Journal Title:International Journal of Health Science (IJHS) Initials: IJHS Frequency: March, July, November Print ISSN: 2827-959X Online ISSN:2827-9603 Editor in Chief: Aufa Rizka Azzumi, S.E.,M.A DOI: 10.55606 Publisher: Lembaga Pengembangan Kinerja Dosen International Journal of Health Science (IJHS) is a peer-reviewed international journal that publishes practices, ideas, and research in all health and nursing science or practice fields from a global viewpoint.This journal is SINTA 5 accredited (Decree of the Director General of Higher Education, Research and Technology Number 10/C/C3/DT.05.00/2025 dated March 21, 2025 concerning the Accreditation Rating of Scientific Journals for Period I of 2025) starting from Volume 2 Number 2 of 2022 to Volume 7 Number 1 of 2027. The International Journal of Health Science (IJHS) aims at highlighting evidence on Surgical Medical Practice, Pharmacy, Maternity, Child Health, Mental Health, Dental, Medical Education, Midwifery, Medicine and Nursing, Health Policy and Management, Community Nutrition, Environmental Health, Epidemiology, Reproductive Health, Health Promotion, Occupational Safety & Health, Other Health Professions to a global audience. The International Journal of Health Science (IJHS) publishes three times a year (in March, July, November). IJHS welcomes submissions of original research, theory and concept development, perspectives, letters to the editors, research methodology papers, study protocols, nursing philosophy papers, case studies, and guest editorials on various clinical and professional health and nursing topics. We also welcome "negative" results (i.e., studies that do not demonstrate a hypothesized difference or relationship). Discussion papers that focus on the concerns and challenges confronting health care in a particular nation are encouraged, as long as the discussion is supported by research. The authors are writing to both a global and a local audience. IJHS publishes most publications in health and nursing science or practice. There are no restrictions on authorship, as long as publications meet the stated objectives and scopes, particularly regarding consequences for health and nursing science or practice. IJHS's intended readership includes health scientists and nurses from all spheres and levels who are committed to advancing practice and professional development through the application of new knowledge and evidence, such as managers and senior members of the health and nursing professions; health and nurse educators as well as students; and researchers from other disciplines with interest in common issues and inter-disciplinary collaboration. Indexed by: Journal Sponsors and Partners :
Anxiety Levels Among Pulmonary Tuberculosis Patients at Dr. Slamet General Hospital, Garut: A Descriptive Study
Pulmonary tuberculosis (TB) is a chronic infectious disease that not only imposes a significant physical health burden but also has profound psychological implications. Among the most commonly observed psychological responses in TB patients is anxiety, which can adversely affect their adherence to treatment regimens and hinder the overall recovery process. Anxiety may arise due to various factors such as prolonged illness, social stigma, isolation, fear of transmission, and uncertainty about treatment outcomes. This descriptive quantitative study aimed to assess the levels of anxiety experienced by pulmonary TB patients undergoing treatment at Dr. Slamet Hospital in Garut, Indonesia. A total of 77 participants who were actively receiving anti-tuberculosis therapy were recruited for the study. Data collection was conducted using the Indonesian version of the Depression Anxiety Stress Scales (DASS-42), a standardized instrument for measuring psychological distress. The findings revealed that a majority of the respondents experienced moderate levels of anxiety (37.7%). This was followed by severe anxiety in 23.4% of the patients, mild anxiety in 19.5%, extremely severe anxiety in 11.7%, and normal levels in only 7.7% of the participants. These results indicate that a considerable proportion of pulmonary TB patients are struggling with anxiety symptoms during their course of treatment. The study underscores the importance of integrating psychological support services into TB treatment programs. Addressing anxiety through counseling, mental health screening, and psychosocial interventions may enhance patients' emotional well-being, improve treatment adherence, and lead to more favorable clinical outcomes. Health professionals and policymakers are encouraged to recognize and respond to the mental health needs of TB patients to ensure a more holistic and effective care approach.
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The Relationship Between Mother’s Knowledge and Breastfeeding Behavior at Mother and Child Hospital Ananda Makassar in 2022
Breast milk is the most complete form of nutrition for infants, capable of fulfilling all their needs across physical, psychological, social, and even spiritual dimensions. It contains essential nutrients, antibodies, and bioactive components that support optimal growth and development while fostering emotional bonding between mother and child. A mother’s level of knowledge plays a pivotal role in shaping her motivation and commitment to breastfeeding, as informed mothers are more likely to initiate and maintain exclusive breastfeeding practices. This study aims to examine the relationship between maternal knowledge and breastfeeding behavior at Mother and Child Hospital (RSIA) Ananda Makassar in 2022. Employing a quantitative research approach with an analytical observational design, the study utilized a cross-sectional method to capture data at a single point in time. Research was conducted from December 2022 to January 2023, targeting a population of 329 mothers who delivered at RSIA Ananda Makassar between May and December 2022. Using purposive sampling based on specific inclusion criteria, a total of 112 respondents were selected for participation. Data were analyzed using the Chi-Square test to assess the association between the independent variable (maternal knowledge) and the dependent variable (breastfeeding behavior). A significance level of 5% (α = 0.05) was applied to determine statistical relevance. The results revealed a significant relationship between mothers’ knowledge levels and breastfeeding behavior (p = 0.003), indicating that higher knowledge levels were associated with better breastfeeding practices. These findings highlight the importance of health education interventions aimed at increasing maternal knowledge on breastfeeding. Strengthening awareness programs, providing counseling during antenatal and postnatal care, and involving family support systems could enhance breastfeeding behaviors. Ultimately, improving maternal knowledge serves as a key strategy to promote exclusive breastfeeding, which in turn contributes to improved infant health outcomes and the overall well-being of both mother and child.
Analysis of Nurses’ Workload in the Inpatient Installation Using the Workload Indicator of Staffing Need (WISN) Method at Pekerja General Hospital, North Jakarta
This study aims to analyze the workload of nurses in the inpatient installation at Pekerja General Hospital, North Jakarta, using the Workload Indicator of Staffing Need (WISN) method. The main objective is to assess whether the number of implementing nurses aligns with the standards set by the Indonesian Ministry of Health Regulation No. 340/MENKES/PER/III/2010 and to provide input regarding the ideal staffing needs for nursing services. This research applies a descriptive quantitative approach with bivariate analysis. The study sample consisted of 68 respondents, encompassing all nurses in the inpatient unit, using probability sampling techniques. Data collection was conducted through work sampling techniques and calculations based on the WISN method. The findings indicate that out of 117 beds, the Bed Occupancy Rate (BOR) ranges from 72.6% to 82.6%, which remains within the normal limit (maximum BOR >85%). The majority of respondents were female (85.2%) and had over one year of working experience. Based on the workload calculation using the WISN method, the hospital is still short of two nurses to meet optimal service requirements. The shortage of nursing staff, although small, has the potential to impact the quality of care, nurse performance, and patient satisfaction. This situation highlights the importance of accurate workload assessment and proper human resource allocation in hospital settings. Nurse managers and hospital administrators are encouraged to use the WISN method regularly as a decision-making tool for staffing adjustments. This study suggests that future research should incorporate additional variables, such as nurse satisfaction, patient acuity levels, and turnover rates, to obtain a more comprehensive understanding of staffing needs. The findings are expected to contribute to nursing human resource planning and management, especially in optimizing nurse-to-patient ratios for better healthcare delivery outcomes.
Evaluation of Environmental Sanitation in Laino Central Market Operations: Assessing Compliance with Health Standards in Raha City
Sanitation issues are critical and need to be addressed by all parties, as they are closely linked to public health. Sanitation refers to efforts aimed at preventing disease by eliminating or controlling environmental factors that contribute to disease transmission. One of the public service facilities that must organize proper sanitation is the public market. This study aims to evaluate the environmental sanitation of Sentral Laino Market in Raha City. The research utilizes a quantitative descriptive analysis method to assess various parameters of the market’s sanitation. A total of 14 parameters were measured based on the Regulation of the Indonesian Minister of Health No. 17 of 2020. The parameters and their respective values are as follows: Market Building (75%), Stall Building (63%), Waste Disposal (60%), Sewage and Drainage (57%), Toilets (88%), Clean Water (83%), Food and Foodstuff Sales Places (57%), Control of Disease Transmitting Animals (33%), Market Security (50%), Lighting, Temperature and Humidity (100%), Hand Washing Places (50%), Parking Places (75%), Traders/Employees (40%), and Visitors/Buyers (25%). Among the 14 components assessed, 5 components met the required standards, while 9 components did not meet the eligibility criteria. The overall category value, based on the “yes” answers from all the components, totaled 56 points (60%). According to the Regulation of the Indonesian Minister of Health No. 17 of 2020 concerning Healthy Markets, a market is considered eligible if the total score reaches ≥70%. Therefore, the Sentral Laino Market does not meet the standards for a healthy market. This study highlights the need for significant improvements in various aspects of the market’s sanitation to ensure public health and safety. It is crucial for local authorities and stakeholders to address these sanitation challenges to create a healthier environment for both traders and consumers.
Relationship Between Family Support and the Level of Utilization of Elderly Posyandu in the Working Area of Mongeudong Health Center, Banda Sakti Subdistrict, Lhokseumawe City, 2025
Posyandu lansia is a community-based health service effort aimed at improving the quality of life for the elderly thru regular health monitoring. However, the utilization rate of posyandu is still influenced by various factors, including family support. This study aims to determine the relationship between family support and the level of utilization of elderly health posts in the Mongeudong Health Center Work Area, Banda Sakti District, Lhokseumawe City in 2025. This study uses a descriptive analytic design with a cross-sectional approach. The study population consisted of all elderly individuals registered at the elderly health post, totaling 22 people. A sample of 22 respondents was selected using the total sampling technique. The research instruments are a family support questionnaire and a questionnaire on the utilization of elderly Posyandu. Data analysis was performed using univariate and bivariate methods with the Chi-Square test at a significance level of α = 0.05. The research results show that out of 21 respondents with family support, 16 people (33.3%) actively utilize the Posyandu. Conversely, out of 27 respondents without family support, 21 people (43.8%) are passive. Statistical tests show a ρ value of 0.001 < α (0.05), which means there is a significant relationship between family support and the utilization of elderly health posts. There is a significant relationship between family support and the level of utilization of elderly Posyandu. Elderly individuals with good family support tend to be more active in participating in Posyandu activities. It is recommended that families play a more active role in accompanying the elderly, and that community health centers strengthen family education programs to increase participation in Posyandu.
The Effectiveness of e-Booklet on Female Sex Workers’ Knowledge and Behaviour of HIV/AIDS Prevention in Semarang
Sex workers (FSW) are a key population at high risk of HIV/AIDS because they work frequently serving guests. HIV prevention knowledge and behavior are not optimal, education using the e-booklet "Mencegah HIV/AIDS Pada PSP" is a solution to improve HIV/AIDS prevention knowledge and behavior with direct media, easy to understand and accessible to sex workers. The study aims to determine the effectiveness of education using the e-booklet "Mencegah HIV/AIDS Pada PSP" on HIV/AIDS prevention knowledge and behavior among female sex workers (FSW) in Semarang Regency. Using quantitative, Quasi-experimental research design one sample group pre-test and post-test design. Samples of 62 respondents, consecutive sampling technique. Data collection using a questionnaire on HIV/AIDS prevention knowledge and behavior among female sex workers (FSW). Data were tested with Marginal Homogeneity. Results Before education, 62 respondents had poor knowledge and behavior of HIV/AIDS prevention and after education, 62 respondents had good knowledge and behavior of HIV/AIDS prevention. The Marginal Homogeneity Test shows a p-value of 0.000 (<0.05) so H1 is accepted and H0 is rejected, there is effectiveness of education using the e-booklet "Mencegah HIV/AIDS Pada PSP" on knowledge and behavior of HIV/AIDS prevention in female sex workers (FSW) in Semarang Regency. The results indicated a notable improvement in both knowledge and behavior among the participants. Prior to the intervention, participants exhibited poor knowledge and behaviors regarding HIV/AIDS prevention. However, after engaging with the e-booklet, there was a significant shift, with all 62 respondents showing improved knowledge and behavior. The statistical analysis using the Marginal Homogeneity Test yielded a p-value of 0.000 (<0.05), confirming the effectiveness of the education provided through the e-booklet.
Depression and Anxiety as Risk Factors for Vitiligo
vitiligo is a disease characterized by the selective loss of melanocytes, resulting in non-scaly chalk-white macules. There is no hypothesis that can clearly explain the scientific cause of vitiligo. However, some studies have indicated that stress and emotional pressure factors, such as anxiety, may contribute to the development or exacerbation of this condition. Research Objective: this study aims to determine whether there is a relationship between depression and vitiligo, whether there is a relationship between anxiety and vitiligo, whether there is a relationship between smoking and vitiligo, and whether there is a relationship between depression and anxiety with vitiligo. Method: analytical observational research using a cross-sectional method is the research design employed. Purposive sampling is used to select the population based on inclusion and exclusion criteria, resulting in 53 responses. This study was conducted by interviewing patients using the Beck Depression Inventory and Beck Anxiety Inventory questionnaires, assisted by the researcher. Data analysis used univariate, bivariate, and multivariate analysis. Results: findings indicate that the significance value of Pearson chi-square is 0.001 < 0.05, meaning there is a significant relationship between depression and vitiligo. There is a significant relationship between anxiety and vitiligo with a significance value of Pearson chi-square 0.003 < 0.05. Simultaneously, depression and anxiety have a significant relationship with vitiligo. Conclusion: from the research results, it can be concluded that 30% of depression and anxiety can be the cause of vitiligo occurrences. Based on these conclusions, the suggestion that can be used as a consideration is that this research can be used as a basis for further research that links risk factors with the severity of vitiligo.
Analysis of Drinking Water Quality and Environmental Health Risks Due to Exposure to Lead (Pb), Cadmium (Cd), and Iron (Fe) at Refill Drinking Water Depots in the Work Area of the Kadolomoko Community Health Center, Baubau City
Heavy mental contamination in drinking water can be toxic to the bodythis is because the metal is not needed by the body. Cadmium (Cd) and lead (Pb) are dangerous heavy metals because they cannot be broken down by the body and can accumulate in the environment, forming complex compounds at the bottom of the water while Iron (Fe) (essential metal) is needed by the body, but in excessive amounts will cause poisoning. The high use of refilled drinking water has the risk of increasing waterborne diseases. This study aims to determine the content of Lead (Pb), Cadmium (Cd), Iron (Fe) and environmental risks due to exposure to drinking water at the Refill Drinking Water Depot in the Kadolomoko Health Center area of ​​Baubau City. This study uses a descriptive observational method with a design of the Environmental Health Risk Analysis method. The population is all the number of Refill Drinking Water Depots and tested using the Atomic Absorption Spectrophotometer (AAS) method and 6497 people who consume drinking water from the Depot with samples using Slovin totaling 96 respondents with questionnaire instruments and univariate tests. The results of chemical parameters in drinking water at the Refill Drinking Water Depot in the working area of ​​the Kadolomoko Health Center are in accordance with the standard quality standards based on Permenkes No. 2 of 2023 and the results of the Intake Risk Analysis of ingestion exposure in the next 5 years, the ECR value of Lead (Pb) = mg / l / day and the RQ value of Cadmium (Cd) = 0.12 mg / l / day and Iron (Fe) = 0.00043 mg / l / day while in the next 30 years the ECR value of Lead (Pb) =mg/day and the RQ value of Cadmium (Cd) = 0.12 mg/l/day and Iron (Fe) = 0.0004 mg/l/day does not exceed the quality standard, namely ECR ≥ E-4 (10-4) and RQ ≥ 1 Conclusion Refill drinking water at the depot in the Kadolomok Community Health Center work area is safe for consumption for up to 5 years and 30 years into the future.
Environmental Health Risk Analysis Due to Carbon Monoxide (CO) Exposure among Traders on Jalan H. Agus Salim, Bataraguru, Baubau City
Karya Nugraha Market is one of the central shopping areas of Baubau City residents located on H. Agus Salim Street, Bataraguru Village, Baubau City. Every day the area is crowded with all types of vehicles. One of the emissions from motor vehicles is carbon monoxide (CO). This study aims to analyze carbon monoxide (CO) exposure to traders selling on H. Agus Salim Street, Karya Nugraha Market, Baubau City. Air quality measurements were carried out for three days (Saturday, Sunday and Monday) at 3 measurement points (point 1, the entrance area of Karya Nugraha Market, point 2, the parking area, and point 3, the vegetable seller area), within 8 hours, namely in the morning (06:00-09:00), noon (12:00-14:00) and in the afternoon (16:00-18:00). This research method uses descriptive observation. The sample used was 89 people . The respondent data collection technique was purposive sampling with the Environmental Health Risk Analysis (ARKL) method. For carbon monoxide (CO) concentration sampling, the AS8700A Carbon Monoxide Meter was used . The results of the research that has been carried out the concentration value on Saturday the highest value is in the afternoon of 27.207 μg / m 3, on Sunday of 47.613 μg / m 3 and on Tuesday the highest value is 36.276 μg / m 3. Of the 3 three sample points in the morning, afternoon and evening have an RQ value ≤ 1 so it can be said to be not at risk . Thus, it is hoped that the Baubau City Environmental Service will routinely monitor the spread of pollutant concentrations, especially carbon monoxide (CO) on Jalan H. Agus Salim, Karya Nugraha Market, Baubau City to support air pollution control.
Environmental Health Risk Analysis Due to Particulate Matter (PM10) on Workers at PT Diamond Alfa Propetindo, Gundu-Gundu Village, Mawasangka Tengah District, Central Buton Regency
According to the ILO ( International Labour Organization ) factory workers in industrialized countries are affected by respiratory diseases (pneumoconiosis, silicosis and others) due to exposure to dust in the workplace. PM 10 in the air is the main parameter in air pollution originating from the use of transportation and increased industrial activity. The results of explosions from factories and vehicles entering and leaving the industry can pollute the air and produce pollutants and some workers at the PT Diamond Alfa Propetindo factory do not use personal protective equipment (PPE) masks so that there is possible pollution of particulate matter (PM 10 ) which is dangerous and causes health problems . This study aims to analyze environmental health risks due to Particulate Matter (PM 10 ), individual characteristics, risk level (RQ), and risk management. This study uses a descriptive observational method and Environmental Health Risk Analysis (ARKL). Respondent data collection techniques use total sampling and questionnaires. The results of PM 10 measurements that have been converted to a 10-hour measurement time at point 1 are 62.8 µg/m 3 , point 2 is 62.7 µg/m 3 , point 3 is 72.2 µg/m 3 and point 4 is 60.1 µg/m 3 and do not exceed the threshold value (NAB) of ambient air quality standards. The results of the RQ calculation obtained from 60 workers are RQ ≤ 1 which means they are not at risk of being exposed to PM 10 so they do not require risk management or risk control
Analysis of Environmental Health Risks from Pesticide Exposure among Green Mustard Farmers in Ngkari-Ngkari Village, Baubau City
Ngkari-Ngkari Sub-district is an agricultural area that produces rice, fruits, and vegetables, particularly green mustard (caisin), with a population composed of diverse ethnic groups. The use of pesticides in agricultural activities may pose health risks when applied improperly. This study aims to analyze environmental health risks due to pesticide exposure among green mustard farmers in Ngkari-Ngkari, Baubau City. Plant samples were collected two days after chemical pesticide spraying using standard procedures and analyzed at the UHO Pharmacy Laboratory. A total of 64 farmers were selected through total sampling, and data were obtained using structured questionnaires. Data analysis employed SPSS and the Environmental Health Risk Assessment (EHRA) method. Laboratory results indicated that pesticide concentration in green mustard plants was 0 mg/kg/day or undetected. The estimated intake exposure among farmers was 0.000364 mg/kg/day, while the calculated risk quotient (RQ) of Chlorpyrifos exposure was 0.0121 mg/kg/day. An RQ value ≤ 1 suggests that the 64 farmers were not at risk of adverse health effects from exposure to Chlorpyrifos-based pesticides. This study concludes that pesticide use in Ngkari-Ngkari remains within safe limits for farmers, although continuous monitoring and proper application are necessary to prevent long-term cumulative risks. Limitations of this study include the influence of environmental factors during sampling and the potential effect of sample storage time, indicating the need for biological monitoring and soil condition evaluation in future studies to strengthen the findings.
Effectiveness of Hypnobreastfeeding on Exclusive Breastfeeding at Mumbulsari Community Health Center Work Area
Exclusive breastfeeding is the best period of breast feeding intake for infants because it maximizes health benefits for growth and development. However in reality, there are many hindrances for mothers to give exclusive breastfeeding. Negative perceptions from the mothers itself regarding breast milk often caused the low rates of exclusive breastfeeding. Conventional therapies that has been given only solved one problem at a time, while the actual solution is a holistic care which includes mind, body, and soul. Hypnobreastfeeding is one of the preferred therapy that contains holistic care to improve the exclusive breastfeeding. The aim of this study is to analyze the effect of hypnobreastfeeding on exclusive breastfeeding at Mumbulsari Community Health Center, Jember, East Java, Indonesia. This study used pre-experimental design with post-test only design on pregnant women in third trimester. Simple random sampling was used as sampling technique with 16 treatment group and 16 control group which fulfill inclusion and exclusion criteria. The experimental data was collected using observation sheets which then statistically analyzed using bivariate chi-square test. The result of chi-square test showed that p=0,003 (p < 0,05) which shows that hypnobreastfeeding positively influence exclusive breastfeeding. In conclusion, hypnobreastfeeding is strongly suggested as the treatment to improve exclusive breastfeeding on mothers.
The Relationship Between the Frequency of Infant Massage and the Increase in Body Weight of Infants Aged 6–18 Months at Ralla Community Health Center, Barru Regency
Infant growth and development can be monitored through anthropometric measurements, particularly body weight. Infants with low birth weight (LBW) (< 2500 grams) are at risk of growth disorders. One form of stimulation that can promote infant weight gain is infant massage. This study aimed to determine the relationship between the frequency of infant massage and the increase in body weight of infants aged 6–18 months at Ralla Community Health Center, Barru Regency. This was a quantitative study with a retrospective design. Resulting in 27 infant respondents. The results showed that most respondents received infant massage frequently (88.9%), and 24 infants experienced weight gain (88.9%). Fisher’s Exact test yielded a p-value of 0.000 (p < 0.05), indicating a significant relationship between the frequency of infant massage and the increase in body weight of infants aged 6–18 months at Ralla Community Health Center. This study recommends that parents routinely practice infant massage to optimize infant growth and development, and encourages further research on other factors influencing infant body weight.
Nutritional Interventions During Pregnancy and Their Impact on Neonatal Stunting: A Systematic Review of Evidence from Low and Middle-Income Countries
Stunting continues to pose a serious public health issue in low- and middle-income countries (LMICs), affecting over 148 million children under five globally in 2022. Maternal nutrition during pregnancy plays a crucial role in determining birth outcomes and reducing the risk of stunting. This systematic review assessed the impact of nutritional interventions during pregnancy on stunting prevention and neonatal health in LMICs. A comprehensive search of PubMed, Scopus, Cochrane Library, and Google Scholar was conducted for studies published from 2005 to 2025, including RCTs, quasi-experimental studies, systematic reviews, meta-analyses, and analytical observational studies involving pregnant women in LMIC settings. From 6,204 initial records, 20 studies with over 114,000 participants were included. The review found that energy-protein supplementation reduced stunting risk by up to 28%, while multiple micronutrient supplements lowered the incidence of low birth weight and small-for-gestational-age (SGA) infants. Vitamin D supplementation also significantly reduced SGA risk. Nutrition education and counseling improved maternal dietary practices and lowered stunting rates. Conversely, maternal undernutrition—indicated by low BMI—was associated with a 22% increased risk of child stunting. These findings highlight the effectiveness of both nutrition-specific and nutrition-sensitive interventions during pregnancy. Integrated approaches combining supplementation and education should be prioritized in public health strategies.
Factors Affecting Filling of the Initial Assessment in Inpatience At Putri Hijau Hospital Medan
The issue of improving the quality of health services is a major focus for hospitals in their efforts to provide effective, efficient, and patient-safety-oriented services. One important indicator in improving the quality of nursing services is the process of completing the initial patient assessment, as this stage forms the basis for planning and implementing further nursing actions. This study aims to identify and analyze the factors that influence the initial assessment process at Putri Hijau Hospital in Medan in 2022. The research method used was quantitative with an analytical survey approach and a cross-sectional design. The research population included 135 nurses working in the inpatient ward, while the research sample consisted of 57 nurses selected using incidental sampling techniques. Data collection was carried out using a structured questionnaire that measured the variables of nurses' abilities, skills, attitudes, and motivation. The data were analyzed using univariate and bivariate analyses with the Chi-Square statistical test to determine the relationship between variables. The results showed that the factors of competence and skills (p = 0.002), attitude (p = 0.000), and motivation (p = 0.013) had a significant effect on the completeness and accuracy of the initial assessment of inpatients. These findings illustrate that nurses with high technical competence, positive attitudes, and strong motivation are better able to carry out initial assessments quickly and accurately. Based on these results, it is recommended that hospital management improve continuing education programs, conduct regular supervision, and provide performance-based rewards to strengthen nurses' motivation and professionalism in carrying out optimal initial assessments of patients.
The Role of Health Management in Enhancing Community Health Center Service Quality under the National Health Insurance (JKN) Program in Coastal Areas
The implementation of the National Health Insurance (JKN) requires Community Health Centers (Puskesmas) as first-level health facilities to not only provide basic services but also optimize management governance to maintain service quality evenly, including in coastal areas that face geographical and social challenges. This study aims to analyze the role of health management in improving the quality of Community Health Center services in coastal areas during the JKN era through planning, organizing, implementing, and evaluating functions. The method used is descriptive qualitative with a phenomenological approach, through a literature review and analysis of the empirical experiences of Community Health Center managers, health workers, and the community. The results of the study indicate that the implementation of management functions has been carried out administratively, but its effectiveness still depends on human resource capacity, cross-sector support, and the ability to adapt to local cultural characteristics. Strategies that have proven effective include a proactive approach , digitalization of simple services, competency-based task allocation, and strengthening therapeutic communication. Structured health management has been shown to have a positive impact on accelerating services, increasing public trust, and reducing patient complaints. Thus, strengthening local needs-based management is key to the success of coastal Community Health Centers in supporting the implementation of JKN in an inclusive and equitable manner.
Factors Influencing Mothers in Breastfeeding in Sibolahotang SAS Village, Balige District, Toba Regency, Year 2025
This study aims to identify and analyze the factors influencing mothers in providing breast milk (ASI) to infants aged 0–24 months in Sibolahotang SAS Village, Balige District, Toba Regency. Breastfeeding is a crucial determinant of infant health and development, yet many mothers face challenges that affect exclusive breastfeeding practices. The research employed a descriptive quantitative method with 56 respondents selected using total sampling. Data were collected through structured questionnaires and analyzed descriptively to determine the level of support and knowledge influencing breastfeeding. The results showed that most respondents (71.4%) were unemployed, and 78.6% received breastfeeding information from health workers. All respondents (100%) reported supportive roles from fathers and families in the breastfeeding process, while 87.5% acknowledged support from healthcare providers. Additionally, all mothers (100%) demonstrated good knowledge about the benefits and importance of breastfeeding. These findings highlight that social support and adequate knowledge are key factors contributing to the success of breastfeeding. Strengthening educational interventions and involving family members, especially fathers, in breastfeeding programs are essential strategies to improve maternal and child health outcomes. This research contributes to the understanding of community-based breastfeeding promotion and provides a foundation for future studies and policy formulation related to maternal and child health development in Indonesia.
Determining Factors in Choosing a Caesarean Section: The Role of Health Financing and Availability of Health Facilities in Indonesia
The rising global cesarean section (SC) rate, projected to reach 29% by 2030, is a concern in Indonesia, where SC prevalence increased to 25.9% in 2023 from 17.6% in 2018. While medical indications drive SC, non-clinical factors like financing and healthcare access may contribute to overuse. This study examines the role of Indonesia’s BPJS health insurance and hospital availability in determining SC utilization. A cross-sectional analysis was conducted using SKI 2023 data, including 70,916 women with deliveries between 2018 and 2023 (weighted n = 20,076,001). Bivariate associations were assessed using chi-square tests with complex sample design, applying survey weights for national representativeness. SC prevalence was 25.9%, with 34.9% of BPJS-covered deliveries being SC compared to 10.8% for out-of-pocket payments (p < 0.001). Hospital availability within the district was associated with a 27.0% SC rate versus 16.1% where no access existed (p < 0.001). Private insurance (50.3%) and employer-funded (37.4%) deliveries also showed higher SC rates. BPJS coverage and hospital availability significantly influence SC utilization in Indonesia, suggesting improved access but potential overuse. Rural disparities highlight the need for infrastructure investment to ensure equitable maternal care under Universal Health Coverage. Further research with causal methods is recommended.
Evaluation of the Knowledge and Preparedness Level of Disaster Response Pharmacists Regarding Disaster Man-agement
Indonesia is an archipelagic country flanked by two continents and two oceans, and is located on the equator which causes Indonesia to have a very high potential for disasters. Pharmacists have a role in disaster management in handling pre, during and post disasters. The aim of this research was to deter-mine the level of knowledge of disaster response pharmacists (ATB) regarding disaster management. This research is a descriptive research with total sampling method. Data collection techniques using a questionnaire. The questionnaire was filled in directly by disaster response pharmacists who were willing to participate. Based on the results of research on pre-disaster pharmacist preparation results, the knowledge level was obtained with a percentage of 88% and included in the good category. For the willingness and readiness of pharmacists during a disaster, the percentage was 97.5%, included in the level of knowledge in the good category, when a disaster occurred, the percentage was 97. 6% was in-cluded in the level of good knowledge category. Based on the results, it can be concluded that the knowledge level of disaster response pharmacist members about disaster management is 95.8% and is categorized as good.
Factors Associated with Work Fatigue (Occupational Health Study) among Firefighters in City X
Firefighters are required to possess excellent physical capacity given that their tasks have major implications for public safety. The volume and criticality of duties often lead firefighters to work more than 12 hours per day for 14 consecutive days. Unmanaged work fatigue can reduce performance and increase occupational safety and health risks. Factors that influence work fatigue include age and Working Period. The aging process, marked by an increase in age, leads to a decrease in work ability due to changes in the functions of body organs, the cardiovascular system, and the body’s hormonal system. Length of service refers to the period of time a person has been employed at a particular office, organization, or institution. A preliminary survey found that 47% of firefighters at the City X Fire and Rescue Agency (DAMKAR) felt moderately fatigued and 13% felt highly fatigued, based on the KAUPK2 instrument. This study aimed to determine factors associated with work fatigue among firefighters in City X. Methods: A cross-sectional design was employed, with data collected at a single point in time, in Mei 2025. The study subjects were firefighters employed by the City X Fire Department. Purposive sampling yielded 56 respondents. Worker Age, working period, and work fatigue were measured using questionnaires. Bivariate relationships among variables were analyzed using the chi-square test. Results: The number of respondents categorized as “not fatigued” was 2, “moderately fatigued” was 21, and “highly fatigued” was 5. Bivariate chi-square analyses indicated significant associations between age and work fatigue, and between tenure and work fatigue (p<0.05). Age was significantly associated with fatigue (p=0.002). Working Period was significantly associated with fatigue (p=0.049). Conclusions: Age and tenure were associated with work fatigue (p<0.05). Future studies were suggested to examine additional factors beyond age and Working Period.
Overview of the Quality of Service for Participants Using the Health Social Security Administering Body and Non-Health Social Security User Body at Hospital X
The quality of healthcare services is a crucial factor in determining patient satisfaction, particularly in the context of the implementation of the National Health Insurance (JKN) through the BPJS Health (Social Security Agency for Health). This study aims to describe the differences in healthcare service quality between BPJS and non-BPJS patients at Hospital X. Using a descriptive qualitative approach with SERVQUAL theory, data were collected through in-depth interviews and direct observation of the administrative service process. The results indicate a gap in service delivery, particularly in the dimensions of responsiveness and empathy. Non-BPJS patients tend to receive faster, friendlier, and more personalized service, while BPJS patients experience longer waiting times and less empathetic interactions with staff. These findings indicate that services at Hospital X do not fully reflect the principles of justice and equality. Improvements to the service system and staff competency are necessary to enhance the quality of care for all patients, regardless of insurance status.
The Relationship Between Self-Esteem and Psychological Well-Being Among Adolescent Victims of Bullying in Junior High School
Bullying is an intentional aggressive action or behavior, carried out by a group of people repeatedly and from time to time against a victim who cannot defend himself easily or as an abuse of power or strength . Bullying is also a serious problem among teenagers that has a direct impact on the psychological condition of the victim, especially on aspects of self-esteem and psychological well-being. This study aims to analyze the relationship between self-esteem and psychological well-being in adolescent victims of bullying in junior high schools . This type of research uses a non-experimental design with a cross-sectional approach that is included in the type of descriptive correlational research with 63 research subjects. Simple sampling in the study used a purposive sampling method calculated by the Slovin formula and produced 54 samples. The instruments used were the Rosenberg Self-Esteem Scale (RSES) to measure self-esteem and the Psychological Well-Being Scale for Children (PWB-C) to measure psychological well-being. Data were analyzed using the Spearman Rank test, the results of the study showed a p-value = 0.000 (p < 0.05) and r = 0.550, which means there is a significant positive relationship between self-esteem and psychological well-being in adolescent victims of bullying . The higher the adolescent's self-esteem, the better their level of psychological well-being.
Literature Review: The Influence of Family Support on the Quality of Life of Patients with Type 2 Diabetes Mellitus
Diabetes mellitus is a chronic, lifelong disease that requires long-term treatment, leading to a decreased quality of life. Diabetes mellitus is a condition characterized by a significant increase in blood sugar levels, or hyperglycemia, which causes a decrease in the insulin hormone. The number of people with type 2 diabetes increases annually, reaching approximately 230 million worldwide. To maintain a healthy lifestyle, patients require support from those around them, especially their families. The purpose of this study was to determine the effect of family support on the quality of life of patients with type 2 diabetes mellitus. This study used a Systems Literature Review design. Articles were collected through PubMed and Google Scholar databases using the keywords (Family Support, Type 2 Diabetes Mellitus, Quality of Life). The criteria for articles published between 2019 and 2025 were those published. The results showed that family support influences the quality of life of patients with type 2 diabetes mellitus. Conclusion: There is a significant relationship between family support and the quality of life of patients with type 2 diabetes mellitus.
Smoking Prevention in Indonesian Schools: Policy Opportunities in the Perspective of the Kingdons Multiple Streams Framework
The prevalence of smoking among children and adolescents (school age) in Indonesia continues to increase, even though there have been various regulations such as Permendikbud No. 64 of 2015 and PP 109 of 2012. This fact indicates that schools are not yet able to become a safe and free environment from cigarette exposure. This study aims to analyze the dynamics of school-age smoking prevention policies using the Kingdon's Multiple Streams Framework (MSF), which identifies three major currents in policy: problem, policy, and politics. Through an integrative literature review approach to various scientific sources and policies for the 2021–2025 period, this study found that problem and policy streams have been relatively strong, but political streams are still weak. The lack of political commitment, the strong influence of the cigarette industry, and the lack of ratification of the FCTC are the main obstacles to the opening of the policy window. The proposed strategy includes a softening up approach with a focus on preventing smoking in schools as a form of protecting the future generation of the nation, as well as coupling focusing events by utilizing viral events to suppress public opinion and policymakers. The role of policy entrepreneurs from academics, teachers, NGOs, and educational and health institutions is very crucial in uniting the three policy streams. This study encourages the birth of new policies that are more specific, evidence-based, and sustainable in protecting school children from the dangers of smoking.
Implementatiton Of Dzikir Therapy On Elderly People Experiencing Anxiety Due To Diabetes Mellitus In The Sindangkasih Community Health Center Area, Ciamis Regency
Based on data collected from the Sindangkasih Health Center UPTD, in 2024 there were 601 recorded cases of diabetes mellitus. By 2025, the number of visits by diabetes mellitus patients fluctuated each month. In January, there were 8 male and 26 female patient visits, while in February there were 9 male and 26 female visits. This study aims to describe the reduction of anxiety symptoms among elderly individuals suffering from diabetes mellitus. Type II diabetes mellitus (Type II DM) represents the most prevalent form of diabetes, comprising approximately 85–90% of all cases worldwide. This condition is commonly observed in older adults and poses a major global health challenge. The elderly, defined as individuals aged 60 years and above, often experience anxiety related to their health conditions. Anxiety itself is an unpleasant emotional state characterized by feelings of worry, fear, and unease at varying intensities. Dhikr, or the remembrance of Allah, serves as a spiritual practice to achieve calmness and closeness to God. This research employs a qualitative descriptive method with a case study approach to explore nursing issues and intervention strategies. The applied intervention—dhikr therapy—was used to help elderly patients reduce anxiety symptom scores. A five-day evaluation revealed that both Patient 1 and Patient 2 showed improvement, each exhibiting a reduction of 10 anxiety-related symptoms. The findings indicate that dhikr therapy effectively lowers anxiety levels and enhances patients’ ability to manage their emotional well-being.
Application of Deep Breathing Relaxation Techniques Accompanied by Mozart's Classical Music to Reduce Anxiety Disorders in Elderly Hypertensive Patients
One of the most common diseases suffered in Tasikmalaya City is hypertension, which is especially common in the Sambongpari Health Center service area. One of the psychological impacts on the elderly who have a history of hypertension is anxiety disorders that affect the quality of life. Deep breathing exercises and Mozart classical music therapy are two non-pharmacological methods that can be used to reduce anxiety. The purpose of this study was to determine the description of the application of deep breathing relaxation techniques accompanied by Mozart classical music in reducing anxiety in elderly hypertensive patients. Hypertension is a chronic condition known as a silent killer that can cause serious consequences including heart failure, stroke, and kidney disease without symptoms. Anxiety is a change in condition felt by a person that can cause fear and anxiety caused by internal and external threats. The study used a descriptive case study approach with two elderly subjects who had hypertension accompanied by anxiety disorders. The intervention was carried out for five days in the Sambongpari Health Center work area of ​​Tasikmalaya City. Measurement of anxiety scores before and after the intervention, observation, and interviews were used to collect data. Based on the results, the anxiety scores of both clients decreased after receiving regular deep breathing relaxation exercises while listening to Mozart classical music. Based on the research results, elderly with a history of hypertension can effectively reduce their anxiety levels by combining deep breathing relaxation techniques with Mozart's classical music. This intervention is an effective non-pharmacological therapy option to reduce anxiety.
Tele-Physiotherapy for Older Adults: A Scoping Review of Feasibility, Accessibility, and Clinical Outcomes
The rapid expansion of digital health technologies has increased interest in tele-physiotherapy as an alternative or complementary approach to traditional in-person rehabilitation for older adults. However, evidence regarding its feasibility, accessibility, and clinical outcomes remains fragmented across different populations and delivery models. This scoping review aimed to explore and synthesize current evidence on the feasibility, accessibility, and clinical effectiveness of tele-physiotherapy interventions for older adults published between 2020 and 2025. A systematic search was conducted across four major databases, PubMed, Scopus, and Google Scholar, for studies published from 2020 to 2025. Inclusion criteria comprised peer-reviewed articles involving older adults (≥60 years) who received physiotherapy via telehealth platforms. Studies focusing on feasibility, usability, or clinical outcomes were included. After screening 490 articles and removing duplicates, 8 studies met the inclusion criteria. Data were extracted on study design, sample characteristics, interventions, and outcomes. Tele-physiotherapy represents a promising, cost-effective, and accessible rehabilitation strategy for older adults, particularly in contexts with restricted physical access to healthcare. Although feasibility and short-term effectiveness are well-supported, further research is required to evaluate long-term outcomes. Integrating tele-physiotherapy into geriatric care models could enhance continuity of care and promote functional independence in the aging population.
The Use of Vitamin D in Heart Failure Management: A Literature Review
Heart failure is a clinical syndrome characterized by structural or functional cardiac dysfunction that leads to hemodynamic disturbances and increased morbidity and mortality. Vitamin D, a prohormone with a vital role in metabolism, is known to exert cardioprotective effects through anti-inflammatory and anti-fibrotic mechanisms, modulation of calcium homeostasis, and inhibition of the renin–angiotensin–aldosterone system. Vitamin D deficiency has been shown to be highly prevalent among patients with heart failure and is correlated with poorer clinical outcomes. Numerous preclinical studies support the protective role of vitamin D against ventricular remodeling and myocardial hypertrophy; however, clinical trials in humans have yielded inconsistent and often contradictory findings regarding its effects on systolic function, surrogate parameters, and primary outcomes such as mortality and hospitalization. Consequently, vitamin D supplementation cannot yet be recommended as a standard therapy for heart failure, except in patients with confirmed deficiency. Further research with robust methodologies and stratified populations remains essential to elucidate its potential clinical benefits.
The Relationship between Knowledge and Preparedness to Deal with Dense Residential Fires in Antang Village, Manggala District, Makassar City
Residential fires are one of the disasters that often occur in densely populated areas and have the potential to cause major losses both in terms of safety and public health. The level of public knowledge is an important factor that affects preparedness in dealing with these situations. This study aims to analyze the relationship between the level of community knowledge and preparedness to deal with residential fires in Antang Village, Manggala District, Makassar City. The research design used was cross-sectional with a total of 67 respondents selected through simple random sampling technique. Data was collected using a questionnaire that had been tested for validity and reliability, then analyzed using the Chi-Square test with a significance level of 0.05. The results showed a significant relationship between the level of community knowledge and preparedness to deal with residential fires (p = 0.000). In conclusion, the higher the level of public knowledge, the better their preparedness in dealing with fire disasters. Efforts to improve education and training on fire simulations are needed periodically to strengthen community preparedness.
The Effectiveness of Education Through Peer Groups on Increasing Knowledge, Attitudes and Implementation of Balanced Nutrition in Preventing Anemia
Adolescence is a crucial period in the human life cycle for improving the Human Development Index. Growth during adolescence is more rapid than in previous periods, resulting in increased nutritional needs. Rapid growth and high activity levels in adolescents can impact nutritional needs. Therefore, adolescents, especially adolescent girls, are a group that is vulnerable to nutritional problems, including anemia and KEK.These problems in girls are closely related to stunting. This study aims to determine the effectiveness of peer group education on improving knowledge, attitudes, and the application of balanced nutrition in preventing anemia in adolescent girls. The research method used a quasi-experimental non-equivalent control group design. The sample size was 62 people. The sampling technique used purposive sampling. The data obtained were then analyzed using paired t-test statistics and Wilcoxon for paired difference tests. The results showed that the overall p-value obtained was <0.05, indicating a difference before and after the intervention in improving knowledge, attitudes, and the application of balanced nutrition in preventing anemia. Peer Group Education is effective in improving knowledge, attitudes, and the application of balanced nutrition in preventing anemia in adolescent girls.
The Effect of Digital Application Rewards on Elementary School Students' Motivation and Learning Engagement Through Digital Behaviorism
The development of digital technology has led to the emergence of learning applications that offer rewards as a strategy to reinforce students' learning behaviors in elementary schools. This study aims to systematically examine the influence of rewards in digital learning applications on students' motivation and engagement through the principles of digital behaviorism. The method used is a Systematic Literature Review (SLR), involving identification, selection, extraction, and synthesis of articles from international and national scientific databases. The findings indicate that digital rewards, such as points, badges, leaderboards, and instant feedback, can enhance both intrinsic and extrinsic motivation, strengthen emotional, cognitive, and behavioral engagement, and promote learning consistency and independence. These findings provide practical implications for teachers in designing interactive and engaging learning experiences and serve as a reference for application developers and researchers to develop effective digital reinforcement strategies
The Effect of Sucking Ice Cubes on Reducing Thirst in CKD Patients at Sentra Medika Cisalak Hospital
Chronic kidney disease (CKD) can be defined as an irreversible impairment of kidney function, where the kidneys' ability to regulate electrolytes, fluid balance, and metabolism declines, resulting in uremia. Fluid restriction in patients with chronic kidney disease increases the frequency of thirst. The increase in plasma sodium concentration causes intracellular dehydration in the thirst center, thereby stimulating the sensation of thirst.This study aims to determine the effect of sucking ice cubes on thirst in chronic kidney disease patients at Sentra Medika Cisalak Hospital. This study uses a one-group pre-post test design. The population was taken using total sampling of 72 patients with chronic kidney disease who received the intervention of sucking ice cubes to reduce thirst. The data collected were thirst scale data before and after sucking on ice cubes. The bivariate analysis conducted was using the paired sample t-test. From the research findings, it can be concluded that there is a significant influence between sucking ice cubes and the thirst scale in patients with chronic kidney disease with p= 0.000. Conclusion sucking on ice cubes can reduce thirst in patients with chronic kidney disease.
Analysis of Occupational Psychological Factors Related to Burnout among Textile Workers in a Textile Manufacturing Company in Semarang
Occupational psychological factors comprising interpersonal relationships, career development, role demands, and organizational climate play a pivotal role in shaping employee well-being and mitigating burnout in industrial settings. Burnout, characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment, poses substantial risks to productivity and mental health, particularly among textile manufacturing workers who often face high physical demands, repetitive tasks, long working hours, and strict production targets. This study examined the associations between key occupational psychological factors and burnout among 54 textile workers in a textile manufacturing company in Semarang, Indonesia. A cross-sectional design was employed, with data collected using structured questionnaires and analyzed through Chi-Square tests. Results revealed significant associations between all examined factors and burnout: interpersonal relationships (p = 0,000), career development (p = 0,000), role demands (p = 0,011), and organizational climate (p = 0,009). These findings highlight the critical importance of fostering supportive interpersonal relationships, transparent career development opportunities, balanced role expectations, and a positive organizational climate to prevent burnout and enhance occupational health and performance.
Administrative Resilience in Middle Eastern Healthcare within Conflict Zones
This study examines the construct of administrative resilience within mental and physical health service systems in Middle East conflict zones using Confirmatory Factor Analysis (CFA) within Structural Equation Modeling (SEM). Data were derived from 847 policy documents and operational reports from twelve countries (2018–2024), accessed through official online sources. The measurement model showed good fit indices (χ²/df = 2.134, CFI = 0.962, TLI = 0.955, RMSEA = 0.047, SRMR = 0.038), indicating structural stability and validity of the theoretical model. CFA confirmed four dimensions of administrative resilience with significant loadings: Adaptive Policy (λ = 0.871, CR = 12.453, p < 0.001), Cross-Sector Coordination (λ = 0.834, CR = 11.287, p < 0.001), Professional Competence (λ = 0.792, CR = 10.564, p < 0.001), and Operational Stability (λ = 0.815, CR = 11.098, p < 0.001). Reliability results were strong (Cronbach's α = 0.863–0.921; Composite Reliability = 0.879–0.934; AVE = 0.647–0.782). Findings reinforce Boin and Lodge’s (2016) concept of organizational resilience and extend Comfort et al. (2010) by integrating operational stability as a relevant dimension in conflict settings. Unlike Kruk et al. (2015), which focused on general health systems, this study identifies unique adaptive mechanisms within dual mental–physical services while addressing the fragmentation gap noted by Jawad et al. (2019) through empirical formulation of interdependent administrative dimensions.
From Benign To Malignant: A Case Report of Male Breast Cancer Mimicking Gynecomastia
Introduction: Carcinoma of the male breast is a very uncommon malignancy and accounts for less than 1% of all cases of breast carcinoma. The nonspecific presentation, along with low clinical suspicion, usually results in diagnosis at a delayed stage and poorer outcomes. Gynecomastia is a benign proliferation of male breast tissue and is the most common differential diagnosis that can mask underlying malignancy. Objective: To present a rare case of male breast cancer initially misdiagnosed as gynecomastia, and to emphasize the importance of early recognition and accurate differentiation between benign and malignant male breast conditions. Case Report: A 40-year-old male patient presented with a progressively enlarging right breast mass, which was earlier diagnosed as gynecomastia. The mass had been present since childhood but showed notable growth over the past two years. Physical examination revealed a hard, immobile, tender mass, 7 × 10 cm in size, without nipple discharge or axillary lymphadenopathy. Histopathology confirmed mixed carcinoma: invasive carcinoma of no special type with invasive lobular carcinoma. No metastasis was seen on imaging studies. Immunohistochemistry showed ER(+), PR(+), HER2(-), and Ki-67 at 20%. The patient underwent modified radical mastectomy, chemotherapy, and tamoxifen therapy, with no recurrence observed at six-month follow-up. Discussion: This case represents the diagnostic dilemma in differentiating male breast cancer from gynecomastia, particularly in young males without any risk factors. The diagnosis is even difficult when it is an invasive lobular carcinoma or a mixed type. Imaging and biopsy remain important in the management. Conclusion: Clinicians should have a high index of suspicion for malignancy when dealing with male breast masses. A timely diagnosis ensures appropriate treatment and results in better patient outcomes.
Index Card Match as an Interactive Strategy to Improve Elementary School Students' Science Learning Activeness
This study aimed to explore whether the Index Card Match learning model could boost student engagement in science lessons for fourth-grade pupils at UPT SDN 83 Mangindara. We took a descriptive qualitative approach, focusing on how the model was applied and its impact on student activities. The research happened at UPT SDN 83 Mangindara in Takalar Regency during the 2024/2025 school year, involving 22 fourth-grade students 7 girls and 15 boys. Data came from observations, tests, and documentation, analyzed through qualitative descriptive methods. The findings showed that using the Index Card Match model in science classes did enhance student learning activities at UPT SDN 83 Mangindara. In Cycle I, activities were low in the first meeting (categorized as "Less" or K) and stayed that way in the second. But by Cycle II, things improved: the first meeting hit "Enough" (C), and the second reached "Good" (B). Meanwhile, the teacher's performance was solid from the start, rated "Good" (B) in both meetings of Cycle I, and it held steady at that level through both meetings in Cycle II.
Analysis Of Referral System at Maccini Sombala Health Center Based on Human Resources, Medicine Availability, And Service Needs
The implementation of the referral system from First Level Health Facilities (FKTP) to Advanced Referral Health Facilities (FKRTL) occurs when a health facility faces limitations in resources, such as infrastructure, tools, personnel, or budget. Referrals are also made when patients require specialized care, hospitalization, diagnostic tools, or services that the initial health facility cannot provide, including emergency situations. The BPJS Health annual report on referrals at the Layang Health Center indicates a steady increase in the number of referrals year by year. This study aims to analyze the factors supporting and hindering the referral system, focusing on input and process aspects. The research adopts a qualitative case study approach with 17 informants, including health service employees, center heads, doctors, nurses, pharmacists, laboratory staff, JKN officers, and referred patients. The findings show that human resources at the Layang Health Center are adequate, but there are challenges with the availability of medicines, such as shortages and delays in distribution. Referrals are generally made based on medical needs, but some patients request their own referrals. The center’s health facilities are insufficient, and some essential tools are missing. Although the referral system is based on BPJS Health regulations, its implementation faces obstacles. Patients are often unaware of referral requirements, highlighting the need for better socialization and improved medicine and facility provision to optimize the system.
Application of Lavender Aromatherapy and Warm Water Foot Soak Therapy in Hypertensive Patients: A Case Report
Hypertension is a chronic increase in blood pressure that serves as one of the leading causes of cardiovascular disease and mortality in Indonesia. Management of hypertension not only focuses on pharmacological therapy but also involves non-pharmacological interventions such as complementary therapy. The combination of lavender aromatherapy and warm foot soak therapy is believed to reduce blood pressure through physiological and psychological relaxation effects. Objective: To describe changes in blood pressure among hypertensive patients after receiving a combination of lavender aromatherapy and warm foot soak therapy. Method: This study employed a case report design on Mr. E, a 52-year-old patient with mild to moderate hypertension in Balikpapan, East Kalimantan. The intervention was conducted for five consecutive days, with each session lasting 15–20 minutes. Blood pressure was measured before and after the therapy using a digital sphygmomanometer. Data were analyzed descriptively by comparing pre-test and post-test results. Results: A gradual decrease in blood pressure was observed, from 139/98 mmHg to 120/85 mmHg, with an average reduction of 19 mmHg in systolic and 13 mmHg in diastolic pressure. The patient also reported increased relaxation, reduced headache, and improved sleep quality after the intervention. Conclusion: The combination of lavender aromatherapy and warm foot soak therapy effectively reduces blood pressure through synergistic mechanisms, namely peripheral vasodilation and activation of the parasympathetic nervous system, which induce relaxation effects. This therapy can be applied as a safe, simple, and holistic complementary non-pharmacological nursing intervention to support hypertension management.
The Potential of Complementary Therapy Using Bay Leaves (Syzygium polyanthum) and Ginger (Zingiber officinale) in Lowering Blood Glucose Levels in Patients with Diabetes Mellitus: A Literature Review
Diabetes mellitus (DM) is a global public health issue, with its prevalence steadily increasing. The 2023 Indonesian Health Survey (SKI) reported that 11.7% of the population aged ≥15 years is affected by DM. DM is marked by high blood glucose levels due to impaired insulin secretion or action, leading to chronic complications. While conventional treatments such as insulin and oral antidiabetic drugs are effective, their long-term use can cause side effects, including hypoglycemia, gastrointestinal issues, and economic burdens. As a result, herbal-based complementary therapies are gaining attention due to their safety, accessibility, and alignment with Indonesian culture. Research suggests that certain herbs can lower blood glucose by increasing insulin secretion, improving insulin sensitivity, inhibiting glucose absorption, and offering antioxidant effects. Herbs like bay leaves (Syzygium polyanthum) and ginger (Zingiber officinale) have shown hypoglycemic activity. This literature review aims to explore the potential, mechanisms, preparation, and clinical evidence of using bay leaves and ginger for glycemic control. Findings indicate that both herbs improve insulin sensitivity, inhibit α-glucosidase, and exhibit antioxidant effects. However, further research, including large-scale clinical trials and multidisciplinary studies, is needed to validate these benefits and explore synergies with conventional therapies.
The Relationship Between the Anxiety Level of Primiparous Mothers Who Are Not Accompanied by Their Husbands and the Duration of Labor
In Indonesia, the main causes of maternal mortality are sepsis, abortion problems, prolonged labor, eclampsia, and hemorrhage. These causes of death have varying contributions, with sepsis (10%), hemorrhage (28%), which is often unpredictable and occurs suddenly, and prolonged labor (9%) contributing each. Psychological illness in pregnant women during pregnancy, environmental factors that trigger labor, and the high maternal mortality rate in Indonesia are contributing factors. This is undeniably due to the lack of support from various parties during pregnancy and childbirth, especially in the role of the family who inspires motivation during the labor process. It is very important to help mothers relax mentally. The purpose of this study was to investigate the correlation between the duration of labor and the level of anxiety experienced by first-time mothers who are not supported by their partners. A cross-sectional methodology was used in this study. A direct random sampling approach was used for sample collection. The relationship between the duration of labor and the level of anxiety was analyzed using the Spearman rank formula, which uses an ordinal scale for anxiety. The results of this study revealed a strong correlation between the level of anxiety experienced by first-time pregnant women who were not accompanied by their partners and the length of the labor process {Spearman rank: 0.515, p value: 0.004, OR: 4.867 (95% CI: 4.74-5.00)}.
Health Service Utilization at West Sulawesi Provincial General Hospital
In 2021, the number of outpatient visits at the West Sulawesi Provincial Hospital decreased by 46% compared to 2019, indicating a significant decline in the utilization of health services. This study aimed to analyze the factors related to the utilization of health facility services among outpatients. This quantitative research employed a cross-sectional design with a total of 100 respondents selected through accidental sampling. Data were collected using a structured questionnaire and analyzed using statistical tests to identify relationships between variables. The findings revealed that health insurance (p < 0.001) and affordability of access (p = 0.008) had a significant relationship with the utilization of health facility services. In contrast, knowledge (p = 0.075) and perception of pain (p = 0.055) were not significantly associated with service utilization. These results suggest that socioeconomic factors, particularly the ownership of health insurance and the accessibility of health services, play a crucial role in determining patients’ healthcare-seeking behavior. Therefore, efforts to improve health service utilization should focus on expanding insurance coverage, reducing access barriers, and ensuring the equitable availability of healthcare facilities in all regions.
The Impact of Community-Based Tuberculosis Education on Public Attitudes in Jambi City, Indonesia
Tuberculosis (TB) remains one of the most persistent infectious diseases worldwide, particularly in Indonesia, which ranks second globally in the number of TB cases. This study aimed to determine the effect of community-based TB education conducted by the Penabulu STPI community on the attitudes of Jambi City residents. The research used a quantitative approach with a pre-test and post-test design. Data were collected using questionnaires to measure participants’ attitudes before and after the intervention. Data were analyzed using univariate and bivariate analyses, with the Wilcoxon signed rank test applied to determine significant differences in pre-test and post-test results. The findings revealed that most respondents were adults (85%), predominantly female (89%), and had completed senior high school (54%). Attitudes improved significantly, shifting from 19.2% negative responses before the intervention to 100% positive responses after. The Wilcoxon signed-rank test showed a statistically significant difference between respondents’ attitude scores before and after the intervention (Z = –8.395, p < 0.001).These results demonstrate that community-based education effectively enhances public awareness and encourages positive attitudes toward TB prevention and treatment, highlighting the essential role of grassroots initiatives in controlling the spread of tuberculosis.
The Effect Of Exclusive Breastfeeding History And Infant Feeding (PMBA) On The Nutritional Status Of Toddlers Aged 1-5 Years In Sialang Panjang Village
Toddlerhood is a golden period that requires optimal nutritional fulfillment to support toddler growth and development. Exclusive breastfeeding and proper Infant and Child Feeding (PMBA) play an important role in preventing nutritional problems. The Indonesian Toddler Nutritional Status Survey (2024) reported that 150.2 million toddlers (23.2%) experienced stunting, 42.8 million toddlers (6.6%) experienced wasting, 12.2 million toddlers (1.9%) experienced severe wasting, and 35.5 million toddlers (5.4%) experienced overweight (WHO, 2024). Data from the Sialang Panjang Village Health Center in 2024 showed that there were still cases of malnutrition in 6 toddlers, stunting in 7 toddlers, and underweight in 17 toddlers. To determine the effect of the history of exclusive breastfeeding and Infant and Child Feeding (PMBA) on the nutritional status of toddlers aged 1–5 years in Sialang Panjang Village. This study used a quantitative method with an analytical observational design with a cross-sectional approach. A sample of 91 toddlers was selected using simple random sampling. Data were collected through questionnaires, interviews, and anthropometric measurements, analyzed using the Chi-Square test (p<0.05). The results showed no significant effect of exclusive breastfeeding history on toddler nutritional status (p=0.189). Meanwhile, infant feeding (PMBA) showed a significant effect (p=0.015). Strengthening exclusive breastfeeding education programs and mentoring PMBA practices according to WHO recommendations is needed, involving village health workers to support optimal nutritional status of toddlers.
The Potential of Bajakah Endophytic Fungus (Spatholobus littoralis Hassk) Against Staphylococcus aureus Bacteria
A plant that has great potential as a source of traditional medicine is Spatholobus littoralis Hassk, or better known as bajakah. The research aims to analyze the Potential of Bajakah Endophytic Fungi (Spatholobus littoralis Hassk) Against Staphylococcus aureus Bacteria. This research was conducted at the Pharmaceutical Microbiology Laboratory, Faculty of Health, Sari Mulia University, Banjarmasin. The study used endophytic fungi on Bajakah wood (Spatholobus littoralis Hassk). The research design used was a True Experimental design with the aim of identifying the antibacterial activity of Bajakah endophytic fungi (Spatholobus littoralis Hassk) and testing the inhibitory power of Bajakah endophytic fungi (Spatholobus littoralis Hassk) against Staphylococcus aureus bacteria. Three isolates of endophytic fungi from Bajakah stems (Spatholobus littoralis Hassk) showed antibacterial activity against Staphylococcus aureus bacteria with varying levels of potency. Isolate (JEB 1) which is estimated to originate from Aspergillus sp showed very strong antibacterial activity with an inhibition zone diameter of 27.18 ± 0.725 mm. Isolate (JEB 1) has a Minimum Inhibitory Concentration (MIC) value at a concentration of 5 x 106 ppm and the best Minimum Bactericidal Concentration (MBC) at a concentration of 5 x 106 ppm. These findings indicate that endophytic fungi, especially from Aspergillus sp, have potential as natural antibacterial agents that can be further developed as candidates for new antibacterial materials based on local natural resources.
Physiological Response of the Body to Heat Exposure in Workers
Heat is a prevalent and serious physical health risk for employees in a range of indoor and outdoor work settings. Heat stress at work alters physiological processes and has a variety of detrimental consequences on people's health and wellbeing. This study aimed to explore the physiological responses and impacts of heat exposure in outdoor workers. This study employed a literature review approach using Google Scholar, Wiley, and Pubmed databases. The results will be described through descriptive narratives and tables. Workers exposed to heat experience increased physiological reactions, including increased body temperature, heart rate, and blood pressure, especially those engaging in intense physical activity outdoors. Heat-related symptoms such as fatigue, excessive sweating, headaches, and muscle cramps can also occur in heat-exposed workers. These increased and altered physiological responses emphasize the importance of implementing preventative measures, such as managing work hours, maintaining hydration, and maintaining good health, to avoid heat-related illnesses and maintain workplace productivity.
The Relationship Between Family Support and Quality of Life in Diabetes Patients At Parongpong Community Health Cen-ter
Diabetes mellitus constitutes a chronic pathological condition that necessitates continuous therapeutic management throughout a patient’s lifetime and has been widely recognized as a major factor contributing to the deterioration of patients’ physical, psychological, and social well-being, thereby reducing their overall quality of life. Within this context, familial support emerges as a pivotal determinant that not only facilitates patients’ psychosocial adaptation to their illness but also enhances adherence to treatment regimens and coping mechanisms in daily life. Hence, the present study was conducted with the objective of elucidating the relationship between family support and the quality of life among individuals diagnosed with diabetes mellitus who receive treatment at Parongpong Public Health Center. This investigation employed a descriptive correlational research design with a cross-sectional orientation, encompassing a total of 34 respondents who were carefully selected through purposive sampling techniques based on predetermined inclusion criteria. The collected data were subjected to statistical analysis using the Pearson Product Moment correlation test to determine the strength and significance of the association between the studied variables. The findings revealed a statistically significant correlation between family support and quality of life (p = 0.009; r = 0.440), indicating a moderate positive relationship, wherein higher levels of family support corresponded to better perceived quality of life among patients. In light of these findings, it can be inferred that the presence of consistent and meaningful familial involvement contributes substantially to the enhancement of the overall quality of life in diabetes mellitus patients at Parongpong Public Health Center.
The Relationship Between Health Care Performance and Mothers' Satisfaction with Toddler Services Integrated Health Post in RW 01 East Pademangan
Study This aim For to determine the Relationship between Health Cadre Performance and Toddler Mother Satisfaction in Posyandu Services in RW 01 East Pademangan, North Jakarta. This type of research is quantitative with a Cross-Sectional design . The data collection technique for this study uses primary data and secondary data. Primary data were obtained directly through filling out questionnaires by mothers of toddlers at Posyandu RW 01 East Pademangan, while secondary data were obtained from sources that could support the research, including documentation and literature . The data analysis of this study used bivariate analysis which was carried out to determine the influence between variables x and y in the form of a static Likelihood Ratio Chi-Square (G - Test ) test . The results of the study showed that the performance of health cadres at Posyandu RW 01 East Pademangan was generally in the good category. This shows that cadres have carried out their roles optimally in providing health services to mothers and toddlers. Most toddler mothers are satisfied with the services provided by Posyandu cadres. This illustrates that the services provided are sufficient to meet the expectations and needs of mothers of toddlers in the area, and there is a significant relationship between the performance of health cadres and the satisfaction of mothers of toddlers at Posyandu RW 01 East Pademangan. This finding indicates that the better the performance of the cadres, the higher the level of satisfaction of mothers of toddlers with Posyandu services
Characteristics of Urinary Tract Stone Patients in Central Sulawesi, 2020–2024
Urolithiasis is a common urologic disorder characterized by stone formation along the urinary tract, predominantly affecting adult males and showing a high recurrence rate. Despite numerous global studies, data on the Central Sulawesi population remain limited, hindering the development of local management strategies. This study aims to describe the epidemiological and clinical characteristics of patients with urinary tract stones in Central Sulawesi from 2020 to 2024. A retrospective cross-sectional study was conducted using secondary data from electronic medical records and surgical archives of referral hospitals. A total of 4,078 patients diagnosed with urinary tract stones were analyzed descriptively based on age, sex, diagnosis, and treatment modalities. The mean age was 47.77 ± 14.80 years, and males accounted for 53.4% of cases. Ureteral stones were the most frequent diagnosis (48.4%), followed by renal stones (40.4%) and bladder stones (11.0%). In terms of management, ureterorenoscopy (URS) with DJ stent insertion was most common (20.15%), followed by extracorporeal shock wave lithotripsy (ESWL) (10.15%), while 47.29% were managed with medical expulsive therapy (MET). These findings indicate that urolithiasis in Central Sulawesi mainly affects males in productive age, with ureteral stones as the leading type. Minimally invasive procedures, especially URS and ESWL, dominate clinical practice, highlighting the need for strengthened prevention, early detection, and urological service infrastructure.
Formulation and Evaluation of Hydrogel Preparations from Jeneponto Horse Oil (Equus caballus)
Horse oil, traditionally used as a medicinal remedy, contains essential amino acids that contribute to the repair of bones, muscle tissues, and skin, particularly in wound healing. Hydrogel preparations serve as topical wound dressings that provide a cooling effect, reduce inflammation, and support faster wound recovery. The aim of this research was to develop and evaluate the stability of a hydrogel formulated with horse oil (Equus caballus). The study involved heating horse fat at 105°C for two hours using an oven, followed by formulating the extracted oil into a hydrogel with a sodium carboxymethyl cellulose (NaCMC) base. The preparation underwent several tests including organoleptic, homogeneity, pH, spreadability, adhesion, viscosity, and stability evaluations. Results showed that formulations F1, F2, and F3 satisfied all evaluation criteria and maintained stability without changes in physical characteristics or pH levels.
The Relationship Between Exclusive Breastfeeding and The Incidence of Pneumonia Among Toddlers At Padasuka Health Center, Bandung City, in 2024
Pneumonia is one of the leading causes of death among toddlers in Indonesia. One effective preventive measure is providing exclusive breastfeeding during the first six months of life. This study aims to determine the relationship between exclusive breastfeeding and the incidence of pneumonia among toddlers at the Padasuka Health Center, Bandung City, in 2024. This research employed an analytical quantitative method with a cross-sectional approach and a total sampling technique involving 200 toddlers recorded as having pneumonia based on medical records and IMCI register books. The results showed that 68.5% of toddlers received exclusive breastfeeding, 76.5% experienced mild pneumonia, and 23.5% had severe pneumonia. The Chi-Square test yielded a p-value of 0.001, indicating a significant relationship between exclusive breastfeeding and the severity of pneumonia. Toddlers who did not receive exclusive breastfeeding had a higher risk of developing severe pneumonia compared to those who were exclusively breastfed. In conclusion, exclusive breastfeeding plays an important role in reducing the risk of severe pneumonia among toddlers. It is expected that these findings can serve as a basis for healthcare workers to enhance education for mothers on the importance of exclusive breastfeeding.
The Effect of Exercise-Based Game Intervention on Reducing Depression in the Older Adults
The older adults are a population vulnerable to mental health problems, particularly depression. Exercise-based game is a game-based training activity that involves body movement according to given instructions and is considered effective in improving emotional balance and reducing depressive symptoms in older adults. This study aimed to determine the effect of exercise-based game and education on reducing depression levels among the older adults at the Posyandu Lansia Bugar Mandiri Bangunrejo, Yogyakarta. This experimental study employed a quasi-experimental approach with a pre-test and post-test two group design. The sampling technique used total sampling with 30 participants divided equally into two groups of 15 each. The training program was conducted three times a week for four weeks. The research instrument used the Geriatric Depression Scale, and data were analyzed using paired sample t-test and independent sample t-test. The results showed that both exercise-based game and education significantly reduced depression in the older adults (p = 0.00; p < 0.05). However, there was no significant difference between the two groups (p = 0.096; p > 0.05). In conclusion, both exercise-based game and education are effective in reducing depression among the older adults, but neither showed a significantly greater effect than the other.