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An electrostimulator is a medical device designed to deliver controlled electrical stimulation to nerves and muscles, supporting rehabilitation and therapy for patients with neuromuscular disorders. This study focuses on designing and developing a portable electrostimulator that offers three distinct waveform modes: continuous wave, discontinuous wave, and dense-disperse wave, providing versatility for different therapeutic needs. The device is powered and controlled by an Arduino Mega 2560 microcontroller, coupled with a Nextion touchscreen LCD interface that allows users to adjust waveform type, frequency, and stimulation intensity with ease. Waveforms are generated through an NE555 IC circuit, with amplitude adjusted via a potentiometer and subsequently amplified using a step-up transformer to achieve therapeutic voltage levels. Functionality and performance tests were conducted using an oscilloscope, and the device was benchmarked against a commercial KWD-808 electrostimulator. Results demonstrate that the developed electrostimulator reliably produces the intended waveforms, achieving peak voltages up to 32V and frequencies ranging from 33.3 Hz to 66.6 Hz, confirming its effectiveness and feasibility for non-clinical nerve and muscle therapy applications.

Low Back Pain (LBP) is often caused by spondylolisthesis, which causes pain, limited mobility, and disability. Conservative physiotherapy is the primary option to reduce symptoms and improve function. This study aims to evaluate the effectiveness of multimodal physiotherapy interventions in patients with LBP and spondylolisthesis. A case report study was conducted on a 59-year-old female patient diagnosed with LBP and spondylolisthesis. The patient underwent three physiotherapy intervention sessions: Infrared (IR), Short-Wave Diathermy (SWD), Transcutaneous Electrical Nerve Stimulation (TENS), William Flexion Exercise, Core Stability, and Strengthening. Evaluation was performed using the Numeric Rating Scale (NRS) for pain, a goniometer for joint range of motion (LGS), Manual Muscle Testing (MMT) for muscle strength, and the Oswestry Disability Index (ODI) for function. The results of the therapy showed a significant reduction in pain, namely silent pain from a score of 5 to 1 and pain on movement from a score of 6 to 3. Lumbar ROM increased with flexion from 70 degrees to 85 degrees. Lumbar muscle strength also improved, flexors from a score of 4 to 5 and extensors from a score of 3 to 5. ODI decreased from 55.5% (severe disability category) to 12% (minimal disability category). Multimodal physiotherapy interventions have been proven effective in reducing pain, improving LGS, muscle strength, and function in patients with LBP et causa spondylolisthesis.

Chronic kidney disease (CKD) is a progressive and irreversible decline in kidney function that, if left untreated, can lead to serious complications. Ultrasonography (USG) is a widely used imaging modality for detecting CKD, yet its interpretation remains highly dependent on the radiologist’s expertise. This study aims to develop a CKD detection system using a convolutional neural network (CNN) on kidney ultrasound images based on estimated glomerular filtration rate (eGFR), and to evaluate the system’s performance. This research employed a research and development (R&D) approach with an experimental design. The dataset consisted of kidney ultrasound images from CKD and non-CKD patients with corresponding eGFR values. The methodology included image preprocessing, CNN model training, and accuracy evaluation using classification metrics. The results demonstrated that the developed CNN model achieved a total accuracy of 97% on internal test data and 95.8% on external validation. The model’s sensitivity reached 100% for the normal category, 91.67% for CKD stage 4, and 90% for CKD stage 5. Specificity exceeded 96% across all categories, with high precision and F1-scores above 94% for all classes. This system has proven to be effective as a diagnostic support tool for automatically detecting CKD through kidney ultrasound imaging. Its advantages lie not only in accurately classifying CKD from USG images but also in correlating the classification results with patients' eGFR values. This provides more precise clinical information and supports appropriate CKD staging and management planning.

Cancer is a chronic disease that not only affects physical conditions but also imposes a significant psychological burden on both cancer patients and cancer survivors. Various mental health problems, such as anxiety, depression, stress, and psychological distress, are frequently experienced throughout the processes of diagnosis, treatment, and the survivorship phase. One psychological intervention that has developed and been widely studied is expressive writing, which allows individuals to freely express their thoughts and emotions through writing. This study aims to examine the effectiveness of expressive writing interventions on the mental health of cancer patients and cancer survivors using a literature review method. The article search process was conducted in international databases (ScienceDirect, PubMed, and SpringerLink) and a national database (Garuda), covering publications from 2020 to 2025. Article selection was carried out using PRISMA guidelines, and methodological quality assessment was conducted using the Critical Appraisal tools from the Joanna Briggs Institute (JBI). Based on the selection results, nine articles met the eligibility criteria for analysis. The review findings indicate that most studies report positive effects of expressive writing in reducing anxiety, depression, stress, and psychological distress, as well as improving quality of life, positive affect, self-efficacy, and posttraumatic growth. However, the effectiveness of this intervention varies depending on individual characteristics, clinical context, writing structure and focus, intervention duration, and cultural appropriateness. Therefore, expressive writing has the potential to serve as an effective, flexible, and low-cost supportive intervention in cancer care, particularly when it is designed contextually and adaptively in accordance with patients’ psychological needs.

Diabetes Mellitus is a metabolic disorder caused by the pancreas failing to produce insulin hormone adequately. Based on the cause, diabetes mellitus is classified into three types, including type 1 DM, type 2 Diabetes Mellitus, and gestational diabetes mellitus. Hyperglycemia can also occur due to food consumed that is not balanced with physical activity carried out so that fat accumulates in the body and causes blood to be unable to enter the body's cells, ultimately increasing blood sugar levels. Signs and symptoms that often appear in Diabetes Mellitus patients are polydipsia (excessive thirst), polyuria (frequent urination due to excessive urine production), polyphagia (quickly feeling hungry even though you eat a lot and want to eat continuously) and weight loss without a clear cause. Symptoms of diabetes mellitus can be controlled by increasing physical activity, following a healthy diet, and getting enough rest. Several studies have proven that bay leaves have the potential as an antidiabetic. This study aims to determine the content of secondary metabolic compounds and the antidiabetic activity of bay leaf extract using α-amylase enzyme inhibition in vitro. This research method uses laboratory experiments. This study uses α-amylase enzyme inhibition to determine the antidiabetic activity contained in bay leaf extract. The method used is DNSA. The results of this study obtained a yield of bay leaf extract of 30%, water content of simplicia of 6.24%, drying loss of simplicia of 5.3%, ash content test of 5.6%, water content test of extract of 6.34%, drying loss test of extract of 7.03%. Bay leaf extract positively contains secondary metabolite compounds, namely saponins, tannins, flavonoids, and alkaloids. The results of IC50 in bay leaf extract of 66.705 ppm are classified as strong antidiabetic. The results of acarbose of 56.818 ppm are classified as strong antidiabetic.

Acne vulgaris is one of the most prevalent dermatological disorders in Indonesia, often affecting adolescents and young adults. This condition not only causes visible skin lesions but also has a profound impact on psychological well-being, leading to decreased confidence and reduced quality of life. Effective management of acne vulgaris requires consistent use of prescribed medications, with doxycycline being one of the commonly recommended systemic antibiotics. This study aimed to evaluate the level of patient adherence to doxycycline therapy for acne vulgaris at Roels Clinic, Ponorogo, during the period of March to April 2025, and to identify factors that may influence this adherence. A descriptive research design was utilized, employing a structured questionnaire distributed to patients who met specific inclusion criteria. The adherence level was assessed using a 5-point Likert scale, and the average percentage was computed and classified into compliance categories. The findings revealed that among 50 respondents, 70.6% demonstrated a “fairly high” level of adherence to doxycycline treatment. These results suggest that most patients follow the prescribed regimen appropriately. High adherence is expected to improve therapeutic outcomes, accelerate recovery, and minimize the potential for antibiotic resistance, which remains a growing concern in dermatological and public health settings.

Lymphadenopathy is a condition characterized by the enlargement of lymph nodes, commonly encountered in clinical practice, and may indicate both infectious and non-infectious disorders. This condition often causes anxiety as it is frequently associated with chronic diseases or malignancies. This study aims to describe nursing care in patients with lymphadenopathy through a case study approach and theoretical review. The method used was a descriptive case study with data collected through interviews, physical examinations, observations, and documentation. The results revealed the main complaint of pain in the anterior neck following surgical intervention. The identified nursing diagnoses included acute pain, knowledge deficit, and risk of infection. Interventions were carried out in the form of infection prevention, pain management, and health education. Evaluation showed significant improvements. The study concludes that comprehensive nursing care for patients with lymphadenopathy is effective in reducing symptoms, alleviating anxiety, increasing patient knowledge, and positively impacting quality of life.

Background: Knee osteoarthritis is one of the most common degenerative conditions in older adults, often causing pain and limited range of motion (ROM), which negatively affects quality of life. Physiotherapy management plays an important role in reducing pain, improving flexibility, and maintaining joint function. Objective: This study aims to evaluate the effectiveness of physiotherapy interventions in reducing pain and improving ROM in elderly patients with knee osteoarthritis. Method: A case study was conducted on a 63-year-old patient at Dr. Soedjono Level II Hospital, Magelang, who underwent three therapy sessions consisting of Infrared (IR), Transcutaneous Electrical Nerve Stimulation (TENS), Proprioceptive Neuromuscular Facilitation (PNF) with the hold-relax technique, and static cycling. Assessments were carried out using the Numeric Rating Scale (NRS), Likert Gait Scale (LGS), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results: The findings showed a significant reduction in pain on palpation (from 4/10 to 1/10), improvement in knee flexion ROM (from 110° to 135°), and functional enhancement indicated by a decrease in WOMAC scores from 39.58% to 27.08%. Conclusion: These results suggest that structured physiotherapy interventions provide therapeutic benefits in reducing pain, improving joint flexibility, and enhancing functional ability in elderly patients with knee osteoarthritis.

Abdominal pain is one of the main complaints frequently encountered in patients in emergency departments and inpatient wards. This condition may be caused by various factors, ranging from gastrointestinal disorders and inflammation to reproductive system problems. Poorly managed pain can affect the patient’s quality of life, reduce daily activities, and increase anxiety. This case study aims to describe nursing care for Mrs. U, who presented with abdominal pain at dr. Soeselo Hospital, Tegal Regency. The research method applied was a case study with a nursing process approach, including assessment, diagnosis, intervention, implementation, and evaluation. The assessment revealed that the patient complained of lower abdominal pain with a pain scale of 5 (moderate), accompanied by nausea, weakness, and intermittent fever. The primary nursing diagnosis established was acute pain related to physiological injury agents. Interventions included pain management education, relaxation techniques, application of warm compresses, and collaboration in administering analgesics. The evaluation showed a decrease in pain intensity from a scale of 5 to 3, with the patient appearing calmer and showing improved sleep quality. This study emphasizes the crucial role of nurses in providing comprehensive care to reduce abdominal pain through both independent and the collaborative interventions with the medical team.

The Emergency Severity Index (ESI) is a triage method that determines the escalation of treatment for patients based on the severity of their emergency condition. In order to improve the level of satisfaction of individuals receiving health services, it is necessary to provide quality services that are responsive to the expectations and needs of patients. This study aims to explore the relationship between the ESI (Emergency Severity Index) level and patient satisfaction in the Emergency Room of Pertamedika Ummi Rosnati Hospital. The research design applied is analytical with a cross-sectional method. From a total population of 500 patients in December, 51 respondents were selected using purposive sampling. The instruments used included the ESI (Emergency Severity Index) Questionnaire and CSQ-8 (Client Satisfaction Questionnaire), with univariate and bivariate data analysis using the Chi-Square test. The results showed that in the high ESI index category, most participants (37 people or 92.5%) expressed satisfaction with the services received, while 3 people (7.5%) were dissatisfied. In the moderate ESI group, 9 respondents (90.0%) reported satisfaction, while only 1 respondent (10.0%) reported dissatisfaction. Conversely, in the mild ESI level, there were no patients who were satisfied (0%), and one patient (20.0%) was dissatisfied. Through analysis using the Chi-Square statistical test, a ρ value of 0.009 (≤ 0.05) was obtained, indicating a significant relationship between ESI levels and patient satisfaction. Based on these findings, it can be concluded that there is a correlation between ESI classification and the level of satisfaction of service users in the Emergency Department. The researchers recommend that patients gain a better understanding of the ESI stages, and the Emergency Department is expected to provide education, such as putting up informative banners related to ESI (Emergency Severity Index) to increase patient understanding of the triage process in the Emergency Department.

Bronchopneumonia is the most common form of pneumonia in children and remains a leading cause of death in those under five years of age. This condition is characterized by shortness of breath due to lung infection. One of the interventions used is nebulizer inhalation therapy, which helps relieve breathing difficulties and thin secretions. This study aims to evaluate the effectiveness of inhalation therapy in children experiencing ineffective airway clearance. The method applied is a case study based on evidence-based practice (EBP) involving one patient, with nebulizer interventions administered for three consecutive days, each lasting 10–15 minutes. The findings showed improvement, including reduced shortness of breath, decreased productive cough, and the disappearance of rhonchi. Therefore, nebulizer therapy is proven effective in managing respiratory problems in children with bronchopneumonia, and its implementation should be accompanied by education for patients and their families to support collaborative nursing care.

Disorders of the musculoskeletal system encompass a wide range of conditions affecting the bones, joints, and muscles. Bone-related disorders include osteoporosis, fractures, spinal deformities, osteopenia, osteomalacia, Paget’s disease of bone, osteopetrosis, achondroplasia, osteogenesis imperfecta, and osteomyelitis. Joint-related disorders consist of arthritis, bursitis, tendinitis, tendon injuries, tennis elbow, and carpal tunnel syndrome, while muscle disorders include myalgia, fibromyalgia, muscle injuries, muscular dystrophy, muscle atrophy, cramps, and spasms (Astuti et al., 2024). Fractures may lead to complications in surrounding tissues, such as soft tissue edema, bleeding into muscles and joints, joint dislocation, nerve damage, vascular injury, and tendon rupture (Rumapea, 2024). A patellar tendon rupture occurs when the fibrous tissue connecting the patella to the quadriceps muscle tears, and complete ruptures typically require surgical repair. The objective of this study was to design and implement a nursing care plan for patient A, who underwent post-operative management of a patellar tendon rupture in Mawar Ward 2 at RSUD dr. Soeselo, Tegal Regency, in 2025. This study applied a descriptive case study method. The findings revealed that the main complaint reported by the patient was pain in the left knee. Three nursing diagnoses were identified: acute pain, impaired physical mobility, and risk of infection. Nursing interventions were structured based on standardized guidelines from SDKI, SLKI, and SIKI, enabling systematic implementation. The results highlight the importance of comprehensive and evidence-based nursing care to optimize recovery outcomes for patients with post-operative tendon rupture.

Hypertension is one of the most common non-communicable diseases, with a high incidence rate that has become a major global health concern. It is often referred to as a “silent killer” because many patients are unaware of their condition until serious complications arise. In Indonesia, the prevalence of hypertension is relatively high, yet many sufferers remain undiagnosed or do not receive proper medical treatment. Several risk factors contribute to hypertension, including age, heredity, high-salt diet, obesity, lack of physical activity, and unhealthy lifestyles such as smoking and alcohol consumption. Without proper management, hypertension may lead to severe complications such as stroke, heart failure, and chronic kidney disease. Management of hypertension generally involves pharmacological therapy, such as the administration of antihypertensive drugs, as well as non-pharmacological interventions through lifestyle modifications. Nurses play a crucial role in patient education, monitoring, and preventing complications through comprehensive nursing care. The purpose of this study is to describe the nursing care provided to Mr. R, who experienced a cardiovascular system disorder, namely hypertension, in the Dahlia Ward of RSUD dr. Soeselo, Tegal Regency. The research method used was descriptive with a case study approach, allowing for a systematic and clear presentation of the patient’s condition. The case findings showed that the patient’s main complaint was a headache radiating to the nape of the neck. Based on nursing assessment, two nursing diagnoses were identified: acute pain and lack of knowledge regarding the disease and its management. Interventions were determined using national standards such as SDKI, SLKI, and SIKI, which are expected to reduce symptoms and improve the patient’s understanding of hypertension.

Both regional and general anesthesia techniques carry the risk of hypotension through different mechanisms. Regional anesthesia often causes hypotension due to sympathetic nerve blockade, which leads to peripheral vasodilation and a decrease in blood pressure. On the other hand, general anesthesia lowers blood pressure through its depressive effects on the cardiovascular system. Hypotension occurs more frequently in patients undergoing regional anesthesia compared to general anesthesia. This study aims to determine the relationship between anesthesia techniques and the incidence of post-anesthesia hypotension in Sectio Caesarea (SC) patients at RSUD dr. Soedirman Kebumen. This study uses a correlation analytic method with the Chi-Square test and a cross-sectional approach. Samples were taken using purposive sampling, consisting of 60 patients, 30 who received general anesthesia and 30 who received regional anesthesia. The research method involved blood pressure observation, which was then analyzed. The results showed that 26 patients (43.3%) in the regional anesthesia group experienced hypotension, while only 1 patient (1.7%) in the general anesthesia group experienced hypotension, with a p-value of 0.000. Based on these results, it can be concluded that there is a significant relationship between anesthesia techniques and the occurrence of hypotension, where regional anesthesia poses a higher risk for post-anesthesia hypotension in SC patients.

The incidence of violent behavior among mental health patients globally reaches 9%. One of the independent interventions carried out by nurses is the application of implementation strategies for patients with violent behavior tendencies, whose risk level is greater than that of other patients. This study aims to analyze the effect of implementation strategies on the risk of violent behavior in patients with mental disorders at the Aceh Mental Hospital. The implementation strategy consists of four main techniques: building trust, training in controlling violent behavior through medication, training in social/verbal risk control, and training in spiritual control. The study used a quasi-experimental design with a one-group pretest-posttest approach. A total of 2,166 inpatients at risk of violent behavior were identified over a one-year period, and 10 respondents were selected as samples using purposive sampling based on inclusion criteria. The research instrument was the BPAQ questionnaire, with aggression assessment ranging from low to very high. The results showed that the pretest average for signs and symptoms was 38.40, while the posttest score decreased to 11.60 after the implementation strategy intervention. Data analysis was performed using univariate and bivariate methods, with a paired t-test yielding a p-value of 0.000 (less than 0.05). This study concluded that the implementation strategy had a significant impact in reducing the risk of violent behavior in patients. It is recommended that patients' understanding of the implementation strategy therapy be continuously improved as an effort to control violent behavior.

One part of the large intestine can be affected by an anal fistula or rectovaginal fistula due to infection of the anal glands. In patients who have undergone colonostomy, radiological examinations such as lopography are necessary to detect abnormalities, especially in the anal region. Pediatric lopography with clinical rectovaginal fistula post colonostomy at the Radiology Department of Dr. Sardjito General Hospital involves inserting contrast media into the proximal section through the proximal stoma with an anteroposterior projection and into the distal section through the anal opening with a lateral projection. The study aimed to determine the contrast enema examination procedure in pediatric patients with clinical rectovaginal fistula post-colonostomy, including examination techniques, patient preparation, equipment and materials used, as well as handling problems such as blockages in the distal intestine. Methods: The study was conducted in May–June 2025 using a qualitative descriptive method through observation, interviews, and documentation, involving three radiographers and one radiologist. Data analysis was performed through data collection, data reduction, data presentation, discussion, and conclusion drawing. Results: The results showed that lopography examinations used water-soluble iodine contrast media mixed with NaCl at a ratio of 1:3, which was inserted through the proximal stoma and anus. Preparation included fasting from breast milk, confirming patient identity, informedconsent, and preparation of equipment such as an X-ray machine with fluoroscopy, catheters, syringes, and Computed Radiography.

Pain is one of the main problems that cancer patients who undergo chemotherapy often experience, both as a direct result of the development of the disease and as a side effect of the therapy undergone. Pain that is not handled properly can decrease the quality of life, interfere with daily activities, and negatively impact the patient's psychological state. Therefore, non-pharmacological interventions are important as a companion effort to medical treatment. This study aims to analyze the effect of the combination of Benson relaxation technique and Quranic Healing therapy on the pain level of cancer patients undergoing chemotherapy at the Sultan Agung Islamic Hospital Semarang. The research uses a quasi experiment design with a nonequivalent control group design approach. The sample size was 36 respondents, divided into intervention groups and control groups, each consisting of 18 respondents. Pain levels were measured with the Numeric Rating Scale (NRS) instrument before and after the intervention. Data analysis was performed using the Wilcoxon test for differences within groups and the Mann–Whitney test for differences between groups. The results showed a significant decrease in pain levels in the intervention group (p = 0.000) compared to the control group (p = 0.046), with a significant difference between the two groups after the intervention (p = 0.001). In conclusion, the combination of Benson relaxation techniques and Quranic Healing has been shown to be effective in reducing pain in cancer patients undergoing chemotherapy. These interventions can be recommended as an alternative to non-pharmacological nursing measures to improve the comfort and quality of life of cancer patients.

Homecare services are increasingly recognized as a preferred healthcare option because of their practicality, flexibility, and accessibility, especially for elderly patients and individuals with physical limitations who face difficulties in reaching health facilities. This study aims to examine the relationship between consumer, provider, sociocultural, and organizational factors with patients’ preferences in selecting homecare services. Employing a quantitative approach with a descriptive analytical design, data analysis was conducted using the chi-square test to determine the significance of each factor. The findings reveal that consumer-related aspects, such as personal needs, convenience, and trust (p = 0.005), along with sociocultural influences including social norms, cultural values, and family support (p < 0.001), have a significant relationship with patients’ choices of homecare services. In contrast, provider factors (p = 0.096) and organizational factors (p = 0.161) were found to have no significant impact on the decision-making process. These results suggest that patients’ decisions are primarily shaped by internal motivations and sociocultural environments rather than institutional or organizational elements. Thus, it is essential for healthcare providers to focus on understanding community needs, cultural practices, and patient expectations to ensure that the services offered are both relevant and acceptable. By integrating cultural sensitivity and consumer-oriented strategies, homecare services can become more effective, trusted, and widely utilized within the community.

Anxiety is an emotional response that is commonly experienced by patients before surgery, including in pre sectio caesarean patients. High levels of anxiety can affect the patient's physiological and psychological condition, so appropriate handling efforts are needed. Non-pharmacological interventions, such as prayer dhikr therapy, can be used as an alternative to help reduce anxiety because it provides relaxation, calmness, and increased spirituality. This study aims to analyze the effectiveness of dhikr sholawat therapy on anxiety levels in pre sectio caesarean patients. The research design used a quasi-experiment with a pre-test and post-test control group approach. The research sample consisted of pre-sectio caesarea patients who met the inclusion criteria, then divided into two groups, namely the intervention group that was given prayer dhikr therapy and the control group that only received standard treatment. The instrument used to measure anxiety levels is the Hamilton Anxiety Rating Scale (HARS). Data analysis was carried out by statistical tests according to the distribution of data to find out the difference in results between the two groups. The results showed a significant decrease in anxiety levels in the intervention group compared to the control group (p < 0.05). These findings prove that prayer dhikr therapy is effective in reducing anxiety in pre-sectio caesarean patients. Thus, this therapy can be recommended as one of the non-pharmacological nursing interventions that support the improvement of service quality and patient comfort.

Cancer is still one of the leading causes of death in Indonesia and poses a major challenge in the world of health. Cancer patients undergoing chemotherapy generally face various psychological problems, one of which is anxiety arising from side effects of therapy, uncertainty of treatment, and deterioration of physical condition. This study aimed to analyze the relationship between family support and anxiety levels in patients undergoing chemotherapy. The research design uses a quantitative approach with a cross-sectional method. The research sample amounted to 40 chemotherapy patients at RSI Sultan Agung Semarang who were selected using a total sampling technique. The research instruments were in the form of family support questionnaires and the Hamilton Anxiety Rating Scale (HARS). Data analysis was carried out using the Marginal Homogeneity test. The results showed that most patients received family support in the moderate to high category (75%) and experienced mild to moderate levels of anxiety (70%). Based on statistical tests, a value of p = 0.001 was obtained, which showed a significant relationship between family support and anxiety levels in chemotherapy patients. The conclusion of this study confirms that good family support plays an important role in helping patients reduce anxiety during treatment. These findings indicate the importance of active family involvement in accompanying patients, both emotionally, informationally, and instrumentally. Therefore, educational programs involving families are highly recommended to improve the quality of care and support the psychological condition of cancer patients.