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Hypertension in the elderly requires long-term treatment to prevent cardiovascular consequences. Adherence to antihypertensive medication is crucial for blood pressure management. Adherence to antihypertensive medication is a crucial aspect in hypertension management. Poor adherence can lead to uncontrolled blood pressure, thereby increasing the risk of cardiovascular problems, including stroke, myocardial infarction, and heart failure. This study aims to determine the correlation between adherence to antihypertensive medication and blood pressure in the elderly at the Ronggo Husada Primary Inpatient Clinic in Malang. This study used a cross-sectional design. The cohort consisted of 52 geriatric patients with hypertension who consistently visited the Ronggo Husada Primary Inpatient Clinic in Malang. The sample consisted of 40 patients. The sampling method used was purposive sampling. Research factors included medication adherence and blood pressure. Data collection was conducted through a questionnaire. This study was conducted at the Ronggo Husada Primary Inpatient Clinic in Malang on November 6, 2025. Data processing used the Chi-square test. The analysis included univariate and bivariate analyses, using the Chi-square test. The results showed that more than 50% of elderly participants demonstrated moderate adherence to antihypertensive medication (18 individuals (45%). Nearly 50% of elderly participants suffered from stage I hypertension (14 individuals (35%), and stage II hypertension (11 individuals (27.5%). Statistical analysis using the Chi-square test showed a significant correlation between adherence to antihypertensive medication and blood pressure in the elderly, with a p-value of 0.000, which is below the alpha threshold of 0.05 (5%). Elderly individuals who demonstrated strong adherence had better blood pressure regulation compared to those with poor adherence. These results emphasize the importance of adherence to therapy in the management of hypertension in the elderly.    

Hypertension is a condition where arterial blood pressure is persistently above normal values. Hypertension management does not only rely on pharmacological therapy, but also requires a non-pharmacological approach as a complementary effort. One non-pharmacological intervention that can be used is Benson relaxation therapy and murottal Surah Al-Kahfi. Both therapies are believed to contribute to lowering blood pressure through the mechanism of reducing stress responses, increasing physiological relaxation, and achieving psychological calm. This study aims to test the effectiveness of the combination of Benson relaxation therapy and murottal Surah Al-Kahfi in lowering blood pressure in hypertensive patients. The study design used a quasi-experimental approach with a pretest-posttest approach and a control group. The study population was 40 people who participated in the prolanis program in Kedungdowo Village. Based on inclusion and exclusion criteria, a sample of 36 respondents was taken, divided into two groups: 18 people in the intervention group who received a combination of Benson relaxation therapy and murottal, and 18 people in the control group who were not given any intervention. The Wilcoxon signed-rank test results in the intervention group showed an effect of Benson relaxation therapy and recitation of Surah Al-Kahf in the elderly (p-value 0.004). The control group showed a p-value of 0.102. The Mann-Whitney test results showed a p-value of 0.044, indicating a difference in post-test blood pressure in those with hypertension in the control and intervention groups.

Chronic Kidney Disease (CKD) is a global health problem with a continuously increasing prevalence and mortality rate. Global data indicates that kidney disorders have affected more than 850 million people, with CKD being one of the leading causes of death. North Sulawesi is recorded as one of the provinces with the highest prevalence of CKD. Blood creatinine is used as the primary marker of kidney function, while hypertension is a comorbidity commonly found in CKD patients and can act as both a cause and a consequence of impaired kidney function. Several studies have reported varying results regarding the relationship between creatinine levels and blood pressure. Purpose to analyze the association between serum creatinine levels and blood pressure in chronic kidney disease patients with hypertension at ODSK Hospital, North Sulawesi Province. Methods the research design used an observational analytic cross-sectional design. This study used an observational analytic cross-sectional design. It was a retrospective study utilizing secondary data from medical records for the period of June 2022 to August 2025. Total sampling method was employed with a sample size of 65 patients who met the inclusion criteria. Based on the Spearman correlation test results, the significance values between creatinine and systolic pressure was 0.685, and between creatinine and diastolic pressure was 0.787 (p-value >0.05). There is no significant correlation between serum creatinine levels and blood pressure in chronic kidney disease patients with hypertension at ODSK Hospital, North Sulawesi Province.

Type 2 Diabetes Mellitus (T2DM) is a global health problem with continuously increasing prevalence, covering the majority of diabetes cases worldwide. Persistent hyperglycemia in T2DM progressively damages the kidneys. Early assessment of kidney function, especially through the examination of urea levels and estimated glomerular filtration rate (eGFR) values, is important to predict CKD prognosis and guide therapeutic intervention. To discover the profile of urea levels and eGFR values in Type 2 Diabetes Mellitus patients at ODSK Hospital, North Sulawesi Province. This study is a descriptive quantitative observational study with a cross-sectional design, conducted retrospectively using secondary data from the medical records of Type 2 Diabetes Mellitus patients at ODSK Hospital, North Sulawesi Province during the period February 2024–August 2025 who met the inclusion criteria. From a total sample of 658 Type 2 Diabetes Mellitus patients, the majority of patients had high urea levels (53.3%). Based on sex, the proportion of high urea levels in males (57.2%) was higher compared to females (50.5%). Meanwhile, the distribution of eGFR values showed that the G1 category was the most frequent (23.9%). However, the majority of other patients (75.1%) were already in categories G2 to G5, which indicates a decrease in kidney function. This decrease in kidney function was slightly more detected in male patients (76.1%) compared to female patients (74.4%). Type 2 Diabetes Mellitus patients at ODSK Hospital, North Sulawesi Province, have high urea levels and the majority have decreased eGFR values.

Acute pain is a complex phenomenon frequently experienced by post-surgical patients. If not properly managed, it can hinder the recovery process and increase the risk of chronic complications. This study aims to conduct an in-depth analysis of the concept of acute pain in surgical patients from a nursing perspective to improve the quality of care. The method used was a narrative literature review, analyzing various research articles and clinical protocols related to surgical pain management. The study findings indicate that acute post-surgical pain involves sensory and emotional dimensions influenced by the type of surgical procedure, individual pain threshold, and the effectiveness of pharmacological and non-pharmacological interventions. Furthermore, the role of nurses in conducting accurate pain assessments and patient education is a key factor in successful pain management. The implications of this study emphasize the importance of implementing integrated multimodality pain management protocols and improving nurses' competency in conducting intensive monitoring. Optimizing pain management is expected to accelerate patient mobilization, shorten hospital stays, and increase patient satisfaction with nursing services.

The body may experience insulin resistance or an insufficient production of the hormone, blood sugar levels rise continuously, leading to a chronic metabolic condition called Type 2 Diabetes Mellitus. Among non-pharmacological approaches proven effective in managing hyperglycemia, physical exercise particularly the Prolanis workout program has shown notable benefits. This study assesses how joining the Prolanis Exercise Program influences blood glucose reduction in Type 2 Diabetes patients at Kuta Baro Health Center, Aceh Besar. This research utilized a quasi-experimental method applying a one-group pretest–posttest framework. Participants, numbering 25 individuals, were selected through an accidental sampling process.. Throughout a four-week implementation of the Prolanis Exercise Program, measurements of blood glucose levels were taken both prior to and subsequent to the program. The findings revealed a notable decline in mean blood sugar levels, decreasing from 158.84 mg/dL before the intervention to 121.92 mg/dL afterward. Based on the Paired Samples t-Test (p < 0.05), the Prolanis Exercise intervention was found to have a significant effect in lowering blood glucose levels. This finding demonstrates that regular participation in Prolanis Exercise serves as an effective non-pharmacological approach for controlling Type 2 Diabetes Mellitus. Community Health Centers are advised to consistently continue developing and facilitating routine Prolanis Exercise activities, in addition to providing ongoing education on healthy lifestyles to patients. Patients are expected to actively engage in this program as part of their diabetes self-management.

Long-term treatment adherence is critical for schizophrenia patients, yet non-adherence remains a significant global challenge, contributing to relapse, re-hospitalization, and increased healthcare costs. Understanding the underlying multidimensional factors is crucial for developing effective interventions. This systematic literature review aims to identify and categorize the dominant factors contributing to medication non-adherence among schizophrenia patients, based on current quantitative evidence (2019-2024). A systematic search of Google Scholar and PubMed targeted quantitative cross-sectional studies using the PICOST framework. Article selection followed PRISMA guidelines, and quality was assessed using the JBI Critical Appraisal Checklist. Seven articles were included in the final narrative synthesis. The synthesis confirms that non-adherence is multifactorial. Identified factors were categorized into three groups: (1) Patient-related factors (e.g., poor illness insight, feeling cured, treatment fatigue); (2) Treatment-related factors (e.g., medication side effects, therapy duration); and (3) System and social factors (e.g., low family support, stigma, poor therapeutic alliance). Non-adherence is a complex issue arising from the interplay of patient, treatment, and social factors. Low family support and poor patient knowledge consistently emerge as key determinants. Interventions require a holistic approach extending beyond pharmacotherapy, focusing on comprehensive psychosocial education for patients and families, active side-effect management, and strengthening the family's role in care.

Hypertension is one of the most common non-communicable diseases in Indonesia. Hypertensive patients must have high self-efficacy to comply with antihypertensive medication so that blood pressure can be controlled and complications prevented. Therefore, intervention is needed to improve therapy compliance. One intervention that can be given is the provision of pill cards. This study was a quasi-experimental design with a pre-intervention post-intervention control group design. Sampling was conducted using non-probability purposive sampling from July to September 2025. A total of 106 respondents were divided into two groups, with 53 respondents in the control group and 53 respondents in the intervention group. The control group was only given the MMAS-8 questionnaire, while the intervention group was given pill cards and the MMAS-8 questionnaire. In the intervention group, prior to intervention, 25 patients (47.2%) had low compliance, 21 patients (39.6%) had moderate compliance, and 7 patients (13.2%) had high compliance. After the intervention, there was a significant increase, with 21 patients (39.6%) showing high compliance, 26 patients (49.1%) showing moderate compliance, and 6 patients (11.3%) showing low compliance. Providing pill cards to outpatients with hypertension can improve patient medication adherence. Based on the results of the Wilcoxon Signed Ranks Test, a value of (p<0.001) was obtained, indicating that H0 was rejected and there was a significant effect.

Radiographic examination plays a crucial role in visualizing internal body structures for diagnostic purposes. One of the radiographic assessments frequently performed is the Acromioclavicular (AC) joint projection, which is used to evaluate abnormalities such as joint widening, subluxation, and dislocation. This study aimed to compare the image quality of the AC joint using the Anteroposterior (AP) projection with a 3-kg load and without load. The study was conducted in the Radiology Laboratory of STIKES Borneo Nusantara using a conventional X-ray system with a quantitative descriptive case-study approach. Data were collected through observation and questionnaires administered to 10 research subjects, including radiographers and patient participants. The findings demonstrated that the AP projection with a 3-kg load produced clearer visualization of the AC joint, particularly in widening of the joint space and separation between the humeral head and glenoid cavity. The average image quality score using load was 3.5 (good), compared with 2.9 (poor) for the projection without load. The study concludes that applying a 3-kg load improves anatomical visualization of the AC joint and is recommended for cooperative patients to enhance diagnostic accuracy.

Background: One of the factors that can trigger diabetes mellitus is a diet high in carbohydrates. Therefore, it is important to educate the community to adopt a healthy lifestyle in order to prevent various diseases, particularly diabetes mellitus. Objective: The objective of this health education activity on the prevention and management of diabetes mellitus through the implementation of a healthy lifestyle is to improve the knowledge of families of diabetes mellitus patients regarding prevention and management by applying healthy lifestyle practices. Methods: The activity was carried out for patients and their families using demonstration and discussion methods supported by leaflet media. Results: The counseling activity successfully increased respondents’ knowledge about the importance of preventing and managing diabetes mellitus through the implementation of a healthy lifestyle.Conclusion: Of the four respondents who attended the health education session on the prevention and management of diabetes mellitus through healthy lifestyle implementation, all participants demonstrated an understanding of the importance of adopting a healthy lifestyle for preventing and managing diabetes mellitus.

This study aims to explore the communication styles and experiences of healthcare workers in enhancing public service communication skills at Petir Community Health Center (Puskesmas Petir) in Tangerang City. Effective communication is a crucial factor in the quality of healthcare services for patients; however, various challenges such as time constraints, differences in patients’ backgrounds, and work pressure often hinder optimal interactions. This research employs a qualitative approach with a case study method, involving in-depth interviews, participatory observations, and document analysis to uncover the experiences, perceptions, and practices of healthcare workers in communicating with patients and the community. The findings indicate that communication skills are improved through internal training, peer mentoring, and the adaptation of communication strategies to match patient characteristics. Additionally, personal motivation, managerial support, and a conducive work environment play significant roles in the successful implementation of communication strategies. The results of this study provide an in-depth understanding of public service communication practices within the community health center context and serve as a basis for recommendations in developing training programs and policies to enhance the quality of interactions between healthcare workers and the community.

Depression is one of the mental health problems that often arise in patients with chronic diseases, such as diabetes mellitus, hypertension, and chronic kidney failure. This condition not only impacts the patient's quality of life, but also affects the treatment process and the burden on the family. However, mental health literacy in the community is still low, so targeted preventive and curative efforts are needed. The Community Service Program (PKM) aims to improve people's mental health through educational interventions with scientific booklet media that are easy to understand and apply. The activity method is carried out in a participatory manner, including the preparation stage, socialization, educational implementation, and evaluation. Education is provided to the community with a focus on preventing depression through a healthy lifestyle, stress management skills, and early intervention efforts by seeking professional support. Evaluation is carried out through pre-post tests, observations, and group discussions. The results of the activity showed an increase in public knowledge about depression, a change in attitudes to be more open in expressing feelings, as well as practical skills in relaxation, maintaining sleep patterns, and building social support. Participants also better understand the importance of seeking professional help when depressive symptoms are getting worse. The conclusion of this PKM is that the scientific booklet has proven to be effective as a preventive and curative educational intervention medium, and can be an innovative strategy in improving the mental health of people affected by chronic diseases.

Background: Dietary adherence is a crucial component in the management of patients with chronic kidney disease (CKD) undergoing hemodialysis. Non-adherence may lead to metabolic imbalance, increased morbidity, and reduced quality of life.Objective: To identify factors associated with dietary non-adherence among patients with CKD undergoing hemodialysis at Imelda Hospital, Medan. Methods: A cross-sectional study was conducted among patients undergoing routine hemodialysis. Data were collected using structured questionnaires assessing knowledge, attitudes, and family support related to dietary adherence. Statistical analysis was performed using chi-square tests and logistic regression with a significance level of p < 0.05. Results: Knowledge, attitudes, and family support were significantly associated with dietary non-adherence (p < 0.05). Family support was identified as the most influential factor. Conclusion: Dietary non-adherence among hemodialysis patients is influenced by knowledge, attitudes, and family support. Strengthening patient education and family-centered nursing interventions is essential to improve dietary adherence.

In this paper, we study the use of linear programming for the performance enhancement of fortified queues systems in which resources are unreliable in terms of variation and a case study on Marjan Hospital is considered. The quality management maturity level in the hospital was measured by an integrated inspection tool; senior management was found to be concerned for quality of service improvement and implementation of modern technology systems. Strengths and weaknesses in that activity are shown, and it is evidenced the need of boosting the quality of service activities and promoting the coordination between the different areas. From the findings, the study recommends the use of linear programming technique,Orgers should as well enhance proper training and development and Acquisition of modern day technology for effective performance improvement and quality of service. The study demonstrates that the adoption of linear programming techniques could be a viable solution to optimize resource allocation and enhance performance in the hospital's queue systems. Additionally, the research underscores the importance of investing in staff training and development programs, as well as the acquisition of state-of-the-art technology, to further improve service delivery and ensure sustainable quality improvement in the long term.

Tuberculosis (TB) remains one of the leading infectious diseases causing morbidity and mortality in Indonesia. Limited public health literacy regarding TB symptoms, prevention, and treatment adherence contributes to delayed diagnosis and poor treatment outcomes. This community service program aimed to improve public understanding and awareness of TB through interactive educational activities conducted at the Outpatient Unit and TB Clinic of UPT Puskesmas DTP Saketi, Pandeglang Regency. The activities involved 30 participants, including TB patients and their families. Interactive counseling sessions, audiovisual media presentations, and group discussions were used to engage participants actively. Evaluation results showed a 35% increase in participants’ knowledge scores, greater awareness of the importance of completing treatment, and improved communication between patients and healthcare workers. The implementation of interactive education proved effective in enhancing TB health literacy and supporting national TB elimination efforts at the primary healthcare level.

Currently, patients experiencing early symptoms of skin disease caused by the exanthema virus are unable to immediately consult a dermatologist due to the high cost and limited time available for specialists in hospitals. Therefore, the author needs to develop an expert system application that can address this issue. Through this application, users can consult with the system, much like an expert, to diagnose their symptoms and find solutions to their problems. This expert system is designed to provide answers based on whether the symptoms are correct or not, or to provide several recommended answer choices based on the symptoms. To diagnose skin disease caused by the exanthema virus, the author used the Case-Based Reasoning method. The CBR method is a weighting technique that compares new cases with previous cases. The diagnosis is based on data provided by the patient and expert, which is then analyzed using case-based reasoning and stored as a knowledge database in the expert system. Therefore, this expert system can help identify solutions for problems experienced by patients suffering from skin disease caused by the Exanthema Virus.

The JKN Mobile application is an electronic-based service innovation introduced by BPJS Health to facilitate JKN participants in accessing healthcare services and managing their membership information. This study aims to explore the experiences and perspectives of outpatient patients regarding the effectiveness of the JKN Mobile online registration system at Baubau City Regional General Hospital. A qualitative phenomenological approach was employed, with informants selected through purposive sampling. Data were collected to capture the meanings of patients’ experiences in using the application. The findings show that most patients are satisfied with the practicality, speed, and flexibility of the online registration system. However, technical problems, particularly unstable internet connectivity, remain a major challenge. Furthermore, the online registration system has contributed to improved service efficiency and patient satisfaction. These findings indicate the importance of continuous evaluation and improvement of the JKN Mobile online registration system to enhance service quality and health information system development at Baubau City Regional General Hospital.

Partial Denture (GTSL) is an ideal option for patients with missing teeth, with various materials such as thermoplastic nylon (flexible denture), acrylic resin, and metal. Heat-cured acrylic resin and thermoplastic nylon are the two most commonly used materials for denture bases. Denture bases must have sufficient mechanical strength to withstand chewing forces. Acrylic resin, made from polymethyl methacrylate, has become the gold standard in prosthodontics due to its affordability, ease of fabrication, and satisfactory functional results. However, acrylic resin tends to be rigid, brittle, and may cause soft tissue irritation. As an alternative, thermoplastic nylon offers high physical strength, resistance to heat and chemicals, as well as plastic and flexible properties. However, thermoplastic nylon tends to absorb water, change color, and is difficult to repair. Thermoplastic nylon-based dentures provide comfort, aesthetics, and good marginal adaptation, with less soft tissue irritation compared to acrylic resin dentures. Although both materials have comparable characteristics in terms of retention, stability, and durability, flexible dentures are more attractive to patients who prioritize comfort and aesthetics.

The National Health Insurance Program (Jaminan Kesehatan Nasional or JKN) is a government initiative aimed at ensuring equitable, accessible, and affordable healthcare services for all Indonesian citizens. Since its implementation in 2014, the program has covered more than 90% of the population; however, several challenges remain, particularly concerning the quality of services at primary healthcare facilities such as community health centers (puskesmas). This study aims to analyze the quality of JKN services at the Cengkareng Public Health Center, West Jakarta, using the five dimensions of service quality proposed by Parasuraman: tangibles, reliability, responsiveness, assurance, and empathy. The research employed a descriptive qualitative method through in-depth interviews, direct observations, and document analysis involving healthcare workers and JKN patients. The findings indicate that the overall service quality at Puskesmas Cengkareng remains suboptimal. The tangibles and assurance dimensions are relatively good, while reliability, responsiveness, and empathy are still lacking. Major complaints include long waiting times, poor doctor–patient communication, and unfriendly staff attitudes. These findings highlight the need for improving human resource professionalism, strengthening service management systems, and conducting periodic evaluations to enhance the overall quality and patient satisfaction among JKN participants.  

Informed consent constitutes a fundamental legal and ethical requirement in healthcare services, ensuring that every medical action is performed with the patient’s full awareness and voluntary approval. In Indonesia, the obligation to obtain informed consent is firmly regulated under the Health Law No. 17 of 2023, the Minister of Health Regulation on Medical Consent, and provisions on medical records. This paper examines the essential role of informed consent as a protective instrument for both patients and healthcare providers within the clinical and legal framework. Informed consent guarantees patients’ rights to information, autonomy, and decision-making, while providing legal safeguards for medical practitioners by documenting the process of explanation, acceptance, or refusal of medical treatment. Proper documentation within medical records ensures accountability, continuity of care, and serves as crucial evidence when medical disputes arise. Medical disputes often stem from dissatisfaction, communication gaps, or misunderstandings about risks inherent in medical procedures. Therefore, informed consent functions not merely as an administrative requirement but as a mechanism for preventing conflict, clarifying responsibilities, and distinguishing unavoidable medical risks from professional negligence. By strengthening the implementation of informed consent, healthcare providers can enhance transparency, improve service quality, and reduce the likelihood of medical litigation.