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.
The Relationship Between Knowledge Level and Self-Medication Behavior of Analgesic Drugs
Self-medication is a method of self-treatment used to treat common ailments and minor illnesses without a doctor’s prescription. Analgesics are among the most commonly used medications in self-medication. This study aims to determine the relationship between knowledge levels and analgesic self-medication behavior in the Nampu Village community, Purwodadi City. Data were collected using a cross-sectional design with random sampling. The sample size was 98 respondents. Questionnaire data were analyzed using the Spearman rank-sum test. The study was conducted from March to May 2025. The results showed that 19 (19.4%) respondents had good knowledge, 43 (43.9%) had sufficient knowledge, and 36 (36.7%) had poor knowledge. Regarding analgesic self-medication behavior, 57 (58.2%) had good knowledge, 28 (14.8%) had sufficient knowledge, and 13 (6.9%) had poor knowledge. In the Spearman rank correlation test, a correlation coefficient of 0.330 was obtained with a p-value of 0.018, indicating a significant relationship between the level of knowledge and self-medication behavior regarding analgesic drugs. Keywords: Analgesics, Community, Behavior, Self-medication, Level of Knowledge
Copyright (c) 2026 Proceedings of the International Conference on Nursing and Health Sciences
Dietary Patterns of Pregnant Women with Anemia in the Working Area of Cepiring Community Health Center
Anemia during pregnancy is a serious public health issue due to its association with the risk of maternal hemorrhage and impaired fetal growth. Inadequate dietary intake and pattern are often a primary factor contributing to low hemoglobin levels. This study aims to describe the characteristics and dietary patterns of pregnant women suffering from anemia within the working area of ​​the Cepiring Community Health Center (Puskesmas). This is a quantitative study employing a descriptive design and a cross-sectional approach. The sample consisted of 43 pregnant women with anemia, selected using a total sampling technique. Data collection utilized a dietary pattern questionnaire with established validity—showing calculated r-values ​​ranging from 0.491 to 0.805—and a reliability coefficient of 0.886. The study results indicate that the mean age of respondents was 29.69 years, with the majority (27 respondents or 62.8%) in the third trimester of pregnancy. Most respondents were multiparous (26 respondents or 60.5%), had a high school education (28 respondents or 65.1%), and were unemployed/homemakers (33 respondents or 76.7%). Regarding family income, the majority (23 respondents or 53.5%) earned ≥ Rp2,784,000. Dietary pattern analysis showed that the majority of respondents fell into the "good" category (19 respondents or 44.2%), followed by the "moderate" category (18 respondents or 41.8%) and the "poor" category (6 respondents or 14%). Future researchers could incorporate additional variables to further investigate anemia in pregnant women and identify the various risk factors contributing to its occurrence
Overview of Antidepressant Use in Depressive Patients at dr. H. Soewondo Hospital
Depression is a mental health condition marked by persistent sadness, reduced interest in daily activities, and impaired social and cognitive functioning, making effective treatment essential to improve outcomes and reduce harmful effects. This study aimed to describe the use of antidepressant medication among patients with depression in a regional general hospital. The study applied a descriptive quantitative design with a retrospective approach using medical record data of patients who met the inclusion criteria during the study period. A total of 209 patients were selected with the Slovin formula, and data were analyzed descriptively and presented as frequencies and percentages. The results showed that the most commonly used medication was escitalopram at 34.9 percent, followed by fluoxetine at 31.6 percent, and sertraline at 10.5 percent. Most patients were female at 60.3 percent, with the largest age group being 15 to 25 years at 31.1 percent. These findings indicate that antidepressant use was dominated by the selective serotonin reuptake inhibitor group, with escitalopram as the preferred therapy reflecting alignment with clinical treatment guidelines for depression.
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 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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
Analysis of the Concept of Responsive Feeding Based on Culture
Background: Responsive feeding is an essential component of child nutrition and responsive caregiving; however, the concept remains inconsistently defined across disciplines and cultural contexts, limiting its application in nursing practice and stunting prevention. Objective: This concept analysis aimed to clarify the meaning, defining attributes, antecedents, consequences, and empirical referents of culturally based responsive feeding among children aged 6–24 months. Method: Walker and Avant’s concept analysis approach was used through the identification of concept use, defining attributes, model cases, antecedents, consequences, and empirical referents. Literature from WHO/UNICEF guidelines, empirical studies, and cross-cultural research related to responsive feeding was comprehensively reviewed. Results: Six defining attributes were identified: caregiver sensitivity to child cues, warm reciprocal interaction, non-coercive and supportive feeding approaches, support for child autonomy and self-regulation, family cultural sensitivity, and orientation towards the feeding process and eating experience. Antecedents included caregiver knowledge of child development, psychological readiness, safe caregiver–child relationships, family support, socioeconomic conditions, family cultural values, access to nutrition education, culturally sensitive healthcare services, and WHO/UNICEF guidelines. Consequences included positive eating experiences, improved diet quality and child self-regulation, more harmonious family relationships, reduced feeding difficulties and caregiver stress, and contributions to stunting prevention. Conclusions: Culturally based responsive feeding is a multidimensional concept integrating nutritional, emotional, relational, and cultural aspects as a foundation for culturally sensitive nursing practice in stunting prevention.
Maternal Parenting Resilience Among Mothers of Children at Risk Of Stunting in Coastal Areas
Stunting remains a major public health problem affecting child growth and development, particularly in vulnerable communities. Mothers living in coastal and island areas often face limited access to health services, health education, and nutritional resources, which may influence caregiving capacity for children at risk of stunting. Maternal parenting resilience is considered an important adaptive factor in supporting childcare practices under challenging conditions. This study aimed to identify maternal parenting resilience among mothers of children at risk of stunting in coastal areas. This study employed a pre-experimental one-group pretest-posttest design involving 32 mothers with children at risk of stunting in the working area of Tambelan Public Health Center. Data were collected using the Parenting Resilience Elements Questionnaire (PREQ). Data analysis was performed using descriptive statistics and paired sample t-test. The findings showed that the mean maternal parenting resilience score increased from 96.91 before assessment to 111.75 after intervention. Statistical analysis demonstrated a significant difference in maternal parenting resilience scores among mothers with children at risk of stunting (p-value = 0.000). Mothers living in coastal communities experienced various geographical and social challenges, including limited access to healthcare services and nutritional information, which may influence adaptive caregiving capacity and maternal resilience. Maternal parenting resilience is an important adaptive component in caring for children at risk of stunting in coastal communities. Mothers living in geographically vulnerable areas experience various social and environmental challenges that may influence caregiving capacity and child nutritional outcomes. Strengthening community-based support and maternal empowerment may enhance adaptive parenting practices and contribute to stunting prevention efforts in vulnerable coastal populations.
Disaster Preparedness: An Analysis of Nurses as the Frontline in Type C General Hospital
Indonesia is known as a region with a high risk of natural disasters. In such emergency situations, nurses often serve as the frontline responders. However, several studies have revealed that there are still deficiencies in their preparedness for such events. This study aims to evaluate the level of disaster preparedness among nurses in Type C regional general hospital, particularly in terms of knowledge and skills, as well as the influencing factors. A quantitative descriptive approach was employed, involving 43 nurses as respondents. The research instrument was a questionnaire developed based on the Disaster Preparedness Evaluation Tool (DPET). The level of nurse preparedness was categorized as moderate, with an average score of 3.27 (SD = 0.49). In terms of knowledge, nurses scored an average of 3.49 (SD = 0.53), while skill scores averaged 3.21 (SD = 0.53). Nurses working in the emergency department (ED) demonstrated the highest level of preparedness. No significant relationship was found between preparedness and gender, age, or education level. However, nurses with more than five years of work experience tended to have better preparedness (p = 0.028). The findings indicate the need to enhance nurses' skills in disaster response through continuous training and simulation. In addition, periodic rotation across work units may serve as an additional strategy to enrich experience and improve nurses’ readiness in emergency situations.
Intervention Strategies and Implementation Determinants of Routine Health Data Quality Improvement in Infectious Disease Programs in Low and Middle-Income Countries: A Scoping Review
Infectious disease surveillance, program monitoring, and policy decision-making in low- and middle-income countries (LMICs) require high-quality routine health data. Data quality gaps continue to undermine the utility of routine health information systems despite large investments. Many existing studies have assessed data quality outcomes independently, but very few have attempted to synthesize how and why intervention strategies and implementation determinants combine to affect sustainable improvements. This scoping review aimed to map intervention strategies designed to improve routine health data quality in infectious disease programs and to identify key implementation determinants shaping their effectiveness across LMIC health system contexts. A scoping review was conducted following PRISMA-ScR guidance. Peer-reviewed studies examining interventions targeting routine health data quality in LMICs were identified through systematic searches of PubMed, Scopus, and ScienceDirect. Eligible studies included quantitative, qualitative, mixed-methods, and program evaluation designs reporting at least one data quality dimension. Data were synthesized using narrative and thematic analysis to categorize intervention strategies and examine implementation determinants across health system levels. Twenty-four studies met the inclusion criteria. When the function was analyzed separately by dimension, intervention strategies were grouped into four categories as follows: (1) capacity strengthening; (2) design and implement a digital health system directly linked to the health sector capacity; (3) design and implement data validation and feedback mechanisms; develop governance-level reforms. The best evidence of improvement in completeness, accuracy, and timeliness came from interventions that combined digital technologies with workforce training and supervisor feedback. Effectiveness, however, was largely dictated by implementation determinants: organizational data-use culture, interoperability constraints, human resource stability, infrastructure readiness, and governance alignment. Fragmented systems and parallel reporting mechanisms frequently limited sustainability. Improving routine health data quality in LMIC infectious disease programs extends beyond technical system enhancements and requires alignment among technological, organizational, and behavioral determinants. By integrating intervention typologies with implementation determinants, this review provides a systems-oriented synthesis to inform context-responsive, sustainable strategies for strengthening data quality.
Factors Associated With Early Breastfeeding Initiation in Newborns at Airan Raya Hospital in 2025
Early breastfeeding initiation (IMD) is one of the most important interventions in ensuring infant survival and supporting exclusive breastfeeding. However, IMD practices in Indonesia, including in Airan Raya Hospital, are still not optimal. The successful implementation of IMD is influenced by various internal and external factors that are not fully understood. This study aimed to determine the factors associated with the implementation of IMD in newborns at Airan Raya Hospital in 2025. This study used a cross-sectional design with purposive sampling technique. The sample size was 100 mothers who gave birth at Airan Raya Hospital and met the inclusion criteria. The variables studied included knowledge, attitude, family support, and cross-sector support. Data were collected through questionnaires and observation, then analyzed using the chi-square test and Hosmer-Lemeshow Test for multivariate analysis. The results showed that maternal knowledge, attitude, family support, and cross-sector support were significantly related to IMD implementation (p < 0.05). Among them, maternal knowledge was the most dominant factor. Continuous educational interventions and active collaboration between health workers and families are necessary to increase IMD success. Strengthening community and institutional support is essential to promote exclusive breastfeeding starting from birth.
Factors Related to Nurses' Performance at West Tulang Bawang Regional General Hospital in 2025
Nurses' performance is a crucial indicator in ensuring the quality of healthcare services in hospitals. A preliminary survey at the Regional General Hospital (RSUD) of Tulang Bawang Barat showed that nurses' performance was 70% in 2022, increased to 80% in 2023, and declined to 60% in 2024. Therefore, this study was conducted to identify the factors associated with nurses' performance at RSUD Tulang Bawang Barat.This research used a quantitative approach with a cross-sectional method. The sample included all 55 nurses at RSUD Tulang Bawang Barat, selected using total sampling. The independent variables in this study were ability, skills, job design, rewards, and motivation, while the dependent variable was nurse performance. Data were collected using questionnaires and direct observation. Data analysis was carried out using univariate, bivariate, and multivariate tests. The results of the study showed a relationship between ability and nurse performance (fisher exact <0.001), skills and nurse performance (fisher exact <0.001), job design and nurse performance (fisher exact <0.001), rewards and nurse performance (fisher exact <0.001), and motivation and nurse performance (fisher exact <0.001). The most dominant factor influencing nurse performance was motivation with Prevalance Ratio (PR) 15,409 and fisher exact <0.001. The conclusion of this study is that there is a relationship between ability, skills, job design, motivation and rewards and the most dominant factor influencing nurse performance is motivation Suggestions to the Regional General Hospital and related agencies, namely the West Tulang Bawang Health Office, are expected to improve the performance of nurses, namely Strengthening social relations by creating applications that can create effective communication between nurses and other nurses and medical personnel. Periodic training curriculum programs for nurses for continuous self-development. Combination of financial approaches and awarding committee forms for financial and non-financial incentive systems based on performance targets. Provide rest room facilities, lactation rooms and a supportive work environment as a form of appreciation for nurses.
The Evaluation of Logistics Management Information System for Medicine and Medical Device Management at Pharmacy Installation of RSUD Jendral Ahmad Yani Metro
Pharmaceutical logistics management in hospitals is a critical component to ensure the availability of medicines and medical devices. In the digital era, the implementation of a Logistics Management Information System (LMIS) is essential for optimizing logistics operations. RSUD Jenderal Ahmad Yani Metro has implemented an LMIS; however, several issues remain, such as data discrepancies, delayed data input, and limited human resource (HR) capacity. This study aims to evaluate the implementation of the LMIS for managing medicines and medical devices at the hospital's pharmacy installation, identify supporting and inhibiting factors, and measure system effectiveness. A qualitative descriptive approach was employed, with data collected through in-depth interviews, direct observation, and document review. The findings indicate that while the LMIS supports logistics tracking and data collection, the system has not been fully optimized. Manual processes persist, HR training is lacking, and key system features are underutilized. Nonetheless, the system has proven beneficial in streamlining distribution processes. Optimization of the system, HR capacity-building, and better integration between service units are necessary to support more effective and efficient healthcare delivery.
Effectiveness of Acupuncture and Hypnopuncture in Improving Functional Independence Among Stroke Patients
Stroke is one of the leading causes of disability worldwide and often results in decreased functional independence and psychological distress among patients. Physical limitations, anxiety, stress, and reduced motivation during rehabilitation may inhibit optimal recovery. Integrative complementary therapies such as acupuncture and hypnopuncture are increasingly explored to support post-stroke rehabilitation through both physiological and psychological mechanisms. This study aimed to analyze the effectiveness of acupuncture and hypnopuncture in improving functional independence among stroke patients and to develop an evidence-based integrative rehabilitation approach. This study employed a quasi-experimental design with pre-test and post-test approaches involving two intervention groups: acupuncture and hypnopuncture. A total of 80 stroke patients participated in the study, consisting of 40 respondents in the acupuncture group and 40 respondents in the hypnopuncture group. Functional recovery was assessed using the Functional Independence Measure (FIM). Data analysis included the Wilcoxon signed-rank test and Mann–Whitney U test due to non-normal data distribution. The findings demonstrated significant improvements in FIM scores in both groups after intervention. In the acupuncture group, the median FIM score increased from 55.00 to 110.50 (p < 0.001). Similarly, the hypnopuncture group showed an increase from 54.50 to 115.00 (p < 0.001). Comparative analysis between groups revealed no statistically significant difference at post-test (p = 0.056), although the hypnopuncture group demonstrated a higher mean rank, indicating a tendency toward better functional recovery outcomes. These findings suggest that both acupuncture and hypnopuncture effectively improve functional independence in stroke patients, while hypnopuncture may provide additional psychological benefits that contribute to rehabilitation outcomes.
Efforts to Increase Visits of Women Aged 30-69 Years for Early Detection of Cervical Cancer Using the Human Papilloma Virus (HPV) DNA Method Through Health Promotion in Bandar Lampung City
Carcinoma (Ca) Cervix or Cervical Cancer is the fourth most common cancer diagnosed in women worldwide. To achieve cervical cancer elimination, World Health Organisation (WHO) recommends screening with a high-performance test, namely the HPV DNA test. Early detection program of cervical cancer among women aged 30-69 are still suboptimal. This is due to various factors, including a lack of public knowledge and negative perceptions of the HPV DNA test, which is considered frightening. Implementing efforts to increase visitation of women aged 30-69 years to carry out early detection of cervical cancer using the HPV DNA method through health promotion. The research is a qualitative research type using in-depth interview techniques and Focus Group Discussions. A series of problem-solving strategies have been formulated and implemented in a planned manner based on an educational and participatory approach at the community level. These strategies include: Direct counseling at the integrated health post (Posyandu) level, the use of innovative, interesting and eye catching educational media, mapping and data collection of screening targets, technical preparation through training of health workers, scheduling and cross-sector coordination. Recommendations and follow-up plans were developed based on field findings and community input Collected during the residency. These efforts are expected to strengthen community-based health promotion strategies, improve women's health literacy, and gradually eliminate the negative stigma surrounding HPV DNA testing. With targeted implementation and the involvement of all stakeholders, the cervical cancer early detection program in Bandar Lampung City can be executed more optimally and sustainably.
Analysis of Healhcare Services on Inpatient Satisfaction of Bpjs Kesehatan Members at Belleza Kedaton General Hospital
Based on medical record data at Beleza Kedaton General Hospital, the Bed Occupancy Rate (BOR) in 2024 increased every month. The results of the National Quality Indicator (INM) measurements at Belleza General Hospital related to patient satisfaction in January 2025 showed an achievement of 76%, which means that patient satisfaction is below the target of ≥80%. The objective of this study is to analyze the satisfaction of inpatient BPJS participants towards healthcare services at Belleza Kedaton General Hospital in Bandar Lampung in 2025. The research was conducted using a Cross Sectional design. The population consisted of 356 inpatient BPJS patients at the time of the study at Belleza Kedaton General Hospital, with a sample of 79 respondents taken through simple random sampling. Data collection was carried out using a questionnaire. Data analysis was conducted univariately, bivariately, and multivariately. The research results indicate that there is a relationship between Responsiveness (p-value = 0.013), Assurance (p-value = 0.006), Reliability (p-value = 0.001), Empathy (p-value = 0.007), and Tangibility (p-value = 0.007) with the satisfaction of BPJS patient participants. The Reliability variable is the dominant factor with a p-value of 0.005 and an OR value of 26.491. Recommendations for Belleza Hospital include improving the discipline of doctors' visiting hours in the inpatient rooms and enhancing the cleanliness of bathrooms in the inpatient area so that BPJS inpatient patients at Belleza General Hospital can achieve a higher level of satisfaction with the health services provided.
Implementation of The Measles Rubella Immunisation Month (BIAS) Programme in Bandar Lampung City
Immunisation Month for School Children (BIAS) targets primary school-aged children. The types of immunisations given during BIAS are Measles Rubella, Tetanus and Diphtheria. Measles and rubella are infectious diseases with the potential to cause serious complications, especially in children. Measles Rubella (MR) immunisation is the main strategy in the elimination of this disease. Evaluate the implementation of the BIAS program on MR immunisation coverage and identify factors that influence its success in Bandar Lampung City. This study used a descriptive quantitative approach with secondary data collection from the Health Office and BIAS implementation report in 2023. Analysis was conducted on immunisation coverage, incidence of suspected measles cases, and supporting and inhibiting factors. MR immunisation coverage reached 93.67%, close to the national target. However, 4 suspected measles cases were still found. The inhibiting factors included lack of public knowledge, suboptimal coverage of the second dose, and limited surveillance and access to health services. The implementation of the BIAS programme in Bandar Lampung City has shown good results, but still requires strengthening in the aspects of community education, tracking of MR two-dose coverage, and case-based surveillance systems. Cross-sectoral efforts need to be increased to achieve complete measles elimination and rubella control.
Implementation of Mental Health Services at The Health Department of Pesawaran District
The Pesawaran District Health Office has a network of health service facilities, namely 15 health centers that are directly in contact with ODGJ and their families. The problem faced by mental health program unit officers at 15 Puskesmas in Pesawaran Regency is that there are 9 Coverage of mental health service efforts in ODGJ patients at the Pesawaran Regency Health Office in 2024 has not yet reached the target. The purpose of the study was to determine the implementation of mental health services at the Pesawaran Regency Health Office in 2025. The type of research is qualitative, descriptive research design with a case study approach, the sample size is 17 people consisting of 15 mental health workers at the Puskesmas, 1 head of the P2P field and 1 non-communicable disease head. Data collection by conducting interviews and Focus Group Discussions (FGD) and data analysis using Root Cause Analysis (RCA). The results of the study obtained that the formation of the Community Mental Health Implementation Team did not reach the target was a priority problem, while the root causes of the problem were: Not all mental health workers at the Puskesmas have attended education and training in handling ODGJ, Limited human resources of mental health workers where 1 Puskesmas only has 1 - 2 mental health workers, the method of forming TPKJM has only relied on the allocation of APBD funds, lack of supporting infrastructure and lack of budget support and operational vehicles. It is expected that mental health workers who have never attended education and training can do OJT (One The Job Training) to Puskesmas that already have mental health workers who have attended education and training and BLUD Puskesmas management can innovate by applying for budget support through Corporate Social Responsibility to companies in Pesawaran Regency.
The Effect of Interpersonal-Based Therapeutic Group Therapy on Improving Self-Identity Among Adolescents as A Bullying Prevention Strategy
Bullying remains a prevalent issue among adolescents and has detrimental effects on mental health, self-esteem, and social functioning. A positive self-identity is considered an important protective factor against involvement in bullying. Adolescents with a strong sense of self-identity tend to exhibit greater self-confidence, better emotional regulation, and healthier interpersonal relationships. Interpersonal-Based Therapeutic Group Therapy is a psychosocial intervention designed to facilitate self-exploration, peer support, and positive interpersonal interactions, thereby promoting the development of self-identity. To examine the effect of Interpersonal-Based Therapeutic Group Therapy on improving self-identity among adolescents in Sorong City as a bullying prevention strategy. This study employed a quasi-experimental pretest–posttest control group design. The sample consisted of 74 junior high school students in Sorong City, who were assigned to either an intervention group (n = 37) or a control group (n = 37). Self-identity was assessed using a self-identity questionnaire. Data were analyzed using the Wilcoxon Signed-Rank Test and the Mann–Whitney U Test. A significant improvement in self-identity was observed among adolescents who received Interpersonal-Based Therapeutic Group Therapy (p = 0.000). Furthermore, the intervention group demonstrated significantly higher post-test self-identity scores than the control group (p = 0.000). Interpersonal-Based Therapeutic Group Therapy effectively enhances self-identity among adolescents in Sorong City and may serve as a promising strategy for bullying prevention
Community Knowledge Regarding Pulmonary Tuberculosis in the Working Area of Sanggeng Primary Health Center, Manokwari, West Papua, Indonesia
Pulmonary tuberculosis remains a major global public health challenge and continues to be one of the leading causes of mortality due to infectious diseases worldwide. Indonesia ranks among the countries with the highest tuberculosis burden globally, with approximately one million new cases reported annually. In West Papua Province, tuberculosis continues to pose substantial challenges to healthcare services and disease control programs. This study aimed to describe the level of community knowledge regarding pulmonary tuberculosis in the working area of Sanggeng Primary Health Center, Manokwari, West Papua, Indonesia. This study employed a descriptive quantitative design using a cross-sectional approach. The study population consisted of patients and accompanying family members visiting Sanggeng Primary Health Center during the data collection period. Samples were selected using accidental sampling techniques, resulting in a total of 30 respondents. Data were collected using a structured questionnaire regarding community knowledge of pulmonary tuberculosis. Data processing included editing, coding, data entry, cleaning, and tabulation procedures. Univariate analysis was conducted using relative frequency distribution to determine the percentage distribution of respondents' knowledge levels. The findings demonstrated that good knowledge regarding pulmonary tuberculosis was predominantly observed among respondents aged 17–25 years (55.56%). Based on educational attainment, respondents with senior high school education constituted the largest proportion of participants with good knowledge levels (61.11%). Female respondents demonstrated a slightly higher proportion of good knowledge (52.63%) compared with male respondents. Regarding occupational status, respondents who were not employed represented the largest proportion of individuals with good knowledge levels (47.37%). Community knowledge regarding pulmonary tuberculosis in the working area of Sanggeng Primary Health Center was generally categorized as good, particularly among younger adults, females, respondents with senior high school education, and individuals who were not employed. Continuous and community-based health education programs are essential to improve public awareness and support tuberculosis prevention and control efforts at the primary healthcare level.
The Relationship Between Handgrip Strength and Pain Complaints Muscles of Fishermen in Bandengan Village, Kendal District
Musculoskeletal pain is a common problem experienced by fishermen due to repetitive physical work activities. This study aimed to determine the relationship between hand grip strength and musculoskeletal pain complaints among fishermen in Bandengan Village, Kendal District. This research employed a quantitative design with a cross-sectional approach. A total of 79 respondents were selected using simple random sampling. Data were collected using the Nordic Body Map (NBM) questionnaire and a Hand Grip Dynamometer, then analyzed using the Spearman Rank test. The results showed that most fishermen had poor hand grip strength (44.3%) and experienced high levels of musculoskeletal pain complaints (84.8%), particularly in the lower back and right upper arm. The correlation test revealed an r-value of -0.347 with a p-value of 0.002 (<0.05), indicating a significant relationship with a negative direction and low correlation strength between hand grip strength and musculoskeletal pain complaints. Fishermen are recommended to adopt healthy work practices, including stretching before and after work, performing regular muscle-strengthening exercises, applying ergonomic work techniques, and balancing work and rest periods to reduce the risk of Musculoskeletal Disorders (MSDs).
How is Medication Planning in Hospitals? A Scoping Review
Effective drug inventory management is crucial for ensuring the timely availability of medications, cost-efficiency, and the overall quality of healthcare services in hospitals. This scoping review systematically examines various methods and models employed in hospital drug planning, with a focus on inventory control techniques such as Economic Order Quantity (EOQ), ABC Classification, Reorder Point (ROP), Safety Stock, machine learning, and real-time inventory systems. A total of eight studies were reviewed, analyzing their impact on optimizing inventory management, reducing costs, and improving the availability of essential drugs. Key findings indicate that advanced forecasting models, such as ARIMA and machine learning, improve demand accuracy and reduce stockouts. Inventory optimization methods like EOQ, ABC Classification, and ROP are effective in minimizing inventory costs and ensuring sufficient drug availability, especially when combined with techniques like VEN (Vital, Essential, Non-Essential) analysis. Additionally, real-time inventory systems offer significant improvements in responsiveness and stock tracking, helping healthcare facilities adjust to fluctuating demand, including seasonal variations. However, challenges such as technical expertise, infrastructure costs, and data accuracy issues remain barriers to successful implementation. This review highlights the importance of integrating traditional inventory models with modern technological advancements to enhance the efficiency and effectiveness of drug management systems in hospitals. Future research should focus on addressing these implementation challenges and exploring the impact of integrated systems on healthcare outcomes
Generic Nursing Care for Elderly People With Physical Mobility Disorders at Katsuren Hospital
Problems that often occur in the elderly are caused by the aging process because it causes changes in the body system, one of which is the musculoskeletal system that causes impaired physical mobility. The purpose of this case study is to determine the description of nursing care for the elderly with impaired physical mobility at Katsuren Hospital. The study period was December 2024. This type of research is descriptive using a case study approach. Data were collected through interviews, observations, and measurements. The subject in this case study was an elderly person with impaired physical mobility. The results of the assessment found that the client complained of difficulty standing and moving from one place to a wheelchair, stiffness and pain in the hands, waist, feet and toes, and the client was at risk of falling because of a history of falls. The main nursing diagnoses that emerged were impaired physical mobility, risk of falls, and impaired skin integrity. The implementation was ambulation training with a wheelchair, ROM exercises, fall prevention with environmental modifications, and pain management with deep breathing techniques. The nursing evaluation showed that the results of the muscle strength of the left hand and left leg increased to 4 from the previous 3, this indicates that the problem was partially resolved.
Nursing Care for Geromic Elderly Openers With Osteoporosis
Aging process in the elderly impact on the decline quality live one​ problems that arise namely Osteoporosis, Osteoporosis is Osteoporosis is a systemic bone disease characterized by decreased bone density, making bones prone to fracture or osteoporosis. The purpose of this paper is to describe the implementation of geriatric nursing care at Oribuyama Hospital with a medical diagnosis of Osteoporosis. The method used is a descriptive method with a case study approach to nursing care which includes interviews and observations. The nursing care process includes assessment, nursing diagnosis, planning, implementation, and evaluation. The results of the assessment indicate that Mrs. T experiences impaired physical mobility, acute pain, and a risk of falling. The nursing diagnoses that emerged were impaired physical mobility related to pain, acute pain related to physical injury agents, and risk of falling related to a history of falls . The interventions carried out were the administration of analgesic drugs and non-pharmacological measures such as light walking using a quad walker and measured using a breg balance scale (BBS). The implementation of these results indicates an improvement in balance ability, although the patient is still at risk of falling and requires assistive devices. Evaluation of nursing problems for acute pain and impaired physical mobility was declared effective. The conclusion of this case study is that comprehensive and continuous nursing care can improve the quality of life of the elderly with Osteoporosis.
An Overview of Family Knowledge Levels Regarding Pulmonary Tuberculosis in Bandengan Village, Kendal Sub-District
Pulmonary Tuberculosis remains a major health problem in Indonesia. Family knowledge plays a crucial role as the primary found gon for making decisions regarding the care and treatment assistance of patients. This study aims to describe the level of family knowledge about Pulmonary Tuberculosis in Bandengan Village, Kendal District. The research design used was descriptive quantitative with a cross-sectional approach. The study population included all families in Bandengan Village, with a sample size of 3/4 respondents selected using the stratified cluster sampling technique. The research instrument consisted of a questionnaire that had been tested for validity and reliability. Data analysis involve he frequency distribution of the knowledge variable. Respondent characteristics were dominated by the productive group, with the majority having an elementary school education (34.1%). he results showed that most respondents had knowledge in the good category (51.5%), followed by the moderate ategory (31.7%), and a small portion in the poor category (16.8%). Respondents with a history of family members suffering from Tuberculosis showed a higher level of knowledge (90.9% in the good category) cogipared to healthy families (50.2% in the good category). In conclusion, the level of family knowledge about Pulmonary Tuberculosis in Bandengan Village is predominantly in the good category. However, strengthening education remains necessary regarding nutritional aspects, emotional support, and drug resistance understanding to enhance family independence in caring for patients at home.
Effectiveness of Active Range of Motion (ROM) on Increasing Muscle Strength In Patients With Hemorrhagic Stroke at Chuzan Hospital Okinawa Japan
The government has implemented a number of initiatives to address health care issues through Health policy decisions. The aim of Health policy is to provide preventive patterns, targeted services to maintain health, treat diseases, and provide Health services to the Community. This study aims to discuss the BPJS Health policy, especially the National Health Insurance Program (JKN) that has been implemented in Indonesia. This research is a system literature review (SLR) research using a qualitative descriptive approach. There are 17 journals sampled in this study. The literature search used various databases, including Pubmed and Google Scholar. The results showed that JKN policy implementation has gone well in several regions and cities by achieving high targets. Although there are still obstacles in its implementation such as lack of facilities, administrative problems, lack of human resources, and lack of public awareness. There are several factors that if not greatly taken into account will affect the success of the policy, namely policy objectives, resources, the nature and attitude of implementers, communication, environment, and facilities.
The Correlation Between Length of Service, Body Mass Index, And Fatigue With Handgrip Strength Among Rss Production Workers
Handgrip strength is an important indicator of musculoskeletal health and overall body muscle strength. The production process of Ribbed Smoke Sheet (RSS) rubber at PTPN I Regional 3 Sukamangli is still dominated by manual handling. Objective: This study aimed to determine the correlation between working period, Body Mass Index (BMI), and fatigue with handgrip strength among RSS production workers. The research method was a quantitative analytic survey with a cross-sectional approach. The sampling technique used a saturated sample (census) with a total of 46 RSS production workers. Data analysis used the Spearman Rho correlation test. The univariate results showed that the respondents were dominated by males (91.3%), with an average age of 40 years, and predominantly had a junior high school education (47.8%). Most workers had a long working period >5 years (89.1%), a normal BMI (54.3%), moderate fatigue levels (34.8%), and handgrip strength in the good and moderate categories (28.3% each). The bivariate analysis indicated a significant correlation between working period and handgrip strength (p=0.004; r=-0.420), a significant correlation between BMI and handgrip strength (p=0.037; r=-0.308), and a very strong significant correlation between fatigue and handgrip strength (p=0.000; r=-0.745). Based on the findings, all three variables were significantly correlated with handgrip strength, with fatigue showing the most optimal negative correlation toward handgrip strength reduction
Implementation of Active ROM Exercise Techniques in Elderly People With Non-Hemorrhagic Stroke With Physical Mobility Impairment at Shangri-La Itoman, Okinawa (Japan)
Stroke is one of the main neurological diseases in adults, assessed by the high incidence rate, emergency, leading cause of disability, and death. Stroke describes an event that occurs acutely or suddenly. In Japan, 1,400,000 stroke sufferers were found consisting of 61% ischemia, 25% intracerebral hemorrhage (ICH), 11% subarachnoid hemorrhage, and almost 132,000 people die every year. Analyze the effectiveness of active ROM exercises in helping the recovery of motor function in stroke patients. This study uses a descriptive analytical method in the form of a literature review to analyze the problem of nursing care carried out on one client with stroke. The location of the client's research was at Shangri-La Itoman, Okinawa Prefecture, Japan. The client review that has been done found an increase in movement in the client. Mrs. S during the client assessment was able to perform exercise techniques (ROM) on the limbs that were experiencing weakness. In establishing the diagnosis, the client had 3 problems resolved on the third day. The conclusion is that the ROM therapy method is expected to help the client's healing process. ROM therapy provides a functional recovery effect on the patient's extremities. This intervention has been proven effective as a complementary therapy in improving extremity movement in patients. There are changes in ROM therapy for stroke patients.
The Relationship between Handwashing with Soap Behavior and the Incidence of Diarrhea among Toddlers
Diarrhea is a disease that poses a serious risk to children's nutritional status and survival. One of the preventive efforts is handwashing with soap (HWWS). Data from Merbau Mataram Community Health Center show an increasing trend in diarrhea cases among toddlers, from 9.94% (2021) to 56.0% (2024). This study aimed to determine the relationship between handwashing with soap behavior (knowledge, attitude, and practice) and the incidence of diarrhea among toddlers. This was a quantitative study using a cross-sectional approach. The sample consisted of 97 toddlers aged 12–59 months selected using proportional random sampling. The research instrument was a questionnaire, and data were collected through interviews with the mothers of toddlers. Data analysis was conducted using univariate and bivariate analyses with the Chi-square test. The results showed that 43 toddlers (44.3%) experienced diarrhea, while 54 toddlers (55.7%) did not. Most mothers had good knowledge (55.7%), negative attitudes were still relatively dominant (50.5%), and 58.8% of mothers had good handwashing practices. Bivariate analysis showed significant relationships between knowledge (p=0.002), attitude (p=0.018), and practice (p=0.000) with the incidence of diarrhea.
Integration of Machine Learning-Based Type 2 Diabetes Prediction Models Into Clinical Workflow Systems
Complications of diabetes mellitus are the main causes of morbidity, mortality, and increased health care costs. In recent years, machine learning-based prediction models, particularly Random Forest (RF) and Convolutional Neural Network (CNN), have shown promising capabilities in identifying diabetic patients who are at risk of complications. This systematic review aims to analyze the extent of integration of RF and CNN-based diabetes complication prediction models into clinical workflow systems, evaluate the operational feasibility of their implementation, and identify key barriers to their adoption. The study was conducted following the guidelines of PRISMA 2020 through a literature search on PubMed, Scopus, and Web of Science for publication in 2015-2026. Studies that meet inclusion criteria include the use of RF or CNN to predict diabetes complications in the context of health care, electronic health records, or clinical decision support systems. Data was synthesized using a thematic narrative synthesis approach. The results of the study show that most of the RF and CNN models are still in the non-integrated or semi-integrated stage. RF is easier to implement because it has better interpretability and computational efficiency, whereas CNN shows high predictive performance especially in medical imaging-based complications, but faces challenges related to computational needs and model transparency. Factors that affect the success of the implementation include system interoperability, data quality, infrastructure readiness, and user acceptance. Further implementation research is needed to support the continued integration of RF and CNN models in clinical practice.