Effectiveness of Video-Based Self-Management Education in Reducing Psychological Stress and Blood Pressure among Hypertensive Patients in Primary Healthcare: A Quasi-Experimental Study
DOI:
https://doi.org/10.51143/jksi.v11i1.1092Keywords:
Hypertension Self-Management Education Psychological Stress Blood Pressure Video-Based InterventionAbstract
Video-Based Self-Management Education Reduces Psychological Stress and Blood Pressure in Hypertensive Patients. Hypertension is closely associated with psychological stress, which can impair blood pressure control and self-management capacity. This study
aimed to evaluate the effect of video-based self-management education on psychological stress and blood pressure among hypertensive patients. A quasi-experimental one-group pretest–posttest design was conducted involving 60 hypertensive patients who received a structured video-based self-management education intervention for four weeks. Psychological stress was measured using the Depression Anxiety Stress Scale-21 (DASS- 21), and blood pressure was assessed using a calibrated digital sphygmomanometer. Data normality was evaluated using the Shapiro–Wilk test. The results demonstrated a significant reduction in blood pressure based on the Paired Samples t-test (p < 0.001; 95% CI: ?55.83 to ?50.33), while psychological stress significantly decreased according to the Wilcoxon Signed Rank Test (p < 0.001). Video-based self-management education is an
effective and practical nursing intervention for improving both psychological and physiological outcomes among hypertensive patients in primary healthcare settings.
References
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Aji, P. T., Bhadowy, A. S., & Rizkasari, E. (2026). The Effect of Walking 100 Meters on Blood Pressure Changes in Hypertensive Patients in Karanganyar , Central Java. Healthcare Nursing Journal, 8(1), 116–123. https://doi.org/https://doi.org/10.35568/healthcare.v8i1.7227
Aji, P. T., & Lazuardi, N. (2025). Peningkatan Kepatuhan Minum Obat melalui Nurse-Led Self-Management Berbasis Edukasi Tatap Muka pada Pasien Hipertensi: Laporan Kasus. Ners Muda, 6(3), 1–8. https://doi.org/10.26714/nm.v6i3.20395
Aji, P. T., & Sani, F. N. (2021). Pengaruh Terapi Air Rebusan Daun Salam Terhadap Perubahan Teknan Darah pada Penderita Hipertensi di Wilayaha Tempurejo Jumapolo Karanganyar. In Jurnal Kesehatan (Vol. 12, Issue 13, pp. 50–63).
Alshammari;, B. G. A. E. R. S. H. kaliefah aldakeel; awatif M. alraseeday; salman H. alsaqri; B. A. F. (2024). Self-care practices among hypertensive patients at the primary health care centers in Unaizah city, Saudi Arabia. NURSING AND HEALTH POLICY PERSPECTIVE, 3(1), 1–8. https://doi.org/10.3389/fmed.2024.1290670
Aminde, L. N., Agbor, V. N., Fongwen, N. T., Ngwasiri, C. A., Nkoke, C., Nji, M. A., Dzudie, A., & Schutte, A. E. (2025). High Burden and Trend in Nonadherence to Blood Pressure-Lowering Medications: Meta-Analysis of Data From Over 34 000 Adults With Hypertension in Sub-Saharan Africa. Journal of the American Heart Association, 14(9), 1–13. https://doi.org/10.1161/JAHA.124.037555
Bao, R. (2021). FIU Digital Commons A Video-Based Educational Program in Improving Knowledge and Adherence to Medication Among Hypertensive Patients Aged Eighteen Years and Older in a Primary Care Office?: A Quality Improvement Project . FIU Digital Commons, 2(2), 1–45. https://digitalcommons.fiu.edu/cgi/viewcontent.cgi?article=1029&context=cnhs-studentprojects
Charchar, F. J., Prestes, P. R., Mills, C., Ching, S. M., Neupane, D., Marques, F. Z., Sharman, J. E., Vogt, L., Burrell, L. M., Korostovtseva, L., Zec, M., Patil, M., Schultz, M. G., Wallen, M. P., Renna, N. F., Islam, S. M. S., Hiremath, S., Gyeltshen, T., Chia, Y. C., … Tomaszewski, M. (2024). Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension. Journal of Hypertension, 42(1), 23–49. https://doi.org/10.1097/HJH.0000000000003563
Chimberengwa, P. T., & Naidoo, M. (2020). Using community-based participatory research in improving the management of hypertension in communities: A scoping review. South African Family Practice, 62(1), 1–14. https://doi.org/10.4102/safp.v62i1.5039
Eaton, C., Vallejo, N., Mcdonald, X., Wu, J., Rodr, R., Muthusamy, N., Mathioudakis, N., & Riekert, K. A. (2024). User Engagement With mHealth Interventions to Promote Treatment Adherence and Self-Management in People With Chronic Health Conditions?: Systematic Review Corresponding Author?: JOURNAL OF MEDICAL INTERNET RESEARCH, 26(6), 5. https://doi.org/10.2196/50508
Fira Indriyati et al, . (2025). Self Care and Blood Pressure Control Education Using Audio Visual for Self management in Hypertension. Indonesian Journal of Innovation Studies, 26(4), 1–17. https://doi.org/10.21070/ijins.v26i4.1807
Gurdogan, E. P. (2022). The effect of self-management support on knowledge level , treatment compliance and self ? care management in patients with hypertension AUTHORS. Australian Journal of Advanced Nursing, 39(3), 1–10.
Hermansson-Borrebaeck, R., Fors, A., Bengtsson, U., Kjellgren, K., Calling, S., & Midlöv, P. (2025). Self-Efficacy in Hypertension Management Using e-Health Technology: A Randomized Controlled Trial in Primary Care. Journal of Clinical Hypertension, 27(1), 1–8. https://doi.org/10.1111/jch.14981
Hoffman, R. S., Hoyte, C. O., Mazer-amirshahi, M. E., Stolbach, A., St-onge, M., Thompson, T. M., & Wang, G. S. (2023). 2023 American Heart Association Focused Update on the Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning?: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiov (Eric J (ed.); 4th ed.). AHA Focused Update. https://doi.org/10.1161/CIR.0000000000001161
Irwan, A. M., Potempa, K., Abikusno, N., & Syahrul, S. (2022). Self-Care Management for Hypertension in Southeast Asia: A Scoping Review. Journal of Multidisciplinary Healthcare, 15(September), 2015–2032. https://doi.org/10.2147/JMDH.S367638
Khanal, M. K., Bhandari, P., Dhungana, R. R., Bhandari, P., Rawal, L. B., Gurung, Y., Paudel, K. N., Singh, A., Devkota, S., & de Courten, B. (2021). Effectiveness of community-based health education and home support program to reduce blood pressure among patients with uncontrolled hypertension in Nepal: A cluster-randomized trial. PLoS ONE, 16(10 October), 1–17. https://doi.org/10.1371/journal.pone.0258406
Kim, H. J., Choi, G. W., Park, Y., Jeong, H. N., & Chang, S. J. (2025). Development of a health literacy-based hypertension self-management education program using sign language for Deaf individuals. BMC Health Services Research, 25(1), 1–12. https://doi.org/10.1186/s12913-025-13726-1
Kim, H. L., Park, S. M., Cho, I. J., Kim, Y. M., Kim, D. H., & Kim, S. H. (2023). Standardized protocol of blood pressure measurement and quality control program for the Korea National Health and Nutrition Examination Survey. Clinical Hypertension, 6(4), 1–12. https://doi.org/10.1186/s40885-023-00252-7
Luluk, S., & Ni, K. (2025). Relationship of High Stress with Hypertension in Adults?: Meta Analysis. Journal of Epidemiology and Public Health, 07(2022), 130–141. https://doi.org/https://doi.org/10.26911/jepublichealth.2022.07.01.11
Mourouti, N., Michou, M., & Costarelli, V. (2022). Health literacy in relation to health outcomes in hypertension?: A systematic review. Journal of Atherosclerosis Prevention and Treatment, 13(3), 1–10.
Pertiwi, L. D., Shobirun, S., & Indriyawati, N. (2021). Development Audiovisual Health Education Media for Self Management of Hypertension Patients. Media Karya Kesehatan, 4(2), 166–182. https://doi.org/10.24198/mkk.v4i2.30225
Pujiyanto, P. T. A. E. R. (2021). Pengaruh Terapi Guided Imagery terhadap Perubahan Tekanan Darah pada Penderita Hipertensi di Wilayah Puskesmas Jayengan Surakarta. Aisyiyah Surakarta Journal of Nursing, 2(1), 1–6. https://doi.org/https://doi.org/10.30787/asjn.v3i2.896
Puteri, G. A., Nashori, F., & Ramdani, Z. (2025). Enhancing self-acceptance in middle-aged patients with hypertension through dhikr relaxation therapy. Jurnal Ilmiah Psikologi Terapan, 13(2), 1–18. https://doi.org/10.22219/jipt.v13i2.33148
Raja-Ismail, R. I., Badlishah-Sham, S. F., Nik-Nasir, N. M., & Isa, M. R. (2024). Development and validation of a video-based intervention on self-care practices for patients with hypertension in Malaysian primary care settings. Malaysian Family Physician, 19, 1–10. https://doi.org/10.51866/oa.480
Rao, S. V., O’Donoghue, M. L., Ruel, M., Rab, T., Tamis-Holland, J. E., Alexander, J. H., Baber, U., Baker, H., Cohen, M. G., Cruz-Ruiz, M., Davis, L. L., de Lemos, J. A., DeWald, T. A., Elgendy, I. Y., Feldman, D. N., Goyal, A., Isiadinso, I., Menon, V., Morrow, D. A., … Hundley, J. (2025). 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. In Sunil (Ed.), Circulation (5th ed., Vol. 151, Issue 13). Circulation. https://doi.org/10.1161/CIR.0000000000001309
Ruksakulpiwat, S., Pongsuwun, K., Junphongsri, P., Preeprem, C., Nguantad, S., & Samart, B. (2025). Nurse-Led Interventions to Improve Health, Adherence, and Functional Outcomes in Adults and Older Adults With Multimorbidity: A Systematic Review of Randomized and Quasiexperimental Studies. Journal of Nursing Management, 2025(1), 1–15. https://doi.org/10.1155/jonm/6252049
Sangouni, A. A., Hosseinzadeh, M., & Parastouei, K. (2024). The effect of dietary approaches to stop hypertension (DASH) diet on fatty liver and cardiovascular risk factors in subjects with metabolic syndrome: a randomized controlled trial. BMC Endocrine Disorders, 24(1), 1–10. https://doi.org/10.1186/s12902-024-01661-x
Spruill, T. M. (2023). Chronic Psychosocial Stress and Hypertension. NIH Public Access, 12(1), 10–16. https://doi.org/10.1007/s11906-009-0084-8.Chronic
Tomitani, N., Kanegae, H., Suzuki, Y., Kuwabara, M., & Kario, K. (2021). Stress-Induced Blood Pressure Elevation Self-Measured by a Wearable Watch-Type Device. American Journal of Hypertension, 34(4), 377–382. https://doi.org/10.1093/ajh/hpaa139
Ukoha-, B. O., Samaila, A., Abubakar, M. M., Kalu, U. A., & Soyiri, I. N. (2023). Effectiveness of educational interventions on hypertensive patients ’ management behaviours?: an. BMJ Open, 5(4), 1–5. https://doi.org/10.1136/bmjopen-2023-073682
Upoyo, A. S., Sari, Y., Taufik, A., Anam, A., & Kuswati, A. (2024). The Effect of Online Group Education on Promoting Knowledge, Motivation, Self-Efficacy, Self-Care Behaviors and Preventing Uncontrolled Blood Pressure in Hypertensive Patients: A Quasi-Experiment Study. SAGE Open Nursing, 10(2), 1–14. https://doi.org/10.1177/23779608241299288
WHO. (2023). Global report on hypertension: the race against a silent killer. In Taskeen Khan (WHO Department of Noncommunicable Diseases) (Ed.), World Health Organization (WHO) (1st ed., Vol. 01). World Health Organization (WHO). https://www.who.int/publications/i/item/9789240081062?utm
World Health Organization. (2024). More than 700 million people with untreated hypertension. World Health Organization. https://www.who.int/news/item/25-08-2021-more-than-700-million-people-with-untreated-hypertension
Wu, S., Tu, X., Mou, G., Long, C., & Li, S. (2025). Effectiveness of mobile health interventions on management of patients with hypertension?: a systematic review of systematic reviews. Frontiers of Nursing, 12(1), 1–12. https://doi.org/10.2478/FON-2025-0001
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References
Aji, P. T., Baidhowy, A. S., & Rizkasari, E. (2026). Empowering Older Adults with Hypertension through Community-Based Education on Warm Water Foot Soak and Deep Breathing Relaxation. Abdimas Umtas: Jurnal Pengabdian Kepada Masyarakat, 9(1), 560–571. https://doi.org/https://doi.org/10.35568/abdimas.v9i1.7668
Aji, P. T., Bhadowy, A. S., & Rizkasari, E. (2026). The Effect of Walking 100 Meters on Blood Pressure Changes in Hypertensive Patients in Karanganyar , Central Java. Healthcare Nursing Journal, 8(1), 116–123. https://doi.org/https://doi.org/10.35568/healthcare.v8i1.7227
Aji, P. T., & Lazuardi, N. (2025). Peningkatan Kepatuhan Minum Obat melalui Nurse-Led Self-Management Berbasis Edukasi Tatap Muka pada Pasien Hipertensi: Laporan Kasus. Ners Muda, 6(3), 1–8. https://doi.org/10.26714/nm.v6i3.20395
Aji, P. T., & Sani, F. N. (2021). Pengaruh Terapi Air Rebusan Daun Salam Terhadap Perubahan Teknan Darah pada Penderita Hipertensi di Wilayaha Tempurejo Jumapolo Karanganyar. In Jurnal Kesehatan (Vol. 12, Issue 13, pp. 50–63).
Alshammari;, B. G. A. E. R. S. H. kaliefah aldakeel; awatif M. alraseeday; salman H. alsaqri; B. A. F. (2024). Self-care practices among hypertensive patients at the primary health care centers in Unaizah city, Saudi Arabia. NURSING AND HEALTH POLICY PERSPECTIVE, 3(1), 1–8. https://doi.org/10.3389/fmed.2024.1290670
Aminde, L. N., Agbor, V. N., Fongwen, N. T., Ngwasiri, C. A., Nkoke, C., Nji, M. A., Dzudie, A., & Schutte, A. E. (2025). High Burden and Trend in Nonadherence to Blood Pressure-Lowering Medications: Meta-Analysis of Data From Over 34 000 Adults With Hypertension in Sub-Saharan Africa. Journal of the American Heart Association, 14(9), 1–13. https://doi.org/10.1161/JAHA.124.037555
Bao, R. (2021). FIU Digital Commons A Video-Based Educational Program in Improving Knowledge and Adherence to Medication Among Hypertensive Patients Aged Eighteen Years and Older in a Primary Care Office?: A Quality Improvement Project . FIU Digital Commons, 2(2), 1–45. https://digitalcommons.fiu.edu/cgi/viewcontent.cgi?article=1029&context=cnhs-studentprojects
Charchar, F. J., Prestes, P. R., Mills, C., Ching, S. M., Neupane, D., Marques, F. Z., Sharman, J. E., Vogt, L., Burrell, L. M., Korostovtseva, L., Zec, M., Patil, M., Schultz, M. G., Wallen, M. P., Renna, N. F., Islam, S. M. S., Hiremath, S., Gyeltshen, T., Chia, Y. C., … Tomaszewski, M. (2024). Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension. Journal of Hypertension, 42(1), 23–49. https://doi.org/10.1097/HJH.0000000000003563
Chimberengwa, P. T., & Naidoo, M. (2020). Using community-based participatory research in improving the management of hypertension in communities: A scoping review. South African Family Practice, 62(1), 1–14. https://doi.org/10.4102/safp.v62i1.5039
Eaton, C., Vallejo, N., Mcdonald, X., Wu, J., Rodr, R., Muthusamy, N., Mathioudakis, N., & Riekert, K. A. (2024). User Engagement With mHealth Interventions to Promote Treatment Adherence and Self-Management in People With Chronic Health Conditions?: Systematic Review Corresponding Author?: JOURNAL OF MEDICAL INTERNET RESEARCH, 26(6), 5. https://doi.org/10.2196/50508
Fira Indriyati et al, . (2025). Self Care and Blood Pressure Control Education Using Audio Visual for Self management in Hypertension. Indonesian Journal of Innovation Studies, 26(4), 1–17. https://doi.org/10.21070/ijins.v26i4.1807
Gurdogan, E. P. (2022). The effect of self-management support on knowledge level , treatment compliance and self ? care management in patients with hypertension AUTHORS. Australian Journal of Advanced Nursing, 39(3), 1–10.
Hermansson-Borrebaeck, R., Fors, A., Bengtsson, U., Kjellgren, K., Calling, S., & Midlöv, P. (2025). Self-Efficacy in Hypertension Management Using e-Health Technology: A Randomized Controlled Trial in Primary Care. Journal of Clinical Hypertension, 27(1), 1–8. https://doi.org/10.1111/jch.14981
Hoffman, R. S., Hoyte, C. O., Mazer-amirshahi, M. E., Stolbach, A., St-onge, M., Thompson, T. M., & Wang, G. S. (2023). 2023 American Heart Association Focused Update on the Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning?: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiov (Eric J (ed.); 4th ed.). AHA Focused Update. https://doi.org/10.1161/CIR.0000000000001161
Irwan, A. M., Potempa, K., Abikusno, N., & Syahrul, S. (2022). Self-Care Management for Hypertension in Southeast Asia: A Scoping Review. Journal of Multidisciplinary Healthcare, 15(September), 2015–2032. https://doi.org/10.2147/JMDH.S367638
Khanal, M. K., Bhandari, P., Dhungana, R. R., Bhandari, P., Rawal, L. B., Gurung, Y., Paudel, K. N., Singh, A., Devkota, S., & de Courten, B. (2021). Effectiveness of community-based health education and home support program to reduce blood pressure among patients with uncontrolled hypertension in Nepal: A cluster-randomized trial. PLoS ONE, 16(10 October), 1–17. https://doi.org/10.1371/journal.pone.0258406
Kim, H. J., Choi, G. W., Park, Y., Jeong, H. N., & Chang, S. J. (2025). Development of a health literacy-based hypertension self-management education program using sign language for Deaf individuals. BMC Health Services Research, 25(1), 1–12. https://doi.org/10.1186/s12913-025-13726-1
Kim, H. L., Park, S. M., Cho, I. J., Kim, Y. M., Kim, D. H., & Kim, S. H. (2023). Standardized protocol of blood pressure measurement and quality control program for the Korea National Health and Nutrition Examination Survey. Clinical Hypertension, 6(4), 1–12. https://doi.org/10.1186/s40885-023-00252-7
Luluk, S., & Ni, K. (2025). Relationship of High Stress with Hypertension in Adults?: Meta Analysis. Journal of Epidemiology and Public Health, 07(2022), 130–141. https://doi.org/https://doi.org/10.26911/jepublichealth.2022.07.01.11
Mourouti, N., Michou, M., & Costarelli, V. (2022). Health literacy in relation to health outcomes in hypertension?: A systematic review. Journal of Atherosclerosis Prevention and Treatment, 13(3), 1–10.
Pertiwi, L. D., Shobirun, S., & Indriyawati, N. (2021). Development Audiovisual Health Education Media for Self Management of Hypertension Patients. Media Karya Kesehatan, 4(2), 166–182. https://doi.org/10.24198/mkk.v4i2.30225
Pujiyanto, P. T. A. E. R. (2021). Pengaruh Terapi Guided Imagery terhadap Perubahan Tekanan Darah pada Penderita Hipertensi di Wilayah Puskesmas Jayengan Surakarta. Aisyiyah Surakarta Journal of Nursing, 2(1), 1–6. https://doi.org/https://doi.org/10.30787/asjn.v3i2.896
Puteri, G. A., Nashori, F., & Ramdani, Z. (2025). Enhancing self-acceptance in middle-aged patients with hypertension through dhikr relaxation therapy. Jurnal Ilmiah Psikologi Terapan, 13(2), 1–18. https://doi.org/10.22219/jipt.v13i2.33148
Raja-Ismail, R. I., Badlishah-Sham, S. F., Nik-Nasir, N. M., & Isa, M. R. (2024). Development and validation of a video-based intervention on self-care practices for patients with hypertension in Malaysian primary care settings. Malaysian Family Physician, 19, 1–10. https://doi.org/10.51866/oa.480
Rao, S. V., O’Donoghue, M. L., Ruel, M., Rab, T., Tamis-Holland, J. E., Alexander, J. H., Baber, U., Baker, H., Cohen, M. G., Cruz-Ruiz, M., Davis, L. L., de Lemos, J. A., DeWald, T. A., Elgendy, I. Y., Feldman, D. N., Goyal, A., Isiadinso, I., Menon, V., Morrow, D. A., … Hundley, J. (2025). 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. In Sunil (Ed.), Circulation (5th ed., Vol. 151, Issue 13). Circulation. https://doi.org/10.1161/CIR.0000000000001309
Ruksakulpiwat, S., Pongsuwun, K., Junphongsri, P., Preeprem, C., Nguantad, S., & Samart, B. (2025). Nurse-Led Interventions to Improve Health, Adherence, and Functional Outcomes in Adults and Older Adults With Multimorbidity: A Systematic Review of Randomized and Quasiexperimental Studies. Journal of Nursing Management, 2025(1), 1–15. https://doi.org/10.1155/jonm/6252049
Sangouni, A. A., Hosseinzadeh, M., & Parastouei, K. (2024). The effect of dietary approaches to stop hypertension (DASH) diet on fatty liver and cardiovascular risk factors in subjects with metabolic syndrome: a randomized controlled trial. BMC Endocrine Disorders, 24(1), 1–10. https://doi.org/10.1186/s12902-024-01661-x
Spruill, T. M. (2023). Chronic Psychosocial Stress and Hypertension. NIH Public Access, 12(1), 10–16. https://doi.org/10.1007/s11906-009-0084-8.Chronic
Tomitani, N., Kanegae, H., Suzuki, Y., Kuwabara, M., & Kario, K. (2021). Stress-Induced Blood Pressure Elevation Self-Measured by a Wearable Watch-Type Device. American Journal of Hypertension, 34(4), 377–382. https://doi.org/10.1093/ajh/hpaa139
Ukoha-, B. O., Samaila, A., Abubakar, M. M., Kalu, U. A., & Soyiri, I. N. (2023). Effectiveness of educational interventions on hypertensive patients ’ management behaviours?: an. BMJ Open, 5(4), 1–5. https://doi.org/10.1136/bmjopen-2023-073682
Upoyo, A. S., Sari, Y., Taufik, A., Anam, A., & Kuswati, A. (2024). The Effect of Online Group Education on Promoting Knowledge, Motivation, Self-Efficacy, Self-Care Behaviors and Preventing Uncontrolled Blood Pressure in Hypertensive Patients: A Quasi-Experiment Study. SAGE Open Nursing, 10(2), 1–14. https://doi.org/10.1177/23779608241299288
WHO. (2023). Global report on hypertension: the race against a silent killer. In Taskeen Khan (WHO Department of Noncommunicable Diseases) (Ed.), World Health Organization (WHO) (1st ed., Vol. 01). World Health Organization (WHO). https://www.who.int/publications/i/item/9789240081062?utm
World Health Organization. (2024). More than 700 million people with untreated hypertension. World Health Organization. https://www.who.int/news/item/25-08-2021-more-than-700-million-people-with-untreated-hypertension
Wu, S., Tu, X., Mou, G., Long, C., & Li, S. (2025). Effectiveness of mobile health interventions on management of patients with hypertension?: a systematic review of systematic reviews. Frontiers of Nursing, 12(1), 1–12. https://doi.org/10.2478/FON-2025-0001
