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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.

M. Agung Rahmadi; Luthfiah Mawar; Ayu Anastasyah; Aisyah Umaira; Nurma Handayani +3 more

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

This meta-review comprehensively examines the effectiveness of social reintegration programs designed for trauma survivors living in territories under foreign occupation in the Middle East, through a systematic analysis of 47 empirical studies with a total of 12,487 participants published between 2010 and 2024. The synthesis indicates that program success rates reached 73.8 percent with a 95 percent confidence interval (70.2–77.4), supported by a strong effect size in reducing PTSD symptoms with a Cohen's d value of 0.82. When effectiveness was compared across intervention approaches, community-based programs demonstrated a more substantial impact, with a correlation of r=0.67 (p<0.001), compared with individual interventions, which yielded a correlation of r=0.43 (p<0.01).

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.

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.

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

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

This meta-analysis evaluates the effectiveness of community-based interventions in addressing complex trauma among children in Gaza through a systematic analysis of 42 studies (N=4,873) published between 2010 and 2024. The findings reveal a significant treatment effect (g=0.78, 95% CI [0.65, 0.91], p<.001) with moderate heterogeneity (I²=68%). School-based interventions demonstrate the greatest effect (g=0.89), followed by family interventions (g=0.76) and peer-group interventions (g=0.65). Furthermore, protocol-based treatment significantly reduces PTSD symptoms (42.3%), anxiety (38.7%), and depression (35.2%) among children in Gaza. Moderator analysis identifies intervention duration (β=0.34, p<.01) and family involvement (β=0.29, p<.01) as significant predictors of successful treatment outcomes for complex trauma. Lastly, meta-regression results indicate a linear relationship between intervention intensity and symptom improvement (R²=0.45, p<.001). These findings expand on previous research by Thompson et al. (2021) and Al-Krenawi (2022) by identifying specific effective intervention components within the Gaza context. Additionally, the discovery that a phased approach integrating community support with protocol-based treatment yields optimal outcomes presents a novel contribution not previously addressed in meta-analyses.

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.