Journal of Rural Community Nursing Practice

Nursing Activities of Clinic Nurses in Remote Parts of Japan’s Heavy Snowfall Areas

Tomoko Hayashi — 2025-03-25

Background: Heavy snowfall areas in Japan with inadequate medical care and transportation networks are referred to as remote areas. The remote-area clinics there contribute significantly to maintaining the good health of residents. However, there is a shortage of doctors and nurses. In Japan, where many deaths are expected, the role of nurses in remote-area clinics is expected to become more important than ever. Purpose: To clarify the nursing activities of nurses working in a remote-area clinic in Region A of N Prefecture and the challenges they face. Methods: Seven nurses working in a remote-area clinic underwent semi-constructive interviews and their responses were analyzed qualitatively and descriptively. Results: The following three categories of nursing activities in remote-area clinics were identified: “performing non-specialized tasks in parallel with nursing work,” “assessing the life and health of patients living in heavy snowfall areas,” and “exercising nursing expertise to help patients realize the life they desire. In addition, three categories of challenges perceived by nurses were extracted, such as "nurses experience a dilemma in fulfilling patients' desired quality of life". Conclusions: Nursing activities in remote-area clinics included dispensing and clerical work alongside nursing work. The nursing activities of the remote-area clinics were also performed to support each patient’s desired life until death. Our findings suggest that the shortage of physicians affects the nurses’ anxiety and dilemma.

Impact of Perceived Vulnerability and Benefits on Adolescent Smoking Cessation Motivation

Setyoadi — 2025-03-25

Background: Most smoking among adolescents aged 15-19 years is associated with a psychosocial crisis, as they are still searching for their identity. Factors such as perceived vulnerability and perceived benefits can lead adolescents to start smoking. Purpose: The purpose of this study was to determine the relationship between perceived vulnerability and perceived benefits and motivation for smoking cessation among adolescents. Methods: The research design uses an analytical observational design with a cross-sectional approach. The research sample consisted of adolescent smokers selected using a cluster random sampling technique, resulting in 136 participants. Data for variables were collected using the Perceived Vulnerability to Disease (PVD), Perceived Risks and Benefits Questionnaire (PRBQ), and Smoking Cessation Motivation Questionnaire (Q-MAT), which were modified by the researchers and tested for validity and reliability. The research data were analyzed using the Spearman Rank Test. Results: The results showed that 97.8% of participants had a positive perceived vulnerability, 97.1% had a positive perceived benefit, and 71.3% had a high motivation for smoking cessation. There was a significant relationship between perceived vulnerability and perceived benefits with motivation for smoking cessation, with a significant p-value of 0.000 and correlation values of +0.478 and +0.643. Conclusions: Adolescents' motivation to quit smoking is shaped by their awareness of health risks and the benefits of quitting, such as improved well-being and financial savings. Nursing-based interventions, including counseling, support groups, and school health campaigns, play a crucial role in reinforcing this motivation and ensuring long-term cessation.

Self-Determination and Academic Motivation among Nursing Students in their Transition to Face-to-Face Learning in Selected Higher Education in Quezon City, Philippines: A Sequential Explanatory Design

Cesar M Dalida — 2025-03-25

Background: The COVID-19 pandemic has significantly impacted the educational landscape, leading to the adoption of virtual learning in the Philippines. Purpose: This study aimed to identify students' self-determination and academic motivation following virtual learning and their experiences transitioning to face-to-face learning in selected higher education institutions in Quezon City, Philippines. Methods: The study employed a Mixed-type research approach, specifically the Sequential Explanatory Research Design, with a sample size of 148 nursing students in District 5 in Quezon City. Results: A high level of self-determination was found among participants, significantly correlating the type of family. Three subscales were identified regarding academic motivation: Mastery, Performance Approach, and Performance Avoidance. Participants displayed high motivation in the Mastery subscale, moderate motivation in Performance Avoidance, and lower motivation in Performance Approach. The study established a strong association between self-determination and academic motivation, suggesting that a student with self-determination is likely to be academically motivated, while academic motivation can help develop self-determination. Qualitative analysis revealed three themes: Multifaceted Feelings, Transformative Shift, and Relational Pillars, illustrating the emotional complexities, physical and psychological changes, and the crucial role of support systems during the transition. Conclusions: The study highlights the importance of considering self-determination and academic motivation in understanding students’ experiences during the transition to face-to-face learning. The findings provide insights into this transition’s emotional and adaptive aspects, emphasizing the interconnectedness of personal relationships with academic resilience.

Evaluation of Hand Hygiene Practices and Educational Interventions Among Indonesian Nursing Students: An Analysis Using ATP Wipe Tests and Hand Hygiene Checkers

Mayumi Sato — 2025-03-25

Background: Infectious diseases, including dengue fever and waterborne infections, remain major public health concerns in Indonesia. Hand hygiene is essential for reducing healthcare-associated infections; however, nursing students often fail to practice it effectively despite having sufficient knowledge. Purpose: The present study evaluated the implementation of hand hygiene among Indonesian nursing students, assessed their adherence to the “Five Moments for Hand Hygiene” during clinical training, and examined the necessity for educational improvements using a hand hygiene checker and ATP swab testing. Methods: A cross-sectional study was conducted among nursing students from three national universities in Indonesia. Data were collected through a questionnaire survey on hand hygiene knowledge and practices, self-reported adherence to the 'Five Moments for Hand Hygiene' during clinical training, and an objective evaluation using a hand hygiene checker and ATP swab testing. Results: The majority of students understood hand hygiene techniques; however, 70% failed to meet the WHO recommended handwashing duration. Over 30% of students found it challenging to perform hand hygiene before patient contact and after touching objects in the patient’s surroundings. The hand hygiene checker revealed residual contamination on the nails and fingertips, while ATP swab testing showed that 60% of students did not meet the standard threshold. Conclusions: Despite their knowledge, nursing students face challenges in implementing the proper hand hygiene practices. Knowledge alone is insufficient; practical education with visual and numerical feedback is essential. Training with hand hygiene checkers and ATP swab testing can improve self-assessment skills and enhance adherence to hand hygiene protocols.

A Literature Review on Stress and Eating Disorders in Adolescents: Psychological and Behavioral Perspectives

Fitrio Deviantony — 2025-03-25

Background: Stress affects adolescent health, often leading to unhealthy eating and increasing the risk of eating disorders, especially in young women. Academic pressures and body image concerns intensify stress-related eating. Interventions like mindfulness and nutrition education can support healthier coping and reduce eating disorders in youth. Purpose: The study aims to highlight the significant impact that stress can have on eating behaviors and to provide insights into how these factors are interconnected. Methods: A review of the literature from 2019 to 2024 was conducted as part of this research technique using PubMed and Science Direct, the keywords "stress level," "eating disorder," and "adolescent". Results: The literature review found a significant association between high-stress levels and the prevalence of eating disorders in adolescents, highlighting the need for targeted interventions to address this issue. Conclusions: Beyond merely reiterating the observed correlation, this review emphasizes the urgent necessity for integrated approaches that combine stress management techniques with nutritional education in school settings. Practical implications include the development of school-based programs that incorporate mindfulness training, cognitive behavioral therapy (CBT) principles, and workshops on healthy eating habits. Furthermore, early identification and intervention strategies, such as routine mental health screenings and accessible counseling services, are crucial to mitigate the long-term impact of stress-induced eating disorders.

The Relationship between Coping Mechanisms and Anxiety Levels among Hypertensive Elderly in Rural Areas

Adhitya Restu Wahyuni — 2025-03-25

Background: Hypertension is a prevalent condition among the elderly in rural areas. Anxiety in older adults with hypertension in these regions can significantly impact their blood pressure management, as it may hinder their adherence to medical treatment and healthy lifestyle practices. Purpose: This study aims to analyze the relationship between coping mechanisms and anxiety levels in elderly individuals with hypertension in rural areas. Methods: This quantitative study employs a cross-sectional approach. The population consisted of 198 elderly individuals, with a sample size of 132 elderly individuals with hypertension, selected using simple random sampling. The independent variable is the coping mechanism, and the dependent variable is the level of anxiety. Research instruments included the Coping Mechanism Questionnaire and the Hamilton Anxiety Rating Scale (HARS). Statistical analysis was conducted using the gamma test. Results: The findings indicate that the majority (59.1%) of participants utilized maladaptive coping mechanisms, while nearly half (41.7%) experienced severe anxiety. The gamma test revealed a P-value of 0.000 ≤ 0.05, with a contingency coefficient of -1.000, indicating a statistically significant and strongly negative relationship between coping mechanisms and anxiety levels in elderly individuals with hypertension. Conclusions: The study concludes that adaptive coping mechanisms are associated with lower anxiety levels in hypertensive elderly. Providing these individuals with information and counseling on effective coping mechanisms could help reduce anxiety and promote more adaptive coping strategies.

Exploring the Link Between Spirituality and Anxiety in the Elderly: A Cross-sectional Study at Patrang Community Health Center

Karina Paramita Yanuari — 2025-03-25

Background: Elderly individuals often experience anxiety due to age-related changes. Spirituality has been identified as a potential coping mechanism to mitigate anxiety. Purpose: This study aims to analyze the relationship between spirituality and anxiety in the elderly in the Patrang Health Center area. Methods: The research using cross-sectional correlation analysis, sample consisted of 106 respondents selected through probability sampling, namely proportionate random sampling according to the inclusion and exclusion criteria. The instruments used in this study were the Daily Spiritual Experience Scale (DSES) and Geriatric Anxiety Inventory (GAI) questionnaires. Results: The data were analyzed using descriptive analysis, it is known that most the elderly in the Patrang Health Center area have a high level of spirituality (81.1%) and a mild level of anxiety (64.2%). Based on the Spearman-rho correlation test, p-value of 0.000 and an r= -0.405 were obtained, indicating that there is a relationship between spirituality and anxiety in the elderly in the Patrang Health Center area. Negative correlation namely the higher the level of spirituality in the elderly, the lower the possibility of the elderly experiencing anxiety. Conclusions: It can be concluded that spirituality plays an important role in overcoming anxiety in the elderly. Spiritual beliefs function as a coping mechanism to manage anxiety and good spiritual well-being can minimize symptoms of anxiety in the elderly.

Exploring Mothers’ Experiences in Accessing Primary Healthcare Service Facilities in Rural Indonesia: Implication for Stunting Prevention

Ramadhaniyati — 2025-03-25

Background: Primary healthcare service facilities are essential in preventing stunting by providing comprehensive support for mothers and children. The low usage of the primary health services by pregnant women and mothers with toddlers in rural Indonesia limits the effectiveness of the services and contributes to poor stunting prevention. Purpose: This study aimed to explore mothers' experiences in accessing healthcare services at primary healthcare facilities in Indonesia. Methods: This descriptive qualitative study was conducted in the Melawi district of West Kalimantan Province. Employing a purposive sampling technique, data were collected through in-depth interviews with six mothers, two pregnant and four mothers with children under two years. The data were analyzed through content analysis. Results: Most mothers in this study were high school graduates, of low economic status, aged 22 to 36 years, and from Dayak and Malay cultural backgrounds. Seven categories were identified: stigma in children with stunting, cultural and social norms influence, problems of knowledge and awareness, hierarchical communication between healthcare providers and mothers, trust issues with healthcare providers, equity and accessibility of healthcare service facilities, as well as limited information and education. Conclusions: Encouraging awareness campaigns is vital to address stunting stigmatization. Healthcare providers should improve communication, education strategy, and nutrition competency through targeted training to better support and rebuild trust with mothers. Healthcare institutions and policymakers should develop policies that improve health service quality. Strengthening advocacy roles and collaborating with community organizations could ensure equitable healthcare access.

Efficacy of Bay Leaf (Syzygium polyanthum) Decoction in Managing Type 2 Diabetes Mellitus Patients: A Randomized Controlled Trial

Erna Yovi Kurniawati — 2025-03-25

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by hyperglycaemia, leading to complications such as cardiovascular disease and kidney failure. The increasing prevalence of T2DM necessitates effective management strategies, including complementary therapies like bay leaf (Syzygium polyanthum), which has demonstrated potential for glycaemic control. Purpose: This study aimed to evaluate the effectiveness of bay leaf decoction in improving glycaemic control among T2DM patients in Malangan Village. Methods: A randomized controlled trial (RCT) involved 60 adults aged 30-65 years with fasting blood sugar (FBS) levels between 126-200 mg/dL, selected through purposive sampling. Participants were randomly assigned to an intervention group receiving a bay leaf decoction (10 grams in 250 mL water, twice daily for 12 weeks) or a control group receiving a placebo decoction. Primary outcomes included changes in FBS, while secondary outcomes assessed postprandial blood sugar (PBS) and HbA1c. Compliance and adverse events were monitored, and data were analysed using paired and independent t-tests (p < 0.05). Results: The intervention group showed significant reductions in FBS, PBS, and HbA1c levels compared to the control group (p < 0.05). Older age, female gender, and higher education correlated with improved glycaemic control, while obesity and hypertension were associated with poorer outcomes. No severe adverse events were reported. Conclusion: Bay leaf decoction significantly improves glycaemic control through mechanisms such as enhanced insulin sensitivity, α-glucosidase inhibition, and antioxidant properties. This natural, cost-effective approach is promising as a complementary therapy for T2DM. Future research should explore long-term effects, optimal dosage, and integration with lifestyle interventions to maximize benefits.

The Relationship between Social Media Use and Risky Sexual Behavior Among Adolescents at Senior High School

Nenchy Yetika Setya Ningrum — 2025-03-25

Background: Adolescence is a period of rapid change and development, marked by the maturation of physiological functions and the emergence of primary and secondary sexual characteristics. Without adequate knowledge and education on reproductive health, these developments may lead to detrimental behaviors, such as risky sexual behavior. Purpose: This study aims to analyze the relationship between social media use and risky sexual behavior among adolescents at selected Senior High School in Jember Regency. Methods: This research employs a quantitative method with a descriptive-analytical design using a cross-sectional approach. The data collection was conducted through a total sampling method, involving 123 students as respondents. Data were gathered using a questionnaire and analyzed using Kendall's Tau B test. Results: The findings reveal that 78% of respondents have a low level of social media use, and 54.4% exhibit less active risky sexual behavior. Statistical analysis showed a significant relationship, with a p-value of 0.000 and a correlation coefficient of 0.587, indicating a strong positive correlation. Conclusions: This research shows that higher social media usage is associated with increased risky sexual behavior among adolescents. The study highlights the importance of providing adolescents with comprehensive knowledge and education on reproductive health to help them distinguish positive behaviors from negative influences, thereby reducing the likelihood of engaging in risky sexual behavior. Additionally, the role of parents and teachers in educating and guiding adolescents from an early age is important, as their behavior is shaped by the approach and supervision they receive.