Journal of Rural Community Nursing Practice

Riding the TIDES: Community Health Adaptation to Flooding in Bulacan

2026-09-16T07:10:05+00:00

Background: Flooding represents more than an environmental issue; it poses a profound threat to livelihoods and psychological well-being. For families living in chronically flood-prone areas, it has become a constant fight for survival. Purpose: Although previous studies have examined flood adaptation and disaster resilience, limited research has explored how residents themselves perceive, experience, and adapt to flood-related health challenges through their own visual narratives. To address this gap, this study sought to explore the community health adaptation strategies of barangay residents, the challenges they face, and their aspirations for a healthier, more resilient future. Methods: Using a qualitative photovoice design, 17 purposively selected flood-affected residents documented lived experiences through photographs discussed in semi-structured interviews and focus group discussions. Data underwent inductive thematic analysis. Trustworthiness was ensured through member checking, triangulation, reflexivity, audit trails, and peer debriefing, and code-recoding procedures. Results: The core theme, Riding the TIDES, captured the dynamic process of adapting, persevering, and striving toward resilience amidst flooding. Five themes emerged: (1) Trussed Boundaries of Inundation, (2) Iterative Pathways of Acclimatization, (3) Dialogues of Meaning-Making, (4) Emerging Consciousness of Needs and Aspirations, and (5) Shared Agency and Sustained Solidarity. Conclusion: The findings reveal that adaptation to chronic flooding transcends physical survival and encompasses resilience-building, meaning-making, and collective empowerment. The study contributes a participant-driven understanding of how chronic flood exposure fosters a nuanced form of toxic resilience, in which adaptive capacities coexist with enduring structural vulnerabilities and aspirations for systemic change.

Fostering Screen-Free Emotion Regulation in Generation Alpha: An Age-Stratified Focus Group Study of Developmental Shifts in Tantrum Management

2026-09-16T07:09:56+00:00

Background: Generation Alpha is growing up in a device-saturated environment where device-dependent tantrum soothing is an early entry point into later screen and behavioral addiction, since poor childhood self-regulation predicts addiction decades later. Purpose: As part of developing a Javanese local wisdom parenting framework, this needs-assessment phase compared caregiver experiences with toddler and preschooler tantrums. By identifying key developmental targets for self-regulation, the study provides an empirical foundation to inform future local wisdom based interventions as an alternative to gadget-dependent soothing. Methods: This qualitative descriptive study used two age-stratified focus group discussions with reflexive thematic analysis. Participants were 16 purposively sampled caregivers in Jember, Indonesia: 8 caregivers of toddlers (1.5-3 years) and 8 of preschoolers (3.1-4.5 years), with audio-recorded, group-coded transcripts. Results: Analysis yielded four toddler themes and five preschool themes, synthesized into five comparative themes spanning emotion regulation, gadgets as control versus instant soother, meaningful-activity substitution, nutritional fulfillment, and parent-child dynamics, revealing a continuum from externally regulated, gadget-assisted soothing toward child-initiated coping, negotiated screen use, and egalitarian communication. Conclusions: Tantrum-management strategies shift from externally regulated soothing toward dialogic, autonomy-supportive approaches. Community and family health nurses should stage self-regulation counseling by developmental phase and operationalize the findings from this study as an initial, evidence-based reference point for a future local-wisdom family nursing strategy during home visits, supporting an addiction-free Generation Alpha.

Social Ecological Model Analysis of Individual, Family, Peer, and Digital Environment Factors Associated with Cyberbullying Behavior among Adolescents

2026-09-16T07:09:54+00:00

Background: Globally, the incidence of cyberbullying remains considerably high. In Indonesia, approximately 45% of adolescents have experienced cyberbullying. The impact of cyberbullying can trigger mental health problems among adolescents who have experienced it. Objective: To develop a comprehensive understanding of cyberbullying behavior among adolescents through a social ecological model analysis integrating individual, family, peer, and digital environment factors. Methods: This study employed a quantitative design with a cross-sectional approach. Sampling was conducted using the proportional random sampling technique, with a sample size of 284 respondents calculated using the Slovin formula. Data collection was carried out from February to March 2026. Results: The findings showed a significant association between individual, family, peer, and digital environment factors and cyberbullying behavior (p < 0.05). In the multivariate analysis, peer and digital environment factors remained significantly associated with cyberbullying behavior. The peer factor had an adjusted odds ratio of 2.644 (95% CI: 1.583–4.415; p < 0.000), while the digital environment factor had an adjusted odds ratio of 3.102 (95% CI: 1.881–5.117; p < 0.000). Based on the adjusted odds ratio values, the digital environment factor showed the strongest association with cyberbullying behavior in the final model. Conclusions: The social ecological approach is highly relevant for explaining cyberbullying as a multidimensional phenomenon. These findings are expected to serve as a basis for developing effective and contextual interventions.

Body Mass Index, Physical Activity, and Physical Balance among Community-Dwelling Older Adults in A Rural Balinese Village: A Cross-Sectional Study

2026-09-16T07:09:58+00:00

Background: Population aging in Indonesia has been accompanied by a rising burden of falls among older adults, and rural villages carry much of this burden while having the least access to geriatric rehabilitation services. Impaired physical balance is a modifiable precursor of falling, yet nutritional status and habitual activity have rarely been examined together in rural Balinese communities. Purpose: To examine the relationship of body mass index and physical activity with physical balance among community-dwelling older adults in Gulingan Village, Mengwi Sub-district, Badung Regency, Bali, Indonesia. Methods: An analytical cross-sectional study was conducted between February and March 2026 among 248 older adults aged 60 years and over, recruited by purposive sampling from the village register of integrated health posts for older people. Nutritional status was expressed as body mass index calculated from measured weight and height, and classified with Asia-Pacific cut-off points. Habitual activity was measured with the Physical Activity Scale for the Elderly, and physical balance with the Timed Up and Go test. Associations were tested with the Spearman rank correlation. Results: Mean age was 71.60 years (standard deviation 7.46) and 134 respondents (54.0%) were women. Obesity class 1 was the most frequent nutritional category (85 respondents; 34.3%); 166 respondents (66.9%) had a low level of habitual activity; and 126 respondents (50.8%) were classified as high risk of falling. A higher body mass index category was associated with poorer physical balance (r = 0.848; p < 0.001), and a lower level of physical activity was likewise associated with poorer physical balance (r = 0.725; p < 0.001). Conclusions: Nutritional status and habitual activity were both strongly associated with physical balance in this rural older population, and both are modifiable. Nurses working in village settings should combine routine measurement of weight, height, and activity level with performance-based balance screening and cadre-delivered balance training within existing integrated health posts for older people.

The Impact of Animation Videos Demonstrating the Heimlich Manoeuvre on Mothers’ Proficiency in Assisting Choking Toddlers: A Preliminary Study

2026-09-16T08:08:09+00:00

Background: Choking caused by a foreign object entering the mouth is a critical emergency requiring immediate intervention; a delay in providing aid risks airway obstruction, leading to oxygen deprivation that can result in permanent brain damage, disability, or death. Choking incidents frequently affect children aged 1 to 2 years. Many mothers are unaware of the correct way to handle a choking, such as performing the Heimlich manoeuvre. Purpose: To evaluate the effect of animation videos demonstrating the Heimlich manoeuvre on mothers' proficiency in assisting choking toddlers. Methods: Utilizing a quasi-experimental research design, based on the G*Power formula, a sample size of 40 respondents was determined using simple random sampling, divided into a treatment group of 20 respondents and a control group of 20 respondents mothers with toddlers. Maternal proficiency was measured using validated and reliable questionnaires and observation sheets. The intervention involved watching the video twice daily over four consecutive days, with each session lasting two minutes and seventeen seconds. Results: A significant difference in proficiency (knowledge, attitudes, and skills) (p < 0.001). A difference in proficiency between the treatment and control groups (p < 0.001), with a mean rank for the treatment groups (30.50) and the control groups (10.50). Conclusions: The animated videos are a valuable tool for enhancing mothers' proficiency in managing choking incidents, offering a practical alternative for improving prevention and intervention skills.

Impact of a Structured Family Empowerment Program on Self-Efficacy and Quality of Life among Diabetes Caregivers: A Repeated-Measures Quasi-Experimental Study

2026-09-21T13:45:35+00:00

Background: Family caregivers play a critical role in supporting patients with type 2 diabetes mellitus (T2DM); however, prolonged caregiving responsibilities may negatively affect caregivers’ self-efficacy and quality of life. Strengthening caregiver empowerment through self-efficacy-oriented interventions may improve caregivers’ confidence, coping ability, and overall well-being. Purpose: This study aimed to examine the effectiveness of a self-efficacy-based family empowerment intervention in improving caregiver self-efficacy and quality of life among family caregivers of patients with T2DM. Methods: A quasi-experimental pre-test–post-test control group design with repeated measurements was conducted in community-based primary healthcare centers in Malang City, Indonesia. A total of 64 family caregivers were recruited and allocated to either the intervention group (n = 32) or the control group (n = 32). The intervention group received the “Berdaya DM” program, a structured family empowerment intervention delivered over four weekly sessions focusing on diabetes care, caregiver support strategies, stress management, and self-efficacy enhancement, whereas the control group received standard diabetes education routinely provided by the primary healthcare centers. Outcome measurements were conducted at baseline, immediately after completion of the intervention (post-test 1), and eight weeks after baseline (post-test 2). Caregiver self-efficacy was assessed using the General Self-Efficacy Scale (GSES), and quality of life was measured using the WHOQOL-BREF. Data were analyzed using repeated-measures ANOVA to examine the effects of time, group, and time-by-group interaction. Results: Caregiver self-efficacy and quality of life improved more markedly in the intervention group than in the control group across repeated measurements. At post-test 2, mean self-efficacy scores were 32.37 ± 3.77 in the intervention group and 27.37 ± 3.77 in the control group, corresponding to a between-group mean difference of 5.00 points. Mean quality-of-life scores were 77.14 ± 7.04 and 67.14 ± 7.04, respectively, yielding a between-group mean difference of 10.00 points. Significant time-by-group interaction effects were observed for self-efficacy (F = 73.92, p < 0.001, partial η² = 0.54) and quality of life (F = 82.41, p < 0.001, partial η² = 0.57), indicating large intervention effects over time. Conclusion: The self-efficacy-based family empowerment intervention effectively improved caregiver self-efficacy and quality of life among family caregivers of patients with T2DM. Integrating caregiver-centered empowerment programs into primary healthcare services may strengthen sustainable diabetes management and caregiver well-being.

A Pilot Evaluation of Educational Game Media on Pregnant Women’s Knowledge and Readiness for Safe Childbirth

2026-09-21T14:18:06+00:00

Background: Interactive digital education may strengthen childbirth preparation by presenting clinically relevant information in an engaging and repeatable format. Purpose: This study evaluated the effectiveness of educational game media in improving pregnant women’s knowledge and readiness for safe childbirth. Methods: A quasi-experimental one-group pretest–posttest study was conducted with 35 pregnant women receiving antenatal care in Balikpapan, Indonesia. Knowledge was measured with five dichotomous items, and childbirth readiness with five Likert-type items. Descriptive statistics, validity and reliability screening, Shapiro–Wilk tests, paired t-tests, Wilcoxon signed-rank sensitivity tests, effect-size analysis, and Spearman correlation were applied. Results: Mean knowledge increased from 2.43 (standard deviation 0.95) to 3.54 (standard deviation 0.92), with a mean change of 1.11 points and p < .001. Mean readiness increased from 15.46 (standard deviation 2.12) to 21.31 (standard deviation 1.88), with a mean change of 5.86 points and p < .001. Wilcoxon tests confirmed significant improvements in both outcomes. The mean game-use score was 22.49/25, and the association between game-use score and post-intervention readiness was not significant. Internal consistency was limited across the three brief scales. Conclusions: The educational game was associated with significant short-term improvements in knowledge and childbirth readiness. It may complement antenatal education, although the one-group design, small sample, and limited internal consistency of the instruments require cautious interpretation and further controlled validation.