The Role of Self-Directed E-Learning-Based Mental Health Models in Strengthening Mental Health Literacy among Nurses in West Lombok Regency, Indonesia: A Cross-Sectional Study

  • Sirajunnasihin Sirajunnasihin Faculty of Health, Science, and Technology, Department of Software Engineering Technology, Universitas Bima Internasional MFH, Mataram, Indonesia
  • Wulandari Dewi Susilawati Faculty of Health, Science, and Technology, Department of Medical Record and Health Information, Universitas Bima Internasional MFH, Mataram, Indonesia
  • Musparlin Halid Faculty of Health, Science, and Technology, Department of Medical Record and Health Information, Universitas Bima Internasional MFH, Mataram, Indonesia
Keywords: Mental Health, Self-Directed E-Learning, Mental Health Literacy, Nursing Psychology, Public Health Center

Abstract

Introduction: Nurses at Public Health Centers (PHCs) are at the forefront of providing health services, including mental health services. Adequate Mental Health Literacy (MHL) is crucial to enhance their ability to recognize, manage, and support patients with mental health disorders. Improving MHL through an Self-Directed E-Learning (SDE) based learning approach is expected to be an innovative solution to strengthen nurses' competencies. The study aimed to analyze the association between the self-directed e-learning-based mental health model and the strengthening of MHL among nurses at PHC.

Methods: The study used a cross-sectional design to analyze the association between exposure to SDE with the strengthening of MHL among nurses at PHC in West Lombok, West Nusa Tenggara, Indonesia, with a sample size of 263. Descriptive analysis was performed to describe the characteristics of the respondents. Chi-square and binary logistic regression tests were performed to determine the association between variables with a significance level of p<0.05 with 95% Confidence Interval (CI) and Adjusted Odds Ratio (AOR) to determine the depth of the association.

Results: The results of the study show that most nurses with high SDE exposure have better MHL-work levels than nurses with low SDE exposure. Males have a higher chance of achieving competency improvement than females (AOR=3.046; p=0.004). Participants with a Diploma in Nursing also showed a significant improvement compared to Bachelor of Nursing graduates (AOR=2.208; p=0.042). Work experience of ?5 years had a significant effect (AOR=2.851; p=0.006). A history of work-related MHL training significantly increased the likelihood of competency (AOR=3.575; p=0.001). Higher exposure to SDE, including the number of reflective discussion and practice sessions (AOR=2.333; p=0.029), longer e-learning duration (AOR=3.524; p=0.001), and the number of modules completed (AOR=2.617; p=0.018), and the number of mental disorder patients treated (AOR=3.703; p=0.001) were found to be significantly associated with increased competency. Meanwhile, workload did not show a significant association (p=0.231).

Conclusions: The study findings confirm that experience, education, training, and intensity of involvement in the SDE program are important determinants in improving MHL competencies.

Downloads

Download data is not yet available.

References

  1. Wang A, Jia S, Shi Z, Sun X, Zhu Y, Shen M, et al. Mental health literacy of Chinese nurses from public general and psychiatric hospitals: a cross-sectional study. Front Psychiatry. 2023;14(August). doi: 10.3389/fpsyt.2023.1148380. Available from: https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2023.1148380/full
  2. Wulf IC. Help-Seeking and Help-Outreach Intentions of Healthcare Workers—The Role of Mental Health Literacy and Stigma in the Workplace. Front Educ (Lausanne). 2022;7(May):1–16. doi: 10.3389/feduc.2022.856458. Available from: https://www.frontiersin.org/journals/education/articles/10.3389/feduc.2022.856458/full
  3. Marangu E, Mansouri F, Sands N, Ndetei D, Muriithi P, Wynter K, et al. Assessing mental health literacy of primary health care workers in Kenya: a cross-sectional survey. Int J Ment Health Syst. 2021;15(1):1–10. doi: 10.1186/s13033-021-00481-z. Available from: https://ijmhs.biomedcentral.com/articles/10.1186/s13033-021-00481-z
  4. Wang A, Jia S, Shi Z, Sun X, Zhu Y, Shen M. Validation and Psychometric Testing of the Chinese Version of the Mental Health Literacy Scale Among Nurses. Front Psychol. 2022;12(January). doi: 10.3389/fpsyg.2021.791883. Available from: https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.791883/full
  5. Richardson R, Dale HE, Robertson L, Meader N, Wellby G, McMillan D, et al. Mental Health First Aid as a tool for improving mental health and well-being. Cochrane Database of Systematic Reviews. 2023;2023(8). doi: 10.1002/14651858.CD013127.pub2. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013127.pub2/full
  6. Wang W, Xia J, Chen W, Ye J, Xie K, Zhang Z, et al. Exploring the interplay of mental health knowledge, stigma, and social distance among clinical nurses: a study in Liaoning, China. Front Psychiatry. 2025;16(February):1–11. doi: 10.3389/fpsyt.2025.1478690. Available from: https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1478690/full
  7. Korhonen J, Axelin A, Stein DJ, Seedat S, Mwape L, Jansen R, et al. Mental health literacy among primary healthcare workers in South Africa and Zambia. Brain Behav. 2022;12(12):1–12. doi: 10.1002/brb3.2807. Available from: https://onlinelibrary.wiley.com/doi/10.1002/brb3.2807
  8. Marthoenis M, Fitryasari R, Warsini S. Mental Health Literacy Among Female Community Health Workers: A Multi-setting Cross-sectional Study. Indian J Psychol Med. 2024;XX(X):1–5. doi: 10.1177/02537176241306137. Available from: https://journals.sagepub.com/doi/10.1177/02537176241306137
  9. Buta BO, Mota ACP, Couto V V.D., Tabak BM. Mental health literacy for public employees. BMC Public Health. 2024;24(1):1–9. doi: 10.1186/s12889-024-19937-1. Available from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-19937-1
  10. Ehmann AT, Ög E, Rieger MA, Siegel A. Work-related health literacy: A scoping review to clarify the concept. Int J Environ Res Public Health. 2021;18(19):9945. doi: 10.3390/ijerph18199945. Available from: https://www.mdpi.com/1660-4601/18/19/9945
  11. Bisri MH, Bakar NA. EXPLORING STAKEHOLDERS’ PSYCHOSOCIAL PERSPECTIVES IN ADDRESSING MENTAL HEALTH ISSUES WITHIN THE LOCAL COMMUNITY: A CASE STUDY IN MATARAM, WEST NUSA TENGGARA. Asian People Journal. 2024;7(1):223–38. doi: 10.37231/apj.2024.7.1.581. Available from: https://journal.unisza.edu.my/apj/index.php/apj/article/view/581
  12. Xing L, Lu Y, Zhang H, Shi Z, Chang S, Liu W, et al. Mediating effect of psychological capital on the relationship between mental health literacy and coping styles among newly recruited nurses. BMC Nurs. 2024;23(1):1–9. doi: 10.1186/s12912-024-01828-w. Available from: https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-024-01828-w
  13. Lindert L, Choi KE (Anna), Pfaff H, Zeike S. Health literacy at work – individual and organizational health literacy, health supporting leadership and employee wellbeing. BMC Health Serv Res. 2023;23(1):1–8. doi: 10.1186/s12913-023-09766-0. Available from: https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-023-09766-0
  14. Zhong SL, Wang S Bin, Ding KR, Tan WY, Zhou L. Low mental health literacy is associated with depression and anxiety among adults: a population-based survey of 16,715 adults in China. BMC Public Health. 2024;24(1):2721. doi: 10.1186/s12889-024-20020-y. Available from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-20020-y
  15. Kelly F, Uys M, Bezuidenhout D, Mullane SL, Bristol C. Improving Healthcare Worker Resilience and Well-Being During COVID-19 Using a Self-Directed E-Learning Intervention. Front Psychol. 2021;12(December):1–9. doi: 10.3389/fpsyg.2021.748133. Available from: https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.748133/full
  16. Li J, Wu C-H. Determinants of Learners’ Self-Directed Learning and Online Learning Attitudes in Online Learning. Vol. 15, Sustainability. 2023. p. 9381. doi: 10.3390/su15129381. Available from: https://www.mdpi.com/2071-1050/15/12/9381
  17. Chen Q, Zhao Z, Bao J, Lin J, Li W, Zang Y. Digital empowerment in mental health: A meta-analysis of internet-based interventions for enhancing mental health literacy. International Journal of Clinical and Health Psychology. 2024;24(3):100489. doi: 10.1016/j.ijchp.2024.100489. Available from: https://www.sciencedirect.com/science/article/pii/S1697260024000541?via%3Dihub
  18. Dickens GL, Ion R, Waters C, Atlantis E, Everett B. Mental health nurses’ attitudes, experience, and knowledge regarding routine physical healthcare: Systematic, integrative review of studies involving 7,549 nurses working in mental health settings. BMC Nurs. 2019;18:16. doi: 10.1186/s12912-019-0339-x. Available from: https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-019-0339-x
  19. Ye S, Yue W, Chen Y, Gui K, Li Y, He R, et al. The relationship between psychological capital and self-directed learning ability among undergraduate nursing students—a cross-sectional study. Front Psychol. 2024;15(September):1–14. doi: 10.3389/fpsyg.2024.1413151. Available from: https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2024.1413151/full
  20. Hizriansyah, Sirajunnasihin, Qudsi J. Self-directed e-learning-based mental health interventions to improve post-covid-19 pandemic health worker resilience and well-being. Science Midwifery. 2024;12(4):1646–56. doi: 10.35335/midwifery.v12i4.1707. Available from: https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1707
  21. Zhao X, Zheng WK, Wang XH, Fang J, Chen WJ, Li N, et al. Influence of perceived stress on professional identity among nursing students: a chain mediating role of self-control and self-directed learning ability. Front Med (Lausanne). 2024;11. doi: 10.3389/fmed.2024.1429014. Available from: https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1429014/full
  22. Park HJ, Kim S. Relationship between super-leadership and self-directed learning ability in online nursing education: The mediating effects of self-leadership and self-efficacy perceptions. Heliyon. 2023;9(6):e17416. doi: 10.1016/j.heliyon.2023.e17416. Available from: https://www.cell.com/heliyon/fulltext/S2405-8440(23)04624-8?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2405844023046248%3Fshowall%3Dtrue
  23. Pallant J. SPSS Survival Manual: A step by step guide to data analysis using IBM SPSS. 7th Editio. London: Routledge; 2020. 378 p. doi: 10.4324/9781003117452. Available from: https://www.taylorfrancis.com/books/mono/10.4324/9781003117452/spss-survival-manual-julie-pallant
  24. Bonanno R, Sisselman-Borgia A, Veselak K. Parental mental health literacy and stigmatizing beliefs. Soc Work Ment Health. 2021;19(4):324–44. doi: 10.1080/15332985.2021.1919815. Available from: https://www.tandfonline.com/doi/full/10.1080/15332985.2021.1919815
  25. Lam LT, Lam MK, Reddy P, Wong P. Efficacy of a Workplace Intervention Program With Web-Based Online and Offline Modalities for Improving Workers’ Mental Health. Front Psychiatry. 2022;13(May):1–8. doi: 10.3389/fpsyt.2022.888157. Available from: https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2022.888157/full
  26. Hermans L, Van den Broucke S, Gisle L, Demarest S, Charafeddine R. Mental health, compliance with measures and health prospects during the COVID-19 epidemic: the role of health literacy. BMC Public Health. 2021;21(1):1365. doi: 10.1186/s12889-021-11437-w. Available from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-11437-w
  27. Kang SJ, Hyung JA, Han H-R. Health literacy and health care experiences of migrant workers during the COVID-19 pandemic: a qualitative study. BMC Public Health. 2022;22(1):2053. doi: 10.1186/s12889-022-14487-w. Available from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-14487-w
  28. Amone-P’Olak K, Kakinda AI, Kibedi H, Omech B. Barriers to treatment and care for depression among the youth in Uganda: The role of mental health literacy. Front Public Health. 2023;11:1054918. doi: 10.3389/fpubh.2023.1054918. Available from: https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1054918/full
  29. Fakhari A, Shalchi B, Rahimi VA, Naghdi Sadeh R, Lak E, Najafi A, et al. Mental health literacy and COVID-19 related stress: The mediating role of healthy lifestyle in Tabriz. Heliyon. 2023;9(7). doi: 10.1016/j.heliyon.2023.e18152. Available from: https://www.cell.com/heliyon/fulltext/S2405-8440(23)05360-4?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2405844023053604%3Fshowall%3Dtrue
  30. Yeo G, Reich SM, Liaw NA, Chia EYM. The Effect of Digital Mental Health Literacy Interventions on Mental Health: Systematic Review and Meta-Analysis. J Med Internet Res. 2024;26:e51268. doi: 10.2196/51268. Available from: https://www.jmir.org/2024/1/e51268
  31. Simões de Almeida R, Trigueiro MJ, Portugal P, de Sousa S, Simões-Silva V, Campos F, et al. Mental Health Literacy and Stigma in a Municipality in the North of Portugal: A Cross-Sectional Study. Vol. 20, International Journal of Environmental Research and Public Health. 2023. p. 3318. doi: 10.3390/ijerph20043318. Available from: https://www.mdpi.com/1660-4601/20/4/3318
  32. Kavanaugh EB. Information Literacy, Mental Health, and Lifelong Learning: Librarians and Health Care Professionals in Academic, Clinical, and Hospital Settings. J Hosp Librariansh. 2021;21(1):20–35. doi: 10.1080/15323269.2021.1860449. Available from: https://www.tandfonline.com/doi/full/10.1080/15323269.2021.1860449
  33. Marinucci A, Grové C, Allen K-A, Riebschleger J. Evaluation of a youth mental health literacy and action program: Protocol for a cluster controlled trial. Ment Health Prev. 2021;24:200216. doi: 10.1016/j.mhp.2021.200216. Available from: https://www.sciencedirect.com/science/article/abs/pii/S2212657021000209?via%3Dihub
  34. Jones A. Postpartum Help-Seeking: The Role of Stigma and Mental Health Literacy. Matern Child Health J. 2022;26(5):1030–7. doi: 10.1007/s10995-022-03399-1. Available from: https://link.springer.com/article/10.1007/s10995-022-03399-1
  35. Drissi N, Ouhbi S, Marques G, de la Torre Díez I, Ghogho M, Janati Idrissi MA. A Systematic Literature Review on e-Mental Health Solutions to Assist Health Care Workers During COVID-19. Telemedicine and e-Health. 2020;27(6):594–602. doi: 10.1089/tmj.2020.0287. Available from: https://www.liebertpub.com/doi/10.1089/tmj.2020.0287
Published
2026-02-02
How to Cite
Sirajunnasihin, S., Wulandari Dewi Susilawati, & Musparlin Halid. (2026). The Role of Self-Directed E-Learning-Based Mental Health Models in Strengthening Mental Health Literacy among Nurses in West Lombok Regency, Indonesia: A Cross-Sectional Study. Media Publikasi Promosi Kesehatan Indonesia (MPPKI), 9(2), 356-368. https://doi.org/10.56338/mppki.v9i2.8806
Section
Article

Most read articles by the same author(s)