Belitung Nursing Journal <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> Department of Publication, Belitung Raya Foundation, Indonesia en-US Belitung Nursing Journal 2477-4073 <p>Authors who publish with Belitung Nursing Journal agree to the following terms:</p> <ol> <li>Authors retain copyright licensed under&nbsp;a&nbsp;<a href="">Creative Commons Attribution-NonCommercial CC BY-NC 4.0</a>,&nbsp;which&nbsp;allows others to&nbsp;remix, tweak, and build upon the authors' work non-commercially, and although the others' new works must also acknowledge the authors and be non-commercial, they don't have to license their derivative works on the same terms.</li> <li>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See&nbsp;<a href="">The Effect of Open Access</a>). In other words, authors <strong>can</strong> archive pre-print (submitted version),&nbsp;<em>&nbsp;</em>post-print (accepted version), and publisher's version/PDF. Read also <a href="">self-archiving-policy</a>.</li> </ol> Establishing appropriate sample size for developing and validating a questionnaire in nursing research <p>The number thirty is often used as the sample size in multiple questionnaires and identified as appropriate for validation of nursing research. However, this is not the best tool or strategy for sample size selection for development and validation, and this often causes immediate rejections of manuscripts. This editorial aims to provide an overview of the appropriate sample size for questionnaire development and validation. The article is the amalgamation of technical literature and lessons learned from our experiences in developing, validating, or adapting a number of questionnaires.</p> Joko Gunawan Colleen Marzilli Yupin Aungsuroch Copyright (c) 2021 Joko Gunawan, Colleen Marzilli, Yupin Aungsuroch 2021-10-28 2021-10-28 7 6 356 360 10.33546/bnj.1927 Aesthetic expressions as data in researching the lived-world of children with advanced cancer <p class="KeywordsCxSpFirst"><strong>Background</strong><strong><span lang="TH">: </span></strong>Understanding the true world of children needs a special method. Using aesthetic expressions through artworks with reflections assists nurse researchers in exploring children’s feelings, thoughts, and behaviors in relation to their health and well-being.</p> <p class="KeywordsCxSpMiddle"><strong>Objective</strong><strong><span lang="TH">: </span></strong>This article focuses on the use of aesthetic expressions as innovative data sources in a study of the lived worlds of children experiencing advanced cancer<span lang="TH">.</span></p> <p class="KeywordsCxSpMiddle"><strong>Method</strong><strong><span lang="TH">:</span></strong> The use of aesthetic expressions in Gadamerian hermeneutic phenomenology and aesthetics, by means of van Manen’s approach using draw and write, is examined as a suitable approach in a study of the lived worlds of children experiencing advanced cancer<span lang="TH">.</span></p> <p class="KeywordsCxSpMiddle"><strong>Results</strong><strong><span lang="TH">:</span></strong> The aesthetic expressions through the Draw<span lang="TH">-</span>and<span lang="TH">-</span>Write method of data generation were well<span lang="TH">-</span>suited to a hermeneutic phenomenological study involving the group of Filipino children living with advanced cancer<span lang="TH">. </span>The children drew images and figures of themselves, their families, classmates, friends, and teachers in several places and events during the series of two days<span lang="TH">. </span>The drawings showed their facial expressions, home, parents, hospital stay, school activities, extracurricular activities, and other daily activities<span lang="TH">.</span></p> <p class="KeywordsCxSpLast"><strong>Conclusion</strong><strong><span lang="TH">: </span></strong>Aesthetic expression linked to art and connected to human experience drew the participants into different realms and expanded their perceptual capacities so that the fullness of the meaning of the experience was appreciated<span lang="TH">. </span>The understanding of the experience through aesthetic expression provided sensitivity to and awareness of the variation of experience among children with advanced cancer<span lang="TH">. </span>It is hoped that this paper can contribute to an understanding of aesthetic expressions as pathways to understanding and support health professionals as they embark on their goal of creating or restoring a comfortable relationship with children<span lang="TH">.</span>&nbsp;</p> <p class="KeywordsCxSpLast"><em><strong>Funding:</strong> This study obtained a research scholarship grant from Thailand Education Hub for ASEAN Countries <span lang="TH">(</span>TEH<span lang="TH">-</span>AC<span lang="TH">).</span></em></p> Barbara Lyn Galvez Waraporn Kongsuwan Savina O. Schoenhofer Urai Hatthakit Copyright (c) 2021 Barbara Lyn Galvez, Waraporn Kongsuwan, Savina O. Schoenhofer, Urai Hatthakit 2021-12-06 2021-12-06 7 6 549 560 10.33546/bnj.1884 Selected factors related to physical activity among persons with heart failure in a university-affiliated hospital, Bangkok, Thailand <p><strong>Background: </strong>Heart failure is a complex clinical syndrome that disturbs physical and psychological health and the quality of life of persons with heart failure and their families. Physical activity is one of the essential self-care in persons with heart failure, which can decrease the exacerbation of the heart failure symptoms, increase activity tolerance, ability to accomplish daily activities, and improve quality of life.</p> <p><strong>Objectives:</strong> This research aimed to determine the physical activity level among persons with heart failure and explore the relationship between physical activity and its related factors based on the self-and family management framework, including motivation, functional ability, family support, and perceived quality of patient-provider relationships.</p> <p><strong>Methods:</strong> A correlational cross-sectional study was conducted with a total of 70 participants who visited the Multidisciplinary Heart Failure Clinic of a university-affiliated hospital, Bangkok, Thailand, from December 2020 to May 2021. Participants were asked to complete five questionnaires that explored their physical activity and its related factors. Data were analyzed and reported using descriptive statistics and correlation coefficient, and the<em> p</em>-value of .05 was considered to be statistically significant.</p> <p><strong>Results:</strong> The results showed most participants (78.50%) had a high physical activity level, and the other participants (21.50%) had a moderate physical activity level. Regarding the relationship between physical activity and its related factors, a total physical activity had a significant positive correlation with a functional ability (<em>r<sub>s</sub></em> = .309, <em>p</em> &lt; .05), and family support (<em>r</em> = .210, <em>p</em> &lt; .05). While the physical activity had a positively non-significant correlation with motivation (<em>r</em> = .050, <em>p</em> &gt; .05), and a negatively non-significant correlation with perceived quality of patient-provider relationships (<em>r</em> = -.049, <em>p</em> &gt; .05).</p> <p><strong>Conclusion: </strong>The research can be used to gain more understanding of physical activity among persons with heart failure. Nurses play an accountable role in promoting and providing appropriate interventions to constantly maintain and enhance physical activity as secondary prevention in persons with heart failure. Additionally, measuring physical activity using an objective measurement with the self-report should be considered for the favorable outcome.</p> <p><em><strong>Funding:&nbsp;</strong>This study was partially funded by the Graduate Studies of Mahidol University Alumni Association, Thailand.</em></p> Sittigorn Saiwutthikul Apinya Siripitayakunkit Sumolchat Duangbubpha Copyright (c) 2021 Sittigorn Saiwutthikul, Apinya Siripitayakunkit , Sumolchat Duangbubpha 2021-12-06 2021-12-06 7 6 500 507 10.33546/bnj.1829 Assessing the financial burden of hemodialysis treatment in Malaysia <p><strong>Background:</strong> Patients with chronic kidney disease (CKD) spend substantial money on hemodialysis (HD) treatment. The growing intersection between socioeconomic status and financial burden represents an emerging challenge to the CKD community.</p> <p><strong>Objective:</strong> This study assessed the financial burden of HD treatment on patients at a Malaysian tertiary teaching hospital.</p> <p><strong>Methods:</strong> A cross-sectional study was carried out in the HD unit at a Malaysian tertiary teaching hospital from January to February 2021. Patients undergoing HD were purposively selected. A self-administered questionnaire was used to collect data on socio-demographic, finances, the patient's health history, treatment costs, and healthcare utilization. In addition, Pearson Chi-Square tests were used to analyze the data.</p> <p><strong>Results:</strong> A total of 100 patients receiving HD treatment were included in the study. The mean age was 62.06 years (<em>SD</em> = 27.50), with 52% reporting moderate financial burdens. The financial burden was associated with employment status, salary, and income class among HD patients (<em>p </em>&lt;0.05).&nbsp;</p> <p><strong>Conclusion:</strong> Evidence showed a large proportion of Malaysian patients receiving HD treatment came from the B40 income bracket. The findings indicate that financial burdens can impact HD patients and are related to employment status, salary, and income class. Therefore, the ability to identify HD patients' financial needs is critical in nursing practice.</p> Nur Fatin Aqilah Mohd Fadzli Ali Aminuddin Mohd Rasani Soon Lean Keng Copyright (c) 2021 Nur Fatin Aqilah Mohd Fadzli, Ali Aminuddin Mohd Rasani, Soon Lean Keng 2021-12-06 2021-12-06 7 6 529 534 10.33546/bnj.1804 Correlates of evidence-based nursing practice among nurses in Saudi Arabia: A structural equation model <p><strong>Background</strong>: Consideration needs to be given to variables that impact the application of evidence-based nursing practice.</p> <p><strong>Objective</strong>: This study aimed to generate and validate a structural model of factors predictive of evidence-based nursing practice.</p> <p><strong>Methods</strong>: A cross-sectional descriptive design was used, with 612 registered nurses in the southern area of Saudi Arabia selected using&nbsp;a convenience sampling procedure. Data&nbsp;were collected during&nbsp;the period&nbsp;from November 2019 to January 2020 using valid&nbsp;and reliable questionnaires, including the novel Registered Nurses’ Competencies, Beliefs, Facilitators, Barriers, and Implementation&nbsp;of&nbsp;the Evidence-based Practice Questionnaire. A structural equation modeling technique was used for data analysis.</p> <p><strong>Results</strong>: Evidence-based nursing practice&nbsp;was significantly influenced by nurses’&nbsp;competency, beliefs, barriers, and facilitators. 38.75%&nbsp;of&nbsp;the variance was explained by all factors. Specifically, nurses’ beliefs partially mediated the relationship between nurses’ competency and the evidence-based&nbsp;application of nursing practice. In addition, the relationship between&nbsp;nurses’ beliefs and evidence-based application&nbsp;of nursing&nbsp;practice was partially mediated by organizational facilitators. Nurses’ competency and beliefs were significantly influenced by attending the workshop, education level, years of experience, and previous research work.</p> <p><strong>Conclusion</strong>: The current&nbsp;study highlights&nbsp;the significant&nbsp;effect of personal and&nbsp;organizational variables toward&nbsp;the application of evidence-based&nbsp;nursing practice.</p> Mohammad H Abuadas Copyright (c) 2021 Mohammad H Abuadas 2021-12-06 2021-12-06 7 6 457 466 10.33546/bnj.1803 Malaysian nurses’ knowledge and attitudes regarding BRCA genetic testing <p><strong>Background:</strong> Breast cancer genetic (BRCA) testing for cancer susceptibility is an emerging technology in medicine.&nbsp;</p> <p><strong>Objective:</strong> This study assessed the knowledge and attitude of nurses regarding BRCA genetic testing in a tertiary teaching hospital in Malaysia.</p> <p><strong>Methods:</strong> A descriptive cross-sectional study was conducted among 150 nurses using a simple random sampling technique in a tertiary teaching hospital in northeast peninsular Malaysia. Data were collected using a self-administered questionnaire consisting of socio-demographic data, assessing nurses’ knowledge and attitude regarding BRCA genetic testing. Fisher exact test analysis was used to determine the association between socio-demographic characteristics with knowledge and attitude level. In addition, the overall knowledge and attitude were analysed using the sum score of each outcome based on Bloom’s cut-off point.</p> <p><strong>Results:</strong> Of the 150 nurses, 66.7% had high knowledge level about BRCA genetic testing, and 58% were positive towards genetic testing. The participants’ mean age was 28.9 years (SD = 6.70). Years of working experience (<em>p </em>= 0.014) significantly influenced knowledge level on BRCA genetic testing, whereas speciality working experience (<em>p </em>&lt;0.001) significantly influenced BRCA genetic testing attitudes.</p> <p><strong>Conclusions:</strong> The results show that most nurses have adequate knowledge of BRCA genetic testing. However, their attitude could be termed negative. Therefore, targeted education programs on BRCA genetic testing and risk are needed to improve the knowledge and attitude of nurses and, ultimately, can educate the women and increase health-seeking behaviour among eligible women.</p> Kien Ting Liu Wan Rosilawati Wan Rosli Azlina Yusuf Soon Lean Keng Copyright (c) 2021 Kien Ting Liu, Wan Rosilawati Wan Rosli, Azlina Yusuf, Soon Lean Keng 2021-12-06 2021-12-06 7 6 493 499 10.33546/bnj.1802 Nurse education today: Between teaching and publication focus <p>“Publish or Perish” is no longer an imagination. On the contrary, it is considered a new reality in nursing education today. All nurse scholars, researchers, faculty members, and students are eager and compete with each other to publish their research works in academic journals. Success in this challenge brings personal benefits, especially for academic reputation and promotion, as well as organizational benefits, such as university ranking and sponsorship. However, despite the advantages of faculty publication, the pros and cons of this topic are on the rise. Therefore, this article aims to discuss the publication-related phenomenon in nursing education, followed by concerns and recommendations for consideration.</p> Joko Gunawan Yupin Aungsuroch Mary L Fisher Copyright (c) 2021 Joko Gunawan, Yupin Aungsuroch, Mary L. Fisher 2021-08-27 2021-08-27 7 6 262 266 10.33546/bnj.1798 Predictors of nurses’ caring practice for critically ill patients in critical technological environments: A cross-sectional survey study <p><strong>Background</strong>: Caring practice for critically ill patients refers to the actions/behaviors/performance of nurses while caring for critically ill adult patients in the intensive care unit (ICU). Although the caring practice is vital in ICUs and complex due to the multitude of availabletechnologies, research on ICU nurses’ caring practice and its predictive factors are lacking.</p> <p><strong>Objective:</strong> This study aimed to explore the level of nurses’ caring practice for critically ill patients in critical technological environments in China and its predictors.</p> <p><strong>Methods</strong>: This was a cross-sectional online survey study with 218 ICU nurses in 29 tertiary hospitals of Guizhou province, China, from 1<sup>st</sup> to 30<sup>th</sup> April 2020. Data were collected by using e-questionnaires made in the Questionnaire Star program, including the Demographic Data Questionnaire (DDQ), Practice of Technological Competency as Caring in Nursing Instrument (P-TCCNI), Influence of Technology Questionnaire (ITQ), and Nurses’ Professional Value Scale (NPVS). The questionnaires were content validated by three experts. Cronbach’s alpha coefficient was 0.96 for the P-TCCNI, 0.70 for the ITQ, and 0.95 for the NPVS. Links to the questionnaires were distributed by research assistants to WeChat groups including target participants. Statistical Package for the Social Science (SPSS) program version 26 (IBM Corporation, Armonk, NY, USA) was used for data analysis. Descriptive and inferential statistics were used to analyze the data. Multiple linear regression analysis using stepwise solution analysis was performed to identify unique predictors of nurses’ caring practice.</p> <p><strong>Results:</strong> The level of nurses’ caring practice for critically ill patients was high (mean = 87.30, standard deviation = 13.73). The professional value was a significant predictor of nurses’ caring practice (<em>β</em> = 0.41, <em>p</em> = 0.00).</p> <p><strong>Conclusion:</strong> ICU nurses exhibited a high level of caring practice. Professional value was a significant predictor of ICU nurses’ caring practice. Nursing administrators should understand the current situation of caring practice in critical technological environments and design strategies to maintain and improve ICU nurses’ professional value to increase the level of caring practice.</p> <p><em><strong>Funding:</strong>&nbsp;This study was financially supported by a thesis grant from Thailand’s Education Hub for Southern Region of ASEAN Countries (TEH-AC) Scholarship through Prince of Songkla University, Thailand.</em></p> Yinglan Li Waraporn Kongsuwan Copyright (c) 2021 Yinglan Li, Waraporn Kongsuwan 2021-12-06 2021-12-06 7 6 476 484 10.33546/bnj.1794 The war on COVID-19 and vaccination mandates: Ethical code of conduct <p>N/A</p> Norma Visagie Copyright (c) 2021 Norma Visagie 2021-10-28 2021-10-28 7 6 443 444 10.33546/bnj.1768 Perceptions of nurse managers and staff nurses regarding Technological Competency as Caring in Nursing theory in general hospitals in Japan <p><strong>Background:</strong> Nurses as primary healthcare providers demonstrate quality nursing care through competencies with healthcare technologies, while nurse managers assume the primacy of managing quality healthcare in their respective care settings. However, little is known about perceptions of the influence of care technologies on their nursing practice.</p> <p><strong>Objective:</strong> This study aimed to determine managers’ and staff nurses’ perceptions regarding the Technological Competency as Caring in Nursing (TCCN) theory in general hospitals in Japan.</p> <p><strong>Methods:</strong> This study employed a cross-sectional survey design, with 421 participants selected using a stratified sampling method. Technological Competency as Caring in Nursing Instrument–Revised (TCCNI-R) was used for online data collection using Survey Monkey©. Data were analyzed using Welch’s t-test and ANOVA.</p> <p><strong>Results: </strong>Nurses with years of experience within the range of 20 to less than 30 years showed the highest TCCNI-R scores among the two groups. Nurses who had received education on caring in nursing showed significant differences for Factor 2 (Technological Competency as Caring), that of expressing Technological Competency as Caring. Three other factors showed no significant difference, namely in Factor 1 (Nursing Expression as Caring), Factor 3 (Technology and Caring), and Factor 4 (Technological Knowing). However, the average scores of these factors were high, which reflect high professional ethics and occupational discipline and increased awareness of caring in nursing. It was also found that the nurse managers were more aware of the TCCN than were the staff nurses. The nurse managers were also more aware of providing care using technology, recognizing the need-to-know patient needs through technology and providing care to the ever-changing patient’s condition.</p> <p><strong>Conclusion:</strong> The study discovered that continuing education is needed regarding the practice of nursing based on theory, enabling appropriate and accurate understanding of practicing knowing persons as caring in nursing.</p> <p><em><strong>Funding:&nbsp;</strong>JSPS KAKENHI Grant Number JP17K12159.</em></p> Youko Nakano Tomoya Yokotani Feni Betriana Chihiro Kawai Hirokazu Ito Yuko Yasuhara Tetsuya Tanioka Rozzano Locsin Misao Miyagawa Copyright (c) 2021 Youko Nakano, Tomoya Yokotani, Feni Betriana, Chihiro Kawai, Hirokazu Ito, Yuko Yasuhara, Tetsuya Tanioka, Rozzano Locsin, Misao Miyagawa 2021-12-06 2021-12-06 7 6 467 475 10.33546/bnj.1767