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Early childhood is a critical period for growth and development, characterized by rapid changes in neurological, motor, sensory, and emotional systems. Stimulation during this stage plays a vital role, and non-pharmacological interventions such as massage and aromatherapy may enhance developmental outcomes. This quasi-experimental study employed a pretest–posttest control group design to evaluate the effectiveness of infant massage combined with aromatherapy. Twenty infants aged 3–12 months who met inclusion and exclusion criteria were recruited and assigned to either a control group (infant massage only) or an intervention group (infant massage with aromatherapy). Growth parameters (weight, length, head circumference) and developmental outcomes were measured using the Developmental Pre-Screening Questionnaire, covering gross motor, fine motor, language, and personal-social domains. Infants in the intervention group demonstrated significantly greater improvements in body weight, body length, head circumference, and developmental scores compared to the control group. These findings indicate that the addition of aromatherapy to infant massage provides measurable benefits for both physical growth and developmental progress. Combined infant massage and aromatherapy represent effective non-pharmacological strategies for early stimulation, supporting optimal growth and developmental trajectories in infants.

Anemia in pregnancy remains a common public health problem and may lead to adverse outcomes for both the mother and the fetus, highlighting the need for effective and practical interventions. This study aimed to analyze the effect of cassava leaf (Manihot esculenta) consumption on hemoglobin levels among second-trimester pregnant women at UPT Puskesmas Rum Balibunga. A quasi-experimental study with a pretest–posttest design without a control group was conducted. The sample consisted of 30 second-trimester pregnant women with mild anemia, selected using purposive sampling. The intervention involved daily consumption of cassava leaves for 14 consecutive days. Hemoglobin levels were measured before and after the intervention using standardized examination tools. The results demonstrated a significant increase in hemoglobin levels following cassava leaf consumption, with a mean increase of 1.2 g/dL. These findings suggest that cassava leaves, which are rich in iron, vitamin C, and protein, can enhance hemoglobin synthesis and serve as a local food-based nutritional intervention. Therefore, cassava leaf consumption can be recommended as an alternative or complementary strategy for preventing and managing anemia among second-trimester pregnant women in primary healthcare settings. 

Type 2 diabetes mellitus (DM type 2) is a chronic metabolic disorder marked by elevated blood glucose due to insulin resistance and impaired insulin secretion. Its prevalence continues to rise worldwide, including in Indonesia. Psychological stress is known to worsen glycemic control by activating the sympathetic nervous system and increasing cortisol levels, which can cause fluctuations in blood glucose. This case report aims to describe the effect of combining Benson relaxation techniques with warm foot soaking on blood glucose regulation in a type 2 DM patient. The subject was Mrs. M, a 52-year-old woman diagnosed with type 2 DM. The intervention was conducted for seven consecutive days and consisted of daily Benson relaxation followed by warm foot soaking for 15–20 minutes. Blood glucose levels were measured before and after each session using a glucometer and analyzed descriptively. After seven days, the patient’s blood glucose level decreased from 248 mg/dL to 186 mg/dL. She also reported improved relaxation, better sleep quality, reduced anxiety, and decreased fatigue. These findings suggest that Benson relaxation helps activate the parasympathetic response and reduce stress hormones, while warm foot soaking supports improved circulation and metabolic processes. In conclusion, the combination of Benson relaxation and warm foot soaking is a simple, safe, and effective complementary therapy to support blood glucose regulation in type 2 DM patients. This intervention can be integrated into self-care routines and community nursing practice as part of evidence-based non-pharmacological management.

Hypertension is a disease whose prevalence continues to increase and occurs frequently in the elderly. The severity of hypertension is often linked to non-adherence to medication consumption. The objective of this community service activity is to improve the knowledge and skills of the elderly and their caregivers regarding the use of herbal therapy as a reliable and effective complementary treatment for controlling blood pressure. The activity was conducted through health education and practical demonstrations involving 29 participants. The main instrument that used in the health education was a leaflet. The results of the pre- and post-activity assessment showed an average increase in knowledge scores regarding herbal therapy for blood pressure control. In conclusion, this community service activity successfully enhanced the health literacy and practical skills of the elderly in utilizing evidence-based herbal therapy to lower blood pressure. Further effort is needed to achieve comprehensive and self-managed blood pressure control in elderly.

This meta-analysis provides an in-depth examination of the effectiveness of community-based interventions in alleviating collective trauma experienced by populations in conflict zones of the Middle East, compiling 47 empirical studies (N = 12,483) published between 2000 and 2023. The synthesis indicates a significant impact of community-based interventions on reducing PTSD symptoms, with a substantial effect size (d = 0.82, 95% CI [0.76, 0.88], p < .001) and moderate heterogeneity (I² = 68%), reflecting inter-study variation yet remaining within interpretable bounds. Among the strategies analysed, community psychosocial support programs demonstrated the most pronounced effectiveness (β = 0.74, p < .001), followed by collective narrative therapy (β = 0.68, p < .001) and family-based rehabilitation interventions (β = 0.59, p < .001), all underscoring the relevance of approaches rooted in social networks and interpersonal relations. Moderator analyses revealed that longer program duration, particularly interventions spanning at least 6 months (β = 0.71, p < .001), and active engagement of local leaders (β = 0.65, p < .001) were critical determinants of intervention success. Furthermore, meta-regression findings indicated a strong and consistent correlation between the intensity of community involvement and reductions in collective trauma symptoms (R² = 0.73, p < .001), highlighting that social participation is not merely complementary but constitutes the foundation of program efficacy. In the researchers' view, these findings extend the contributions of prior studies by Hassan et al. (2016) and Morrison & Marrison (2024) by affirming the central role of local wisdom in trauma recovery processes, while offering a conceptual contribution in the form of an integrative framework that merges psychosocial interventions with community cultural values. Consequently, these results provide not only an empirical basis for developing more effective trauma-healing programs in Middle Eastern conflict zones but also underscore the urgency of contextual adaptation to ensure that interventions meet the most essential needs of affected populations.

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.

Chronic kidney disease (CKD) patients undergoing hemodialysis are at risk of experiencing intradialytic complications, one of which is hypertension. Management of hypertension in hemodialysis units is generally pharmacological, although non-pharmacological interventions may serve as an effective, simple, and safe complementary option. One such technique is Benson relaxation, which combines controlled deep breathing with spiritual elements to reduce sympathetic activity and promote relaxation. This case study to determine the effect of Benson relaxation therapy on blood pressure of intradialytic hypertension patients at RSUD Batang. The case study design was a case study involving 5 CKD patients undergoing hemodialysis. The intervention was performed by guiding patients to practice Benson relaxation for about 10–15 minutes, with blood pressure measured before and after the intervention using a digital sphygmomanometer. The results showed a decrease in blood pressure in most respondents. The average systolic blood pressure decreased from 153.4 mmHg to 145.6 mmHg, while diastolic pressure decreased from 92.4 mmHg to 87.6 mmHg. In addition to physiological improvement, patients also reported subjective relief such as reduced dizziness, palpitations, and tension. In conclusion, Benson relaxation therapy proved effective in reducing blood pressure among intradialytic hypertension patients. This intervention can be recommended as a complementary non-pharmacological therapy in nursing care to improve comfort in hemodialysis patients.  

Hypertension is one of the most common diseases experienced by the community and poses a high risk of causing serious complications. Persistently elevated blood pressure can damage vital organs and increase the risk of cardiovascular diseases such as heart attacks, strokes and kidney failure. The purpose of this study is to determine the implementation of foot reflexology massage to reduce blood pressure in patients with hypertension. This research employed a case study approach involving two hypertensive patients at TK II Putri Hijau Hospital Medan. The Nursing care process included assessment, nursing diagnosis, planning, implementation, and evaluation. The results showed a decrease in both systolic and diatolic blod pressure after the foot reflexology intervention. The first patient experienced a reduction in blood pressure from 145/90 mmHg to 130/82 mmHg, while the second patient’s blood pressure from 144/89 mmHg to 128/82 mmHg. The study cocludes that the implementation of foot reflexology massage is proven to be efeective in lowering blood pressure in hypertensive patients. This therapy is recommended as a complementary intervention in nursing practice to assist in controlling hypertension.

In order to guarantee the best possible maternal health and fetal growth throughout pregnancy, complementary services for expectant mothers are required. These services include nutrition, mental health, and supplementary medical treatment. According to data, 70% of pregnant women have low back discomfort. According to a different poll, eight out of ten third-trimester pregnant women report having back pain. Doing Childpose (Balasana) exercises is one more way to lessen this problem. This study sought to ascertain if Childpose (Balasana) exercises were beneficial in lowering low back pain complaints among pregnant women in their third trimester at the South Bolango City Health Center. This study employed a quasi-experimental pretest-posttest approach with a sample of 34 pregnant women in the third trimester. There were twenty participants in the study's sample. Childpose or balasana exercises are beneficial in relieving back discomfort in third trimester pregnant women at the South Bolango Health Center, according to the data, which indicated a P-value of 0.000 <0.05.

Background: Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system and often leads to fatigue, mobility impairments, and psychological issues such as anxiety and depression, all of which significantly reduce the quality of life of those affected. Yoga therapy, as a holistic non-pharmacological approach, has gained attention as an alternative rehabilitative intervention for MS patients. Objective: The aim of this review is to literatureally examine the effectiveness of yoga therapy on the physical and psychological aspects of individuals with MS, with a particular focus on the duration, frequency, and forms of yoga practice used. Methods: The method employed in this study was a literature literature search across databases including Google Scholar, PubMed, ScienceDirect, and ResearchGate, using clearly defined inclusion and exclusion criteria. A total of 15 articles with experimental and quasi-experimental research designs published within the past 10 years were analyzed in this review. Result: The results indicate that yoga is effective in reducing fatigue levels, improving balance and muscle strength, and enhancing daily physical functioning. Psychologically, yoga has been shown to significantly reduce anxiety, stress, and depression, while also improving self-efficacy, focus, and emotional quality of life. Conclusion: In conclusion, yoga is a safe and effective intervention that can serve as a complementary rehabilitative strategy in the management of MS, both physically and psychologically, although further research with stronger methodologies is needed to support its implementation in clinical practice.

Background: Constipation is a common health problem among infants aged 6–12 months, which can lead to discomfort, feeding difficulties, and reduced quality of life. Non-pharmacological interventions, such as the I Love You (ILU) massage, have been suggested to improve bowel regularity and reduce gastrointestinal discomfort in infants. Objective: This study aimed to examine the effect of ILU massage on reducing constipation in infants aged 6–12 months at the South Bulango Health Center. Methods: A pre-experimental design with a one-group pretest–posttest approach was applied. Data on bowel movement frequency, stool consistency, and abdominal discomfort were collected before and after the intervention using structured observation sheets and caregiver questionnaires. Data analysis was performed using paired t-tests, with statistical significance set at p < 0.05. Results: The results showed a significant increase in bowel movement frequency from 2.1 ± 0.8 times per week before the intervention to 4.5 ± 1.0 times per week after the intervention (p = 0.000). Stool consistency improved from a mean Bristol score of 2.0 ± 0.6 to 4.0 ± 0.7 (p = 0.000), and abdominal discomfort decreased from 3.5 ± 1.0 to 1.2 ± 0.8 (p = 0.000). These findings indicate that ILU massage effectively alleviates constipation symptoms in infants. Conclusion: ILU massage is an effective, safe, and non-invasive method to reduce constipation in infants aged 6–12 months. Involving caregivers in the intervention enhances its effectiveness and supports parent–child bonding, making it suitable for integration into routine infant care at community health centers.

Emesis gravidarum, or nausea and vomiting during early pregnancy, is a common condition affecting the health and comfort of first-trimester pregnant women. Persistent symptoms can lead to dehydration, electrolyte imbalance, reduced nutrient intake, and psychological distress, potentially affecting both maternal and fetal health. Although pharmacological treatments are available, many pregnant women prefer non-pharmacological approaches due to concerns about fetal safety. Aromatherapy, using essential oils such as lemon, peppermint, and lavender, has emerged as a complementary therapy that may reduce nausea and vomiting through olfactory stimulation and autonomic nervous system modulation. This study aimed to examine the effect of aromatherapy on reducing emesis gravidarum in first-trimester pregnant women at Puskesmas Pagatan. A quasi-experimental design with pretest-posttest control group was conducted, involving 40 participants divided into an intervention group (n=20) and a control group (n=20) using purposive sampling. The intervention group received lemon essential oil inhalation twice daily for seven consecutive days, while the control group continued standard antenatal care. Data were collected using the Visual Analog Scale (VAS) for nausea severity and a structured diary for vomiting frequency. Results showed that the intervention group experienced a significant reduction in nausea severity (pretest mean 6.8 ± 1.2, posttest mean 3.2 ± 1.0, p < 0.001) and vomiting frequency (pretest mean 5.2 ± 1.0, posttest mean 2.1 ± 0.9, p < 0.001). In contrast, the control group showed minimal, non-significant changes. These findings indicate that aromatherapy is an effective, safe, and culturally acceptable non-pharmacological intervention for managing emesis gravidarum. The study concludes that integrating aromatherapy into routine antenatal care can improve maternal comfort, adherence to nutritional intake, and overall well-being in first-trimester pregnancies, supporting holistic prenatal care practices.

Patients with chronic kidney disease (CKD) often experience shortness of breath, fatigue, and a decline in quality of life due to fluid imbalance, anemia, and reduced lung capacity. These conditions highlight the need for simple, safe, and effective non-pharmacological interventions. This community service program, titled “Napas Lega Bersama” (“Breathing Relief Together”), aimed to improve the knowledge and skills of CKD patients in applying pursed-lip breathing (PLB) techniques as a strategy to enhance breathing patterns and overall well-being. The activity was conducted at a partner hospital’s hemodialysis unit through educational sessions, live demonstrations, and guided PLB practice over a two-week period. Pre- and post-program assessments were performed using standardized questionnaires to measure participants’ knowledge and perceived quality of life. The results showed an 85% increase in participants’ understanding of PLB and a 70% improvement in perceived comfort and daily activity performance after the intervention. Participants also reported reduced shortness of breath and greater relaxation during dialysis sessions. This program demonstrates that pursed-lip breathing can serve as a simple and effective complementary therapy to improve the quality of life of CKD patients. It is recommended that this initiative be continued through routine mentoring and interdisciplinary collaboration to promote therapeutic breathing exercises across healthcare settings.

Background: Stroke is a medical condition characterized by a disruption in blood flow to the brain, most commonly resulting in ischemic stroke, which accounts for 70%–85% of all stroke cases. Prolonged immobility in stroke patients increases the risk of pressure ulcers. Effective prevention strategies Include regular repositioning and meticulous skin care. Effleurage massage, when combined with Virgin Coconut Oil (VCO), enhances blood circulation and skin hydration, thereby potentially reducing the risk of impaired skin integrity. Objective: To analyze the management of a non-hemorrhagic stroke patient Through the application of Effleurage Massage therapy using Virgin Coconut Oil (VCO) to reduce the risk of skin integrity impairment. Methods: This case study involved a non-hemorrhagic stroke patient who was observed during hospital visits over a three-day period. Effleurage massage using VCO was applied twice daily—once in the morning and once at night. Skin integrity was assessed before and after the intervention using the Braden Scale Results: A decrease in the risk of skin integrity impairment was observed following the intervention, as evidenced by improved Braden Scale scores. Conclusion: Effleurage Massage using Virgin Coconut Oil may serve as an effective complementary therapy to reduce the risk of skin integrity Impairment in non-hemorrhagic stroke patients.

This study aimed to evaluate the effect of murrotal therapy on pain and anxiety levels in patients after radiofrequency action. This study uses a quantitative approach with a pre-experimental design of one group pretest-posttest involving 50 post-radiofrequency patients at Sultan Agung Hospital Semarang. The research data were collected using the Numeric Rating Scale (NRS) instrument to assess pain levels and the Zung Self-Rating Anxiety Scale (SAS) to assess anxiety levels. Univariate analysis showed that most of the respondents were women with an average age of 44.04 years, included in the intermediate adult category. The results of bivariate analysis with the Wilcoxon Signed Rank Test showed a significant decrease in both pain and anxiety levels after being given murrative therapy, with a p-value of 0.000 for both variables. This shows that murrotal therapy is effective in providing psychological relaxation and spiritual distraction effects, so that it can reduce the intensity of pain while reducing anxiety in patients. Based on these findings, it can be concluded that murrotal therapy is a non-pharmacological intervention that is simple, safe, and easy to apply by health workers. It also has great potential as a complementary therapy that supports the management of pain and anxiety after medical procedures, especially invasive procedures such as radiofrequency. Thus, the application of murrotal therapy can be used as an additional alternative in improving the quality of nursing services in hospitals.

Background : Nausea and vomiting are common physiological complaints during the first trimester of pregnancy, caused mainly by increased levels of hCG, estrogen, and progesterone. Although considered normal, these symptoms can disrupt daily activities and decrease quality of life. If excessive, they may result in complications such as dehydration, electrolyte imbalance, weight loss, and hyperemesis gravidarum, which threaten maternal and fetal health. Management can involve pharmacological and non-pharmacological strategies. One safe, simple, and widely applied non-pharmacological approach is acupressure at the Pericardium 6 (PC6) point, believed to regulate the nausea center in the brain. Objective : This study aimed to determine the effectiveness of acupressure at the PC6 point in reducing nausea and vomiting among first-trimester pregnant women at PMB Ariyawati Susiandari, S.Tr.Keb., Central Lampung Regency. Method : This pre-experimental study used a one-group pretest–posttest design. Acupressure was performed at the PC6 point for 30 seconds, twice daily (morning and evening). Data were collected by observing changes in the intensity of nausea and vomiting before and after the intervention.The assessment was conducted by observing changes in the intensity of nausea and vomiting before and after the intervention. Result : Before acupressure, all respondents experienced moderate nausea and vomiting. After the intervention, most reported improvement, with symptoms reduced to the mild category. Statistical analysis with the Wilcoxon test showed a significance value of p=0.000, indicating a significant difference between pre- and post-intervention scores. Conclusion : Acupressure at the PC6 point effectively reduced nausea and vomiting in first-trimester pregnant women. This method can be recommended as a complementary non-pharmacological therapy that is safe, practical, and easily integrated into midwifery care.

Complementary therapy is increasingly receiving attention as an alternative approach in supporting the healing process and improving the quality of life of the community. One of the therapies that is popular among the people is cupping, which is known as a traditional method with a spiritual basis and extensive health benefits. This community service activity aims to introduce cupping therapy and increase public understanding of the basic principles, benefits, and safety aspects in practice. The activity will be carried out in August 2025 by directly involving the community through the method of health education lectures and case discussions in the field. The counseling material includes the history of cupping, medical indications, implementation procedures, and the importance of maintaining the cleanliness of the device and the therapeutic environment. People's motivations in choosing complementary therapy, especially cupping include affordable cost factors, therapist friendliness, family support, religious beliefs, and belief in the effectiveness of natural remedies. The results showed a significant increase in the knowledge and awareness of the community, especially students, regarding cupping therapy as part of a safe and beneficial complementary approach. The conclusion of this activity emphasizes that education about complementary therapies, especially cupping, can be an effective strategy in expanding public health insights and encouraging the wise and responsible use of traditional therapies.

The rate of deliveries by cesarean section (CS) continues to increase globally and is projected to reach 29% by 2030. Although CS is medically effective in ensuring maternal and neonatal safety, the procedure often results in moderate to severe postoperative pain, which may hinder early mobilization, slow recovery, and reduce the mother’s overall quality of life. Effective pain management is therefore crucial. Non-pharmacological therapies such as endorphin massage and lavender aromatherapy have been recognized as complementary approaches that stimulate the release of relaxation hormones, provide natural analgesic effects, and help reduce anxiety. This study aimed to analyze the effect of combining endorphin massage and lavender aromatherapy on reducing pain levels in post-cesarean section mothers. A quasi-experimental design with a pre–posttest control group was employed. A total of 34 respondents were selected using purposive sampling and divided into intervention and control groups. The study was conducted in the maternity ward of SMC Telogorejo Hospital from March to April 2025. The intervention group received endorphin massage combined with lavender aromatherapy for 10–30 minutes, while the control group was given deep breathing relaxation only. Pain levels were measured before and after the intervention using the Numeric Rating Scale (NRS). Data were collected through questionnaires and medical records, and analyzed using univariate and bivariate techniques with the Mann–Whitney test. Results showed a p-value of 0.000 and Z = -3.774, indicating a significant effect of the intervention. These findings suggest that endorphin massage combined with lavender aromatherapy is effective in reducing postoperative pain. Further studies with larger samples are recommended to explore the optimal duration and frequency of therapy.

Hypertension, often referred to as high blood pressure, is a major global health problem that significantly increases the risk of atherosclerotic cardiovascular disease, heart failure, stroke, and kidney failure. Various complementary and alternative therapies have been explored to support conventional treatments in reducing blood pressure, one of which is smile therapy. This study aimed to analyze the effect of smile therapy on blood pressure among hypertensive patients at RSUI Harapan Anda Tegal. The research employed a quantitative approach with a quasi-experimental design using a one-group pretest-posttest method. A total of sixty hypertensive patients were selected through exhaustive sampling. Data were collected before and after the intervention and analyzed using the Wilcoxon test to determine the statistical significance of changes in blood pressure. The demographic characteristics of participants showed that most were in their early to mid-forties (36 individuals, 60%), predominantly female (38 individuals, 63.3%), with a junior high school education or below (25 individuals, 41.7%), and unemployed (41 individuals, 71.7%). The findings indicated that prior to the intervention, 41 participants (68.3%) had uncontrolled blood pressure. After undergoing smile therapy, 48 participants (80%) demonstrated improvement with more stable blood pressure levels. Statistical analysis revealed a significant effect of smile therapy on reducing blood pressure with a p-value of 0.000. These results suggest that smile therapy can serve as an effective, simple, and low-cost complementary intervention to help hypertensive patients manage their condition and improve overall health outcomes

Post-cesarean section (SC) patients with premature rupture of membranes (PROM) require comprehensive nursing care due to their high risk of pain, infection, and limited mobility. This case study aims to describe the nursing care process applied to a 39-year-old woman post-SC with PROM indication. The study was conducted over five days in Nusa Indah Room at RSUD dr. Soeselo, Tegal. Data collection included interviews, observation, physical examination, and medical record review. The nursing interventions were guided by the Indonesian Nursing Diagnosis Standards (SDKI), Interventions (SIKI), and Outcomes (SLKI). Results showed a reduction in pain scale from 6 to 2, improved mobility, and wound healing without signs of infection or bleeding. These findings indicate that structured and holistic nursing care, combined with patient education and family involvement, can significantly enhance recovery outcomes. The implications suggest the need for clinical protocols in managing post-SC patients with PROM to ensure consistent, evidence-based nursing practice.