Interdisciplinary Journal of Ethnopsychiatric Nursing

Classical Gamelan Music Therapy for Sleep Quality and Cardiovascular Parameters in Third-Trimester Pregnant Women: A Case Series

2025-09-09T06:40:20+00:00

Background: Sleep disturbances severely impact third-trimester pregnant women, increasing adverse
obstetric risks. Non-pharmacological interventions are strongly preferred, yet culturally congruent
therapies like classical gamelan music remain critically underexplored in clinical practice.
Methods: In this prospective case series conducted between January and March 2026 in Indonesia, we
enrolled three third-trimester pregnant women experiencing severe sleep disturbances (Pittsburgh Sleep
Quality Index [PSQI] >5). Participants received a 3-day classical gamelan music therapy regimen (10–
15 minutes, twice daily). The primary outcomes included changes in PSQI global scores and sleep
duration, as well as secondary cardiovascular parameters including blood pressure.
Result: The three participants, aged 24 to 29 years, presented with severe baseline sleep fragmentation
(mean PSQI 13.7). Following the intervention, individual PSQI scores decreased substantially (Patient
A: 14 to 9; Patient B: 12 to 8; Patient C: 15 to 10). Mean nightly sleep duration increased from 3.8 to
6.0 hours. Concurrently, resting heart rates decelerated from a mean of 102 bpm to 81 bpm, and systolic
blood pressure normalized from 129 mmHg to 120 mmHg across all three individual participants.
Conclusion: A brief regimen of classical gamelan music therapy appears feasible and is associated with
marked improvements in subjective sleep quality and autonomic regulation in third-trimester pregnant
women. This culturally congruent, non-pharmacological intervention offers a safe, accessible adjunctive
strategy for gestational sleep management. Future large-scale randomised controlled trials with
objective polysomnographic endpoints are warranted to validate these preliminary findings and establish
definitive clinical efficacy and safety.

A Netnographic Study of Cross-Cultural Miscommunication in Digital Mental Health Nursing and Telepsychiatry Among Online Communities

2026-07-31T08:17:04+00:00

Background: A chatbot cannot ask about a patient's family before it asks about their symptoms, and in cultures where healing begins with relationship rather than data, that single omission may be where digital psychiatric care quietly loses the people it was built to reach. Telepsychiatry and tele-nursing platforms have expanded rapidly across Southeast Asia, yet whether these tools translate psychological distress across cultural boundaries, and not merely across language, remains poorly understood. This study explored how Indonesian- and Malay-speaking internet users described experiences of cross-cultural miscommunication with digital mental health providers.

Methods: A 20-week netnographic study was conducted across Indonesian- and Malay-language online communities discussing telepsychiatry, tele-nursing, and digital mental health applications. Publicly available discussion threads were analysed using an inductive, Braun-and-Clarke-informed thematic approach.

Results: Analysis of threads from participants who described a personal digital mental health encounter generated four interconnected themes: linguistic and semantic dissonance, relational asymmetry and digital etiquette mismatches, algorithmic cultural bias in screening, and an anonymity–trust paradox.

Conclusion: Cultural miscommunication in digital psychiatric nursing appears to cluster around the translation of idioms of distress and the compression of relational care into transactional data collection. Culturally responsive intake design and provider training may help narrow this gap, although the findings warrant confirmation in structured, representative samples.

Navigating Two Worlds: A Netnographic Study of Traditional Healing Integration within Digital Mental Health Communities and Implications for Psychiatric Nursing Practice

2026-07-31T04:01:45+00:00

Background: Indonesian mental health service users increasingly negotiate biomedical psychiatric treatment alongside jamu, dukun consultations, and spiritual rituals, yet how this negotiation is enacted and disclosed outside the clinic remains poorly documented. Objective: To examine how Indonesian-language digital communities construct, coordinate, and communicate the integration of traditional healing with psychiatric care, and to derive implications for psychiatric nursing practice.

Methods: An 18-week netnographic study (1 February–10 June 2026) of four Indonesian-language digital communities captured 1,563 threads and 9,847 posts from 2,489 participants who explicitly discussed integrating traditional healing with psychiatric treatment. Data were examined using reflexive thematic analysis.

Results: Five interconnected themes emerged: epistemological pluralism, concealment and selective disclosure, temporal negotiation patterns, digital knowledge translation, and identity preservation through healing. Most participants (63.0%) concealed traditional healing use from every provider, while digital communities functioned as informal sites of herb–drug interaction surveillance and peer knowledge exchange.

Conclusion: Traditional healing integration is better understood as a parallel, patient-managed care system than as covert non-adherence; psychiatric nurses require culturally responsive, non-judgemental assessment approaches that make this system visible rather than punishable

A Netnographic Study of Identity, Acculturative Stress, and Transnational Grief Among the Diaspora

2025-09-09T01:40:39+00:00

Background: International migration exposes diaspora populations to a distinctive constellation of psychological stressors, including acculturative friction, identity renegotiation, and disrupted mourning, that host-country psychiatric services rarely address in culturally congruent ways. Gap: Digital communities have become a primary site where diaspora members process these stressors, yet qualitative evidence describing how such platforms function as informal psychosocial infrastructure remains scarce, particularly for Southeast Asian diaspora populations. This study examined how global Indonesian diaspora communities construct cultural identity, negotiate acculturative stress, and manage transnational grief within digital spaces, with attention to implications for psychiatric nursing practice.

Methods: A 22-week netnographic observation was conducted across transnational Facebook groups, Reddit communities, Discord servers, and WhatsApp networks, capturing publicly archived discussion threads analysed thematically in accordance with Standards for Reporting Qualitative Research (SRQR) guidance.

Results: Four interrelated themes emerged: digital homeland and cultural anchoring; acculturative stress and the in-between identity; collective digital resilience and peer support; and transnational grief and intergenerational trauma. Diaspora members used online spaces to rehearse cultural practices, informally broker encounters with foreign healthcare systems, and mourn losses they could not physically attend.

Conclusion: Digital diaspora communities represent an underrecognised psychosocial resource; psychiatric nursing should engage with them directly through culturally responsive assessment and cross-sector partnership, rather than treating online help-seeking as a proxy for formal care.

A Netnographic Critique of Cultural Appropriation versus Cultural Competence in Digital Mental Health Ethnic Communities

2026-08-01T19:11:47+00:00

Background: Digital mental health campaigns increasingly incorporate local cultural symbols to improve engagement among ethnically diverse populations. However, whether these adaptations represent genuine cultural responsiveness or merely superficial branding remains unclear, particularly within Indonesia's multicultural context. This study explored how ethnic and indigenous communities interpret, contest, and reclaim the cultural authenticity of institutional digital mental health advocacy.

Methods: A qualitative netnographic study was conducted through 24 weeks of non-participant observation across Indonesian- and Malay-language digital ecosystems, including institutional social media platforms, community-led discussion forums, and professional nursing and psychiatric networks. Public discussion threads were purposively sampled and analysed using reflexive thematic analysis to identify recurring patterns of community interpretation.

Results: Four interrelated themes emerged: (1) tokenistic aesthetic inclusion, (2) decontextualisation of sacred healing practices, (3) community reclamation through counter-narrative production, and (4) a discursive transition from cultural competence toward cultural justice. Participants overwhelmingly perceived institutional campaigns as relying on symbolic cultural representation rather than meaningful collaboration, criticising the use of indigenous knowledge and cultural symbols without shared decision-making or reciprocal community benefit.

Conclusion: Superficial visual and linguistic localisation alone does not meet communities' expectations of culturally safe digital mental health advocacy. The findings suggest that psychiatric nursing and digital health communication should move beyond conventional cultural competence frameworks toward culturally just approaches that prioritise community co-design, shared governance, equitable benefit-sharing, and recognition of indigenous epistemic authority in the development of digital mental health campaigns.