Hrev_master Healthcare in Low-resource Settings 2024; volume 12(s1):13063 A model of nursing intervention on the psychological needs of a group of neighborhood children in a shelter place in Surabaya Dyah Wijayanti, Siti Nur Kholifah, Dinarwiyata Health Polytechnic of the Health Ministry of Surabaya, Surabaya, East Java, Indonesia Abstract The fulfillment of the psychological needs of neglected chil- dren in shelters is important. However, only the physical need has been fulfilled, resulting in a feeling of dissatisfaction and hampers a positive attitude towards the social environment. Therefore, this study aimed to present a significant nursing intervention model to meet the psychological needs of neglected children. The model integrates behavioral (Lawrence Green), Caring (Jean Watson), and psychogenic needs theory (Murray) to explain the influence of predisposing, enabling, and supporting factors on behavior. This study adopted a cross-sectional design and observational analytic method with a population of 240 neglected children in Surabaya city shelters. The cluster sampling rule of thumb was used in SEM to select 110 (5x22 observe variables) respondents. The result showed that the unique aspects of the group nursing intervention model fulfilled the psychological needs of adolescents in shelters. Furthermore, interpersonal human caring behavior was influenced by predisposing factors and care values with a coefficient value of 0.203. Supporting factors and environmental caring had a coeffi- cient of 0.220 while driving was 0.332. In conclusion, this study showed that the group nursing intervention model fulfilled the psychological needs of adolescents in shelters by integrating the theories of goal attainment, caring (Jean Watson), and psychoso- cial (Murray). These theories increased adolescent parenting actions, thereby enhancing self-confidence within shelters. Introduction The number of neglected children in Indonesia is increasing, necessitating the urgency of addressing their need to become qual- ity national assets. These neglected children are vulnerable in a society where one or both parents are sick or dead. Consequently, the parents are unable to meet the children’s needs, leading to disharmony within the family. Neglecting children can lead to delays in physical development and neurological repercussions, as well as induced psychological problems. A previous study showed that the number of neglected children in Indonesia was 67,368 in 2020.1 According to data from the Central Bureau of Statistics for East Java Province, the number was 118,718, and 6,349 in Surabaya. Neglected children are significantly affected physically and psychologically, as reported in a previous study.2 Fulfilling both psychological and physiological needs is cru- cial, as a lack of nutrition can lead to illness. Similarly, unfulfilled psychological needs can lead to dissatisfaction, frustration, and disrupt the growth and development of a positive attitude toward the community.3 This study developed a new model in the field of community homicide by integrating behavioral (Lawrence Green), Caring (Jean Watson), the human interaction theory (King), and the concept of psychogenic needs from Murray. No previous study has been conducted on this constructed surgical intervention model. Therefore, the novelty of this study is an inter- vention model that community nurses can use in providing inter- vention. This condition will impact personality maturity, a positive attitude towards the environment, and a spirit of independence.4 Neglected children whose psychological needs have been fulfilled will become a quality young generation for the development of Indonesia. Materials and Methods The study used a cross-sectional design with a population of 240 neglected children living in 8 Surabaya shelters. The sample size used the rule of thumb in the Structural Equation Model (SEM), with the maximum likelihood method requiring 5 x 22 indicators (observed variables) with 110 respondents. The vari- ables that will be described are each dimension of Predisposing Factors and Values (X1), Supporting (X2), Pushing (X3), Parenting Behavior (X4), and Psychological Needs (Y). The SEM was used based on variance or component-based SEM, known as Smart Partial Least Square version 2.0 (Smart PLS, 2.0).5 Results and Discussion Table 1 shows the description of the characteristics of the tribe and length of stay of respondents. The criteria for the majority of ethnicity are Javanese, with 108 respondents or 98.2%, and only 2 for other ethnic groups, accounting for 1.8%. It shows that the answer chosen by 50% of the respondents for length of stay was 1-6 months, followed by 7- 12 months and greater than 1 year for 35 (31.8%) and 15 (13.7%), [Healthcare in Low-resource Settings 2024;12(s1):13063] [page 113] Significance for public health Neglected children in shelters often have their emotional well-being overlooked, even though their physical needs are being addressed. Implementing a thought- ful nursing intervention model that draws from various theories is crucial. This approach can effectively cater to the psychological needs of these children, particularly adolescents, and boost their self-confidence. Non -co mmerc ial us e o nly respectively. Table 2 explains the description of predisposing fac- tor variables and values Two dimensions of predisposing factors had more scores in the high category, namely attitude and motivation, accounting for 66 (60%) and 91 (82.7%) respondents, respectively. Meanwhile, com- mitment was in the low category with 57 respondents at 51.8%. Table 3 shows the description of the supporting factors. All dimen- sions of supporting factors are in the high category, namely learn- ing, social, counseling facilities, and achievement opportunities with 65 (59.1%), 77 (70%), 82 (74.5%), and 66 (60%), respective- ly. Table 4 shows the motivating factors, parenting behaviors and psychological needs. Two dimensions within the parenting behav- ior factor had a higher prevalence in the high category. Interpersonal communication had 70 respondents (63.6%), while actions aimed at enhancing self-confidence were reported by 58 (52.7%). The remaining two dimensions are more commonly clas- sified within the moderate category, namely health education and parenting strategies, accounting for 66 (60%) respondents each. The descriptive statistics showed that the psychological needs of the six dimensions are in the lower category, namely affiliation, autonomy, division, respect, order, and understanding. There was improvement in one dimension with the number of respondents in both low and high categories remaining consistent at 55. In the achievement dimension, there are slightly more respondents in the high category, accounting for 56 (50.9%), compared to 54 (49.1%) in the low category. The results of this study showed the importance of implement- ing group nursing interventions to achieve the psychological needs of adolescents in shelters, with a coefficient of 0.794. Human car- ing interpersonal behavior was directly influenced by predisposing factors, nurturing values, supporting factors, and environmental caring with coefficients of 0.203, 0.220, and 0.332, respectively. These results showed that the group nursing intervention model fulfilled the psychological needs of adolescents by integrating goal attainment and Jean Watson’s caring theories, as well as Murray’s psychosocial needs. This model can improve predisposing factors and care values , including attitudes, motivation, and commitment of administra- tors/caregivers. Supporting factors and environmental caring were also enhanced as critical infrastructure in fulfilling adolescents’ psychological needs. Furthermore, driving factors consisting of legal aspects, family, and community support were increased to 4th International Nursing and Health Sciences Symposium Table 1. Description of the characteristics of the tribe and length of stay (N=110). Criteria Frequency Percentage (%) Tribes Java 108 98.2 Bugis 2 1.8 1-6 months 60 54.5 Length of stay 7-12 months 35 31.8 >1 year 15 13.7 Table 2. Frequency distribution of predisposing factor (N=110). Self-leadership Frequency Percentage (%) Dimension Category Attitude Low 44 40.0 High 66 60.0 Motivation Low 19 17.3 High 91 82.7 Commitment Low 57 51.8 High 53 48.2 Table 3. Frequency distribution of the supporting factors (N=110). Supporting factors Frequency Percentage (%) Dimension Category Learning Facilities Low 45 40.9 High 65 59.1 Socialization Facility Low 33 30.0 High 77 70.0 Counseling Facilities Low 28 25.5 High 82 74.5 Achievement OpNHigh 66 60.0 Table 4. Frequency distribution of motivating factor, parenting behavior, psychological needs (N=110). Categories Category Frequency Percentage (%) Motivating factor Parenting system Low 26 23.6 High 84 73.4 Family support Low 20 18.2 High 90 81.8 Community Support Low 14 12.7 High 96 87.3 Parenting behavior Interpersonal communication Low 40 36.4 High 70 63.6 Health Education Low 66 60.0 High 44 40.0 Parenting Actions Low 57 51.8 High 53 48.2 Actions increase confidence Low 52 47.3 High 58 52.7 Psychological needs Achievement Low 54 49.1 High 56 50.9 Affiliate Low 57 51.8 High 53 48.2 Autonomy Low 63 57.3 High 47 42.7 Correcting the situation Low 55 50.0 High 55 50.0 Split Yourself Low 65 59.1 High 45 40.9 Respect Low 62 56.4 High 48 43.6 Orderliness Low 66 60.0 High 44 40.0 Understanding Low 60 54.5 High 50 45.5 [page 114] [Healthcare in Low-resource Settings 2024;12(s1):13063] Non -co mmerc ial us e o nly fulfill the psychological needs of adolescents living in shelters. The implementation of health education for adolescents needs to be enhanced by developing collaboration between the social and health services in implementing education periodically. This model increased parenting actions in adolescents and improved self-con- fidence in several ways. The result of this study on the need to improve the situation had the same percentage between high and low, namely 50%. Meanwhile, the need for Counteraction (Improving the problem) was defined as the adolescent’s need to correct failures, suppress fear, and maintain self-esteem.6 Positive relationships with friends will further strengthen adolescents’ feelings of value to others. Remembering and sharing experiences with friends is extremely important during adolescence, as it significantly impacts their behaviour and overall well-being. The quality of friendships plays a crucial role in the mental development of adolescents, influenc- ing companionship, trust, closeness, and how they handle con- flicts.7-9 Therefore, shelter caregivers need to help adolescents overcome mistakes and disappointments from an early age. The best way to increase adolescents’ self-esteem is to take an active role in their early life. The majority of results regarding the need for self-defense (59.1%) were in the low category. The concept of self-defense in this study relates to safeguarding oneself against attacks, criticism, and blame. The results of data analysis from the questionnaire administered to adolescents showed that caregivers occasionally afford opportunities for reasoning or argumentation when adoles- cents are guilty. According to a previous study, adolescents’ needs for self-defense will be fulfilled when given the freedom to speak and take action, explore the environment, justice, honesty, and fair- ness.10-12 The analysis results of the psychological need for respect were 56.4% high. Deference (Respectful attitude) implies respecting and happily submitting to the influence of others. The results of the questionnaire data analysis showed that the adolescents greeted, did not speak louder, and were reluctant towards the caretakers of the shelter. Respect for adolescents is based on the recognition that each individual possesses inherent value by virtue of uniqueness and diversity. According to a previous study, showing respect is speaking calmly and politely, specifically to older people.13-15 The study on psychological needs on the order component found that most (60%) were in the high category. The need for order in this study is defined as the need for adolescents to orga- nize things and maintain cleanliness and order. The results of data analysis through adolescents’ answers showed that most adoles- cents had arranged personal belongings and rarely borrow from friends without permission. Remembering and sharing experiences with peers is crucial during adolescence, as it significantly impacts their behaviour and overall well-being. The quality of friendships plays a vital role in the emotional growth of adolescents, influenc- ing their feelings of companionship, trust, closeness, and ability to resolve conflicts.16-18 The results of the psychological needs showed that the major- ity of the data (54.5%) were in the low category. Analysis of answers to the questionnaire showed that adolescents already understand the conditions of the shelter. Caregivers, however, still perceived the majority as lacking cognitive maturity. The necessity for comprehension involves posing or addressing general inquiries concerning the shelter circumstances. This comprehension is cru- cial for fostering a solid self-acceptance of the shelter’s exis- tence.19 Furthermore, the application of the group nursing interven- tion model fulfilled the psychological needs of adolescents in shel- ters. Quantitatively, the statistical test results of H0 were rejected, showing that there were differences in psychological needs before and after implementing the group nursing intervention model. The results of this test were strengthened by interviews with adoles- cents at the shelter who already felt confident and were willing to participate in community organization activities. This model was recommended to the Head of Social Services as material for build- ing development programs for adolescents in shelters. In addition, the results are recommended for universities with a Faculty of Psychology to ensure counselors’ contribution to neglected chil- dren. The analysis results showed that implementing group nursing interventions was important for fulfilling the psychological needs of adolescents in shelters, as evidenced by a coefficient of 0.794. Human caring interpersonal behavior was directly influenced by predisposing, nurturing values, and driving factors, supported by coefficient values of 0.203, 0.220, and 0.332, respectively. These results showed that the development of a group nursing interven- tion model addressed the psychological needs of adolescents in nursing homes. This model integrated Goal Attainment and Jean Watson’s Caring Theory, as well as Murray’s Psychosocial Needs, providing a comprehensive framework for effective intervention. Furthermore, the model improved predisposing factors and care values , including attitudes, motivation, and commitment of care- givers. Factors that support and advocate for environmental care has been recognized as crucial infrastructure in addressing the psy- chological needs of adolescents. Significant drivers in this context encompass legal considerations and the backing of family and the community, which have been amplified to address these psycho- logical requirements. This model underscores empathetic human interaction, seeking to improve interpersonal communication to cultivate positive perceptions and better fulfil adolescents’ psycho- logical needs. Implementing health education for adolescents should be enhanced by fostering collaboration between social and health services to ensure consistent delivery of education.20-23 Conclusions In conclusion, the group nursing intervention model was struc- tured with components, consisting of predisposing, supporting, and driving factors, as well as values of care and interpersonal human caring behavior. Predisposing factors and care values were important to improve interpersonal human caring behavior. In this study, the indicators of predisposing factors and values of care included caregivers’ attitudes, motivation, and commitment. Furthermore, supporting factors and a caring environment improved interpersonal human caring behavior and the Indicators included learning, socialization, and counseling facilities, as well as opportunities to develop achievements. Driving factors with several indicators, such as parenting atti- tudes, family, and community support also improved interpersonal human caring behavior, which had an essential effect on the psy- chological needs of adolescents. The indicators of this variable were communication, health education, parenting actions, and actions to increase self-confidence. 4th International Nursing and Health Sciences Symposium [Healthcare in Low-resource Settings 2024;12(s1):13063] [page 115] Non -co mmerc ial us e o nly References 1. Coordinating Ministry for Human Development and Culture of the Republic of Indonesia. Handling Abandoned Children Needs Commitment | Coordinating Ministry for Human Development and Culture [Internet]. 2020 [cited 2023 Aug 13]. Available from: https://www.kemenkopmk.go.id/penanganan-anak-terlantar- butuh-komitmen. 2. Firadika AR. Handling of Abandoned Children by the Social Service Based on Article 34 of the 1945 Constitution (Case Study of the Social Service of Gowa Regency) [Internet] [diploma]. Alauddin State Islamic University Makassar; 2017 [cited 2023 Aug 13]. Available from: http://repositori.uin-alauddin. ac.id/4261/. 3. Ali M. Psychology of Adolescents. Jakarta: Bumi Aksara; 2006. 4. Hurlock EB. Developmental Psychology A Lifespan Approach. 5th ed. Soedjarwo ABDI dan D, editor. Jakarta: PT.Erlangga; 2007. 5. Kuntoro. Sampling Methods and Determination of Sample Size. Surabaya: Pustaka Melati; 2010. 6. Nurhafni A, Kadam N. Self-Concept And Achievement Motivation In Adolescents Residents of “X” Orphanage yogyakarta [Internet] [thesis]. UIN Sunan Kalijaga Yogyakarta; 2019 [cited 2023 Aug 13]. Available from: https://digilib.uin- suka.ac.id/id/eprint/51878/. 7. Alsarrani A, Hunter RF, Dunne L, Garcia L. Association between friendship quality and subjective wellbeing among adolescents: a systematic review. BMC Public Health 2022;22:2420. 8. Hamm J, Faircloth B. The role of friendship in adolescents’ sense of belonging. New directions for child and adolescent develop- ment. 2005;2005:61–78. 9. Abrams Z. The science of friendship [Internet]. 2023 [cited 2023 Aug 13]. Available from: https://www.apa.org/monitor/ 2023/06/cover-story-science-friendship 10. Peace Over Violence. Empowerment Self-Defense — Peace Over Violence [Internet]. 2024 [cited 2024 Feb 13]. Available from: https://www.peaceoverviolence.org/empowerment-self- defense 11. Givler JI. Self-Defense for Teens. Strategies 2005;18:24–5. 12. Strategic Living. Strategic Living. 2021 [cited 2023 Aug 13]. Self Defense Class For Teen Girls Seattle WA. Available from: https://www.strategicliving.org/classes-item/for-teen-girls-only/ 13. van der Geugten W, Goossensen A. Dignifying and undignifying aspects of care for people with dementia: a narrative review. Scand J Caring Sci 2020;34:818-38. 14. Søvde BE, Hovland G, Ullebust B, Råholm MB. Struggling for a dignifying care: experiences of being next of kin to patients in home health care. Scand J Caring Sci 2019;33:409-16. 15. Anderson JG, Bartmess M, Hundt E, Jacelon C. "A Little Bit of Their Souls": Investigating the Concept of Dignity for People Living With Dementia Using Caregivers' Blogs. J Fam Nurs 2021;27:43-54. 16. Burk WJ, Laursen B. Adolescent perceptions of friendship and their associations with individual adjustment. Int J Behav Dev 2005;29:156-64. 17. Faur S, Leggett-James MP, Kaniušonytė G, Žukauskienė R, Laursen B. Perceptions of relationship quality that predict friend- ship dissolution during childhood and adolescence: Social sup- port matters more than negativity. Dev Psychol 2024;60:560-6. 18. Hiatt C, Laursen B, Mooney KS, Rubin KH. Forms of Friendship: A Person-Centered Assessment of the Quality, Stability, and Outcomes of Different Types of Adolescent Friends. Pers Individ Dif 2015;77:149-55. 19. Allen L, Kelly BB, Committee on the Science of Children Birth to Age 8: Deepening and Broadening the Foundation for Success, Institute of Medicine, National Research Council. Child Development and Early Learning. In: Transforming the Workforce for Children Birth Through Age 8: A Unifying Foundation [Internet]. National Academies Press (US); 2015 [cited 2023 Aug 13]. Available from: https://www.ncbi. nlm.nih.gov/books/NBK310550/ 20. Ryff CD, Keyes CL. The structure of psychological well-being revisited. J Pers Soc Psychol 1995;69:719-27. 21. van Dierendonck D, Díaz D, Rodríguez-Carvajal R, et al. Ryff’s Six-factor Model of Psychological Well-being, A Spanish Exploration. Soc Indic Res 2008;87:473–9. 22. Hall CS, Lindzey G. Personality Psychology I Psychodynamic Theories (Clinical). Yogjakarta: Kanisius; 1993. 23. Alligood MR. Nursing Theorists and Their Work. 10th–23rd ed. America: Mosby; 2021. 4th International Nursing and Health Sciences Symposium [page 116] [Healthcare in Low-resource Settings 2024;12(s1):13063] Correspondence: Dyah Wijayanti, S.Kep., Ns., M.Kep.; Nursing Department Health Polytechnic of the Health Ministry of Surabaya, Pucang Jajar Tengah Street No. 56, 60282 Kertajaya, Gubeng, Surabaya, East Java, Indonesia. Tel. +62315028141- Fax: +62-5028141. E-mail: dyahwi@poltekkesdepkes-sby.ac.id Key words: children; model of nursing intervention; psychological needs Contributions: the authors contributed equally to increase adolescent self-confidence in shelters Conflict of interest: the author declares no potential conflict of interest. Funding: this study was financially supported by the Association of Indonesian Nursing Vocational Education Institutions (AIPViKI) grant- funded Ethics approval: Ethical approval has been granted by the Ethics Board of the Health Polytechnic of the Ministry of Health in Surabaya, under the reference number EA/1205/KEPK-Poltekkes_Sby/V/2023. Clinical trials: not applicable. Conference presentation: part of this article was presented at the 4th International Nursing and Health Sciences Symposium, from 27th-28th of October 2023, Universitas Brawijaya, Malang, East Java, Indonesia. Acknowledgment: the authors are grateful to the Director of Surabaya Health Polytechnic for supporting this study. The authors are also grate- ful to the Association of Indonesian Nursing Vocational Education Institutions (Asosiasi Institusi Pendidikan Indonesia/AIPViKI) for fund- ing this study. Received: 3 November 2023. Accepted: 12 June 2024. Early view: 10 September 2024. This work is licensed under a Creative Commons Attribution 4.0 License (by-nc 4.0). ©Copyright: the Author(s), 2024 Licensee PAGEPress, Italy Healthcare in Low-resource Settings 2024; 12(s1):13063 doi:10.4081/hls.2024.13063 Publisher's note: all claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organi- zations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher. Non -co mmerc ial us e o nly