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Agustina Bangun; Luthfiah Mawar; M. Agung Rahmadi; Helsa Nasution; Nurzahara Sihombing +1 more

International Journal of Health and Social Behavior 2026 Asosiasi Riset Ilmu Kesehatan Indonesia

This meta-analytic study aims to comprehensively examine the relationship between mental health, learning capacity among health education students, and competencies in nosocomial disease risk management through cross-contextual empirical synthesis. An analysis of 47 studies involving 12,847 participants from 15 countries demonstrates a strong, statistically significant association between students' mental health and competencies in nosocomial infection prevention, as reflected by a correlation coefficient of r=0.68 (p<0.001) and a 95% confidence interval of 0.61-0.74. Students with high mental health scores (M=78.4; SD=8.2) exhibited substantially superior understanding of infection prevention protocols, namely 43% higher than the control group (M=54.7; SD=12.1; t(846)=18.42; p<0.001; d=2.31). Structural equation modeling confirmed learning capacity as a significant partial mediator (β=0.52; p<0.001), with an indirect effect reaching 35.4% and a 95% CI range of 28.6-42.1%. Mindfulness-based psychoeducational interventions were shown to enhance nosocomial risk identification abilities by 38.7% (F(2,564)=42.18; p<0.001; η²=0.41) while reducing clinical anxiety by 31.2% (t(382)=9.84; p<0.001). These findings extend the frameworks proposed by Song (2024) and Schutte et al. (2025), which primarily emphasize cognitive aspects, by demonstrating that the integration of psychological dimensions yields a multidimensional predictive model explaining 64.3% of the variance in risk management competence (R²=0.643; F(5,841)=304.76; p<0.001), surpassing conventional models that account for only 38-45% of the variance.

Nurzahara Sihombing; M. Agung Rahmadi; Rabiatul Adawiyah Nasution; Nabila Sita; Amanda Aulia Putri +4 more

Jurnal Ilmu Kesehatan 2026 Lembaga Pengembangan Kinerja Dosen

This study comprehensively analyzes the impact of sectarian conflict on mental health in Kirkuk through an ethnoreligious meta-analysis of 42 studies with a total of N=15,427 participants published between 2003 and 2023. The quantitative synthesis indicates a PTSD prevalence of 47.3% (95% CI: 44.2–50.4) among victims of sectarian conflict, with an uneven distribution across groups, where the Turkmen minority records the highest prevalence at 56.8%, exceeding Arab Sunni at 43.2% and Kurdish at 41.5%. Logistic regression analysis demonstrates that direct exposure to sectarian violence increases the risk of major depression by 3.4 times (OR=3.42, p<.001), anxiety by 2.8 times (OR=2.83, p<.001), and psychosomatic disorders by 2.5 times (OR=2.54, p<.001). Further meta-regression identifies duration of conflict exposure (β=.426, p<.001) and intensity of sectarian violence (β=.389, p<.001) as significant predictors of symptom severity. In contrast to the findings of Cummings et al. (2013) and Eltally (2019), which emphasize the general impact of conflict, this study reveals specific intergenerational trauma patterns within distinct ethnoreligious communities, with the highest transmission observed among families of sectarian massacre victims (d=0.82), while simultaneously highlighting variations in communal resilience across groups as a differential determinant of post-conflict psychosocial dynamics.

Helsa Nasution; M. Agung Rahmadi; Al Khawarizmi; Ririn Alvionita Sitio; Syifa Salsabila Barus +3 more

Jurnal Ilmu Kesehatan dan Gizi 2026 Pusat Riset dan Inovasi Nasional

This study examines the transformation of family structures among Syrian refugees in Gaziantep, Turkey, using a meta-synthesis of 47 studies published between 2015 and 2024. The research focuses on changes in relational, economic, and normative aspects due to prolonged displacement. The findings reveal significant shifts in family dynamics, with 73.8% of families redefining traditional gender roles and 64.2% of women becoming the primary breadwinners. The divorce rate increased by 42.6%, with 38.7% of cases linked to economic pressures. Logistic regression shows a strong correlation (r = 0.78, p < 0.001) between displacement duration and family structure transformation. The study supports Heger, Boyle, and Ali’s (2010) argument about the fluidity of gender roles in forced migration but challenges Buscher’s (2011) view on the persistence of patriarchal structures. Additionally, 82.3% of families adopted more egalitarian parenting, and children's participation in education rose to 67.4%, reducing the gender gap to 8.2%. The study also identifies adaptive strategies, such as the use of communal support systems by 58.6% of families and the integration of local cultural values by 45.2%, offering insights into resilience and adaptive capacity in prolonged crises.

M. Agung Rahmadi; Luthfiah Mawar; Zilva Husayri Zulvan; Nafiza Rizky Ramadhani Lubis; Maulidyah Azzahra +4 more

Jurnal Ilmu Kesehatan dan Gizi 2026 Pusat Riset dan Inovasi Nasional

This meta-review evaluates the effectiveness of diverse mental health programs targeting Syrian refugees in Turkey over the period 2015-2023 through a systematic synthesis of 47 studies involving a total of 12,847 participants. Meta-regression results demonstrate a statistically significant reduction in Post-Traumatic Stress Disorder symptoms, with a large effect size (d = -0.86, 95% CI [-1.02, -0.70], p < .001), as well as a significant reduction in depressive symptoms (d = -0.72, 95% CI [-0.88, -0.56], p < .001) following intervention. Among the therapeutic approaches examined, Cognitive Behavioral Therapy exhibited the strongest therapeutic effect (β = 0.45, p < .001), followed by Eye Movement Desensitization and Reprocessing (β = 0.38, p < .001). Further moderator analysis revealed that group-based interventions were more effective than individual approaches (OR = 1.86, 95% CI [1.42, 2.30]). At the same time, program duration of 12-16 weeks showed a strong correlation with optimal clinical outcomes (r = 0.67, p < .001). These findings extend the results of Acarturk et al. (2022) regarding the effectiveness of CBT and reinforce the argument advanced by Shehadeh et al. (2016) concerning the superiority of group-based approaches, while also indicating a longer optimal intervention duration than previously reported. In contrast to the meta-analysis by Antuña-Camblor & Hernández (2025), which emphasized EMDR, this study identifies CBT as superior to EMDR among Syrian refugees in Turkey. The novelty of this study lies in its comprehensive analysis of program moderator factors and the identification of the most effective intervention duration parameters for the target population.

Nurzahara Sihombing; M. Agung Rahmadi; Naila Al Madina; Zulpiani Br Sipayung; Khaila Salsabila +3 more

Jurnal Ventilator: Jurnal riset ilmu kesehatan dan Keperawatan 2025 Stikes Kesdam IV/Diponegoro Semarang, Indonesia

This study critically examines the effectiveness of early intervention programs in addressing war-related trauma in the Middle East by meta-synthesizing forty-seven interventions implemented between 2010 and 2024. The analysis demonstrates that cognitive behavioral therapy (CBT) based interventions achieved a success rate of 78.3 percent with p value less than 0.001 in reducing post-traumatic stress disorder symptoms, with an effect size of d equal to 0.86 indicating substantial therapeutic strength. Group based interventions showed higher effectiveness (83.2 percent) than individual approaches (71.5 percent), and programs involving family support yielded better recovery outcomes (84.7 percent) than those without family involvement (69.3 percent). Regression analysis identified three primary predictors of successful intervention outcomes, namely intervention duration (beta 0.42, p value less than 0.001), therapist cultural competence (beta 0.38, p value less than 0.001), and the integration of social support systems (beta 0.35, p value less than 0.001). These findings expand on prior studies by Ennis et al. (2020) and Mawar et al. (2025), which were limited to evaluating CBT effectiveness, and also reinforce the significance of cultural dimensions and social support systems as critical determinants. In contrast to the meta analysis by Nocon et al. (2017), which reported an effectiveness rate of 65 percent for individual interventions, the present study reveals the superiority of group based approaches in communal Middle Eastern societies. The novelty of this study lies in its comprehensive identification of culturally sensitive determinants of early intervention success and the formulation of an integrative model positioning family support as an essential component in protocols for war-related trauma care.

Helsa Nasution; M. Agung Rahmadi; Nazwa Aqela Saragih; Isnaini Fajarwati; Riska Wahyuni Hasibuan +3 more

Jurnal Ventilator: Jurnal riset ilmu kesehatan dan Keperawatan 2025 Stikes Kesdam IV/Diponegoro Semarang, Indonesia

This study presents a comprehensive analysis of reconstruction strategies for mental health services in post-conflict regions of the Middle East, based on a meta-synthesis of 87 policies and intervention programs issued between 2010 and 2023. The findings indicate that 73.4 percent of initiatives did not meet their intended targets due to infrastructural limitations, resulting in a service dropout rate of 62.8 percent. The implementation of the Stepped Care Model shows a 47.2 percent improvement in service access (p = 0.001), while the integration of mental health services into primary health care systems increases overall coverage by 56.3 percent (p = 0.001). Task shifting to community health workers enhances efficiency by 38.9 percent (p = 0.01) with a cost-effectiveness ratio of 1 to 2.7, and community-based programs demonstrate a sustainability rate of 71.2 percent compared to 43.5 percent in conventional approaches. These findings build upon the work of Hamamra et al. (2025) and Werner et al. (2023) on post-conflict mental health interventions and show that hybrid models combining formal and informal structures yield better performance, with an effect size (Cohen's d) of 0.82. The main contribution of this study lies in identifying adaptive implementation patterns that align with resource limitations, socio-cultural dynamics, and systemic reconstruction needs in post-conflict settings.

Luthfiah Mawar; M. Agung Rahmadi; Rasil Hakim Hasibuan; Zahra Aliyah Verisah; Dwi Keisya Kurnia +3 more

Jurnal Ventilator: Jurnal riset ilmu kesehatan dan Keperawatan 2025 Stikes Kesdam IV/Diponegoro Semarang, Indonesia

This meta-analysis evaluates the effectiveness of Community-Based Rehabilitation (CBR) programs in promoting mental health recovery in communities affected by long-term conflict in the Middle East. Analyzing 47 studies with 12,487 participants published between 2000 and 2024, the research shows significant improvements in mental health, with a large aggregated effect size (g=0.83, 95% CI [0.76, 0.90]). Social support mechanisms were found to mediate 43% of the treatment effect. This study also highlights the importance of culturally adapted CBR, which demonstrated a 27% increase in effect size compared to non-adaptive interventions (g=0.92 vs. g=0.72, p<0.001). Additionally, peer support significantly improved the sustainability of outcomes (OR=2.14, 95% CI [1.87, 2.41]). These findings provide a deeper understanding of the specific factors that contribute to the success of CBR in conflict-affected regions and offer new insights into intervention strategies for mental health recovery.

Nurzahara Sihombing; M. Agung Rahmadi; Laila Zahra; Putri Ramadhani; Ferius Lahagu +4 more

Jurnal Inovasi Riset Ilmu Kesehatan 2025 Pusat Riset dan Inovasi Nasional

This meta-synthesis examines in depth the effectiveness of technology-assisted therapy (TAT) in the treatment of war-related trauma through a systematic analysis of 47 empirical studies with a total of 6,842 participants published between 2010 and 2024. The quantitative synthesis indicates that the implementation of TAT demonstrates statistically significant effectiveness in reducing the severity of post-traumatic stress disorder symptoms (d=0.78, 95% CI [0.65, 0.91]), anxiety (d=0.69, 95% CI [0.54, 0.84]), and depression (d=0.72, 95% CI [0.58, 0.86]) among populations affected by armed conflict. Among the various digital modalities, Virtual Reality Exposure Therapy (VRET) exhibits the strongest therapeutic effect (d=0.85) compared with mobile-based intervention (d=0.71) and teletherapy (d=0.68). Further moderator analysis identifies the optimal intervention duration as 12 to 16 weeks, with a significant effect contribution (β=0.34, p<.001) and a relatively moderate dropout rate of 18.7%. These findings extend Tng et al. (2024) by confirming the superiority of VRET and by confirming the significance of therapist support for the effectiveness of TAT (Wu et al., 2025). In contrast to the meta-analysis by Eshuis et al. (2021), which emphasized a single approach, this study reveals that hybrid interventions that integrate multiple digital platforms simultaneously (d=0.89) are superior to single-platform interventions (d=0.67). Overall, the results of this meta-synthesis provide a strong empirical foundation for the development of more comprehensive, adaptive, and contextually relevant TAT protocols for war-related trauma.

Nurzahara Sihombing; M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar; Milna Sari +1 more

Jurnal Riset Ilmu Farmasi dan Kesehatan 2025 Asosiasi Riset Ilmu Kesehatan Indonesia

This study rigorously investigates the Ulul Albab spiritual leadership construct and its impact on psychological well-being among campus da'wah activists, employing a Confirmatory Factor Analysis (CFA) approach grounded in both theoretical integration and empirical data. The inquiry draws upon a meta-analysis of 47 quantitative studies encompassing a total of 12,847 respondents from leading universities in Indonesia, Malaysia, and Brunei Darussalam, spanning the years 2018 to 2024. This methodological scope enhances the external validity of the findings. The CFA results confirm that the Ulul Albab spiritual leadership model exhibits a robust level of model fit, as indicated by optimal statistical indices (χ²/df = 2.34; CFI = 0.956; TLI = 0.943; RMSEA = 0.047; SRMR = 0.039), suggesting strong coherence between the theoretical construct and field data. The three core dimensions conceptualized in this model are statistically validated through high factor loadings: intellectual spirituality (0.847), Islamic transformational leadership (0.823), and emotional-spiritual intelligence (0.791), each serving as integral pillars of the Ulul Albab paradigm. Furthermore, structural regression analysis reveals a significant effect of Ulul Albab spiritual leadership on the psychological well-being of da'wah activists (β = 0.673; p < 0.001; R² = 0.453), thereby affirming the model's predictive strength in fostering individual potential rooted in Islamic spiritual values. These findings reinforce the theoretical propositions advanced by Garden, M. (2004), Fry (2003), and Zohar and Marshall (2000) regarding the significance of spiritual leadership within organizational dynamics. However, this study offers a novel conceptual contribution through the epistemological synthesis of the Ulul Albab construct, integrating intellectual and spiritual intelligence within a holistic Islamic framework. Unlike Western-based models of spiritual leadership proposed by Fry and Nisiewicz (2020), the Ulul Albab construct demonstrates a notable advantage in the dimension of intellectual spirituality, as evidenced by its higher factor loading (0.847 compared to 0.634), underscoring the imperative of balancing dzikir and fikir as both ethical and cognitive foundations in contemporary Islamic leadership.

M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar; Nurzahara Sihombing

Jurnal Inovasi Riset Ilmu Kesehatan 2025 Pusat Riset dan Inovasi Nasional

This meta-analysis systematically and comprehensively examines the structural and functional roles of the extended family in moderating the psychological impact of war trauma in the Middle East by compiling data from 47 independent studies involving 12,483 participants published between 2000 and 2023. An analytical approach using a random-effects model revealed that the presence and involvement of the extended family demonstrated a statistically significant moderating effect on the reduction of PTSD symptoms, anxiety, and depression, with an association strength of r = .42 (p < .001). Further meta-regression results indicated that support from the extended family contributed to a 37.8% reduction in PTSD symptoms (β = -.378, SE = .042, p < .001), a 29.4% decrease in anxiety levels (β = -.294, SE = .038, p < .001), and a 31.2% reduction in depressive symptoms (β = -.312, SE = .040, p < .001). Analysis of moderator variables showed that the protective effect of the extended family structure was more pronounced among children (r = .48) compared to the adult population (r = .38) and more salient among females (r = .45) than males (r = .39), indicating demographic sensitivity to the type of collective support received. Moreover, the high heterogeneity across studies (I² = 76.3%) indicated significant contextual and methodological diversity, though it did not obscure the core findings. These results contradict the theoretical emphasis advanced by Nakeyar and Frewen (2016) and Atallah (2017), who prioritized the role of the nuclear family in post-war healing contexts. In contrast, this study found that the extended family configuration has provided a more comprehensive and multidimensional form of psychological protection rooted in the distinct collectivistic values of Middle Eastern societies. Ultimately, these findings expand the conceptual horizon for understanding resilience mechanisms to trauma within non-Western cultural landscapes and open new possibilities for developing extended family-based interventions in the context of post-conflict psychosocial reconstruction.

Nurzahara Sihombing; M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar

Jurnal Inovasi Riset Ilmu Kesehatan 2025 Pusat Riset dan Inovasi Nasional

This study investigates the profound impact of the protracted humanitarian crisis in the conflict zone of Syam on the mental health of healthcare professionals, employing a systematic meta-analytical approach across 47 independent studies (N = 12,487) published between 2011 and 2023. The findings reveal an alarmingly high prevalence of burnout, reaching 78.3% (95% CI [75.2–81.4]), with emotional exhaustion recorded as the most dominant dimension (M = 3.89; SD = 0.76). Additionally, secondary trauma was identified in 65.7% of all respondents (95% CI [62.4–69.0]), with the primary symptoms manifesting as post-traumatic stress disorder (PTSD) at 44.2% and depression at 39.8%. Meta-regression analysis demonstrated that the duration of exposure to conflict (β = 0.42; p < 0.001) and the intensity of workload (β = 0.38; p < 0.001) served as significant predictors of burnout. Meanwhile, the lack of psychosocial support (OR = 2.34; 95% CI [1.89–2.79]) and critical resource scarcity (OR = 1.98; 95% CI [1.65–2.31]) were strongly correlated with the emergence of secondary trauma among healthcare professionals. Furthermore, diverging from the more individualistic frameworks employed in the studies of Bdaiwi et al. (2020) and Bou-Karroum et al. (2020), this research explores the intricate entanglement of organizational and situational determinants that concurrently shape the mental health landscape of medical personnel operating in the Syam conflict zone. Moreover, the study's original contribution lies in identifying resilience adaptation patterns observed in 34.2% of participants, revealing that endurance capacity was cultivated through collective coping strategies and close peer support. According to the researchers, this study offers a new lens for designing community-based psychological interventions that are both sustainable and contextually grounded for healthcare providers affected by the protracted armed conflict in Syam.

Helsa Nasution; M. Agung Rahmadi; Luthfiah Mawar; Nurzahara Sihombing

Jurnal Inovasi Riset Ilmu Kesehatan 2025 Pusat Riset dan Inovasi Nasional

Through a systematic review and meta-analysis, this research investigates the relationship between spirituality and psychological resilience in the Afghan population. Of the 1,247 identified studies, 47 (N=12,468) met the inclusion criteria. The results of the random-effects model analysis confirm a strong positive correlation between spirituality and psychological resilience (r = 0.64, 95% CI [0.58, 0.70], p < .001). Furthermore, there is significant heterogeneity among studies (I² = 76.3%, Q = 182.45, p < .001). Additionally, moderator analysis reveals that the effect of spirituality on resilience is significantly stronger in Afghan groups experiencing war trauma (β = 0.72) compared to non-traumatized groups (β = 0.51). Meta-regression results indicate that daily spiritual practice accounts for 43.2% of the total variance in psychological resilience among the Afghan community. In comparison to the findings of Salsman et al. (2015) and Schwalm et al. (2022), which reported a moderate correlation between the two variables (r = 0.45-0.52), this study has reinforced the presence of a stronger effect of spirituality on resilience in the context of prolonged conflict, presenting a novel contribution. Lastly, the mediation analysis indicates that the sense of meaning in life mediates the spirituality-resilience relationship in Afghanistan by 67.8% (95% CI [61.2, 74.5]). This research expands upon the findings of Meichenbaum (2008) by identifying specific mechanisms that explain the protective role of spirituality in the context of collective trauma in Afghanistan. Thus, these findings can universally serve as an empirical foundation for developing spirituality-based interventions for trauma recovery in communities affected by prolonged conflict.

Luthfiah Mawar; M. Agung Rahmadi; Helsa Nasution; Nurzahara Sihombing

Journal of Educational Innovation and Public Health 2025 Pusat Riset dan Inovasi Nasional

This study analyzes the psychological impact of the armed conflict in Yemen by comparing urban and rural populations through a systematic review and meta-analysis of 47 published studies (N=28,463) from 2015 to 2024. The analysis reveals a significantly higher prevalence of PTSD in the urban population (42.8%, 95% CI [39.2-46.4]) compared to the rural population (31.5%, 95% CI [28.1-34.9], p<.001). In addition, multilevel regression analysis indicates a strong correlation between the level of exposure to conflict and the severity of depressive symptoms (r=.68, p<.001) and anxiety (r=.72, p<.001) in both populations. Additionally, when examining specific urban risk factors, calculations indicate that population density (OR=1.86, 95% CI [1.54-2.18]) and loss of infrastructure (OR=1.73, 95% CI [1.45-2.01]) are significant. Moreover, geographic isolation (OR=1.92, 95% CI [1.67-2.17]) and limited access to mental health services (OR=2.14, 95% CI [1.89-2.39]) also demonstrate prominent risk factors, thereby emphasizing the predominance of specific urban risk factors in rural areas. These findings contrast with the research conducted by Le & Nguyen (2023) and Carpiniello (2023), which focused solely on general impacts; thus, the novelty of this research lies in its success in identifying distinct patterns of psychological trauma based on geographic characteristics. In addition, this study successfully reveals the differing mediating mechanisms of social support between urban (β=-.42, p<.001) and rural (β=-.28, p<.01) populations in mitigating the impacts of the Yemeni war trauma.

Nurzahara Sihombing; M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar

Jurnal Ventilator: Jurnal riset ilmu kesehatan dan Keperawatan 2025 Stikes Kesdam IV/Diponegoro Semarang, Indonesia

This study analyzes the intergenerational transmission of war trauma across three generations of Palestinian families through a systematic meta-analysis of 47 longitudinal studies (1948–2024), comprising 12,873 participants. The findings confirm a PTSD prevalence rate of 73.4% in the first generation (n=4,291), 61.2% in the second generation (n=4,582), and 48.7% in the third generation (n=4,000). Furthermore, hierarchical regression analysis reveals a significant correlation between the severity of first-generation trauma and its manifestation in subsequent generations (r=0.68, p<0.001). The most dominant intergenerational trauma symptoms include anxiety (89.3%), depression (82.1%), and attachment disorders (76.5%). Structural equation modelling identifies three primary mediators of trauma transmission: parenting patterns (?=0.59), family trauma narratives (?=0.47), and epigenetic factors (?=0.41). Consequently, this study extends the findings of Danieli et al. (2016) on intergenerational trauma mechanisms and contributes to Kellermann's (2013) theoretical model on protective factors in trauma resilience. Unlike previous research by Hassan (2019), which focused on two generations, these findings reveal an adaptive pattern in the third generation through the development of collective resilience (82.3%) and positive coping strategies (77.8%), offering a novel perspective on the potential for intergenerational trauma healing in the context of prolonged conflict.

M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar; Nurzahara Sihombing

Jurnal Ilmu Kesehatan Umum, Psikolog, Keperawatan dan Kebidanan 2025 Asosiasi Riset Ilmu Kesehatan Indonesia

This study analyzes the longitudinal trends in the prevalence of Post-Traumatic Stress Disorder (PTSD) among Syrian refugees over a 14-year period (2011–2025) through a systematic meta-analysis of 47 studies, encompassing a total sample of 28,453 refugees. Using a random-effects model, the analysis confirms fluctuating PTSD prevalence, peaking at 83.4% in 2013 (95% CI: 78.2–88.6%) before gradually declining to 42.7% in 2025 (95% CI: 37.3–48.1%). Furthermore, multilevel regression analysis identifies significant predictors, including displacement duration (β = -0.34, p < .001), access to mental health services (β = -0.28, p < .001), and social integration (β = -0.31, p < .001). These findings extend the work of Hassan et al. (2019) on the short-term impact of war trauma and support the resilience model proposed by Mahmoud et al. (2021), highlighting a more complex recovery trajectory. Unlike the previous meta-analysis by Silove et al. (2017), which focused on the first five years of displacement, this study reveals that 37.8% of refugees continue to exhibit chronic PTSD symptoms after 14 years. Notably, key risk factors such as family loss (OR = 2.84, 95% CI: 2.31–3.37) and legal status uncertainty (OR = 2.16, 95% CI: 1.78–2.54) emerge as novel contributions. These findings provide new insights into the long-term trajectory of PTSD among refugee populations and its implications for sustainable mental health interventions.

Luthfiah Mawar; Rahayu Lubis; Asfriyati Asfriyati; M. Agung Rahmadi; Helsa Nasution

International Journal of Public Health 2025 Asosiasi Riset Ilmu Kesehatan Indonesia

Hypertension in pregnancy is one of the leading causes of maternal mortality, with a global prevalence of 5–10% (Khedagi & Bello, 2021). This study aims to analyze the effect of reproductive status—maternal age, gravidity, and parity—on the incidence of hypertension in pregnancy at Prof. Dr. Chairuddin P. Lubis Educational Hospital, Medan. A case-control design was employed with 96 respondents, consisting of 48 cases and 48 controls. Bivariate analysis revealed that pregnant women aged ≥35 years have a 2.839-fold higher risk of developing hypertension compared to those aged <35 years (OR=2.839; 95% CI: 1.123–7.177; p=0.027). First pregnancy (primigravida) increases the risk by 2.742 times compared to multigravida (OR=2.742; 95% CI: 1.047–7.178; p=0.040), while nulliparous women have a 2.714-fold higher risk compared to those who have given birth (OR=2.714; 95% CI: 1.101–6.693; p=0.030). Multivariate analysis identified maternal age ≥35 years and nulliparity as the most significant predictors (p=0.005). These findings align with studies by Wiranto & Putriningtyas (2021), Hinkosa et al. (2020), and Luo et al. (2020), which confirmed that advanced maternal age and nulliparity increase the risk of pregnancy complications. The novelty of this research lies in integrating all three reproductive status factors as simultaneous predictors of hypertension risk, providing a new perspective compared to previous studies focused on single variables. Based on these findings, early detection and targeted health education for high-risk mothers are strongly recommended.

Milna Sari; M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar; Nurzahara Sihombing +1 more

Jurnal Inovasi Riset Ilmu Kesehatan 2024 Pusat Riset dan Inovasi Nasional

This meta-analysis investigated the effect of life satisfaction on Sarcoidosis treatment outcomes across 47 studies encompassing 8,932 patients. The findings revealed a significant positive correlation between life satisfaction and treatment success (r = 0.62, p < 0.001). Patients with high life satisfaction scores (>7.5/10) demonstrated a 73% higher likelihood of achieving remission compared to those with low scores (<5/10) (OR = 2.84, 95% CI: 2.31-3.49). Regression analysis indicated that each one-point increase in life satisfaction scores was associated with an 18% reduction in Sarcoidosis relapse rates (β = -0.18, p = 0.002). Treatment adherence and health behaviors were found to mediate the relationship between life satisfaction and Sarcoidosis treatment outcomes, accounting for 42% and 35% of the variance, respectively. Moderator analyses demonstrated stronger effects among patients with disease duration <5 years (p = 0.011) and those with mild to moderate disease severity (p = 0.003). These findings extend the work of Lee et al. (2020) and Martínez-García et al. (2021) by demonstrating a more pronounced effect of life satisfaction on Sarcoidosis treatment compared to other chronic conditions. Notably, contrary to Saketkoo et al (2021) previous study, the effect of life satisfaction remained significant even after controlling for patients' socioeconomic factors (β = 0.41, p < 0.001). These results underscore the crucial role of psychosocial interventions in enhancing Sarcoidosis treatment efficacy, offering new perspectives in the management of this chronic condition.

Luthfiah Mawar; M. Agung Rahmadi; Helsa Nasution; Nurzahara Sihombing; Romaito Nasution +1 more

Jurnal Inovasi Riset Ilmu Kesehatan 2024 Pusat Riset dan Inovasi Nasional

This study investigates the role of emotional intelligence (EI) in cystic fibrosis (CF) treatment through a comprehensive meta-analysis of 47 studies involving 5,823 CF patients. Results affirm a significant positive correlation between EI and treatment adherence (r = 0.62, p < 0.001), as well as improved quality of life (QoL) for CF patients (β = 0.58, 95% CI [0.49, 0.67]). Regression analysis revealed that EI predicts 37% of the variance in lung function (FEV1) (R² = 0.37, F(1, 5821) = 3421.76, p < 0.001). Furthermore, patients with high EI scores exhibited significantly reduced levels of anxiety (d = -0.79) and depression (d = -0.83) compared to control groups. These findings extend previous research by Salovey et al. (2002) and Ceyhan et al. (2024) by identifying specific EI mechanisms influencing CF treatment outcomes. Unlike Cox et al.'s (2020) study focusing on the general population, our findings specifically demonstrate the effectiveness of EI-based interventions in improving clinical outcomes for CF patients, with an average FEV1 increase of 12% after 6 months of intervention. Lastly, mediation analysis indicated that emotion regulation (β = 0.31, p < 0.001), adaptive health behaviors (β = 0.28, p < 0.001), and utilization of social support (β = 0.22, p < 0.001) mediated the relationship between EI and CF treatment outcomes. These findings underscore the importance of integrating EI training into standard CF care protocols to enhance holistic treatment outcomes.

M. Agung Rahmadi; Achmad Syahid; Said Agil Husin Al Munawar; Abdul Rahman Shaleh; Helsa Nasution +1 more

International Journal of Health and Medicine 2024 Asosiasi Riset Ilmu Kesehatan Indonesia

Using a mixed-method approach, This study examines emotional support for Quranic memorization students (santri tahfidz) in Islamic boarding schools (pesantren). Quantitative analysis of 515 santri tahfidz revealed high levels of emotional support (M = 3.74, SD = 0.68) with two primary dimensions: reliable relationships (74.96%) and trusted guidance (75.17%). Multiple regression analysis uncovered a significant relationship between emotional support and Quranic memorization achievement (β = 0.42, p < .001, R² = 0.18). A meta-analysis of 28 studies (N = 3,627) confirmed a positive correlation between emotional support and students' psychological well-being (r = 0.39, 95% CI [0.34, 0.44]). MANOVA results indicated significant differences in santri tahfidz's perceptions of emotional support based on gender (Wilks' λ = .97, F(2, 512) = 7.85, p < .001, partial η² = .03) and age (Wilks' λ = .95, F(4, 1022) = 6.73, p < .001, partial η² = .03). These findings extend previous research by Hasfi (2018) and Vista (2018) by identifying the specific roles of teacher support (β = 0.31, p < .01) and peer support (β = 0.28, p < .01) in enhancing student resilience. Furthermore, this study contributes to a more comprehensive understanding of emotional support dynamics in pesantren tahfidz education, integrating Bronfenbrenner's (1979) ecological perspective and Deci and Ryan's (2000) self-determination theory. Finally in a practical context, the researcher evaluates this study has implications for the development of more structured and efficient emotional support intervention programs in tahfidz pesantren.

M. Agung Rahmadi; Said Agil Husin Al Munawar; Achmad Syahid; Abdul Rahman Shaleh; Helsa Nasution

International Journal of Medicine and Health 2024 Lembaga Pengembangan Kinerja Dosen

This study examines the dynamics of personal adjustment in Quranic memorization students using a mixed methods approach, combining quantitative field analysis as primary data and meta-analysis as secondary data. The field study involved 515 students from two Indonesian Islamic boarding schools: Pesantren Tahfizh Daarul Qur'an and Yayasan Islamic Centre Sumatera Utara. The meta-analysis included 30 studies (N = 4,827) from international databases. The quantitative analysis showed a high level of personal adjustment among students (M = 3.66, SD = 0.52), with the highest score on acting objectively according to one's conditions and potential (M = 3.85, SD = 0.48). Regression analysis revealed that self-acceptance significantly predicted overall personal adjustment (β = 0.42, p < .001). The meta-analysis confirmed a positive relationship between self-acceptance and personal adjustment (r = 0.53, 95% CI [0.47, 0.59]). Moderator analysis indicated a stronger effect for female students (r = 0.58) than males (r = 0.49). These findings extend the research of Ahmad et al. (2022) and Rahma (2023) by identifying unique factors influencing personal adjustment of Quranic memorization students, such as memorization intensity (β = 0.31, p < .01) and social support in Quranic boarding schools (β = 0.28, p < .01). Additionally, the integration of primary and secondary data provides a comprehensive understanding of the dynamics of personal adjustment in Quranic memorization students, emphasizing the importance of evidence-based interventions to enhance the psychological well-being of these students.