Inggriane Puspita Dewi

Background: Integrating spiritual care into undergraduate nursing curricula remains inconsistent, particularly in Muslim-majority contexts. Existing models are predominantly grounded in Western or secular frameworks and fail to adequately address the theological and cultural dimensions of Islamic spiritual care. A validated, culturally responsive pedagogical framework is therefore needed. Aim: To develop and establish the content validity of the IneRISE-IMAN ( Islamic Nurturing Experience through Reflective-Islamic values embedded , Simulated and Engaged Learning for Internalization , Meaningful , Active Communication , and Nurturing ) model for undergraduate nursing education. Methods: A two-round electronic Delphi (e-Delphi) study was conducted with 22 purposively selected experts representing nursing education, clinical practice, Islamic chaplaincy, and nursing students. Content validity was assessed using I-CVI, S-CVI/Ave, and S-CVI/UA. Inter-rater agreement was examined using Fleiss’ Kappa. Results: Round 1 demonstrated excellent content validity (S-CVI/Ave = 0.94; S-CVI/UA = 79%). Following targeted revision of six sub-elements, full universal agreement was achieved in Round 2 (S-CVI/UA = 1.00), with 100% panel retention across both rounds. Fleiss’ Kappa indicated moderate inter-rater agreement (κ = 0.44), acceptable for an interdisciplinary panel. Conclusion: The IneRISE-IMAN model shows strong content validity as a theoretically grounded framework that integrates Islamic philosophical anthropology, constructivist learning theory, and person-centered nursing for Islamic spiritual care education in undergraduate nursing. Future research should explore construct validity, implementation feasibility, and the impact on students’ clinical skills.

Background: Cervical cancer remains a significant health issue in Indonesia, where structural barriers, fragmented information, and sociocultural norms continue to hinder timely diagnosis and treatment. Families play a central role throughout the illness journey, yet their perspectives are often overlooked in the development of digital patient navigation systems. This study explored family experiences, caregiving challenges, and expectations for a family-centered digital navigation model, DIVA.ID, by integrating Digital Health frameworks and Family Systems Theory. Methods: A qualitative descriptive approach was employed through semi-structured, in-depth interviews with 18 purposively selected family caregivers of women with cervical cancer at a major referral hospital in West Java. Participants were selected because they were directly involved in daily care, treatment decisions, logistical support, or emotional assistance. Interviews were conducted between August and October 2025 and continued until thematic saturation was reached, as indicated by repetition of categories and the absence of new major codes in the final interviews. Data were analyzed using inductive–deductive content analysis guided by Elo and Kyngäs, with five researchers conducting independent coding, iterative code comparison, consensus meetings, and theoretical mapping. Results: Four main themes emerged: (1) family involvement in decision-making, including collective discussion, shifting authority roles, and patient autonomy; (2) caregiver burden, involving physical exhaustion, psychological distress, social restriction, stigma, financial pressure, and employment disruption; (3) psycho-spiritual coping mechanisms, including emotional sharing, prayer, crying, patience, and surrender to God; and (4) digital healthcare needs, covering BPJS guidance, treatment information, scheduling, communication pathways, shelter support, and mental–spiritual support. Mapping these themes to Digital Health frameworks and Family Systems Theory clarified how DIVA.ID could translate family experiences into practical navigation functions. Conclusions: This study provides empirical foundations for a culturally sensitive, family-centered digital navigation model in Indonesia. Rather than demonstrating effectiveness, the findings identify design requirements for DIVA.ID that should be tested in subsequent feasibility, usability, and intervention studies.

Introduction: Spiritual care is essential in holistic nursing; however, nursing students often feel less confident and reflective in providing it. Innovative teaching methods combining active learning and reflection are needed to fill this gap. Objective: This study evaluated the impact of reflective, flipped-classroom spiritual care training on students' self-efficacy and reflective thinking. Methods: A quasi-experimental pretest–posttest design with a control group was conducted among 82 undergraduate nursing students from two universities in Indonesia. Participants were allocated to an intervention group (n = 41) or a control group (n = 41) based on existing class enrollment. The intervention consisted of a 16-week reflective flipped classroom supported by an interactive e-module, while the control group received conventional lecture-based instruction. Self-efficacy and reflective thinking were measured at baseline and post-intervention. Data normality was assessed using the Shapiro–Wilk test. Within-group differences were analyzed using the Wilcoxon signed-rank test or paired sample t-test as appropriate, and between-group differences were examined using the Mann–Whitney U test. Results: Within-group analyses showed statistically significant improvements in self-efficacy and reflective thinking in the intervention group (p < 0.001). In the control group, changes in reflective thinking were not statistically significant (p = 0.062). Between-group post-test comparisons demonstrated significantly higher self-efficacy and reflective thinking scores in the intervention group than in the control group (p < 0.001), with a large effect (r = 0.67 for self-efficacy and r = 0.61 for reflective thinking). Conclusion: The findings indicate that a reflective flipped classroom approach is associated with higher self-efficacy and reflective thinking among nursing students in spiritual care education. While causal conclusions cannot be drawn, the results support the educational value of reflective and interactive learning strategies in undergraduate nursing curricula.

Spiritual care is recognized as a crucial component of holistic nursing education, significantly enhancing patient well-being, health outcomes, and decision-making. However, a systematic evaluation of spiritual care education programs in the Middle East and Asia remains limited. This systematic review aims to assess the effectiveness of spiritual care education programs in enhancing undergraduate nursing students’ competencies in these regions. Following PRISMA-P guidelines and registered on PROSPERO (CRD42024552137), the study employed the PICOS framework for selection criteria: Participants (undergraduate nursing students), Intervention (spiritual nursing education programs), Comparison (education without spiritual content), Outcomes (spiritual care competencies), and Study design (RCT or quasi-experiment). Searches were conducted in Cochrane, Medline, PubMed, Sage, and Scopus from April to May 2024. Multiple reviewers independently performed data extraction and quality assessment using ROB 2 and ROBIN-I tools. A narrative synthesis approach explored data relationships and theoretical applications. Out of 1,350 reviewed articles, 10 studies involving 749 nursing students from Iran, Taiwan, and Turkey met the inclusion criteria. The interventions spanned from one month to a full semester and combined theoretical learning with clinical practice. The findings indicate that education in spiritual care significantly enhances students’ self-awareness, knowledge, attitudes, and practical skills. The study emphasizes the importance of incorporating spirituality into nursing curricula to promote a holistic approach to patient care. Limitations of the study include differences in study designs, selection bias, variability among participants, and reliance on self-reported data. Future research should aim for longitudinal studies to evaluate long-term effects and create culturally sensitive assessment tools for measuring spiritual competencies.