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Background: Gender-based violence (GBV) remains a major public health issue that negatively affects women’s psychological well-being and reproductive health. Trauma-informed care (TIC) is an approach to health services that recognizes the long-term effects of trauma and incorporates this understanding into all aspects of patient care. This study aimed to evaluate the effectiveness of TIC implementation in midwifery services on the psychological recovery of pregnant and postpartum women with a history of GBV in Medan City. Methods: This study applied a quasi-experimental pre-test and post-test control group design involving 86 pregnant and postpartum women identified through GBV screening at six primary health centers in Medan. Participants were divided into a TIC intervention group (n=43) and a control group (n=43). Psychological outcomes assessed included post-traumatic stress disorder symptoms using the PCL-5, depression with the EPDS, anxiety with the GAD-7, self-efficacy with the GSE, and mother–infant bonding using the PBQ. Data collection was conducted at baseline, week 8, and week 16. Statistical analysis employed repeated measures ANOVA and multiple linear regression.Results: Women receiving TIC showed significantly better psychological outcomes at week 16 compared with the control group. PTSD, depression, and anxiety scores decreased significantly, while self-efficacy and mother–infant bonding improved markedly (p<0.001). TIC also emerged as an independent predictor of psychological recovery after adjustment for confounding variables (β=-0.48; p<0.001). Conclusion: Trauma-informed care in midwifery services effectively enhances psychological recovery among women with GBV histories and should be integrated into maternal healthcare standards for vulnerable populations in Indonesia. 

The implementation of Electronic Medical Records (RME) in hospitals often faces various obstacles that hinder the achievement of maximum benefits. The main problems lie in the visual design, content quality, and user acceptance of the system, which have an impact on the work efficiency of medical personnel and the quality of service to patients. This study aims to analyze the effect of visual design and content quality of RME on Net benefits by considering system users as intervening variables. This research approach uses the HOT-Fit model that integrates human, organizational, and technological dimensions, accompanied by EUCS theory to assess visual and content quality and UTAUT theory to understand user perceptions. The results showed that the dimensions of visual design and content quality had a significant influence on the Net benefits of RME, both directly and through intervening system user variables. The findings also revealed that weaknesses in menu structure and information relevance hindered system performance, although overall, the Net benefits of RME were in the high category. Therefore, continuous evaluation and improvement on visual aspects, such as a more intuitive layout, as well as more organized and relevant content, are priorities for improving RME implementation. Key suggestions include optimizing the menu structure, simplifying navigation, integrating the system across hospital units, and providing ongoing training for system users. Thus, this study contributes to the development of a more effective RME implementation strategy, so as to support digital transformation in the healthcare sector.

Nurses need to improve the quality of their responses and complaint handling in serving patients, so that the quality of nursing services can be considered good and patients feel satisfied. In conditions of response time, healthcare personnel, especially nurses, are required to provide quick, accurate, and holistic handling immediately. The objective of this study is to determine the relationship between nurses' response time and family complaint handling in the Emergency Room of RSUD Maria Walanda Maramis. The research uses a cross-sectional design. The sample in this study consisted of 68 respondents using the purposive sampling technique. Data collection on response time and complaint handling was conducted using observation sheets and questionnaires, and analyzed using the chi-square statistical test. The research results showed that the most common response time was the quick response time category, with 61 respondents (89.7%), and the most common complaint handling was in the good category, with 59 respondents (86.8%). The result of the chi-square test obtained a p-value of 0.004 where < α 0.05. Conclusion: There is a relationship between the nurses' response time and the handling of family complaints in the Emergency Room of RSUD Maria Walanda Maramis. Patient families are expected to provide constructive feedback regarding the emergency department services so that the hospital can continue to improve the quality of its services.

This study aims to evaluate the implementation of Public Service Standards in inpatient services at Dumai City Regional General Hospital (RSUD) as an important part of the provision of health services to the community. Public service standards are needed to ensure service quality, efficiency, transparency, and public satisfaction as service users. However, in practice, various problems are still found, particularly related to the timeliness of service, clarity of service costs, and the availability of supporting facilities and infrastructure. This study uses a qualitative descriptive approach with research subjects including hospital management, inpatient service staff, and community service users. Data collection was conducted through in-depth interviews, direct observation, and documentation studies to obtain a comprehensive picture of the implementation of public service standards. The data obtained were analyzed using thematic analysis methods through the stages of data transcription, coding, theme identification, theme grouping, and data interpretation. The results of the study indicate that the overall implementation of Public Service Standards in inpatient care at Dumai City Regional General Hospital is in the good category. Indicators of service procedures, service products, and the competence of service providers have been implemented quite optimally, characterized by clear procedures, services that meet patient needs, and friendly and professional staff attitudes. However, the service completion time and cost indicators are still in the fairly good category, which indicates delays in service and limited information regarding costs received by patients. Furthermore, facilities and infrastructure are the indicators that require the most attention, especially regarding the comfort of the waiting room and the completeness of service support equipment. In conclusion, although the standard of public service at the Dumai City Regional Hospital inpatient has been running well, continuous improvement efforts are needed to increase service time efficiency, cost transparency, and the provision of facilities and infrastructure to increase public satisfaction and trust in health services.

Quality health services are an important factor in increasing patient trust in medical facilities and health workers. One of the crucial aspects is accuracy in providing drug recommendations that suit the patient's needs. Drug recommendations are influenced by various criteria, including effectiveness, safety, price, availability, and potential side effects. However, in practice, there is often a gap between the patient's expectations and the reality of the treatment received. This can affect patient satisfaction and perception of health services. To overcome these challenges, a Decision Support (SPK) is needed that is able to provide drug recommendations in a more objective, measurable, and structured manner. This study uses the Simple Additive Weighting (SAW) method because of its advantages in processing various complex and diverse criteria. SAW works by giving weight to each attribute, normalizing the data, and then calculating the preference value to determine the best alternative from several available drug options. The results of the study show that the SAW method is able to produce more structured and consistent recommendations than manual determination. In this study, the drug with the highest preference value, which is 92.00, was recommended as the top choice. These findings confirm that SPK and SAW-based approaches can be an effective solution in supporting medical personnel, especially in the selection of external drugs. In addition to improving decision accuracy, this SPK also has the potential to be further developed, for example by integrating into an electronic medical record (EMR) or based on a mobile application, so that its use becomes more practical and accessible. Thus, the implementation of the SAW method in SPK not only provides benefits on the technical aspect, but also contributes to improving the quality of health services as a whole.

The emergency department (ED) is the frontline of the hospital that provides health care tp patients the hospital that provides health care to patients who experience emergency conditions. The principle of service in the emergency room is fast and timely, but the increase in the the number of patients visiting the emergency room and the availability of inadequate resources can result in patient waiting time. This study is known to know the relationship between the availability of facilities and human resources with patient waiting time in the emergency department installation. This study is an observational analytic study with a cross sectional study research design. Data collection using SAP and questionnaire sheets. For the analysis test using chi-square with a level of significance (a <0.05). The chi-square statistical test obtained a value ≤ p +(a <0.005). From this study, there is a relationship between the availability of facilities and human resources with patient waiting time in the emergency room.

Cesarean section (Sectio Caesarea) is a surgical procedure performed by making an incision in the anterior wall of the uterus to assist the childbirth process. This study aims to examine the application of Benson relaxation technique in reducing the intensity of pain scale in post-cesarean section mothers at Bengkalis Regional General Hospital (RSUD Bengkalis). This research is a quantitative study using a quasi-experimental design. The study was conducted from November to December 2024, involving a sample of 15 respondents. Data were analyzed using univariate and bivariate analysis, with the Chi-Square test applied. All respondents were post-cesarean section mothers. The findings showed that before the intervention, all 15 respondents (100%) experienced severe pain. After receiving the Benson relaxation intervention for 10–15 minutes, a decrease in pain scale was reported. The data indicated that the majority of respondents (86.7% or 13 respondents) experienced a reduction from severe to moderate pain. The statistical test results yielded a p-value of 0.000, indicating a significant effect of Benson relaxation therapy on pain reduction in post-cesarean section patients in the Mawar Ward of RSUD Bengkalis. It is recommended that RSUD Bengkalis consider adopting this technique as an innovation in health services, particularly in nursing care, to help reduce pain in post-cesarean section mothers.

The decreasing number of visits is a problem for hospitals. Word of mouth (WOM) advertising plays an important role in business development in the health sector. This study aims to analyze the effect of price perception and patient experience on word of mouth with integrity as an intervening variable in patients at Lanud Manuhua Biak Hospital. The study used a quantitative causality design that analyzed the causal influence along with descriptive analysis using the threebox method. Respondents consisted of 200 hospital patients. The sampling method used purposive sampling. The data analysis method used PLS SEM. The results of the study found that there was a simultaneous effect of price perception and patient experience on word of mouth through integrity mediation. Price perception has a positive effect on word of mouth. Patient experience has a positive effect on word of mouth. Price perception has a positive effect on integrity. Patient experience has a positive effect on integrity. Integrity has a positive effect on word of mouth. Hospitals are expected to improve the quality of services provided in accordance with the prices that have been set, such as adding chairs, providing information about doctors' delays, simplifying the bureaucratic service process, training doctors to be more willing to listen to patients and sincerely serve their patients, shortening waiting hours, adding facilities in the waiting room.

This study aims to analyze the marketing strategies implemented by non-BPJS private hospitals in increasing revenue and competitiveness amidst the dominance of BPJS services in Indonesia. Private hospitals face challenges in attracting patients due to the perception of high service costs and limited public access. However, they have advantages in speed of service, modern facilities, and direct access to specialists. This study uses a literature review method with a content analysis approach to various secondary sources such as scientific journals, industry reports, and policy documents. The results of the study indicate that the implementation of a marketing strategy based on the 7P marketing mix concept (product, price, place, promotion, people, process, physical evidence), digital marketing, and customer relationship management through Customer Relationship Management (CRM) are key to increasing patient attraction and loyalty. Collaboration with private insurance also provides added value through ease of payment and access to premium health services. This study provides recommendations for hospitals in developing adaptive, holistic, and patient satisfaction-oriented marketing strategies.

This meta-analysis evaluates the cost-effectiveness of mental health interventions implemented in conflict-affected regions of the Middle East between 2010 and 2023, compiling data from 47 programs across eight countries. Statistical analysis reveals substantial variation in program effectiveness levels (Cohen's d = 0.78, 95% CI [0.65, 0.91], p < 0.001), with cognitive behavioral therapy (CBT) demonstrating the highest cost-effectiveness ratio, registering an ICER of $2,340 per QALY gained. Multilevel regression findings indicate that community-based intervention approaches consistently prove more cost-efficient than those conducted in clinical settings (β = 0.67, p < 0.001), yielding an average savings of 43% per participant. Remote teletherapy programs exhibit significant potential, particularly in regions with limited access to services, with an ROI reaching 1.89 (95% CI [1.65, 2.13]). The economic burden analysis estimates that untreated mental health conditions incur an average annual cost of $4,623 per individual, whereas intervention expenses amount to approximately $1,876 per patient per year, resulting in a benefit-cost ratio of 2.47. This study expands upon prior research by Tol et al. (2011) and McBain et al. (2016), which were limited to clinical outcomes without addressing the economic dimension. In contrast to the study by Reed et al. (1994), which explored general health economics within conflict zones, this research specifically quantifies the cost-effectiveness of mental health interventions in Middle Eastern conflict areas. It reveals that cultural adaptation within intervention programs can enhance return on investment by up to 31%. Finally, this review uniquely demonstrates that community-based mental health programs integrated within conflict zones can meet the cost-effectiveness thresholds recommended by WHO-CHOICE while maintaining a high level of clinical efficacy.

This systematic literature review examines queue system simulation in hospitals across four key service areas: emergency departments, outpatient clinics, laboratories, and pharmacies. Following PRISMA methodology, 72 relevant studies (2015-2020) were analyzed to identify simulation models, software tools, performance parameters, and emerging trends. Findings reveal Discrete-Event Simulation dominance (59.7%), with increasing hybrid model adoption integrating System Dynamics and Agent-Based approaches. Emergency departments remain the primary application focus (52.8%), while Arena and AnyLogic emerged as predominant simulation platforms. Patient waiting time (91.7%) and resource utilization (77.8%) constitute the most evaluated performance metrics. Technological convergence trends demonstrate integration of real-time data analytics, machine learning, and digital twin concepts into traditional simulation frameworks. This review contributes methodological insights for optimizing hospital queueing systems while identifying research gaps in cross-departmental model interoperability and comprehensive value-based performance evaluation within contemporary healthcare systems.  

Legal awareness among nurses is crucial to prevent malpractice that negatively impacts patients and healthcare institutions. This community service project aimed to enhance nurses’ understanding of health law based on Law No. 17 of 2023 at Melati General Hospital Perbaungan. The method employed was participatory interactive training and group discussions conducted over three months. The results indicated a significant improvement in nurses’ legal knowledge and a positive shift in their compliance behavior in daily practice. The program also fostered the emergence of local leaders who actively educate peers and contribute to creating a legal-conscious work culture. These findings suggest that targeted legal education can effectively reduce malpractice risks and improve healthcare quality.

The role of nurses in fulfilling patients' spiritual needs is a crucial component of holistic healthcare, encompassing physical, psychological, social, and spiritual well-being. This study aimed to analyze the relationship between the nurse's role as a caregiver and the fulfillment of patients' religious needs in the inpatient ward of Dr. Chasan Boesorie Regional Hospital, Ternate. A descriptive-analytic method with a cross-sectional approach was used. A total of 33 respondents were selected through purposive sampling. Data were collected using questionnaires and observations and analyzed with the Fisher Exact Test at a significance level of 0.05 using SPSS version 16.0. The results showed that the caregiver role of nurses was very high (66.7%), while the fulfillment of religious needs was good (21.2%). Statistical analysis revealed a significant relationship between the two variables (p=0.012). In conclusion, there is a significant relationship between the nurse's role as a caregiver and the fulfillment of patients' spiritual needs, confirmed by a significance value of p<0.002. These findings highlight the essential role of nurses in addressing the spiritual aspects of patient care.

Handling drug abuse is one of the main focuses in the Prevention and Eradication of Drug Abuse and Illicit Trafficking (P4GN) efforts in Indonesia. In this context, medical and social rehabilitation plays an important role as a recovery effort for addicts to return to optimal functioning in society. This community service activity uses a qualitative approach with a combination of observation, interview, and digital-based direct intervention methods in handling medical and social rehabilitation for drug abusers. This community service activity successfully implemented a digital-based medical and social rehabilitation strategy in supporting the P4GN program with a smart power approach. A web-based information system and mobile application designed to facilitate registration, monitoring, and mentoring of rehabilitation patients were successfully developed. This system provides easy access to information for the community and drug abusers to register and obtain rehabilitation services efficiently without having to come directly to the rehabilitation facility. The digital rehabilitation system is integrated with national electronic medical record platforms (such as SIRENA and the Ministry of Health's SATU SEHAT service), thus facilitating coordination between institutions and ensuring continuous monitoring of client health during and after the rehabilitation period. This community service activity successfully demonstrated that the handling of medical and social rehabilitation in a digital-based P4GN strategy with a smart power approach is an effective solution in an effort to realize a drug-free society. The smart power approach that integrates hard power (law enforcement) and soft power (prevention, community empowerment, and rehabilitation) with the support of digital information technology can improve the accessibility, effectiveness, and quality of rehabilitation services.

As one of the oldest hospitals in Bekasi Regency, KM I Hospital is required to remain trusted by patients in choosing health services including inpatient care. The decline in BOR (Bed Occupancy Rate) experienced by KM I Hospital in the last 1 year indicates that hospital marketing needs to be improved.  This study aims to analyze the effect of competitive advantage and informational reference groups on patient's decision in choosing inpatient services with benevolence trust as an intervening variable at KM I Hospital. The research method uses a quantitative explanatory research approach. Respondents were 185 patients at KM I Hospital who were willing to be hospitalized. The sample collection technique was purposive sampling. Data collection used a questionnaire, and the data analysis technique used SEM-PLS. Results show that Competitive Advantage and Informational Reference Group have a direct and indirect effect on patient’s decision to choose inpatient services through benevolence trust at KM I Hospital (p<0.05). These results theoretically support previous theories and research. Managerially, it is expected to provide input for KM I Hospital management to increase competitive advantage and strengthen informational reference groups. These efforts can increase benevolence trust and ultimately increase patient’s decision to choose inpatient services.

Technology that develops very rapidly brings many changes, especially in the development of medical records in hospitals that are increasing. Electronic medical records bring many benefits, one of which is improving the quality of services in hospitals. The medical records used at Hermina Arcamanik Hospital are mostly electronic-based, including reporting. However, problems were found in the medical record installation, namely, there were several reports that had not been managed optimally. This is because reporting still uses google spreadsheets which requires data to be moved manually one by one, so it takes a long time, and the quality of reporting becomes less accurate. A real example of this problem can be seen in the process of reporting patient Mortalitys. Meanwhile, accurate and systematic reporting of Mortality data is essential in supporting decision-making in hospitals. Therefore, the design of a patient Mortality reporting information system is urgently needed to make time efficient and improve the quality of reports. The method used in designing this system is extreme programming and web-based. The results of this information system design are able to shorten the time to make Mortality reports and can produce accurate data

The health services that will be provided must go through stages of approval from the patient verbally or in writing, so as not to violate the patient's rights as consumers of services and is one of the obligations of the health worker himself. This research aims to determine the implementation of informed consent in health services provided by physiotherapy students during field work practice in health institutions. This research also uses a sociological juridical method, which is the result of drawing conclusions as a result of connecting cause and effect variables in accordance with social science design. From the results of this research, it was found that physiotherapy students at Widya Husada University, Semarang, during field work practice in health institutions, always gave informed consent to patients before providing health services, either verbally or in writing. Students cannot yet be called full-fledged health workers, but when students practice field work in health institutions and provide health services to patients, they are required to provide informed consent to the patient first as a form of approval for the patient's actions.

This study aims to design and implement a web-based outpatient registration information system at Regional General Hospital (RSUD) X to overcome issues arising from the manual registration system. The current manual registration system at RSUD X causes problems such as long queues, potential data entry errors, lost files, and difficulty in finding patient medical history. As a result, patient waiting times are longer, the administrative staff's workload increases, and the overall effectiveness of services decreases. The research method used is a qualitative one, which describes various processes in the system, from patient data input to the digital registration receipt output. The system design approach uses the waterfall method. Data collection was carried out through purposive sampling, while data gathering was done through interviews with registration officers, direct observation, and a documentation study in the medical records unit. The system is built with a combination of technologies, including PHP as a server-side programming language and MySQL as the database. The result is a web-based outpatient registration information system that can improve the efficiency and quality of hospital services. The advantages of this system include wide accessibility, time efficiency, and effective data management. This system is expected to reduce patient queues, improve the efficiency of the registration process, and simplify patient data management. However, the implementation of this system may face challenges such as limited resources and user skills. Solutions to overcome these challenges are effective resource allocation and user training. Overall, the web-based outpatient registration information system can be an effective solution to improve service quality at RSUD X.

Background: In 2021, there were 38 deaths for every 1000 live births in the world's under-five population. Predisposing factors, enabling resources, need, and health service usage are the three primary elements that make up Andersen's theory and have an impact on health care utilisation. Goal: To ascertain how patient trust and service quality relate to Sekanak Raya Village's whole basic immunisation program. Method: This study is quantitative in nature and uses a cross-sectional, analytical observational methodology. The mothers who had children in Sekanak Raya Village made up the study's population. Tools for gathering data include questionnaires and observation sheets. In data analysis, the chi-square test was employed. Result: The findings indicate that 15 out of 100 underdog moms believe in complete basic immunisation status, whereas 18 out of 100 underdog mothers believe that the quality of service is good with complete basic immunisation status. For patient confidence, the chi square statistical test yielded a p-value of 0.022 < 0.05, whereas for service quality, the p-value was 0.004 < 0.05. In Sekanak Raya Village, UPTD Working Area, Puskesmas, Rear Padang, Batam City, total basic immunisation quality and patient trust are significantly correlated in 2024.

Spiritual services have not been implemented optimally, this is because nurses consider spiritual services less important and not a priority, busyness in the room, differences in religion, considering religion as a private matter, and lack of understanding of spiritual concepts. The purpose of this study was to determine the relationship between the role of nurses and the fulfillment of patients' spiritual needs in the ICU and Teratai Rooms of X Hospital. The research method used was a quantitative research design with a cross-sectional approach, the population in this study was 118 people, and the research instrument used the DSES (Daily Spiritual Experience Scale) spiritual fulfillment questionnaire developed by Underwood and Teresi. The data analysis used was univariate analysis and bivariate analysis. The results of the study showed that the majority of the role of caregiver nurses was sufficient at 56.8% (67 respondents), the majority of patients' spiritual needs were good at 78.8% (93 respondents) and there was no relationship between the role of nurses and the fulfillment of patients' spiritual needs in the ICU and Teratai Rooms of X Hospital with a p-value of 0.630. This research can improve nurse training in spiritual nursing care and provide facilities that support patients' spiritual needs.