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Introduction: Repurchase intention is one of the important indicators in the world of health services, especially in hospitals. XYZ General Hospital must evaluate the services provided to patients by understanding patient perceptions, particularly through patient experience, as 50% of respondents expressed unwillingness to recommend or reuse the hospital’s services. This highlights a potential gap between service delivery and patient expectations. Method The purpose of this study was to analyze the influence of patient experience, brand image, and trust on repurchase intention at XYZ Hospital, with attitude as an intervening variable. This study employed a quantitative explanatory research design, involving 182 patients from outpatient and inpatient units who had visited more than once. Data were collected through structured questionnaires and analyzed using the Structural Equation Model (SEM) with the Partial Least Square (PLS) method, supported by the SmartPLS software. Results: The results revealed that patient experience, brand image, and trust significantly affect patient attitudes, which in turn directly influence repurchase intention. Attitude serves as a mediating variable between patient experiences, brand image, trust, and repurchase intention. Simultaneous testing confirmed that all independent variables have a joint effect on repurchase intention. Among the variables tested, attitude showed the strongest direct influence on repurchase intention, while patient experience had the highest indirect effect through attitude. Conclusion: These findings underscore the critical role of patient experience in shaping positive perceptions of service quality, which contribute to strengthening brand image, increasing trust, and fostering patient attitudes that support future service utilization. Therefore, healthcare providers must prioritize improving communication, staff responsiveness, and patient-centered care to enhance overall experience, build loyalty, and ensure long-term sustainability of healthcare services.

Typhoid fever is an infectious disease caused by the bacterium Salmonella typhi, commonly found in developing countries, including Indonesia. Prompt and accurate treatment is crucial to prevent serious complications in patients. One way to assist in diagnosing typhoid fever is by applying machine learning methods to classify patient data. The Naive Bayes method is one of the machine learning algorithms frequently used in medical data classification due to its strong ability to handle large and complex datasets. This article discusses the application of the Naive Bayes method for classifying typhoid patient data at Rantauprapat General Hospital (RSUD Rantauprapat). By utilizing medical data that includes clinical symptoms, laboratory test results, and patients’ medical histories, the Naive Bayes model can provide fairly accurate predictions regarding the likelihood of a person having typhoid fever. The research findings indicate that Naive Bayes is reliable in predicting typhoid diagnoses with adequate accuracy, thereby supporting healthcare professionals in making faster and more precise decisions. It is expected that the implementation of this method can accelerate the diagnostic process and improve the quality of healthcare services at RSUD Rantauprapat, as well as in other regions.

Patient safety is a critical component of healthcare services, particularly as it directly impacts patient outcomes and the quality of hospital care. Nurses, as the frontline health professionals, play an essential role in implementing patient safety standards. This study aimed to analyze the relationship between nurses’ knowledge and attitudes toward the implementation of patient safety at Baitul Hikmah General Hospital Kendal. A descriptive correlational design with a cross-sectional approach was employed. The study recruited 78 nurses using a total sampling technique, and data were collected through questionnaires that had been previously tested for validity and reliability. The results indicated that the majority of nurses demonstrated good levels of knowledge and attitudes, which were reflected in their adherence to patient safety practices. Bivariate analysis using the Spearman Rho test revealed a significant relationship between nurses’ knowledge (p-value = 0.008; r = 1.000) and attitudes (p-value = 0.008; r = 0.297) with the implementation of patient safety. These findings suggest that better knowledge and positive attitudes among nurses significantly contribute to the proper implementation of patient safety protocols. Consequently, continuous education, training, and awareness programs are necessary to strengthen nurses’ knowledge and attitudes, thereby improving the quality of healthcare services and minimizing risks to patient safety in hospital settings.

The Emergency Department (ER) serves as a critical unit in hospitals with the primary objective of providing fast, precise, and integrated health services aimed at preventing disability and death. According to national standards, the maximum response time for ER services is 5 minutes. However, increasing patient volume combined with limited capacity and resources often hinders compliance with this standard, potentially affecting the quality of service and patient satisfaction. This study aimed to determine the relationship between response time and patient satisfaction in the ER of QIM Batang Hospital. The research employed an observational method with a correlational design and a cross-sectional approach. Data were collected using a stopwatch to measure response time and a structured questionnaire to assess satisfaction. A total of 100 patients who visited the ER were included as respondents through accidental sampling. Data analysis using the Chi-Square test revealed a significance value of ρ = 0.000, while the correlation test showed a coefficient value of 0.639, indicating a statistically significant relationship with a strong correlation between response time and patient satisfaction. These findings suggest that shorter and timely response times are closely associated with higher levels of patient satisfaction. In conclusion, adherence to response time standards and continuous improvement in the five key satisfaction indicators are crucial strategies to enhance the quality of ER services.

Siloam Sentosa Hospital always tries to provide a service that is appropriate to the expectations based on feedback from SOFAS and MCU Siloam Sentosa Hospital revenue has problem and doubtfull from patien to recomended MCU Service to acquintance. The Goals is research corelation and interaction between of Brand Image, Patient Experience, patient decision do medical check up and motivation consumer in Siloam Sentosa Hospital in 2022. Using categorical research with analytical method of study (explanatory student) using the design of cross-sectional research.. From Correlation test the result is > 0,5, it shows that inpendent variables giving the connection correlation. The result of Anova test theres siginificant relation simulataneously from Brand Image, Patient Experience and Consument Motivation as intervening variabel to decision patient do MCU. Dari hasil uji t maka disimpulkan variabel dependen dan inpenden memiliki hasil yang signifikan Hasil tersebut menunjukkan bahwa Brand image, Patient Experience, dan Motivasi konsumen sebagai variabel intervening memiliki pengaruh positif dan signifikan terhadap keputusan pasien melakukan MCU di Rumah Sakit Siloam Sentosa. The result from T test, concluded dependent and independent variable has significant result. It shows Brand Image, Patient Experience and Consument Motivation as intervening variable have a positive influence and significant to patient decision do MCU in Siloam Sentosa Hospital.

Work stress is a prevalent and complex phenomenon frequently encountered by inpatient nurses as a result of the intense physical, emotional, and psychological demands inherent in their professional responsibilities. Nurses are required to deliver high-quality care under conditions of time pressure, emotional strain, and patient diversity, which can increase their susceptibility to stress. Individual factors—including age, gender, marital status, years of service, personality type, and self-assessment—play a crucial role in shaping nurses’ capacity to adapt to these pressures and maintain their performance. This study aims to comprehensively describe the influence of individual factors on work stress among inpatient nurses at RSUP Dr. Sitanala in 2025. Employing a quantitative descriptive design with a cross-sectional approach, a total of 34 inpatient nurses were recruited using total sampling. Data were collected using the NIOSH Job Stress Questionnaire, which measures multiple aspects of job-related stress. The results indicate that younger nurses, those with shorter work tenure, and individuals exhibiting type A personality traits are more vulnerable to experiencing high levels of stress compared to their counterparts. These findings underscore that individual characteristics significantly contribute to variations in work stress levels. The study emphasizes the importance of developing responsive human resource management strategies, such as stress management training, mentoring, and supportive work environments, to strengthen resilience and improve nurses’ well-being. By identifying and addressing these individual factors, healthcare organizations can enhance employee retention, promote patient safety, and ensure sustainable quality of care.

Healthcare-associated infections (HAIs) are a crucial issue that significantly impacts morbidity and mortality rates, as well as healthcare costs. Nurses' compliance with infection prevention is a key indicator of the quality of hospital services. Rewards are one factor that can influence compliance. This study aims to analyze the relationship between rewards and nurses' compliance with infection prevention at Qolbu Insan Mulia Hospital, Batang. The study employed a quantitative design with a cross-sectional approach. A total of 153 nurses were selected through purposive sampling. Data collection instruments included a 10-item reward questionnaire and a 21-item infection prevention compliance questionnaire. Data analysis was performed using the Spearman Rank correlation test. The results showed that the majority of respondents were in the 30–39 age group (50.3%), female (71.2%), had a Diploma 3 (D3) in Nursing (56.8%), and had worked for 5–10 years (44.5%). Most respondents received high rewards (79.1%) and demonstrated high compliance with infection prevention (90.8%). The Spearman test yielded a ρ value of 0.000 with an r value of 0.598, indicating a significant and positive relationship between rewards and nurse compliance. Therefore, providing targeted rewards can be used as a managerial strategy to improve service quality and support patient safety on an ongoing basis.

Nurses’ response time is a crucial indicator of service quality in the Emergency Department (ED). A prompt response not only plays a vital role in ensuring patient safety but also significantly affects patient satisfaction with the care received. Patient satisfaction in the ED is often considered a benchmark of hospital quality, as the ED operates 24/7 and frequently deals with critical conditions. This study aimed to determine the relationship between nurses’ response time and patient satisfaction in the ED of Harapan Anda Islamic General Hospital, Tegal. This study employed an observational analytic design with a cross-sectional approach. A total of 92 ED patients were included as samples based on inclusion criteria. Nurses’ response time was measured using a stopwatch, starting from the completion of triage until the first contact with the nurse. Patient satisfaction was assessed using the standardized Brief Emergency Department Patient Satisfaction Scale (BEPSS) questionnaire. Data analysis was conducted using Pearson’s Chi-Square test to examine the relationship between the two variables. The results showed that 75 patients (81.5%) experienced a fast response time, while 72 patients (78.3%) reported being satisfied with the care provided. Statistical analysis yielded a Pearson’s Chi-Square value of 11.933, with an odds ratio of 6.545 and a significance level of 0.001 (p < 0.05). These findings indicate a significant association between nurses’ response time and patient satisfaction. In conclusion, nurses’ response time is strongly related to patient satisfaction in the ED of Harapan Anda Islamic General Hospital. Other factors such as effective communication, clinical competence, ED environment, and triage system may also influence satisfaction and should be considered in future studies.

This study aims to determine the effectiveness of progressive muscle relaxation techniques in reducing headache pain in hypertensive patients in the inpatient ward of Harapan Anda Hospital in Tegal City. Hypertension is often accompanied by complaints of headaches, which is a significant problem for patients. One non-pharmacological approach that can be used to alleviate headaches caused by hypertension is progressive muscle relaxation therapy. In this study, 55 respondents with hypertension and complaints of headache were involved. The research used a quasi-experimental design with a quantitative approach. Before and after the intervention, patients underwent progressive muscle relaxation therapy for three consecutive days, with a duration of fifteen minutes per session. Pain levels were assessed using a pain scale before and after the intervention. Data analysis was conducted using the Wilcoxon test. The results showed that 53 patients (96%) experienced a decrease in pain levels after the therapy. The average pain scale significantly decreased, with moderate pain levels reducing from 89.1% to 3.6%, while mild pain increased from 10.9% to 85.5%. The Wilcoxon test results indicated a p-value of 0.000 (p < 0.05), indicating that progressive muscle relaxation therapy is effective in reducing headache pain in hypertensive patients. This therapy has been shown to be a simple, safe method that can be applied both independently by patients and in healthcare services. Therefore, progressive muscle relaxation can be an effective alternative in managing headaches in hypertensive patients.

Patient safety is a crucial aspect of hospital service quality, with one of the main indicators being the prevention of fall risks. Fall risks among patients often lead to serious injuries and impact the quality of care, making preventive measures essential. Nurses play a central role in implementing these preventive actions. However, the level of nurse compliance in following preventive procedures is often influenced by work motivation. This study aims to analyze the relationship between work motivation and nurse compliance in implementing fall risk prevention at the Sultan Agung Islamic Hospital in Banjarbaru. This quantitative study used a cross-sectional design, involving 97 inpatient nurses as respondents. The instruments used in this study included a 20-item Likert scale questionnaire to measure motivation and an observation sheet with 10 items to assess nurse compliance in applying fall risk prevention procedures. The data collected were analyzed using the Somers’ D test to determine the strength and direction of the relationship between the two variables. The results showed that the majority of nurses had high motivation (92.8%) and high compliance (90.7%) in implementing the prevention procedures. The Somers’ D test revealed a significant relationship between work motivation and nurse compliance in fall risk prevention (p = 0.003; d = 0.866), indicating that higher work motivation leads to higher compliance. The conclusion of this study is that work motivation is closely related to nurse compliance in fall risk prevention. Therefore, enhancing work motivation should be an important strategy for hospital management in developing a better patient safety culture.

Patient safety is one of the main components in determining the quality of hospital services. Every hospital is required to minimize incidents that may harm patients. Among various patient safety incidents, falls in children rank second after medication errors, making them a serious issue that requires attention. This study aims to evaluate the relationship between nurses’ motivation and compliance in conducting fall risk assessments with the incidence of falls among pediatric patients in the inpatient ward of QIM Hospital Batang. This study employed a descriptive quantitative design with a correlational approach. A total of 44 nurses who met the inclusion criteria were recruited as respondents. Research instruments included a motivation questionnaire, an observation sheet on compliance, and records of patient fall incidents. Data were analyzed using the Spearman Rank test to measure the strength of the relationship between variables. The findings showed that most respondents (84.1%) had a high level of motivation, and all nurses (100%) demonstrated full compliance in performing fall risk assessments according to standard operating procedures. During the study period, no cases of pediatric falls were reported in the inpatient ward, indicating the effectiveness of fall risk assessment implementation. Statistical analysis produced a p-value of 0.011, indicating a significant relationship between motivation and nurses’ compliance. These findings emphasize that work motivation plays an important role in maintaining nurses’ consistency in adhering to safety procedures. Motivation can be enhanced through managerial support, continuous training, and the establishment of a strong patient safety culture, thereby reducing the risk of falls and improving the overall quality of healthcare services.

This study aims to analyze the influence of Multidimensional Service Quality, Perceived Value, and Customer Relationship Management (CRM) on Customer Satisfaction, with Customer Engagement as a mediating variable at Awal Care Veterinary Clinic in East Jakarta. The research background is driven by a significant decline in patient numbers in 2023 and intense competition in the veterinary healthcare sector. This study employs a quantitative correlational approach using purposive sampling, involving 310 respondents who are clients of the clinic. Data were collected through a questionnaire with a 6-point Likert scale, and analyzed using the Structural Equation Modeling Partial Least Squares (SEM-PLS) method. The results indicate that all independent variables service quality, perceived value, and CRM—have a positive and significant influence on both customer engagement and customer satisfaction. Customer engagement is also found to have a significant impact on customer satisfaction. Furthermore, all indirect relationships through the mediation of customer engagement are significant, indicating that customer engagement serves as an important partial mediator. The R² value of 0.646 demonstrates that the model has strong predictive power for customer satisfaction. These findings highlight the importance of strengthening experience-based strategies and fostering emotional and cognitive connections with customers. This study contributes theoretically to the field of service marketing and provides practical implications for veterinary clinic management in enhancing customer satisfaction and loyalty.

  Medication adherence among pulmonary TB patients is crucial to prevent recurrence and ensurecomplete recovery. Patient knowledge of tuberculosis treatment and adherence to prescribed dosages andadministration methods are key components to successful treatment. This study aimed to determine therelationship between knowledge and medication adherence in pulmonary TB patients at Harapan Anda IslamicHospital, Tegal City. This study used a quantitative cross-sectional design. A sample size of 60 pulmonary TBpatients at Harapan Anda Islamic Hospital, Tegal City, was selected through purposive sampling. Data werecollected using a knowledge questionnaire and a medication adherence questionnaire. Data were analyzed usingthe chi-square test. Based on the analysis results, it was found that of the 60 patients with pulmonary TB atHarapan Anda Islamic Hospital, Tegal City, most were in the early elderly age (46-55 years), most were malebecause they were men, the majority were married, most had graduated from high school and most had privateemployment status. The level of compliance with taking medication in patients with pulmonary TB at HarapanAnda Islamic Hospital, Tegal City was in the high category. There was a relationship between the level ofknowledge and compliance with taking medication in patients with pulmonary TB at Harapan Anda IslamicHospital, Tegal City. There was a relationship between the level of knowledge and compliance with takingmedication in patients with pulmonary TB at Harapan Anda Islamic Hospital, Tegal City. Patients who had goodknowledge tended to be more compliant in undergoing treatment. These results serve as input for health servicesto provide health service programs to improve knowledge and compliance with taking medication in patients withpulmonary TB better.

Schizophrenia is a severe mental disorder characterized by a decline in cognitive abilities and social skills, an inability to care for oneself, and potential brain function impairment. One of the consequences often observed in schizophrenia patients is social isolation, where the individual is unable to interact with others around them. This study aims to assess and provide psychiatric nursing care for Sdr. A, who is experiencing the primary issue of social isolation: withdrawal due to paranoid schizophrenia at the Gatotkaca ward of RSJD dr. Gondohutomo in Central Java Province. Initial assessment of the patient revealed that Sdr. A is experiencing social isolation, particularly withdrawal from their social environment. Four nursing problems were identified, including social isolation: withdrawal, low self-esteem, sensory perception disturbances such as hallucinations, and self-care deficits. A nursing care plan was developed based on the Indonesian Nursing Diagnosis Standard , Indonesian Nursing Service Standard, and Indonesian Nursing Information System , tailored to the patient's condition at the time. The care plan includes interventions to enhance social interaction, improve self-esteem, address sensory perception disturbances, and promote self-care abilities. The nursing implementation was carried out using a holistic approach involving psychosocial support and appropriate medical therapy based on the patient’s needs. It is expected that through this approach, the patient can reduce social isolation symptoms and improve their quality of life. This study emphasizes the important role of psychiatric nursing care in addressing social issues in patients with paranoid schizophrenia and how a structured nursing care plan can support patient recovery.

Acute myocardial infarction is a leading cause of death both in Indonesia and globally, with incidence rates remaining quite high. This disease is closely associated with various modifiable risk factors, including hypertension, diabetes mellitus, dyslipidemia, obesity, and smoking. Various literature reviews confirm that patients with myocardial infarction often have complex clinical conditions, especially when comorbidities worsen the prognosis and increase the burden on healthcare services. This study reviews the latest national literature on risk factors, clinical profiles, nursing management, prognostic predictors, and non-pharmacological interventions such as relaxation techniques. The analysis demonstrates the need for a comprehensive and integrative approach to the management of myocardial infarction patients. This includes early detection using clinical risk scores, intensive nursing interventions in severe cases such as Killip III NSTEMI, and the use of simple prognostic tools that are easily implemented in healthcare facilities. A supportive approach also plays a crucial role in improving patient comfort and adherence to therapy. The integration of these strategies is expected to improve clinical outcomes, reduce morbidity and mortality, and enhance patients' overall quality of life. This study emphasizes the importance of updating local evidence-based clinical practices tailored to the needs of the Indonesian healthcare system, so that the management of myocardial infarction does not only focus on medical therapy, but also on aspects of prevention, non-pharmacological interventions, and ongoing care.

This study aims to examine the influence of compliance audit on service procedures toward patient satisfaction at Prambon Public Health Center, Nganjuk Regency. The research is driven by concerns over a decline in the average number of patients in 2024 compared to previous years. This decline in patient visits is a key issue that prompted the need to investigate the relationship between compliance audits in service procedures and the resulting impact on patient satisfaction. A descriptive quantitative approach was used in this study, with 100 respondents for each variable. The sample was determined using probability sampling with a simple random sampling technique, involving both employees and patients who visited the health center during the period between 2021 and 2024. Data were collected through questionnaires, observations, and interviews to ensure a comprehensive understanding of the issue. The regression analysis revealed that service compliance audits have a significant impact on patient satisfaction, contributing 56.67% to the overall patient experience. This finding suggests that improving the service procedures through compliance audits can be a key factor in enhancing patient satisfaction at Prambon Public Health Center. The results of this study provide important insights for healthcare administrators, indicating that regular compliance audits should be integrated into healthcare management practices to maintain and improve patient satisfaction.

Self-medication is a form of pharmaceutical service that allows the public to treat mild symptoms independently without a doctor’s prescription. While beneficial, improper self-medication practices can pose health risks such as drug resistance and misuse of prescription-only medicines. If not carried out carefully, it may lead to further issues such as bacterial resistance and dependency. This study aims to evaluate the self-medication services at Sehat Farma Pharmacy in Banjarharjo. A descriptive method was employed using interviews and direct observations to provide a comprehensive overview of self-medication practices in the field. Informants included a pharmacist, pharmaceutical vocational staff, and patients engaged in self-medication. The results indicate inconsistencies in the service flow, including the provision of prescription-only medications without proper medical consultation. There is a need to improve the understanding and adherence to appropriate service standards to enhance the safety and effectiveness of self-medication practices.

Diabetes mellitus continues to be an alarming health challenge, especially in the context of public health, where there are so many cases of diabetes mellitus that patients do not know how to manage and prevent it. The aim of this community service program is to integrate local community empowerment with herbal innovations, especially clitoria ternatea and diabetic foot exercises as a holistic way to manage blood glucose levels. The program was delivered in RW XIII of Beringin village, Ngaliyan sub-district and included health education components and training sessions, including the production of herbal products. The initiative changed participants' knowledge and attitudes towards diabetes and enabled them to take control of managing their condition. This model proves that combining traditional herbal innovations with physical activity at the community level can effectively prevent and help manage diabetes mellitus at minimal cost.

Nurses are healthcare workers who have a high workload because they are in direct contact with patients 24 hours a day. Complex tasks, limited manpower, and high service demands often cause work stress. Unresolved stress can affect nurses' health, reduce performance, and even impact patient safety. This study aims to investigate the relationship between stress levels and workloads among nurses at Semarang General Hospital. The study design employs a cross-sectional approach with a quantitative methodology. The study population consists of all nurses in the inpatient ward of Semarang General Hospital, with a sample size of 80 respondents selected using proportional random sampling. The research instruments used the Perceived Stress Scale (PSS-10) questionnaire to measure stress and the NASA-TLX questionnaire to measure workload. Data analysis was conducted using the Spearman Rank test. The results of the study show that most nurses are in the moderate stress category (65%), while the highest workload is in the high category (58.8%). Bivariate analysis yielded a p-value of 0.001 (p < 0.05) with a correlation coefficient of r = 0.412, indicating a significant positive relationship between stress levels and nurses' workload. The higher the workload of nurses, the higher the stress levels they experience. Hospitals are encouraged to implement effective workload management, including proportional task distribution, additional staff, and stress management programs for nurses.

Electronic Medical Records (EMR) are medical records compiled and stored through an electronic system used to support the provision of healthcare services. The implementation of EMR facilitates faster, more practical, and integrated patient data recording. Electronic Medical Records (EMR) are designed to improve the efficiency, accessibility, and accuracy of patient information within healthcare institutions. This study used a qualitative descriptive approach with a case study design through interviews to assess the readiness of EMR implementation in terms of the 5M management aspects (Man, Money, Material, Machine, Method) at Muhammadiyah General Hospital, Ponorogo Regency. The study sample consisted of 27 healthcare workers selected using a purposive sampling technique. The case study design allowed researchers to capture in-depth insights from healthcare workers directly involved in EMR implementation. The results showed that from the Man element, most healthcare workers were ready to use EMR, as indicated by their comfort and skills in operating the application. In the Money element, there is a system maintenance budget and support for EMR development in the inpatient unit and the Emergency Room. The Material element indicates the availability of adequate software, while the Machine element includes computer devices, internet connections, and a stable server to support users. These technological resources ensure a user-friendly and reliable system. The final element, Method, is demonstrated by the existence of clear SOPs and workflows, enabling healthcare workers to understand and effectively follow the EMR implementation process. Overall, the findings indicate that the hospital is institutionally prepared for EMR adoption.