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Diabetes mellitus, as a persistent non-infectious metabolic pathology increasingly prominent in the global epidemiological spectrum, is fundamentally characterized by dysfunctional hyperglycemia rooted in primary disruptions of pancreatic insulin hormone synthesis or peripheral resistance to its biological action, thereby inducing dynamic imbalances in gluconeogenesis and glycolysis pathways; amid the hypothesis that body mass index (BMI) as a measure of central adiposity potentially mediates variability in serum glucose levels, this quantitative observational study with a cross-sectional design rigorously tests the causal relationship between BMI and fasting/random blood glucose concentrations in a cohort of 134 adult subjects with type 2 diabetes mellitus affiliated with primary care services at Puskesmas Bongo II, Boalemo Regency, through an inclusive total sampling recruitment strategy, precision anthropometric measurement instruments (height, weight, WHO BMI categorization), and laboratory-validated glucometric validation, with multivariate inferential processing based on the Chi-Square independence test at a Type I error rate of α=0.05 using the latest edition of the SPSS analytical suite; the demographic profile highlights female gender supremacy (90 individuals, 67.2%), the normoweight group (78 cases, 58.2%), concurrent with substantial glycemic elevation prevalence (78 subjects, 58.2%), but the crucial statistical output reveals a p-value of 0.831 (>0.05) that negates any probabilistically meaningful association, thus the substantive conclusion affirms the non-significance of the BMI-glucose relationship in this local context, while implying the dominance of alternative etiopathogenic factors such as hypercaloric macronutrient intake patterns, deficits in aerobic/anaerobic physical activity, non-adherence to multidisciplinary pharmacological protocols (e.g., metformin/oral hypoglycemics), and a comprehensive management paradigm integrating behavioral education, continuous monitoring, and personalized interventions to mitigate long-term cardiovascular risks across the diabetes mellitus spectrum.

Patient satisfaction is one of the key indicators in assessing the quality of nursing care in hospitals. High-quality nursing care can enhance patient trust, comfort, and satisfaction during their treatment. This study aims to determine the relationship between the quality of nursing care and the satisfaction of inpatients at Bahteramas General Hospital in Kendari City. This is an analytical quantitative study using a cross-sectional approach. The sample consisted of 39 inpatients. Data were collected using a questionnaire and analyzed using univariate and bivariate analyses with the chi-square test. The results indicate a significant relationship between all dimensions of nursing service quality and inpatient satisfaction. The tangible dimension was associated with patient satisfaction (p = 0.003), reliability (p = 0.000), responsiveness (p = 0.000), assurance (p = 0.012), and empathy (p = 0.000). In general, patients who rated the quality of nursing care as “poor” tended to be more likely to fall into the “dissatisfied” category, while patients who rated the quality of care as “adequate” tended to be more likely to fall into the “satisfied” category. This study concludes that the quality of nursing care is significantly associated with inpatient satisfaction at Bahteramas General Hospital in Kendari City. . Therefore, hospitals need to improve the quality of nursing care, particularly in terms of physical evidence, reliability, responsiveness, assurance, and empathy, in order to enhance patient satisfaction.

Background: Ischemic stroke is one of the leading causes of death and disability, especially in the elderly population. The impact of stroke is not only limited to physical activity, but also greatly affects the psychosocial condition of the sufferer. From a psychological aspect, stroke sufferers often experience various complex emotional disorders. Research tends to be deep sadness, anger, disappointment, and feelings of helplessness. One of the significant psychosocial problems experienced by stroke survivors is a decrease in low self-esteem. Methods: The approach used in this study is a qualitative approach. The data source in this study came from informants. This research was conducted at Royal Prima Hospital, Jambi City. Results: Based on the results of the research that has been conducted, it was found that stroke patients experience various psychological changes due to physical limitations that arise after having a stroke. Family support is the most influential factor in the psychological condition of stroke patients.  Families who always accompany patients are able to help patients accept sick conditions and increase patient morale during the rehabilitation process. However, the results of the study show that psychological support from nurses is still not fully optimal. Conclusion: Based on the results of the study, stroke patients experience psychological changes such as feeling embarrassed, insecure, feeling a burden on the family, withdrawing from the social environment, and losing their zest for life due to physical limitations. This condition shows that the stroke has an impact not only on the physical, but also on the psychological of the patient. Family support in the form of attention, motivation, affection, mentoring, and medical assistance is very helpful in increasing the patient's enthusiasm and confidence during rehabilitation. Nurses also play a role in the recovery process through health education, motivation, and treatment assistance. However, emotional support and therapeutic communication from nurses are still not optimal because services are more focused on medical measures.

Tuberculosis (TB) remains a global and national health issue. Sijunjung Regency has seen an increase in TB cases, with fluctuating treatment success rates. Medication adherence is a key factor in treatment success and is influenced by the quality of health care services. This study aims to analyze the quality of services regarding medication adherence among TB patients, explore patients’ perceptions, describe service factors influencing adherence, and understand the role of health workers from the patients’ perspective at Community Health Centers (Puskesmas) throughout Sijunjung District. This study employed a qualitative approach with a phenomenological design. The primary informants consisted of 8 TB patients, plus key informants (2 healthcare workers) and additional informants (2 family members). Data were collected through in-depth interviews, observations, and document reviews. Analysis utilized the Miles & Huberman model.Research results on the quality of healthcare services are related to the level of medication adherence in tuberculosis patients. The dimensions that contribute most to adherence are empathy, assurance, and responsiveness. Positive perceptions are seen in aspects of interpersonal relationships (friendliness, patience, effective communication) and logistical reliability (drug availability), while negative perceptions are related to the lack of privacy in waiting rooms, long administrative waiting times, and inflexible service hours for informal workers. Health service factors that influence adherence include continuous education and information, active supervision and monitoring, ease of service access, and support from healthcare workers. The role of healthcare workers in supporting patient adherence, according to the patient's perspective, is as educators and motivators.Based on this study, high-quality care particularly empathy, assurance, and responsiveness is crucial for patient adherence. Improvements to physical facilities and greater flexibility in service hours are needed.  

Tuberculosis (TB) remains a global and national health issue. Sijunjung Regency has seen an increase in TB cases, with fluctuating treatment success rates. Medication adherence is a key factor in treatment success and is influenced by the quality of health care services. This study aims to analyze the quality of services regarding medication adherence among TB patients, explore patients’ perceptions, describe service factors influencing adherence, and understand the role of health workers from the patients’ perspective at Community Health Centers (Puskesmas) throughout Sijunjung District. This study employed a qualitative approach with a phenomenological design. The primary informants consisted of 8 TB patients, plus key informants (2 healthcare workers) and additional informants (2 family members). Data were collected through in-depth interviews, observations, and document reviews. Analysis utilized the Miles & Huberman model.Research results on the quality of healthcare services are related to the level of medication adherence in tuberculosis patients. The dimensions that contribute most to adherence are empathy, assurance, and responsiveness. Positive perceptions are seen in aspects of interpersonal relationships (friendliness, patience, effective communication) and logistical reliability (drug availability), while negative perceptions are related to the lack of privacy in waiting rooms, long administrative waiting times, and inflexible service hours for informal workers. Health service factors that influence adherence include continuous education and information, active supervision and monitoring, ease of service access, and support from healthcare workers. The role of healthcare workers in supporting patient adherence, according to the patient's perspective, is as educators and motivators.Based on this study, high-quality care particularly empathy, assurance, and responsiveness is crucial for patient adherence. Improvements to physical facilities and greater flexibility in service hours are needed.  

An abstranct is a brief summary of a research article, thesis, review, conference proceeding or any-depth analysis of a particular subject or disipline, and is often used to help the reader quickly ascertain the paper purposes. When used, an abstract always appears at the beginning of a manuscript or typescript, acting as the point-of-entry for any given academic paper or patent application. Absatrcting and indexing services for various academic discipline are aimed at compiling a body of literature for that particular subject. Abstract length varies by discipline and publisher requirements. Abstracts are typically sectioned logically as an overview of what appears in the paper.

Background: Recurrent Aphthous Stomatitis (RAS) is a common disorder characterized by recurrent ulcers limited to the oral mucosa. The etiology of RAS itself is not yet known for certain, but it is suspected that there are several predisposing factors, including hormonal changes, trauma, malnutrition, stress. Purpose: This study aims to determine the description of RAS in patients at the Oral Medicine Department of Dental Hospital University of Jember based on classification, general condition, suspected predisposing factors, and management. Method: This research is a descriptive observational study with a research population of 722 data from the Department of Oral Medicine, Dental Hospital of University of Jember. The number of samples that met the researchers' criteria was 171. Results: RAS patients is more common in women, 64.91% . RAS occurs in 69.60% of patients aged 21-30 years. RAS were mostly found in patients who did not experience symptoms of systemic factors, in 91.22%. The type of RAS that often occurs is the minor type in 78.37%. 68.42% RAS patients had no suspected predisposing factors. Based on RAS management, pharmacological therapy is divided into two parts, topical pharmacological therapy 59.07% and supportive pharmacological therapy 40.93%. Communication, information and education service was done for all 171 RAS patients. Conclusion: Based on the research conducted, that minor RAS is more prevalent in female 21-30 age group, with absence of underlying diseases, and the most frequently therapeutic modality is topical agents.

Background: Recurrent Aphthous Stomatitis (RAS) is a common disorder characterized by recurrent ulcers limited to the oral mucosa. The etiology of RAS itself is not yet known for certain, but it is suspected that there are several predisposing factors, including hormonal changes, trauma, malnutrition, stress. Purpose: This study aims to determine the description of RAS in patients at the Oral Medicine Department of Dental Hospital University of Jember based on classification, general condition, suspected predisposing factors, and management. Method: This research is a descriptive observational study with a research population of 722 data from the Department of Oral Medicine, Dental Hospital of University of Jember. The number of samples that met the researchers' criteria was 171. Results: RAS patients is more common in women, 64.91% . RAS occurs in 69.60% of patients aged 21-30 years. RAS were mostly found in patients who did not experience symptoms of systemic factors, in 91.22%. The type of RAS that often occurs is the minor type in 78.37%. 68.42% RAS patients had no suspected predisposing factors. Based on RAS management, pharmacological therapy is divided into two parts, topical pharmacological therapy 59.07% and supportive pharmacological therapy 40.93%. Communication, information and education service was done for all 171 RAS patients. Conclusion: Based on the research conducted, that minor RAS is more prevalent in female 21-30 age group, with absence of underlying diseases, and the most frequently therapeutic modality is topical agents.

Pharmaceutical services initially focusing solely on drug management (Drug Oriented) to comprehensive services that include clinical pharmacy services and medication services aimed at improving patients' quality of life (Patient Oriented). Clinical pharmacy services in pharmacies are part of pharmaceutical services that are directly responsible to patients in relation to pharmaceutical preparations, medical devices, and disposable medical supplies. This study aims to determine the implementation of clinical pharmacy services in pharmacies in the Gedong Tataan District of Pesawaran Regency. The research approach used was quantitative descriptive with a simple random sampling technique. The sample in this study consisted of 16 pharmacies and pharmacy staff working in pharmacies in the Gedong Tataan District, Pesawaran Regency, who met the inclusion and exclusion criteria. Data collection was carried out by conducting with guided interviews using questionnaires and observation on the implementation of clinical pharmacy services by pharmacy staff. The results showed that the clinical pharmacy services implemented in pharmacies in Gedong Tataan District, Pesawaran Regency, were prescription assessment and services by 74% with a good category (61-80%), dispensing by 95% with a very good category (81-100%), and drug information services (PIO) obtained a percentage of 72% with a good category (61-80%). Clinical pharmacy services were mostly carried out by Pharmacy Vocational Personnel (TVF) at 37.5%. Clinical pharmacy services in pharmacies throughout the Gedong Tataan District of Pesawaran Regency have not been fully implemented in accordance with the standards of pharmaceutical services in pharmacies according to Permenkes No. 73 of 2016, as there are still several aspects that have not been carried out.

Health communication plays a crucial role in dental practice, particularly in conveying sensitive clinical information or bad news. Barriers to communication can increase patient anxiety, decrease adherence to therapy, and impact the quality of healthcare services. The SPIKES protocol presents a six-stage, systematic and empathetic communication model for conveying clinical information. This study aims to analyze the implementation of the SPIKES protocol as a health communication model in dental practice. The study used a systematic literature review method with data sources from the Scopus, PubMed, and Web of Science databases for the period 2020–2025. Article selection was carried out using the PRISMA approach based on inclusion and exclusion criteria. The results of the study indicate that the implementation of the SPIKES protocol can improve the clarity of information delivery, strengthen the relationship between healthcare professionals and patients, and reduce patient anxiety. In addition, the empathetic approach in SPIKES contributes to increased patient satisfaction and adherence to treatment plans. In conclusion, the implementation of the SPIKES protocol can support the improvement of the quality of clinical communication in dental practice through the delivery of targeted, humanistic, and patient-centered information.

Malpractice in the health professions is one of the issues that can cause harm to patients, health professionals, and healthcare institutions. A lack of understanding among students as prospective health professionals regarding ethical aspects, legal principles, professional standards, and proper service procedures may increase the risk of malpractice. This Community Service activity aims to provide students of STIKES Pasapua Ambon with an understanding of the concept of malpractice, the factors causing malpractice, and preventive efforts through the implementation of professional ethics, compliance with standard operating procedures, effective communication, and the improvement of professional competence. The activity was carried out through counseling, educational sessions, interactive discussions, and guidance on health law for participants. The results of the activity indicate an increase in students’ knowledge and awareness of the importance of understanding the limits of professional authority, legal responsibility, and preventive measures to avoid malpractice in healthcare practice. This activity is expected to help develop future health professionals who are professional, ethical, and responsible in providing safe and high-quality healthcare services.

The premium healthcare industry in urban areas is experiencing increasing competition along with the increase in healthcare facilities and the increasing public demand for fast, comfortable, and quality medical services. In this context, Columbia Asia Pulomas Hospital is implementing an expansion strategy by increasing facility capacity, modernizing services, and adding a Center of Excellence (COE) as a service differentiation. This study aims to analyze customer retention strategies within the Balanced Scorecard (BSC) framework, focusing on the relationship between customer perspectives, internal processes, learning and growth, and their application to the financial perspective. The research method uses a document-based policy and strategy analysis approach, field findings, and a synthesis of Balanced Scorecard theory and patient experience.The analysis shows that customer retention during the expansion phase is influenced not only by clinical quality, but also by the assurance of doctor time in practice, speed of service, physical comfort, and digitization of queues and administration. The addition of a COE has been shown to increase the perception of service value and expand market share through service specialist differentiation. Within the BSC framework, the customer perspective serves as a leading indicator for achieving the financial perspective, where increased patient retention contributes to increased revenue, ROI growth, and long-term financial expectations. The research implications emphasize that strategies for strengthening human resources, modernizing internal processes, and service innovation are important foundations in ensuring successful hospital expansion and enhancing competitive advantage.

Health communication plays a crucial role in dental practice, particularly in conveying sensitive clinical information or bad news. Barriers to communication can increase patient anxiety, decrease adherence to therapy, and impact the quality of healthcare services. The SPIKES protocol presents a six-stage, systematic and empathetic communication model for conveying clinical information. This study aims to analyze the implementation of the SPIKES protocol as a health communication model in dental practice. The study used a systematic literature review method with data sources from the Scopus, PubMed, and Web of Science databases for the period 2020–2025. Article selection was carried out using the PRISMA approach based on inclusion and exclusion criteria. The results of the study indicate that the implementation of the SPIKES protocol can improve the clarity of information delivery, strengthen the relationship between healthcare professionals and patients, and reduce patient anxiety. In addition, the empathetic approach in SPIKES contributes to increased patient satisfaction and adherence to treatment plans. In conclusion, the implementation of the SPIKES protocol can support the improvement of the quality of clinical communication in dental practice through the delivery of targeted, humanistic, and patient-centered information.

The highly competitive healthcare industry in Cirebon poses a significant challenge for Klinik Utama X, especially as a non-BPJS facility. This condition requires a paradigm shift from a provider-centric marketing mix to a patient-centric approach to retain patient loyalty. This study aims to evaluate and formulate the marketing strategy of Klinik Utama X using a comparative 4P (Product, Price, Place, Promotion) and 4C (Customer Solution, Customer Cost, Convenience, Communication) approach based on SWOT analysis. This research used a qualitative descriptive design with purposive sampling, gathering primary and secondary data through in-depth interviews, observations, and document studies. The data were systematically evaluated using Internal Factor Evaluation (IFE) and External Factor Evaluation (EFE) matrices. The findings reveal that the clinic is strategically positioned in Quadrant I, with an IFAS score of 2.53 and an EFAS score of 2.60, indicating strong internal capabilities to seize external opportunities. The recommended aggressive growth strategy involves integrating psychiatric and aesthetic services, penetrating the Business-to-Business (B2B) market through corporate medical check-ups, accelerating digitalization via telemedicine and online queuing, and preparing for BPJS accreditation. The managerial implications suggest that the clinic must prioritize resolving internal human resources and strengthening financial record-keeping systems before investing heavily in medical assets, while actively expanding digital convenience and corporate partnerships to secure short-term financial stability.

Healthcare-Associated Infections (HAIs) remain a major global challenge in healthcare services, contributing significantly to increased morbidity, mortality, and healthcare costs. Nurses’ compliance with the use of Personal Protective Equipment (PPE) is a critical component in infection prevention and control programs. Supervision by Infection Prevention and Control Nurses (IPCNs) is considered a key factor in improving compliance. This study aimed to analyze the relationship between IPCN supervision and nurses’ compliance with PPE usage in inpatient wards at Grha Permata Ibu Hospital, Depok, in 2025. This study employed a quantitative approach using a correlational analytic design with a cross-sectional method. The population consisted of all 56 nurses working in four inpatient wards, and total sampling was applied. Data were collected using a structured IPCN supervision questionnaire and direct observation checklists of PPE compliance. Data analysis included univariate and bivariate analysis using the Chi-square test. The results revealed that most respondents perceived IPCN supervision as moderate (58.9%), while the majority demonstrated compliance with PPE usage (62.5%). Bivariate analysis indicated a statistically significant relationship between IPCN supervision and PPE compliance (p = 0.001). Nurses receiving high-level IPCN supervision were 33.85 times more likely to comply with PPE usage compared to those receiving moderate supervision. In conclusion, IPCN supervision plays a crucial role in enhancing nurses’ compliance with PPE usage. Strengthening IPCN supervisory functions through structured monitoring, continuous education, and consistent evaluation is strongly recommended to improve patient and healthcare worker safety and to reduce the incidence of HAIs in hospital settings.

Abstract. The right to health is an integral part of human rights guaranteed by the Constitution and further reinforced by Law Number 17 of 2023 on Health, which places the state as the party responsible for ensuring the provision of safe, high-quality, and non-discriminatory health services for all citizens. However, in practice, the fulfillment of the right to health continues to face various challenges, particularly in the delivery of health services for participants of BPJS Kesehatan. This study aims to analyze the legal protection of the right to health in Indonesia and to examine the refusal of medical services to BPJS patients that resulted in death in Papua from a human rights perspective. The research employs a normative legal research method using statutory, conceptual, and case approaches. The findings indicate that although the national legal framework has clearly regulated the obligations of the state and health care facilities in providing emergency services, its implementation remains weak due to administrative barriers, unequal access to health services, and inconsistent law enforcement. The refusal of medical services to BPJS patients in Papua reflects a tension between hospitals’ administrative compliance and the professional obligation of medical personnel to save human lives. The implications of this study emphasize the need to strengthen supervision, ensure consistent law enforcement, and improve health service governance so that the right to health is truly protected as part of human dignity within the Indonesian rule of law. 

The case of medical malpractice involving a toddler in Bima has attracted public attention and raised the urgency of evaluating legal accountability mechanisms in healthcare. This study aims to analyze the law enforcement process and the forms of legal responsibility that can be imposed on medical personnel and healthcare institutions suspected of involvement. Using a normative juridical approach, this study examines relevant laws, doctrines, and legal literature, including provisions in the Medical Practice Law, the Health Law, the Hospital Law, and the Criminal Code. The results indicate that law enforcement in malpractice cases can be pursued through administrative, civil, and criminal channels, depending on the level of negligence and the resulting consequences. Medical personnel can be held personally liable for violations of professional standards, while healthcare institutions can be held accountable based on the principle of vicarious liability. This study concludes that the case in Bima underscores the importance of strengthening regulations, improving medical service standards, and ensuring transparency in law enforcement to protect patient rights, particularly children.

Emergency medical care constitutes a fundamental patient right and an institutional obligation of hospitals that must be provided without temporal discrimination. However, in practice and public discourse, the meaning of “physician presence” is often narrowly reduced to physical presence alone, giving rise to allegations of medical negligence, particularly during weekends or outside regular working hours. This distorted understanding risks generating legal injustice, undermining the dignity of the medical profession, and encouraging defensive medical practice. This article aims to analyze the meaning of physician presence from a health law perspective through theoretical, normative, and systemic approaches, by distinguishing models of physician presence as on-site, on-call, and home-call/teleconsultation in emergency care services. This study employs a normative legal research method using statutory, conceptual, and limited comparative approaches. The analysis examines Law Number 17 of 2023 on Health, Government Regulation Number 28 of 2024, as well as health law literature and emergency care practices. The analysis demonstrates that, in legal terms, physician presence is not synonymous with physical presence, but rather should be understood as process-based professional responsibility, provided that care is delivered in accordance with professional standards, service standards, and an adequate triage system. Physician presence must be reconstructed as the presence of professional responsibility within an integrated emergency care system. Legal assessment in health law should be grounded in process and system integrity, rather than solely on clinical outcomes or public perception.

Healthcare is an integral part of health development in Indonesia, which aims to optimally improve public health. Hospitals, as healthcare facilities, are required to provide quality, safe, and patient-centered services. Service quality is a key indicator of service success, as good service impacts patient satisfaction. One of the most important services in hospitals is obstetrics, which directly relates to maternal and infant health, making patient satisfaction a crucial aspect. Midwives, as professional healthcare workers, play a strategic role in providing comprehensive, sustainable, and patient-centered midwifery care. This study aims to analyze the influence of healthcare facilities and midwife performance on patient satisfaction through service quality. The method used is a quantitative study with an analytical approach and a cross-sectional design. The results of the multiple linear regression test indicate that midwife performance has a more dominant influence on service quality than healthcare facilities. Meanwhile, regarding patient satisfaction, service quality is the most dominant factor, followed by midwife performance and healthcare facilities. The conclusion of this study is that service quality reflects the overall patient experience and is a key factor in improving patient satisfaction.

Services in the health sector are a form of public service that must be implemented properly by the government. In the context of health services, the importance of effective and efficient implementation cannot be ignored because this has a direct impact on people's quality of life. In order for health services to achieve their goals, various requirements must be met, including the availability of adequate facilities and infrastructure, a harmonious relationship between patients and service providers, easy accessibility, and high quality. The aim of this research is to determine the description of the service quality of administrative staff. at the Kelapa Gading Community Health Center. The method used is descriptive with a quantitative approach which produces univariate results. This research was conducted at the Kelapa Gading Community Health Center with a total of 150 respondents. The variables in this research are Service Procedures, Completion Time, Service Costs, Service Products, Facilities and Infrastructure, Accreditation of Service Officers. The population in this study were all 1.216 outpatients with a sample of 150 respondents.