Journal of Rural Community Nursing Practice

Spatial Accessibility of Community-Based Child-Rearing Health Consultation Services in a Mixed Urban-Rural Municipality in Japan: An Open-Data GIS Analysis

Ryota Kumakura, Yutaro Takahashi, Ryo Horiike, Shizuko Omote, Rie Okamoto — Mon, 30 Mar 2026 00:00:00 +0000

Background: Community-based child-rearing support services are essential for promoting equitable access to maternal and childcare. However, spatial inequities in accessibility may persist in municipalities that encompass both urban and rural areas. The expansion of open government data enables transparent evaluation of spatial accessibility in local health planning. Purpose: This study aimed to evaluate the spatial accessibility of community-based child-rearing health consultation services in Kanazawa City and to demonstrate a reproducible open-data GIS framework applicable to municipal-level child health planning. Methods: A cross-sectional spatial analysis was conducted using consultation site locations and population data in 250-m grid-cells for children aged 0–2 years. Network-based service areas were generated using predefined walking (900 m and 1,800 m) and driving (7.5 km and 15 km) distances. Both area-based coverage and population-weighted coverage within these service areas were calculated. Results: Forty-nine consultation sites were identified. At the 1,800-m walking-distance threshold, service areas covered 76.1% of child-inhabited residential grid areas and 86.5% of the population aged 0–2 years, indicating higher population-weighted coverage than area-based coverage. In contrast, driving-distance service areas encompassed nearly all residential grid areas and virtually all children within the municipality. Conclusions: Pedestrian accessibility to child-rearing consultation services varies within this mixed urban–rural municipality, leaving geographically dispersed areas underserved despite relatively high population-weighted coverage in urban districts. Open-data-driven spatial analysis using both area-based and population-weighted indicators provides a scalable framework for identifying spatial inequities and supporting evidence-based municipal child health planning

Toward the Integration of Agro-Nursing in Philippine Public Health Systems: A Policy Analysis

Jestoni Maniago, Jennifer Joy Olivar, Leahleonila Tungcul, Oscar Turingan — Mon, 30 Mar 2026 00:00:00 +0000

Background: The integration of public health and agriculture represents a unique and revolutionary mechanism to create solutions to the problems of malnutrition, hunger and rural health that are prevalent in the Philippines. Purpose: This policy analysis documents the introduction of "agro-nursing" – an interdisciplinary approach that incorporates agriculture into therapeutic health interventions and nutritional care – into the public health system of the Philippines. Methods: The policy analysis uses the Health Policy Triangle as an analytic lens to contend with the content, context, process, and actors associated with the integration of agro-nursing. Results: The results of the policy analysis demonstrate that while there is a policy-oriented window of opportunity, specifically in the Universal Health Care (UHC) Act, to enact multi-disciplinary, multi-agency health interventions, the coordination of Agency-level partnerships between the Department of Health (DOH) and the Department of Agriculture (DA) must continue to advance. The findings suggest the integration of agro-nursing can create a bridge between clinical care and community food sovereignty, especially amongst climate-affected rural communities. More significantly, the findings show that several issues of policy related to legislation, regulatory scopes of practice, and resource allocation need to be addressed. Conclusion: It is recommended that inter-agency governance be institutionalized, nursing education be supplemented with nutrition-sensitive agriculture components, and pilot models be implemented at the Local Government Unit (LGU) level. By shifting community health from reactive medical care to a proactive ecological health lens, the Philippines could bolster community resilience and sustainable health outcomes.

Internet of Things Enabled Nursing Education and Care: A Global Scoping Review of Evidence, Implementation Challenges, and Policy Implications

Glenn Ford Valdez — Mon, 30 Mar 2026 00:00:00 +0000

Purpose: To outline, evaluate, and integrate empirical and review literature provided by the requester on IoT, other smart-health technologies, and the digital policies influencing nursing education, clinical practice, and population health. Methods: Five-stage Arksey & O’Malley scoping review with Mattos, Levacs Refinements and PRISMA-ScR reporting. 16 full-text PDFs spanning publication years 2014-2024. Inclusion criteria: English, peer-reviewed, IoT, “Internet +” or other digital-transition technologies; relevance to nursing curricula, nursing services, and healthcare delivery or health-enabling smart cities. Results: Sixteen eligible records were identified: four quantitative primary studies, three cross-sectional surveys, one RCT, two engineering/architecture papers, two systematic reviews, one scoping review protocol, one narrative review, one meta-review of IoT definitions, one Macro-policy analysis of digital broadband policies, and one commentary, “Healthy Smart City.” Geographic publication clustering identified East Asia (7) and Europe (3). Substantial repetitive benefits included enhanced psychomotor competence, high intention to adopt IoT in practice, real-time decision support, and macro-level public health improvements. Barriers focused on interoperability, privacy, expense, and gaps in digital readiness. Conclusions: Learning and service outcomes from IoT-enabled pedagogies and care systems are positive, but practical evaluation and equity-focused implementation science are lacking. For increased adoption, cross-national reimbursement frameworks, revised curricula, and multi-disciplinary standards frameworks are essential.

Comprehensive Fall Risk Assessment in an Older Adult Male with Diabetes Mellitus, Hypertension, and a History of Transient Ischemic Attack Using the Morse Fall Scale and Berg Balance Test: A Case Report

Ummi Malikal Balqis, Rizkiyani Istifada, Agnestria Winarto, Lailiyatul Munawaroh — Sat, 28 Mar 2026 00:00:00 +0000

Background: Fall risk in older adults is a multifactorial condition associated with balance impairment, muscle weakness, and chronic as well as neurological diseases, requiring a comprehensive assessment. Purpose: This case report aims to analyze fall risk in an older adult with chronic comorbidities using the Morse Fall Scale (MFS) and the Berg Balance Test (BBT). Method: A descriptive case study was conducted on a 70-year-old older adult male with a history of diabetes mellitus, hypertension, and a transient ischemic attack (TIA) in 2025, accompanied by left upper extremity weakness with a muscle strength of 4. Assessment was performed through direct clinical examination using the MFS and BBT instruments. Results: The patient scored 35 on the MFS, indicating a moderate fall risk, and 38 out of 56 on the BBT, indicating moderate balance impairment, particularly in dynamic activities. Conclusions: These findings suggest that the patient’s fall risk is influenced by a combination of post-TIA neurological factors, muscle strength imbalance, and chronic diseases. The combined use of the MFS and BBT provides a comprehensive overview of fall risk, serving as a basis for planning targeted and sustainable nursing interventions.

Caregiving in Schizophrenia: The Role of Self-Efficacy in Shaping Resilience Among Family Caregivers

Sat, 28 Mar 2026 00:00:00 +0000

Background: Caring for patients with schizophrenia is a significant challenge for caregivers. The responsibility of caring for patients with schizophrenia creates its own pressures and burdens for caregivers, requiring resilience to adapt to these challenges. In addition, self-efficacy is essential for caregivers to maintain confidence and a positive outlook regarding their ability to provide care. Purpose: This study aims to analyze the relationship between self-efficacy and resilience among caregivers of patients with schizophrenia in the Sumbersari District of Jember. Methods: This research uses a cross-sectional correlational design. The population includes 177 caregivers of schizophrenia patients in the Sumbersari District, Jember. A non-probability purposive sampling technique was used, resulting in a total of 123 respondents. The research instruments used were the General Self-Efficacy Scale (GSES) and the Connor-Davidson Resilience Scale (CD-RISC), and data were analyzed using Kendall’s Tau-C test. Results: Most caregivers had low self-efficacy (64, 52%) and moderate resilience (116, 94.3%). The analysis revealed a significant positive relationship between self-efficacy and resilience, with a weak strength (p = 0.001; r = 0.202). This indicates that higher self-efficacy is associated with greater resilience. Conclusions: Caregivers with high self-efficacy tend to be more confident, optimistic, and capable of handling stress while caring for patients with schizophrenia, thus demonstrating stronger resilience in fulfilling their roles. In contrast, caregivers with low self-efficacy may feel less capable of managing caregiving responsibilities, making them more susceptible to psychological stress. It is recommended that interventions prioritize enhancing caregivers’ self-efficacy, as this may improve resilience.

The Effect of Orem’s Self-Care Model on the Improvement of Personal Hygiene in Post-Stroke Clients

Dani Riyanto, Widiyono, Fajar Alam Putra — Sat, 28 Mar 2026 00:00:00 +0000

Background: Stroke is a leading cause of disability, resulting in impaired physical mobility and increased patient dependence in fulfilling basic needs, particularly personal hygiene. Orem’s Self-Care Model is a nursing intervention that focuses on empowering patient independence through structured supportive nursing systems. Objective: To analyze the effect of implementing Orem’s Self-Care Model on the improvement of personal hygiene among post-stroke clients. Methods: This study employed a pre-experimental design using a One-Group Pretest–Posttest approach. A total of 55 respondents were selected through purposive sampling at the General Hospital, Dr. Soehadi Prijonegoro, Sragen. Personal hygiene levels were assessed using the Barthel Index. Data analysis was conducted using the Wilcoxon Signed Ranks Test. Results: Prior to the intervention, the majority of respondents were categorized as totally dependent (41.8%). After three days of implementing the Orem Self-Care Model, no respondents remained in the total dependence category (0%), with most shifting to mild dependence (43.6%) and independent status (30.9%). Statistical analysis revealed a p-value < 0.001, indicating a significant effect of the Orem Self-Care Model on improving personal hygiene. Conclusion: The application of Orem’s Self-Care Model was significantly effective in improving personal hygiene independence among post-stroke clients. This intervention is recommended for integration into rehabilitative nursing care in hospital settings.

The Correlation Between Medication Adherence and Disability among Leprosy Patients in Kunir Public Health Center, Lumajang

Sampiyono, Ainul Yaqin Salam, Zainal Abidin — Sat, 28 Mar 2026 00:00:00 +0000

Background: Leprosy is a chronic infectious disease that can lead to permanent disability if not properly managed, especially due to non-adherence to the Multi-Drug Therapy (MDT) regimen. Medication adherence plays a crucial role in preventing disease progression and the onset of disability. Purpose: This study aimed to examine the relationship between medication adherence and the level of disability among leprosy patients in Kunir Public Health Center, Lumajang. Methods: This research employed a quantitative, correlational design to examine the relationship between medication adherence and disability level among leprosy patients. The study population comprised all leprosy patients in Kunir Public Health Center, with a total of 14 respondents selected using total sampling. The research instruments used were the MMAS-8 questionnaire to assess adherence and the POD scale to assess disability. Data were analyzed using the Spearman Rank test with a significance level of p < 0.05. Results: Most patients had moderate medication adherence (50%), and the majority experienced Grade 1 disability (42.9%). The Spearman test revealed a significant relationship between medication adherence and disability level (p = 0.000; r = 0.930), indicating that higher adherence is associated with lower levels of disability. Conclusions: Regular and timely MDT treatment can suppress disease progression and prevent nerve damage leading to disability. Therefore, improving medication adherence should be a priority in primary healthcare-based leprosy control programs.

Community Nursing Assessment of Family Health Management Among Factory Workers' Households in Rural Indonesia

Hilda Mazarina Devi, Nurul Aisyiyah Puspitarini, Dimas Kurniawan — Sat, 28 Mar 2026 00:00:00 +0000

Background: Background: Wiloso Hamlet, Gondowangi Village, Wagir Subdistrict, Malang Regency, is predominantly inhabited by informal laborer residents. Occupational health has become a key priority within Indonesia’s primary health care transformation at the Puskesmas (Community Health Center). Purpose: The researcher would like to apply the nursing process to the community health problem in Wiloso Hamlet, Gondowangi Village, Wagir District, Malang Regency. Methods: This study employed a case study design using a Community Health Nursing Care approach to assess working groups residing in three neighborhoods (RT 20; RT 22, and RT 23) of RW 04. The instrument used was the Community Health Nursing Assessment Format, which measured demographic characteristics, family health conditions during the past six months, and health-related behaviors, including waste disposal, smoking habits, insurance ownership, and health service utilization. Results: Data were collected from 583 individuals representing 180 households, with 61.41% in the productive age group. Employment distribution showed that 138 individuals (23.67%) were private employees, 81 (13.89%) farmers, and 79 (13.55%) informal workers: laborers, domestic helpers, and construction workers. The most common diseases were acute respiratory infections (32%) and hypertension (26%). Two primary diagnoses were identified: Tendency toward Risky Health Behavior (D.0099) and Ineffective Health Maintenance (D.0003). The proposed interventions included Health Education (I.12383), Promotion of Healthy Behavior and Lifestyle (I.12472), education on the dangers of smoking and air pollution from waste burning, and screening for pulmonary tuberculosis (TB), chronic obstructive pulmonary disease (COPD), and cancer. Conclusions: Strengthening partnerships among Puskesmas, local government, and nearby industries is recommended to ensure the sustainability of occupational health initiatives.

The Relationship Between Satisfaction and Expectations of the Healthcare Community and the Quality of Services in the Emergency Unit of the Klakah Community Health Center, Lumajang

Ulva Kurnia Chahyanti, Zainal Abidin, Ainul Yaqin Salam — Sat, 28 Mar 2026 00:00:00 +0000

Background: The quality of healthcare services is a crucial aspect of service delivery, particularly in emergencies, where timeliness and effectiveness are crucial for patient safety. As a primary healthcare facility, the Klakah Community Health Center plays a crucial role in providing emergency services to the community through its Emergency Unit (ER). However, the quality of services provided in the ER is often influenced by various factors, including community satisfaction and expectations. Purpose: This study aims to determine the relationship between community satisfaction and expectations regarding the quality of healthcare services in the emergency room of the Klakah Community Health Center, Lumajang. Methods: This study is a cross-sectional study. The population in this study consisted of all patients/patients' families who visited the emergency room at the Klakah Community Health Center, Lumajang. A total of 50 respondents were selected. Accidental sampling was used. To determine the effect of the two variables, a Spearman's rank correlation test was conducted at the 0.05 significance level. Results: The Spearman Rank test yielded a p-value of 0.000 (< 0.05), indicating a significant relationship between satisfaction and the quality of emergency room healthcare services, with a coefficient of 0.675 indicating a strong correlation. The Spearman Rank test yielded a p-value of 0.000 (< 0.05), indicating a significant relationship between expectations and the quality of emergency room healthcare services, with a coefficient of 0.604, indicating a strong correlation. Conclusions: Therefore, public satisfaction and expectations significantly influence perceptions of service quality in the emergency room. Patients with high expectations for speed, accuracy, and service friendliness will perceive the emergency room as good if these expectations are met.

The Impact of Climate Change on Cardiovascular Problems of the Elderly in Agricultural Areas

Decky Vrista Tri Anggoro, Tantut Susanto, Fahruddin Kurdi — Sat, 28 Mar 2026 00:00:00 +0000

Exposure to extreme temperatures and air pollution in the agricultural sector causes cardiovascular problems in the elderly. The aging process in the agricultural sector is also correlated with hypertension problems, because the aging process also changes the cardiovascular system and is related to the incidence of hypertension. Furthermore, climate change is also related to hypertension problems or cardiovascular disorders in the elderly. Therefore, it is necessary to analyze the impact of climate change on cardiovascular disease among the elderly to ensure their quality of life in the agricultural sector. Based on the explanation above, it can be concluded that climate change has a significant impact on the health problems of the elderly in the agronursing system. Climate change, including exposure to extreme heat and air pollution, affects cardiovascular disorders among elderly farmers. In responding to these problems, mitigation should be carried out to provide access to health services, enabling farmers, the majority of whom are in developing countries, to minimize the impact of climate change and improve their welfare and quality of life.