Achir Yani Syuhaimie Hamid

BACKGROUND Poor sleep quality is increasingly recognized as a risk factor for cardiovascular disease and stroke. Despite the heightened vulnerability of individuals with cardiometabolic conditions, evidence on multidimensional sleep characteristics in adults at elevated stroke risk remains limited, particularly in low- and middle-income countries. OBJECTIVE This study aimed to characterize multidimensional sleep profiles among adults at elevated risk of stroke and examine their associations with demographic, behavioral, and cardiometabolic risk factors. The findings provide context-specific evidence from Indonesia to support the conceptual development of a Structured and Measurable Multidimensional Sleep Management Model for LMIC settings. METHODS This cross-sectional study included 303 adults with established stroke risk factors. Multidimensional sleep characteristics were assessed, including subjective sleep quality, sleep duration, sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. Associations between sleep characteristics, demographic factors, lifestyle behaviors, and cardiometabolic conditions were analyzed using descriptive statistics, chi-square tests, and multivariable logistic regression analysis. RESULTS Poor sleep quality was identified in 65.7% of participants, with a marked discrepancy between subjective and objective sleep measures, as most participants perceived their sleep as good despite substantial impairments in sleep efficiency and duration. Smoking, diabetes mellitus, hypercholesterolemia, hypertension, obstructive sleep apnea, and low physical activity were independently associated with cardiometabolic comorbidity, and the final model explained 66.0% of its variability. These findings demonstrate that integrating multidimensional sleep characteristics with cardiometabolic risk profiling enables the identification of heterogeneous sleep dysfunction patterns that may not be detected by subjective sleep perception alone. Accordingly, the findings provide empirical support for the conceptual development of a Structured and Measurable Multidimensional Sleep Management Model to guide individualized stroke prevention strategies. CONCLUSIONS These findings demonstrate that multidimensional sleep assessment identifies substantial sleep impairment associated with cardiometabolic risk factors among adults at elevated risk of stroke, despite generally favorable subjective sleep perception. Integrating multidimensional sleep assessment with cardiometabolic risk evaluation may improve early identification of high-risk individuals and support comprehensive stroke prevention strategies, particularly in resource-limited healthcare settings. Future research should prospectively validate the proposed Structured and Measurable Multidimensional Sleep Management Model and evaluate its clinical effectiveness, implementation feasibility, and cost-effectiveness before widespread adoption in routine clinical practice.

This qualitative study explored the deskilling and upskilling experiences of Indonesian nurses working in Japan during the post-COVID-19 period, with particular relevance on professional adaptation and evolving health system needs and labor demands. An exploratory qualitative design was adopted with 41 Indonesian nurses providing care in hospitals and long-term care facilities in Chiba, Meguro, Saitama and Yokohama. Data were collected during 2023 through face-to-face semi-structured interviews. Data were analysed using Braun and Clarke's six-phase inductive thematic analysis. The analysis generated seven interrelated themes: (1) deskilling experiences, (2) upskilling and reskilling strategies, (3) post-COVID-19 workplace changes, (4) bilateral cooperation dynamics, (5) cultural and professional adaptation, (6) career transition planning, and (7) perceived benefits of working in Japan. Deskilling emerged as a dominant issue, driven by occupational downgrading, restricted clinical practice, and regulatory barriers. Yet people put into action adaptive behaviours such as: informal learning; training attendance and skill reconstruction attempts. Deskilling thus appears not as a simple linear decline but rather as a hybrid phenomenon influenced both by structural factors linked to business performance and individual actions connected to the nature of work itself. These have policy implications for the design of clinical bridging programs, with structured pre-departure preparation in Japan integrated with medical Japanese language training; clinical skill maintenance under supervision in host institutions; and re-licensure pathways for returnee Indonesian nurses. Keyword: Deskilling; Upskilling; Migrant Nurses; Career Transition; Post-COVID-19; Japan–Indonesia Cooperation

Schizophrenia is a severe chronic mental disorder characterized by symptoms that affect human thought processes, emotions, and behavior. This study aimed to explore nurses' perspectives on therapy adherence among individuals with schizophrenia in Indonesia, focusing on types of therapy programs, causes of non-adherence, consequences of non-adherence, barriers to adherence, and strategies for improving continuity of care. A qualitative phenomenological approach was employed, involving in-depth interviews with 11 nurses purposively selected from psychiatric hospitals and mental health clinics across Indonesia. Participants had at least three years of experience in schizophrenia care. Data were analyzed using the Colaizzi method to identify themes and subthemes. Five key themes emerged: (1) Types of therapy programs (nursing therapy, psychopharmacology, psychotherapy); (2) Causes of non-adherence (negative attitudes, lack of family support, drug side effects, healthcare system challenges, economic barriers); (3) Consequences of non-adherence (relapse, rehospitalization, social and familial impacts); (4) Barriers to adherence (nurse-related, doctor-related, patient-related, and family-related obstacles); and (5) Continuity of care (increasing resources, health collaboration, service integration). Nurses emphasized the need for multidisciplinary collaboration and systemic improvements to enhance adherence. The study highlights the multifaceted challenges in achieving therapy adherence among schizophrenia patients in Indonesia. Addressing these issues requires tailored interventions, stronger family and healthcare provider support, and integrated care models. These findings can inform policy and practice to reduce relapse rates and improve patient outcomes.

The increase in cyberbullying among adolescents poses a challenge for mental health professionals. One contributing factor is the lack of a clear and consistent definition of self-control in digital interactions, leading to variability in prevention and intervention strategies in nursing care. This concept analysis aimed to clarify the concept of self-control in the context of adolescents’ experiences with cyberbullying. The concept analysis method developed by Walker and Avant was employed. A comprehensive literature search was conducted in PubMed, ProQuest, ScienceDirect, Scopus, and Google Scholar for articles published between 2010 and 2024.The results revealed that the defining attributes of self-control include self-regulation, impulse control, delayed gratif ication to achieve goal orientation, responsible decision-making, and self-care capacity. Antecedents comprise emotional intelligence, motivation for positive behaviour, empathy, awareness of digital ethics, understanding of cyberbullying’s impact, and social support. The consequences include improved problem-solving skills, better social relationships, enhanced mental health, increased self-conf idence, and a higher quality of life. In conclusion, understanding the attributes, antecedents, and consequences of self-control provides a transparent framework for designing preventive strategies against cyberbullying. This conceptual clarity can be applied in nursing practice, particularly in psychosocial care programs that empower adolescents to navigate digital environments with resilience and responsibility.

This policy brief aims to identify existing policies related to heart failure management and support group interventions, and also to examine how these policies can be optimized by strengthening the role of nurses in Indonesia. Specifically, it examines the integration of nursing-led support groups into the healthcare system as a strategic approach to reducing hospital readmissions and enhancing patient continuity of care for those with heart failure. A policy analysis approach was used by combining a literature review, synthesis of national regulations, and evaluation of global best practices. The process included identifying critical gaps in current heart failure management policy, assessing the impact of support groups, and formulating evidence-based, context-specific policy recommendations. Key challenges identified include high rates of rehospitalization, increased financial burden on BPJS Kesehatan, caregiver stress, and lack of structured, multidisciplinary post-discharge interventions. The evidence shows that support groups effectively enhance treatment adherence, patient empowerment, and overall quality of life. Moreover, nursing-led initiatives have demonstrated significant potential in improving patient engagement and reducing healthcare disparities in diverse populations. Nurses must play active roles in facilitating peer education and providing psychosocial support to contribute to improved health outcomes and system efficiency. This brief emphasizes the necessity of policy frameworks that empower nurses with adequate training, resources, and authority to lead these groups effectively. Nursing-led support groups offer a cost-effective and scalable approach to reducing rehospitalization and promoting self-care in patients with heart failure. Furthermore, integrating these groups within existing clinical pathways can foster multidisciplinary collaboration, improve data collection for monitoring outcomes, and support sustainable healthcare financing models. This policy brief calls for their integration into clinical pathways, supported by regulation, cross-sector collaboration, and sustainable funding. Nurses, alongside interdisciplinary teams, play a key role in ensuring continuity of care through structured peer support at all levels of service.

Introduction: Teenagers in detention centres often experience high levels of stress due to loss of freedom, an uncertain future, and social stigma. This study aims to determine the effect of stress management training on the stress level of adolescent inmates in detention centres. Methods: Quasi-experimental research with pre-post test with control group design. The study sample was 72, divided into intervention and control groups of 36. Purposive sampling technique. Stress management training was conducted in 8 sessions. Instrument used: Depression Anxiety Stress Scale 42. Data analysis with paired t-test and independent t-test. Results: The average age of respondents in the control group was 20.42 years, and the intervention group was 19.94 years. All respondents were male. The last education of the majority of respondents was high school; the control group was 55.6%, while the intervention was 69.4%. Most jobs before entering the prison were self-employed; the control group was 47.2%, while the intervention was 55.6%. Most cases were narcotics; the control group was 44.4%, while the intervention was 41.7%. The average length of stay in the detention centre in the control group was 2.69 months, while the intervention group was 2.61 months. There was a significant difference in reduced stress levels between the intervention and control groups (p = 0.002; d = 0,75). Conclusion: Stress management training lowers stress levels in adolescents in Rutan. These findings open up an excellent opportunity to develop more holistic rehabilitation programs that focus on the recovery and self-development of juvenile inmates. To maximize the positive impact of the study's findings, the researchers recommend that correctional institutions integrate stress management training programs into existing rehabilitation programs.

Lansia membutuhkan petugas yang bersahabat, kompeten, responsif, serta lingkungan yang terorganisir, bersih, dan ramah. Akan tetapi, wawancara pendahuluan dengan tim multidisiplin di panti lansia menunjukkan bahwa mereka kadang merasa jenuh. Penelitian ini bertujuan untuk memahami pengalaman tim multidisiplin dalam merawat lansia di panti. Penelitian ini bersifat deskriptif kualitatif, menggunakan wawancara semi-terstruktur, diskusi kelompok tefokus (FGD) dengan 64 peserta di panti lansia milik pemerintah, analisis dokumen, dan observasi. Data dikumpulkan dari September 2022 hingga Juli 2023 dan dianalisis dengan menggunakan langkah-langkah Colaizzi. Hasil penelitian menunjukkan bahwa lansia di panti mengalami perubahan fisik, psikologis, perilaku, dan sosial, dimana sebagian responden berasal dari latar belakang kemiskinan atau keterlantaran. Kebutuhan lansia meliputi aspek biologis, psikologis, sosial, dan spiritual. Tim multidisiplin merasakan beragam perasaan saat melayani lansia, seperti kebahagiaan, kesedihan, dan kadang-kadang rasa kesal. Beberapa juga merasakan "reframing," yakni perasaan terpaksa karena tidak ada pilihan lain. Oleh karena itu, penting untuk menumbuhkan karakter seperti empati, kasih sayang, kesabaran, dan ketulusan dalam memberikan perawatan kepada lansia. Perubahan lansia yang memiliki latar belakang berbeda memerlukan dukungan terpadu. Manajemen panti lansia disarankan untuk memberikan pelatihan berkala kepada tim multidisiplin agar kualitas pelayanan tetap terjaga.

Introduction: The global community is increasingly recognizing the importance of mental health. However, adolescents in correctional institutions are often overlooked and do not have sufficient access to the mental health services they need. These young individuals have the same right to proper care and support. This study aims to explore the challenges and needs related to adolescent mental health while serving sentences in correctional facilities. Methods: This study utilized a qualitative research design with a phenomenological approach to explore experiences within the prison system. Participants were selected using purposive sampling based on specific criteria, resulting in 30 individuals: nine adolescent inmates, eight caregivers, five nurses, and eight prison officers. The characteristics of participants were analyzed using frequency distribution and measures of central tendency. Qualitative data from interviews were examined through thematic analysis to identify key themes and patterns reflecting the complex realities of those in the prison environment.Results: This study identified four themes: 1) Transition experience during legal proceedings, 2) Risk factors for adolescent mental health problems, 3) Protective factors of adolescent development, and 4) The need to handle mental health problems.Conclusion: Incarceration creates significant psychological stress for adolescents, contributing to anxiety and mental health issues. Factors such as violence during arrest, stigma, and isolation worsen these problems. However, family support, education, and positive activities can help. Comprehensive mental health interventions, including regular check-ups, are essential for the well-being of detained adolescents.

Aim: This study aims to analyze the preparations needed to support Indonesian nurses returning to work in healthcare facilities after working in Kuwait. Introduction: Identifying the factors that motivate Indonesian nurses to return home from Kuwait is crucial. This understanding will help prepare those who wish to continue their nursing careers or pursue other opportunities in Indonesia, in alignment with government policies to ensure their well‐being and that of their families. Background: Nearly all Indonesian nurses who have worked in Kuwait for an extended period plan to return to Indonesia upon retirement, contract completion, or for family or other reasons. The reintegration process for these nurses needs to be optimized, considering its impact on their lives, families, and the government’s recognition and acceptance of the profession they practiced in Kuwait. Methods: This qualitative study uses a descriptive phenomenological approach. Participants consisted of 40 nurses working in government and private hospitals in Kuwait, selected through purposive sampling with maximum diversity. Data were collected using semistructured face‐to‐face interviews, which were audio‐recorded. Data analysis followed Colaizzi’s nine‐step method. The trustworthiness of the data was verified using Lincoln and Guba’s criteria. Results: Four themes emerged: motivation and decision to return, expected preparedness for reintegration, brain gain contribution to the home country, and government support. Discussion: Indonesian nurses returning to their home country face various motivations and challenges, whether continuing their nursing profession or starting their own business. The government is expected to have effective strategies to facilitate their reintegration, enabling them to make optimal contributions in healthcare or other sectors and to support the well‐being of the nurses and their families. Conclusions: Indonesian nurses returning from Kuwait are financially prepared and have gained valuable international experience. However, due to a lack of supportive government policies, they may face challenges related to differing practice systems and professional recognition. Implications for Nursing and Health Policy: The reintegration of Indonesian nurses into the local work and social environment involves navigating differences in work systems, income, professional expectations, and family well‐being. The government must develop and manage specific policies to utilize these nurses as a valuable resource in the healthcare sector.

Background: Stunting is a condition that children are too short of normal height in their age range. One of the risk factors for stunting is parenting that is applied in families to children. Mothers are at the core in the stunting phenomenon so that understanding their experiences in caring for the children with stunting is essential. In this study, we explored the Indonesian mothers’ experiences in caring for the children with stunting. Methods: This research was a qualitative research with descriptive phenomenology approach. Using purposive sampling, we recruited 12 mothers who were caring for the children with stunting. Data were collected through in-depth interviews and were analyzed using Colaizzi method. Results: We identified four themes in this study: (1) the diverse responses reflecting the mothers’ subjective burden; (2) negative views from the society adding the burden to the mothers; (3) trying to be at peace with the children’s stunting condition; and (4) the importance of social support in caring for the children with stunting. Conclusion: Mothers caring for children with stunting experienced a multifaceted burdens coupled with the negative stigma from the community. They tried various ways from cognitive and religious approach to passive appraisal to cope with the stressful situation. The mothers also expressed their needs of social support from their husbands, families, and communities to help them through the stressful situation of caring for the children with stunting.