the Capability-Opportunity-Motivation Behavior (COM-B) model of dietary behavior program on gestational weight gain in Thailand: A randomized controlled trial.","authors":"Pantipa Buakhai, Piyanut Xuto, Pimpaporn Klunklin, Petsunee Thungjaroenkul","doi":"10.33546/bnj.4215","DOIUrl":"10.33546/bnj.4215","url":null,"abstract":"<p><strong>Background: </strong>Excessive gestational weight gain can adversely affect maternal and fetal health. Dietary behavior change can help control gestational weight gain and prevent adverse pregnancy outcomes.</p><p><strong>Objective: </strong>This study aimed to examine the effect of the Capability-Opportunity-Motivation Behavior (COM-B) model of dietary behavior program on gestational weight gain.</p><p><strong>Methods: </strong>This single-blind randomized controlled trial used a pre-posttest control group design and included 96 pregnant women from a northern province of Thailand. Participants were randomly assigned equally to the experimental and control groups (48 each) using permuted block randomization. The experimental group received a 14-session COM-B model of dietary behavior program, while the control group received usual care. Data were collected via questionnaires between November 2023 and October 2024, and were analyzed using SPSS version 26, employing descriptive and inferential statistical methods.</p><p><strong>Results: </strong>At 36 weeks' gestation, pregnant women in the experimental group had a significantly lower mean difference in gestational weight gain based on the Institute of Medicine (IOM) recommendation compared with both their baseline at 20 weeks and the control group. After adjusting for maternal age and education, the experimental group continued to show significantly lower gestational weight gain than the control group. The adjusted intention-to-treat analysis indicated a mean difference of -2.227 kg (95% CI: -3.75 to -0.70; <i>p</i> = 0.005; partial η² = 0.084), while the adjusted per-protocol analysis showed a mean difference of -2.648 kg (95% CI: -4.31 to -0.99; <i>p</i> = 0.002; partial η² = 0.110). These results suggest that the COM-B model of dietary behavior program effectively limited gestational weight gain, independent of sociodemographic differences. Even modest reductions in gestational weight gain may contribute to lowering the risk of pregnancy complications such as gestational diabetes and preeclampsia. Dietary behavior change was monitored, but not a predefined secondary outcome.</p><p><strong>Conclusion: </strong>The COM-B model of dietary behavior program led to minimal but potentially clinically relevant reductions in gestational weight gain. The findings highlight the clinical relevance of nurse-led interventions, underscoring the need for nurse training to implement the program in routine antenatal care.</p><p><strong>Trial registry number: </strong>Thai Clinical Trials Registry (TCTR20230907001).</p>","PeriodicalId":42002,"journal":{"name":"Belitung Nursing Journal","volume":"12 1","pages":"21-29"},"PeriodicalIF":1.4,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146054343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural recognition for women with diabetes using alternative health care in Malay Ethnic, West Kalimantan, Indonesia: A focused ethnography.","authors":"Parliani, Chatkhane Pearkao","doi":"10.33546/bnj.4175","DOIUrl":"10.33546/bnj.4175","url":null,"abstract":"<p><strong>Background: </strong>The use of alternative health care among people with diabetes remains widespread, especially in rural areas of West Kalimantan, Indonesia. In the Malay ethnic community, alternative health care is not just an issue of access but also deeply rooted in cultural and spiritual practices. However, limited research has explored the symbolic meanings and socio-cultural dynamics that underlie the consistent use of alternative health care by people with diabetes.</p><p><strong>Objective: </strong>This study aimed to explore the cultural recognition and socio-cultural meanings embedded in the use of AHC among Malays with diabetes in West Kalimantan, Indonesia.</p><p><strong>Methods: </strong>A focused ethnography was conducted from July to November 2024 using in-depth interviews, focus group discussions (FGDs), observations, and field notes. A total of 45 participants took part in interviews, including people with diabetes, healthcare providers, traditional healers (Tabib), family members, healthcare volunteers, and community leaders. FGDs comprised five groups, and observations included nine participants. Data were analyzed through content, typology, and matrix analysis. To ensure trustworthiness, triangulation and member checking were employed. The study was guided by three theoretical frameworks: Symbolic Interactionism, Cultural Theory, and Critical Social Theory.</p><p><strong>Findings: </strong>Four main themes emerged: (1) cultural logic and illness meaning, in which illness was viewed as a spiritual and moral imbalance; (2) symbolic meanings in alternative health care practices, highlighting ritual healing and spiritual faith; (3) social structures as pillars of healing, where family and community roles legitimized alternative health care; and (4) social processes that created cultural recognition through intergenerational transmission and community validation.</p><p><strong>Conclusion: </strong>Recognizing AHC culturally is essential for understanding the illness experiences of people with diabetes. For nursing practice, these findings emphasize the importance of providing culturally respectful care, fostering open communication between healthcare providers and people with diabetes, and incorporating alternative healthcare approaches into safe, evidence-based health education.</p>","PeriodicalId":42002,"journal":{"name":"Belitung Nursing Journal","volume":"12 1","pages":"79-88"},"PeriodicalIF":2.1,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress levels, stressors, and coping strategies among nursing students during maternal and child health clinical rotations: A cross-sectional study in Saudi Arabia.","authors":"Amaal Samir Abdelmaksoud, Doaa El Sayed Fadila, Bandar Naffaa Alhumaidi, Khaled Mohammed Al-Sayaghi, Mark Yuga Roque, Joyce Toriente Relloso, Hammad Ali Fadlalmola","doi":"10.33546/bnj.4212","DOIUrl":"10.33546/bnj.4212","url":null,"abstract":"<p><strong>Background: </strong>Nursing students often experience high levels of stress during clinical training, particularly in maternal and child health (MCH) rotations, which may affect learning and well-being. Understanding stress levels, stressors, and coping strategies can inform the development of supportive and culturally appropriate educational approaches.</p><p><strong>Objective: </strong>To assess perceived stress levels, identify clinical stressors, and examine coping strategies among nursing students during MCH clinical rotations in Saudi Arabia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in 2024 among 187 female nursing students enrolled in MCH clinical rotations. Data were collected using validated Arabic versions of the Perceived Stress Scale (PSS-10), the Nursing Student Clinical Stressor Scale (NSCSS), and the Brief COPE Inventory. Descriptive statistics and Spearman's rho correlation analyses were performed using SPSS.</p><p><strong>Results: </strong>Most students reported moderate perceived stress (75.4%), with a mean PSS-10 score of 20.5 ± 5.9. The highest stressor domains were MCH-specific challenges (9.13 ± 5.00), academic pressures (8.72 ± 3.95), and the clinical environment (7.65 ± 3.64). Religion (5.20 ± 2.06) and acceptance (4.79 ± 1.80) had the highest mean scores among coping strategies, while substance use was least reported (3.04 ± 1.40). Self-blame showed the strongest association with total clinical stressors (rho = 0.501, <i>p</i> <0.001).</p><p><strong>Conclusion: </strong>Female nursing students experienced moderate stress during MCH clinical rotations, largely related to clinical and academic demands. Coping strategies were predominantly emotion-focused, with self-blame showing a strong association with higher stress levels. These findings highlight the importance of culturally sensitive support strategies in nursing education.</p>","PeriodicalId":42002,"journal":{"name":"Belitung Nursing Journal","volume":"12 1","pages":"121-129"},"PeriodicalIF":1.4,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}