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Cardiovascular dysfunction is a disorder of the blood vessels, such as hypertension, heart failure, and stroke. In 2016, cardiovascular disease was the leading cause of death worldwide, based on data from the World Health Organization (WHO). Coronary Heart Disease (CHD) is the leading cause of death, along with stroke, as shown by the Sample Registration System survey in 2014.This case involves a 64-year-old male, Mr. N, who presented to the emergency department of RSUD dr. Fauziah Bireuen with complaints of chest pain that developed gradually and worsened over the past month. The pain was located across the entire chest and radiated to the back and neck. The pain was described as severe, like being crushed by a heavy load, worsened during strenuous activities such as cutting grass and chopping wood, and relieved when the patient bent forward. The pain could occur at any time, with a Visual Analog Scale (VAS) score of 10 (severe pain). The patient also reported easy fatigue during heavy physical activity over the past month. Laboratory examination revealed elevated leukocytes, mean corpuscular volume (MCV), segmented neutrophils, troponin I, cholesterol, and triglycerides. The patient was diagnosed with extensive anterior ST-elevation myocardial infarction (STEMI) post successful fibrinolytic therapy.

Hypertension is a non-communicable disease that can lead to cardiovascular complications and requires both pharmacological and non-pharmacological management. One of the non-pharmacological therapies that can be applied is warm water foot soaking and progressive muscle relaxation, which may help reduce blood pressure through peripheral vasodilation, stimulation of the parasympathetic nervous system, and decreased sympathetic nervous system activity. This study aimed to analyze the implementation of nursing care through warm water foot soaking therapy and progressive muscle relaxation to reduce blood pressure in patients with hypertension. The method used was a case study with a pre-experimental design using a one group pre-test post-testapproach involving three hypertensive patients, with the intervention administered once daily for three days. The results showed a decrease in blood pressure in all patients. The average systolic reduction was 5.3 mmHg, 12.3 mmHg, and 5.6 mmHg, while the diastolic reduction was 1.6 mmHg, 2.6 mmHg, and 4 mmHg, respectively. In addition, all patients reported a reduction in pain scale. It can be concluded that warm water foot soaking therapy combined with progressive muscle relaxation is effective as a complementary nursing intervention to help reduce blood pressure in patients with hypertension.

The IV infusion process will cause pain that can be disturbing for children. Pain is a form of uncomfortable sensation that is felt personally by each individual. In addition, there will be changes in vital signs such as increased pulse, blood pressure, and respiration so that it will be an unpleasant experience for children. Non-pharmacological therapy as an intervention to reduce pain perception in children and increase comfort during medical procedures. One form of non-pharmacological technique is audio visual distraction using a smart book. Smart books are fun and interactive play therapy that can support cognitive, fine motor, and sensory aspects in children and to divert children's attention from pain by displaying more pleasant and interesting images and musical sounds so that it can reduce the pain scale after IV installation. The design used in the preparation of this Final Scientific Paper for Nurses is a case study with an intervention in the form of audio visual distraction using a smart book for ± 10 minutes. The number of respondents was 3 people, the intervention was carried out on September 14, October 7, and November 24, 2025, located in the Theresia Charitas Hospital Palembang room. After the smart book audio visual distraction therapy, there was a decrease in the pain scale for 3 respondents, namely in An. A from a pain scale of 7 to a pain scale of 4, An. G from a pain scale of 10 to a pain scale of 4, and An. R from a pain scale of 7 to a pain scale of 4. The application of EBP smart book audio visual distraction therapy can be used to reduce the pain scale in preschoolers after IV installation.

Background: Discomfort in third trimester pregnant women often arises due to physiological changes, with back pain being the most common complaint, occurring in 70% to 90% of cases. If left untreated, this pain can interfere with daily activities, cause insomnia, and even affect the childbirth process. Objective: This study aimed to determine the effect of back massage on reducing the intensity of back pain in third trimester pregnant women at Adow Community Health Center. Methods: The research design used a pre experimental approach with a one group pretest posttest design. The sample consisted of 40 third trimester pregnant women experiencing back pain at Adow Community Health Center. Data were analyzed using the paired t test statistical method. Results: Before receiving back massage, the majority of respondents (57.5%) experienced moderate scale pain. After the intervention, the majority of respondents (70%) reported a reduction in pain to a mild scale. The statistical test results showed a p value of 0.000 (p < 0.05) with an average pain reduction of 1.125. Conclusion: Back massage has a significant effect on reducing the intensity of back pain in third trimester pregnant women at Adow Community Health Center.

A fracture occurs when bone continuity is disrupted due to external pressure or force that exceeds the bone's capacity. Fractures constitute a medical emergency requiring immediate treatment. A primary surgical intervention for this condition is the Open Reduction and Internal Fixation (ORIF) procedure, which aims to reposition broken bone fragments to their normal anatomy. This procedure is considered crucial for achieving proper bone union and minimizing the potential for postoperative complications. As a consequence of the surgical incision and tissue trauma, patients commonly experience postoperative pain. The management of this pain can broadly be categorized into two approaches: pharmacological and non-pharmacological. Among non-pharmacological methods, cold compress therapy has proven effective in alleviating pain in patients following ORIF surgery. The sensation of pain can be alleviated through the application of a cold pack by inhibiting sensory nerve conduction and suppressing local inflammation. Simultaneously, cryotherapy also reduces blood flow to the injury site, which in turn limits blood extravasation and the accumulation of edema fluid. A descriptive case study analysis of four patients with acute pain after lower extremity ORIF surgery. The effectiveness of the intervention was measured using the Numeric Rating Scale (NRS).: The application of cold compresses using cold packs for 3 days to 4 respondents before the cold compress was applied was on a pain scale of 6–7 (moderate to severe category), after the intervention the pain scale became 2–3 (mild category). The results indicate that cold compress therapy in patients with lower extremity post-ORIF fractures is effective in reducing pain levels. Therefore, cold compress therapy is recommended as a non-pharmacological therapy to reduce pain in patients with fractures after ORIF.

The postpartum period following Sectio Caesarea is often accompanied by acute pain due to surgical incisions, which may interfere with mobilization, breastfeeding, and maternal recovery. Effective pain management is essential to prevent further complications and enhance maternal comfort. In addition to pharmacological therapy, non-pharmacological interventions such as Benson relaxation therapy can be implemented. This study aimed to evaluate the application of Benson relaxation therapy in reducing acute pain among postpartum Sectio Caesarea mothers.This study employed a case study design involving four postpartum Sectio Caesarea patients (Ny. R, Ny. A, Ny. Y, and Ny. S) treated in the Ayyub Ward of RS Roemani Muhammadiyah Semarang in 2026. Data were collected through comprehensive nursing assessments, pain intensity measurement using a numeric rating scale, observation of mobilization ability, and evaluation before and after intervention.The results showed that after regular implementation of Benson relaxation therapy, all patients experienced a gradual decrease in pain intensity (from scale 4–7 to ≤3), improved comfort, better breathing control, and increased ability to perform early mobilization. Consistent nursing education, therapeutic guidance, and family involvement supported the effectiveness of the intervention. It can be concluded that Benson relaxation therapy is an effective, safe, and easily applicable nursing intervention for reducing acute pain in postpartum Sectio Caesarea patients.

Cold compresses or cryotherapy are one of the non-pharmacological therapies often used in nursing practice to help reduce pain, especially in patients with fractures. Fractures are often accompanied by acute pain that can inhibit mobilization, prolong recovery time, and reduce patient comfort. Therefore, a safe, effective, and easy-to-use pain management method is needed. This article was compiled with the aim of identifying and mapping scientific evidence regarding the effectiveness of cold compresses in reducing pain intensity in fracture patients. This study used the Arksey and O'Malley model in conducting the analysis, with articles searched through PubMed, ScienceDirect, and Google Scholar for the 2021–2025 publication period. The article selection process followed the PRISMA flow. A review of ten articles showed that most studies used quantitative designs, both experimental and quasi-experimental. The results of the analysis of 11 articles consisted of 8 quantitative articles with experimental and quasi-experimental designs, while 2 articles were case studies. These articles generally discuss the effectiveness of cold compresses in reducing pain intensity in fracture patients using various measurement instruments, such as NRS, VAS, Wong-Baker Faces Scale, and Bourbanis Pain Scale. In addition to reducing pain, several studies also reported that cold compresses can reduce edema, increase mobility, and improve patient comfort. However, variations in the duration, frequency, and method of cold compress application were still found, so there is a need to develop a more standardized protocol in nursing practice.

Postoperative pain is a common physiological response following surgical procedures, and its suboptimal management can have physiological and psychological effects, including sleep disturbances, decreased functional capacity, increased anxiety, and deterioration in quality of life. This scoping review aims to describe the empirical evidence regarding the effectiveness of music therapy in reducing the intensity of postoperative pain in surgical patients. A systematic search was conducted through four major databases (ScienceDirect, PubMed, Neliti, and Google Scholar) using Boolean operators and keywords such as ‘postoperative pain,’ ‘music therapy,’ and ‘pain scale.’ Inclusion criteria included articles published in the last decade, in English or Indonesian, and available in full text format. In accordance with PRISMA-ScR guidelines, this review analysed 10 articles. The synthesis of results showed that music therapy consistently reduced pain intensity, anxiety, and analgesic requirements through mechanisms such as increased endorphin secretion, decreased stress hormone levels, and activation of the gate control theory. Typically administered for 15–30 minutes, music therapy is a safe, cost-effective, and patient-acceptable non-pharmacological modality. This intervention is recommended as an adjunct component in perioperative pain management in nursing practice, although further standardised research is needed to improve consistency.

During gravidity, back pain is a significant issue, especially due to changes in posture along with increasing physical load in the third trimester. Muscle relaxation and stretching exercises for pregnant women can help reduce back pain, one of which is the butterfly exercise. That study aims until determine the impact to the butterfly activity on gravidity in their third trimester at TPMB Amilia Intarti Klampisrejo, Pasuruan Regency. A quantitative method was used with a quasi-experimental approach employing a one-group pre-test also post-test design. The study involved 32 third-trimester gravidity as respondents. Data were collected using purposive sampling, before-and-after measurements, and assessed with the Numeric Rating Scale (NRS). The intervention be carried out over a period of four weeks. The findings show that the butterfly pregnancy exercise effectively reduces back pain in third-trimester gravid. Therefore, the butterfly exercise can serve as an alternative method to help alleviate back pain and enhance comfort during pregnancy.  

Pain is a prevalent issue frequently seen by pregnant women in their third trimester, attributable to physiological, biomechanical, and psychological alterations during gestation. Non-pharmacological pain management is essential as a secure alternative to enhance the comfort of pregnant women. Perinatal Yoga and Relaxation Techniques are two commonly endorsed non-pharmacological therapies; yet, comparative analyses of their efficacy remain scarce, particularly within primary health care settings. This study is to evaluate the efficacy of Perinatal Yoga against Relaxation Techniques in alleviating pain among pregnant women in their third trimester at the Bongo II Community Health Centre. The research employed a quasi-experimental design with a two-group pretest-posttest methodology. The sample comprised 38 pregnant women in their third trimester, categorized into two groups: 19 participants in the Perinatal Yoga group and 19 participants in the Relaxation Techniques group. The Numeric Rating Scale (NRS) was utilized to assess pain severity prior to and following the intervention. A paired t-test was utilized for intra-group differences, whereas an independent t-test was employed to assess inter-group efficacy.The findings indicated that both Perinatal Yoga and Relaxation Techniques markedly diminished pain intensity in pregnant women throughout their third trimester (p<0.001). The decrease in pain in the Perinatal Yoga group was statistically significant compared to the Relaxation Technique group (p<0.05). This study concludes that Perinatal Yoga is superior than Relaxation Techniques in alleviating pain in pregnant women during their third trimester. Perinatal Yoga is indicated as an effective and practical non-pharmacological technique in antenatal treatment inside primary health facilities.

Dysmenorrhea, which is common in adolescent girls, is a painful menstrual cycle that frequently interferes with daily activities, both in the classroom and in social situations. Dysmenorrhea is a common condition that needs particular care as a reproductive health concern, notably among young people. Both pharmacological and non-pharmacological approaches can be used to treat dysmenorrhea. The use of warm water compresses is a simple, inexpensive, and effective non-pharmacological approach. By increasing blood vessel dilatation, enhancing blood circulation, lowering muscular tension, and lowering pain perceptions, warm water compresses aid in alleviating dysmenorrhea symptoms. The objective of this study is to assess the impact of warm compresses on the severity of dysmenorrhea pain scales in teenage girls at the Buntalo Community Health Center. The design of this trial was pre-experimental, using a one-group pretest-posttest technique. Using a purposive sampling method, a sample of 20 respondents was chosen. The Wilcoxon test was used to conduct the data analysis. According to the data, there was a statistically significant reduction in pain intensity, with a Z value of -4.065 and a p-value of 0.000 (p < 0.05). The average pain scale decreased from 2.95 to 1.80. Based on these findings, it is reasonable to conclude that warm water compresses are helpful in alleviating dysmenorrhea pain in young women. One of the suggestions for non-pharmacological treatments to help alleviate dysmenorrhea symptoms in adolescents is anticipated to be the outcome of this research.

Low back pain is a common complaint among pregnant women in the second and third trimesters due to biomechanical and hormonal changes. Non-pharmacological interventions like prenatal exercise are believed to be effective, though evidence from controlled trials is limited. This study aimed to evaluate the effectiveness of prenatal exercise in reducing low back pain intensity. A quasi-experimental pretest–posttest control group design was used with 30 pregnant women (15 in the intervention group, 15 in the control group), selected by purposive sampling. The inclusion criteria were gestational age of 20–36 weeks, no medical contraindications, and willingness to participate. The intervention group performed prenatal exercises twice a week for 8 weeks (45 minutes per session), while the control group received health education without physical exercise. Pain intensity was measured using the Visual Analogue Scale (VAS). Data analysis was conducted using paired t-test, independent t-test/Mann–Whitney, and ANCOVA to control for age, parity, and BMI. Both groups had homogeneous baseline characteristics (p > 0.05). The intervention group’s pain score decreased from 6.9 ± 1.1 to 3.6 ± 1.0 (Δ = -3.3; p < 0.001), while the control group’s pain score decreased from 6.8 ± 1.2 to 6.3 ± 1.1 (Δ = -0.5; p = 0.09). The difference in pain reduction between groups was significant (p < 0.001). ANCOVA confirmed that prenatal exercise was significantly effective after adjusting for confounders (β = -2.8; p < 0.001). Prenatal exercise is an effective, safe, and affordable intervention for reducing low back pain in pregnant women.

Patients undergoing surgery often experience preoperative anxiety due to concerns about the outcome, pain, and the risk of complications. Uncontrolled anxiety can affect the patient's physiological and psychological condition and slow the recovery process. One non-pharmacological effort that can be used to reduce anxiety is the finger-holding relaxation technique, a simple method that can help balance emotions and provide a sense of calm. To determine the effect of the finger-holding relaxation technique on changes in preoperative anxiety levels in patients at Batang Regional General Hospital. Method: This study used a descriptive case study approach. The respondents were four patients who were about to undergo surgery and were experiencing anxiety. The intervention was conducted for approximately 15 minutes using the finger-holding relaxation technique. Anxiety levels were measured before and after the intervention using the Hamilton Anxiety Rating Scale (HARS). All respondents experienced a decrease in anxiety levels after the intervention. The average reduction in anxiety scores was 7.25 points. Before the intervention, two patients experienced severe anxiety and two patients experienced moderate anxiety. After the intervention, two patients experienced mild anxiety and two others experienced a decrease to moderate levels. This indicates that finger-holding therapy has a positive effect on reducing preoperative anxiety in patients. The finger-holding relaxation technique has been proven effective in reducing preoperative anxiety in patients. This intervention can be used as a simple, safe, and easy-to-implement non-pharmacological therapy alternative for nurses to improve patient psychological comfort.

Research at Diponegoro University found that 66.7% of 63 respondents experienced neck pain due to using a laptop for more than 4 hours. Prolonged laptop use can negatively impact health from an ergonomic perspective, as the recommended maximum usage is 2 hours per day. However, students often maintain non-ergonomic positions for extended periods. This study aimed to determine the relationship between laptop use and neck pain among Diploma Three Nursing Students at Abulyatama University, Aceh. The research utilized an analytical, cross-sectional design, with a population of 556 students and a sample of 85 students, selected through purposive random sampling. The research was conducted at Abulyatama University from May 15 to June 2, 2025, and data was collected using a questionnaire with a Numeric Rating Scale. Analysis involved both univariate and bivariate methods using the Chi-Square test. The results showed that among 85 respondents, 44 (95.7%) experienced moderate pain, 8 (40.0%) had mild pain, and 8 (42.1%) reported severe pain. Statistical analysis indicated a significant correlation (p=0.000) between laptop use and neck pain. In conclusion, there is a strong relationship between laptop use and complaints of neck pain among university students. The research is expected to raise student awareness about the health risks associated with prolonged and improper laptop use, encourage better posture, and serve as a reference about limiting laptop use and improving ergonomics.

Sectio caesarean (SC) is a major surgical procedure performed to save the mother and baby when normal delivery is not possible. However, this procedure may cause postoperative complications such as impaired physical mobility due to pain, muscle weakness, and anesthesia effects. These limitations can delay the healing process, increase the risk of infection, and reduce the mother's self-care ability. One effective non-pharmacological intervention to accelerate recovery is early mobilization through Range of Motion (ROM) exercises. This case study aims to analyze the effectiveness of early mobilization (ROM) intervention on improving mobility and reducing pain in post-sectio caesarean mothers. The study was conducted in June 2025 at RSUD Kajen with three respondents who underwent SC for different obstetric indications (postterm, CPD, and severe preeclampsia). The research design used a descriptive case study with pre–post intervention approach. The results showed that after performing ROM exercises gradually from six hours post SC, pain intensity decreased from a scale of 7–8 to 1–3 within three days. Mobility ability improved from only being able to turn sideways to sitting and walking with assistance. Respondents also showed increased motivation and independence in self-care activities. In conclusion, early mobilization (ROM) intervention is effective in accelerating recovery for post-sectio caesarean mothers. This intervention helps reduce pain, improve circulation, strengthen muscles, and enhance psychological adaptation. Early mobilization should be applied as part of routine nursing interventions in the postpartum ward.

Sectio caesarean surgery is a surgical procedure that can effectively prevent ma- ternal and newborn deaths when used for reasons of medical indications. Post operative sectio caesarean can pose several risks of complications, one of which is pain and surgical wound infection. Non pharmacological approach aromatherapy as a complementary therapy to reduce postpartum pain. This case study aims to analyze the influence aromatherapy lavender on reducing pain levels in post sectio caesarean mothers by using the case study method pre and post test. The case study was carried out in 25 May 2025 – 07 June 2025. This type of case study is descriptive with the number of subjects used, namely three post partum mothers in the RSUD Batang private sector with pain assessment using a questionnaire Numeric Rating Scale (NRS). The results of the case study showed a change in pain intensity from a scale of 6-7 to a scale of 4-5. This shows an influence aromatherapy lavender on reducing pain levels in postpartum mothers caesarean section Giving innovation aromatherapy can be used as an independent nursing in- tervention so that it can be applied to patients regularly.

Knee osteoarthritis is one of the most prevalent musculoskeletal disorders in the elderly, characterized by progressive degeneration of articular cartilage, chronic pain, joint stiffness, and reduced functional capacity. In Indonesia, the prevalence of knee osteoarthritis is notably high, affecting over 30% of individuals aged above 60 years. This condition leads to significant health burdens, impaired quality of life, and increased economic costs. Non-pharmacological management strategies such as hydrotherapy and quadriceps exercise are widely recommended to relieve pain and improve joint function. Hydrotherapy utilizes the physical properties of water including buoyancy, hydrostatic pressure, viscosity, and warmth to reduce joint loading, enhance circulation, and promote relaxation. Quadriceps exercise, on the other hand, focuses on strengthening the quadriceps muscle to stabilize the knee joint, thereby reducing pain and improving functionality. The combination of these two interventions is expected to provide greater benefits than a single modality. Research Design: This study employed a quasi-experimental design with a one-group pre-post test approach on 12 elderly respondents with knee osteoarthritis at OSF Magdalena Daemen BSB Convent. Pain was measured using the Visual Analogue Scale (VAS) before and after the intervention, which consisted of hydrotherapy and quadriceps exercise administered twice a week for four weeks. Results: The findings showed a decrease in the mean pain score from 4.42 to 3.08, with the Wilcoxon test yielding p = 0.001 (p < 0.05), indicating a significant difference in pain levels before and after the intervention. Conclusion: The combination of hydrotherapy and quadriceps exercise is effective in reducing pain in patients with knee osteoarthritis.

The World Health Organization (WHO) reported in 2019 that 40 million people worldwide require palliative care, including those with cardiovascular disease (38%), cancer (34%), chronic lung disease (10.3%), AIDS (5.7%), and diabetes (4.6%). Palliative care aims to improve the quality of life of patients and families facing life-threatening illnesses by managing pain and physical, psychological, social, and spiritual problems. The main goal of this care is to reduce suffering and help patients cope with the limitations imposed by illness. The principles are to respect life, consider death a normal process, neither hasten nor delay death, and provide support until the end of life. This study aims to determine whether knowledge can influence the level of self-efficacy of nursing students at Awal Bros University. Using a correlational quantitative method, data were collected through the Palliative Care Quiz for Nursing and Self-efficacy Palliative Care Scale questionnaires. The results of the study show a significant relationship between knowledge and self-efficacy among students with p<0.005. These findings can be used as a basis for learning to improve the understanding of nursing students, especially in the context of palliative care, which is important for the quality of health services in the future.

Background: Indonesia, as an agrarian country, has a large workforce engaged in physically demanding activities that increase the risk of myofascial pain. The prevalence of myofascial pain syndrome (MPS) in the upper trapezius muscle in Indonesia reaches 40% annually, with a higher rate in women. This condition often causes complaints in the neck, shoulders, and lower back, leading to a decline in quality of life. Various management strategies exist, but many are less effective in the long term and carry potential side effects. Lidocaine, as a local anesthetic, offers an alternative therapy due to its simple procedure, affordable cost, rapid effect, and good safety profile; therefore, its effectiveness in managing myofascial pain needs to be evaluated. Methods: This study was an observational research with a prospective cohort design conducted at PKU Muhammadiyah Gamping Hospital. Patients with myofascial pain who received lidocaine injections were followed for 4 weeks, and pain intensity was measured using the Numeric Rating Scale (NRS) to assess the relationship between lidocaine administration and pain reduction. Results: The study showed that lidocaine injection was effective in significantly reducing myofascial pain. The Wilcoxon Signed Rank Test produced negative Z values with p = 0.000 (<0.05) for all comparisons from pretest to the fourth week. The Friedman test also indicated significant differences between weeks (χ² = 9.731; p = 0.021), with optimal pain reduction observed in the second week. Although lidocaine provided significant analgesic effects, its effectiveness tended to decrease in subsequent weeks, indicating a short-term effect that should be combined with other interventions for sustained outcomes. Conclusion: Lidocaine injection proved effective in reducing pain among patients with myofascial pain syndrome, with the most optimal reduction occurring in the second week after therapy. The dominant factors influencing the outcomes were the relatively short duration of lidocaine’s action and individual variability in response. This implies that lidocaine can be used as an effective initial therapy, but should be combined with other interventions such as physiotherapy or activity modification to achieve more stable and sustainable pain management.

Labor is a complex interaction between psychological and physiological drives in women. (90%) delivery is accompanied by pain. In the active phase there is an increase in the intensity and frequency of contractions, so that the peak pain response is in this phase. Pain and soreness during labor are basically caused by strong contractions during labor. Breathing relaxation techniques can control pain by minimizing sympathetic activity in the autonomic nervous system. This study aims to determine the effect of deep breathing relaxation techniques on reducing labor pain in the first active phase. The type of design in this study is pre-experimental with The number of samples was taken according to the Accidental Sampling technique, samples were taken when patients went to the Andra Agustiana PMB Clinic with a minimum of 30 respondents. The data collection technique used a questionnaire sheet and a Numeric Rating Scale (NRS) pain scale. Data analysis used the Wilcoxon test. The results showed that before being given the breathing relaxation technique, most respondents experienced severe pain or pain levels on a scale of 7-10, namely 25 respondents (71.4%) and after being given deep breathing relaxation technique treatment, most respondents experienced moderate pain (scale 4-6) as many as 28 respondents (80%). The results of data analysis obtained the Asymp.significancy value = 0.000 (ρ<0.05). The conclusion is that there is an effect of providing deep breathing relaxation techniques on reducing labor pain in the first active phase. It is hoped that deep breathing relaxation techniques can be applied in the management of labor care as an alternative to reduce labor pain for mothers giving birth in the first active phase