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"Latar Belakang: Terdiagnosis kanker payudara menjadi masalah yang mengancam kehidupan masa depan pada populasi perempuan dewasa awal. Menurunnya konsep diri sebagai perempuan yang mempunyai payudara yang sempurna dan karir hidup di masa depan merupakan hal serius yang dihadapi perempuan dewasa awal ketika menerima diagnosis kanker payudara. Diperlukan suatu intervensi keperawatan untuk membantu mengatasi permasalahan tersebut, dan intervensi keperawatan berbasis digital teknologi merupakan intervensi yang tepat, mengingat literasi digital pada populasi ini bukan hal yang tidak mungkin dilakukanTujuan: Tujuan umum penelitian ini adalah membuktikan pengaruh implementasi intervensi keperawatan SAKAPA berbasis teknologi informasi terhadap adaptasi psikologis, self-efficacy dan kualitas hidup perempuan dewasa awal yang terdiagnosis kanker payudaraMetode: Penelitian ini menggunakan desain research and development melalui tiga tahap. Purposive sampling digunakan untuk pengambilan sampel. Tahap pertama melibatkan 22 pasien kanker payudara sebagai partisipan, tahap kedua melibatkan tiga orang pakar; pakar teknologi informasi, pakar psikologi dan pakar onkologi, dan tahap ketiga melibatkan 88 pasien kanker payudara sebagai respondenHasil: : Teridentifikasi delapan tema yang menjadi dasar pengembangan intervensi keperawatan. Terbentuk intervensi keperawatan SAKAPA untuk membantu pendampingan pasien kanker payudara. Hasil menunjukkan adanya efektivitas intervensi keperawatan SAKAPA terhadap adaptasi psikologis, self-efficacy dan kualitas hidup dengan nilai (p < 0,001). Analisis lebih lanjut menunjukkan bahwa pendidikan dan pekerjaan sebagai variabel perancu memilki efek terhadap kualitas hidup dengan angka (p= 0,001).Kesimpulan: Setelah mengontrol variabel perancu, intervensi keperawatan SAKAPA mampu meningkatkan skor rerata adaptasi psikologis, self-efficacy dan kualitas hidup.

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Background: Being diagnosed with breast cancer is a problem that threatens the future life of the early adult female population. The decline in self-concept as a woman who has perfect breasts and a future career is a serious problem that early adult women face when they receive a diagnosis of breast cancer. A nursing intervention is needed to help overcome this problem, and digital technology-based nursing intervention is the right intervention, considering that digital literacy in this population is not impossible.

Aim: The general aim of this study is to prove the effect of implementing the nursing intervention “SAKAPA” information technology-based on psychological adaptation, self-efficacy and quality of life for early adult women diagnosed with breast cancer.

Method: This research uses a research and development design in three stages. Purposive sampling was used for sampling. The first stage involved 22 breast cancer patients as participants, the second stage involved three experts; information technology expert, psychologist and oncologist, and the third stage involved 88 breast cancer patients as respondents.

Results: Eight themes were identified which became the basis for developing nursing interventions. The SAKAPA nursing intervention was formed to help breast cancer patients. The results show the effectiveness of the SAKAPA nursing intervention on psychological adaptation, self-efficacy and quality of life with a value of (p < 0.001). Further analysis shows that education and employment as confounding variables have an effect on quality of life with a number (p=0.001)."

"Kehamilan merupakan periode kritis dalam tahap kehidupan perempuan. Perubahan fisik dan psikologisdapat menyebabkan gangguan keseimbangan dalam kehidupannya. Penelitian ini bertujuan untuk mengembangkan model integrasi spiritual pada perawatan prenatal untuk meningkatkan adaptasi maternal dan kualitas luaran persalinan. Kemampuan ibu beradaptasi dapat terlihat dari maternal fetal attachment, maternal distress, prenatal symptomsdan luaran persalinan.Penelitian ini terdiri dari tiga tahap yang meliputi tahap identifikasi, tahap pengembangan model dan tahap uji model. Hasil analisis dari wawancara dengan tujuh partisipan pada penelitian tahap I ditemukan lima tema terkait pengaruh spiritual selama kehamilan. Model ini berupa intervensi edukasi yang berbasis spiritual dengan perspektif islam. Intervensi ini terdiri dari sepuluh materi pembelajaran yang dibagi dalam lima sesi pertemuan. Pertemuan dilakukan setiap minggu secara berkelompok di puskesmas atau di wilayah kerja puskesmas. Penelitian ini menggunakan desain quasi experiment pre-post test dengan kelompok kontrol, pengambilan sampel dilakukan dengan teknik consecutive sampling terhadap 124 responden.Hasil penelitian menunjukkan bahwa model integrasi spiritual perspektif islam pada perawatan prenatal efektif dalam meningkatkan adaptasi kehamilan (aspek spiritual, maternal fetal attachment, maternal distress, prenatal symptoms) dan luaran persalinan (berat badan bayi dan nyeri persalinan). Dukungan sosial merupakan variabel perancu yangberpengaruh terhadap spiritual dan status gravidamerupakan variabel perncu yang berpengaruh pada kecemasan.

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Pregnancy is a critical period in the stage of women's lives. Physical and psychological changes are stimuli that can cause disruption of balance in her life. The purpose of this study is to develop a model of spiritual integration in prenatal care to improve maternal adaptation and obstetric outcomes. The ability of the mother to adapt can be seen from the maternal fetal attachment, maternal distress, prenatal symptoms and labor outcomes.This study consisted of three stages which included the identification phase, the model development stage and the model test phase. The results of the first stage based on the analysis from interviews with seven participants in the first stage of this study found five themes related to spiritual influence during pregnancy. This model is the form of educational interventions that are spiritually based on Islamic perspectives. This intervention consists of ten learning materials which are divided into five meeting sessions. The meeting is conduct every week in groups at the puskesmas or in the puskesmas working area.This study useda quasi experiment design pre-post test with a control group, sampling was done by consecutive sampling technique on 124 respondents.The results showed that the Islamic perspective spiritual integration model on prenatal care was effective and significant in improving pregnancy adaptation (spiritual aspects, maternal fetal attachment, maternal distress, prenatal symptoms) and labor outcomes (infant weight and labor pain). Social support is a confounding variable that has a significant effect on the spiritual and the number of deliveries is a significant variable that significantly affects anxiety in pregnancy."

"Perawatan prakonsepsi merupakan periode penting persiapan kehamilan yang memerlukan perawatan komprehensif. Perawatan kehamilan berbasis budaya dapat mengurangi masalah dan risiko penyulit kehamilan. Penelitian ini merupakan studi kualitatif dengan menggunakan metode ethnonursing bertujuan mengeksplorasi perencanaan dan perawatan kehamilan berdasarkan nilai-nilai budaya suku Batak Toba. Sampel penelitian terdiri atas 23 orang informan yang terbagi dalam 4 kelompok agregat, yakni: 1) keluarga, 2) perempuan Batak tidak hamil dan masa hamil, 3) tokoh masyarakat dan tokoh agama, dan 4) tenaga kesehatan dan terapis kusuk (pemijat). Seluruh informan keturunan suku asli Batak Toba yang tinggal di lokasi penelitian, berusia antara 26-69 tahun, mayoritas beragama Kristen, berpendidikan SMU, bekerja sebagai pegawai swasta, pemerintah, wirausaha, dan terapis kusuk (pemijat). Analisis tematik digunakan untuk mengidentifikasi pola perilaku kesehatan, norma, nilai, kepercayaan, dan keyakinan perempuan berdasarkan budaya masyarakat suku Batak Toba. Analisa tematik menyimpulkan 21 tema dari 23 informan yang berasal dari 4 kelompok agregat suku Batak Toba dalam merencanakan dan merawat kehamilan. Hasil penelitian menunjukkan bahwa masyarakat suku Batak Toba memegang teguh prinsip norma, nilai-nilai, keyakinan, dan kepercayaan budaya yang mendasari perilaku sehat dalam merencanakan dan merawat kehamilan. Falsafah Dalihan Na Tolu merupakan dasar sistem kekerabatan suku Batak Toba yang menganut nilai-nilai Hagabeon, yang bermakna bahwa perkawinan sejahtera adalah perwakilan dengan keturunan anak laki-laki dan perempuan. Anak laki-laki adalah keutamaan keluarga karena fungsinya sebagai penerus identitas marga, pendukung silsilah keluarga, pemegang hukum adat, warisan, dan status sosial adat. Penerapan metode ethnonursing dalam pengkajian dan intervensi keperawatan berbasis culture care dapat meningkatkan kesadaran perawatan prakonsepsi dan perilaku positif perawatan kehamilan. Pengintegrasian nilai budaya dalam pelayanan kesehatan ibu dan anak serta keluarga berencana akan mendukung kebijakan pemerintah dalam menurunkan angka kematian dan kesakitan ibu dan anak serta pencegahan terjadinya risiko stunting jangka panjang.

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Preconception care is an important period of pregnancy preparation that requires comprehensive care. Culture-based pregnancy care can reduce the problems and risks of pregnancy complications. This qualitative study uses the ethnonursing method to explore pregnancy planning and care based on the Toba Batak cultural values. The samples were 23 informants from 4 aggregate groups: 1) family, 2) Batak women who are not pregnant and during pregnancy, 3) community and religious leaders, and 4) health workers and masseuses. All informants are Toba Batak people living in the research location, aged 26-69 years, mostly Christians, high school graduates, employed in private agencies or government institutions, entrepreneurs, and masseuses. Thematic analysis was applied to identify health behavior patterns, norms, values, and beliefs based on the Toba Batak culture. The thematic analysis concluded 21 themes from 23 Toba Batak informants in the 4 aggregate groups on planning and caring for pregnancy. The results show that the Toba Batak people adhere to the principles of the norms, values, beliefs, and culture underlying their healthy behavior in planning and caring for pregnancy. The philosophy of Dalihan Na Tolu is the kinship system of the Batak Toba tribe adhering to Hagabeon values, meaning a prosperous marriage should have sons and daughters. Sons are the priority of the family since they carry the function as a determinant of clan identity, family tree, customary law, inheritance, and customary social status. Applying the ethnonursing method in culture care-based assessment and nursing interventions can increase the awareness of preconception care and positive behavior in pregnancy care. Integrating cultural values in maternal and child health and family planning services will support government policies to reduce maternal and child mortality and morbidity, and prevent long-term stunting risks."

"Kesehatan kehamilan berkaitan dengan perilaku ibu melakukan perawatan kesehatan dirinya secara mandiri, selain antenatal care di pelayanan kesehatan. Studi ini mengembangkan konsep perawatan mandiri kesehatan selama kehamilan dengan rancangan classical grounded theory. Theoretical sampling mendapatkan 25 informan ibu hamil trimester 3, ibu dengan anak berusia kurang dari 6 bulan, suami, bidan dan dokter obgyn dan ulama di perkotaan Jakarta, Bekasi, Bogor dan Tangerang. Wawancara mendalam, observasi dan studi dokumen dianalisis secara perspektif konseptual dari pengkodean terbuka dan selektif menggunakan analisis perbandingan konstan dan memo. Penelitian ini menghasilkan konsep inti: merawat kesehatan diri selama kehamilan, dan 5 konsep aktivitas/strategi: 1) Menjaga kesehatan selama hamil; 2) Menghindari atau mengatasi masalah kesehatan selama kehamilan: 3) Memenuhi kebutuhan intimasi dengan suami: hubungan seksual; 4) Menjalani praktik budaya dan agama sehari-hari; dan 5) Mencari infomasi kesehatan. Strategi/aktivitas dipengaruhi oleh faktor internal kondisi ibu hamil: perubahan fisik dan emosi ibu hamil, keluhan dan masalah medis; faktor eksternal yaitu dukungan keluarga dan profesi kesehatan; dan faktor lingkungan makro yaitu kebijakan pelayanan kesehatan ibu hamil dan pandemi Covid 19. Konsep perawatan mandiri kesehatan selama kehamilan ini mendukung kebijakan pelayanan kesehatan ibu hamil, peran profesi kesehatan dan keluarga untuk meningkatkan kemampuan mandiri (selfcare) ibu hamil menjaga kesehatannya.

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Health selfcare during pregnancy were carried out in addition to antenatal care. This study aims to develop the health selfcare concepts using a classical grounded theory design. Theoretical sampling with 25 informants, including pregnant women in the third trimester, mothers with the children aged less than 6 months, husbands, midwives, obstetricians, and religious leaders in the urban areas in Jakarta, Bekasi, Bogor and Tangerang. In-depth interviews, observations, and studies of document, were analyzed using conceptual perspective from open and selective coding with constant comparison and memo. The results are core concept: health selfcare concepts during pregnancy, and five selfcare activities/strategies are: 1) staying healthy; 2) avoiding or addressing health problems; 3) fulfilling the intimacy needs with the husbands: sexual intercourse; 4) performing daily cultural and religious practices; and 5) seeking health information. Those are influenced by the internal factors i.e. the health condition of the pregnant women, which consists of physical and emotional changes, complaints and health issues during pregnancy. External factors including family and health care providers support, and macro environmental factor including the policy of the pregnant women health care service in Indonesia and the COVID-19 pandemic. Concepts of the health selfcare during pregnancy imply the urgency of the policy for antenatal health care service, the role of the health care providers and the family to improve the health selfcare during pregnancy."

"Kesehatan psikologis seorang ibu berdampak positif terhadap ikatan emosional ibu dan janin dalam mencapai peran transisi menjadi seorang ibu. Masalah kesehatan psikologis ibu serta kurangnya dukungan suami merupakan faktor utama terganggunya interaksi ibu dan janin. Penelitian ini bertujuan menghasilkan intervensi keperawatan untuk meningkatkan ikatan emosional orang tua dan janin berbasis mobile health yang berpengaruh terhadap kesehatan psikologis, keharmonisan suami istri serta jalinan kasih orang tua dan janin. Penelitian terdiri dari tiga tahap. Desain penelitian tahap pertama descriptive qualitative dengan 14 partisipan yang terdiri dari ibu hamil dan pasangannya. Tahap kedua, mengembangkan rancangan intervensi menjalin ikatan emosional dengan janin  berbasis mobile health berdasarkan analisis tahap satu dan konsultasi pakar. Tahap ketiga menggunakan desain quasi experiment pre-post test with control group. Sebanyak 82 pasang ibu hamil sebagai responden, terdiri dari kelompok berpasangan (26 pasang), kelompok mandiri (27 pasang) dan kelompok kontrol (29 pasang). Kelompok berpasangan: mendapatkan intervensi bersama pasangan, kelompok mandiri: mendapatkan intervensi sendiri tanpa pasangan, kelompok kontrol: melakukan kegiatan sesuai kebiasaan sehari-hari. Hasil penelitian kualitatif ditemukan 3 tema yaitu 1) Keterbatasan pengetahuan dan informasi dalam  menjalin ikatan emosional dengan janin, 2) Memperoleh dukungan internal dan eksternal dalam menjalin ikatan emosional dengan janin dan 3) Menjalin ikatan emosional dengan janin membutuhkan berbagai kebutuhan. Intervensi keperawatan untuk meningkatkan ikatan emosional orangtua dan janin berbasis mobile health berpengaruh menjadi lebih baik kesehatan psikologis ibu dan ayah, keharmonisan suami istri menurut ibu dan ayah, serta jalinan kasih orang tua dan janin dibanding kelompok kontrol. Nilai perbaikan kesehatan psikologis ibu kelompok berpasangan dan mandiri (β = -2.68, p < 0.001 ;I² = -3.03, p < 0.001), keharmonisan suami istri menurut ibu kelompok berpasangan dan mandiri (β = -7.46, p = 0.002 ; I² = -9.11, p = 0.001) dan jalinan kasih orang tua dan janin kelompok berpasangan dan mandiri (I² = 6.77, p = 0.013 ; I² = 9.73, p < 0.001). Nilai perbaikan kesehatan psikologis ayah kelompok berpasangan dan mandiri (I² = -5.80, p < 0.001 ; I² = -3.95, p < 0.001), keharmonisan hubungan suami istri menurut ayah kelompok berpasangan dan mandiri (I² = -7.04, p < 0.001 ; β = -3.74, p = 0.024). Disimpulkan bahwa ibu kelompok mandiri lebih besar nilai perbaikan variabelnya dibanding kelompok berpasangan, sebaliknya pada kelompok ayah. Merekomendasikan intervensi keperawatan MIESRA berbasis mobile health dapat digunakan untuk meningkatkan kesehatan psikologis, keharmonisan suami istri serta jalinan kasih orang tua dan janin di tatanan layanan kesehatan

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The psychological health of a mother has a positive impact on the emotional bond of the pregnant mother and her baby in achieving the transitional role of being a mother. Psychological health problems of the mother and the lack of husband's support are the main factors that interfere with the interaction of the mother and baby. This study aimed to create nursing interventions to increase the emotional bond of parents and babies based on mobile health that could affect psychological health, the harmonious relationship of husbands and wives and the love relationship between parents and babies. The research consisted of three stages. The first phase of the research design was descriptive qualitative with 14 participants consisting of pregnant women and their partners. The second stage was to develop an intervention to build an emotional bond with the babies using mobile health application based on stage one analysis and expert consultation. The third stage used a quasi-experimental pre and post-test design with a control group. Eighty two pairs participated as respondents, consisting of the paired group (26 pairs), the independent group (27 pairs) and the control group (29 pairs). The paired group received intervention with their partner, the independent group received intervention alone without a partner, and the control group performed daily activities as usual. The results of the qualitative research found 3 themes, namely 1) Limited knowledge and information in establishing an emotional bond with the babies, 2) Obtaining internal and external support in establishing an emotional bond with the babies and 3) Establishing an emotional bond with the babies requires various needs. Interventions for establishing emotional bonds between parents and babies using mobile health application have an effect on better psychological health of mothers and fathers, harmonious relationship between husband and wife according to mothers and fathers, and the relationship between parents and babies compared to the control group. The value of psychological health improvement for paired and independent mothers (I² = -2.68, p < 0.001 ; = -3.03, p < 0.001), harmonious marital relationship according to paired and independent group mothers (I² = -7.46, p = 0.002 ; = -9.11, p = 0.001) and the relationship between parents and babies in paired and independent groups (I² = 6.77, p = 0.013 ; = 9.73, p < 0.001). The psychological health improvement value of fathers in the paired and independent group (I² = -5.80, p < 0.001 ; = -3.95, p < 0.001) and the harmonious marital relationships according to the fathers of the paired and independent group (I² = -7.04, p < 0.001 ; = -3.74, p = 0.024). It was concluded that the independent group mothers had a higher improvement value for the variable than the paired group, on the contrary in the father group. It is recommended that mobile health-based MIESRA nursing interventions can be used to improve psychological health, marital harmonious relationship and the love of parents and babies in health care settings."

"Ibu remaja berkontribusi terhadap rendahnya praktik menyusui di Indonesia. Dukungan keluarga diperlukan agar ibu remaja berhasil menyusui dini, menyusui eksklusif dan mempertahankan durasi menyusui. Sayangnya, instrumen baku untuk mengukur bagaimana bentuk dukungan keluarga yang diberikan belum ada sampai saat ini, mengingatkan keunikan dari ibu menyusui berusia remaja yang berbeda dibandingkan dengan ibu yang sudah berusia matang. Penelitian bertujuan untuk mengembangkan instrumen dukungan keluarga yang valid pada praktik menyusui ibu berusia remaja. Desain penelitian berupa pengembangan instrumen dan validasi cross-sectional. Terdapat tiga tahap penelitian yaitu tahap pertama, menyusun draf instrumen dukungan keluarga dengan studi literatur bentuk dukungan keluarga pada remaja masa reproduksi, studi kualitatif melibatkan 17 partisipan, uji validitas isi melibatkan tiga orang pakar dan uji keterbacaan pada sepuluh responden ibu berusia remaja menyusui. Tahap kedua, melakukan uji validitas konstruk instrumen dukungan keluarga hasil pengembangan kepada 209 ibu berusia remaja menyusui dan tahap ketiga, membuktikan bahwa instrumen dukungan keluarga mampu mengukur praktik menyusui pada ibu berusia remaja. Hasil penelitian tahap satu terdapat penambahan tiga indikator dukungan keluarga yaitu tanggung jawab, kohesif dan evaluasi diri yang sesuai dengan kebutuhan spesifik remaja yaitu otonomi, pencapaian kompetensi dan keterhubungan serta penambahan item pernyataan dengan total 64 item dan nilai Content Validity Index (CVI) =1., Penelitian tahap dua menghasilkan 58 item pernyataan yang valid dan fit secara unidimensional mengukur dukungan keluarga berdasarkan uji Confirmatory Factor Analysis (CFA) dan tahap ketiga instrumen dukungan keluarga terbukti dapat mengukur praktik menyusui pada ibu berusia remaja mengunakan Structural Equation Model (SEM) yaitu terdapat pengaruh yang signifikan antara status menjadi ibu terhadap keluarga pendukung, antara keluarga pendukung terhadap dukungan keluarga, antara dukungan keluarga terhadap perilaku menyusui dini dan dukungan keluarga terhadap perilaku menyusui eksklusif. Instrumen dukungan keluarga pada praktik menyusui ibu berusia remaja yang telah valid versi long form (58 item) dapat digunakan pada lingkungan akademis dan versi short form (10 item) oleh seluruh tenaga kesehatan termasuk perawat untuk mengkaji kebutuhan ibu menyusui berusia remaja terutama dalam hal dukungan keluarga sehingga dapat mengambil keputusan klinis yang tepat dalam melaksanakan asuhan keperawatan.

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Adolescent mothers contribute to the low level of breastfeeding practices in Indonesia. Family support is needed for adolescent mothers to breastfeed early, breastfeed exclusively, and successfully maintain the duration of breastfeeding. Unfortunately, there is no standard instrument to measure the form of family support provided to date, reminding us that the uniqueness of teenage breastfeeding mothers is different compared to mature mothers. The research aims to develop a valid family support instrument for the breastfeeding practices of adolescent mothers. The research design consisted of instrument development and cross-sectional validation. There were three research stages, namely the first stage, drafting a family support instrument with a literature study on forms of family support for adolescents during the reproductive period, a qualitative study involving 17 participants, a content validity test involving three experts, and a readability test on ten respondents who were breastfeeding teenage mothers. The second stage tested the construct validity of the family support instrument developed on 209 breastfeeding adolescent mothers, and the third stage proved that the family support instrument could measure breastfeeding practices in teenage mothers. The results of the first phase of research included the addition of three indicators of family support, namely responsibility, cohesiveness and self-evaluation which are in accordance with the specific needs of adolescents, namely autonomy, achievement of competence and connectedness as well as the addition of statement items with a total of 64 items and a Content Validity Index (CVI) value = 1., The second stage of research produced 58 valid and unidimensionally fit statement items measuring family support based on the Confirmatory Factor Analysis (CFA) test and the third stage of the family support instrument was proven to be able to measure breastfeeding practices in teenage mothers using the Structural Equation Model (SEM), namely that there was an influence significant relationship between motherhood status and supporting family, between supporting family and family support, between family support for early breastfeeding behavior and family support for exclusive breastfeeding behavior. The valid long-form version (58 items) of the family support instrument for breastfeeding practices of teenage mothers can be used in academic settings, and the short-form version (10 items) by all health workers, including nurses, to assess the needs of teenage breastfeeding mothers, especially in terms of family support. So that they can make appropriate clinical decisions in implementing nursing care."

"Framework manajamen tenaga keperawatan di RS yang dapat membantu para manajer keperawatan dalam mengelola tenaganya merupakan hal yang penting khususnya di negara berkembang. Penelitian ini bertujuan untuk mengembangkan framework continuous quality improvement (CQI) manajemen tenaga keperawatan dan menguji secara statistik pengaruh framework CQI manajemen tenaga keperawatan terhadap kompetensi perawat. Desain penelitian ini adalah penelitian kuantitatif yaitu metode penelitian yang menggunakan angka dan statistik dalam proses penelitiannya. Penelitian kuantitatif ini diperkuat dengan penelitian kualitatif yang dilakukan terhadap 14 manajer rumah sakit. Penelitian ini terdiri dari dua tahapan yaitu pengembangan framework dan pengujian secara statistik pengaruh framework terhadap kompetensi perawat. Tahap pengembangan framework terdiri dari wawancara mendalam pada 14 manajer dan expert opinion pada 5 expert. Selanjutnya tahap kedua melakukan uji validasi framework CQI manajemen tenaga keperawatan untuk kompetensi perawat di rumah sakit menggunakan SEM-PLS pada 113 manajer keperawatan di himpunan perawat manajer Indonesia menggunakan online kuesioner. Hasil penelitian tahap satu diperoleh framework CQI manajemen tenaga keperawatan siap uji. Hasil penelitian tahap dua membuktikan bahwa framework CQI manajemen tenaga keperawatan memiliki pengaruh terhadap kompetensi perawat dengan penjelasan tujuh dari delapan aktivitas manajemen SDM yaitu perencanaan, rekrutmen, seleksi dan orientasi, pelatihan dan pengembangan, sistem reward, penilaian kinerja, sistem alokasi staf dan maintenance memiliki pengaruh terhadap kompetensi perawat. Hanya ada satu variabel yang mengindikasikan hal berbeda yaitu jenjang karir dimana ditemukan jenjang karir tidak ada pengaruh terhadap kompetensi perawat. Dapat disimpulkan framework ini secara statistik memiliki pengaruh terhadap kompetensi perawat.

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A nursing workforce management framework in hospitals is important, especially in developing countries, as it can help nursing managers in handling their staff. This research aims to develop a continuous quality improvement (CQI) framework for managing hospital nurses and statistically test the effect of the CQI framework for hospital nurses management on nurse competency. The research employs a quantitative design, which is a research method that uses numbers and statistic in the research process. This quantitative research is strengthened by qualitative research conducted with 14 hospital managers. This research consists of two stages, namely framework development and statistical testing of the framework’s influence on nurse competency. The framework development stage consist of in-depth interviews on 14 hospital manajers and expert opinions on 5 experts. The Next stage was conducting a validation test of the CQI framework for hospital nurses management for nurse competency using SEM-PLS. The test was administered using online questionnaires on 113 nurse managers from the Indonesian Nurse Manager Association. The result of the first phase of the research yielded a CQI framework for hospital nurses management that was ready for testing. The second phase of research demonstrated that the CQI model for nursing workforce management influences nurse competency. This is evidenced by seven out of the eight human resource management activities: planning, recruitment selection and orientation, training and development, reward systems, performance appraisals, staff allocation systems and maintenance -having an impact on nurse competency. Only one variable that indicated something different, namely career path, where it was found that career path had no influence on nurse competency. It can be concluded that this framework statistically has an influence on nurse competency."