Proceedings of the International Conference on Nursing and Health Sciences
Proceedings of the International Conference on Nursing and Health Sciences is a conference collection of official papers generously accessible to scholars over the world. This publication is dedicated to report original research findings, best practices, and review articles presented at International Conference on Nursing and Health Sciences. provides a forum for sharing timely and up-to-date publication of scientific research, health care and promoting the development of nursing, public health, community, environmental and occupational health, epidemiology, health promotion, health policy, nutrition, environmental health and safety, nursing and midwifery, and other sciences related to health development, and applied science in health.
Respiratory Health Risks Due to Exposure to Secondhand Smoke in Pregnant Women and Their Impact on Pregnancy Outcomes: A Literature Review
Exposure to secondhand smoke (SHS) during pregnancy is a significant public health concern, particularly within households, as it can adversely affect maternal respiratory health and pregnancy outcomes. Objective to review the current evidence regarding SHS exposure in pregnant women, its impact on respiratory health, and pregnancy outcomes. A literature review was conducted on national and international journals published between 2018 and 2024. Studies were extracted based on their characteristics, sources of SHS, effects on maternal respiration, and pregnancy outcomes. Five Indonesian journals and five international journals were selected to represent both national and global contexts. The analysis indicated that households are the primary source of SHS exposure, particularly from husbands or other family members who smoke. This exposure leads to maternal respiratory disturbances, such as cough, shortness of breath, increased carbon monoxide levels, and reduced oxygen saturation. Adverse pregnancy outcomes include low birth weight, shorter body length, smaller head circumference, preterm birth, and maternal complications such as placental abruption. Similar findings have been reported internationally, highlighting the cumulative nature and significant risks of SHS exposure for both mother and fetus. \ SHS exposure during pregnancy negatively affects maternal respiratory health and pregnancy outcomes. Health interventions should target all family members, particularly active smokers in the household, to reduce exposure and maternal–fetal complications.
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The Role of the Nursing Committee on Nurse Professionalism in Providing Nursing Care
Nurse professionalism is a fundamental component in improving the quality of healthcare services in hospitals. The Nursing Committee plays a strategic role in maintaining professional standards, credentialing, supervision, and ethical guidance in nursing practice. Strengthening the function of the Nursing Committee is expected to enhance nurse professionalism in delivering comprehensive and quality nursing care. This study aimed to analyse the role of the Nursing Committee on nurse professionalism in providing nursing care at Alimuddin Umar Regional General Hospital in 2025. This quantitative analytic study used a cross-sectional design. The research was conducted at Alimuddin Umar Regional General Hospital in 2025. The population consisted of nurses working in inpatient and related units. Samples were selected based on inclusion criteria using an appropriate sampling technique. The independent variable was the role of the Nursing Committee, while the dependent variable was nurse professionalism in providing nursing care. Data were collected using structured questionnaires and analysed through univariate, bivariate (chi-square test), and multivariate logistic regression analyses with a significance level of p<0.05. The majority of respondents perceived that the Nursing Committee performed its role effectively. Most nurses demonstrated good professionalism in providing nursing care. Bivariate analysis showed a significant association between the role of the Nursing Committee and nurse professionalism (p<0.05). Multivariate analysis indicated that the effective role of the Nursing Committee significantly influenced nurse professionalism. The role of the Nursing Committee is significantly associated with nurse professionalism in providing nursing care. Strengthening the committee’s functions in supervision, credentialing, evaluation, and professional development is essential to enhance nursing service quality.
The Relationship Between Social Protection and Stunting Incidence in Toddlers
A child is classified as stunted if the length or height according to age is lower than the applicable national standard. The study showed that heredity only slightly (4-7% in women) affects a person's height at birth. In contrast, the influence of environmental factors at birth was very large (74-87% in women). This proves that supportive ecological conditions can help children's growth and development. The research design in this study is analytic with a cross-sectional approach. Data analysis used univariate and multivariate analysis. The results of the analysis of the relationship between social protection ownership showed that as many as 159 (71.0%) toddlers who did not have social protection were stunted. Meanwhile, among toddlers with social protection, 94 (55.0%) experience stunting. The results of the analysis obtained OR = 2.004 meaning that toddlers who do not have social protection have a 2.004 chance times to experience stunting compared to toddlers who have social protection. There is a significant relationship between social protection and the incidence of stunting in children aged 0-59 months in Pringsewu Regency in 2021 (p-value = 0.001, OR = 2.004).
Detecting A School-Based Foodborne Outbreak in Wonogiri 2025
School feeding programmes play a critical role in improving student nutrition. However, inadequate food safety practices may increase the risk of foodborne outbreaks. On 12 September 2025, a suspected foodborne outbreak was reported among students of a senior high school in Wonogiri District, Central Java, Indonesia, following consumption of meals provided through the Free Nutritious Meal Programme (MBG). To investigate the magnitude, epidemiological characteristics, and source of a school-based foodborne outbreak. A cross-sectional outbreak investigation was conducted among all students who consumed the implicated meals on 11 September 2025. A case was defined as any exposed student who developed at least one symptom, including diarrhoea, abdominal pain, nausea, vomiting, dizziness, or fever. Data were collected through structured interviews, environmental assessment of food preparation and storage practices, and laboratory testing of food and water samples. Descriptive analysis by person, place, and time was performed, and food-specific attack rates were calculated. Of 516 exposed students, 340 developed symptoms, resulting in an overall attack rate of 66%. The most frequently reported symptoms were abdominal pain (26.1%), diarrhoea (25.0%), nausea (16.7%), and vomiting (14.9%). Consumption of eggs prepared with barbeque sauce showed the highest attack rate (71%) compared with non-consumers (28%). The epidemic curve demonstrated a point-source outbreak, with symptom onset occurring 20 - 35 hours after exposure. Laboratory analysis detected Escherichia coli contamination in egg, sauce, and vegetable samples, with possible co-contamination by Salmonella spp. Environmental assessment identified improper food handling, inadequate temperature control, and prolonged food storage prior to distribution. This outbreak was most likely associated with contamination of egg-based dishes served in a school feeding setting. Strengthening food safety protocols, hygiene training for food handlers, and routine monitoring of school meal provision are essential to prevent future foodborne outbreaks.
A Legal Sociological Analysis of Cases of Non-Narcotic Substance Abuse in Whip Pink Circulating in Society in Indonesia
The phenomenon of substance abuse in Indonesia has undergone a paradigm shift with the emergence of New Psychoactive Substances (NPS) and the use of legal commodities for recreational purposes. This study aims to analyze the construction of sociological meanings of Whip Pink (Nitrous Oxide/ N2O ) and identify the obstacles of legal instruments in reaching its distribution. Through a sociological legal approach, it was found that there has been a shift in the objective meaning of N2O from a culinary aid to an instrument of "intoxication" normalized by urban culture. Legally, law enforcement is hampered by the principle of legality (nullum delictum) because this substance is not listed in the appendix to Law No. 35 of 2009 concerning Narcotics. The results of the study indicate that the legal vacuum and bureaucratic obstacles in the classification of new substances create gaps for the free circulation of dangerous psychoactive substances. This study recommends the need for regulatory flexibility in the 2026 National Criminal Code and the strengthening of the function of forensic laboratories to respond to the dynamics of NPS in real time
Exploring The Relationship between Sleep Related Myths among Pregnant Women and Stunting: Literatur Review
Stunting remains a major public health problem in Indonesia, with its incidence largely influenced by the first 1,000 days of life. Such traditions, including taboos and unsafe practices like home delivery, can increase the risk of complications for both mothers and newborns 1. Cultural beliefs and practices related to the care of pregnant and postpartum women are still widely found within communities2. In the third trimester, many pregnant women experience sleep difficulties due to physical discomfort or frequent urination at night, making daytime naps important. This study aims to examine the cultural myth of prohibiting daytime naps during pregnancy and its potential impact on maternal sleep quality, birth outcomes, and stunting prevention. The study employed a comprehensive literature review. Data were collected from Scopus, Google Scholar, and media articles, using specific inclusion and exclusion criteria to ensure relevance and quality. Findings indicate that myths discouraging daytime naps in pregnancy, particularly in Javanese culture, may exacerbate maternal sleep deprivation, affect fetal growth, and increase the risk of low birth weight a known contributor to stunting. While these cultural beliefs have been passed down through generations, they can hinder the promotion of healthy sleep practices in pregnancy. This research provides evidence to dispel unfounded cultural myths and highlights the importance of adequate maternal sleep, including daytime naps, for healthy pregnancy outcomes and stunting prevention. Continuous education from healthcare providers, community leaders, and families is essential to correct misconceptions and promote maternal well-being.
Anemia Determinant Model in Adolescent Girls: Empirical Analysis Based on Logistic Regression
Anemia is a condition in which the body lacks sufficient red blood cells and/or hemoglobin. In women, a hemoglobin level of less than 12.0 g/100 ml is considered an indication of anemia. It is a major global public health problem in both developed and developing countries. This study aimed to determine the relationship between Body Mass Index (BMI), Upper Arm Circumference (MUAC), Iron Tablet Intake (Fe), and Level of Knowledge on the occurrence of anemia in adolescent girls at the Asy Syifa Islamic Boarding School in Balikpapan City. This study was an analytical study with a cross-sectional design. This study was conducted in Balikpapan City from March to June 2025. The subjects were all 12th grade female students at the Asy Sifa Islamic Boarding School in Balikpapan. Data were collected through questionnaires and HB, BMI, and MUAC examinations. Data analysis used logistic regression. The results of the analysis with the logistic regression test concluded that there was an inverse effect between adolescent girls' knowledge and the risk of anemia (OR = 0.42, CI = 0.70-2.50, p = 0.342). There is a positive influence between Lila and the risk of anemia (OR=6.07, CI=1.47-24.92, p=0.012), compliance in consuming Fe tablets (OR=3.91, CI=1.06-14.35, p=0.0039), and BMI (OR=4.64, CI=1.23-17.50, p=0.023) with the risk of anemia. Anemia in adolescent girls is influenced by LILA, Compliance in consuming Fe tablets and BMI.CI=1.47-24.92, p=0.012), compliance in consuming Fe tablets (OR=3.91, CI=1.06-14.35, p=0.0039), and BMI (OR=4.64, CI=1.23-17.50, p=0.023) with the risk of anemia. Anemia in adolescent girls is influenced by LILA, Compliance in consuming Fe tablets and BMI.
Related to Anxiety among Elective Preoperative Patients Under General Anesthesia
The prevalence of preoperative anxiety in Indonesia ranges from 9% to 12%. Preoperative anxiety can negatively affect surgical outcomes and postoperative recovery. Therefore, understanding factors associated with anxiety before surgery is essential to improve patient preparation and perioperative care. This study aimed to identify factors associated with anxiety among elective preoperative patients undergoing general anaesthesia at RS US in 2025. This study used an analytical correlational design with a cross-sectional approach. The research was conducted from October to December 2025. The population consisted of elective preoperative patients undergoing general anaesthesia. A total of 124 respondents were selected using purposive sampling. Data were collected using questionnaires on therapeutic communication, hospital environment, family support, and the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Data analysis included univariate and bivariate analysis using the Chi-square test. Among 124 respondents, 69 (55.6%) experienced poor therapeutic communication, 74 (49.7%) perceived the hospital environment as good, 68 (54.8%) reported inadequate family support, and 68 (54.8%) had a moderate level of anxiety. There was a significant association between therapeutic communication and patient anxiety (p = 0.001; OR = 21.491). The hospital environment was also significantly associated with patient anxiety (p = 0.001; OR = 9.852). In addition, family support showed a significant relationship with patient anxiety (p = 0.001; OR = 23.148). Therapeutic communication, family support, and the hospital environment were significantly associated with anxiety levels among elective preoperative patients undergoing general anaesthesia.
The Effect of Structured Maternal Engagement on ARI Prevention
Acute respiratory infection (ARI) remains a major cause of morbidity and mortality among under-five children in India. Despite being preventable through simple home-based measures, repeated hospital visits indicate gaps in maternal knowledge and practices. Objective to evaluate the effectiveness of structured maternal engagement strategies on knowledge and home-based practices regarding prevention of acute respiratory infection among mothers of under-five children. A true experimental pre-test post-test control group design was adopted in paediatric units of selected hospitals in Dehradun, Uttarakhand. A total of 290 mothers were selected using purposive sampling. Structured knowledge questionnaire and practice checklist were used. The experimental group received structured maternal engagement strategies, while the control group received routine care. Data were analysed using descriptive and inferential statistics. Post-test knowledge and practice scores significantly improved in the experimental group (p < 0.05). Significant differences were observed between experimental and control groups. Structured maternal engagement strategies are effective in improving maternal knowledge and preventive practices regarding ARI.
Physical Activity, Body Mass Index, and Smartphone Addiction: A Cross-Sectional Study among Adolescents
Smartphone addiction has become a growing public health concern among adolescents. Excessive smartphone use has been associated with physical inactivity, mental health problems, and unhealthy lifestyle behaviors that may contribute to abnormal body mass index (BMI). This study aimed to examine the association between physical activity level, body mass index, and smartphone addiction among adolescents. A cross-sectional study was conducted among 102 adolescents, 15–17 years old in Surakarta, Indonesia. Data were collected using a structured questionnaire including demographic characteristics, the Smartphone Addiction Scale–Short Version (SAS-SV), and the International Physical Activity Questionnaire (IPAQ). BMI was calculated based on measured height and weight. The prevalence of smartphone addiction was 52.9%. Most participants had normal BMI (52.0%), while 28.4% were obese. Low physical activity levels were observed in 42.2% of respondents. Chi-square analysis indicated a borderline association between physical activity level and smartphone addiction (p = 0.054), suggesting a tendency for lower physical activity to be associated with higher smartphone addiction. No significant association was found between BMI and smartphone addiction (p = 0.084), nor between physical activity level and BMI (p = 0.359). Smartphone addiction was highly prevalent among adolescents. Although physical activity showed a potential association with smartphone addiction, BMI was not significantly correlation to either smartphone addiction or physical activity. These findings showed that the importance of promoting regular physical activity as part of preventive strategies against smartphone addiction among adolescents.
The Effect of Puzzle Therapy on Improving Cognitive Skills in Elderly People with Dementia
Dementia is a common problem in the elderly, primarily due to aging and disease. Non-pharmacological interventions such as puzzle therapy are a safe and effective option for managing this condition. To evaluate the implementation of puzzle therapy in nursing care for elderly people with dementia at the Tedakoen nursing home in Okinawa (Japan). This study used a case study of a 92-year-old woman with dementia and cognitive decline. The puzzle therapy intervention was conducted for three consecutive days, with each session lasting 15-30 minutes. There was an improvement in cognitive function in the elderly with dementia. Playing puzzles can reduce the level of dementia in the elderly, so this therapy can be used as an alternative to improve memory in the elderly, as it stimulates the elderly's brain to function and remember. Puzzle therapy has an effect on the cognitive function of the elderly with dementia.
Nanoemulsion Aromatherapy Cupping Reduces Anxiety in Hypertension Patients
Hypertension is a chronic condition that is often accompanied by psychological issues, such as anxiety, which can affect blood pressure control and the quality of life of patients. Various complementary therapies have been developed to help reduce anxiety, including cupping therapy and nanoemulsion aromatherapy. This study aims to analyse the effect of nanoemulsion aromatherapy cupping on anxiety levels in hypertension patients and compare it with cupping therapy. This study employed a quasi-experimental design with a pretest-posttest control group. The sample consisted of 30 hypertension patients, divided into two groups: cupping therapy and nanoemulsion aromatherapy cupping, with 15 respondents in each group. Anxiety levels were measured before and after the intervention using an anxiety questionnaire. Data analysis was performed using paired t-tests to examine the difference in anxiety within each group and an independent t-test to compare the reduction in anxiety between the two groups. The results showed a significant reduction in anxiety levels in both the cupping therapy group (p = 0.002) and the nanoemulsion aromatherapy cupping group (p = 0.000). However, the independent t-test revealed no significant difference in anxiety reduction between the two groups (p = 0.215). Both cupping therapy and nanoemulsion aromatherapy cupping were effective in reducing anxiety levels in hypertension patients, with no significant difference in effectiveness between the two therapies. Nanoemulsion aromatherapy cupping has the potential to be a complementary therapy in managing anxiety in hypertension patients.
Factors Associated with the Effectiveness of Hospital Management Information System Implementation
The Hospital Management Information System (HMIS) is a critical component in improving hospital service quality, operational efficiency, and decision-making processes. Effective implementation of HMIS supports accurate data management, integrated services, and timely information for healthcare providers and hospital management. However, variations in system utilisation, human resource competence, and organisational support may affect the effectiveness of HMIS implementation. This study aimed to analyse factors associated with the effectiveness of Hospital Management Information System implementation at Alimuddin Umar Regional Public Hospital, West Lampung Regency, in 2025. A quantitative study with a cross-sectional design was conducted involving hospital employees who utilised the Hospital Management Information System in their daily work. Respondents were selected using purposive sampling. Data were collected using structured questionnaires. Data analysis included univariate analysis, bivariate analysis using the chi-square test, and multivariate analysis using logistic regression to identify dominant associated factors. The results indicated that the effectiveness of Hospital Management Information System implementation was significantly associated with user competence, system quality, organisational support, and infrastructure availability (p<0.05). The effectiveness of Hospital Management Information System implementation is influenced by human resource competence, system quality, organisational support, and infrastructure. Strengthening user training, improving system reliability, and enhancing organisational commitment are recommended to optimise system effectiveness.
Literature Review: Community-Based Promotive and Preventive Approaches in Non- Communicable Disease Control in Indonesia
Non-communicable diseases (NCDs) are a major health problem in Indonesia with an increasing prevalence. Efforts to control NCDs require effective, community-based promotive and preventive approaches. This literature review aims to analyse community-based promotive and preventive approaches in the control of non-communicable diseases in Indonesia. This study used a literature review design with a descriptive-analytical approach. Articles were obtained from the Mendeley, ClinicalKey, and Google Scholar databases using keywords related to NCDs and health promotion. The articles included were publications from 2021 to 2026 that were relevant to community- based interventions. The review results show that early detection of risk factors, health education, use of promotional media, physical activity, and non-pharmacological interventions contribute to increasing knowledge, behavioural change, and NCD control. Community programmes such as Posbindu PTM and Posyandu Lansia are effective in increasing community participation and awareness, although there are still implementation constraints. Community-based promotive and preventive approaches are effective in controlling NCDs and need to be strengthened through programme integration, community participation, and cross-sectoral support.
Investigation of Food Poisoning Outbreak
Food poisoning outbreaks remain a major public health problem, particularly in settings involving mass food preparation and distribution. On 14 January 2026, a suspected food poisoning outbreak was reported in the working area of Ngadirojo Primary Health Center, Wonogiri Regency, following the implementation of the Free Nutritious Meal Program (MBG). This investigation aimed to describe the outbreak by person, place, and time, and to identify the suspected source of exposure and contributing risk factors. A field epidemiological investigation with a descriptive observational design and cross-sectional approach was conducted. A case was defined as any individual who developed symptoms of food poisoning, including nausea, vomiting, diarrhea, abdominal pain, dizziness, or fever after consuming MBG meals on 13 January 2026. Data were collected through active case finding, structured questionnaires, medical record review, environmental health inspections, and laboratory examination of food samples. Descriptive analysis included calculation of the attack rate (AR), case fatality rate (CFR), and construction of an epidemic curve. A total of 604 cases were identified among 3,976 beneficiaries, yielding an attack rate of 15.2% and a CFR of 0%. The majority of cases occurred among junior high school students (49.5%) and males (56.5%). The incubation period ranged from 30 minutes to 36 hours 30 minutes, with a mean of approximately 14 hours 30 minutes. The epidemic curve demonstrated a common-source outbreak with a point-source pattern. Laboratory examinations identified contamination with Escherichia coli and Salmonella spp. in raw vegetables and fresh fruit. Environmental health inspections revealed multiple hygiene and sanitation deficiencies. This investigation confirmed a food poisoning outbreak associated with contaminated MBG food items, most likely caused by Escherichia coli with possible co-contamination by Salmonella spp. Strengthening food hygiene and sanitation practices in mass food provision programs is essential to prevent similar outbreaks.
Portable X-Ray as A Strategy for the Prevention and Control of Pulmonary Tuberculosis: A Systematic Review
Pulmonary tuberculosis (TB) remains a global public health problem with high morbidity and mortality rates, particularly in developing countries. Indonesia has the second-highest number of cases in the world, with East Nusa Tenggara (NTT) as one of the provinces with the highest number of cases nationally. Early detection is a key component of TB prevention and control strategies, but limited access to conventional radiology facilities is a major obstacle, particularly in remote areas such as NTT. The use of portable X-ray technology is considered a potential innovation to expand screening coverage and accelerate the diagnosis of pulmonary TB. This study aims to systematically analyze the role and effectiveness of portable X-ray use as a strategy for preventing and controlling pulmonary tuberculosis. The method used was a systematic review by examining scientific articles published in electronic databases such as PubMed, Scopus, and Google Scholar within a specific publication year. Inclusion criteria included studies discussing the use of portable X-rays in the screening, early diagnosis, and control of pulmonary tuberculosis in the general population and high-risk groups. The article selection process followed the PRISMA guidelines. The review results show that the use of portable X-ray significantly increases access to pulmonary TB screening, especially in areas with limited health infrastructure. Several studies report relatively high sensitivity and specificity in detecting lung abnormalities suggestive of TB, especially when combined with Computer-Aided Detection (CAD) technology. Furthermore, the implementation of portable X-ray has proven effective in supporting mass screening activities, active case detection, and accelerating referrals for further bacteriological examination. Challenges identified include the need for operator training, the initial cost of equipment procurement, and radiation safety aspects. Portable X-ray is an effective and innovative strategy for preventing and controlling pulmonary tuberculosis, particularly in improving early detection and reaching populations with limited access to healthcare. Integrating this technology into the national TB program requires radiation safety regulations, increased healthcare worker capacity, and ongoing policy support.
The Relationship Between Knowledge of Healthy Food and Food Additives and Attitudes and Behaviors Toward Safe Food Selection among School Adolescents
Food safety is a critical public health issue among adolescents, particularly in school environments where exposure to processed foods and snacks containing food additives is high. Limited awareness and understanding of healthy foods and food additives may influence adolescents’ attitudes and behaviors in food selection. This study aimed to analyze the relationship between knowledge of healthy food and food additives with attitudes and behaviors related to safe food selection among school adolescents. This quantitative study employed a cross-sectional design involving tenth-grade students at SMA X Pekanbaru. Data were collected using a structured questionnaire consisting of 21 items covering knowledge, attitudes, and self-reported behaviors related to healthy food and food additives. Data were analyzed using univariate analysis to describe respondents’ characteristics and levels of knowledge, attitudes, and behaviors, as well as bivariate analysis to examine the relationships between variables using appropriate statistical tests. The results indicated that most respondents had a good level of knowledge regarding healthy foods and food additives. However, good knowledge was not consistently accompanied by positive attitudes and healthy food selection behaviors. A significant relationship was found between knowledge level and both attitudes and behaviors toward safe food selection. These findings suggest that knowledge plays an important role in shaping adolescents’ attitudes and behavioral tendencies related to food safety. Continuous and context-based nutrition education is therefore necessary to support sustainable behavioral change.
Implementation of An Integrated Referral System to Optimize the Quality of Referral Services
The Integrated Referral System (SISRUTE) is an information technology-based service innovation aimed at accelerating the referral process and improving service efficiency. At Alimuddin Umar Regional Hospital, the implementation of SISRUTE has not yet reached optimal performance. Internal reports indicate delays in data entry, the absence of dedicated personnel, and network and infrastructure issues that hinder the referral process. This study aimed to analyze factors associated with medication adherence among patients with type 2 diabetes mellitus at Alimuddin Umar Regional Public Hospital in 2025. This study aims to evaluate the implementation of SISRUTE at Alimuddin Umar Regional Hospital. A descriptive qualitative method was used with purposive sampling. Data were collected through in-depth interviews with 13 informants (management, medical, and administrative staff), field observations, and document review conducted in March-April 2025. Data analysis was carried out using an interactive analysis model. Most respondents demonstrated good medication adherence (84.8%). Bivariate analysis showed significant associations between family support (p=0.004), diabetes knowledge (p=0.001), and self-efficacy (p=0.000) with medication adherence. Multivariate analysis identified self-efficacy as the most dominant factor influencing adherence (β=0.612; p=0.000). The findings revealed: (1) Communication between units occurs through formal and informal channels, but gaps in technical understanding still exist; (2) Human resources and technology are available but insufficient due to high workloads, limited budgets, and network disruptions; (3) Staff showed a positive attitude toward the system after training, but motivation remains inconsistent; (4) Bureaucratic structure and SOPs are in place, yet implementation is not uniform, and lengthy procedures slow down the referral process. The Integrated Referral System (SISRUTE) is an information technology-based service innovation aimed at accelerating the referral process and improving service efficiency. At Alimuddin Umar Regional Hospital, the implementation of SISRUTE has not yet reached optimal performance. Internal reports indicate delays in data entry, the absence of dedicated personnel, and network and infrastructure issues that hinder the referral process. This study aimed to analyze factors associated with medication adherence among patients with type 2 diabetes mellitus at Alimuddin Umar Regional Public Hospital in 2025. This study aims to evaluate the implementation of SISRUTE at Alimuddin Umar Regional Hospital. A descriptive qualitative method was used with purposive sampling. Data were collected through in-depth interviews with 13 informants (management, medical, and administrative staff), field observations, and document review conducted in March-April 2025. Data analysis was carried out using an interactive analysis model. Most respondents demonstrated good medication adherence (84.8%). Bivariate analysis showed significant associations between family support (p=0.004), diabetes knowledge (p=0.001), and self-efficacy (p=0.000) with medication adherence. Multivariate analysis identified self-efficacy as the most dominant factor influencing adherence (β=0.612; p=0.000). The findings revealed: (1) Communication between units occurs through formal and informal channels, but gaps in technical understanding still exist; (2) Human resources and technology are available but insufficient due to high workloads, limited budgets, and network disruptions; (3) Staff showed a positive attitude toward the system after training, but motivation remains inconsistent; (4) Bureaucratic structure and SOPs are in place, yet implementation is not uniform, and lengthy procedures slow down the referral process.
Analysis of Risk Factors Associated with Dengue Hemorrhagic Fever Incidence
Dengue Hemorrhagic Fever (DHF) remains a major public health problem in tropical and subtropical regions, including Indonesia. The incidence of DHF is influenced by multiple risk factors, such as environmental conditions, vector density, population behaviour, and socio-demographic characteristics. Rapid urbanisation and population mobility in Bandar Lampung City may contribute to increased transmission risk. This study aimed to analyse risk factors associated with the incidence of Dengue Hemorrhagic Fever in Bandar Lampung City in 2025. A quantitative analytic study with a case–control design was conducted involving DHF cases and non-DHF controls in Bandar Lampung City. Samples were selected using an appropriate sampling technique based on inclusion and exclusion criteria. Data were collected through structured questionnaires, observation sheets, and secondary data from health records. Data analysis included univariate analysis, bivariate analysis using the chi-square test, and multivariate analysis using logistic regression to identify dominant risk factors. The results showed that several factors were significantly associated with DHF incidence, including environmental sanitation, presence of mosquito breeding sites, larval density, water storage practices, and household preventive behaviours (p<0.05). Multivariate analysis identified the presence of mosquito breeding sites as the most dominant risk factor for DHF incidence. The results showed that several factors were significantly associated with DHF incidence, including environmental sanitation, presence of mosquito breeding sites, larval density, water storage practices, and household preventive behaviours (p<0.05). Multivariate analysis identified the presence of mosquito breeding sites as the most dominant risk factor for DHF incidence.
Correlation between Aldrete Scores and Length of Stay for Postoperative Patients Undergoing General Anesthesia
The length of hospital stay for postoperative patients is an indicator of hospital service quality and treatment efficiency. Factors related to recovery from general anesthesia affect this length, given that this phase is critical for physiological monitoring. The Aldrete score is used to assess early recovery through five parameters: activity, respiration, circulation, level of consciousness, and oxygen saturation in the recovery room. This study aimed to determine the relationship between the Aldrete Score and the length of stay in patients after general anesthesia at Dr. R. Hardjanto Balikpapan Regional General Hospital. An analytical observational design with a cross-sectional approach was applied. The sample consisted of 61 patients after general anesthesia who were selected purposively from medical records. Data analysis used Spearman's correlation test. The results showed a p-value of 0.173 with a correlation coefficient of r = −0.177, indicating no significant relationship between the Aldrete Score and length of stay. Nevertheless, the Aldrete Score remains relevant as an indicator of early recovery in postoperative patients.
Case Study of Nursing Care Implementation in COPD Patients with Indefective Breathing Patterns and Indefective Airway Clearance
Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable, and manageable chron-ic lung disease that affects both men and women worldwide. Abnormalities in the small airways of the lungs cause limitations in airflow entering and leaving the lungs. COPD is sometimes referred to as emphysema or chronic bronchitis. To evaluate nursing care for COPD patients at Wellness Hospital Okinawa, Japan. This scientific paper used a case study method with a nursing care ap-proach involving two respondents who were treated at Wellness Hospital Okinawa, Japan. Data col-lection was conducted using nursing care documentation, including assessment, diagnosis, inter-vention, implementation, and evaluation. Based on data analysis obtained from the assessment re-sults, good observational and communication skills were required to support the establishment of accurate nursing diagnoses according to the patient’s condition. Nursing diagnoses were identified in the patients. Nursing care plays an important role in improving breathing patterns and airway clearance in COPD patients. Appropriate nursing interventions can reduce dyspnea and help im-prove respiratory function, thereby enhancing the patient’s quality of life.
Geronic Nursing Care for Elderly Parents with Acute Subdural Hematoma
The aging process contributes to a decline in physiological function due to degenerative changes, increasing the vulnerability of older adults to neurological disorders, such as acute subdural hematoma (ASDH). This neurological emergency condition carries a high risk of mortality and morbidity in the elderly population. This case study aims to describe the implementation of gerontological nursing care in an older adult with a medical diagnosis of acute subdural hematoma accompanied by decreased level of consciousness, through the intervention of Nasopharyngeal Airway (NPA) insertion. This study employed a descriptive design using a case study approach. Data were collected through observation, physical examination, vital sign monitoring, and review of medical records. The initial assessment revealed posterior tongue displacement, which increased the risk of aspiration and airway obstruction. The results of nursing care showed that after NPA insertion, the patient’s airway patency was optimally maintained. Although the patient’s Glasgow Coma Scale (GCS) score remained at the baseline value, the NPA intervention was effective in preventing deterioration of respiratory status, as indicated by oxygen saturation (SpO₂) and respiratory rate remaining within normal limits. In conclusion, this case study demonstrates that comprehensive gerontological nursing care plays a crucial role in improving patient safety and the quality of care in older adults with acute neurological problems.
Factors Associated with Patient Satisfaction in Radiology Services
Patient satisfaction is a key indicator of healthcare service quality, including radiology services. Efficient radiology services supported by adequate administrative processes, responsive healthcare personnel, and appropriate facilities contribute to positive patient perceptions and overall hospital performance. However, variations in service delivery may influence patient satisfaction levels. This study aimed to analyse factors associated with patient satisfaction in radiology services at Alimuddin Umar Regional Public Hospital in 2025. A quantitative study with a cross-sectional design was conducted involving 105 patients who had utilised radiology services at least once. Respondents were selected using purposive sampling. Data were collected through structured questionnaires and interviews. Data analysis included univariate analysis, bivariate analysis using the chi-square test, and multivariate analysis using logistic regression. The results showed that 59.0% of patients were satisfied with radiology services. Significant associations were found between patient satisfaction and waiting time (p<0.001; OR=23.833), patient record administration (p<0.001; OR=6.584), healthcare personnel services (p<0.001; OR=8.143), and facilities and infrastructure (p<0.001; OR=7.102). Physician services did not show a significant association with patient satisfaction in multivariate analysis (p>0.05). Waiting time was identified as the dominant factor influencing patient satisfaction. Waiting time is the most influential factor associated with patient satisfaction in radiology services. Improving service efficiency through revision of radiology service standard operating procedures is recommended to enhance patient satisfaction.
The Effectiveness of Deep Breath Relaxation Technique to Overcome Pain in Hypertension Clients
Hypertension is a major non-communicable disease that often causes pain such as headache and neck stiffness, which can reduce quality of life. Non-pharmacological interventions are needed to support pain management safely. To determine the effectiveness of deep breathing relaxation techniques in reducing pain among hypertensive clients at Tedakoen Day Care, Okinawa, Japan. This study used a descriptive case study design with a nursing care approach. The subject was an 89-year-old hypertensive client experiencing moderate pain. Pain levels were measured using the Numeric Rating Scale (NRS) before and after the intervention. Deep breathing relaxation was performed twice daily for 3 days. After the intervention, the client showed a decrease in pain scale and improvement in comfort. Vital signs, especially blood pressure, also showed a tendency to decrease. Deep breathing relaxation is effective as a non-pharmacological intervention to reduce pain in hypertensive clients.