JKEP (JURNAL KEPERAWATAN)
Vol 9.
No 2.
November 2024 ISSN: 2354-6042 (Prin.
ISSN: 2354-6050 .
The Effectiveness of Transcultural Nursing Model to Improve Malaria Childcare Lamria Situmeang.
Sulistiyani.
Elizabeth Mebri.
Lalu Guntur Payasan* Poltekkes Kemenkes Jayapura.
Indonesia email: lalumguntur@gmail.
Artikel history Dikirim.
Jun 02th, 2024 Ditinjau.
Nov 11th, 2024 Diterima.
Nov 25th, 2024 Copyright A 2024 Authors This work is licensed under a Creative Commons Attribution-ShareAlike 4.
International License.
ABSTRACT
Malaria is endemic to Papua due to various factors, rendering its eradication a continual Nurses, as healthcare practitioners engaged in malaria management, frequently encounter clinical and sociocultural challenges.
Consequently, transcultural nursing has emerged as an effective approach to improve pediatric malaria treatment.
This study seeks to assess the efficacy of the transcultural nursing model in enhancing malaria care for children provided by their families.
This quasi-experimental design used two groups: a control group and an intervention group, each comprising 50 participants.
Data analysis utilized t-tests and a general linear model to evaluate the efficacy of the transcultural nursing model among groups subjected to three interventions over time The findings indicated notable disparities in child malaria care practices between the control and intervention groups, as demonstrated by both the t-test and general linear model analyses.
This research concludes the transcultural nursing model can effectively address cultural barriers in the provision of nursing care for Keywords: Behavior.
Care.
Children with Malaria.
Transcultural Nursing ABSTRAK Papua menjadi endemik malaria disebabkan oleh multifaktor sehingga dalam eliminasinya masih menjadi tantangan.
Perawat sebagai salah satu tenaga kesehatan yang terlibat langsung dalam proses penanganan malaria tidak jarang mengalami kendala baik yang bersifat klinis maupun sosial budaya.
Transkultural nursing diciptakan untuk menjembatani kendala yang dialami perawat dalam memberikan asuhan kepada pasien malaria baik pada individu, keluarga dan komunitas.
Tujuan penelitian ini ialah mengkaji pengaruh model transkultural nursing untuk meningkatkan asuhan anak malaria oleh keluarga.
Penelitian ini menggunakan pendekatan eksperimen semu dengan dua kelompok yakni kontrol dan intervensi dengan JKEP (Jurnal Keperawata.
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Analisa data yang digunakan ialah t-test dan general linier model guna melihat perbandingan efektivitas penerapan model transkultural nursing ini baik pada setiap kelompok dengan tiga kali perlakuan .
ntar wakt.
Hasil penelitian ini memperlihatkan bahwa pada ada perbedaan yang signifikan perilaku perawatan anak dengan malaria antara kelompok kontrol dan intervensi baik pada uji t-test maupun general linier model.
Kesimpulan model transkultural nursing dapat diterapkan dalam membantu menjembantani kendala budaya dalam penerapan asuhan keperawatan pada konteks malaria.
Kata Kunci: Anak dengan Malaria.
Perawatan.
Transkultural Nursing INTRODUCTION Regency recorded the highest Air Pollution Malaria is a mosquito-transmitted illness.
Index (API), surpassing 100, followed by with Papua province documenting the other regencies in Papua, such as Keerom.
Sarmi, and Timika.
Indonesia, representing 79% of the annual parasite incidence (API) cases in 2023.
Jayapura Regency exhibits the highest incidence at the district level in the nation.
If not treated promptly, malaria can lead to gradual It is transmitted by the bite of female Anopheles mosquitoes, which inject parasites into the human body.
Malaria is 2 billion individuals, or nearly half of the global population, susceptible to infection.
Children under five malaria-related 438,000 globally in 2015, of which 69% were children in this age group (WHO, 2.
In 2018.
Indonesia documented 222,085 cases of malaria nationwide.
The five provinces with the highest incidence were Papua.
West Papua.
Maluku.
North Maluku, and East Nusa Tenggara.
Jayapura Indonesia aims to eliminate malaria by 2030 (Kemenkes, 2.
, requiring strategic actions to diminish the incidence of Anopheles Indonesia's malaria presents four variants:
Plasmodium Plasmodium Plasmodium Plasmodium ovale.
In 2015.
Indonesia reported 209,413 cases of malaria (Kemenkes RI, 2.
Jayapura Regency, 2,600 malaria cases were documented in children aged 1 to 4 years from January to December 2015 (Dinkes Kabupaten Jayapura, 2.
Data from the Sentani Health Center between January and April 2016 indicated 265 cases within the same age demographic.
Heni Sesanti .
identified 290 cases of individuals aged 14Ae64 .
1%), with a male representation of 53%, and the peak JKEP (Jurnal Keperawata.
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%).
Sullivan & Bettger .
cited Sesanti's research identified 98 incidence by Honduras and Steury .
in Zambia hotspots, with RW 3 documenting the identified comparable challenges, noting highest number of cases .
RW 3 is that engaging local communities was situated adjacent to a forest, characterized essential to surmounting resistance.
by marshy land that facilitates mosquito Consequently, community engagement is proliferation owing to stagnant water.
Local health workers report that certain nursing methodologies.
This study aims to community members improperly utilize evaluate the efficacy of engaging local bed nets.
Some individuals suspend them traditional leaders and applying culturally- without utilizing them, fold and stow them informed nursing care as preventive and in cabinets, or even repurpose them for mitigation strategies for malaria cases in The effective utilization of bed nets is essential for malaria prevention.
Jayapura Regency.
Harapan Health Center, however, hesitance to employ them arises advantages, especially regarding the initial This misconception, along with Papua's malaria prevention and health promotion Intervention group This quasi-experimental research used preposttest only design with control group.
scent of insecticide-treated nets.
Control group
METHOD
This research identified the effectiveness of the given intervention by involving two subject groups: the control and research groups (Siedlecki, 2.
Pre-test Treatment Post-test Figure 3.
1 Research Design The research lasted from May to October control and intervention cohorts.
Malaria 2023, encompassing 50 families in both the cases in children were identified using JKEP (Jurnal Keperawata.
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Committee of the Health Polytechnic of the proficiency in Indonesian, basic literacy.
Ministry of Health in Jayapura, which deemed it ethically viable, as confirmed by Ethical Approval Letter No: 271/KEPK- Sampling Ethics J/Vi/2023.
The evaluation of culturally-based nursing cultural values, dependency factors, social and economic influences, and community feedback on transcultural nursing practices.
The instrument comprised 50 Likert-scale The instrument underwent validity and reliability testing, resulting in a validity score of 0.
279 via the product-moment method and a reliability score of 0.
according to Cronbach's alpha for the culturally-based nursing model, and 0.
The data analysis encompassed frequency and percentage analysis, t-tests, post hoc tests, and a general linear model tailored to malaria-related intervention groups.
Child care behavior included families' readiness to embrace technologies that originated beyond their cultural traditions.
This study was performed within the jurisdiction of Harapan Health Center, one of the 20 health centers in Jayapura Regency, located in Nolokla.
East Sentani District.
Jayapura Regency.
The health center is accredited and operates as an outpatient facility.
Harapan Health Center ranks fourth in visit frequency, following Sentani.
Waibu, and Yapsi Health Centers.
Moreover.
Harapan Health Center oversees Posyandu .
ntegrated health service post.
, amounting to 39 (Dinkes Kabupaten Jayapura, 2.
Harapan Health Center employed 15 for malaria child care behavior.
RESULTS
nurses, 13 midwives, 1 public health officer, 3 sanitarians, 4 nutritionists, 3 pharmaceutical technician, 1 pharmacist, 2 general practitioners, and 2 dentists.
In 2022.
Harapan Health Center ranked among the top three health centers for malaria prevalence, documenting 4,981 cases and two fatalities attributed to malaria (Dinkes Kabupaten Jayapura, 2.
JKEP (Jurnal Keperawata.
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frequency and percentage of each variable.
Table 1.
The respondentsAo characteristics of both groups Groups Total Variables Control Treatment Sex Male Female .
%) 19 .
%) Age Education level Primary .
%) 9 .
%) Junior High Earning <RMW .
%) 29 .
%) >RMW .
%) 21 .
%) Pediatric care history Never at the hospital due to .
%) Malaria Recorded .
%) 12 .
%) Source: primary data 2023 The table shows most respondents are males for both groups.
the dominant age is distribution if the p-value > 0.
Here are within the range between 18 and 45 years the results:
Most education level.
earning lower than RMW.
and experience of receiving treatment at hospital due to malaria.
The Normality Test The Kolmogorov- Smirnov normality test assisted by SPSS because the sample was more than 50.
The JKEP (Jurnal Keperawata.
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Normality Test Results Variables Caring behavior for children with malaria Groups Control Intervention p-value* Pre-Test Post-test * Kolmogorov-smirnov The table shows normality data for both The researchers used Levene to examine groups have normal data distribution, p- the variance homogeneity.
The assumption value higher than 0.
of the homogeneity is Ae p-value higher than the = 0,05.
Here is the result:
Homogeneity Test Table 3.
Homogeneity Test Variable Coefficient p-value* Caring behavior for children with malaria *Levene Test Remarks Homogenous The table shows the variable variance is The bivariate analysis used t-test homogenous because the p-value is higher for both groups, including the group with transcultural care.
Here are the The nursing model to improve caring behavior for children with malaria Table 4.
the Dependent T-Test for Control and Intervention Groups Variable Groups Caring behavior for children with Control Interventio Pre-Test Post-test Mean A 862A0.
767A0.
Mean A 852A0.
319A0.
*Paired t-test Table 5.
4 shows the analysis of the post-test score is 6.
Meanwhile, the culturally-based nursing care model in analysis results on the variable of the intervention group yielded a p-value malaria child care behavior in the 000 .
-value<0.
, indicating a control group has a p-value of 0.
difference before and after the treatment indicating no significant difference in in the intervention group.
The mean malaria child care behavior.
The mean pre-test score is 4.
767, and the mean JKEP (Jurnal Keperawata.
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862, while the mean post-test score is 2.
Table 5.
the Independent T-Test of Control and Intervention Groups Groups p-value* Intervention Control Post-test *Independent t-test The table above reveals that the test for The Analysis of General Linear the difference in average child care Model of Behavioral Changes from behavior with malaria between the Time to Time control and intervention groups yielded General linear model was useful a significance value of 0.
The to examine the mean difference of the significance value .
is less than cultural-based nursing care model time-interval significant difference in the child care Here are the detailed behavior with malaria, as evidenced by the higher average of the intervention group .
compared to the control group .
Table 6 General Linear Model-Uji Repeated Anova Groups Source Control Time Sphericity Assumed GreenhouseGeisser Huynh-Feldt Lowe-bound Error Sphericity (Tim.
Assumed GreenhouseGeisser Huynh-Feldt Lowe-bound Type i Sum Squares 15,160 27,507 Mean Square Sig*.
7,580
1,725
8,791
1,782
1,000
8,509
15,160
84,505
87,302
49,000
JKEP (Jurnal Keperawata.
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Assumed GreenhouseGeisser Huynh-Feldt Lowe-bound *Repeated measures annova The Tests of Within-Subjects Effects indicating a significant difference over indicates that the Greenhouse-Geisser time in the intervention group.
Sig value is between 0.
000 and 0.
Therefore, each repetition time reveals a significant difference in the average malaria care behavior of children with Meanwhile, intervention group, the Greenhouse- To obtain information regarding the average behavior of malaria treatment for children at each measurement over time (PostH3.
PostH6.
PostH.
, refer to the following pairwise table.
Geisser Sig value is 0.
000 < 0.
Table 7.
the Post Hoc Control Group Groups Control Intervention PostH3-PostH6 PostH6-PostH9 PostH9-Post3 PostH3-PostH6 PostH6-PostH9 PostH9-Post3 OI Mean p-value *Uji Post Hoc Pairwise Comparisons Table 7 shows the differences in results post-test between the control group and the measurement results intervention group.
The difference in compared to day 3.
Meanwhile, for the the impact of the culturally-based intervention group, there are significant nursing care model on the control group changes in the post-test results from day JKEP (Jurnal Keperawata.
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caring for children with malaria after 119, and 3.
The increase is PostH6.
Figure 1 shows the reading of significant with a Sig.
value of 0.
the differences over time.
Therefore, the intervention group experienced a significant increase in Figure 1 the Comparison of Caring Behaviors of Children with Malaria from both Groups Intervensi Kontrol The differences between both group Regency, and most had children deal with the over-time increase from previously hospitalized for malaria.
post-intervention on day 15 for control group and post-intervention on day 16 for the intervention group.
The variation in gender distribution across the control and intervention groups arose because the researchers DISCUSSION RespondentsAo Characteristics The characteristics of respondents varied, with males dominating the control group and females in the intervention group.
All respondents were aged 18Ae45 years.
the majority had a middle school education, earned below the minimum wage in Jayapura did not limit the respondents to mothers The researchers also allowed fathers and other family members to Additionally, according to data from the Department of Population and Civil Registration of Jayapura Regency, populations in East Sentani District were nearly equal, with 5,581 males and JKEP (Jurnal Keperawata.
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The behavior of malaria childcare in the intervention group showed a significant difference with a p-value of 0.
- The Central Bureau of Statistics (BPS) of Jayapura Regency .
found most residents in the regency were employed 60,479 3,821 unemployed in the productive age However, value < 0.
, indicating a significant The mean pre-test score the mean post-test score was Conversely, the control group showed no significant changes, with a p-value of 0.
570, an mean pre-test score 862, and a post-test score of 2.
management, aligning with the finding that most respondents earned below the The findings demonstrated a clear minimum wage.
BPS also reported that difference between the group that 15,430 people in Jayapura Regency lived below the poverty line.
model intervention and the group that did not.
Previous research by Erika In terms of education, most respondents had a middle school or high school education, which aligns with the availability of educational facilities.
BPS data showed 47 junior high schools (SMP) and 23 high schools (SMA) or their equivalents in Jayapura Regency.
In East Sentani District specifically, there were 3 junior high schools and 4 high schools.
Observations revealed that respondents came not only from the .
demonstrating that transcultural nursing models improved mothers' knowledge and behavior in caring for children with Similarly, studies by Rosiah & Laili .
and Hardini.
Rustina, & Syahreni .
indicated significant improvements in family enthusiasm, knowledge, and childcare behaviors when using a transcultural nursing mainland but also from islands within Harapan Health Center's Transcultural nursing models focus on values, beliefs, and cultural adoption in nursing practices from assessment to The Influence of Transcultural Care Model to Improve Malaria Childcare evaluation (Leininger & McFarland.
Addressing cultural values and JKEP (Jurnal Keperawata.
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Weidman .
malaria is a common disease , leading and Giger & Haddad .
further them to think that it has no negative emphasized that cultural approaches impact on their family members.
facilitate changes in health behavior by However, this belief would change if aligning interventions with patients' the family believed that malaria could cultural norms.
cause pain to their family members.
Families in the two examples above will The Differences of Malaria Childcare Behavior and Malaria Childcare Over Time The undoubtedly behave differently when caring for children with malaria.
differences in malaria child care behavior between the control group and the intervention group over time.
Hohashi .
conducted research in five countries: the United States.
Japan.
China.
Indonesia, and the Philippines, which aligns with these findings.
The implements a transcultural nursing care model that fosters closeness, the acceptance of nurses as healthcare professionals can swiftly shift the perception of malaria from a common disease to a potentially dangerous one, thereby changing the family's approach to caring for children with malaria.
study focused on the implementation of culturally-based Research Limitation applying family value-based care in This study has some flaws, such as the each country.
The study found that incapability to track how children were accommodating values and beliefs cared for and how economic factors and past hospitalizations might affect those acceptance, and the belief that the behaviors, which could make it harder provided care is beneficial and will to change how children are cared for positively impact the family's health.
during malaria.
Furthermore.
Im & Lee .
explored how the acceptance and closeness between nurses significantly influence the effectiveness of nursing care.
CONCLUSION
This study found significant differences in malaria childcare behaviors between the control and intervention groups.
The transcultural nursing model effectively JKEP (Jurnal Keperawata.
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2 November 2024 hlm 294-307 improved malaria childcare behaviors over RECOMMENDATION Families with children affected by malaria Debora.
Rinonce.
Fransiska.
Astari.
Gisela,M.
dan Fadli Kasim.
Prevalensi malaria di Asmat.
Papua: Gambaran situasi terkini di daerah endemik tinggi.
Journal of Community Empowerment for Health.
Vol 1 .
2018, 11-19 can apply the transcultural nursing model.
Future studies should focus on long-term monitoring of childcare behavior changes over weeks and months and investigate economic and hospitalization history as factors that may hinder program success.
REFERENCES