International Journal of Public Health Science (IJPHS)
The International Journal of Public Health Science (IJPHS), with p-ISSN 2252-8806 and e-ISSN 2620-4126, is an interdisciplinary journal that publishes papers on all aspects of public health science. This journal is published by Intelektual Pustaka Media Utama (IPMU). The IJPHS provides an ideal forum for authors and readers from all over the world to discuss more sophisticated public health research and practice. The focus is on originality and excellence. The journal welcomes high-impact articles on emerging public health science, including epidemiology, biostatistics, nutrition, family health, infectious diseases, health services research, gerontology, child and adolescent health, behavioral medicine, rural health, chronic diseases, health promotion, evaluation, and intervention, public health policy and management, health economics, occupational health, and environmental health. This journal holds SINTA 1 accreditation from the Ministry of Education, Culture, Research, and Technology of the Republic of Indonesia. It was awarded First Grade status ("Peringkat 1") under Decree No. 169/E/KPT/2024, dated 1 October 2024.
Mental health status of healthcare workers in COVID-19 vs non-COVID-19 units: findings from Shariati Hospital, Tehran
This cross-sectional study compared the mental health status of healthcare workers in COVID-19 and non-COVID-19 wards at Shariati Hospital, Tehran, Iran. A total of 250 healthcare workers were selected via systematic random sampling and completed the 28-item General Health Questionnaire (GHQ-28). Data were analyzed using descriptive and inferential statistics in SPSS 24.0. Participants had a mean age of 35.5 years (SD = 8.28) and included 52.6% females and 47.4% males. Based on a GHQ score >23, 63 (53.3%) of staff in COVID-19 wards and 51 (44.7%) in non-COVID-19 wards were suspected of having some degree of mental health disorder. Independent t-test results indicated that healthcare workers in COVID-19 wards experienced significantly higher levels of general mental health problems (t = 4.20, P < 0.001), anxiety (t = 5.55, P < 0.001), and somatic symptoms (t = 4.09, P < 0.001) compared to their counterparts in non-COVID-19 wards. The study highlights a relatively high prevalence of mental health disorders among hospital staff, particularly those working in COVID-19 units. Early identification of at-risk personnel, implementation of targeted interventions, and provision of counseling and psychological support are essential to safeguard the mental well-being and performance of healthcare workers during the ongoing pandemic.
Copyright (c) 2026 Abdolhakim Jorbonyan, Maryam Khosrozadeh, Ali Karimi-rozveh http://creativecommons.org/licenses/by-nc/4.0
Post-COVID-19 syndrome in children: a scoping review
Post-COVID-19 syndrome (PCS) and multisystem inflammatory syndrome in children (MIS-C) have emerged as significant pediatric health challenges, yet the true prevalence and long-term effects remain unclear. Children typically experience milder acute infections than adults, but a subset develop persistent physical, neurological, and psychological symptoms that impair quality of life. To synthesize current evidence on the long-term symptoms, risk factors, and outcomes of PCS and MIS-C in children and adolescents from 2021-2025. Following the PRISMA-ScR framework, 30 studies involving children aged 0-19 years were systematically reviewed across major databases. Thematic analysis identified clinical patterns, risk determinants, and mechanistic explanations. The construal level theory (CLT) was used to interpret behavioral and psychological adaptations influencing recovery. While most pediatric cases resolved fully, 15-30% of MIS-C survivors exhibited prolonged neuropsychological symptoms, fatigue, cognitive impairment, and mood disturbances lasting beyond12 weeks. Risk factors included adolescent age, severe acute illness, and preexisting conditions. Major gaps include inconsistent definitions, limited longitudinal follow-up, and the absence of standardized rehabilitation or psychosocial care protocols. Post-COVID-19 sequelae in children warrant structured follow-up programs integrating neurocognitive assessment, mental health support, and standardized care pathways to reduce long-term disability and guide policy formulation. Post-COVID-19 syndrome, MIS-C, pediatrics, long COVID, scoping review.
Copyright (c) 2026 Raphael Folorunsho Oluwasina Babatola, Evelyn Funke Folorunsho http://creativecommons.org/licenses/by-sa/4.0
Strengthening intensive care training in response to COVID-19: lessons for medical education
Frequent updates to clinical guidelines during the COVID-19 pandemic have posed significant challenges for audit processes, quality improvement, and the preparedness of healthcare professionals, particularly in intensive care settings. This study aimed to explore the impact of COVID-19-related demands on medical education and training from the perspective of healthcare teams working in intensive care units (ICUs) in Indonesia during the first wave of the pandemic. A qualitative design was employed using semi-structured interviews and focus group discussions with medical personnel directly involved in the care of COVID-19 patients at national referral hospitals. Purposive sampling was applied to recruit participants, including general practitioners, interns, residents, anesthesiologists, and ICU consultants. A total of 66 participants were included across eight focus group discussions, each consisting of eight to nine participants. Data collection continued until thematic saturation was achieved. Transcripts were analyzed using content analysis to identify key themes and subthemes. The analysis revealed five major themes: i) the need for continuous upgrading of knowledge and competencies, ii) the importance of innovative education and training approaches, iii) the role of professional organizations, iv) challenges encountered during training implementation, and v) time constraints. These findings highlight the urgent need for adaptive, continuous, and technology-supported training strategies to strengthen intensive care workforce preparedness during public health emergencies.
Copyright (c) 2026 Mochamat Helmi, Djayanti Sari, Yenny Sulistyowati, Andreasta Meliala, Tjahja Nurrobi, Tugas Ratmono, Laksono Trisnantoro http://creativecommons.org/licenses/by-nc/4.0
Evaluating the performance of TAG-IT for prediabetes detection in Indonesian population
Early detection of prediabetes plays a critical role in preventing type 2 diabetes mellitus (T2DM), especially within primary care, where access to laboratory testing may be constrained. Non-laboratory-based risk assessment instruments, including the tool to assess the likelihood of fasting glucose impairment (TAG-IT), can facilitate preliminary risk screening. This study sought to determine the diagnostic accuracy of the TAG-IT questionnaire in detecting prediabetes, using the oral glucose tolerance test (OGTT) as the reference standard. A cross-sectional design was implemented across three community health centers in the Special Region of Yogyakarta, Indonesia. Although 308 individuals were initially enrolled, only 93 participants with complete datasets were eligible for final analysis. The discriminative capacity of TAG-IT was evaluated through receiver operating characteristic (ROC) curve analysis along with a contingency table. Among the participants analyzed, 24.7% (23/93) were classified as having prediabetes. The TAG-IT tool exhibited modest discriminatory performance, yielding an AUC of 0.656 (95% CI 0.525-0.786; p = 0.026). Using the identified optimal threshold, sensitivity reached 52.2% while specificity was 67.1%. The negative predictive value was 81.0%, indicating better performance in excluding low-risk individuals. Overall, TAG-IT demonstrated moderate utility as a preliminary screening instrument in primary healthcare, particularly for identifying individuals unlikely to have prediabetes.
Copyright (c) 2026 Yaltafit Abror Jeem, Rahma Yuantari, Hajar Admira Widiatninda, Russy Novita Andriani, Siti Solichatul Makkiyyah http://creativecommons.org/licenses/by-sa/4.0
Technology to support mental health adolescents: a literature review
The increasing prevalence of mental health issues among adolescents highlights a critical public health concern. Adolescents face unique challenges during this developmental phase, including academic pressure, social media influence, and the stigma surrounding mental health, which may hinder their willingness to seek help. This paper aims to explore the role of technology in preventing and addressing mental health challenges among adolescents, focusing on the potential of digital tools to provide accessible and effective support. This study is a literature review using the PRISMA method, covering articles published between 2001 and 2024. A total of 56 relevant articles were retrieved from the Science Direct, Scopus, and Google Scholar databases. This study seeks to analyze technological interventions in mental health care. The primary strategies include examining mobile applications, telehealth services, and other digital platforms that facilitate early detection and the sustainable management of mental health conditions. The review also considers the implications of privacy, data security, and digital literacy in implementing technology. Findings indicate that digital tools can significantly enhance access to mental health resources, enable timely interventions, and reduce the stigma associated with seeking help.A comprehensive approach that combines technological innovation with robust data protection is crucial to improving adolescent mental well-being. By leveraging the power of technology while ensuring personal information security, stakeholders in mental health, technology, and policy can collaborate to create effective, accessible, and safe mental health interventions for young people.
Copyright (c) 2026 Lina Handayani, Heni Trisnowati, Isah Fitriani, Beddu Hafidz, Asa Ismia Bunga Aisyahrani http://creativecommons.org/licenses/by-sa/4.0
Tacrolimus outcomes in adult kidney transplants: a decade review
Tacrolimus remains a principal immunosuppressive agent in kidney transplantation, yet its reported efficacy and safety vary due to differences in study design, treatment regimens, and patient characteristics. Objectives: To summarize recent evidence on the clinical performance of tacrolimus in adult kidney transplant recipients and identify factors contributing to variability in outcomes. A narrative review was conducted using PubMed as the primary database because of its comprehensive indexing of clinical and pharmacological studies relevant to transplant immunosuppression. Additional databases were screened to ensure completeness. Studies published between 2015 and 2025 were searched using predefined keywords. Of 91 open-access articles identified, 19 met the inclusion criteria and were analyzed. Results: Reported clinical outcomes demonstrated wide variability across studies. Acute rejection ranged from 0-18.8%, while biopsy-proven acute rejection varied substantially (0-85%). Graft loss occurred in 0-15% of recipients and mortality in 0-8%. Major adverse events were also heterogeneous, including cytomegalovirus (CMV) infection (0-16.9%), new-onset diabetes after transplantation (NODAT) (0-22.8%), and tremor (3-28.6%). Variability in findings was largely influenced by differences in study methodology, concomitant immunosuppressive protocols, monitoring practices, population characteristics, and limited ethnic diversity, as most participants were Caucasian. Tacrolimus maintains a strong efficacy-safety profile in adult kidney transplantation. Future studies with more diverse populations, standardized therapeutic drug monitoring, and longer follow-up durations are required to enhance generalizability and support individualized immunosuppressive management.
Copyright (c) 2026 Lolita, Isrovanigoro, Metalia Puspitasari, Zijie Wang http://creativecommons.org/licenses/by-sa/4.0
Game on for health: designing gamified campaigns to drive behavioral change
An awareness campaign aims to reach out to the public, measure the outreach accurately, and motivate the public to act. In other words, awareness campaigns deliver messages on the importance and effects of the promoted event to the audience. However, studies that examine the users’ perception of design for behavior change through gamified health awareness campaigns are limited, especially in combating the coronavirus disease 2019 (COVID-19) outbreak. Subsequently, analysis of such perceptions is crucial in supporting game designers in developing engaging games for health awareness campaigns. Thus, the current study explores users’ perceptions based on elements in the GAMEBC Model: Autonomy, Relatedness, Competence, and Engaging. A total of 180 students from UiTM Cawangan Melaka (UiTMCM), Jasin Campus, participated in the study. The data was evaluated using conventional descriptive statistical methods. The findings revealed users’ perceptions of the design for behavior change in the context of a gamified health awareness campaign. The study offers a valuable understanding of the necessity of creating a comprehensive gamified campaign that promotes behavioral change for improved quality of life.
Copyright (c) 2026 Nurul Hidayah Mat Zain, Anita Mohd Yasin, Zainab Othman, Siti Nuramalina Johari, Norshahidatul Hasana Ishak, Siti Rahayu Abdul Aziz http://creativecommons.org/licenses/by-sa/4.0
The wellness equation: understanding health practices and behaviors of university students in Southern Philippines
This study aimed to explore the health practices and behaviors of university students in the Southern Philippines, focusing on key domains such as health perception and management, nutritional practices, physical activity, sleep, cognitive function, and stress tolerance. Using a quantitative, descriptive correlation design, data were gathered from 1,086 students through a simple random sampling technique. The primary instrument used was the health practices and behaviors questionnaire, which assessed students' health behaviors across the various domains. Statistical analysis involved computing composite means to describe health practices and Spearman's rho to examine the interrelationships between these behaviors. Results indicated that students exhibited moderate health practices across most domains, with a significant positive correlation found between health behaviors in areas such as physical activity, stress tolerance, and sleep. The study highlights the interconnected nature of health behaviors and the need for integrated health promotion strategies that address multiple aspects of student well-being simultaneously. The findings suggest that universities should focus on holistic programs that foster healthier lifestyles, improving students’ overall health outcomes and academic performance. Future research should explore additional factors influencing student health behaviors, including socio-economic, environmental, and cultural influences, to create more targeted interventions.
Copyright (c) 2026 Jomar B. Esto, Jemwell B. Francisco, Ruben L. Tagare, Jr., Cheeze R. Janito, Norge D. Martinez, Eduard S. Sumera, Marichu Calixtro, Vinus P. Java, Moreno B. Java, Jr., Gladys Pearl O. Ambrocio, Jessa S. Buisan, Gauvin Adlaon http://creativecommons.org/licenses/by-sa/4.0
Association between risky dietary behaviors and academic achievement among adolescent girls: a cross-sectional study in Surabaya, Indonesia
Risky dieting is an unbalanced eating pattern increasingly practiced by adolescent girls and has the potential to impact cognitive function and academic achievement. However, previous research has focused more on the impact of risky dieting on nutritional status and physical health, while empirical evidence regarding its relationship with academic achievement in adolescent girls is still limited, particularly in the context of higher education. This study aimed to analyze the relationship between risky dieting and academic achievement in adolescent girls. The study used a quantitative design involving 70 adolescent girls. Data were collected through a peer counselor-based questionnaire to measure risky dietary habits and academic achievement. Data analysis was performed using Fisher's exact test. The results showed p-values of 0.05 and 0.023, respectively, indicating a significant relationship between risky dieting and academic achievement. Adolescent girls who engaged in risky dieting tended to have lower semester GPAs (11%) and cumulative GPAs (4%). The study concluded that risky dieting contributes to decreased academic achievement. This study contributes by expanding empirical evidence regarding the impact of risky dieting on academic achievement and emphasizes the importance of integrating nutrition interventions and health education in strategies to improve academic achievement in adolescent girls.
Copyright (c) 2026 Tatarini Ika Pipitcahyani, Ervi Husni, Dina Isfentiani, Nina Primasari, Halimatus Sa'diyah, Mohammad Zamroni http://creativecommons.org/licenses/by-sa/4.0
Effectiveness of delivery mode of pharmacist intervention to improve medication adherence and clinical outcomes in people with depression: a systematic review
Depression is a treatable mental health condition with various medication options available. For patients with major depressive disorder (MDD), adherence to antidepressants is essential for effective treatment. However, low medication adherence remains a significant challenge, particularly in individuals with depression. Pharmacists play a crucial role in managing these patients. This systematic review evaluated the impact of pharmacist-led interventions, focusing on the effectiveness of delivery modes (in-person vs. online) in improving medication adherence and clinical outcomes for patients with depression. Randomised and non-randomised controlled trials were included. Data were sourced from PubMed, Scopus, ScienceDirect, and Google Scholar using keywords such as "pharmacist intervention," "education," "medication adherence," "depression," and "medication compliance." Three reviewers independently screened and selected articles, and methodological quality was assessed using the Joanna Briggs Institute Randomized Controlled Trial Checklist. From an initial pool of 791 publications, 364 underwent a comprehensive review, and 14 met the inclusion criteria. The most successful interventions were those conducted face-to-face (83%), compared to those conducted through video and phone calls (16%). However, neither method could improve the severity of depression significantly. Pharmacist interventions can enhance patient adherence to antidepressant medication in patients with depression. Compared to virtual methods, face-to-face techniques are more effective at improving adherence. However, they were not able to improve the symptoms of depression.
Copyright (c) 2026 Yosi Febrianti, Ika Puspita Sari, Anna Wahyuni Widayanti, Diana Setiyawati http://creativecommons.org/licenses/by-sa/4.0
Geospatial patterns and determinants of toddler stunting: evidence from geographically weighted regression
This study aimed to map and analyze the spatial distribution of toddler stunting in Malang and identify key risk factors that are spatially correlated with stunting incidence across sub-districts and villages. A geospatial modeling approach using geographically weighted regression (GWR) was employed to account for local variations in the influence of risk factors, reflecting the heterogeneity of conditions that contribute to stunting in different areas. The analysis revealed significant spatial autocorrelation, with stunting cases clustering in specific locations. Results indicate that sanitation risks and household waste management practices were the most significant determinants of stunting prevalence among toddlers in Malang. Improper waste segregation, which leads to odors and attracts flies, and ineffective disposal methods, such as open burning or dumping, were strongly associated with higher stunting rates. These findings underscore the importance of targeted interventions addressing environmental health and sanitation at the local level. By integrating geospatial analysis with GWR modeling, this study highlights the spatial heterogeneity of stunting determinants, providing evidence to guide community-specific public health strategies. Improved sanitation practices and proper household waste management are critical to reducing toddler stunting in areas with clustered risk.
Copyright (c) 2026 Muhammad Anismuslim, Henny Pramoedyo, Sri Andarini, Sudarto http://creativecommons.org/licenses/by-nc/4.0
Physical activity and associated factors among Indonesian pregnant women: a mixed-method study
Exercise is recommended for pregnant women, but many are sedentary. Studies on barriers to physical activity and exercise among pregnant women in West Java Province, Indonesia, are scarce. This study aims to identify and explore the underlying factors associated with physical activity during pregnancy in West Java, Indonesia. This study was conducted using a mixed-methods strategy that integrates quantitative and qualitative data. The study surveyed pregnant women in West Java, Indonesia, from January to March 2023. The study involved 18-year-olds, married women, and fluent Bahasa participants. It used a questionnaire to assess physical pregnancy activity intention, and analyzed data using descriptive, correlation withp<0.025 included in linear regression analysis. While in a qualitative study used semi-structure interview. A study of 200 pregnant women found that age negatively correlated with total metabolic equivalent of task (MET), while gestational age, education level, body mass index (BMI), and pregnancy complications positively impacted it. Pregnancy symptoms, limited time, and low social support were identified as themes impacting adhering to physical activity recommendations. The study reveals that factors such as age, gestational age, education level, BMI, and pregnancy complications significantly influence total MET in pregnant women, suggesting the need for personalized interventions.
Copyright (c) 2026 Feva Tridiyawati, Dg Marshitah Pg Baharuddin, Nicholas Pang http://creativecommons.org/licenses/by-sa/4.0
Sex differences on patient safety culture practices among nurses in Karawang, Indonesia: a cross-sectional study
Nurses are critical in enhancing the quality of care and patient safety due to their commitment to caring for patients 24 hours a day and their interaction with families and other health professionals. The role of gender in the interprofessional team is more complex and warrants further investigation, even though it has been increasingly studied at the level of the individual healthcare provider. In this study, we examined sex differences in patient safety culture practices among nurses. This study was conducted using a cross-sectional design at a general public hospital in Karawang, West Java, Indonesia. The hospital survey on patient safety culture (HSPSC) was used. A chi-square test and an independent t-test were used to determine whether there were any differences in patient safety culture practice between the sexes. A total of 75 males and 145 females agreed to join this study. The mean age of female and male participants was 34.21 ± 14.07 and 36.29 ± 12.51 years old, respectively. Age, marital status, and working position were significantly different between males and females (p < 0.05). Females reported to have a higher overall score of patient safety culture practices than males (3.65 (SD = 1.12 vs. 3.11 (SD = 1.43), p-value = 0.001). According to the patient safety culture practice domain, teamwork (4.21 (SD = 1.35) vs. 3.78 (SD = 1.76), p-value = 0.001), response to error (3.56 (SD = 1.93) vs. 3.31 (SD = 1.93), p-value = 0.001), and communication openness (3.881.56 vs. 2.35 (SD = 0.92), p-value = 0.001) were higher among female than male. Nurses must be trained, and professional communication must be improved as a means of ensuring better patient safety. Patient safety cultures vary widely across hospitals, units, and countries, as evidenced by the growing number of studies that have looked at this issue in depth.
Copyright (c) 2026 Lilis Suryani, Santhna Letchmi, Faridah Mohd Said http://creativecommons.org/licenses/by-nc/4.0
Antibiotic susceptibility profile of uropathogens in pregnant women with asymptomatic bacteriuria in tertiary care hospital: a cross-sectional study
Urinary tract infections (UTIs) are common during pregnancy due to physiological and anatomical changes that predispose women to infections. One such condition, asymptomatic bacteriuria (ASB), if left undiagnosed and untreated, can lead to serious maternal complications such as pyelonephritis, postpartum UTI, and hypertensive disorders, as well as neonatal complications including preterm birth, low birth weight, and intrauterine growth restriction. This study aimed to determine the prevalence of ASB, identify the major uropathogens, and analyze their antibiotic susceptibility patterns in pregnant women, to guide effective antenatal care and treatment. This cross-sectional study was conducted on 100 midstream urine samples, which were cultured using standard microbiological techniques. The bacterial isolates obtained were identified, and their antibiotic susceptibility was determined following standard guidelines. Out of 100 samples, 14 (14%) were positive for significant bacteriuria. The most common isolates were Staphylococcus aureus (42.8%), followed by Escherichia coli (28.6%) and Klebsiella species (28.6%). ASB was most prevalent in women aged 21-30 years (64.3%), during the first trimester (64.2%), and among multigravida women (57.2%). The isolated organisms showed good susceptibility to Ceftazidime/Clavulanic acid, Ciprofloxacin, Vancomycin, Amikacin, Piperacillin–Tazobactam, Imipenem, Teicoplanin, and Linezolid. Early detection and treatment can significantly reduce adverse outcomes, making bacteriuria screening an essential part of routine antenatal care.
Copyright (c) 2026 K. Murugesh, Harvick P. Gowda, K. Pushpalatha, J. V. Sathish http://creativecommons.org/licenses/by-sa/4.0
Effects of soy plus zinc supplementation on growth and kidney health in Wistar rats: Implications for childhood stunting prevention
Zinc deficiency can cause growth and health problems, whereas protein from soy sources contributes to essential nutritional intake. This study aimed to evaluate the effects of soy plus zinc (SPZ) supplementation on growth and kidney health in Wistar rats. This study used a randomized controlled trial design with 24 rats divided into five treatment groups, including a control group. SPZ supplementation was administered daily for 14 days with varying zinc doses (0.020 mg and 0.035 mg per gram of body weight) and palatability enhancement using vanilla flavoring. Data obtained through measurements of initial and final body weights and kidney weights were analyzed using ANOVA to determine significant differences between groups. The results showed that SPZ supplementation positively contributed to growth, as evidenced by a significant increase in the final weight of rats compared to their initial weight (p < 0.05). Histological analysis of the kidneys indicated no visible structural damage, and the average increase in kidney weight was approximately 26.5%. The combination of soy and zinc in SPZ was shown to have a synergistic effect that benefits the development and kidney health of rats, demonstrating its potential application in the context of animal nutrition.
Copyright (c) 2026 Yuniastini, Purwati, Antun Rahmadi, Sulastri, Wien Wiratmoko, Iradah Lia Prasetio, Hendri Busman, Muhammad Al Hafidz, Fannia Khairani Mz, Mohammad Hafid Hak http://creativecommons.org/licenses/by-sa/4.0
Calgary family intervention model enhances dietary compliance and knowledge in T2DM patient
The urgency was in developing a more holistic and sustainable approach to supporting type 2 diabetes mellitus (T2DM) patients. This study evaluated the effectiveness of the Calgary Family Intervention Model (CFIM) in improving dietary adherence and knowledge in patients with T2DM. This study used a quantitative method with a quasi-experimental design, involving 280 patients with type 2 diabetes mellitus at the Bolo Community Health Center from January to October 2025. The sample was divided into two groups: intervention (CFIM education) and control (booklet). Data were collected using a valid and reliable questionnaire to measure knowledge and dietary adherence. Data analysis was performed using the Wilcoxon and Mann-Whitney tests. The analysis showed significant results, with the mean knowledge score in the intervention group increasing from 4.84±1.235 to 8.98±2.851 (p < 0.05), while in the control group, it increased from 4.64±1.120 to 7.06±1.219. For dietary adherence, the intervention group showed an increase from 27.00±6.518 to 61.38±7.171 (p = 0.000), compared to the control group, which increased from 27.28±5.592 to 49.44±10.194(p < 0.05). The implications of these results have the potential to strengthen the family-based health intervention model and improve the overall well-being of T2DM patients. This study contributes significantly to family nursing practice by demonstrating the efficacy of the CFIM in enhancing dietary adherence and knowledge among patients with T2DM.
Copyright (c) 2026 Muhtar, Aniharyati, Julhana, Fadlurahmi, Muhammad Arifki Zainaro, Martiningsih http://creativecommons.org/licenses/by-sa/4.0
Workplace spirituality and nurses’ well-being: integrative review (2015-2025)
Occupational well-being and workforce sustainability in post-pandemic healthcare systems are at risk due to increasing emotional, ethical, and workload-related stressors that nurses encounter. Workplace spirituality has also been suggested as a protective factor, but empirical research remains fragmented and insufficiently synthesized. This integrative review aimed to synthesize the recent evidence on the role of workplace spirituality in the occupational well-being of nurses. A systematic search of Scopus, MEDLINE, and Cochrane databases identified English-language quantitative studies published between 2015 and 2025. Nineteen studies met the inclusion criteria and were synthesized using Whittemore and Knafl integrative review framework, with reporting relying on PRISMA 2020. There were five themes that included i) spirituality and burnout reduction, ii) organizational commitment and retention, iii) work engagement and job satisfaction, iv) spiritual congruence and interpersonal care, and v) spiritual leadership and well-being. Most findings demonstrated moderate-to-strong associations between workplace spirituality and decreased burnout, increased engagement, and greater organizational commitment. Nevertheless, these advantages were conditional and mitigated in the conditions of overwork, insufficiency of staffing, moral tension, and insufficient organizational support. This review offers a quantitative integrative synthesis of the first nursing-specific evidence to be published after the pandemic and shows that workplace spirituality serves as a complementary resource, rather than a standalone, to occupational well-being. The findings highlight important implications of nursing policy regarding introducing spirituality-based leadership development, ethical governance, and workforce support as part of the broader structural reforms.
Copyright (c) 2026 M. Fahrin Azhari, Johari Daud Makajil, Fredie Robinson, Muthmainnah , Dwi Agustina, Winda Maolinda http://creativecommons.org/licenses/by-sa/4.0
Association between anemia, mental health, and nutritional status among junior high school students: a cross-sectional study in Pontianak
Iron deficiency can affect emotional regulation and contribute to symptoms of anxiety, stress, and depression. Poor dietary habits combined with mental health problems may further increase the risk of anemia. This study examined the association between anemia, mental health, and nutritional status among junior high school students in Pontianak. A cross-sectional design was used from May to December 2024 involving 277 students. Data were collected using body mass index (BMI) measurements, hemoglobin screening, and the DASS-Y questionnaire, and were analyzed with Spearman’s Rho. Most respondents were female (63.9%), and 90.96% had experienced menstruation. A total of 103 students were underweight, with an average mid–upper arm circumference of 21.48 cm, indicating chronic nutritional risk. Eighty-one students (29.2%) had anemia, predominantly females. Most students had good mental health (below the 50th percentile). No significant associations were found between anemia and mental health (p = 0.623) or between anemia and nutritional status (p = 0.664). Despite the lack of significant relationships, ongoing nutrition education, regular iron supplementation, counseling support, and routine monitoring of students’ nutritional and mental health remain important to maintain and improve overall wellbeing.
Copyright (c) 2026 Agustina Arundina Triharja Tejoyuwono, Iit Fitrianingrum, Desriani Lestari http://creativecommons.org/licenses/by-sa/4.0
Spatial analysis of stunting risk factors in Central Java, Indonesia: A geographically weighted regression approach (2023 data)
The 2022 Indonesian Nutritional Status Survey (SSGI) reported a stunting prevalence of 20.8% in Central Java. Although various studies have examined its risk factors, few have applied a spatial perspective. This study aims to analyze regional variations in stunting risk factors and their contribution to rising stunting rates. This is a quantitative explanatory study employing the geographically weighted regression (GWR) method. Secondary data were obtained from the Central Java Health Profile and Badan Pusat Statistik Indonesia (BPS) in 2023, using a total sampling of 35 districts/cities. The GWR results indicated that chronic energy deficiency (CED; β = 0.0014, p = 0.068) and exclusive breastfeeding (β = 0.0791, p = 0.087) were marginally positively associated with stunting. Low birth weight (LBW) showed a significant positive association (β = 0.1009, p = 0.041), while access to improved sanitation had a strong negative effect (β = -0.1882, p = 0.004). Iron supplementation (≥90 tablets) was not significant (β = -0.0629, p = 0.134), whereas access to improved drinking water was positively and significantly correlated with stunting (β = 0.3778, p = 0.028). These findings contradict existing theories, particularly where higher rates of exclusive breastfeeding and access to clean water are unexpectedly associated with increased stunting in several regions. This suggests the need for further in-depth investigation in those areas to better understand the underlying factors.
Copyright (c) 2026 Sylvia Anjani, Faik Agiwahyuanto, Maulana Tomy Abiyasa http://creativecommons.org/licenses/by-sa/4.0
Hepatotoxicity effect of alcoholic beverages on histology and IL-6 gene detection in Rattus norvegicus using polymerase chain reaction
The liver is an organ that has an important role in metabolic and detoxification processes. Alcohol consumption will cause metabolic disorders in the liver and can cause changes in histological structures. Interleukin-6 has a profound role in liver pathology and plays an important role in the body's defense mechanism, and contributes to the manifestation of tissue damage. This study was an experimental study using 20 Rattus norvegicus treated with 25% alcohol, and a normal treatment only given distilled water. Histological observations were carried out on each preparation in 5 fields of view. The hepatotoxicity effect of alcohol was observed based on the presence of cell degeneration and necrosis in histological preparations stained with hematoxylin eosin. IL-6 detection with polymerase chain reaction was analyzed qualitatively using electrophoresis. Based on the statistical test results, the sig. (2 tailed) of 0.00 < 0.05 so that it can be seen that there is a significant difference in histological results between the normal control group without treatment and the group induced by alcohol. The administration of alcoholic beverages with 25% ethanol content in vivo for 21 days causes necrosis and bleeding around the hepatocyte cells. IL-6 overview appeared to be stronger in the group with alcohol-induced drinking, it could indicate that giving alcohol causes a higher inflammatory response. This study provides scientific evidence that alcohol consumption significantly damages the liver. Further research can be conducted to increase the sample size and quantitatively assess IL-6 expression.
Copyright (c) 2026 Fitria Diniah Janah Sayekti, Vector Stephen Dewangga, Muhammad Taufiq Qurrohman http://creativecommons.org/licenses/by-sa/4.0
Nipah virus as an emerging threat: mutational dynamics, pathogenesis, and advances in vaccine development- a systematic review
Nipah virus (NiV) is an emerging zoonotic pathogen with significant pandemic potential. Large outbreaks, such as in Malaysia, required the culling of over one million pigs to control transmission. However, the epidemiology of NiV among animal hosts, including pigs, horses, and bats, remains incompletely understood. NiV infection primarily affects the respiratory and nervous systems, causing severe pneumonia, vasculitis, and meningitis, while encephalitis may be mild or infrequent in some cases. This systematic review summarizes current evidence on NiV mutational variation, pathogenesis, treatment strategies, and vaccine development up to 2022. Data were collected from major databases, including PubMed, PMC, and Cochrane Library. Due to limited therapeutic options, NiV management relies mainly on supportive care, as no approved vaccines or specific antiviral treatments are available for humans or livestock. Preventive strategies focus on reducing zoonotic transmission, particularly by minimizing contact between livestock and bat-contaminated food sources, and improving farm management practices. Early detection and continuous surveillance of high-risk populations and animal reservoirs are essential for outbreak control. Current vaccine research targets viral antigens using subunit and vector-based approaches. Overall, further studies are urgently needed to develop effective vaccines and antiviral therapies for NiV infection.
Copyright (c) 2026 Sadia Afrin, Md. Rezwan Ahmed Mahedi, Asma Akhter Radia, Joti Devi http://creativecommons.org/licenses/by-nc/4.0
Acute and chronic lead exposure and intelligence quotient among Indonesian adolescents: a cross-sectional study
Lead exposure is a persistent environmental health concern that can impair cognitive function in adolescents. Therefore, this study aims to examine the association between acute and chronic lead exposure and intelligence quotient (IQ) scores among Indonesian adolescents. A cross-sectional study was carried out involving 39 adolescents who were chosen through purposive sampling. Acute exposure was assessed using blood lead levels(n = 15), while chronic exposure was evaluated with hair lead levels(n = 24). IQ was measured using WAIS administered by a licensed psychologist, while associations between the variables were examined utilizing the Chi-square test. The results revealed that chronic lead exposure was significantly linked to below-average IQ (OR = 1.90; 95% CI: 1.07-3.36), while acute exposure had a weaker relationship (OR = 0.35; 95% CI: 0.13-0.89; p = 0.022). These results indicated the importance of long-term environmental exposure control.
Copyright (c) 2026 Noviana Dewi, Indah Tri Susilowati http://creativecommons.org/licenses/by-sa/4.0
Factors affecting health-promoting services provision of the sub-district health promoting hospital transferred to mahasarakham provincial administration
Hospital services have been transferred to provincial government oversight, making it important to assess the impact of this policy on service quality and efficiency. This study examined factors influencing service delivery at sub-district health-promoting hospitals transferred to the Mahasarakham Provincial Administration in Mahasarakham Province, Thailand. The research was conducted from March 2022 to September 2023 using a mixed-methods approach, including descriptive content analysis for qualitative data. The examined factors were categorized into accessibility, processes, productivity, and outcomes. Data were collected from 500 health workers and 300 patients using questionnaires consisting of six sections with a Likert scale to evaluate perceptions of service quality. Paired t-tests were applied to compare service unit performance before and after the transfer, while one-way ANOVA was used to assess differences among service units. Binary logistic regression identified key factors influencing service quality. The findings revealed a significant relationship between healthcare workers’ attitudes and skills and overall service quality. Units with less than 50% transfer showed minimal improvement, indicating that the extent of transfer strongly influences service outcomes. Despite these differences, the main goal of health promotion remained consistent across units. Effective policy decisions, appropriate management, and stakeholder engagement are essential to improve health outcomes. These findings provide insights for policymakers and administrators to refine health service transfer policies and highlight the need for further research on long-term impacts on service quality and patient outcomes.
Copyright (c) 2026 Sirimaporn Nassapat, Vorapoj Promasatayapot, Jatuporn Luangubol http://creativecommons.org/licenses/by-sa/4.0
Compulsive buying behavior and self-esteem among K-pop fan undergraduate medical students in Jakarta
The rising popularity of K-pop has attracted many teenagers and young adults. Fans tend to purchase idol merchandise as a sign of support and affection, which can lead to compulsive buying behavior. Compulsive buying behavior is one of the coping mechanisms for low self-esteem. This study aimed to investigate the relationship between self-esteem and compulsive buying behavior among undergraduate medical students in Jakarta who are fans of K-pop. A cross-sectional study was conducted involving 97 students, aged 18 to 25, from various medical schools in Jakarta who were actively engaged as members of a K-pop fan club. Data were obtained through the Revised Edwards Compulsive Buying Scale (ECBS-R) and the Rosenberg self-esteem Scale questionnaire. Among the 97 respondents, 35.1% with low self-esteem, and 51.6% with compulsive buying behavior. A significant relationship was found between self-esteem and compulsive buying behavior (p = 0.014). In conclusion, low self-esteem is associated with compulsive buying behavior among K-pop fan medical students, particularly females, which may adversely impact their academic performance.
Copyright (c) 2026 Julia Rahadian Tanjung, Heunice Precious, Mariani Santosa http://creativecommons.org/licenses/by-sa/4.0
Analysis of the implementation of the healthy Indonesia program policy with a family approach
This study evaluates the implementation of the Healthy Indonesia Program Family Approach to improve public health and identify inhibiting and supporting factors. This qualitative research employs a case study approach to investigate healthcare dynamics at the Tambora Community Health Center in Bima City, Indonesia. Twelve informants were purposively selected. Data collection involved in-depth interviews, direct observation, and document review, allowing for a multifaceted perspective. An interactive analysis model by Miles and Huberman was used for data analysis, incorporating data collection, reduction, and presentation iteratively. Results showed that 85% of implementing staff had been trained, but there was a shortage of field surveyors, and family visit coverage only reached 72%, below the national target of 80%. Although the average healthy family index of 0.65 indicates adequate results, the main challenges lie in clean living behavior and nutritious diets. The program for mothers giving birth in health facilities reached 95%, but awareness of improving the management of chronic diseases, such as hypertension and tuberculosis, remained low, with treatment fulfillment at 65% and 70%, respectively. The conclusions highlight the need for adaptation strategies and continuous evaluation for the Healthy Indonesia Program to be successful across communities.
Copyright (c) 2026 Abdul Haris, M. Rizki Aditya http://creativecommons.org/licenses/by-sa/4.0
Causes and risk factors of neonatal mortality through the AMP-SR framework: a scoping review in Indonesia
Neonatal mortality in Indonesia continues to increase, especially during the first 0-6 days of life, indicating persistent gaps in the quality of maternal and neonatal care. The maternal perinatal surveillance and response audit (AMP-SR) is implemented to identify causes of death and guide preventive and curative actions. This scoping review aims to explore the causes and risk factors of neonatal mortality using the AMP-SR framework. Article searches were conducted in Google Scholar, Garuda, and PubMed using the keywords (“Neonatal Death” OR “Cause of Death” OR “Kematian Neonatal”) AND (“AMP-SR” OR “Death Notification”). Inclusion criteria comprised primary studies published in Indonesian or English between 2021 and 2025 that examined neonatal deaths using the AMP-SR approach. Seventeen articles were selected and thematically analyzed following the PRISMA guidelines. The main causes of neonatal death were clinical conditions, including asphyxia, prematurity, sepsis, hypothermia, and congenital abnormalities. Identified risk factors encompassed maternal age, pregnancy complications, referral delays, inadequate quality of care, and limited health worker competence. Most neonatal deaths occurred within the first 72 hours of life, predominantly among male infants with low birth weight or gestational age under 37 weeks. These findings demonstrate that neonatal mortality results from interconnected medical, maternal, and health system factors that can be systematically identified through AMP-SR. From a policy and practice perspective, strengthening the routine use of AMP-SR findings to inform targeted quality improvement, referral system strengthening, and workforce capacity-building is essential to reduce preventable neonatal deaths in Indonesia.
Copyright (c) 2026 Sulicha Nurhayati, Martha Irene Kartasurya, Cahya Tri Purnami http://creativecommons.org/licenses/by-sa/4.0
Predictive factors of quality of life among older adults in rural Indonesia: a cross-sectional study
The older adults are a vulnerable group facing physical, social, and economic health challenges that impact their quality of life. Information on the quality of life of the older adults in rural Indonesia is still limited, so this study aims to identify predictors of quality of life in the older adults in the working area of the Dusun Tengah Community Health Center, Lubuk Sandi District, Seluma Regency, Bengkulu Province, Indonesia. This quantitative cross-sectional study involved 60 elderly individuals who met the inclusion criteria. The research instruments included quality of life with WHOQOL-BREF, activities of daily living with the Barthel Index, ambulation with CAS, mobility with the timed up and go (TUG) Test, and lower limb muscle strength with the 30-second STS Test. The results showed that age, employment status, income, walking ability, mobility, lower limb muscle strength, and activities of daily living were significantly associated with quality of life (p < 0.05). In contrast, gender, education level, and social support were not significantly associated with quality of life. Multivariate analysis identified walking ability (OR = 13.65; 95% CI: 1.03-180.61) and income (OR = 5.81; 95% CI: 1.02-33.07) as the most dominant predictors of quality of life in the older adults. These findings provide important implications that interventions to improve the quality of life in older adults in primary health care need to prioritize programs to improve ambulation, prevent physical function decline, and strengthen the economic aspects of older adults, especially in rural areas.
Copyright (c) 2026 Pagela Pascarella Renta, Rahmad http://creativecommons.org/licenses/by-sa/4.0
Comparative assessment of knowledge, attitude, and practice toward self-medication among health and non-health students at Daffodil International University, Dhaka (2022–2023)
Self-medication, a popular self-care practice, is common throughout the world and is responsible for serious health complications. The present investigation assessed the knowledge, attitudes, and practices of self-medication among healthcare and non-healthcare students at Daffodil International University, Savar, Dhaka, Bangladesh. A cross-sectional survey of 240 students from the Pharmacy and Environmental Science Departments, ages 19 to 24, was carried out between October 2022 and January 2023. Socio-demographics, knowledge, attitudes, information sources, common medications, and diseases treated were all covered in the pre-tested questionnaire used to gather data. SPSS v16.0 with correlations and descriptive statistics was used for the analysis. Among 240 participants, 50.8% were health science students and 49.2% were non-health science students; 45.8% were male, and 54.2% were female. Most (74.2%, p < 0.01) were aged 21-22 years, mainly in the 4th year (43.3%, p < 0.001). Knowledge analysis showed 37.5% knew over-the-counter (OTC) drugs (p < 0.001) and 55% supported self-medication for minor illness. Common conditions treated were headache (49.2%), fever (23.3%), and cold (16.7%). Painkillers were the most used drugs (39.2%), with family members as the main source of advice (50%). Knowledge had a significant correlation with health science students (p < 0.001). Attitudes revealed 70% used self-medication in the last 6 months; 67.5% discouraged peers, 55.8% reused prescriptions, 73.3% read leaflets, and 61.2% consulted doctors for adverse effects. Previous experiences (74.2%) were the main reason for self-medication. Self-medication is widespread among university students. Health science students demonstrated better knowledge and awareness against self medication while contrasted to non-healthcare students. Awareness programs are needed for all groups.
Copyright (c) 2026 Md. Mizanur Rahman, Md. Jahir Alam, Ms Tamanna Khatun, Chaity Sutar, Shabnaz Akter, As-Ad Din Mahmood, Sher Mostafa Sadiq Khan http://creativecommons.org/licenses/by-sa/4.0
Empathy and forgiveness on student victims of toxic relationships
A toxic relationship shows a negative impact on the physical and mental condition of individuals who have undergone the subject. Even though the students have experienced unpleasant conditions in life, to continue her life journey, the student needs to make peace and build a concept of forgiveness for the circumstances that are formed through empathy. This research aims to determine the relationship between empathy and forgiveness in students who have been victims of toxic relationships. The method used is quantitative correlational. An equal number of 355 students who had been victims of toxic relationships came to be participants in this study, with the sampling technique used, specifically, incidental sampling. This study uses a scale, namely the Interpersonal Reactivity Index (α = 0.863) and Transgression-Related Interpersonal Motivations -18 (α = 0.843). The research data analysis method uses the product-moment correlation test from Karl Pearson. The results show that there was a significant positive relationship between empathy and forgiveness (r = 0.228 and sig = 0.000 (p<0.01). Empathy contributed 5.2% to forgiveness. It appears that empathy is one of the factors associated with increased forgiveness in students who have been victims of a toxic relationship.
Copyright (c) 2026 Felani Omie Timpal, Arthur Huwae http://creativecommons.org/licenses/by-sa/4.0
Emotional experiences of Indonesian health science students with self-harm: a phenomenological study
Health students often face academic pressure and interpersonal conflicts that can affect their emotional regulation, thereby increasing the risk of self-harm behavior. This study aimed to explore the emotional experiences of health students who have engaged in self-harm through a phenomenological approach. A total of 8 participants (aged 18-25 years) who had engaged in self-harm and came from various health study programs participated in in-depth interviews lasting 45-70 minutes. The results of the study reveal three main themes: i) psychosocial stress as a trigger for negative emotions, ii) the role of social support in the recovery process, and iii) coping mechanisms and the need for professional intervention. These findings reveal emotional dynamics that have not been widely explored in the context of health students in Indonesia, particularly how self-harm is perceived as a strategy to control excessive emotional intensity. This study makes a new contribution by highlighting the need for interventions based on emotional regulation and increased social support that are appropriate to the subjective experiences of health students. Interventions based on empathy and psychological approaches that are more sensitive to the cultural context of the campus are the main recommendations.
Copyright (c) 2026 Meidiana Dwidiyanti, Geovanny Serviam Permana Putri Rahamitu, Luky Dwiantoro, Nur Setiawati Dewi, Sri Padma Sari, Alifia Dian Yusriana http://creativecommons.org/licenses/by-sa/4.0