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The Application Of Hallucination Management Using The Shutting-Out Technique For The Control Of Auditory Hallucinations In Schizophrenia Patients In The Angruk Ward Of Prof. Dr. Margono Soekarjo General Hospital, Purwokerto. Schizophrenia is a severe mental disorder often accompanied by auditory hallucinations. Auditory hallucinations may cause patients to talk to themselves, appear restless, and experience difficulty in controlling responses to internal stimuli. One non-pharmacological nursing intervention that can be applied is the rebuking technique, a strategy used to firmly reject or dismiss hallucinatory voices. This study aimed to examine the application of the rebuking technique in controlling auditory hallucinations in patients with schizophrenia. This research employed a descriptive case study design using a nursing process approach and was conducted from February 17 to 19, 2026, on a patient diagnosed with schizophrenia experiencing auditory hallucinations. The intervention was implemented over three days, with one session per day lasting approximately 15–20 minutes. The results showed an improvement in the patient’s ability to recognize and control hallucinations, as indicated by a reduction in self-talking behavior, increased awareness of hallucination onset, and the ability to independently apply the rebuking technique. In conclusion, the rebuking technique is an effective nursing intervention to assist patients with schizophrenia in controlling auditory hallucinations.

Patient revisit intention is a key indicator of hospital success in maintaining patient loyalty. In the digital era, the use of digital marketing and the quality of nurse communication play important roles in shaping patients’ perceptions of service quality and their decisions to return. This study aimed to analyze the effect of digital marketing utilization and nurse communication on patient revisit intention, with service quality as an intervening variable at Cabangbungin Regional General Hospital, Bekasi Regency.This research used a quantitative survey design with purposive sampling of outpatient participants. Data were analyzed using index analysis with the three-box method and hypothesis testing through Structural Equation Modeling–Partial Least Squares (SEM–PLS).The findings revealed that digital marketing utilization and nurse communication have a positive and significant effect on both service quality and patient revisit intention. Additionally, service quality was proven to mediate the relationship between digital marketing, nurse communication, and revisit intention. These results highlight the importance of integrating effective digital marketing strategies with empathetic and clear nurse communication to enhance perceived service quality.In conclusion, strengthening digital-based patient engagement, improving communication systems among healthcare professionals, and promoting empathetic service behavior are essential strategies to increase patient loyalty and revisit intention. This study provides practical insights for hospital management in optimizing service quality through digital transformation and communication improvement.

Medication adherence among the elderly is an important factor in achieving successful therapy, particularly during the month of Ramadan when changes occur in meal patterns and medication schedules. Elderly patients with chronic diseases often experience difficulties in adjusting their medication timing, which may lead to poor adherence. This study aimed to implement a smart pill boxwith educational labels to improve knowledge and medication adherence among elderly individuals during fasting. The study involved 40 elderly respondents in a social care institution. The intervention consisted of training on the use of the smart pill box, educational labeling, and evaluation through observation, interviews, and checklist forms. The results showed that most respondents took medication twice daily (42.5%) and adjusted their medication schedules to sahur and iftar (45%). Before the intervention, 57.5% of respondents had not received information about medication use during fasting. The implementation of the smart pill boxwith educational labels improved the elderly’s understanding of medication use and supported better medication adherence during Ramadan.

Bronchopneumonia is a type of infection of the lower respiratory tract that often occurs in children, especially toddlers. This disease is characterized by inflammation of the bronchioles and lung tissue which triggers increased production of secretions in the airways. The buildup of secretions often causes nursing problems in the form of ineffective airway clearance, which is indicated by ineffective coughing, rapid breathing, shortness of breath, and the appearance of additional breath sounds such as rales. Chest physiotherapy in children was carried out to evaluate the effectiveness of the clapping technique in helping to clear the airway in bronchopneumonia patients. The method applied in evidence-based practice (EBP) uses case studies with a nursing care approach. Intervention was given to three patients with a diagnosis of bronchopneumonia for three days, with a duration of approximately 1-2 minutes in each area of ​​the chest. Evaluation is carried out using a stethoscope and measuring time (clock), with the results recorded on an observation sheet. After chest physiotherapy (clapping), the three patients showed improvement in airway clearance, which was indicated by respiratory frequency returning to normal, no additional breath sounds (ronchi), and reduced secretion production. Based on these results, it can be concluded that the application of EBP through chest physiotherapy is effective in increasing airway clearance in bronchopneumonia patients.

Introduction: Appendectomy is a relatively safe surgical procedure. One important aspect of this stage is maintaining the patient's mental stability, especially before administering anesthesia. However, anesthesia often causes anxiety in patients. Mindfulness-based cognitive therapy has been shown to significantly improve quality of life by minimizing anxiety. Objective: This study analyzed the effect of Mindfulness-based cognitive therapy (MCT) in reducing pre-anesthetic anxiety in appendectomy patients. Methods: This study used a case study design with a nursing care process approach. The subjects in this case study were two patients who met the inclusion criteria. The instrument used was an observation sheet according to the Indonesian Society for Anesthesia and Clinical Trials (SLKI). Results: The results of the case study showed that both patients experienced pre-anesthetic anxiety. After receiving Mindfulness-based cognitive therapy, pre-anesthetic anxiety decreased. Conclusion: This case study demonstrated that pre-anesthetic anxiety decreased after Mindfulness-based cognitive therapy.

Leprosy remains a significant public health problem in various developing countries, including Indonesia. This disease is caused by Mycobacterium leprae, which attacks the skin and peripheral nerves and can cause long-term physical, psychological, and social impacts if not treated early and adequately. Health-seeking behavior in leprosy patients is also influenced by structural factors such as the availability of health facilities, distance, transportation costs, and the quality of communication between health workers and patients. Research in various endemic countries confirms that friendly, accessible primary health care services that provide comprehensive education can improve early detection and therapy adherence. Patient SA, an 11-year-old child diagnosed with multibacillary (MB) leprosy and has been undergoing treatment for four months. The progression of the disease to MB indicates limitations in early symptom recognition and the family's health-seeking behavior, which may be influenced by low perceptions of disease susceptibility and severity, lack of knowledge, and barriers to accessing health services. However, after the diagnosis was confirmed and education provided by health workers, positive behavioral changes occurred, indicated by the patient's adherence to routine therapy as recommended.

Aggressive behavior is one of the manifestations commonly found in individuals with mental disorders, and this can potentially cause harm both to themselves and to their surroundings. To address this condition, one non-pharmacological approach that can be implemented is the use of Mozart classical music therapy. This study aims to evaluate the impact of Mozart classical music therapy on patients who have the potential to exhibit violent behavior at Aceh Mental Hospital. The research activities were conducted from July 2 to 5, 2025. The research design adopted in this study is pre-experimental using the One group pretest-posttest Design method. The study subjects consisted of 15 inpatients who had been identified as being at risk for violent behavior, with sample selection carried out through purposive sampling. The findings of the study showed that the average score of signs and symptoms before the intervention was 5.73, with a score range of 3 to 8. After the intervention in the form of Mozart classical music therapy, the average score of signs and symptoms decreased significantly to 1.60, with a range between 1 and 2. Statistical analysis using the Wilcoxon Signed Rank test showed a Z value of -3.437 with a significance level of P = 0.000 (P < 0.05). Based on these results, it can be concluded that Mozart classical music therapy has a significant effect in reducing the risk of violent behavior in patients. Therefore, Mozart classical music therapy is recommended as an effective supportive intervention and can be routinely integrated into psychiatric care rooms.

Patient safety is a top priority in healthcare services in hospitals. One of the critical elements is the accuracy of patient identification to prevent incidents such as procedural errors or medication administration. The purpose of this study was to determine the relationship between nurses' compliance in implementing SBAR communication with the accuracy of patient identification at Hospital X, West Jakarta. This study is a quantitative analytical study. The research design used was a cross-sectional study. The population in this study were nurses working at Hospital X, West Jakarta with a sample of 50 respondents taken using the total sampling technique. The data collection technique used an instrument in the form of an observation sheet for SBAR compliance and patient identification accuracy. Data analysis used the Chi-Square statistical test method. Based on the results of the study, it was found that most nurses were not compliant in implementing SBAR communication, namely 27 people (54%) and the majority were not accurate in identifying patients, namely 30 people (60%). The results of the statistical test showed a p value = 0.000 (p <0.05), which means there is a significant relationship between nurses' compliance in implementing SBAR communication with the accuracy of patient identification at Hospital X, West Jakarta. This study indicates that the better nurses' adherence to SBAR communication, the better the accuracy of patient identification. Hospitals are recommended to increase routine supervision and ongoing training to strengthen a culture of patient safety through effective communication.  

The dimensions of healthcare service quality are a concept for measuring service quality. This study aims to determine the effect of the dimensions of healthcare service quality on the satisfaction of inpatients at Cut Nyak Dhien General Hospital in Langsa City. This study uses a quantitative design of the Survey Analytic type with a cross-sectional approach. The population consisted of 121 inpatients with a sample size of 55 respondents using purposive sampling technique. Analysis used multiple logistic regression test (α=0.05). The research results show that there is an influence between Responsiveness p<0.042 with an EXP (B) value of 11.361, Assurance p<0.008 with an EXP (B) value of 20.163, Empathy p<0.018 with an EXP (B) value of 13.547, Reliability p<0.033 with an EXP (B) value of 6.896 on inpatient patient satisfaction (p<0.05), while the Tangible variable shows no influence with p<0.088 and an EXP (B) value of 4.967. Among these variables, the one that significantly affects inpatient patient satisfaction is the Assurance variable with p<0.008 and an EXP (B) value of 20.163. It is recommended to continuously improve the quality of service comprehensively in every dimension of service quality, strengthen the competence and professionalism of healthcare personnel, enhance the speed and accuracy of service, and build good communication to improve the quality of inpatient services and maintain patient trust in the hospital.  

Pneumonia caused by extensively drug-resistant (XDR) Pseudomonas aeruginosa is still  clinicaly chalenging, particularly among geriatric patients with neurological comorbidities such as stroke. This report presents a case of XDR P. aeruginosa pneumonia complicated by sepsis in a 73-year-old patient, characterized by persistent leukocytosis until the tenth day of hospitalization despite empirical meropenem therapy. This evidence-based case report aims to analyze clinical outcomes, specifically 28-day and 30-day mortality rates, and to identify mortality predictors in the adult population through a systematic literature search of the PubMed and Google Scholar databases for the 2019–2026 period. Synthesized evidence from six core studies indicates that XDR P. aeruginosa infections carry a profoundly high 28-day mortality rate, ranging from 41% to 51% in cohorts receiving antibiotic monotherapy. Key mortality predictors identified include the presence of sepsis or septic shock, a delay in initiating adequate therapy exceeding 52 hours, advanced age, and the requirement for Intensive Care Unit (ICU) admission. The phenomenon of persistent or worsening leukocytosis during treatment, as observed in this case, serves as a critical clinical indicator associated with antimicrobial response failure and a dismal prognosis. Ultimately, XDR P. aeruginosa pneumonia is associated with poor clinical outcomes, where therapeutic success is strictly contingent upon the timely administration of antibiotic regimens with proven activity against these highly resistant isolates.

Gout arthritis is a disease characterized by sudden inflammation of the joints due to high levels of uric acid in the body (hyperuricemia). This condition is marked by acute episodes of joint inflammation, often affecting a single joint and preceded by asymptomatic periods of varying duration. Older adults represent the final stage in the human lifespan and experience the natural aging process. This study employed an analytic survey design with a cross-sectional approach. The purpose of this study was to determine the relationship between gout arthritis pain and the level of independence in activities of daily living among patients at the Helvetia Public Health Center. The results showed that the majority of older adults in the working area of UPT Puskesmas Helvetia experienced high levels of pain, with 73 respondents reporting severe pain. Meanwhile, most respondents demonstrated independence in their daily activities, with 72 categorized as independent. The findings indicate a significant relationship between gout arthritis and the level of independence in activities of daily living among older patients at the Helvetia Public Health Center.

Pulmonary Tuberculosis (TB) is a contagious infectious disease caused by the bacterium Mycobacterium tuberculosis through droplets from patients diagnosed with TB. Based on the Global TB Report 2024, WHO reported that Indonesia ranks second in the world, where 81% of cases were confirmed and 90% of them had received treatment, where there was an increase in the number of cases compared to 2023 with 77% of confirmed cases and 88% of them received treatment. The increase in the number of pulmonary TB cases is inseparable from factors that determine the transmission of M. tb such as the concentration of organisms in the air related to ventilation and the length of time a person inhales contaminated air. To determine the relationship between ventilation conditions and home lighting to the incidence of pulmonary TB in the working area of ​​the Glugur Darat Health Center in 2025 This study is an analytical study with a cross-sectional study design. Sample selection used the consecutive sampling method with 56 patients who met the inclusion criteria. Of the 56 people who met the criteria, 30 people (53.6%) were pulmonary TB sufferers and 26 people (46.4%) were not pulmonary TB sufferers. The majority of respondents were male (38 people) and the highest number was found in the 18-59 age range (48 people) (85.7%). Regarding ventilation conditions, 34 people (60.7%) did not meet adequate ventilation requirements, and 29 homes (51.8%) did not meet adequate lighting requirements. There was a relationship between ventilation conditions and the incidence of pulmonary tuberculosis in the Glugur Darat Community Health Center work area, but there was no relationship between home lighting and the incidence of pulmonary tuberculosis in the Glugur Darat Community Health Center work area.

Stroke is a leading cause of disability that requires long-term rehabilitation. Herbal-based therapies, such as Shengmai San, may complement conventional medical treatments in aiding post-stroke recovery. This quasi-experimental study involved 10 post-stroke patients who received Shengmai San therapy for four weeks, with one session per week. Key parameters measured included blood pressure, muscle strength, motor function, sensory complaints (e.g., tingling, numbness), sleep quality, and Traditional Chinese Medicine diagnostic findings (pulse and tongue). The results showed clinical improvements across all patients, including stabilized blood pressure, enhanced muscle strength and mobility, reduced sensory complaints, better sleep quality, and increased physical stamina. Pulse and tongue diagnostics suggested improved Qi and Xue circulation. No significant side effects were reported. The study concludes that Shengmai San is a promising adjunct therapy for post-stroke rehabilitation, especially for patients with Qi deficiency and impaired blood circulation. However, the study suggests that Shengmai San should not replace conventional treatments but be used as a complementary therapy to support recovery.

Appendicitis is inflammation and obstruction of the vermiform appendix and is the most common cause of acute abdomen. A surgical wound is said to be infected if the wound discharges pus or pus and is likely infected if it shows signs of inflammation or discharges serous discharge. The purpose of this study was to determine the effect of modern wound care dressing tribee ointment on preventing infection in wound healing after laparotomy exploration appendectomy at Yarsi Cempaka Putih Hospital. The method in this study was pre-experiment one group pre-test and post-test. The population and sample were 18 respondents. The results of the study showed the effect of modern wound care dressing tribee ointment in preventing infection in wound healing in patients after laparotomy exploration appendectomy at Yarsi Cempaka Putih Hospital with a p value of 0.000 <0.05. The conclusion is that there is an effect of modern wound care dressing tribee ointment in preventing infection in wound healing in patients after laparotomy exploration appendectomy.

Preoperative anxiety can lead to increased blood pressure, accelerated heart rate, and bleeding. One of the non-pharmacological interventions that can be provided is dhikr therapy, particularly tahlil dhikr (repeated recitation of La ilaha illallah). This study aims to determine the effect of tahlil dhikr on reducing anxiety in preoperative patients. This research is a quantitative study with a quasi-experimental design, using a one-group pretest-posttest approach. Data collection was conducted from May 22 to May 27, 2025, at Meuraxa Hospital. The population in this study consisted of 270 patients scheduled for surgery at Meuraxa Hospital, Banda Aceh, with a sample of 73 respondents selected through random sampling. The research instruments used were the Standard Operating Procedure (SOP) for Tahlil Dhikr Therapy and the Depression Anxiety Stress Scale 21 (DASS-21) questionnaire, which had a Cronbach’s Alpha score between 0.6 – 0.7 and was considered reliable with a result > 0.6. The results showed a decrease in the intensity of anxiety after the administration of tahlil dhikr. Data analysis using the Wilcoxon Signed-Rank Test showed a p-value = 0.000 (≤ 0.05), indicating a significant effect of tahlil dhikr on reducing preoperative anxiety among patients at Meuraxa Hospital, Banda Aceh. The study recommends the integration of tahlil dhikr as an alternative method for reducing anxiety in preoperative patients.

The problem that is often faced by patients after cesarean section surgery is pain in the operating area, many therapies are used to reduce pain scores in patients. From non-medical mentosa, medical therapy to pain intervention. Two of the methods to reduce postoperative cesarean section pain are intrathecal morphine injections and transversus abdominis muscle blocks (TAP blocks). This study aims to find differences in pain scores after sectio caesaria surgery between patients who received intrathecal morphine and patients who received TAP block. An experimental study used the Post Test Only Control Group Design on Dirgahayu Hospital patients. A total of 108 patients were divided into 3 groups. Group K was not intervened by pain, group B was intervened by TAP block, group M was intervened with intrathecal morphine injection. VAS score was measured at the 4th hour postoperatively. Data were analyzed with the One-Way ANOVA test followed by the Post Hoc Test Bonferroni. Lower pain score was obtained in the group that received pain intervention than the control group with a significant difference (p<0.05). The pain scores of patients who received TAP block were lower than those who received intrathecal morphine with a significant difference (p<0.05). There was a significant difference in pain scores between intrathecal morphine and TAP block. It is hoped that TAP block administration will be used to reduce the pain scale after sectio caesaria surgery. Further research is needed regarding these 2 methods.

Hallucinations are one of the symptoms of mental disorders in individuals which are characterized by sensory perception changes, namely feeling false sensations in the form of sounds, sight, tasting, touching or smelling. The application of drawing therapy in patients with auditory hallucination disorder may reduce hallucinogenic stimuli. The goal is to apply and analyze Nursing Care in Patients with Mental Disorders with the implementation of the application of drawing therapy to control auditory hallucinations. The method used in this is descriptive analysis with a case study approach. This study describes the application of drawing therapy to reduce the signs and symptoms of auditory hallucinations. It was also carried out by providing an intervention to apply drawing therapy for 15 minutes every day to three respondents for 7 consecutive days. The application of drawing therapy to the three respondents obtained results in the reduction of hallucinations from a moderate hallucinatory level score (22) to a mild level with a score (9). Brother B experienced a decrease in hallucinations from a moderate hallucination level score (20) to no hallucinations on days 6 and 7 with a score of (0). Brother JS decreased from a moderate hallucination level of score (20) to no hallucination on day 7 with a score of (0). It is hoped that the results of this study can provide an understanding of the application of drawing therapy to control auditory hallucinations.

Diabetic foot ulcer is a disease of the feet of DM sufferers with the characteristics of sensory, motor, autonomic neuropathy as well as macrovascular and microvascular disorders. Diabetic foot injuries are one of the complications that DM sufferers fear because they can result in amputation. Modern Dressing wound treatment with the Moist Wound Healing method is effective in healing ulcer wounds in DM patients. The wound healing method aims to maintain the moisture of the wound by using a moisture-retaining bandage so that wound healing and tissue growth can occur naturally. To determine nursing care in dm patients with leg injuries the application of Modern Dressing wound care using metcovazin and foam in diabetic ulcer patients. This study presents a descriptive study describing the treatment of ulcer wounds in DM patients with Modern Dressing wound treatment using a case study approach. Based on the results of the application of Evidence Based Practice (EBP) dapart, it is concluded that the application of Modern Dressing wound care is more effective than conventional wound treatment. as evidenced by the change in the decreased score in Mrs. N with 3 intervention processes, namely by decreasing the initial score of 30 down to 22 after Modern Dressing wound treatment. Modern dressing is more effective for diabetic foot ulcer care because it accelerates new tissue growth, reduces pain, and lowers the risk of infection.

Stroke is a serious neurological disorder. A stroke is an acute attack that can cause death or disability, both physically and mentally. Muscle weakness is one of the most common clinical signs experienced by stroke patients. One way to prevent permanent disability in stroke patients is to train muscle strength through acupressure therapy. This study aims to analyze the application of nursing care through acupressure therapy in improving muscle strength in stroke patients. The method used is a case study using a descriptive one-group research method with a pre-test-post-test design on three stroke patients with an intervention of 7 consecutive days with a frequency of 2 times a day for a duration of 12 minutes. The results showed that respondent I's muscle strength before therapy was on a scale of 3 and post-therapy was on a scale of 4, respondent II's pre-therapy was on a scale of 1 and post-therapy was on a scale of 1, and respondent III's pre-therapy was on a scale of 3 and post-therapy was on a scale of 4. It was concluded that acupressure therapy is effective as an additional therapy in nursing practice to help improve muscle strength in stroke patients.

Asthma is a heterogeneous disease characterized by chronic inflammation of the airways and respiratory symptoms such as wheezing, shortness of breath, chest tightness, and cough, which vary over time in both frequency and severity. This condition is accompanied by limitations in expiratory airflow, which can be either reversible or persistent. In asthma patients, especially those treated in the Emergency Department (ED), a common nursing problem is ineffective airway clearance due to mucus accumulation and bronchospasm. One strategy to address this is the administration of warm drinking water, aimed at improving airway clearance. The design used in this final nursing scientific paper is a qualitative case study with an intervention of warm water intake. The subjects of this study consisted of 3 asthma patients in the ED, and the intervention was conducted from January 3-11, 2026, at the Emergency Department of Charitas Hospital Km.7 Palembang. Airway clearance was measured before and after the intervention, which involved giving 200 ml of warm water at 38ºC, without a control group. After the intervention, all three patients showed improved airway clearance, indicated by more effective coughing, decreased sputum production, reduced wheezing, improved breathing patterns, and improved respiratory rate. The implementation of this evidence-based practice (EBP) is expected to provide additional information regarding the use of nonpharmacological therapy, specifically the administration of warm drinking water, in asthma patients with ineffective airway clearance.