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.