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                  <text>VOL. 6 NO. 1 2025</text>
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                  <text>peri irawan</text>
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                <text>Relationship Between Family Support and Adherence to Antiretroviral Medication in Patients with HIV</text>
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                <text>adherence,&#13;
antiretroviral,&#13;
family support, HIV&#13;
patient</text>
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                <text>Introduction: Adherence to antiretroviral (ARV) treatment is one of the&#13;
most critical factors in the successful management of HIV patients. Family&#13;
support significantly influences treatment adherence, as family members&#13;
are closest to the patient and are expected to provide motivation and&#13;
monitor adherence to ARVs. This study aimed to determine the&#13;
relationship between family support and ARV adherence among HIV&#13;
patients.&#13;
Methods: This study employed an analytic design with a cross-sectional&#13;
approach. The population comprised HIV patients undergoing treatment&#13;
in the Treatment Support Care Room (PDP) at Bhayangkara Indramayu&#13;
Hospital, with an average monthly visit rate of 375 patients. A sample of&#13;
190 respondents was selected using the Z formula. The sampling technique&#13;
employed purposive sampling based on inclusion and exclusion criteria.&#13;
Bivariate analysis was performed using the chi-square test.&#13;
Results: The findings revealed that 97 respondents (51.1%) reported good&#13;
family support, and 146 respondents (76.8%) were compliant with taking&#13;
ARV medication. The statistical analysis showed a p-value of 0.006 (α &lt;&#13;
0.05).&#13;
Conclusion: There is a relationship between family support and adherence&#13;
to ARV medication in HIV patients. It is recommended for nurses to educate&#13;
families to provide support to HIV patients in ARV treatment.</text>
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            <description>An entity primarily responsible for making the resource</description>
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                <text>Wenny Nugrahati Carsita1*&#13;
&#13;
, Julisah Rusyani1, Alvian Pristy Windiramadhan1, &amp;&#13;
&#13;
Ridho Kunto Prabowo1</text>
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            <description>A related resource from which the described resource is derived</description>
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              <elementText elementTextId="127180">
                <text>https://doi.org/10.37363/bnr.2025.61439</text>
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                <text>13 January 2025</text>
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                <text>peri irawan</text>
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                  <text>VOL. 6 NO. 1 2025</text>
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              <name>Contributor</name>
              <description>An entity responsible for making contributions to the resource</description>
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                  <text>peri irawan</text>
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            <description>A name given to the resource</description>
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                <text>Spiritual Needs and Resilience Women with Cervical Cancer</text>
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          <element elementId="49">
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            <description>The topic of the resource</description>
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                <text>spiritual, resilience,&#13;
cervical cancer</text>
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                <text>Introduction: Spiritual needs are crucial in providing support for cervical&#13;
cancer patients in palliative care. Spiritual support helps reduce feelings of&#13;
despair and depression, enabling patients to undergo treatment and&#13;
maintain their quality of life. Resilience refers to individual characteristics&#13;
that are adaptable and support successful coping with cancer. This study&#13;
aimed to examine the spiritual needs and resilience of women with cervical&#13;
cancer.&#13;
Methods: This research employed a correlational analytical design with a&#13;
cross-sectional approach conducted in North Surabaya, which has the&#13;
highest number of cervical cancer patients in the city of Surabaya. All&#13;
women with cervical cancer recorded in the integrated service system&#13;
constituted the population, and 42 women were recruited using total&#13;
sampling. Spiritual needs were assessed using the Spiritual Needs&#13;
Questionnaire, while resilience was measured with the Connor-Davidson&#13;
Resilience Scale (CD-RISC). The collected data were analyzed using the&#13;
Spearman rho test with a 95% confidence interval and an alpha (α) of 0.05.&#13;
Results: A significant relationship was found between spiritual needs and&#13;
resilience in women with cervical cancer (p = 0.000), with a correlation&#13;
coefficient of r = 0.572, indicating a strong relationship.&#13;
Conclusion: A spiritual approach is essential for cervical cancer patients to&#13;
enhance their spiritual well-being, thereby fostering physical and&#13;
psychosocial resilience.</text>
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            <description>An entity primarily responsible for making the resource</description>
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              <elementText elementTextId="127158">
                <text>Supatmi1*&#13;
&#13;
, Fathiya Lutfil Yumni1, Reliani Reliani1, &amp; Diah Priyantini1</text>
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            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="127159">
                <text>https://doi.org/10.37363/bnr.2025.61427</text>
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            <name>Date</name>
            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
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              <elementText elementTextId="127160">
                <text>09 Desember 2024</text>
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          <element elementId="37">
            <name>Contributor</name>
            <description>An entity responsible for making contributions to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127161">
                <text>peri irawan</text>
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            <description>A language of the resource</description>
            <elementTextContainer>
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                <text>english</text>
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        <name>spiritual, resilience, cervical cancer</name>
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                  <text>VOL. 6 NO. 1 2025</text>
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            <element elementId="37">
              <name>Contributor</name>
              <description>An entity responsible for making contributions to the resource</description>
              <elementTextContainer>
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                  <text>peri irawan</text>
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          <element elementId="50">
            <name>Title</name>
            <description>A name given to the resource</description>
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                <text>The Effectiveness of ROMATIF Therapy (Mirror Therapy and Positive Affirmation) on Strength of Muscle and Self-acceptance in Post Stroke Patients</text>
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          </element>
          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127146">
                <text>mirror therapy, positive affirmations, stroke</text>
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          <element elementId="41">
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            <description>An account of the resource</description>
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                <text>Introduction: Stroke is a neurological condition in which some brain cells&#13;
die due to a disruption of cerebral blood flow caused by a blockage or&#13;
rupture of blood vessels. In stroke patients, muscle weakness typically&#13;
occurs on one side of the body, a condition known as hemiparesis. This&#13;
condition can lead to impaired self-acceptance. This study aims to&#13;
determine the effectiveness of a combined therapy, namely mirror therapy&#13;
and positive affirmations, referred to as ROMATIF therapy (Mirror&#13;
Therapy and Positive Affirmations).&#13;
Methods: This study used a quasi-experimental design with a one-group&#13;
pretest-posttest approach. The sample consisted of 35 post-stroke&#13;
patients, selected using purposive sampling. The inclusion criteria were&#13;
patients aged 21–74 years who were compos mentis and experiencing&#13;
upper limb hemiparesis after a stroke. The instruments used in this study&#13;
included a muscle strength observation sheet and a self-acceptance&#13;
questionnaire. Statistical analysis was performed using the Wilcoxon test.&#13;
Results: The results showed that pre- and post-treatment self-acceptance&#13;
yielded an Asymp. Sig. (2-tailed) or p-value of 0.001 &lt; α, while pre- and&#13;
post-treatment muscle strength also yielded a p-value of 0.001 &lt; α. This&#13;
indicates that H1 is accepted, meaning there was a significant difference&#13;
before and after ROMATIF therapy.&#13;
Conclusion: Nurses can empower patients to undertake these therapies&#13;
independently, promoting self-management and engagement in their care</text>
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          <element elementId="39">
            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127148">
                <text>Putu Sintya Arlinda Arsa1, Lie Liana Fuadiati1*&#13;
&#13;
, &amp; Desy Rinawaty1</text>
              </elementText>
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            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="127149">
                <text>https://doi.org/10.37363/bnr.2025.61457</text>
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            <name>Date</name>
            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
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                <text>24 January 2025</text>
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          <element elementId="37">
            <name>Contributor</name>
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            <elementTextContainer>
              <elementText elementTextId="127151">
                <text>peri irawan</text>
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        <name>mirror therapy, positive affirmations, stroke</name>
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              <name>Title</name>
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                  <text>VOL. 6 NO. 1 2025</text>
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            <element elementId="37">
              <name>Contributor</name>
              <description>An entity responsible for making contributions to the resource</description>
              <elementTextContainer>
                <elementText elementTextId="126941">
                  <text>peri irawan</text>
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    <elementSetContainer>
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            <name>Title</name>
            <description>A name given to the resource</description>
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              <elementText elementTextId="127135">
                <text>Body Mind Therapy Improving Mental Health in&#13;
Teenager</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127136">
                <text>aromatherapy,&#13;
body-mind therapy,&#13;
mental health, music&#13;
therapy, yoga</text>
              </elementText>
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          <element elementId="41">
            <name>Description</name>
            <description>An account of the resource</description>
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                <text>Introduction: Mental health has become a critical concern among&#13;
&#13;
adolescents, particularly affecting their emotional regulation, problem-&#13;
solving abilities, and interpersonal relationships. Middle school students&#13;
&#13;
are especially vulnerable as they navigate identity formation while being&#13;
susceptible to external influences. Various factors, including peer pressure,&#13;
media influence, and gender norms, can exacerbate the gap between&#13;
adolescents' reality and future perceptions. This study aims to determine&#13;
the effect of Body Mind Therapy on adolescent mental health.&#13;
Methods: A quasi-experimental study with a one-group pretest-posttest&#13;
design was conducted. The population comprised middle school students&#13;
in the Puskesmas II Denpasar Utara area. The sample size was calculated&#13;
using the Lemeshow formula (n=97), with final participants of 40 students&#13;
selected through simple random sampling. Inclusion criteria were&#13;
students aged 12-16 years with parental consent. Variables measured&#13;
included vital signs (blood pressure, pulse, respiration), sleep quality&#13;
(PSQI), anxiety (SAS/SRAS), and mental health (SDQ). Data were analyzed&#13;
using a paired t-test with a 95% confidence interval.&#13;
Results: Most of the adolescents were 14 years old (45%) and female&#13;
(92.5%). After conducting a paired t-test, the results showed that diastolic&#13;
blood pressure, pulse, respiration, sleep quality, and mental health&#13;
&#13;
variables in the difficulty component showed significant effects with a p-&#13;
value &lt; 0.05.&#13;
&#13;
Conclusion: This intervention can be relied upon to improve adolescents'&#13;
physical and mental health, particularly in reducing physiological stress&#13;
and improving aspects of mental health such as emotional difficulties.</text>
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            <description>An entity primarily responsible for making the resource</description>
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                <text>Putu Intan Daryaswanti1*, Ni Made Sri Muryani1, &amp; Ni Made Diah Pusparini Pendet1</text>
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              <elementText elementTextId="127139">
                <text>https://doi.org/10.37363/bnr.2025.61436</text>
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                <text>13 January 2025</text>
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                <text>peri irawan</text>
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determinant factors,&#13;
family, stress</text>
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                <text>Introduction: Chronic diseases are degenerative conditions that require&#13;
long-term treatment. Older adults patients who are unable to care for&#13;
themselves independently often rely on assistance from others,&#13;
particularly family members, who serve as family caregivers. Stress among&#13;
family caregivers is a significant issue encountered when caring for older&#13;
adults individuals with chronic diseases. This research aims to analyze the&#13;
factors contributing to stress in family caregivers providing care for older&#13;
adults people with chronic diseases.&#13;
Methods: This study employed a literature review design, analyzing 16&#13;
articles published between 2017 and 2024 in either Indonesian or English.&#13;
Articles included were complete and relevant to the study objectives. The&#13;
PRISMA checklist was utilized to guide the protocol and evaluation&#13;
process, ensuring the appropriate selection of studies aligned with the&#13;
literature review objectives.&#13;
Results: Several factors contribute to stress among family caregivers caring&#13;
for older adults individuals with chronic diseases, including (1) age of&#13;
family caregiver; (2) sex; (3) Llow levels of education and knowledge can&#13;
trigger stress family caregiver; (4) type of work and income level; and (5)&#13;
the length of treatment carried out family caregiver also affects the stress&#13;
he experiences.&#13;
Conclusion: Nurses can play a vital role in supporting family caregivers by&#13;
conducting comprehensive assessments, providing individualized support,&#13;
teaching stress management techniques, offering caregiver education, and&#13;
facilitating respite care.</text>
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            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
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                <text>Ni Kadek Nefi Widiastuti1, Ni Putu Kamaryati1*, Made Rismawan1, &amp; Ni Kadek&#13;
Sriasih1</text>
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            <elementTextContainer>
              <elementText elementTextId="127131">
                <text>peri irawan</text>
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            <description>A language of the resource</description>
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                  <text>VOL. 6 NO. 1 2025</text>
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              <description>An entity responsible for making contributions to the resource</description>
              <elementTextContainer>
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            <description>A name given to the resource</description>
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                <text>The Relationship between Work Environment Factors, Communication, and Teamwork with The Implementation of Patient Safety Culture: A Literature Review</text>
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          <element elementId="49">
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            <description>The topic of the resource</description>
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                <text>work environment,&#13;
factors,&#13;
communication,&#13;
team-work, patient&#13;
safety culture</text>
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            <description>An account of the resource</description>
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                <text>Introduction: A key component of quality management in the healthcare&#13;
industry is the patient safety culture, which involves initiatives to prevent&#13;
and reduce the likelihood of patient harm or injury during medical care.&#13;
This literature review aims to explore the relationship between the&#13;
implementation of a patient safety culture and factors such as work&#13;
environment, communication, and teamwork.&#13;
Methods: This review was based on an analysis of published articles&#13;
presenting findings from previous research. Using the search terms&#13;
“patient safety culture” AND “factors” AND “work environment” AND&#13;
“communication” AND “teamwork,” articles were retrieved from PubMed,&#13;
ScienceDirect, and additional sources in Bahasa. A total of 17 articles met&#13;
the inclusion criteria. The analysis employed a critical review approach to&#13;
assess the strengths and limitations of the included studies, ensuring a&#13;
comprehensive understanding of the current research landscape in this&#13;
field.&#13;
Results: The primary factors influencing a strong patient safety culture&#13;
include teamwork, effective communication between supervisors and&#13;
nursing staff as well as between departments, a supportive work&#13;
environment, adequate nursing staff, and access to high-quality resources.&#13;
Conclusion: Hospital management should prioritize improving patient&#13;
safety culture through effective staff training programs, fostering clear and&#13;
&#13;
efficient communication, promoting teamwork, and ensuring a well-&#13;
supported work environment.</text>
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            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127085">
                <text>Ni Komang Sri Wahyuni1, Ni Luh Putu Inca Buntari Agustini&#13;
&#13;
1*, I Nyoman Arya&#13;
&#13;
Mahaputra1, &amp; Ni Made Manik Elisa Putri1</text>
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            <description>A related resource from which the described resource is derived</description>
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              <elementText elementTextId="127086">
                <text>https://doi.org/10.37363/bnr.2025.61463</text>
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            <name>Date</name>
            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
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                <text>29 September 2024</text>
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          <element elementId="37">
            <name>Contributor</name>
            <description>An entity responsible for making contributions to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127088">
                <text>peri irawan</text>
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            <name>Format</name>
            <description>The file format, physical medium, or dimensions of the resource</description>
            <elementTextContainer>
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          <element elementId="44">
            <name>Language</name>
            <description>A language of the resource</description>
            <elementTextContainer>
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            <description>The nature or genre of the resource</description>
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      <tag tagId="14882">
        <name>work environment, factors, communication, team-work, patient safety culture</name>
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                  <text>VOL. 6 NO. 1 2025</text>
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              <description>An entity responsible for making contributions to the resource</description>
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    <elementSetContainer>
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            <name>Title</name>
            <description>A name given to the resource</description>
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                <text>Analysis of Factors Affecting the Implementation of Discharge Planning by Nurses in the Inpatient Ward: A Literature Review</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127062">
                <text>discharge planning, nurses, inpatient ward</text>
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            </elementTextContainer>
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          <element elementId="41">
            <name>Description</name>
            <description>An account of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127063">
                <text>Introduction: Suboptimal discharge planning is a global issue that&#13;
contributes to high patient readmission rates and increases the burden on&#13;
healthcare systems. Effective discharge planning is essential to ensure the&#13;
continuity of patient care after leaving the hospital, including follow-up&#13;
care and maintaining the patient's health status. The purpose of this&#13;
literature review is to identify the factors affecting the implementation of&#13;
discharge planning by nurses in inpatient wards.&#13;
Methods: This study employed a literature review design. Articles were&#13;
selected according to the PRISMA guidelines. Inclusion criteria were&#13;
established to ensure the selection of eligible articles: publications&#13;
between 2017 and 2024, written in English or Indonesian. The literature&#13;
review was conducted using three journal databases: ScienceDirect,&#13;
PubMed, and Google Scholar. Keywords were adjusted to align with the&#13;
Medical Subject Heading (MeSH) terms, including “influencing factors,”&#13;
“discharge planning,” “discharge planning implementation by nurses,” and&#13;
“hospitalization room.”&#13;
Results: A total of 17 articles were reviewed. Overall, eight factors were&#13;
identified as influencing the implementation of discharge planning by&#13;
nurses in inpatient wards. These factors include knowledge, attitude,&#13;
motivation, personnel, involvement and participation, communication,&#13;
time, and agreements and consensus.&#13;
Conclusion: The factors influencing the implementation of discharge&#13;
planning include medical staff, involvement and participation,&#13;
communication, time, agreements, consensus, knowledge, attitude, and&#13;
motivation. These factors are interconnected and significantly impact the&#13;
quality of discharge planning, ultimately affecting patient satisfaction and&#13;
health outcomes after discharge.</text>
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          <element elementId="39">
            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127064">
                <text>I Made Yudi Wahyu1*&#13;
&#13;
, Ni Luh Putu Dina Susanti2, I Gusti Ngurah Made Kusuma&#13;
&#13;
Negara2, &amp; Ni Made Sri Rahyanti2</text>
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          <element elementId="48">
            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="127065">
                <text>https://doi.org/10.37363/bnr.2025.61472</text>
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            </elementTextContainer>
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            <name>Date</name>
            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
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                <text>29 January 2025</text>
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          <element elementId="37">
            <name>Contributor</name>
            <description>An entity responsible for making contributions to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127067">
                <text>peri irawan</text>
              </elementText>
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            <name>Format</name>
            <description>The file format, physical medium, or dimensions of the resource</description>
            <elementTextContainer>
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                <text>pdf</text>
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          <element elementId="44">
            <name>Language</name>
            <description>A language of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127069">
                <text>english</text>
              </elementText>
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            <description>The nature or genre of the resource</description>
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      <tag tagId="14881">
        <name>discharge planning, nurses, inpatient ward</name>
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          <elementContainer>
            <element elementId="50">
              <name>Title</name>
              <description>A name given to the resource</description>
              <elementTextContainer>
                <elementText elementTextId="126940">
                  <text>VOL. 6 NO. 1 2025</text>
                </elementText>
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            <element elementId="37">
              <name>Contributor</name>
              <description>An entity responsible for making contributions to the resource</description>
              <elementTextContainer>
                <elementText elementTextId="126941">
                  <text>peri irawan</text>
                </elementText>
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    <elementSetContainer>
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        <description>The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.</description>
        <elementContainer>
          <element elementId="50">
            <name>Title</name>
            <description>A name given to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127040">
                <text>Factors Associated with Readmissions in Ischemic Stroke: A Literature Review</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127041">
                <text>ischemic stroke, readmission, risk factors</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="41">
            <name>Description</name>
            <description>An account of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127042">
                <text>Introduction: Readmission cases among stroke patients are common, with&#13;
only 15% of patients surviving and avoiding readmissions over a five-year&#13;
period. Ischemic stroke patients who are readmitted face a higher risk of&#13;
death and significantly increased healthcare costs. Therefore, identifying&#13;
factors associated with the readmission of ischemic stroke patients is&#13;
essential to prevent these occurrences.&#13;
Methods: Articles were selected following PRISMA Guidelines. A literature&#13;
review used three journal databases: ScienceDirect, PubMed, and Google&#13;
Scholar. Keywords were aligned with the Medical Subject Heading (MeSH)&#13;
terms, including "readmission," "ischemic stroke," and "risk factors."&#13;
Several inclusion criteria were applied to identify eligible articles:&#13;
publication between 2014 and 2023 and written in English or Bahasa.&#13;
Sixteen eligible articles were ultimately included in the analysis.&#13;
Results: A total of 16 articles were reviewed (n = 354,682). The causes of&#13;
readmission in ischemic stroke patients were categorized into two&#13;
groups: neurological and non-neurological disorders. Seven common&#13;
comorbidities were identified as risk factors: hypertension,&#13;
cardiovascular diseases, diabetes, dyslipidemia, obesity, previous stroke&#13;
events, and stroke recurrence.&#13;
Conclusion: The review revealed significant variation in readmission rates&#13;
among ischemic stroke patients, ranging from 6.7% to 74% within 28&#13;
days to 10 years. This trend was particularly pronounced among adults&#13;
and older women. These findings provide valuable insights for initiatives&#13;
to prevent patient readmissions and highlight the importance of&#13;
improving future care quality.</text>
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          <element elementId="39">
            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127043">
                <text>Ni Made Ratih Comala Dewi1, Ni Luh Putu Dina Susanti2*&#13;
&#13;
, I Kadek Nuryanto2, &amp; Ni&#13;
&#13;
Kadek Sutini2</text>
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            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="127044">
                <text>https://doi.org/10.37363/bnr.2025.61444</text>
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            <name>Date</name>
            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
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              <elementText elementTextId="127045">
                <text>14 January 2025</text>
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          <element elementId="37">
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            <description>An entity responsible for making contributions to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127046">
                <text>peri irawan</text>
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                <text>pdf</text>
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          <element elementId="44">
            <name>Language</name>
            <description>A language of the resource</description>
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        <name>ischemic stroke, readmission, risk factors</name>
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                  <text>VOL. 6 NO. 1 2025</text>
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                  <text>peri irawan</text>
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                <text>Acupuncture as a Therapeutic Intervention for Alleviating Pain Associated with Knee Osteoarthritis in the Elderly</text>
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            <name>Subject</name>
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                <text>acupuncture, elderly, pain, knee pain</text>
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                <text>Introduction: Osteoarthritis is a common joint disease associated with&#13;
aging, with knee osteoarthritis (KOA) affecting both elderly men and&#13;
women in Indonesia. KOA is a major cause of disability and immobility,&#13;
significantly impacting the quality of life of the elderly. Acupuncture is&#13;
frequently used as a complementary and alternative medicine therapy to&#13;
alleviate pain associated with KOA. This study aims to investigate the&#13;
effect of acupuncture in relieving KOA-related pain in the elderly.&#13;
Methods: A pre-experimental study with a one-group pre-post-test design&#13;
was conducted, involving 30 elderly respondents from the Payangan Desa&#13;
hamlet, selected using purposive sampling. Data were collected using an&#13;
observation sheet and the Comparative Pain Scale to evaluate pain levels.&#13;
All respondents provided informed consent before participating in the&#13;
study. The Wilcoxon Signed Rank Test was used to analyze and interpret&#13;
the results.&#13;
Results: Before the intervention, 9 respondents (30.0%) reported&#13;
moderate knee pain, 10 (33.3%) reported severe pain, and 9 (30.0%)&#13;
reported very severe pain. After the intervention, pain levels decreased&#13;
significantly: 4 respondents (13.3%) reported no pain, 14 (46.7%)&#13;
experienced mild pain, and 12 (40.0%) had moderate pain. The change in&#13;
pain levels was statistically significant (p &lt; 0.05). The median pain score&#13;
decreased from Md = 5.50 before the intervention to Md = 2.00 after, with&#13;
a z-value of -4.53 and r = 0.58.&#13;
Conclusion: Acupuncture therapy is effective in alleviating pain levels&#13;
among elderly individuals suffering from KOA-related pain, with no&#13;
observed negative side effects. Acupuncture is a promising, safe, and&#13;
effective alternative medicine for elderly patients with KOA.</text>
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                <text>Ida Ayu Suptika Strisanti1*, Ida Ayu Anom Rastiti1, Kadek Buja Harditya1, I Dewa&#13;
Ayu Agra Darmawati1, &amp; Komang Rosa Tri Anggaraeni1</text>
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              <elementText elementTextId="127034">
                <text>https://doi.org/10.37363/bnr.2025.61450</text>
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            <name>Date</name>
            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
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              <elementText elementTextId="127035">
                <text>16 January 2025</text>
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            <name>Contributor</name>
            <description>An entity responsible for making contributions to the resource</description>
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              <elementText elementTextId="127036">
                <text>peri irawan</text>
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            <description>A language of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127038">
                <text>english</text>
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        <name>acupuncture, elderly, pain, knee pain</name>
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                <elementText elementTextId="126940">
                  <text>VOL. 6 NO. 1 2025</text>
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            <element elementId="37">
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                  <text>peri irawan</text>
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                <text>Ethical Dilemma in Diabetes Wound Care: A Literature Review</text>
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          <element elementId="49">
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                <text>dilemma ethics, diabetic wound care, decision making</text>
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            <description>An account of the resource</description>
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                <text>Introduction: One of the main complications of diabetes is diabetic foot&#13;
ulcer (DFU), which often requires intensive care and involves&#13;
collaboration between various disciplines. In managing diabetic foot&#13;
ulcers, several ethical dilemmas arise regarding autonomy, beneficence,&#13;
non-maleficence, and justice. This review of the literature aims to&#13;
examine ethical dilemmas in the care of diabetic wounds.&#13;
Methods: A literature review was conducted to analyze articles published&#13;
over the last five years (2019–2024). The analysis involved a detailed&#13;
review of healthcare workers' ethical dilemmas, particularly nurses, in&#13;
managing diabetic wounds.&#13;
Results: Nurses are crucial in addressing ethical dilemmas in diabetic&#13;
wound care. They must have a comprehensive knowledge of diabetic&#13;
wounds, including their pathophysiology, complications, and treatment&#13;
options. Nurses must also have strong decision-making skills, allowing&#13;
them to analyze situations, weigh various factors, and make appropriate&#13;
decisions. Furthermore, they must maintain effective relationships with&#13;
patients and their families.&#13;
Conclusion: Ethical dilemmas in wound care present complex and&#13;
multidimensional challenges. Nurses must possess adequate knowledge,&#13;
skills, and support to navigate these situations effectively. By doing so,&#13;
they can provide high-quality, dignified care to patients while protecting&#13;
their well-being.</text>
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            <description>An entity primarily responsible for making the resource</description>
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              <elementText elementTextId="127023">
                <text>Harsah Bahtiar Zainudin1 &amp; Tantut Susanto2*</text>
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          <element elementId="48">
            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="127024">
                <text>https://doi.org/10.37363/bnr.2025.61455</text>
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            <name>Date</name>
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              <elementText elementTextId="127025">
                <text>17 January 2025</text>
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            <name>Contributor</name>
            <description>An entity responsible for making contributions to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127026">
                <text>peri irawan</text>
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            <description>The file format, physical medium, or dimensions of the resource</description>
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              <elementText elementTextId="127027">
                <text>pdf</text>
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            <description>A language of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127028">
                <text>english</text>
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        <name>dilemma ethics, diabetic wound care, decision making</name>
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