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Mammary tumor is a condition where an abnormal mass or lump forms in the breast, caused by excessive and continuous cell reproduction. This condition often develops unnoticed and can be dangerous if not promptly treated. In 2018, the incidence rate of breast cancer in Indonesia was 136.2 per 100,000 people, making it one of the most common cancers in Southeast Asia, ranking 8th in the region. If untreated, mammary tumors have the potential to spread to other parts of the body, and in many cases, can be fatal for the patient. One of the common medical treatments for mammary tumors is surgery. This surgery aims to remove the tumor and prevent further spread. In this context, the role of nurses is critical, as according to Orem's theory, nurses have the responsibility to help improve the health status of patients, especially in situations where patients are unable to perform self-care. In such cases, nursing assistance is necessary to ensure that the patient can undergo proper post-operative care. This study aims to provide an overview of nursing care for patients with post-operative right mammary tumor in the Mawar 2 room at RSUD dr. Soeselo, Tegal Regency. The nursing care provided includes several important steps: patient assessment, nursing diagnosis, planning, implementation of care, and evaluation of the care outcomes. This research uses a descriptive case study design, offering an in-depth view of the nursing approach applied to patients after mammary tumor surgery. With this approach, the study aims to provide clearer insights into the role of nurses in supporting patient recovery and improving the quality of care in hospitals.

When problems such as antepartum hemorrhage, fetal distress, atypical fetal presentation, and gestational hypertension occur, a cesarean section can save the lives of both mother and baby. A cesarean section (CS) is a surgical technique in which the uterus and abdominal wall are opened to deliver the fetus. In many countries, cesarean sections are the most common surgical procedure, and over the past 30 years, their use has gradually increased. Intrauterine fetal death is the death of a fetus weighing 500 grams or more in the womb at 20 weeks of gestation or later. The partial or complete separation of a normally implanted placenta after 22 weeks before birth is known as placental abruption. he purpose of this paper is to provide nursing care to Mrs. P with a Caesarean section indicating intra uterine fetal death (IUFD) due to placental abruption in the Nusa Indah room of dr. Soeselo Regional General Hospital, Tegal Regency, according to nursing standards. The method used is descriptive with a case study approach. The data collection techniques in this scientific paper are in the form of interviews, observations, documentation studies and literature studies. From the case review, the main complaint was pain in the operated area, pain increased when moving, pain like being squeezed with a pain scale of 5, pain that comes and goes. The patient appeared to be grimacing in pain and restless, the patient always held the area that had been operated on, the results of the vital signs examination obtained: BP: 139/100 mmHg, pulse: 103 x / minute, S: 36.5oC, RR: 20 x / minute, there was a bandage on the lower abdomen along 15 cm with a horizontal line, the patient did not know and was confused about the birth control used after the CS. The nursing problems identified were acute pain, risk of infection, and knowledge deficit. Interventions were developed based on the theory in the SDKI, SLKI, and SIKI, as well as the client's condition, and were implementable

The students often faced experiences that cause anxiety in the early semester of the college period, especially in the presentation session. To overcome this, students need strong coping strategies. Coping strategies help people deal with stress. We interviewed 12 students from the 2024 batch at Abulyatama University's Nursing Program on October 29, 2024. Most of them (10 out of 12) said they often feel anxious and nervous when presenting or speaking in front of many people, which makes them less focused. This study aims to explore the correlation of coping strategies with anxiety during presentation among college students. This study uses a descriptive analytical design with a cross-sectional approach. The sample was 189 Diploma III nursing students 2024,the study took from march 21st to may 1st,2025 and chosen using a total sampling technique. The questionnaire, Brief Cope, and PSAS with Cronbach's Alpha were employed in this study. The result indicated 0.6 for coping strategies and PSAS Cronbach Alpha = 0.90. Univariate and bivariate analysis using the chi-square test was used to analyze the data. The finding reveals that the coping strategies were Public Speaking Anxiety, which is the medium category, with as many as 87 respondents (58.8). Based on the result of the chi-square test, the ρ-value is 0.000 (< 0.05). The findings indicate a correlation between coping strategies and anxiety during presentation among students. This study is expected to provide valuable insights and knowledge for educators and mentors on the benefits of Coping Strategies in enhancing public speaking confidence and improving teaching quality.

At the higher education level, students are expected to develop independence in their learning process. One crucial aspect that influences the achievement of self-directed learning is the ability to manage time effectively. This study focuses on the relationship between time management and self-regulated learning among students of the Diploma Three in Nursing Program at Abulyatama University. The research employed a quantitative approach using a correlational design and a cross-sectional method. A total of 85 participants were selected through proportional random sampling from a population of 554 students. The instruments used were the Time Management Questionnaire (TMQ) with a Cronbach's Alpha reliability of 0.910, and the Motivated Strategies for Learning Questionnaire (MSLQ) with a Cronbach's Alpha of 0.909. Data collection took place within the Diploma Three in Nursing Program at Abulyatama University from April 26 to May 9, 2025.The results showed that the majority of students had a moderate level of time management, with 63 students (74.1%), and a high level with 22 students (25.9%). Meanwhile, the level of self-regulated learning among students was moderate in 59 students (69.4%) and high in 26 students (30.6%). Analysis using the Chi-Square test revealed a significant correlation between time management and self-regulated learning, as indicated by a p-value of 0.000 (p ≤ 0.05). These findings suggest that students who are skilled in time management are more likely to possess higher self-regulated learning abilities. It is hoped that the results of this study will enhance students' understanding of the importance of time management, thereby encouraging them to adopt a more structured, focused, and sustainable self-learning pattern. Time management skills are believed to be a foundational element in strengthening self-regulated learning in students’ academic activities.

In the final phase of their studies, students often experience intense psychological pressure, especially when writing their final thesis. If this academic stress is not managed optimally, it can cause mental health problems, reduce internal motivation, and lead to despair in the context of education. Hardiness personality is one of the psychological characteristics that is believed to play a crucial role in dealing with such situations. Hardiness encompasses the dimensions of control, commitment, and the ability to see challenges as opportunities, thereby encouraging individuals to persevere in the face of external pressures. This study focuses on the relationship between hardiness personality and the level of stress experienced by final-year students of the Diploma Three Nursing Study Program at Abulyatama University while writing scientific papers. This study used a correlational quantitative approach with a cross-sectional design, involving 63 students selected through proportional random sampling. The Dispositional Resilience Scale (DRS) was used to measure hardiness, while the Student-Life Stress Inventory (SSI) was used to assess stress levels. Data collection took place from April 26 to May 8, 2025. To obtain valid results, data analysis was performed using the Chi-Square test with a significance level of 0.05. The research findings show a significant negative correlation between hardiness personality and stress levels in the process of writing scientific papers (p=0.004; p<0.05). Students who show high levels of hardiness tend to experience lower stress during the preparation of scientific papers, while those with low hardiness are more vulnerable to high academic pressure. Based on these results, it can be concluded that increasing hardiness in students is very important as a strategy for dealing with academic demands, especially in writing scientific papers. Thus, students are expected to be able to strengthen their self-control, commitment to the learning process, and positive perspective towards various challenges.

The digestive system plays a role in processing food into nutrients so that they can be absorbed and utilized by the body, but it is often found that the digestive system experiences disorders that can be caused by various factors such as infection, inflammation, motility disorders, or even neoplasms (Suryati et al., 2025).One of the diseases caused by digestive system disorders is ileus obstruction, which is a disorder of the digestive system that occurs due to a mechanical blockage in the intestine and is often found in patients with intestinal obstruction. One of the diseases resulting from digestive system disorders isileus obstruction, which is a disorder of the digestive system caused by a mechanical obstruction in the intestines and is commonly found in patients who visit the emergency room. It is estimated that approximately 2-8% and 15% of patients require treatment in the surgical unit (Andi Nailah et al., 2024). Obstructive ileus occurs in the small intestine and can be caused by incarcerated hernia, intussusception, intestinal adhesions or adhesions, ascariasis, volvulus, tumors, or gallstones entering the ileum (Su’un, Gani, & Purnama, 2024). The purpose of this writing is to understand and provide nursing intervention  for Mrs. T with a digestive system disorders: a case of ileus obstruction in Mawar 2 ward dr. Soeselo Regional General Hospital, Tegal Regency. The method used in this writing is a descriptive method. From the case review, it was found that the patient's main complaint was pain in the lower right abdomen. Three diagnoses emerged: acute pain, anxiety, and knowledge deficit. Interventions were developed based on SDKI, SLKI, and SIKI, which can be implemented.

Dependence on smartphones, characterized by excessive anxiety when unable to access them, known as Nomophobia, has become a common problem among students aged 18 to 24 years. One significant consequence of this condition is a decline in sleep quality. This study aimed to examine the correlation between the level of Nomophobia and the degree of sleep quality among third-year students of the Diploma Three Nursing Study Program at Abulyatama University. The research employed a correlative descriptive design with a cross-sectional survey method. Out of 177 third-year students, 64 participants were selected as samples using proportional random sampling. The Nomophobia Questionnaire (NMP-Q) was used to assess the level of Nomophobia, while the Pittsburgh Sleep Quality Index (PSQI) was utilized to measure sleep quality. Data collection occurred at the Diploma Three Nursing Study Program, Faculty of Health Sciences, Abulyatama University, from May 7 to 30, 2025. The bivariate analysis, performed using the chi-square method, showed a statistically significant relationship between Nomophobia and sleep quality, with a p-value of 0.048 (p < 0.05). The results revealed that 71.9% of respondents had a high level of Nomophobia, and 90.6% experienced sleep quality problems. These findings highlight the urgency of managing healthy smartphone use among students to ensure good sleep quality and reduce the risk of physical and psychological disorders.

The endocrine system is a ductless body control system that produces hormones to regulate various organs and physiological processes. Hormones act as important biological messengers in the human body. One of the most essential hormones is insulin, which plays a key role in blood sugar regulation. Insufficient insulin production or impaired insulin action can cause disruption of blood glucose control, leading to diabetes mellitus. Diabetes mellitus is a chronic metabolic disorder characterized by persistently high blood glucose levels caused by impaired insulin secretion, insulin action, or both. The purpose of this paper is to apply nursing care to Mr. N, a patient with endocrine system disorders: diabetes mellitus, treated in the Dahlia Ward of Dr. Soeselo Regional Hospital, Tegal Regency. This descriptive case study method was used to explain the nursing process in a structured manner. The main complaint presented by the client was pain in the wound on the left foot. Four nursing diagnoses were identified during the assessment, namely unstable blood glucose levels, acute pain, impaired skin/tissue integrity, and knowledge deficit. Nursing interventions were developed and implemented based on the Standar Diagnosis Keperawatan Indonesia (SDKI), Standar Luaran Keperawatan Indonesia (SLKI), and Standar Intervensi Keperawatan Indonesia (SIKI). The case highlights the importance of comprehensive nursing care in diabetes management, with a focus on blood glucose stabilization, pain management, wound care, and patient education. The results of this study are expected to provide additional references for clinical practice and strengthen the role of nurses in preventing complications of diabetes mellitus.

Final-year students often face significant academic pressure, especially when writing their final assignments. If this type of stress is left unaddressed, it can have a negative impact on students' psychological well-being, academic achievement, and even physical health. Given this situation, this study aims to evaluate the effectiveness of applying Mindfulness, particularly the Mindful Breathing technique, in reducing stress levels among students in the Diploma Three Nursing Program at Abulyatama University who are completing their final projects. The research took place from March 10 to 25, with a population of 180 students who were in the final stage of their education, namely 177 students from the 2022 batch and 3 students from the 2021 batch. Using a one-group pretest-posttest quasi-experimental approach, this study sampled 22 students through purposive sampling. Over two weeks, participants attended six Mindful Breathing intervention sessions, each lasting 30 minutes. Stress levels were measured using the SASS questionnaire, which has been tested for reliability with a Cronbach Alpha value of 0.945. After the intervention, the results of the paired simple t-test analysis showed a significant decrease in stress scores, with an average reduction of 11.136 points and a p-value of 0.000 (p < 0.05). These findings confirm that the Mindful Breathing method contributes significantly to reducing stress in students. As a follow-up, students are encouraged to integrate Mindfulness practices into their daily routines to maintain mental stability, and educational institutions are expected to implement structured Mindfulness programs as a strategy for preventing academic stress.

First-year out-of-town students face a challenging transition period because they have to adapt to new social and academic environments, college adjustment is the key to academic success and psychological well-being, and peer social support plays a crucial role in helping the adaptation process. The purpose of this study was to determine the correlation of peer social support with college adjustment for first-year out-of-town students in the Diploma Three Nursing Study Program at Abulyatama University. This study applied a quantitative method through a cross-sectional study approach and involved 109 populations. The sample consisted of 52 respondents selected through purposive random sampling using the Slovin formula. The instruments implemented include the questionnaire MSPSS to measure peer social support, it was found that the Croncbach Alpha for the family subscale was 0.81, the friend subscale was 0.82, and other significant subscales was 0.75 and SACQ to measure the level of college adjustment, it was found that the Alpha coefficient = 0.877, while the analysis used was univariate and bivariate by applying the chi square test. The study findings are based on the test findings using Chi-Square, it is known that the ρ value = 0.036 (≤ 0.05). The conclusion contains a correlation between peer social support and college adjustment in first-year out-of-town students. The results of this study are expected to be input for out-of-town students to improve their ability to adjust to the campus environment by utilizing peer social support. Educational institutions are expected to provide guidance or counseling programs that support the adaptation process of new students, especially out-of-town students. In addition, further research is expected to examine other factors that influence student adjustment, such as family and environmental factors, and use more diverse research methods to enrich the research results.

Post-operative care is a critical phase in the recovery process, beginning immediately after the completion of surgery until the patient is stabilized and transferred to the inpatient ward. Among various surgical procedures, lumpectomy is a common intervention performed to manage mammary tumors, aiming to preserve breast tissue while removing the tumor (Arif et al., 2021). This paper presents a case study of Mrs. D, a patient with an endocrine disorder who underwent a right breast lumpectomy at Mawar 2 Ward, Dr. Soeselo Regional General Hospital, Tegal Regency. The study employed a descriptive method to explore the patient’s condition and nursing interventions. Upon assessment, the main complaint reported by the patient was pain localized in the post-operative area. Based on the findings, two primary nursing diagnoses were established: acute pain related to surgical trauma and knowledge deficit related to post-operative care and self-management. Nursing interventions were designed and implemented according to the Indonesian Nursing Diagnosis Standard (SDKI), the Indonesian Nursing Outcomes Standard (SLKI), and the Indonesian Nursing Interventions Standard (SIKI). Interventions included pain management strategies, such as pharmacological support and non-pharmacological relaxation techniques, as well as health education to improve patient knowledge and self-care ability. The case highlights the importance of comprehensive nursing care that addresses both physical discomfort and the patient’s understanding of recovery, thereby promoting optimal health outcomes after breast surgery.

Menstrual pain is one of the most common health complaints experienced by many women and often interferes with daily activities, both in academic and social contexts. This study aimed to examine the effect of red ginger decoction in relieving menstrual discomfort. The research employed a quasi-experimental design with a One Group Pretest-Posttest approach. From a total population of 487 students enrolled in the Diploma III Nursing program, 15 participants were selected using purposive random sampling. The study was conducted over a three-week period, from May 7 to May 27, 2025, using an observation sheet as the research instrument. The initial pain level was measured before the intervention using the Numeric Rating Scale (NRS). Each participant who reported menstrual pain was then given 200 ml of red ginger decoction, and after 30 minutes, pain levels were reassessed to determine any changes. The Shapiro-Wilk test was applied to examine data distribution, while differences in mean scores before and after the intervention were analyzed using the Paired Sample t-Test. The findings showed that the average pain score before treatment was 7.53 and decreased to 5.67 after the intervention, with a mean difference of 1.89. The statistical analysis yielded a significance value of p = 0.001 (p < 0.05), indicating a meaningful difference. Therefore, it can be concluded that consuming red ginger decoction is effective in reducing menstrual pain intensity. Consequently, red ginger may be recommended as a natural alternative for managing dysmenorrhea, while educational institutions are encouraged to provide health education regarding the use of herbal remedies, particularly red ginger, for menstrual pain relief. Future researchers are expected to use these findings as a reference and further explore other variables in subsequent studie.

Acute myocardial infarction is a leading cause of death both in Indonesia and globally, with incidence rates remaining quite high. This disease is closely associated with various modifiable risk factors, including hypertension, diabetes mellitus, dyslipidemia, obesity, and smoking. Various literature reviews confirm that patients with myocardial infarction often have complex clinical conditions, especially when comorbidities worsen the prognosis and increase the burden on healthcare services. This study reviews the latest national literature on risk factors, clinical profiles, nursing management, prognostic predictors, and non-pharmacological interventions such as relaxation techniques. The analysis demonstrates the need for a comprehensive and integrative approach to the management of myocardial infarction patients. This includes early detection using clinical risk scores, intensive nursing interventions in severe cases such as Killip III NSTEMI, and the use of simple prognostic tools that are easily implemented in healthcare facilities. A supportive approach also plays a crucial role in improving patient comfort and adherence to therapy. The integration of these strategies is expected to improve clinical outcomes, reduce morbidity and mortality, and enhance patients' overall quality of life. This study emphasizes the importance of updating local evidence-based clinical practices tailored to the needs of the Indonesian healthcare system, so that the management of myocardial infarction does not only focus on medical therapy, but also on aspects of prevention, non-pharmacological interventions, and ongoing care.

Heart failure or congestive heart failure (CHF) is a condition where the heart is unable to pump blood optimally to meet the body's metabolic needs, resulting in symptoms such as shortness of breath, excessive fatigue, and edema (Majid, 2017). According to WHO data in 2023, CHF is one of the main causes of death with a total of 17.5 million deaths from a total of 58 million cases recorded worldwide. This paper aims to describe and provide an overview of nursing care for patient Mr. H who experiences cardiovascular system disorders in the form of CHF in the Dahlia room of Dr. Soeselo Regional Hospital, Tegal Regency in accordance with nursing practice standards. The method used is a descriptive method through a case study with data collection techniques using interviews and observations. From the results of the case review, the main complaint experienced by the patient was shortness of breath which was quite disruptive to daily activities. Based on this condition, four main nursing diagnoses were found, namely ineffective airway clearance, hypervolemia, activity intolerance, and knowledge deficits related to the disease and self-care. The interventions provided are based on theoretical references in the Indonesian Nursing Diagnosis Standards (IDHS) and the Indonesian Nursing Outcome Standards (SLHS), and are tailored to the patient's actual condition. The implemented action plan is expected to help reduce symptoms, improve the patient's ability to function, and provide a better understanding of CHF so that the patient can actively participate in the care process.

Schizophrenia is a severe mental disorder characterized by a decline in cognitive abilities and social skills, an inability to care for oneself, and potential brain function impairment. One of the consequences often observed in schizophrenia patients is social isolation, where the individual is unable to interact with others around them. This study aims to assess and provide psychiatric nursing care for Sdr. A, who is experiencing the primary issue of social isolation: withdrawal due to paranoid schizophrenia at the Gatotkaca ward of RSJD dr. Gondohutomo in Central Java Province. Initial assessment of the patient revealed that Sdr. A is experiencing social isolation, particularly withdrawal from their social environment. Four nursing problems were identified, including social isolation: withdrawal, low self-esteem, sensory perception disturbances such as hallucinations, and self-care deficits. A nursing care plan was developed based on the Indonesian Nursing Diagnosis Standard , Indonesian Nursing Service Standard, and Indonesian Nursing Information System , tailored to the patient's condition at the time. The care plan includes interventions to enhance social interaction, improve self-esteem, address sensory perception disturbances, and promote self-care abilities. The nursing implementation was carried out using a holistic approach involving psychosocial support and appropriate medical therapy based on the patient’s needs. It is expected that through this approach, the patient can reduce social isolation symptoms and improve their quality of life. This study emphasizes the important role of psychiatric nursing care in addressing social issues in patients with paranoid schizophrenia and how a structured nursing care plan can support patient recovery.

A tumor is a collection of abnormal cells that develop due to excessive and uncontrolled cell division (Angkotasan & Vioneery, 2022). Currently, tumors are considered one of the leading causes of morbidity and mortality worldwide (Maryati, 2023). The purpose of this study is to provide an in-depth understanding and description of nursing care for Mr. T, a patient with a medical diagnosis of post-operative soft tissue tumor (STT) in the right arm, who was treated in Room Mawar 2 at RSUD dr. Soeselo, Tegal Regency, in accordance with standardized nursing care guidelines. This study employed a descriptive case study method, with data obtained through interviews, observations, physical examinations, and documentation reviews. Based on the case analysis, the patient’s main complaint was severe pain following surgery. Three priority nursing diagnoses were identified: acute pain, knowledge deficit related to the disease and its management, and risk of infection due to post-surgical wound. Nursing interventions were planned and implemented according to SDKI (Standar Diagnosa Keperawatan Indonesia), SIKI (Standar Intervensi Keperawatan Indonesia), and SLKI (Standar Luaran Keperawatan Indonesia), adapted to the patient’s condition. The interventions included pain management techniques, health education, wound care, and infection prevention strategies. The results showed that after the nursing care was carried out, the patient reported a decrease in pain intensity, demonstrated increased knowledge regarding his condition, and exhibited no signs of infection. This study highlights the importance of systematic nursing care in post-operative soft tissue tumor patients to reduce complications, promote recovery, and improve quality of life. The findings are expected to contribute as a reference for nursing practice and further research on tumor management in clinical settings.

First aid in emergencies is an essential skill that must be possessed by nursing students as prospective health workers. Educational media in the form of practical guidebooks is believed to be able to improve students' knowledge and skills, but their effectiveness needs to be proven empirically. This study aims to determine the effectiveness of the educational media of the Emergency First Aid Guide in improving the knowledge and skills of Basic Life Assistance (BHD) for nursing students. The research design used was pre-experimental with a one group pretest-posttest design approach. The research sample consisted of nursing students selected through purposive sampling techniques. The research instruments include a knowledge questionnaire and a BHD skill observation sheet. Data analysis was carried out by the normality test and the Wilcoxon Signed Rank Test. The results showed a significant improvement in respondents' knowledge from an average of M: 12; SD ± 2.52 to M: 17; SD ± 1.55 (Z = -7.789; p = 0.00), as well as an improvement in BHD skills from M: 83; SD ± 9 to M: 99; SD ± 10.2 (Z = -7.789; p = 0.00). These findings show that educational media in the form of handbooks is effective in improving the ability of nursing students to deal with emergency situations. This media can be used as an alternative strategy in emergency nursing learning to support students' clinical readiness.

Latar belakang: Hemodialisa merupakan suatu teknologi canggih yang digunakan sebagai alternatif pengganti fungsi ginjal untuk menyaring produk-produk limbah metabolik atau racun tertentu dari darah, seperti air, natrium, kalium, hidrogen, urea, dan zat lainnya dengan memanfaatkan membran semipermeabel. Salah satu faktor yang mempengaruhi hemodialisa ialah akses vaskuler, akses vaskuler yang berfungsi dengan baik dapat digunakan untuk jangka Panjang yang adekuat dapat menghasilkan aliran darah yang lancar serta meminimalkan komplikasi. Tujuan: dilakukan penelitian ini ialah untuk mengetahui bagaimana gambaran pengetahuan dan perawatan akses vaskuler pada pasien hemodialisa. Metode: Penelitian ini menggunakan metode deskriptif dengan pendekatan potong lintang (cross sectional). Sebanyak 90 pasien hemodialisa terlibat sebagai responden yang dipilih melalui teknik pengambilan sampel total. Data dikumpulkan dengan menggunakan kuesioner yang mengukur pengetahuan dan perawatan akses vaskuler. Dalam menganalisis data, digunakan uji distribusi frekuensi. Hasil: penelitian ini menjelaskan bahwasannya mayoritas responden mempunyai tingkat pengetahuan akses vaskuler kategori baik sebanyak 71 (78,9%), sedangkan sebagian besar memiliki Tingkat perawatan akses vaskuler kategori baik sebanyak 69 (76,7%). Adanya Gambaran pengetahuan dan perawatan akses vaskuler yang baik pada pasien hemodialisa sehingga, penelitian ini dapat digunakan perawat dalam intervensi keperawatan untuk lebih meningkatkan pengetahuan dan perawatan akses vaskuler pasien dalam hemodialisa.

Psychological fatigue is a common condition experienced by nursing students due to heavy academic workload, clinical practice demands, and emotional pressure during the learning process. This condition may negatively affect concentration, learning motivation, and overall mental health. One non-pharmacological intervention strategy proven effective in reducing stress and psychological fatigue is Progressive Muscle Relaxation (PMR) based on Jacobson’s technique. In this community service program, PMR was combined with instrumental music to provide a more optimal relaxation effect and to be easily applied by students independently. The purpose of this activity was to provide education, training, and hands-on experience for students in practicing Self-Guided PMR combined with instrumental music as a preventive and promotive effort for mental health. The program was carried out on Thursday, August 14, 2025, involving 15 nursing students as participants. The stages of implementation included delivering material on PMR concepts and mental health, demonstrating Jacobson’s technique, independent practice of PMR with instrumental music, and a reflection session to explore participants’ experiences. The evaluation results indicated that most students reported feeling calmer, more relaxed, experiencing reduced muscle tension, and decreased symptoms of psychological fatigue after the intervention. In addition, students stated that this technique was easy to practice independently, making it a potential simple strategy to maintain mental health throughout their nursing studies. In conclusion, the implementation of Self-Guided PMR based on Jacobson’s technique combined with instrumental music was effective in reducing psychological fatigue among nursing students and in increasing awareness of the importance of independent relaxation practice as part of maintaining mental and physical balance.

Background : Appendectomy is a surgical procedure to remove the appendix which is done as soon as possible to reduce the risk of perforation. Nursing problems that arise after appendectomy is acute pain. Objectives: Gaining real experience and knowledge and being able to document the application of deep breathing relaxation techniques is an appropriate non-pharmacological action in reducing pain scale. Method: this type of scientific paper uses a descriptive method with a descriptive case study approach with a case study approach to explore the problem of nursing care carried out on two patients carried out on June 15 - 20 2021. Results: from the results of nursing care to Mrs "S" and Mr "M" with a nursing diagnosis in the first patient, namely acute pain related to physical injury agents (eg abscess, amputation, burns, cuts, heavy lifting, surgical procedures, trauma, excessive physical exercise), impaired sense of comfort related to symptoms of the disease ( pain), impaired physical mobility related to decreased muscle strength (pain), and the second patient's diagnosis was acute pain related to physical injuring agents (eg abscess, amputation, burns, cuts, heavy lifting, surgical procedures, trauma, excessive physical exercise), discomfort related to symptoms of disease (pain), anxiety related to situational crises, lack of exposure to information, impaired physical mobility associated with decreased muscle strength (pain). The interventions in both patients were: identification of location, characteristics, duration, frequency, quality and intensity of pain, identification of pain scale, identification of non-verbal pain responses. The evaluation of the first patient had a pain intensity scale of 6 (moderate), and the second patient a pain scale of 7 (severe). The results of the study in the Surgery Room of the Palembang Bari Regional General Hospital after the deep breathing relaxation technique was carried out in the first patient on a pain scale of 6 (moderate) to 3 (mild), and the second patient pain scale of 7 (severe) to 4 (moderate). Conclusion: Progress notes to both patients on the application of deep breathing relaxation techniques to reduce pain intensity. The results of the nursing evaluation of the problem were partially resolved.