Indonesian Nurses’ Experiences with Ethical Problems and Challenges and the Need for an Ethical Supervision Model: A Qualitative Descriptive Study Yanis Kartini, Yurike Septianingrum, Imamatul Faizah Pacific Rim International Journal of Nursing Research, 2026 Nurses frequently encounter ethical problems and challenges in clinical practice, highlighting the need for an ethical supervision model. This study explored nurses' experiences with ethical problems and challenges, and identified requirements for developing an ethical supervision model suitable for clinical practice. A qualitative descriptive design was used, with focus group discussions involving 28 nursing managers, ward heads, and staff nurses at a private hospital in Surabaya, Indonesia, conducted between June and August 2025. Participants with at least one year of work experience participated in six focus group sessions. The discussions were transcribed and analyzed thematically using NVivo 11 software. The analysis revealed three themes: (1) emotional and practical ethical challenges in daily nursing practice; (2) ethical supervision as a catalyst for caring and professional integrity; and (3) expectations regarding ethical supervision. Findings emphasize that ethical supervision is vital for promoting professionalism and patient-centered care. A structured model, such as the Proctor framework with the 4S approach (Structure, Skills, Support, Sustainability), is recommended to ensure consistent implementation and long-term sustainability.
Stroke-Associated Pneumonia: Risk Factors and Discharge Status Yurike Septianingrum, Ratna Yunita Sari, Erika Martining Wardani, Nur Ainiyah, Imamatul Faizah, et al. Nurse Media Journal of Nursing, 2024 Background: Stroke-associated Pneumonia (SAP) is one of the complications that occur in stroke patients and is associated with worse clinical outcomes. Risk factors for SAP and its impact on discharge status remain unclear.Purpose: This study aimed to determine the factors influencing the incidence of stroke-related pneumonia in the hospital and the patient’s discharge status.Methods: A case-control study was conducted at a private hospital in Surabaya from January 2021 to 2022. Medical record data were reviewed to identify stroke patients with suspected or confirmed pneumonia, after which risk factors (age, gender, stroke type, length of stay, stroke frequency, dysphagia, diabetes mellitus, hypertension, COVID-19, and discharge status) associated with the occurrence of SAP were examined. We excluded diagnoses of diseases with clinical manifestations such as tuberculosis-like pneumonia, lung tumor, pulmonary edema, pulmonary embolism, pulmonary atelectasis, and incomplete or missing medical record data. Data analysis used the Chi-square test to identify the risk factors for stroke-associated pneumonia.Results: One hundred sixty-three stroke patients treated in all inpatient rooms were diagnosed with pneumonia; 52.8% of them had confirmed pneumonia, while the rest were still suspected of pneumonia. Most pneumonia occurs in ischemic stroke patients (93.9%), first-time stroke patients (87.1%), experienced dysphagia (55.2%), length of stay less than 7 days (55.2%), hypertension (55.2%), diabetes mellitus (57.1%), and discharged home (84%). We also found as much as 12.9% inpatient mortality due to SAP. Dysphagia, DM, and COVID-19 were significantly correlated with the incidence of stroke-associated pneumonia (p=0.000).Conclusion: Stroke-associated pneumonia is a substantial medical complication among stroke patients affected by dysphagia, DM, and COVID-19. Screening for dysphagia is necessary for nurses to prevent SAP in stroke patients.
APPLICATION OF BENSON RELAXATION THERAPY COMBINED WITH SPIRITUAL THERAPY TO REDUCE ANXIETY IN CHRONIC KIDNEY DISEASE PATIENTS UNDERGOING HEMODIALYSIS Abdul Muhith, Riska Rohmawati, Imamatul Faizah, Ratna Yunita Sari, Siti Nur Hasina Revista De Gestao Social E Ambiental, 2024 Background: Chronic Kidney Disease (CKD) is a failure of kidney function to maintain metabolism and fluid and electronic balance due to progressive kidney structural damage. Hemodialysis is a replacement therapy for damaged kidney performance, if hemodialysis is carried out for a long time it can cause disturbances in the biological aspects and psychological aspects for hemodialysis patients. One of the effects that is often experienced in hemodialysis patients is anxiety. The research objective was to determine the application of spiritual-based benson relaxation therapy to anxiety levels in CKD patients undergoing hemodialysis. Method:Quasy-Experimental research design with one group pre post test design. Population of all CKD patients undergoing hemodialysis. The large number of samples of 20 intervention respondents. The sampling technique was purposive sampling by taking samples according to the inclusion criteria. The research intervention that was carried out was benson relaxation therapy which was carried out in CKD patients who routinely had hemodialysis for more than 6 months with a frequency of 2 times a week for 10-15 minutes with guidance from a clergyman and repeated until the patient could be independent. The research instrument for measuring anxiety used HARS (Hamilton Anxiety Rating Scale) and the respondent's intervention used Benson relaxation SOP and spiritual healing SOP (spiritual guidance). Test analysis in this study was paired t test. Results: the results of the research based on the intervention carried out obtained the anxiety score before the intervention from 20 respondents, the majority on the score of severe anxiety (28-41) which is as much as 70% then followed by moderate anxiety (21-27) which is as much as 30%. Anxiety scores after the intervention of 20 respondents, the majority on mild anxiety scores (14-20) which is as much as 70% then followed by moderate anxiety (21-27) which is as many as 20% and the minority in non-anxious conditions (<14) which is as many as 10% . From the results of the analysis using the paired t test, the results obtained were a p value of 0.001, with α = 0.05 so that the p value <α (0.001 <0.05). meaning that there is a difference between the pre and post tests on the level of anxiety with the spiritual-based benson relaxation therapy intervention in CKD patients undergoing hemodialysis. Conclusion: Based on the discussion that we have conveyed, it can be concluded that benson relaxation and spiritual healing can reduce anxiety in CKD patients undergoing hemodialysis.
FACTORS INFLUENCING THE APPLICATION OF THE CODE OF NURSING ETHICS AT INDONESIA Yanis Kartini, Imamatul Faizah, Riska Rohmawati, Iis Noventi, Nur Ainiyah Revista De Gestao Social E Ambiental, 2024 Background: Nurses are health workers who are vulnerable to lawsuits because the scope of services performed carries a risk of malpractice and negligence. Aim: This study was aimed to determine the application of a code of ethics in health services and analyze the influencing factors, as well as analyze the factors with the strongest influence. Methods: The study used an explanatory research method with a cross sectional approach. The population in this study were nurses who worked in health services, both in hospitals and health centers in the Surabaya area. The sample size in this study was calculated using the rule of thumb, amounting to 150 respondents. Samples were taken by means of purposive sampling, data were analyzed by path analysis with a significance level of α <0.005. Result: Nurses apply a code of ethics in the good and excellent categories. The influencing factors were individual characteristics (p=0.000), work environment characteristics (p=0.000), experience (p=0.000), knowledge (p=0.000). The biggest influencing factor is experience with a large influence on knowledge is 0.803 and the influence on the application of the code of ethics is 0.823. Conclusion: Most nurses in Indonesia have implemented a code of ethics in the good and excellent categories. Factors that influence the application of the code of ethics in health services are individual characteristics, characteristics of the work environment, experience. and knowledge. The most influential factor is experience. Nurses should be active in the activities of professional organizations. Workplace rotation is needed for nurses to gain experience in decision making, legal ethics
Combination of AROM with deep breathing exercise against fatigue and quality of life of hemodialysis patients; an experimental study Ratna Yunita Sari, Yanis Kartini, Imamatul Faizah, Riska Rohmawati, Siti Nur Hasina Journal of Nephropharmacology, 2024 Introduction: In hemodialysis patients, the main problem that often occurs is experiencing fatigue. Untreated fatigue conditions have an impact on decreasing quality of life. Objectives: In this study, we aimed to analyse the effect of the combination of AROM with deep breathing on fatigue and quality of life in the Jemursari Islamic hospital of Surabaya. Patients and Methods: This study is a quasi-experimental investigation with a pre-post-test control group design. The population was 244 of all hemodialysis patients at our hospital. The research sample was 220 respondents, 110 respondents in the intervention group and the control group. The intervention group was given a combination of active range of motion (AROM) and deep breathing exercises for 30 minutes daily for one month. Meanwhile, the control group was assigned training according to hospital procedures. Results: The results showed that almost all of the intervention group (96.4%) had mild fatigue and almost half (40%) had good quality of life. In the control group, most participants (54.5%) experienced severe fatigue, and most (53.6%) experienced a poor quality of life. Data analysis showed that the combination of AROM with deep breathing affected hemodialysis patients’ fatigue and quality of life (P =0.000), which means that the combination of AROM with deep breathing affects the fatigue and quality of life of hemodialysis patients. Conclusion: A combination of air exercise regularly can reduce fatigue levels and improve quality of life. Nurses can provide a combination of AROM with deep breathing exercises in hemodialysis patients as an exercise program for hemodialysis patients.
Effectiveness of ASWAJA An Nahdliyah-based caring training on caring behavior, performance in patient safety and service quality Yanis Kartini and Gaceta Medica De Caracas, 2023 Objective: To analyze the effectiveness of ASWAJA An Nahdliyah-based caring training on caring behavior, performance in patient safety goals, and service quality. Methods: Quasi-experimental research design. The population was nurses and patients in the internal medicine and surgery rooms at the Surabaya Islamic Hospital A. Yani and Jemursari. Samples were taken from all practicing nurses working in the Az Zahrah 1 room at the Jemursari Islamic Hospital as the intervention group (n=19) and nurses working in the Shofa and Marwa rooms at the Surabaya Islamic Hospital A. Yani Islamic Hospital (n=19) were taken as the control group. The sample size for each group of patients was 38 people. Sampling was purposive sampling. The research instrument used a questionnaire.
Development of Aswaja An-Nahdliyah-based caring model to improve performance in patient safety goals Yanis Kartini, Nursalam, Ahsan, Imamatul Faizah, Abd Nasir Bali Medical Journal, 2023 Introduction: The efforts to improve quality and safe health services for patients have been carried out, However, the adverse event is still occurring. This study aims to develop a caring model based on ASWAJA An-Nahdliyah To Improve Performance In Patient Safety Goals. Methods: This study used a cross-sectional approach to 123 nurses, taken by cluster-random sampling. The research instrument is a questionnaire. Data analysis using Structural Equation Modeling (SEM) based on variance or component-based SEM is called partial least square (PLS). The development of the ASWAJA An-Nahdliyah-based caring model was carried out after a path analysis study and the formulation of strategic issues through focus group discussions (FGD) and expert discussions. Results: There is an effect on individual characteristics of nurses, patient characteristics, and caring ASWAJA An-Nahdliyah on performance in patient safety goals (t statistic >1.96 and p-value 0.005). The resulting coefficient is positive 0.561, meaning that the higher the caring value of ASWAJA Annahdiyah tends to improve performance. Conclusion: The ASWAJA Annahdliyah-based Caring Development Model has a major effect on performance in patient safety goals. The individual characteristics of nurses are the biggest factors that affect ASWAJA Annahdiyah-based caring so strengthening the characteristics of nurses is very much needed in order to improve performance in patient safety goals.
Family Caregiving Behavior and its Correlation with Stroke Severity among Patients with Stroke RY Sari, R Rohmawati, I Faizah, DI Krisnawati, SN Hasina, DTT Anh, ... Journal Of Nursing Practice 9 (3), 669-677 , 2026 2026
Indonesian Nurses’ Experiences with Ethical Problems and Challenges and the Need for an Ethical Supervision Model: A Qualitative Descriptive Study Y Kartini, Y Septianingrum, I Faizah Pacific Rim International Journal of Nursing Research 30 (2), 381-396 , 2026 2026
OPTIMALISASI PERAN KELUARGA DALAM REHABILITASI KOGNITIF DAN SPIRITUAL PENDERITA STROKE I Faizah, Y Kartini, RY Sari, R Rohmawati, SN Hasina, NN Aulia Jurnal Pepadu 6 (4), 645-651 , 2025 2025
Analysis of Factors Associated with Acute Myocardial Infarction (AMI) SN Hasina, RA Putri, R Rohmawati, I Faizah, RY Sari Journal Of Nursing Practice 9 (1), 1-16 , 2025 2025
OPTIMALISASI SELF-MANAGEMENT MELALUI HEALTH COACHING DAN PSIKOEDUKASI GIZI UNTUK KONTROL GULA DARAH OPTIMAL RY Sari, Y Septianingrum, M Shodiq, I Faizah, R Rohmawati, SN Hasina Jurnal Pepadu 6 (3), 591-600 , 2025 2025
Parenting Approaches and Emotional-Mental in Children with Speech Delay DU Sari, C Zahroh, I Faizah, N Hidayaah Jurnal Ilmiah STIKES Yarsi Mataram 15 (2), 173-181 , 2025 2025 Citations: 1
Hubungan pola makan dan aktivitas fisik dengan kejadian overweight pada anak dan remaja: Relationship between diet patterns and physical activity with overweight incidents in … RA Putri, SN Hasina, R Rohmawati, I Faizah, RY Sari Jurnal Ilmiah Keperawatan (Scientific Journal of Nursing) 11 (2), 347-356 , 2025 2025 Citations: 1
Hubungan Kepatuhan Minum Obat dengan Tingkat Resiko Stroke pada Pasien Hipertensi RY Sari, SN Hasina, I Faizah, R Rohmawat, RA Putri Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal 15 (3), 595-604 , 2025 2025
Pengendalian Tekanan Darah melalui Senam Hipertensi di Posyandu Lansia Akar Nusa Benowo Surabaya Y Kartini, I Faizah, I Noventi, A Aisyah, A Anisah, PA Shofianty, RA Putri Jurnal Kreativitas Pengabdian Kepada Masyarakat (PKM) 8 (2), 898-909 , 2025 2025
Stroke-associated pneumonia: Risk factors and discharge status Y Septianingrum, RY Sari, EM Wardani, N Ainiyah, I Faizah, A Yusuf, ... Nurse Media Journal of Nursing 14 (3), 344-355 , 2024 2024 Citations: 1
COMBINATION BENSON RELAXATION AND MURROTAL ALQURAN TO DECREASE ANXIETY, STRESS, AND DEPRESSION HEMODIALYSIS PATIENTS: AN EXPERIMENTAL STUDY R Rohmawati, RY Sari, I Faizah, SN Hasina Nurse and Health: Jurnal Keperawatan 13 (2), 163-170 , 2024 2024
Aktivasi Kader Surabaya Hebat melalui Stroke Self-Management Program pada Penderita Stroke I Faizah, Y Kartini, RY Sari, R Rohmawati, SN Hasina, Y Septianingrum, ... Jurnal Kreativitas Pengabdian Kepada Masyarakat (PKM) 7 (9), 4044-4054 , 2024 2024
Optimalisasi Self-Management Diabetes melalui Health Coaching bagi Kader Kesehatan Sebagai Upaya Pengontrolan Kadar Gula Darah Penderita DM RY Sari, Y Septianingrum, I Faizah, R Rohmawati, SN Hasina, ... Jurnal Kreativitas Pengabdian Kepada Masyarakat (PKM) 7 (9), 4020-4031 , 2024 2024 Citations: 2
Effect of progressive muscle relaxation therapy and slow deep breathing on blood pressure of elderly with hypertension SN Hasina, RA Putri, RY Sari, R Rohmawati, I Faizah Journal for Quality in Public Health 7 (2), 128-137 , 2024 2024 Citations: 11
Essential Oil for Diabetic Neuropathy Pain. I Noventi, S Maimunah, SN Hasina, RA Putri, I Faizah, Y Kartini Frontiers in Health Informatics 13 (3) , 2024 2024 Citations: 1
Improving Self-Efficacy and Physical Self-Reliance of Diabetes Mellitus Patient through Mindfulness based on spiritual intervention. R Rohmawati, R Rusdianingseh, A Muhith, I Faizah, RY Sari, L Wijayanti, ... Frontiers in Health Informatics 13 (3) , 2024 2024
The Influence Of Mindfulness Spiritual Therapy Based On Breathing Exercise On The Optimism And Meaningfulness Of Life Of Breastfeeding Mothers In Providing Exclusive Breastfeeding. F Nisa, SN Hasina, I Faizah, RK Afiyah, Y Windarti, I Mardiyanti Frontiers in Health Informatics 13 (3) , 2024 2024
Psychoeducation and Interactive Nursing Reminder Based on Health Belief Model Theory on Health Locus of Control and Blood Sugar Levels of Diabetes Mellitus Patients. RY Sari, Y Septianingrum, I Faizah, R Rohmawati, A Muhith Frontiers in Health Informatics 13 (3) , 2024 2024
Stroke Self-Management Program Based on Health Behavior Theory on Self-Management Behavior and Subjective Well-Being of Post-Ischemic Stroke Patients. I Faizah, Y Kartini, RY Sari, R Rohmawati, Y Septianingrum, A Muhith Frontiers in Health Informatics 13 (3) , 2024 2024
Spiritual Diabetes Self-Management Health Coaching Against Psychological Well-Being and Self-Management Compliance in Diabetes Mellitus Patients R SARI, Y Septianingrum, I Faizah, R Rohmawati, A Muhith South Eastern European Journal of Public Health, 183-192 , 2024 2024 Citations: 1
MOST CITED SCHOLAR PUBLICATIONS
Hubungan tingkat pengetahuan dengan kepatuhan minum obat anti tuberkulosis (OAT) pada pasien tuberkulosis paru SN Hasina, A Rahmawati, I Faizah, RY Sari, R Rohmawati Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal 13 (2), 453-462 , 2023 2023.0 Citations: 57
Analisis Faktor yang Berhubungan dengan Ketepatan Penegakan Diagnosa Keperawatan Menurut Standar Diagnosa Keperawatan Indonesia (SDKI) SN Hasina, I Faizah, RA Putri, RY Sari, R Rohmawati Jurnal Keperawatan 15 (1), 389-398 , 2023 2023.0 Citations: 19
Spiritual emotional freedom technique against anxiety and psychological well-being of type 2 dm patients during the covid-19 pandemic RY Sari, A Muhith, R Rohmawati, U Soleha, I Faizah, RK Afiyah, ... Open Access Macedonian Journal of Medical Sciences 9 (G), 260-265 , 2021 2021.0 Citations: 17
Pengaruh murrotal Al-Qur’an terhadap nyeri dan status hemodinamika pada pasien penyakit jantung koroner RY Sari, R Rohmawati, I Faizah, SN Hasina, RA Putri Jurnal Keperawatan 15 (2), 481-490 , 2023 2023.0 Citations: 15
Dukungan suami berhubungan dengan pencapaian peran ibu menggunakan pendekatan teori ramona t. mercer pada ibu primipara RK Afiyah, RY Sari, I Faizah Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal 10 (3), 417-428 , 2020 2020.0 Citations: 13
Pengaruh Manajemen Lifestyle Terhadap Kadar Gula Darah Dan Kualitas Hidup Penderita Dm Dalam Pandemi Covid-19 R Rohmawati, AH Setiawan, PMP Winoto, RY Sari, I Faizah, F ILMI, ... Jurnal Ilmu Keperawatan Jiwa 4 (3), 545-552 , 2021 2021.0 Citations: 12
Effect of progressive muscle relaxation therapy and slow deep breathing on blood pressure of elderly with hypertension SN Hasina, RA Putri, RY Sari, R Rohmawati, I Faizah Journal for Quality in Public Health 7 (2), 128-137 , 2024 2024.0 Citations: 11
Resistance exercise berpengaruh terhadap perbaikan neuropati diabetikum pada penderita dm tipe 2 RY Sari, I Faizah Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal 10 (3), 395-406 , 2020 2020.0 Citations: 11
Combination of AROM with deep breathing exercise against fatigue and quality of life of hemodialysis patients; an experimental study RY Sari, Y Kartini, I Faizah, R Rohmawati, SN Hasina Journal of Nephropharmacology 13 (1), e10551-e10551 , 2023 2023.0 Citations: 10
Self-acceptance affects attitudes in caring for sexual function after hysterectomy RK Afiyah, CU Wahyuni, B Prasetyo, MB Qomaruddin, RY Sari, I Faizah, ... Open Access Macedonian Journal of Medical Sciences 9 (G), 293-296 , 2021 2021.0 Citations: 9
Social support and acceptance commitment therapy on subjective well-being and mental health of COVID-19 patient I Faizah, Y Kartini, RY Sari, R Rohmawati, RK Afiyah, FS Rahman Open Access Macedonian Journal of Medical Sciences 9 (G), 238-243 , 2021 2021.0 Citations: 9
Efektivitas senam bugar tehadap insomnia pada lansia di kelurahan tambak sawah sidoarjo R Rohmawati, RY Sari, I Faizah, U Soleha Jurnal Ilmiah Keperawatan Stikes Hang Tuah 15 (1), 58-65 , 2020 2020.0 Citations: 8
Spiritual diabetes self-management health coaching on self-efficacy, self-care, and blood glucose levels in type 2 diabetes mellitus patients RY Sari, NM Hatmanti, I Faizah, R Rohmawati, A Muhith, RK Afiyah Bali MedJ: Bali Medical Journal 12 (3), 2768-2773 , 2023 2023.0 Citations: 7
The effectiveness of mirror therapy in stroke patients: A systematic review Z Jannah, Y Septianingrum, RK Afiyah, I Faizah Journal Of Nursing Practice 6 (2), 137-144 , 2023 2023.0 Citations: 6
Factors that influence on Islamic caring behavior Y Kartini, N Nursalam, A Ahsan, K Khamida, I Faizah, RY Sari Bali Medical Journal 11 (1), 397-404 , 2022 2022.0 Citations: 6
Nur Hasina Fakultas Keperawatan dan Kebidanan, S.(2022) R Rohmawati, E Sudarti, I Faizah, R Yunita Sari Korelasi Usia Terhadap Kecemasan Pada Pasien Pre Operasi Histerectomi. JKJ … , 0 Citations: 6
Training For Health Cadres In Controlling Risk Factors For Non-Communicable Diseases As An Effort To Realize A Healthy Productive Age RY Sari, R Rohmawati, I Faizah, SN Hasina, RA Putri Community Service Journal of Indonesia 5 (1), 13-19 , 2023 2023.0 Citations: 5
Effectiveness of ASWAJA An Nahdliyah-based caring training on caring behavior, performance in patient safety and service quality Y Kartini, N Nursalam, A Ahsan, I Faizah, S Damawiyah, A Nasir Gaceta Medica de Caracas 131 (1), 100-110 , 2023 2023.0 Citations: 5
The effectiveness of visual art on the psychological response in stroke survivors: A systematic review YA Pangestu, Y Septianingrum, I Faizah Journal of Nursing Practice 6 (2), 183-194 , 2023 2023.0 Citations: 5
Pengaruh Pre-Operative Teaching Islami Terhadap Tingkat Cemas Pasien Pre-Operasi TUR-P di RSI Jemursari Surabaya RY Sari, R Rohmawati, I Faizah, W Herisanti Jurnal Ilmiah Keperawatan 15 (1), 66-77 , 2020 2020.0 Citations: 5