Belitung Nursing Journal 2022-04-26T12:24:47+00:00 Dr. Joko Gunawan Open Journal Systems <div id="journalDescription"> <h5><strong>Editors</strong>&nbsp;&gt;<a href=""> Editorial Board</a><br><a href="" target="_blank" rel="noopener">Assoc. Prof. Dr. Yupin Aungsuroch</a><br><a href="" target="_blank" rel="noopener">Dr. Joko Gunawan</a></h5> <br><br> <p>BNJ is a peer-reviewed, "<a href="">Gold</a>" open access journal&nbsp;that provides a venue for nursing scholarship with an Asian focus and perspectives from the region.&nbsp;</p> </div> Quality of life among mothers of preterm newborns in a Malaysian neonatal intensive care unit 2022-04-26T12:24:47+00:00 Swee Leong Ong Kim Lam Soh Emni Omar Daw Hussin Salimah Japar Kim Geok Soh Ponpun Vorasiha Azlina Daud <p><strong>Background</strong>: As Quality of Life (QoL) becomes progressively vital in health care services, its importance in mother and child health is of no exception too. Quality of life among mothers with a premature newborn is an issue that has led to growing concerns in the health care system. Yet, despite the knowledge about mother’s QoL being essential to family-centered planning on prematurity integrated healthcare, current evidence has been scant. </p> <p><strong>Objective:</strong> To examine factors related to the QoL of mothers having preterm newborns hospitalized in the neonatal critical unit.</p> <p><strong>Methods:</strong> A non-probability convenience survey was used in a public hospital in Malaysia, covering 180 mothers whose preterm newborns were hospitalized into level III Neonatal Intensive Care Unit (NICU) through the completion of a 26-questions survey of the World Health Organization Quality of Life (WHOQOL-BREF) and the 26-questions of Parental Stress Scale: Neonatal Intensive Care Unit (PSS: NICU). The data were analyzed using descriptive statistics, bivariate analysis, and Pearson correlation coefficients.</p> <p><strong>Result: </strong>The mean scores for mothers' quality of life were (<em>M</em> = 3.67, <em>SD</em> = 0.73) and maternal stress (<em>M</em> = 3.03, <em>SD</em> = 0.90) out of 5. A mother’s occupation was found to be the only factor associated with the quality of life among mothers who have preterm newborns admitted to the NICU. Furthermore, maternal role change was found to have a moderate negative relationship with the quality of life (<em>r </em>= 0.310, <em>p = </em>0.05).</p> <p><strong>Conclusion:</strong> The findings of this study revealed that the main factors contributing to the mother’s QoL during their preterm newborns’ NICU admission were role change-related stress. Thus, to maintain a better QoL among this group of mothers during this traumatic period, a special nursing intervention program must be implemented immediately, right after the preterm newborns’ admission, to relieve the mothers’ stress which has been proven to have a direct effect on the mothers’ QoL. The study results will alert healthcare providers, particularly neonatal nurses, on the need to support mothers psychologically in terms of role change. This is to ensure a better quality of life among mothers whose newborns were admitted to the NICU.</p> 2022-04-26T00:00:00+00:00 Copyright (c) 2022 Swee Leong Ong, Kim Lam Soh, Emni Omar Daw Hussin, Salimah Japar, Kim Geok Soh, Ponpun Vorasiha, Azlina Daud Prevalence, severity, and self-management of depressive mood among community-dwelling people with spinal cord injury in Nepal 2022-04-26T12:21:27+00:00 Mandira Baniya Luppana Kitrungrote Jintana Damkliang <p><strong>Background: </strong>Depression is a common psychological condition after spinal cord injury. There are increased incidences of self-harm, suicidal behavior, and lower quality of life among people with spinal cord injury and depression. However, self-management of depressive symptoms in the community is less explored.</p> <p><strong>Objective: </strong>This study aimed to examine the prevalence, severity, and self-management of depressive mood in community-dwelling people with spinal cord injury.</p> <p><strong>Methods: </strong>A descriptive study was conducted in 2019 among 115 people with spinal cord injury discharged from three health centers and living in the 13 districts of Bagmati Province. Participants were selected using stratified random sampling. Questionnaires were related to demographics, health and environment, depressive mood, and self-management. Descriptive statistics and quantitative content analysis were used to analyze the data.</p> <p><strong>Results: </strong>Ninety-seven (84.3%) people with spinal cord injury had a depressive mood. Of these, 60.8% had moderate to severe depressive moods. They mainly used the internet and social media, shared feelings with family members, and practiced Hindu religious activities for depressive mood management because of the physical barriers to accessing a healthcare facility and easiness to use of non-pharmacological methods. Nearly half of participants who used sharing of feelings felt their depressive mood disappeared when they often used the method.</p> <p><strong>Conclusion: </strong>Depressive mood following initial hospitalization is highly prevalent among people with spinal cord injury in Nepal, most of whom live in rural settings. Therefore, nurses and other health professionals should provide psychoeducation for this population and their family members to better address mental health problems. Facilitating pathways for those in rural areas to engage in social activities and timely treatment access may improve depressive mood. Nurses and other rehabilitation professionals can use social media to assess depressive moods and deliver management approaches in the community.</p> 2022-04-26T00:00:00+00:00 Copyright (c) 2022 Mandira Baniya, Luppana Kitrungrote, Jintana Damkliang “I can live a normal life”: Exploring adherence to antiretroviral therapy in Indonesian adolescents living with HIV 2022-04-26T12:20:20+00:00 Nuraidah Nuraidah Dessie Wanda Happy Hayati Imami Nur Rachmawati Agung Waluyo <p><strong>Background:</strong> Adherence to antiretroviral therapy (ART) can be challenging since it needs to be continued for a lifetime. At their age, adolescents start to be responsible for their life, and this continued therapy might be a challenge for them.</p> <p><strong>Objective:</strong> This study explored the experiences of adherence to ART in adolescents living with HIV in Jakarta, Indonesia.</p> <p><strong>Methods:</strong> A qualitative study with an Appreciative Inquiry (AI) approach was employed to explore challenges adolescents face in ART adherence which focused more on positive aspects of the experience. In-depth interviews were conducted with ten adolescents who were selected purposively based on criteria including those aged 13-19 years, having been diagnosed with HIV infection and receiving ART for more than a year, and never having discontinued ART. All participants were registered in the outpatient clinic in one top referral hospital in Jakarta. The data were analyzed using thematic analysis.</p> <p><strong>Results:</strong> Five themes were identified from the data: living a normal life, wanting to be healthy, taking medication on time, challenges in undergoing treatment, and there is hope.</p> <p><strong>Conclusion:</strong> Adolescents with HIV want to live as normal and healthy as possible, like other adolescents. Even though adolescents face several challenges to comply with ART, they try to take the medication as prescribed. The findings of this study serve as input for nurses to maintain compliance with ARVs in adolescents who have HIV.</p> 2022-04-26T00:00:00+00:00 Copyright (c) 2022 Nuraidah Nuraidah, Dessie Wanda, Happy Hayati, Imami Nur Rachmawati, Agung Waluyo The mechanism of anger and negative affectivity on the occurrence of deviant workplace behavior: An empirical evidence among Malaysian nurses in public hospitals 2022-04-26T12:20:50+00:00 Maslina Mansor Rashidah Mohd Ibrahim Asyraf Afthanorhan Ahmad Munir Mohd Salleh <p><strong>Background:</strong> Employees’ work experience significantly impacts their cognition and workplace actions. Anger and negative affectivity are two personality traits that have been linked to workplace deviant behavior conduct.</p> <p><strong>Objective:</strong> This study aimed to empirically analyze the deviant workplace behavior and its antecedents among Malaysian nurses in public hospitals.</p> <p><strong>Methods:</strong> A cross-sectional design was employed in this study. The survey questionnaires were distributed proportionately to staff nurses in six government hospitals in 2020, with a total of 387 nurses selected using a simple random sampling. Partial Least Squares Structural Equation Modeling (PLS-SEM) was used for data analysis.</p> <p><strong>Results:</strong> Trait anger triggered deviant workplace behavior in Malaysian nurses, thus supporting the argument that the personality trait could increase deviant behavior (<em>β</em> = 0.245, <em>p</em> = 0.000). At the same time, there was no evidence that negative affectivity could influence deviant behavior in the workplace among nurses in selected public hospitals in Malaysia (<em>β</em> = 0.074,<em> p</em> = 0.064).</p> <p><strong>Conclusion:</strong> The Malaysian nurses had positive affectivity, related to positive emotions like happiness, work interest, and attentiveness. On the other hand, the nurses were suffering from high levels of emotional tiredness. Further research should highlight a deeper understanding of Malaysian nurses’ work experiences and workplace stress affecting their physical and mental health.</p> 2022-04-26T00:00:00+00:00 Copyright (c) 2022 Maslina Mansor, Rashidah Mohd Ibrahim, Asyraf Afthanorhan, Ahmad Munir Mohd Salleh Knowledge, attitude, and practice of surgical site infection prevention among operating room nurses in southwest China 2022-04-26T12:20:24+00:00 Wen Feng Wipa Sae-Sia Luppana Kitrungrote <p><strong>Background:</strong> Surgical site infection has become a problem in the operating room, and the nurses’ knowledge, attitude, and practice could impact the incidence of the infection. Unfortunately, there is a dearth of studies on this issue in China. Therefore, determining nurses’ knowledge, attitude, and practice of surgical site infection prevention is necessary.</p> <p><strong>Objectives:</strong> This study aimed to examine the knowledge, attitude, and practice of surgical site infection prevention and their relationships, as well as to identify differences in knowledge, attitude, and practice of surgical site infection prevention according to nurses’ demographic characteristics.</p> <p><strong>Methods:</strong> A sample of 999 operating room nurses participated in 49 tertiary hospitals and 75 secondary hospitals in Guizhou Province, Southwest China. Data were collected using validated questionnaires through a Chinese survey website. Data were analyzed using descriptive statistics, One-Way Analysis of Variance, and Pearson product-moment correlation.</p> <p><strong>Results:</strong> The knowledge of surgical site infection prevention was at a low level, the attitude was positive, and the practice was at a high level. Approximately 39% of the nurses passed knowledge scores of ≥ 70%, 60% gave a positive attitude score of ≥ 80%, and 76% achieved a practice score of ≥ 80%. The nurses’ attitude was positively related to knowledge (<em>p</em> &lt; .01), and practice (<em>p</em> &lt; .01), respectively. However, knowledge and practice did not significantly relate. The age group of 30-39 years old had significant higher knowledge than other age groups. The nurses with working experience of 6-15 years had significant higher knowledge scores than other groups. In addition, the nurses with one time of training frequency had significant lower attitude and practice scores than those with six to ten times of training frequency.</p> <p><strong>Conclusion:</strong> Approximately 60% of operating room nurses still had inadequate knowledge regarding surgical site infection prevention, but they had a positive attitude and high level of practice. The findings of this study might serve as an input for nurse administrators or policymakers to provide updated knowledge or guideline, closed supervision, and in-service training on surgical site infection prevention for operating room nurses. </p> 2022-04-26T00:00:00+00:00 Copyright (c) 2022 Wen Feng, Wipa Sae-Sia, Luppana Kitrungrote Life skills and sexual risk behaviors among adolescents in Indonesia: A cross-sectional survey 2022-04-26T12:23:24+00:00 Ati Surya Mediawati Iyus Yosep Ai Mardhiyah <p><strong>Background: </strong>Adolescents require life skills and individual and interpersonal abilities to grow into adults with a healthy lifestyle. Although the majority of the literature indicates that life skills increase teenagers’ cognitive, social, and emotional abilities, there is a lack of data correlating life skills to sexual risk behaviors.</p> <p><strong>Objective</strong>: This study aimed to examine the relationship between life skills and sexual risk behaviors among adolescents aged 15–19 in Bandung, Indonesia.</p> <p><strong>Methods: </strong>This study was conducted using a cross-sectional survey of 480 adolescents from April to May 2021. A representative sample was drawn from the students aged 15–19 years. The participants were selected using simple random sampling generated by computer software. Life Skill Training Questionnaire High School (LSTQ-HS) and sexual risk behaviors instruments were used for data collection, and logistic regression was used for data analysis.</p> <p><strong>Results: </strong>From a total of 480 respondents, about 23.3% had masturbation experience, 25.8% had petting experience, 8.3% had sexual intercourse, 5% had sex before 18 years of age, and 4.2% had oral sex experience. Sexual risky behaviors were associated with unfavorable refusal skill (AOR = 6.46, 95% CI = 2.37, 17.53), assertiveness skill (AOR = 3.51, 95% CI = 1.32, 4.33), problem-solving skill (AOR = 5.35, 95% CI = 2.88, 11.39), and self-control skill (AOR = 7.31, 95% CI = 2.79, 17.24).</p> <p><strong>Conclusion:</strong> Life skills are important protective aspects for those who engage in sexually risky behavior. Considering the study findings, tailored life skills programs are critical for adolescent wellbeing and risk reduction. Nurses who take a proactive role in providing sexual and reproductive health services may provide more accurate information and provide early screening and assessment for sexual and reproductive behavior to reduce risky sexual behavior among adolescents. Schools are also encouraged to work with local health departments to conduct sexual education counseling programs.</p> 2022-04-26T00:00:00+00:00 Copyright (c) 2022 Ati Surya Mediawati, Iyus Yosep, Ai Mardhiyah Relation between socio-demographic factors and professionalism among nurses in Saudi Arabia: A comparative analysis 2022-04-26T12:23:45+00:00 Hussein Alshumrani Bander Albagawi Sandro Villareal Benito Areola Jr Hamdan Albaqawi Saleh Algamdi Abdulrahman Alerwi Ahmed Saad Altheban Seham Alanazi <p><strong>Background:</strong> Analyzing how nurses handle professionalism in their careers will help all concerned individuals identify areas of concern to develop and enhance further to achieve or maintain a high degree of professionalism.</p> <p><strong>Objective:</strong> This study aimed to determine the level of professionalism among nurses and its differences according to socio-demographic characteristics.</p> <p><strong>Methods:</strong> A quantitative cross-sectional approach was utilized in three significant regions of Saudi Arabia. A simple random sampling technique was employed with 305 respondents, resulting in a 95.9% response rate. A Google Form survey was used to collect the data between January and April 2021.</p> <p><strong>Results:</strong> Nurses perceived themselves highly in professional organization (Mean = 3.94, <em>SD =</em> 0.17), belief in public service (Mean = 3.91, <em>SD = </em>0.22), belief in self-regulation (Mean = 3.97, <em>SD =</em> 0.08), sense of calling (Mean = 4.01, <em>SD =</em> 0.13), and belief in autonomy (Mean = 3.71, <em>SD = </em>0.15). There was no significant difference between gender and professional organization, belief in public service, self-regulation, or belief in autonomy. Still, there was a significant difference in belief in public service (<em>t</em> = 2.794; <em>p</em> = 0.006) and sense of calling (<em>t</em> = 4.290; <em>p</em> = 0.001). As to age, only belief in self-regulation was significant (<em>t</em> = 5.984; <em>p</em> = 0.003). Moreover, the educational qualifications reached an insignificant difference in professionalism. Conversely, the type of facility has been found to have reached significant differences with a professional organization (<em>F</em> = 3.057; <em>p</em> = 0.029), belief in public service (<em>F</em> = 4.130; <em>p</em> = 0.007), beliefs in regulation (<em>F</em> = 3.452; <em>p</em> = 0.017), sense of calling (<em>F</em> = 3.211; <em>p</em> = 0.023), and belief in autonomy (<em>F</em> = 5.995;<em> p</em> = 0.001). Lastly, the current position found no significant difference in professionalism.</p> <p><strong>Conclusion:</strong> Nurses in the Kingdom of Saudi Arabia perceived themselves as highly professional, and male nurses were found to have a sense of calling more than their female counterparts. Age, educational qualification, and current position had no significant difference in professionalism. Conversely, the type of facility had a significant difference with the belief in autonomy. These findings support and sustain the role of nurses in this 21st-century health care that is significantly needed to provide the most quality care. </p> 2022-04-26T00:00:00+00:00 Copyright (c) 2022 Hussein Alshumrani, Bander Albagawi, Sandro Villareal, Benito Areola Jr, Hamdan Albaqawi, Saleh Algamdi, Abdulrahman Alerwi, Ahmed Saad Altheban, Seham Alanazi Children’s psychosocial state after the 2018 Lombok earthquake 2022-04-26T12:21:41+00:00 Ariyanti Saleh Budi Anna Keliat Herni Susanti Heni Dwi Windarwati Framita Rahman Ahmad Sapoan Fitrawati Arifuddin <p><strong>Background: </strong>The current earthquake disaster in Lombok, Indonesia, in July 2018 has caused 564 deaths, and 445.343 were evacuated to refugee camps, including children. Disasters have the potential in resulting short-and long-term effects on the psychological functioning, emotional adjustment, health, and developmental trajectory of children. Nurses play a significant role when a disaster occurs. One of the nurses’ roles is to give a traumatic healing intervention to the victims</p> <p><strong>Objective:</strong> This study sought to assess children’s psychosocial state after the 2018 Lombok earthquake.</p> <p><strong>Methods:</strong> A total of 189 children from five regencies in Lombok were selected to participate in the study using accidental sampling. Data were collected using the Strengths and Difficulties Questionnaire (SDQ). Descriptive statistics and cross-tabulation were used for data analysis.</p> <p><strong>Results:</strong> The participants consisted of 98 girls (51.9%) and 91 boys (48.1%), with the majority (<em>n</em> = 142 [75.1%]) being from school-aged children. The SDQ results showed that most of the children were at the abnormal stage for difficulties (<em>n</em> = 103 [54.5%]), and most of them were at a normal stage for strength (<em>n</em> = 97 [51.3%]). The cross-tabulation analysis revealed that gender might influence the SDQ score for the strength (<em>p</em> = 0.034), but not for difficulties (<em>p</em> = 0.482). However, age did not have a correlation with SDQ score, either for strength (<em>p</em> = 0.475) or difficulties (<em>p</em> = 0.836), respectively.</p> <p><strong>Conclusion:</strong> The study found that children in Lombok generally displayed positive behavior and emotional progress after the earthquake. However, some children remained in distress and thus required more observation from parents or other social welfare agencies. This research may help nurses decide on their nursing care for children who experience disasters.</p> 2022-04-26T00:00:00+00:00 Copyright (c) 2022 Ariyanti Saleh, Budi Anna Keliat, Herni Susanti, Heni Dwi Windarwati, Framita Rahman, Ahmad Sapoan, Fitrawati Arifuddin Acceptance Theory of Family Caregiving 2022-04-26T12:20:27+00:00 Alfredo Feliciano Evelyn Feliciano Daisy Palompon Ferdinand Gonzales <p>Acceptance of roles in the care of older adults by a family caregiver depends on factors emanating from commitment to familial relationships, widespread cultural expectation, and debt of gratitude. This study aims to develop a theory that explains the acceptance of the role of caregiving of the older adults by the family caregiver necessary to predict behavioral adaptation and control caring phenomenon that favors successful meeting of caring expectation across trajectory phases and transitions. A deductive axiomatic approach to theory generation was utilized, resulting in four axioms that served as bases for four propositions. Acceptance Theory of Family Caregiving implies that older adults who expect their children to take care of them as they age have cultural influence and that the acceptance of the role will determine the caregiver’s acceptance of consequences in the form of physical, economical, psychological, and spiritual aspects. In terms of preparedness, family members who accept the possibility of the decline of their older adults are more likely to be assume caregiving roles efficaciously. In the process that family members face in this so-called trajectory caregiving process, resources play a significant role. The developed theory suggests that the care of the older adult in the family caregiving process is determined by the acceptance of role assumption by the family caregiver across trajectory phases. This study highlights the vital implication of acceptance of role assumption to the outcomes of the caregiving process with respect to older adult care, prevention of family caregiver burden, and establishment of strong familial and social relationships.</p> 2022-04-26T00:00:00+00:00 Copyright (c) 2022 Alfredo Feliciano, Evelyn Feliciano, Daisy Palompon, Ferdinand Gonzales Development of a clinical learning model to enhance patient safety awareness competency among Thai nursing students 2022-04-26T12:20:34+00:00 Jutarat Bandansin Danulada Jamjuree Manat Boonprakob Saisamorn Chaleoykitti <p><strong>Background:</strong> Enhancing patient safety awareness competency in nursing students is a necessity as they will be the next generation of professional nurses to take care of patients. One of the strategies is to create an innovative learning model using questioning as part of the metacognitive thinking concept.</p> <p><strong>Objective:</strong> This study aimed to develop a clinical learning model to enhance patient safety awareness competency among Thai nursing students and determine its effectiveness.</p> <p><strong>Methods:</strong> The study used a research and development design with two phases: (1) the development of a clinical learning model to enhance patient safety awareness competency among nursing students, and (2) the evaluation of the effectiveness of the developed clinical learning model<span lang="TH">. </span>The evaluation was done quantitatively and qualitatively. In the quantitative strand, a quasi-experimental method using repeated measures design was used in 24 students. While in the qualitative strand, a qualitative descriptive design was employed in 24 students and three teachers.</p> <p><strong>Results:</strong> In the first phase, the DUIR clinical learning model was developed, consisting of four processes: 1) Doubt (D), 2) Understanding (U), 3) Insight (I), and 4) Reflected value (R). The patient safety awareness competency included two components: managing patient safety and solving problems related to unsafe patient care. In the second phase, the model was evaluated by the students and the teachers. It revealed that nursing students’ patient safety awareness competency was very high, and the competency was statistically different before and after the learning model.</p> <p><strong>Conclusion:</strong> The developed DUIR learning model using a questioning strategy is considered effective to encourage students to reflect critically on their own clinical experiences in order to achieve quality and safe care outcomes, thereby enhancing patient safety awareness for nursing students in a sustainable way. This model serves as an input for Thai nursing education and beyond.</p> 2022-04-26T00:00:00+00:00 Copyright (c) 2022 Jutarat Bandansin, Danulada Jamjuree, Manat Boonprakob, Saisamorn Chaleoykitti Human-In-The-Loop (HITL) application design for early detection of pregnancy danger signs 2022-04-26T12:22:41+00:00 Melyana Nurul Widyawati Ery Hadiyani Puji Astuti Kurnianingsih Kurnianingsih <p><strong>Background:</strong> Pregnancy period is a period for mothers to empower themselves to be safe and comfortable. Pregnant women must acquire pregnancy-related information, such as warning signs of pregnancy, to avoid severe complications and even death during pregnancy and childbirth. Therefore, developing an application for pregnant women would be very helpful.</p> <p><strong>Objective:</strong> This study aimed to apply Human-In-The-Loop design with an android application to detect pregnancy risk early and avoid maternal morbidity and mortality.</p> <p><strong>Methods:</strong> We collected data from the cohort of 5324 pregnant women at the community health centers in the West Lombok District from 2020 to February 2021. The data included age, parity, height, inter-pregnancy interval, hemoglobin levels, upper arm circumference, previous diseases, and bleeding history. We developed a Human-In-The-Loop mobile application and employed the decision tree for identifying pregnancy danger signs. The midwife (human-in-the-loop) reviewed and clarified the data to generate the final detection and made a recommendation.</p> <p><strong>Results:</strong> The ordinal regression model revealed that older patients who have more parity, lower height, the distance of children &lt;2 years, hemoglobin &lt;11 g/dl, upper arm circumference (UPC) &lt;23.5 cm, have positive HBsAg, have HIV disease, have a history of diabetes mellitus (DM), have a history of hypertension, positive protein urine, and have other diseases are more likely to have a high maternal risk. The decision tree outperformed and obtained a high accuracy of 92% ± 0.0351 compared to the nine individual classifiers (Nearest Neighbors, Random Forest, Neural Net, AdaBoost, Gaussian Naïve Bayes, Bagging, Extra Tree, Gradient Boosting, and Stacking).</p> <p><strong>Conclusion: </strong>The Human-In-The-Loop mobile app developed in this study can be used by healthcare professionals, especially midwives and nurses, to detect danger indications early in pregnancy, accurately diagnose the high risk of pregnancy, and provide treatment and care recommendations during pregnancy and childbirth.</p> 2022-04-26T00:00:00+00:00 Copyright (c) 2022 Melyana Nurul Widyawati, Ery Hadiyani Puji Astuti, Kurnianingsih Kurnianingsih Cross-culture adaptation and validation of the Indonesian version of the Hospital Survey on Patient Safety Culture (HSOPSC 2.0) 2022-04-26T12:24:19+00:00 Lilis Suryani Santhna Letchmi Faridah Binti Moch Said <p><strong>Background</strong>: Hospital Survey on Patient Safety Culture (HSOPSC) is considered one of the most scientifically rigorous tools available with excellent psychometric properties. However, it is not yet available in an Indonesian version.</p> <p><strong>Objective:</strong> This study aimed to determine the validity of the content and psychometric properties of HSOPSC 2.0 for use in Indonesian hospitals.</p> <p><strong>Methods</strong>: The study was divided into three stages: translation, adaptation, and validation. Culture-adaptation was assessed using cognitive interviews with ten direct care nurses who worked in the hospital to evaluate their perceptions and the coherence of the translated items, response categories, and questionnaire directions. Content validity was also done by ten experts from academic and clinical settings. Finally, Confirmatory Factor Analysis (CFA) and reliability testing were conducted among 220 nurses from two Indonesian hospitals.</p> <p><strong>Results</strong>: The cognitive test results indicated that the language clarity was 87.8 % and 84.5% for cultural relevance. The Content Validity Index (CVI) ranged between 0.73 to 1.00, while the construct validity results indicated that each factor had factor loadings above 0.4, from 0.47 to 0.65. The fit indices showed an acceptable fit for the data provided by the 10-factor model, with RMSEA = 0.052, SRMR = 0.089, and CFI = 0.87. The Pearson correlation coefficients between the ten subscales ranged from 0.276 to 0.579 (<em>p </em>&lt; 0.05). The Cronbach’s alpha for all sub-scales was more than 0.70, except for organizational learning – continuous improvement, response to error, and communication openness.</p> <p><strong>Conclusion</strong>: This study offers initial evidence of the psychometric properties of the Indonesian-HSOPSC 2.0. Future studies are needed to examine its psychometric features to improve generalizability. However, nurses and other healthcare professionals could use the tool to measure hospital patient safety culture in Indonesia.</p> 2022-04-26T00:00:00+00:00 Copyright (c) 2022 Lilis Suryani, Santhna Letchmi, Faridah Binti Moch Said Characteristics of interactive communication between Pepper robot, patients with schizophrenia, and healthy persons 2022-04-26T12:20:31+00:00 Feni Betriana Ryuichi Tanioka Tomoya Yokotani Kazuyuki Matsumoto Yueren Zhao Kyoko Osaka Misao Miyagawa Yoshihiro Kai Savina Schoenhofer Rozzano C. Locsin Tetsuya Tanioka <p><strong>Background:</strong> Expressing enjoyment when conversing with healthcare robots is an opportunity to enhance the value of human robots with interactive capabilities. In clinical practice, it is common to find verbal dysfunctions in patients with schizophrenia. Thus, interactive communication characteristics may vary between Pepper robot, persons with schizophrenia, and healthy persons.</p> <p><strong>Objective:</strong> Two case studies aimed to describe the characteristics of interactive communications, 1) between Pepper as a healthcare robot and two patients with schizophrenia, and 2) between Pepper as a healthcare robot and two healthy persons.</p> <p><strong>Case Report:</strong> The “Intentional Observational Clinical Research Design” was used to collect data. Using audio-video technology, the conversational interactions between the four participants with the Pepper healthcare robot were recorded. Their interactions were observed, with significant events noted. After their interactions, the four participants were interviewed regarding their experience and impressions of interacting with the Pepper healthcare robot. Audio-video recordings were analyzed following the analysis and interpretation protocol, and the interview data were transcribed, analyzed, and interpreted.</p> <p><strong>Discussion:</strong> There were similarities and differences in the interactive communication characteristics between the Pepper robot and the two participants with schizophrenia and between Pepper and the two healthy participants. The similarities were experiences of human enjoyment while interacting with the Pepper robot. This enjoyment was enhanced with the expectancy of the Pepper robot as able to entertain, and possessing interactive capabilities, indicating two-way conversational abilities. However, different communicating characteristics were found between the healthy participants’ impressions of the Pepper robot and the participants with schizophrenia. Healthy participants understood Pepper to be an automaton, with responses to questions often constrained and, on many occasions, displaying inaccurate gaze.</p> <p><strong>Conclusion:</strong> Pepper robot showed capabilities for effective communication pertaining to expressing enjoyment. The accuracy and appropriateness of gaze remained a critical characteristic regardless of the situation or occasion with interactions between persons with schizophrenia, and between healthy persons. It is important to consider that in the future, for effective use of healthcare robots with multiple users, improvements in the areas of the appropriateness of gaze, response time during the conversation, and entertaining functions are critically observed.</p> 2022-04-26T00:00:00+00:00 Copyright (c) 2022 Feni Betriana, Ryuichi Tanioka, Tomoya Yokotani, Kazuyuki Matsumoto, Yueren Zhao, Kyoko Osaka, Misao Miyagawa, Yoshihiro Kai, Savina Schoenhofer, Rozzano C. Locsin, Tetsuya Tanioka