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Mental health issues among university students have become a growing concern, driven by academic pressures, career uncertainties, and complex social transitions. However, a large proportion of students remains reluctant to seek professional psychological support due to social stigma and limited access to institutional counseling services. This study proposes the design and implementation of an Android-based chatbot application that integrates mood tracking and sentiment analysis to continuously monitor the emotional states of university students. The system employs a fine-tuned RoBERTa (Robustly Optimized BERT Pretraining Approach) model trained on the EmoContext conversational dataset (SemEval-2019 Task 3), comprising 30,160 labeled three-turn dialogue instances across four emotion classes: angry, happy, sad, and others. The model was fine-tuned for four epochs using the AdamW optimizer with a learning rate of 2e-5 and a maximum sequence length of 128 tokens. Evaluation on a held-out validation set of 6,032 samples yielded an overall accuracy of 88.28%, a macro-average F1-score of 0.87, and a weighted-average F1-score of 0.88. Per-class F1-scores were 0.89 (angry), 0.83 (happy), 0.91 (others), and 0.86 (sad). The classified emotion is transmitted in real time to the chatbot response logic, which generates empathetic replies and personalized relaxation recommendations based on the detected mood. Primary data collection through questionnaires and interviews with 62 and 19 university students respectively confirmed the need for accessible digital mental health support. The results demonstrate that RoBERTa-based fine-tuning on conversational data provides a reliable foundation for real-time emotion-aware mental health chatbot systems.

Decline in the ability to perform activities of daily living among older adults can lead to poor personal hygiene practices, thereby increasing the risk of infections, including urinary tract infections. This study aims to analyze the effect of improving self-care in personal hygiene on reducing the risk of urinary tract infections in the elderly.The method used was a case study involving a single respondent (Mr. W), with a four-week intervention consisting of one visit per week, each lasting approximately 45 minutes. The intervention included personal hygiene education, practical demonstrations, direct assistance, and environmental modification.The results showed an improvement in both awareness and personal hygiene practices, as indicated by the ability to brush teeth regularly, perform proper genital care after urination, and maintain consistency in changing clothes and underwear, although some habits still required ongoing assistance.In conclusion, a holistic approach through education, assistance, and environmental support is effective in gradually improving personal hygiene practices among older adults. However, continuous efforts are necessary to achieve long-term behavioral consistency.

Decline in the ability to perform activities of daily living among older adults can lead to poor personal hygiene practices, thereby increasing the risk of infections, including urinary tract infections. This study aims to analyze the effect of improving self-care in personal hygiene on reducing the risk of urinary tract infections in the elderly.The method used was a case study involving a single respondent (Mr. W), with a four-week intervention consisting of one visit per week, each lasting approximately 45 minutes. The intervention included personal hygiene education, practical demonstrations, direct assistance, and environmental modification.The results showed an improvement in both awareness and personal hygiene practices, as indicated by the ability to brush teeth regularly, perform proper genital care after urination, and maintain consistency in changing clothes and underwear, although some habits still required ongoing assistance.In conclusion, a holistic approach through education, assistance, and environmental support is effective in gradually improving personal hygiene practices among older adults. However, continuous efforts are necessary to achieve long-term behavioral consistency.

Clean water availability is an essential component of hospital hygiene and sanitation operations, including hand hygiene, environmental cleaning, linen management, food sanitation, and infection prevention. RSUD Sumbersari Bantul Metro Selatan still relies on one bore well and has limited water storage without a permanent backup source. This study aimed to analyze the adequacy of clean water quantity and quality in supporting hygiene and sanitation operations at RSUD Sumbersari Bantul Metro Selatan in 2026. This study used a descriptive analytic design. Data were collected through observation, interviews, water discharge and consumption measurement, document review, and laboratory examination of clean water samples. The analysis compared water availability, water demand, unit-based distribution needs, and water quality with the standards of Ministry of Health Regulation Number 2 of 2023. The results showed that during January-March 2026, the hospital served 154 inpatients and 1,028 outpatients and had 151 staff members. The total clean water requirement was 715.44 m3/90 days, while the available water was only 414.00 m3/90 days, fulfilling 57.87% of the required amount. The average daily need was 7.95 m3/day, compared with the availability of 4.60 m3/day. High-risk service units, particularly inpatient care, emergency services, intensive care, CSSD, isolation, maternity care, laundry, and nutrition services, require priority water distribution. Laboratory testing found Escherichia coli and total coliform at 19 CFU/100 ml each, exceeding the required standard of 0 CFU/100 ml. In conclusion, the quantity and microbiological quality of clean water at RSUD Sumbersari Bantul have not adequately supported optimal hygiene and sanitation operations.

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.

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. 

This study aims to explore the role of pet attachment among cat owners in Palembang, focusing on how emotional bonds are formed, interpreted, and influence psychological well-being. A qualitative approach was employed using purposive sampling to select two main participants who had high interaction intensity with their cats, along with additional informants from family members and neighbors. Data were collected through in-depth interviews, observations, and documentation, then analyzed thematically with source triangulation to ensure validity. The findings reveal that pet attachment develops through daily interactions such as feeding, cleaning, playing, and monitoring the cat’s health. Cats are perceived not only as domestic animals but also as companions that provide psychological comfort, emotional support, and stress reduction. Factors shaping attachment include emotional needs, intensity of daily interaction, empathy toward the pet’s condition, long-term caregiving commitment, and the perception of cats as significant companions. The duration of ownership strengthens attachment quality, while the loss of a pet triggers profound grief comparable to losing a family member. Moreover, pet attachment influences family dynamics and social identity, portraying owners as caring and empathetic individuals. In conclusion, pet attachment among cat owners in Palembang is a complex psychological phenomenon involving emotional, social, and behavioral dimensions. The relationship between humans and cats extends beyond utilitarian functions, evolving into deep affective bonds that serve as coping mechanisms and psychosocial support in urban life. These findings enrich the literature on human-animal relationships and highlight the therapeutic and emotional value of pets in modern society.

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.

Patient safety culture is a critical component in healthcare organizations, reflecting the values, attitudes, competencies, and behavioral patterns that ensure safe patient care. This study aims to analyze the influence of knowledge and work environment on patient safety culture, with attitude serving as an intervening variable. A quantitative approach with an explanatory causal design was employed, involving 118 nurses as respondents selected through total population sampling. Data were collected using structured questionnaires and analyzed using Structural Equation Modeling with Partial Least Squares. The findings reveal that both knowledge and work environment have a significant direct effect on patient safety culture. Additionally, knowledge and work environment significantly influence attitudes, while attitudes themselves have a significant effect on patient safety culture. However, attitude does not mediate the relationship between knowledge and patient safety culture, but it does mediate the influence of the work environment on patient safety culture. These results indicate that improving nurses’ knowledge and creating a supportive work environment are essential strategies for strengthening patient safety culture. The study also highlights the importance of fostering positive attitudes through organizational support and conducive working conditions. The implications suggest that hospital management should focus on continuous training programs, enhancing workplace conditions, and developing systems that promote positive behavioral attitudes among healthcare workers to improve overall patient safety outcomes.

Preeclampsia remains a major contributor to maternal morbidity and mortality, particularly in developing countries such as Indonesia. Early detection and integrated management at the primary healthcare level are essential to prevent disease progression and improve maternal outcomes.  Modifiable risk factors such as maternal obesity, inadequate calcium intake, and poor clinical management contribute significantly to disease progression (WHO, 2021; Zhang et al., 2020). This study aimed to evaluate the effectiveness of an Integrated Maternal Health Model (IMHM) combining risk assessment, nutritional intervention, and clinical management for early prevention and control of preeclampsia in primary healthcare settings. A quasi-experimental cohort study was conducted among 104 pregnant women, consisting of 52 preeclamptic and 52 normotensive participants in community health centers in Medan, Indonesia. Data were collected across four antenatal visits, including blood pressure measurements, proteinuria (dipstick), calcium intake, supplementation adherence, and antihypertensive therapy. Statistical analyses included bivariate and longitudinal tests. The results showed that maternal obesity, history of preeclampsia, and hypertension were significant risk factors. Adequate calcium intake demonstrated a protective effect against preeclampsia (p < 0.05), consistent with recent evidence indicating that calcium supplementation can reduce the risk of preeclampsia by up to 49%. However, calcium supplementation did not significantly influence blood pressure among normotensive pregnant women. Antihypertensive therapy, particularly intensive nifedipine regimens, showed significant differences in blood pressure patterns across visits (p < 0.05). In addition, proteinuria levels significantly decreased over time (p < 0.001), indicating improvement in renal function. In conclusion, the IMHM is effective in improving maternal outcomes through a multi-component approach integrating clinical, nutritional, and monitoring strategies. This model provides a practical and scalable framework for early prevention and management of preeclampsia in primary healthcare settings.

Indonesia ranks 36th among countries most prone to natural disasters, with 216 earthquakes recorded by BNPB between 2009 and 2019. Aceh is one of the high-risk regions, having experienced major disasters such as floods, earthquakes, and the 2004 tsunami. These conditions highlight the importance of knowledge of basic life support (BLS), which is essential for managing respiratory arrest, cardiac arrest, and airway obstruction in emergency situations. This study aimed to determine the level of basic life support knowledge among health workers at the North Lhoksukon Health Center, Aceh. A descriptive observational method with a survey approach was used to provide a general overview of respondents’ characteristics. The study applied univariate analysis and involved a total sample of 139 health workers. The results showed that most respondents had a good level of knowledge (116 people; 83.5%), followed by sufficient knowledge (13 people; 9.4%) and poor knowledge (10 people; 7.2%). These findings indicate that while the majority of health workers demonstrate good understanding, there is still a need for improvement among those in the sufficient and poor categories. Therefore, it is recommended that institutions provide regular BLS training to maintain and enhance the knowledge of health workers.

The implementation of Hospital Management Information Systems (HMIS) has become a strategic imperative to enhance operational efficiency amidst the ongoing global digital health transformation era. This study aims to analyze the determinants of successful HMIS implementation and its impact on service efficiency and patient outcome quality. Employing a narrative review approach with thematic synthesis of literature from PubMed, Scopus, and ScienceDirect databases between 2016-2026, the study evaluates the relationship between technology investment and organizational performance. The synthesis results indicate that while HMIS significantly reduces administrative burdens and medication errors, a "digital paradox" exists where technical efficiency may disrupt interpersonal interactions between healthcare providers and patients if systems are not user-centered. Key success factors include data interoperability (HL7/FHIR standards), human resource readiness, and governance policy support. This study concludes that a patient-centered efficiency model is the fundamental basis for ensuring technology investments yield sustainable added value within the healthcare delivery system.

This study aims to examine the relationship between family support and depression levels among the elderly in Pejuang Village, Bekasi City, through a descriptive-narrative literature review. The review analyzed relevant scientific articles discussing family support, social support, and depression in older adults. Literature was selected based on the suitability of the elderly population, the presence of family or social support variables, and the measurement of depressive symptoms or depression levels. The analysis compared each article’s objectives, research design, respondent characteristics, instruments, findings, and conclusions. The results indicate that most studies found a relationship between family support or social support and depression among the elderly. Adequate family support, including emotional, instrumental, informational, and appraisal support, helps older adults feel cared for, valued, secure, and better able to adapt to the aging process. Preliminary findings at the Elderly Posyandu in Pejuang Village also show variations in family support and depression levels among elderly participants. Conversely, limited family support may increase loneliness, psychological distress, and depressive symptoms. Therefore, family support functions as a protective factor in reducing depression risk among older adults. Strengthening the involvement of families, health workers, and elderly posyandu cadres is necessary as a promotive and preventive strategy to maintain psychological well-being through education, early detection, and sustainable community-based assistance for vulnerable elderly groups living in community and family environments.

Background: HIV (Human Immunodeficiency Virus) and AIDS (Acquired Immune Deficiency Syndrome) remain global health issues, including in Indonesia. One of the management strategies is antiretroviral therapy (ART), which requires a high level of adherence to be effective. Objective: This study aims to analyze the effect of reminders on adherence to ARV treatment among people living with HIV (PLHIV) at the Tembuku I Community Health Center. Methods: This study employed a quasi-experimental design using a one-group pretest-posttest approach. The sample consisted of 30 PLWHA selected using total sampling, and data were analyzed using the Wilcoxon test. Results: Univariate analysis revealed that the average age of respondents was 35 years; the majority were female, had a high school education, and worked as homemakers and farmers. Bivariate analysis revealed that prior to the intervention, the majority of PLWHA (70%) had low adherence levels, whereas after the intervention, adherence levels increased to 100%. Statistical test results showed a p-value < 0.05, indicating a significant effect of social media-based reminders on improving ARV adherence in the Tembuku I Community Health Center area. Conclusion: The use of social media-based reminders is effective in improving adherence to ARV treatment among people living with HIV. This intervention can be recommended as a simple and practical strategy to support the success of ARV therapy in primary health care settings.

The quality of interaction between physicians and patients plays a crucial role in the healthcare system, as it directly affects patient satisfaction. Ineffective communication by physicians may reduce patient satisfaction and increase the risk of complaints and medical disputes. This study aims to analyze the relationship between doctor–patient communication patterns and patient satisfaction in outpatient services. This research employed a quantitative approach with an observational analytic design using a cross-sectional method. The study population included all outpatient patients, with a sample of 110 respondents selected through accidental sampling. The independent variable was doctor–patient communication, while the dependent variable was patient satisfaction. Data were collected using a questionnaire, and analysis was performed using the Chi-Square test with a 95% confidence level. The results showed that the majority of respondents rated doctor–patient communication as good (80.9%) and reported high levels of satisfaction (75.5%). The analysis revealed that among respondents who experienced good communication, 84.3% reported high satisfaction, whereas the proportion of high satisfaction decreased significantly in the groups with moderate and poor communication. In conclusion, there is a significant relationship between the quality of doctor–patient communication and patient satisfaction in outpatient services, where improvements in communication quality are consistently associated with increased patient satisfaction.

Hypertension is a major public health concern with a high prevalence and a significant risk of complications if left uncontrolled. Effective management requires not only pharmacological treatment but also non-pharmacological approaches and active family involvement. One potential non-pharmacological therapy is the use of celery (Apium graveolens), which is believed to lower blood pressure. This study aimed to evaluate the effectiveness of family education combined with celery decoction administration in reducing blood pressure among patients with hypertension. A descriptive case study design was employed using a family nursing care approach over three home visits, each lasting 30–45 minutes. The intervention included health education on hypertension and a demonstration of how to prepare and administer celery decoction, which was consumed twice daily. Data were collected through interviews, observation, and blood pressure measurements. The results showed a reduction in blood pressure from 159/90 mmHg to 130/80 mmHg, along with a decrease in symptoms such as headaches and dizziness. In addition, there was an improvement in family knowledge, caregiving skills, and the ability to modify the home environment. In conclusion, family-based education combined with the administration of celery decoction appears to be effective in reducing blood pressure and enhancing the family’s role in managing hypertension.

This reflective autoethnographic study explores the lived experience of being an only child caring for an elderly mother with Parkinson's disease while working as a full-time lecturer. The research aims to understand how this dual role affects the caregiver's mental health, work productivity, and relationship with the mother. Using a reflective autoethnographic approach based on Ellis, data were collected through three techniques: autobiographical narratives and memos, analysis of personal artifacts (work schedules, medical records, photographs), and an integrated self-interview. Thematic-reflective analysis revealed three main themes. First, structural loneliness describes the profound isolation resulting from having no sibling to share physical, emotional, and decisional responsibilities, which informal support cannot easily remedy. Second, stealth strategies at work refer to hidden tactics such as leaving early without disclosure, using breaks to check on the mother, and concealing caregiving struggles to avoid being perceived as less committed or losing professional opportunities. Third, fought for bonds shows that despite exhaustion and initial frustration, the caregiver’s relationship with her mother deepened through daily effort, patience, and reframing caregiving as meaningful devotion, a process aligned with filial maturity. The findings highlight the unique pressures faced by only-child working caregivers, including invisible productivity loss and the inadequacy of general social support. Practical implications for employers, social workers, and policymakers are discussed. This study contributes a rich first-person account to the underexplored area of only-child caregiving and offers recommendations for workplace cultural change, targeted support groups, and subsidized respite services.

Background:Reproductive health education plays a crucial role, particularly for adolescents with disabilities, in maintaining their reproductive health. One effort to reduce menstrual-related problems is by developing hygienic behaviors. Menstrual personal hygiene refers to individual cleanliness practices aimed at maintaining, preserving, and improving personal hygiene and health to achieve physical and psychological well-being through the implementation of hygienic actions during menstruation. Objective; This study aimed to identify factors associated with menstrual personal hygiene behavior among adolescents with disabilities as part of long-term care. Methods:This study employed a correlational analytic design with a cross-sectional approach. The sample consisted of 36 respondents, selected using a total sampling technique. Data were collected using a questionnaire. Data analysis was conducted using bivariate analysis with the Chi-square test. Results: The results showed that variables significantly associated with respondents’ menstrual personal hygiene behavior were knowledge (p-value = 0.018), family support (p-value = 0.003), and adequacy of facilities and infrastructure (p-value = 0.003). Meanwhile, self-motivation was not significantly associated with menstrual personal hygiene behavior (p-value = 0.124). Conclusion: Therefore, nurses and healthcare providers are encouraged to enhance reproductive health education, involve families, and promote the provision of disability-friendly facilities to support long-term care for adolescents with disabilities.

Anemia in adolescents is a serious health issue that impacts students' concentration and productivity. This community service activity aims to conduct early detection of anemia through a comprehensive manual screening method at three high schools: SMA Sains Alumnika Palembang, SMA Candradimuka, and SMA Mandiri. The implementation method involved three main stages: identification of clinical signs and symptoms (5L), visual observation of the palpebral conjunctiva, and hemoglobin (Hb) level measurement using Point of Care Testing (POCT) devices. Held from April 1st to 8th, 2026, the activity involved the active participation of students and school authorities as an effort toward independent nutritional surveillance. The screening results showed a correlation between subjective symptoms, pale conjunctiva conditions, and Hb measurement results in the field. Changes in students' behavior regarding nutritional intake and the emergence of new awareness among school authorities about the importance of routine check-ups served as indicators of successful social transformation. In conclusion, integrated manual screening is highly effective as a preventive health measure for adolescents within educational environments.

Data on malnutrition in toddlers at the Amondo Health Center in 2023 were 47 toddlers, then in 2024 from early January to November, malnutrition data increased by 64 toddlers. This study aims to determine the Risk Factors for Malnutrition in Toddlers in the Working Area of ​​the Amondo Health Center, South Palangga District, South Konawe Regency in 2025. The design of this study is quantitative with a cross-sectional approach. The population of this study was all toddlers registered in the working area of ​​the Amondo Health Center, South Palangga District, South Konawe Regency in 2024 with a total of 966 people. The sampling used was Accidental Sampling. To obtain a representative sample, the selection of subjects from each stratum or certain region was determined in a balanced or comparable manner in each matched region. The sample size used was 91 respondents. The data were analyzed using the SPSS application with the Odds Ratio test. The OR test results obtained knowledge values ​​(OR = 1.08), eating habits (OR = 0.70), family income (OR = 1.10), carbohydrate intake (OR = 2.47), protein intake (OR = 0.91) and fat intake (OR = 1.30). The conclusion that maternal knowledge, children's eating habits, family income, and nutrient intake (carbohydrates, proteins and fats) in the past are risk factors for malnutrition. It is recommended that health workers always provide information about malnutrition to the community, carry out vegetable planting movements in the community, do not carelessly give food to toddlers, always consume and provide nutritious food for the family