Nursalam

How to attract health students to remote areas in Indonesia: a discrete choice experiment

BACKGROUNDnRemote areas of Indonesia lack sufficient health workers to meet the health-care needs of the population. There is an urgent need for evidence regarding interventions to attract health workers and specifically health students to serve in remote areas. The aim of this research was to analyze the job preferences of health students to develop effective policies to improve the recruitment and retention of health students in remote areas.nnnMETHODSnA discrete choice experiment was conducted to investigate health students preferences regarding job characteristics. This study was conducted in three different regions of Indonesia, with a total included 400 health students. Mixed logit models were used to explore the stated preferences for each attribute.nnnRESULTSnData were collected from 150 medical, 150 nursing and 100 midwifery students. Medical students gave the highest preference for receiving study assistance, while nursing students viewed salary as the most important. Midwifery students valued advanced quality facilities as an important attribute.nnnCONCLUSIONSnThis study confirmed the importance of combination interventions in attracting and retaining health workers in remote areas of Indonesia. Money is not the only factor affecting student preferences to take up a rural post; good management and better facilities were viewed as important by all health students. Addressing health student preferences, which are the candidate of future health workforce, would help the nation solve the recruitment and retention issues. Copyright

Lived experience of Indonesian nurses in Japan: A phenomenological study.

AIMnThe movement of Indonesian nurses via a bilateral agreement with Japan has led to a substantial number of migrants to work as nurses in that nations healthcare system. The purpose of this research was to develop a deeper understanding of the meaningful experiences of Indonesian nurses while working in Japanese hospitals.nnnMETHODSnIn this phenomenological study, sampling was purposive and was based on information shared by five Indonesian nurses. The data were collected in interviews; the analysis was thematic.nnnRESULTSnSix key themes were identified: (i) seeking better than before; (ii) communication challenges; (iii) the nursing examination as a culmination; (iv) differences in nursing practice; (v) cultural differences; and (vi) the benefits of living in developed country. Among these challenges, communication as the basis of shared meaning and understanding was viewed as a complex issue, by both patients and coworkers.nnnCONCLUSIONnThe results of this study call for further intervention in supporting Indonesian nurses living in Japan in their struggle with the issue of communication. The emphasis on language acquisition for personal and professional objectives, and the bridging of cultural differences as well, should be considered in an international context.

Nursing qualification and workforce for the Association of Southeast Asian Nations Economic Community

International nurse migration among Association of Southeast Asian Nations (ASEAN) countries has the potential to increase the effectiveness of health services and access for the ASEAN Economic Community. Providing equivalent nursing qualifications and licensure standards and increasing the availability of the nursing workforce has become a challenge for ASEAN members. The purpose of this study is: 1) to comparatively analyze information on nursing licensing examinations (NLE) across ASEAN countries; and 2) to present information on the human resources required for a successful nursing workforce. This study reviews all documents published on the subject within the ASEAN Economic Community. NLE systems exist in all ASEAN Member States (AMSs)s except Brunei, Vietnam, and Lao PDR. Nursing education systems also vary across ASEAN countries. Language as a means of general communication and nursing examinations also differs. The availability of a qualified health workforce at the regional level is above the threshold in some areas. However, at the national level, Indonesia, Myanmar, Cambodia, and Lao PDR fall below the threshold. Professional licensure requirements differ among ASEAN nurses as a part of the process to become a qualified nurse in host and source countries. Mutual Recognition Agreements on nursing services should address the differences in NLE requirements as well as the availability of nurses.

Development of an empowerment model for burnout syndrome and quality of nursing work life in Indonesia

Objectives This study aimed to develop an empowerment model for burnout syndrome and quality of nursing work life (QNWL). Methods This study adopted a mixed-method cross-sectional approach. The variables included structural empowerment, psychological empowerment, burnout syndrome and QNWL. The population consisted of nurses who have civil servant status in one of the regional hospitals in Indonesia. The participants were recruited using multi-stage sampling measures with 134 respondents. Data were collected using questionnaires, which were then analysed using partial least squares. A focus group discussion was conducted with nurses, chief nurses and the hospital management to identify strategic issues and compile recommendations. Results Structural empowerment influenced psychological empowerment (path coefficientu202f=u202f0.440; tu202f=u202f6.222) and QNWL (path coefficientu202f=u202f0.345; tu202f=u202f4.789). Psychological empowerment influenced burnout syndrome (path coefficientu202f=u202f−0.371; tu202f=u202f4.303), and burnout syndrome influenced QNWL (path coefficientu202f=u202f−0.320; tu202f=u202f5.102). Structural empowerment increased QNWL by 39.7%. Conclusion The development of a structural empowerment model by using the indicators of resources, support and information directly influenced the psychological empowerment of the sample of nurses. As an indicator of meaning, psychological empowerment decreased burnout syndrome. In turn, burnout syndrome, as the indicator of personal achievement, could affect the QNWL. Structural empowerment directly influenced the QNWL, particularly within the workplace context. Further studies must be conducted to analyse the effects of empowerment, leadership styles and customer satisfaction.

Return migration of nurses: A concept analysis

Background: Return migration is a complex, challenging phenomenon and to date it remains a concept that is not well understood. A concept analysis would help to clarify what is meant by return migration. This paper aims to report on an analysis of the concept of return migration of nurses. nDesign: Concept analysis using the Walker and Avant approach. nData Sources: Google Scholar, Pubmed, EBSCO, JSTOR and Web of Science databases were searched without a timeframe. Twenty-one articles meeting the inclusion criteria were included. nMethod: This study employs eight steps of Walker and Avant’s method to conduct the concept analysis. nResults: Return migration of nurses can be defined by five attributes: the motivation and decisions of migrant nurse, return as human right, resource mobilisation, reintegration and return itineraries. Antecedents of return migration include the economic, social, geographical, political, family and life cycle that comprise the cause and eRect framework. With regards to return migration, the consequences are beneficial or detrimental depend on the point of view migrant nurses, source country, receiving country, nursing profession and country health system. Empirical referents have been identified and support potential area to undertake a research on return migration. nConclusion: This concept analysis has clarified current understandings and enhance the clarity of return migration concept. It recognises the centrality of return as a component in migration stage that needs a comprehensive approach.

Analysis of the Survival of Children Under Five in Indonesia and Associated Factors

The under-five mortality rate (U5MR) remains a challenge for developing nations, including Indonesia. This study aims to assess the key factors associated with mortality of Indonesian infants using survival analysis. Data taken from 14,727 live-born infants (2007–2012) was examined from the nationally representative Indonesian Demographic Health Survey. The Weibull hazard model was performed to analyse the socioeconomic status and related determinants of infant mortality. The findings indicated that mother factors (education, working status, autonomy, economic status, maternal age at birth, birth interval, type of births, complications, history of previous mortality, breastfeeding, antenatal care and place of delivery); infant factors (birth size); residence; and environmental conditions were associated with the childhood mortality. Rural or urban residence was an important determining factor of infant mortality. For example, considering the factor of a mothers education, rural educated mothers had a significant association with the survival of their infants. In contrast, there was no significant association between urban educated mothers and their infants mortality. The results showed obvious contextual differences which determine the childhood mortality. Socio-demographic and economic factors remain critical in determining the death of infants. This study provides evidence for designing targeted interventions, as well as suggesting specific needs based on the populations place of residence, in the issue of U5MR. Further interventions should also consider other identified variables while developing programmes to address infants needs.

Factors Affecting Husband Participation in Antenatal Care Attendance and Delivery

The government has implemented several programs to prevent and reduce a mothers mortality rate by enhancing active role of the family. The most responsible family member on maintaining the pregnancy and delivery process is the husband. The husband must be active to take care of his wife. Active participation of the husband in accompanying his wife during pregnancy and the delivery process is one of the substantial factors, which helps the husband to take decisions related to the health of his wife. This study aimed to identify variables and its trends, which significantly affect a husbands participation in accompanying his wife during pregnancy and the delivery process. The data used in this study was from an Indonesian Demographic Health Survey 2012. The study used binary logistic regression as the analysis method. The result showed as many as 8,237 husbands accompanied their wife in antenatal care and the delivery process. The significant variables affecting the husband participation are the age of the wife, the education of wife, the education of the husband, the occupational status of the wife and the husband, the number of children, pregnancy status, and residency region. The possibility for a husband to accompany his wife is larger in several factors, such as the wife being between the ages of 21 – 35 years old, a husband who minimally graduated from junior high school, a working husband, as well as a wife, and the number of children less than and equal to two and the expected pregnancy. The government should consider those factors to create policy related womens health and integrate the factors into various sectors.

QUALITY OF NURSING DOCUMENTATION AND NURSE’S OBJECTIVE WORKLOAD BASED ON TIME AND MOTION STUDY (TMS)

Introduction. The quality of documentation can decrease because of bad admission filling of documentation. Workload is one of the factor that can influence admission filling of documentation. This study was aimed to analyze the correlation between nurse’s objective workload and the quality of nursing documentation in RSU Haji. Method. The design of this study was descriptive correlation with cross-sectional approach. The population on this study was the nurse that works in Marwah 3 and 4 inpatient care in RSU Haji Surabaya. The number of the sample was 14 respondents were selected by simple random sampling. The independent variable was nurse’s objective workload and the dependent variable was quality of nursing documentation. The data were analyzed by using regression logistic. Result. Nurse’s objective workload in RSU Haji was 72%. There was no correlational between nurse’s objective workload with the completeness of nursing documentation (P= 0,999), also nurse’s objective workload with accurate of nursing documentation (P= 0,999). Discussion. This study concluded that nurse’s objective workload was low and quality of nursing documentation was accurate enough and complete enough. Next researcher should provide precise operational so the factors that affected the quality of documentation can be reached and the workload of the nurses in RSU Haji become ideal. Keyword:xa0 nurses, quality of nursing documentation, objective workload

The Effect of Sleep Hygiene on The Sleep Quality in Elderly

Most elderly has decreasing quality of sleep. Sleep patterns of elderly are different from children and adults, the need of the elderly to sleep is 5-7 hours / day. Elderly often awakened in the middle of the night because of physical changes due to age and disease patterns, sleep quality significantly decreases. A good sleep hygiene behavior is assumed can conduct a well sleep. The purpose of this study was to determine the effect of sleep hygiene on sleep quality in elderly. This study used quasi experiment with pre-test and post-test with control group. The research sample consisted of 14 respondents using purposive sampling technique. The statistical test used was simple linear regression to test the hypothesis and paired t-test, to analyze the difference average between the two paired samples (pre and post test). Sleep hygiene has a significant effect on the sleep quality in elderly. It had p value 0.023 <0.05 with F-count> F-table (6.827> 4.45). Correlation of pre-test and post-test was 0.078. Sleep hygiene has an influence on the effect of sleep quality for the elderly. Keywords— elderly, sleep, sleep hygiene, and sleep quality

Developing Format of Clinical Pathway Using Nursing Diagnosis Based on Indonesian Nursing Diagnosis Standart (Standar Diagnosis Keperawatan Indonesia: SDKI)

Clinical Pathway is an integrated service planning nconcept that summarizes each step are given to patients naccording to the standard of service, the standard of nursing care, and other health personnel service standards, based on evidence with results that can be measured and within a certain period (Depkes, 2014). Problems that occur in the hospital, nurses do not know what should be included in the template of clinical pathways because they do not know what should be documented. Most of nurses just do and write as documentation from other professions e.g., (1) taking a blood sample, (2) access IV-line, (3) administered drugs (4) Catheterization, and (5)measure vital signs. The aim of this study was developing format of clinical pathway using standard nursing diagnosis based on Indonesian Nursing Diagnosis Standart (SDKI). Method of this study was analytical descriptive study that conducted to 50 health nrecord for tracer study, 10 nurses at ward and 25 articles for literature review. The result showed that the appropriate nursing diagnosis based on SDKI for clinical pathway of Diabetic Mellitus were : unstable glucose level, activity intolerance, deficit of nutrition. For thrombotic Stroke were : decrease of adaptive intracranial capacity, physical mobility impairment, ineffective breathing pattern. For pneumonia were : ineffective airway clearance, activity intolerance, hyperthermia. For acute myocardial infarction were decreased of cardiac output, activity nintolerance, spontaneous, circulation impairment. The next study will be good for issued not only diagnosis but also intervention on nursing nKeywords—clinical pathway; nursing diagnosis; SDKI