Electronic nursing documentation for patient safety, quality of nursing care, and documentation: a systematic review .

Objective: To evaluate the impact of electronic nursing documentation on patient safety, quality of nursing care and documentation. METHODS: The systematic review was conducted in December 2022, and comprised a comprehensive search on Scopus, ScienceDirect, ProQuest, PubMed, Cumulative Index to Nursing and Allied Health Literature, Sage Journals and Google Scholar databases for English-language human studies published between 2018 and 2022. The key words used in the search included "Nursing", "care", "documentation", "record", "electronic", "process" and "health services". The risk of bias was assessed using Strengthening the Reporting of Observational Studies in Epidemiology tool. RESULTS: Of the 469 items initially identified, 15(3.2%) were analysed in detail, indicating a positive influence of electronic nursing documentation on patient safety, care quality, and documentation. However, shortcomings were observed in the development of electronic nursing documentation for optimal effectiveness. Conclusion: Electronic nursing documentation significantly enhanced patient safety, care quality and documentation. To facilitate its integration into clinical settings, a standardised and logically structured electronic nursing documentation system is essential.

Factors associated with infant and young child feeding practices in children aged 6-23 months in Indonesia: A nationwide study.

INTRODUCTION: Children-related nutrition raises significant attention due to the low implementation of infant and young child feeding (IYCF) practices. However, the factors affecting the low implementation of IYCF remains limited globally. This study aimed to identify factors influencing IYCF in children aged 6-23 months in Indonesia. METHODS: We conducted a cross-sectional study using data from the 2017 Indonesian Demographic and Health Survey. A total of 4943 responses were included. We employed binary logistic regression to determine the factors affecting IYCF practices in children aged 6-23 months. The results are reported as odds ratios (OR) with a 95% confidence interval (CI) and a significance level of p < 0.05. RESULTS: Several factors significantly influenced IYCF practices among children aged 6-23 months, including the age of the child (OR: 0.42; 95% CI: 0.27-0.65), middle wealth index (OR: 1.85; 95% CI: 1.12-3.08), regional disparities (OR: 0.43; 95% CI: 0.23-0.77), place of residence (OR: 1.77; 95% CI: 1.17-2.68), and a history of childhood diseases like fever (OR: 1.65; 95% CI: 1.05-2.58). CONCLUSION: This study highlights the significance of various factors related to IYCF practices among children aged 6-23 months. These factors include maternal aspects such as wealth index, child-related factors like age, a history of childhood illnesses such as fever, and environmental factors such as regional disparities and place of residence. PRACTICE IMPLICATIONS: Paediatric nurses can contribute to enhancing maternal knowledge by providing education on the importance of infant and child feeding practices, beginning early in the child's life.

A scoping review of theories and models applied for grief and bereavement projects.

This scoping review aimed to identify the theory-based studies related to grief and bereavement in palliative care. The investigation was carried out by searching seven databases and conducting manual searches. The search procedure yielded 51 scholarly papers, which revealed 33 theories or models and 37 instruments. The theories and models can be classified into distinct categories, namely grief patterns and coping mechanisms. This study can be a valuable reference for future research endeavors, particularly those employing deductive methodologies. It offers guidance in selecting appropriate theories or models that can be applied to further studies.

Policies and cultural beliefs: Community perceptions about COVID-19 vaccine hesitancy in Indonesia.

OBJECTIVE: Vaccine hesitancy is a global concern and a significant threat to COVID-19 vaccination programs. This study aimed to explore vaccine hesitancy from the perspective of the Indonesian community related to policies and cultural beliefs. DESIGN: A descriptive qualitative approach was utilized in this study. SAMPLE: Twenty participants were recruited from various settings to ensure the representation of experiences in different contexts in Indonesia. MEASUREMENT: Audio-recorded, semi-structured, individual, in-depth interviews were carried out. Content analysis was performed to identify the main key themes. RESULTS: Twenty participants were recruited from various regions of Java Island, Indonesia. The participants revealed hesitancy about the COVID-19 vaccine, including the themes of mistrust, controversy, and the culture and beliefs of the community. CONCLUSIONS: This study highlights COVID-19 vaccine hesitancy in Indonesia, which may have implications for the community's perceptions and beliefs regarding the uptake of the COVID-19 vaccine. The trust issue remains a major challenge to convincing the community to accept the vaccine at the grassroots level. Targeted education and communication strategies are essential in addressing trust issues surrounding COVID-19 vaccines among critical stakeholders and religious leaders in Indonesia. Public health nursing plays a crucial role in fostering community acceptance and ensuring the success of vaccination programs.

Spirituality and Recovery From Severe Mental Disorders: A Systematic Review.

PURPOSE: The current study investigated the impact of spirituality and mental disorder recovery practices among individuals with severe mental disorders. METHOD: A comprehensive search across six databases-Scopus, ScienceDirect, ProQuest, SpringerLink, PubMed, and CINAHL-was performed to identify relevant articles. A total of 651 articles were screened, and 16 met inclusion criteria. RESULTS: Findings revealed that spirituality significantly contributed to the improvement of individuals with severe mental disorders by fostering the development of self-confidence, self-control, strength, and hope, thereby enhancing overall quality of life. In addition, spirituality appeared to correlate with increased self-efficacy. CONCLUSION: Within the mental health recovery framework, spirituality has emerged as a crucial element in facilitating significant life improvements through the exploration of essential motivational strategies. Psychiatric-mental health nurses could play a pivotal role in helping individuals with severe mental disorders by addressing their spiritual needs, thereby promoting holistic recovery and care. [Journal of Psychosocial Nursing and Mental Health Services, 62(8), 11-17.].

How Is Telehealth Currently Being Utilized to Help in Hypertension Management within Primary Healthcare Settings? A Scoping Review.

Telehealth has improved patient access to healthcare services and has been shown to have a positive impact in various healthcare settings. In any case, little is understood regarding the utilization of telehealth in hypertension management in primary healthcare (PHC) settings. This study aimed to identify and classify information about the types of interventions and types of telehealth technology in hypertension management in primary healthcare. A scoping review based on PRISMA-ScR was used in this study. We searched for articles in four databases: Pubmed, Scopus, Science Direct, and Embase in English. The selected articles were published in 2013-2023. The data were extracted, categorized, and analyzed using thematic analysis. There were 1142 articles identified and 42 articles included in this study. Regarding the proportions of studies showing varying trends in the last ten years, most studies came from the United States (US) (23.8%), were conducted in urban locations (33.3%), and had a quantitative study approach (69%). Telehealth interventions in hypertension management are dominated by telemonitoring followed by teleconsultation. Asynchronous telehealth is becoming the most widely used technology in managing hypertension in primary care settings. Telehealth in primary care hypertension management involves the use of telecommunications technology to monitor and manage blood pressure and provide medical advice and counselling remotely.

Meta-analysis and moderator analysis of the prevalence of malnutrition and malnutrition risk among older adults with dementia.

BACKGROUND: Aging and dementia are common and closely related health problems in older adults, affecting their ability to maintain a healthy diet and ultimately resulting in malnutrition. OBJECTIVE: In this study, we estimated the global prevalence of malnutrition and malnutrition risk in older adults with dementia. DESIGN: Meta-analysis. DATA SOURCES: Embase, Ovid MEDLINE, PubMed, CINAHL, Scopus, and Web of Science were comprehensively searched for articles published from database inception to October 2022. METHODS: Pooled prevalence analysis was conducted using a generalized linear mixed model and a random-effects model. I2 and Cochran's Q statistics were used for identifying heterogeneity. Publication bias was evaluated using Peters' regression test and a funnel plot. Moderator analyses were conducted to investigate variations in the prevalence estimates of the included studies. All statistical analyses were conducted using R software. RESULTS: A total of 16 studies involving a total of 6513 older adults with dementia were included in the analysis. The results indicated that 32.52 % (95 % confidence interval: 19.55-45.49) of all included older adults with dementia had malnutrition, whereas 46.80 % (95 % confidence interval: 38.90-54.70) had a risk of malnutrition. The prevalence of malnutrition was found to be high among older patients living in institutionalized settings (46.59 %) and those with Alzheimer's disease (12.26 %). The factors moderating the prevalence of malnutrition included adequate vitamin B12 consumption, risk behaviors, medical comorbidities, and certain neuropsychiatric symptoms. The prevalence of malnutrition risk was high among women (29.84 %) and patients with Alzheimer's disease (26.29 %). The factors moderating the prevalence of malnutrition risk included total cholesterol level, vitamin B12 consumption, risk behaviors, medical comorbidities, and certain neuropsychiatric symptoms. CONCLUSIONS: Approximately one-third of older adults with dementia are malnourished and nearly half of older adults are at a risk of malnutrition. Encouraging collaboration among health-care professionals and ensuring early assessment and effective management of malnutrition are crucial for maintaining a favorable nutritional status in older adults with dementia. REGISTRATION: This study was registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD42022369329). TWEETABLE ABSTRACT: Globally, approximately 32.52 % of older adults with dementia are malnourished and approximately 46.80 % are at a risk of malnutrition.

RETRACTED: Dewi et al. Efficacy of Intermittent and Continuous Subglottic Secretion Drainage in Preventing the Risk of Ventilator-Associated Pneumonia: A Meta-Analysis of Randomized Control Trials. Medicina 2023, 59, 283.

The journal retracts the article entitled "Efficacy of Intermittent and Continuous Subglottic Secretion Drainage in Preventing the Risk of Ventilator-Associated Pneumonia: A Meta-Analysis of Randomized Control Trials" [...].

MIESRA mHealth: Marital satisfaction during pregnancy.

The transition of a pregnant woman's role often causes emotional changes that have an impact on marital satisfaction. We develop MIESRA mHealth and evaluate its impact on satisfaction of husband-wife relationship during pregnancy. A quasi-experimental study was conducted on 82 couples of pregnant women and divided into control, single, and paired group. We implemented MIESRA mHealth for four weeks. In the couple group, the wife did mindfulness based on the information in the MIESRA mHealth together with her husband. In a single group, the wife sees the video as an initial guide to doing mindfulness. In the control group, respondents received programme interventions from hospitals which included education and consultation with obstetricians. Husband-wife relationship is evaluated using Compatibility of Husband-and-Wife Relationships / Kesesuaian Hubungan Suami Istri (KHSI) questionnaire and the generalised estimating equations (GEE) was used to analyse the data. The women's KHSI scores in the couple and single intervention groups (ß = -7.46, p = 0.002; ß = -9.11, p = 0.001) were better than the control group. The husbands' KHSI scores in the paired and individual intervention groups (ß = -7.04, p<0.001; ß = -3.74, p = 0.024) were better than the control group. Nursing interventions to build emotional bonds between parents and foetuses based on mHealth can be a promising intervention for marital harmony during the perinatal period. MIESRA m-Health is a promising intervention on marital satisfaction during pregnancy and can be implemented as a part of the antenatal care programme to increase marital satisfaction.

Islamic Mindfulness-Based Caring as an Intervention to Manage Fatigue.

Purpose: This study aims to determine the effects of Islamic Mindfulness-based Caring (IMC) on fatigue among breast cancer patients. Design: A quasi-experimental study was undertaken in the chemotherapy unit of a hospital, in Bandung, Indonesia. Methods: A total of 112 females with stage III breast cancer undertaking chemotherapy treatment were recruited by purposive sampling technique. The experimental group (n = 53) was given both IMC and usual care, whereas the control group (n = 59) received only the usual care. Data were collected on days 1, 3, 23, and 44 using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) and demographic information tools. Data analyses were carried out with the Mixed-Effects Linear Regression. Findings: We found a significant difference in fatigue between the control and experimental groups on days 23 (mean: 29.34-34.92; p = .001) and 44 (mean: 28.68-37.89; p < .001) after IMC intervention. The increase of time was significantly associated with a lower fatigue score (p < .05). Mixed-Effect Linear Regression showed a significant interaction between time and intervention of IMC effect on fatigue score on time-4 (adjusted ß coefficient: 6.62; 95% CI: 2.17-11.06). Conclusions: Nurse-administered IMC is capable of reducing fatigue among breast cancer patients who underwent chemotherapy.

Efficacy of Intermittent and Continuous Subglottic Secretion Drainage in Preventing the Risk of Ventilator-Associated Pneumonia: A Meta-Analysis of Randomized Control Trials.

Ventilator-associated pneumonia (VAP) is hospital-acquired pneumonia that develops 48 h or longer following mechanical ventilation. However, cuff pressure fluctuates significantly due to patient or tube movement, which might result in microaspiration. Subglottic secretion drainage (SSD) has been suggested as a method for VAP prevention bundles. This systematic review and meta-analysis aims to investigate the efficacy and safety of subglottic SSD in preventing VAP. The secondary outcomes of this study are to investigate the intensive care unit (ICU) stay length and mortality rate regarding VAP. This study followed the Preferred Reporting Item for Systematic Review and Meta-Analysis guidelines. A thorough search of PubMed, Embase, and the Web of Science was conducted between June and August 2022. The study analysis used the Mantel-Haenszel method, and the quality of the included study was assessed using the Cochrane Risk of Bias 2. Eighteen randomized controlled trials with a total of 2537 intubated patients were included. It was found that SSD was associated with a lower risk of VAP (RR 1.44; 95% CI; 1.20-1.73; p < 0.0001). The subgroup analysis (utilizing intermittent and continuous methods) found no statistically significant difference between the two groups (p = 0.28). The secondary endpoints showed that there was no significant difference in mortality (RR 1.02; 95% CI; 0.87-1.20; p = 0.83), but there were substantial differences in ICU stays (mean difference, 3.42 days; 95% CI; 2.07-4.76; p < 0.00001) in favor of the SSD group. This was based on a very low certainty of evidence due to concerns linked to the risk of bias and inconsistency. The use of SSD was associated with a reduction in VAP incidence and ICU stay length, but there was no significant difference in the mortality rate.

Determinants of Burden in Family Caregivers of Individuals With Schizophrenia: A Systematic Review.

The current systematic review was performed to determine the specific burdens placed on families of individuals with schizophrenia. Scopus, PubMed, and CINAHL databases were searched, resulting in 21 articles that met inclusion criteria. Results showed that treatment of individuals with schizophrenia poses a burden on families. Most caregivers experienced emotional and financial problems that affected their quality of life. Influencing factors in caregivers were age, sex, educational level, family status, income, time spent with the individual per day, knowledge regarding schizophrenia, attitude, and psychological stress. Influencing factors in individuals with schizophrenia were age, sex, severity of illness, social function, and treatment adherence. Environmental factors were stigma, social support, and professional support from health care providers. Family caregivers of individuals with schizophrenia need to be empowered to improve resilience and acceptance in caring for these individuals. [Journal of Psychosocial Nursing and Mental Health Services, 61(2), 38-43.].

Nursing Care on HIV/AIDS-Positive Men Who Have Sex with Men: A Qualitative Descriptive Study of Nurse's Perspective in Indonesia.

HIV/AIDS-positive men who have had sex with men (MSM) account for roughly one-third of new infections in the region, with numerous nations facing a high and rising prevalence. They often face stigmatization and discrimination from society, including nurses. This study aims to explore nurses' perspectives on caring for HIV/AIDS-infected MSM. A descriptive qualitative design was utilized. Fifteen nurses who cared for HIV/AIDS-positive MSM in the two hospitals in Jakarta, Indonesia, were recruited with purposive sampling techniques. A semi-structured and in-depth interview was conducted. Data were analyzed using thematic analysis. We emerged three superordinate and nine subordinate themes: (1) negative nurse perceptions in the early phase of treatment, (2) nurse attitudes contrasting with negative perceptions, and (3) nurses with knowledge of HIV/AIDS. The negative perceptions appeared only at the beginning of the treatment phase, and thereafter, they were followed by a positive attitude. Nurses appeared to develop a better understanding after interacting with their patients and receiving training on HIV/AIDS. Therefore, intensive training is expected to not only increase their knowledge but to encourage a positive attitude.

The Impact of Online Learning among Adolescents during the COVID-19 Pandemic: A Qualitative Study of Mothers' Perspectives.

Background: The COVID-19 pandemic changed the educational system from conventional learning in schools to online learning. The use of the internet as a learning medium can have positive and negative impacts on adolescents and cause concern for mothers. In this study, mothers' perspectives were explored with the phenomenological approach to assess their experience of the effect on line learning during the COVID-19 pandemic among adolescents. Materials and Methods: The qualitative study design: phenomenology was conducted on mothers with children at senior high school education levels. The data were collected using in-depth interviews from June to November 2020 in West Java, Indonesia. A total of 13 mothers were recruited using the purposive sampling technique. Data analysis was performed using the Colaizzi method and NVIVO software for managing the coding process. Results: We obtained four themes, namely (1) formation of adolescent behavior with the internet, (2) prevention of internet addiction, (3) disturbance of cognitive development, and (4) negative effect of online learning. Conclusions: The usage of the internet cannot be avoided. By guiding adolescents, the negative effects of the internet could be prevented. Developing learning programs, media, and online learning strategies according to students' needs should be promoted.

Analysis of Modifiable, Non-Modifiable, and Physiological Risk Factors of Non-Communicable Diseases in Indonesia: Evidence from the 2018 Indonesian Basic Health Research.

Purpose: Indonesia is facing an increasing occurrence of non-communicable diseases (NCDs) every year. We assessed the modifiable, non-modifiable, and physiological risk factors of NCDs among the Indonesian population. Methods: Secondary data was analyzed from the 2018 Indonesian basic health research (RISKESDAS). The national survey included participants aged 15-54 years and obtained 514,351 responses. Linear systematic two-stage sampling was conducted by RISKESDAS. Furthermore, chi-square and binary logistic regression were utilized to explore the determinant of NCDs with a significance level of 95%. Results: We found that almost 10% respondents in Indonesia had NCDs. We observed that depression has a higher odd (aOR: 2.343; 95% CI: 2.235-2.456) contributed to NCDs and followed other factors such as no education (aOR: 1.049; 95% CI: 1.007-1.092), passive smoking (aOR: 0.910; 95% CI: 0.878-0.942), fatty food (aOR: 1.050; 95% CI: 1.029-1.073), burnt food (aOR: 1.033; 95% CI: 1.005-1.062), food with preservatives (aOR: 1.038; 95% CI: 1.002-1.075), seasoned food (aOR: 1.057; 95% CI: 1.030-1.084), soft drinks (aOR: 1.112; 95% CI: 1.057-1.169), living in an urban area (aOR: 1.143; 95% CI: 1.119-1.168), living in central Indonesia (1.243; 95% CI: 1.187-1.302), being female (aOR: 1.235; 95% CI: 1.177-1.25), and obese (aOR: 1.787; 95% CI: 1.686-1.893). Conversely, people in Indonesia who undertook vigorous activity (aOR: 0.892; 95% CI: 0.864-0.921), had employment (aOR: 0.814; 95% CI: 0.796-0.834), had access to improved sources of drinking water (aOR: 0.910; 95% CI: 0.878-0.942), and were aged 35-44 years (aOR: 0.457; 95% CI: 0.446-0.467) were less likely to develop NCDs. Conclusion: Modifiable, non-modifiable, and physiological risk factors have a significant influence on NCDs in Indonesia. This finding can be valuable information for Indonesian Government to arrange a cross-collaboration between government, healthcare workers, and society through advocacy, partnership, health promotion, early detection, and management of NCDs.

What I felt as a diabetes fatigue survivor: a phenomenology study.

Purpose: Diabetes has resulted in an increase in diabetic fatigue syndrome, which has a negative influence on health, particularly the risk of worsening quality of life (QoL) due to physical and mental limitations. The purpose of this study was to evaluate the experiences of patients with unregulated type 2 diabetes mellitus (T2DM) and diabetes fatigue syndrome. Methods: This study used a qualitative phenomenological design and focused on patients from four primary health centers (PHCs) in Surabaya, Indonesia with higher incidents of unregulated T2DM. Thirty participants were recruited using purposive sampling with the following inclusion criteria: adult T2DM patients, willing to participate in the study, and able to recount experiences associated with their illness. Data collection took place between April and June 2020 across 36 interview sessions. Semi-structured interviews were carried out face-to-face with each participant with the principles of social distancing applied due to the COVID-19 pandemic. Results: Analysis identified five themes and thirteen subthemes. The first theme was participants' experiences during blood glucose imbalance. Other themes included experiences of boredom with diet, physical and psychological distress, financial problems during treatment, and sexual problems. Conclusion: Participants with T2DM who experienced diabetes fatigue reported negative effects on their life, especially on health, functional daily activity, and finances. The results of this study can provide information for nurses and other healthcare providers to promote interventions for patients with T2DM, such as modifying lifestyle, self-acceptance, and self-efficacy.

Resilience-based Islamic program as a promising intervention on diabetes fatigue and health-related quality of life.

Psychological problems commonly experienced by patients with type 2 diabetes mellitus (T2DM) cause diabetes fatigue conditions that can further worsen the treatment prognosis. We conducted this investigation to determine the effectiveness of a resilience-based Islamic program on diabetes fatigue and health-related quality of life (HRQoL) by measuring the biochemical indicators of T2DM. This was a quasi-experimental study performed from May to August 2021, in which 80 respondents aged 18-64 years diagnosed with T2DM were included through purposive sampling at a male:female sex ratio of 1:1 in the control group and 17:23 in the treatment group. A resilience-based Islamic program (a combination of stress management, mindfulness, prayer, and dhikr (the ritual formula of Sufi brotherhood recited devotionally in praise of Allah and as a means of attaining ecstatic experience)) was implemented in the treatment group for six sessions by blended online and offline interventions. Multidimensional Fatigue Inventory-20 and World Health Organization Quality of Life, Brief Form were used to evaluate diabetes fatigue and HRQoL. Blood tests were performed to measure HbA1c, total antioxidant serum, insulin, cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c) levels from baseline to 3 months. Statistical analyses were conducted using paired t test, Wilcoxon signed-rank test, independent t test, and Mann-Whitney U test. The resilience-based Islamic program had a beneficial impact on the levels of HbA1c (p < 0.001), lipid profile (triglyceride) (p = 0.011), HDL-c (p = 0.01), LDL-c (p < 0.001), total antioxidant serum (p = 0.001), insulin (p < 0.001), diabetes fatigue (p < 0.05), and HRQoL (p < 0.05) in patients of the treatment group. The results of biochemical tests related to T2DM also indicated a reduction in diabetes fatigue and an increase in HRQoL due to the resilience-based Islamic program. Considering that a patient's resilience to diabetes is an important factor in the management of diabetes fatigue, the resilience-based Islamic program can be applied at public health centers and community levels to increase T2DM resilience.

Investigation of discriminatory attitude toward people living with HIV in the family context using socio-economic factors and information sources: A nationwide study in Indonesia.

Background: The well-being of people living with HIV (PLHIV) remains a concern. In addition to facing discrimination in their communities, many PLHIV have family members who have a discriminatory attitude. This study analyzes the discriminatory attitude toward PLHIV in the family context using socio-economic factors and information sources in Indonesia. Methods: A cross-sectional study design was adopted using secondary data from the 2017 Indonesian Demographic Health Survey (IDHS). A total sample of 28,879 respondents was selected using two-stage stratified cluster sampling. The study variables are information sources, sex, age, education, residence, earnings, and familial discriminatory attitude. We used the STATA 16.1 software to analyze Chi-square and binary logistics with a 95% confident interval (CI) with a significance of 5% (p-value < 0.05). Results: In Indonesia, familial discriminatory attitude has a prevalence of 72.10%. In the survey, the respondents with access to some information about HIV (AOR: 0.794; 95% CI [0.722-0.873]), women (AOR: 0.768; 95% CI [0.718-0.820]), and those living in rural areas (AOR: 0.880; 95% CI [0.834-0.929]) were the least likely to have a familial discriminatory attitude. Meanwhile, the respondents aged 15-24 years (AOR: 1.329; 95% CI [1.118-1.581]) and those with a secondary level of education (AOR: 1.070; 95% CI [1.004-1.142]) were the most likely to have a familial discriminatory attitude. Conclusion: In the study, we found that, the younger the age and the lower the educational level of the respondent, the more likely they were to have a familial discriminatory attitude. The government may consider these factors when designing policies to tackle familial discrimination faced by PLHIV; in particular, education on HIV and AIDS should be promoted.

Efficacy of Internet-Based Cognitive Behavioral Therapy for Depression and Anxiety among Global Population during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis of a Randomized Controlled Trial Study.

Background: Depression and anxiety have become the most common mental health disorders worldwide during the COVID-19 pandemic, and increasing interest in telemedicine has led to the innovation of using internet-based cognitive behavioral therapy (iCBT). Objective: This systematic review and meta-analysis aimed to evaluate the efficacy of iCBT for depression and anxiety among the global population during the COVID-19 pandemic. Methods: A literature search was conducted on PubMed, Scopus, Cochrane, ProQuest, Wiley, and Web of Science using the PRISMA framework, and only randomized controlled trials (RCTs) were included in the study. A critical appraisal was also performed using Cochrane's Risk of Bias (RoB) 2. The meta-analysis used random-effects models to analyze pooled mean difference (MD) and its p-value. Results: Twelve RCTs were included for qualitative analysis and nine RCTs, which yielded 6778 patients with depression and 6556 patients with anxiety during the COVID-19 pandemic, were included for quantitative analysis. Despite high heterogeneity, all studies had a low risk of bias. Pre- and post-iCBT intervention in the depression forest plot depicts a significant effect (p < 0.00001) with a pooled MD of 4.73 (95% CI: 4.55−4.90), while the pre- and post-iCBT intervention depicts a significant effect (p < 0.00001) with a pooled MD of 4.50 (95% CI: 4.34−4.67). This demonstrates that iCBT was found to significantly decrease depression and anxiety scores in patients during the COVID-19 pandemic. However, substantial heterogeneity was also found (I2 = 93%; p < 0.00001 and I2 = 90%) for the pre-/post-depression and anxiety forest plots, respectively. Conclusions: This meta-analysis comprises an evidence-based result for iCBT to treat depression and anxiety in the COVID-19 population, as indicated by the significantly lower assessment scores. Delivering iCBT in this situation needs to be considered more extensively, as it has promising results and yields the benefits of technological advancement in psychotherapy.

Prevalence and determinants of diarrhea among under-five children in five Southeast Asian countries: Evidence from the demographic health survey.

PURPOSE: To describe the prevalence and the correlation between individual, environmental and household, health behavior, and source of information factors with diarrhea among under-five children in five Southeast Asian countries based on the National Health Survey. DESIGN AND METHODS: Cross-sectional design conducted in five countries in Southeast Asia. Datasets from Demographic and Health Surveys and Multiple Indicator Cluster Surveys in five countries were analyzed. RESULTS: A total of 12,447 children under 5 years of age from five countries in Southeast Asia (Indonesia 1807, Cambodia 2650, Myanmar 1717, the Philippines 3669, and Timor-Leste 2614) were included in this study. Binary logistic regression was performed to analyze the data. A total of 12,447 under-five children were included in the study. Overall, in five Southeast Asian countries, the prevalence of diarrhea is known from 8.39% in the Philippines to 18.21% in Indonesia. Several factors related to diarrhea are individual; environmental and household; health behavior such as stool disposal, breastfeeding mothers, and children's food history; and source of information factors. CONCLUSION: The findings of this study indicate that diarrhea is a serious public health problem in the Southeast Asian region that must be addressed using preventive and curative approaches. PRACTICE IMPLICATION: The results indicate the need for cross-collaboration among nurses, medical doctor, and sanitarian is needed to tackle the childhood diarrhea and minimize the severity based on those determinants.