Introduction Consistent with the significant of the stress issue in education, this study aimed to survey type of stressors and identifies the coping strategies used by diploma nursing students during clinical practices. Methods A descriptive cross-sectional study was carried out at the Kubang Kerian Nursing College, Kelantan which involved 346 respondents using simple random sampling method. The inclusion criteria were year one, two and three of nursing students who have clinical posting and voluntarily joining the study. Perceived Stress Scale (PSS) and Brief COPE inventory were utilised in the data collection. Higher mean score indicates higher degree of stress. Results Clinical assignments and workload were the main stressor (mean = 3.19, SD = 1.09). Religion approach was the most coping strategy applied (mean = 3.30, SD = 0.71). Pearson’s correlation coefficient test found that six domains of stressors during clinical practices (taking care of patients; clinical educators/instructors and ward staff; clinical assignments and workload; peers and nursing students from other college; lack of professional knowledge and skills and clinical environment) were statistically significant correlation with coping strategies, where P -value < 0.05. Conclusion Clinical assignment was the main stressor among nursing students; therefore, successful activities should be promoted to help them in managing clinical assignment and enhancing knowledge in religion.

The Delphi technique is a widely used and accepted method to obtain consensus among the experts. This technique uses a judgement to prove the accuracy of the content item when evaluating instrument. The objective of this study is to discuss the process of the three rounds Delphi technique to obtain consensus of concept mapping care plan and multiple choice questions (MCQ) in Diabetic Mellitus subject. In the first round, participants were given a structured questionnaire regarding item of concept mapping care plan and MCQ in Diabetic Mellitus subject. In the second round, the mean and median values of round one were added. In the third round, the mean and median values of round two were added. Participants were asked to rate the categorised responses from Round 1 on a scale of 1 to 5, with 1 being "Very Irrelevant" and 5 being "Very Relevant". This technique does not require that participants be collocated or meet face-to-face, thereby making it useful to conduct surveys with qualified people over a wide geographic area. The feedback process allows and encourages the selected Delphi participants to reassess their initial judgements about the information provided in previous iterations. The analysis of consensus data of the experts was done based on median, inter quartile range and quartile deviation on round one, two and three data. The median score was used to analyse the level of consensus of experts and result shows that in all three rounds Delphi the medium result more than 4. It reported that level of importance of the statements were high. As a conclusion, the concept mapping care plan and MCQ have meets the consensus by using three rounds of Delphi techniques. Therefore, the Delphi technique is the best method to obtain consensus in health care education research.

The Delphi technique is a widely used and accepted method for gathering data from participants within domain of expertise. The objective of this study is to discuss the process of the three rounds Delphi technique in seeking a consensus of concept mapping structure and Multiple Choice Questions (MCQ) in Diabetic Mellitus subject. In the first, round, participants were given a structured questionnaire regarding item of concept mapping structure and MCQ in Diabetic Mellitus subject. The second were added mean and median value of round one. In the third round were add mean and median value of round two were added. Participants were asked to rate the categorised responses from Round 1 on a scale of 1 to 5, with 1 being "Very irrelevant" and 5 being "Very relevant". This technique does not require participants to meet face-to-face, thereby making it useful to conduct surveys with qualified people over a wide geographic area. The feedback process allows and encourages the selected Delphi participants to reassess their initial judgements about the information provided in previous iterations. Data is then analysed to check for consistency of experts' responses between rounds. Instrument developed from the Delphi technique research findings is also examined for validation from experts in educational medical health sciences on content and constructs validity. Analysis on the consensus of data from experts was based on median, inter quartile range and quartile deviation on Round 1, 2 and 3 data. Therefore, the Delphi technique is an appropriate method for identifying significant issues related with academic.

In today's challenging and highly complex health care settings nurses must be able to think critically. With the current traditional and rote methods of learning, the critical thinking skills among the students are seen to diminish. As nurse educators must find a different method in their teaching on how to encourage students to engage in analytical thinking and how to make the analytical thinking process part of their daily practice due to increase safety of the patients. This will give challenge for the nurse educators to reshape education by adopting instructional strategies to equip students with foundational knowledge in critical thinking, creative problem solving and collaboration. Through concept mapping, students should be able to transfer applied didactic objectives from the classroom to the clinical practice, where critical thinking and problem solving skills are needed for success. It also provide nurse educators with the ability to help students learn how to organise data, prioritise patient needs and can relate patient medical illness and nursing intervention.

Introduction: Stress is a particularly important issue in education because it has the potential to decline learning and performance. However, little empirical evidence about the influence of stress in nurse students' clinical practices. Methods: There are 346 totals of respondents for this study. Perceived Stress Scale (PSS), which have six domains of stressors and Brief COPE inventory, consisted of 28 items which measure 14 different coping styles was used. By using Likert scale in order to measure the degree of stress for each stressor. Higher mean score indicates higher degree of stress. Results: In this study, stress from clinical assignments and workload was the most stressful having by nursing students (Mean = 3.19, SD = 1.09). Among the 14 types of coping strategies, religion was the most frequently used, religion (Mean = 3.30, SD = 0.71). Conclusion: The results provided valuable information for nurse educators, clinical educators and clinical staff in identifying students' needs, facilitating their learning in the clinical setting and developing effective interventions to reduce the stress. Therefore it is important, especially nursing students can handle the pressure because it will affect the level of achievement in academic and thereby affecting student skills in the field of clinical nursing. And this affects the care of patients.

Background: Concept mapping has been established as a learning strategy that encourages critical thinking and creativity among students, leading to the development of a concept mapping guideline designed to guide nurse educators in using this teaching strategy. Objectives: This paper illustrates the development of a guideline to build a concept mapping based-learning strategy. Called the Rusnani concept mapping (RCM) protocol guideline, it was adapted from the Mohd Afifi learning model (MoAFF) and the analysis, design, development, implementation and evaluation (ADDIE) model, integrated with the Kemp model. Methods: This model uses the five phases of analysis, design, development, implementation and evaluation. The validity of the guideline was determined by using content and face validity and the Delphi technique. Content validity for this RCM guideline was established using expert review. This formula suggested that if the content validity is greater than 70%, it shows good content validity, and if it is less than 70%, the content validity is low and it is advisable to recheck the content according to the objective of the study. Results: The reliability of the RCM was 0.816, showing that the RCM guideline has high reliability and validity. Conclusion: It is practical and acceptable for nurse educators to apply RCM as an effective and innovative teaching method to enhance the academic performance of their nursing students.

This cross-sectional study aimed to examine breastfeeding trends and factors in Indonesia using Demographic Health Survey (DHS) data from 2007 to 2017. The research data were obtained from three Indonesia Demographic Health Surveys. The data covered households and women aged 15‒49 years old, including 40,701 households and 32,895 women in 2007; 43,852 households and 45,607 women in 2012; and 47,963 households and 49,627 women in 2017. Descriptive statistics was deployed to analyze the sociodemographic factors of the respondents. A questionnaire was employed to obtain data on the mothers' age, residence, education, economic status, mother working, marital status, literacy, place of delivery, first Antenatal Care (ANC) place, child size at birth, and gender of the child. Multinomial logistic regression analysis was used to analyze factors related to breastfeeding and how big the impact is. The findings indicate that the trend of breastfeeding in Indonesia significantly decreased based on the characteristics of mothers and children. The rates of breastfeeding (exclusive breastfeeding infants aged 0‒5 months who received only breast milk) among mothers living in urban areas decreased significantly from 41.6% in 2012 to 38.4% in 2017. In 2017, children with normal birth weight (OR=0.87, 95% CI:0.53‒1.45), boys (OR=1.01, 95% CI:0.92‒1.10), and non-illiterate mothers (OR=0.50, 95% CI:0.46‒0.55) had higher odds of breastfeeding compared to children with small birth weight, girls, and illiterate mothers. Factors associated with breastfeeding also change every year. In 2012, breastfeeding was related to marital status and delivery, but in 2017 it was not associated with those factors. Factors related to breastfeeding in Indonesia are age, residence, education, weight index, size of child at birth, mother’s occupation, marital status, literacy, place of delivery, and first ANC place. These results are important for developing policies to improve maternal and child health in Indonesia by increasing education and mother training for early initiation of breastfeeding.

The educational system in Malaysia, including schools, colleges, and universities, is based on a traditional system. The outbreak of COVID-19 has an impact on the educational system across the world because it was forced to shut down during pandemics and changed from traditional methods to online and distance learning(ODL) or non-face to face. Due to this nature, COVID-19 tremendously affected the personal interaction of lecturers and students. The absence of traditional classroom teaching and computer-based learning has emerged as the closest replacement for offline teaching and the students' perception and readiness about the online distance learning adopted during the covid -19 pandemic, mainly laboratory-based courses in the Faculty of Health Sciences. In the present study, 265 diploma students of