Background: Death is a common occurrence in nursing practice, and nurses are expected to provide professional and sensitive care to families, which can be psychologically demanding. However, there is a paucity of studies describing the experiences of nurses dealing with pediatric end-of-life (EOL) care and death.Purpose: This study explored nurses’ lived experiences following EOL care among pediatric nurses working in two selected hospitals in Nigeria.Methods: A hermeneutic qualitative design was adopted to describe and interpret participants’ experiences. Twenty-one nurses were purposively selected from pediatric wards. Data were collected through semi-structured, in-depth interviews and analyzed using ATLAS.ti with thematic analysis.Results: Five themes emerged: (1) EOL care training during nursing education, (2) experiences of EOL care as a practicing nurse, (3) perceived contributing factors to child death, (4) nurses’ roles in supporting families after child loss, and (5) coping strategies for managing grief after pediatric patient death. The findings revealed that nurses are affected by the death of a child regardless of years of experience. Limited knowledge of EOL care negatively influenced their coping abilities. Nurses considered open grieving unprofessional, with the primary coping strategy being increased commitment to work.Conclusion: The study concluded that years of work experience do not significantly influence nurses’ lived experiences of pediatric patient death. Limited knowledge of EOL care strongly shapes their perspectives on death, dying, and grieving. Grieving is perceived as unprofessional, while dedication to work serves as the preferred coping mechanism. Mandatory training on EOL nursing care and the provision of institutional guidelines are recommended.

Background: A health-promoting lifestyle serves as the foundation for healthy living and is highly relevant to nursing students, who are expected to model such behaviors as future healthcare providers. However, few studies have examined these patterns among nursing students in regions such as Hail, Saudi Arabia.Purpose: This study aimed to evaluate the health-promoting lifestyle behaviors of nursing students and their correlations with demographic factors.Methods: A cross-sectional correlational design was employed. A total of 263 male and female participants provided demographic information and completed the Health Promoting Lifestyle Profile II (HPLP II) questionnaire through convenience sampling. Independent-samples t-tests were used to compare HPLP scores by gender, one-way analysis of variance (ANOVA) was used to compare scores across year levels, and Pearson’s correlation was applied to examine associations between HPLP scores and selected demographic variables, including year level, GPA, family income, and BMI.Results: The overall health-promoting lifestyle behavior was classified as good (M=142.88, SD=28.77). No significant differences were observed across gender or year level for any HPLP subdomains. GPA was positively correlated with health-promoting behaviors (r=0.34, p<0.001), whereas family monthly income was negatively correlated (r=–0.15, p=0.01). BMI and year level were not significantly associated with HPLP scores.Conclusion: Nursing students demonstrated generally good health-promoting behaviors. Higher academic performance was linked to more frequent engagement in such behaviors, whereas students from higher-income families displayed slightly lower engagement. These findings highlight the importance of culturally and contextually tailored interventions to support nursing students in adopting and maintaining healthy lifestyles.

Background: Chronic and acute wounds affect millions of individuals worldwide, placing a substantial burden on patients and healthcare systems. Previous evaluations have often focused on limited types of dressings or specific wound conditions. Therefore, a comprehensive network meta-analysis is essential for comparing various interventions, bridging knowledge gaps, improving healing outcomes, and addressing clinical and economic challenges.Purpose: This study assessed the comparative effectiveness and safety of advanced wound dressings in promoting healing.Methods: This network meta-analysis, registered with PROSPERO (CRD42023433268), systematically searched PubMed, ProQuest, Scopus, CINAHL, ScienceDirect, Springer Nature, Wiley, Cochrane Library, and Taylor & Francis from January 2012 to December 2022. Eight reviewers independently assessed and extracted data from randomized controlled trials evaluating different dressings, including placebo, alginate, collagen, gamat, honey, hyaluronic acid, hydrocolloid, hydrogel, mebo, platelet-rich plasma, povidone-iodine, and silver sulfadiazine. Data were synthesized using a random-effects network meta-analysis with SUCRA rankings. Study quality was evaluated using Cochrane RoB2, and certainty of evidence was assessed through CINeMA.Results: This review included 38 RCTs with a total of 4,049 patients. The largest placebo group comprised 1,628 participants, while the smallest group was mebo with 10 participants. Heterogeneity and consistency analysis showed negligible variation (χ²=1.757, p=0.78). Alginate dressings were the most effective in reducing wound size compared to placebo (OR 0.64; 95% CI 0.38–1.08; SUCRA probability 0.73), whereas hyaluronic acid dressings were the least effective (OR 0.22; 95% CI 0.06–0.79; SUCRA probability 0.08).Conclusion: Alginate was identified as the most effective primary dressing for wound healing, while hyaluronic acid dressings were the least effective. However, clinical practitioners should carefully weigh the benefits and limitations of each dressing type before selecting the most appropriate treatment for patients.

Background: Medication adherence remains a critical challenge in tuberculosis (TB) control, particularly in Indonesia, which ranks second globally in TB incidence. Most existing studies focus on single-factor analyses rather than a comprehensive multifactorial assessment of adherence predictors among Indonesian TB patients.Purpose: This study aimed to identify and quantify key predictors of medication adherence among diagnosed pulmonary tuberculosis patients with particular emphasis on sociodemographic factors, clinical variables, and psychosocial determinants.Methods: A cross-sectional study was conducted involving 150 pulmonary TB patients recruited through consecutive sampling. Data were collected using validated instruments, including the 8-item Morisky Medication Adherence Scale (MMAS-8) for adherence, the Knowledge About Tuberculosis Questionnaire (KATUB-Q) for TB knowledge, a structured questionnaire for drug side effects, the Treatment Motivation Questionnaire for motivation, the Multidimensional Scale of Perceived Social Support (MSPSS) for support systems, and the TB-related Stigma Scale for stigma measurement. Statistical analyses included descriptive statistics, Chi-square tests, and ordinal logistic regression to evaluate relationships between variables and adherence levels.Results: Only 20% of participants demonstrated high adherence, while 50.7% exhibited low adherence. Significant predictors of adherence included early adulthood (OR = 0.061, 95% CI 0.004−0.857, p = 0.038) and middle adulthood (OR = 0.052, 95% CI 0.005−0.565, p = 0.015), indicating lower adherence compared to late elderly. Other predictors were poor TB knowledge (OR = 0.316, 95% CI 0.154–0.650, p = 0.002), motivation (OR = 0.244, 95% CI 0.108–0.553, p < 0.001), family support (OR = 0.470, 95% CI 0.232–0.952, p = 0.036), healthcare worker support (OR = 0.349, 95% CI 0.204–0.840, p = 0.015), and drug side effects (OR = 5.294, 95% CI 2.134–13.126, p < 0.001). Younger adults showed lower adherence rates compared to older populations, while patients with better knowledge and stronger support systems demonstrated higher adherence.Conclusion: Key predictors of medication adherence were age, TB knowledge, motivation, family support, healthcare worker support, and drug side effects. Younger patients, those with poor knowledge, moderate motivation, inadequate support systems, and severe side effects demonstrated significantly lower adherence rates. These findings highlight the need for targeted, multifactorial interventions to improve TB treatment outcomes.

Background: The spiritual significance of Tahajjud (Islamic voluntary night prayer) is well established; however, its association with physiological markers, such as body weight (BW), body mass index (BMI), and blood pressure (BP), particularly in relation to gender, remains underexplored.Purpose: This study aimed to assess the association between Tahajjud prayer and anthropometric and BP parameters in young adults by comparing Tahajjud and non-Tahajjud groups, as well as regular and irregular Tahajjud practice, with attention to gender differences.Methods: A cross-sectional study was conducted among 462 Muslim participants (206 men, 256 women) aged 18–22 years. Data on demographics, religious practices, and Tahajjud frequency were collected through questionnaires. Participants were categorized into Tahajjud and non-Tahajjud groups; those who performed Tahajjud were further classified as regular (≥3 times/week) or irregular (<3 times/week). BP was measured using a digital sphygmomanometer, BW with a digital scale, and height with a digital stadiometer. Comparisons of BW, BMI, and BP were made across Tahajjud and non-Tahajjud groups, regular and irregular Tahajjud practitioners, and by gender. Data were analyzed using Chi-square and t-tests at a 95% confidence level (p<0.05).Results: The prevalence of Tahajjud practice was higher among women than men, both overall (70.71% vs. 66.51%) and for regular practice (32.04% vs. 13.86%), with a significant gender difference in regular Tahajjud (p=0.001). No significant gender-specific differences in BW or BMI were observed between Tahajjud and non-Tahajjud groups. Among women, systolic BP was significantly lower in the Tahajjud group (p=0.001). Regular Tahajjud practice was associated with lower BW and BMI in both women (p<0.005) and men (p<0.05). Although systolic and diastolic BP were lower among regular Tahajjud practitioners, differences were not statistically significant. Irregular Tahajjud was associated with a higher prevalence of overweight and obesity (p=0.016).Conclusions: Regular Tahajjud practice was associated with lower BW, BMI, and modest reductions in BP, suggesting a potential role in obesity prevention and cardiovascular health. Nurses can incorporate culturally relevant practices, such as Tahajjud, into health education and lifestyle counseling programs.

Background: HIV-related stigma remains a persistent barrier to psychological well-being and care among people living with HIV. Although research on its psychological burden has grown, no bibliometric synthesis has mapped its development or implications for nursing practice.Purpose: This study aimed to conduct a bibliometric analysis of global research on the psychological burden of HIV stigma among adults, with particular attention to thematic evolution and implications for nursing care.Methods: A bibliometric and thematic analysis was conducted on 131 journal articles indexed in Scopus from 2014 to 2025. Bibliometric mapping was performed using VOSviewer to examine publication trends, authorship patterns, country distribution, keyword co-occurrence networks, and temporal thematic evolution.Results: The analysis found no publications prior to 2014, with output peaking in 2022 and 2024, confirming the field’s novelty. Keyword clustering revealed six thematic domains: psychological distress (depression, anxiety, shame), treatment adherence and healthcare engagement, trauma-related stigma, resilience and protective factors, methodological advances in stigma measurement, and structural-societal stigma. Temporal analysis indicated a shift from documenting emotional distress to examining mediating processes, resilience, and intersectionality, marking a transition from descriptive to explanatory and intervention-focused research.Conclusion: Research on the psychological burden of HIV stigma has expanded, with depression and anxiety remaining central, but increasing attention to resilience, coping, and systemic factors. However, gaps persist in translating these insights into stigma-sensitive nursing interventions. This bibliometric synthesis provides evidence to inform nurse-led strategies such as therapeutic communication, psychoeducation, and psychosocial support to mitigate stigma’s psychological impact on PLHIV.

Background: Maternal and child health (MCH) is crucial for public health, especially in low- and middle-income countries like Indonesia. Despite improvements in healthcare infrastructure, challenges remain in reducing maternal and neonatal mortality rates, with low birth weight (LBW) posing a significant concern. Previous research has largely examined individual factors, such as maternal age, parity, or nutritional status, in isolation. To date, there has been no comprehensive analysis integrating the various determinants of LBW within the Indonesian context.Purpose: This study aimed to comprehensively analyze factors associated with LBW incidence in Indonesia to inform sustainable MCH strategies.Methods: A cross-sectional study design was used to analyze data from 420 newborns and their mothers. A structured questionnaire and medical record reviews were used to collect data on maternal characteristics, antenatal care attendance, birth outcomes, and infant characteristics. Data were obtained from maternal and child health reports collected by primary health centers and hospitals under the Ministry of Health between 2021 and 2023. Statistical analyses, including bivariate Chi-square tests and multivariable logistic regression, were conducted to identify factors associated with LBW incidence.Results: The prevalence of LBW among newborns was 34.3%. Significant associations were found between LBW and maternal anemia (OR = 1.53; 95% CI = 1.16–2.03), irregular antenatal care attendance (OR 11.9; 95% CI 8.17–17.32), multiparity (OR = 0.61; 95% CI = 0.43–0.88), and preterm birth (OR = 11.22; 95% CI = 7.55–16.68). Primiparous mothers and full-term infants were less likely to experience LBW. Among the associated factors, irregular antenatal care visits and preterm birth emerged as the most dominant risk factors. No significant associations were observed with maternal complications, chronic diseases, infant gender, mode of delivery, or maternal age.Conclusion: Targeted interventions addressing maternal anemia, improving access to and adherence with antenatal care, and preventing preterm births are critical strategies for reducing LBW in Indonesia. The findings in this study underscore the need to improve maternal nutrition and encourage pregnant women to attend regular antenatal care visits.

Background: The number of older adults with dementia in Indonesia continues to increase. However, many family caregivers still have limited knowledge and skills, which can adversely affect both older adults and caregivers. Existing interventions mainly focus on single aspects of care and have not adequately addressed the physical, psychological, social, and spiritual dimensions. Therefore, there is a need for a comprehensive intervention model that holistically meets caregivers’ needs.Purpose: This study aimed to develop a home-based holistic dementia nursing intervention model for family caregivers and identify its key features.Methods: Three approaches were used for model development: (1) literature review, (2) in-depth interviews, and (3) expert validation. Five articles addressing holistic care dimensions and nursing interventions were included in the review. Fifteen participants took part in the in-depth interviews, and expert validation involved three specialists in the field of geriatrics with specific qualifications. Data were collected between August and September 2022. Analysis was conducted by comparing and synthesizing the findings from the literature review, interviews, and expert validation.Results: The holistic dementia nursing intervention model for family caregivers consisted of four intervention domains: (1) physical, (2) psychological, (3) social, and (4) spiritual. The model also incorporated three key components: (1) communication processes, (2) organizational processes, and (3) belief systems.Conclusion: The home-based holistic dementia nursing intervention model for family caregivers offers a potential conceptual framework to comprehensively address the physical, psychological, social, and spiritual needs of both older adults and their caregivers.

Background: Menstrual hygiene management (MHM) is critical for adolescents’ health and well-being; however, challenges such as limited water, sanitation, and hygiene (WASH) facilities, stigma, and lack of education persist in low- and middle-income countries. In Indonesia, most studies have focused on knowledge and attitudes rather than the determinants of practices, leaving this area underexplored.Purpose: This study aimed to identify the determinants of menstrual hygiene management practices among adolescents.Methods: This cross-sectional study was conducted online with 365 female adolescents recruited through purposive sampling. Data collection tools included the Menstrual Hygiene Management (MHM) questionnaire, the Depression Anxiety Stress Scale (DASS-21), the Multidimensional Scale of Perceived Social Support (MSPSS), and demographic questionnaires. Associations were analyzed using independent t-tests, Pearson correlations, and linear regression.Results: Bivariate analysis showed that higher MHM scores were significantly associated with age (r=0.290; p=0.000), age at menarche (r=0.173; p=0.001), education level (r=0.288; p=0.000), menstrual cycles (r=0.122; p=0.020), employment (r=0.277; p=0.000), family income (r=0.130; p=0.013), and place of residence (r=0.132; p=0.012). In contrast, a history of dysmenorrhea was negatively associated with MHM practices (r=-0.159; p=0.002). Linear regression analysis revealed that menstrual cycle (B=0.408; p=0.028) was a significant positive predictor of MHM, while a history of dysmenorrhea (B=-0.160; p=0.020) was a significant negative predictor.Conclusion: Menstrual hygiene management was generally good among adolescents. Significant determinants included menstrual cycle length and history of dysmenorrhea. The findings underscore the importance of addressing biological and physiological factors in menstrual health education. Public health programs should also integrate menstrual cycle education and dysmenorrhea management strategies to improve hygiene practices.

Background: Diabetic Peripheral Neuropathy (DPN) is a common complication of type 2 diabetes mellitus (T2DM), and is closely linked to poor glycemic control. However, little is known about how environmental and lifestyle differences between urban and rural settings affect the risk of DPN.Purpose: This study aimed to identify and compare the risk factors of DPN among T2DM patients living in rural and urban areas.Methods: A comparative cross-sectional design with convenience sampling was used to recruit 156 T2DM patients from both urban (Surabaya) and rural (Lamongan) areas of East Java, Indonesia. Data were collected using the Vascular Quality of Life-6 (VQ-6), Diabetic Neuropathy Symptom (DNS), Diabetic Neuropathy Examination (DNE), and Ankle-Brachial Index (ABI). Logistic regression was performed for analysis, with a significance level set at p<0.05.Results: The mean age of rural participants was 55.86 (SD=8.4) years, slightly younger than that of urban participants at 57.27 (SD=9.3) years. Urban residents had higher education levels (37.7%), but engaged less in regular physical activity (51.9%). The risks of DPN were significantly higher in rural areas (p<0.05), with key contributing factors including higher ABI (OR=17.07), more diabetic neuropathic symptoms (OR=3.35), multiple diabetes medications (OR=10.27), lower physical activity (OR=0.24), and lower education level (OR=0.25). Of these, ABI was the strongest predictor of DPN risks.Conclusion: Rural T2DM patients are at greater risk of DPN due to vascular and neuropathic complications combined with sociodemographic disadvantages. These findings highlight the importance of early detection and tailored education programs for rural communities to prevent and manage DPN.