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The purpose of this research is to examine how guidance and counseling instructors may help children in junior high get over their anxiety about speaking out in class. Students' lack of confidence and engagement in class might be exacerbated by the widespread problem of their fear of asking questions. In order to delve further into the issue, this study used a descriptive technique based on qualitative research. Students and instructors of guidance and counseling participated in interviews and observations to compile the data. The results highlight the important role that counseling and guidance instructors play in assisting students in coping with anxiety. Counseling sessions with individuals, group guidance exercises, and making an attempt to establish a welcoming classroom setting all contribute to this goal. Teachers also use excellent communication tactics and motivating initiatives to help pupils feel more comfortable expressing themselves. A more favorable classroom environment may also be achieved via collaboration between topic teachers and counseling instructors. Ultimately, the research demonstrates that students' anxiety of asking questions may be successfully reduced via the use of suitable counseling and guiding interventions. Consequently, students' self-esteem, classroom engagement, and academic performance are all much improved when guidance and counseling instructors are present.

Asthma is a chronic inflammatory disease of the airways characterized by reversible bronchoconstriction, mucus hypersecretion, and bronchial hyperresponsiveness. This condition causes shortness of breath, coughing, wheezing, and increased respiratory rate which impacts increased respiratory muscle work. One of the non-pharmacological interventions that can be applied in nursing practice is diaphragmatic breathing relaxation to help improve breathing patterns and increase respiratory muscle relaxation. Objective: To analyze the application of diaphragmatic breathing relaxation in improving respiratory muscle relaxation in asthma patients in the inpatient ward. Method: The study used a case study design with an Evidence Based Practice (EBP) approach. The research subjects were three asthma patients who experienced increased respiratory frequency. The intervention was carried out for three days in the form of structured diaphragmatic breathing exercises. Data were collected through nursing assessment, observation of respiratory frequency before and after the intervention, and evaluation of patient responses. Results: Before the intervention, all respondents experienced tachypnea with the use of accessory respiratory muscles. After three days of diaphragmatic breathing relaxation, the respiratory rates of all three respondents returned to normal (12–20 breaths/minute), respiratory muscle tension decreased, and the patients appeared more relaxed. Conclusion: Diaphragmatic breathing relaxation is effective in increasing respiratory muscle relaxation and stabilizing respiratory rate in asthmatic patients. This intervention can be used as part of non-pharmacological nursing care for patients with respiratory system disorders.

Developmental Dysplasia of the Hip (DDH) in children often results in joint stiffness, muscle weakness, limited range of motion, and gait impairment following surgical management and immobilization. Early physiotherapy intervention is essential to restore hip function and walking ability. This study aimed to evaluate the effectiveness of active exercise on functional walking in outpatient children aged 3–5 years after DDH surgery. A case study design was conducted on three female patients who completed a five-week rehabilitation program consisting of ten active exercise sessions, including hip strengthening, mobility training, and balance exercises, combined with a home program. Outcome measures included hip range of motion, Manual Muscle Testing, and Modified McKay and Harris Hip Score assessed at baseline, mid-intervention, and post-intervention. The results showed improvements in hip range of motion, particularly in flexion, extension, abduction, adduction, and external rotation, while internal rotation improved but did not reach normal values. Muscle strength increased from grade 1–2 to grade 3 in most hip muscle groups. Functional walking scores improved from poor to good and excellent, with patients achieving independent, symmetrical gait without pain. These findings indicate that active exercise is an effective rehabilitation approach to reduce impairments and enhance functional walking in children after DDH surgery. The study highlights the importance of structured physiotherapy and caregiver involvement to optimize recovery and participation in daily activities.

Pulmonary tuberculosis is a chronic infectious disease that can cause impaired gas exchange due to lung tissue damage, increased mucus production, and decreased lung elasticity. This condition may lead to shortness of breath, decreased oxygen saturation, and ineffective breathing patterns. Non-pharmacological nursing interventions such as pursed lip breathing exercise and body positioning are needed to improve respiratory function. The combination of pursed lip breathing exercise and the high Fowler position is expected to enhance alveolar ventilation and improve oxygenation in patients with pulmonary tuberculosis.Method: This study is a quantitative research with a pre-experimental/quasi-experimental design using a pre-test and post-test approach. The sample consists of pulmonary tuberculosis patients who experience impaired gas exchange and meet the inclusion criteria. The intervention provided is a combination of pursed lip breathing exercise and the high Fowler position. Gas exchange is measured by assessing oxygen saturation and respiratory rate before and after the intervention. Data will be analyzed using appropriate statistical tests to determine the effect of the intervention.Results: The expected results of this study are an increase in oxygen saturation and improvement in respiratory rate after the application of the combination of pursed lip breathing exercise and the high Fowler position in patients with pulmonary tuberculosis.Conclusion: The combination of pursed lip breathing exercise and the high Fowler position is expected to have a positive effect on improving gas exchange in patients with pulmonary tuberculosis and can be applied as an independent nursing intervention in clinical practice.

Lifestyle changes, such as smoking habits, low physical activity, and suboptimal sleep patterns, have the potential to affect various health indicators. However, empirical evidence showing a direct link between lifestyle factors and objective health indicators still shows varying results. This study aims to analyze the relationship between lifestyle factors and health indicators in adult respondents, in an effort to provide an empirical picture of behavioral factors related to health conditions. This study used a quantitative approach with a cross-sectional observational analytic design. Data were obtained from 94 respondents who had complete lifestyle data and health examination results. Lifestyle factors analyzed included smoking habits, exercise frequency, and sleep duration, while health indicators included body mass index (BMI), systolic and diastolic blood pressure, blood sugar levels, cholesterol, uric acid, and pulse rate. Data analysis was performed using descriptive statistics, the Shapiro–Wilk normality test, and the Spearman correlation test according to the characteristics of the data distribution. The results showed that smoking habits were significantly associated with diastolic blood pressure (p < 0.05), exercise frequency was significantly associated with BMI and systolic blood pressure (p < 0.05), and sleep duration was significantly associated with uric acid levels (p < 0.05). Meanwhile, the relationship between lifestyle factors and other health indicators did not show statistical significance. These findings indicate that the influence of lifestyle on health is specific to certain indicators and is not evenly distributed across all health parameters. This study concludes that identifying lifestyle factors relevant to certain health indicators is important as a basis for formulating more targeted health promotion strategies.

Hypertension is one of the most common chronic diseases among the elderly and is often accompanied by insomnia. This condition can increase anxiety and reduce quality of life. Progressive Muscle Relaxation (PMR) is an effective non-pharmacological therapy to lower blood pressure and improve sleep quality. This paper describes nursing care for elderly patients with hypertension and insomnia through PMR application at RSUD Embung Fatimah Batam City in 2025. A case study approach was used through the nursing process, including assessment, nursing diagnosis, intervention, implementation, and evaluation. The main nursing diagnosis was sleep pattern disturbance related to physical discomfort and anxiety. Interventions included education and PMR exercises for six consecutive days. Results showed blood pressure decreased from 180/100 mmHg to 130/80 mmHg, sleep quality improved from difficulty sleeping to 6–7 hours per night, and anxiety levels reduced. Progressive muscle relaxation therapy proved effective as an independent nursing intervention to reduce blood pressure and improve sleep quality in elderly patients with hypertension and insomnia. Nurses should use this therapy as a routine non-pharmacological intervention in gerontological nursing practice.

Type 2 diabetes mellitus in the elderly significantly impacts quality of life (QoL) due to physiological changes in aging, comorbidities,and the risk of chronic complications. Nutritional management is considered a key intervention to improve glycemic control and functional status in the elderly.Objective: To review the current evidence regarding the effect of nutritional interventions on the quality of life in elderly with type 2 diabetes mellitus through a Literature Review approach.Methods: The Literature Review was conducted by identifying articles from the Scopus database published in 2020–2025. The review process included screening based on inclusion-exclusion criteria, eligibility assessment, and narrative synthesis of relevant studies,including controlled trials,quasi-experimental studies, observational studies, and systematic observations.Results: From the selected studies, interventions with a low glycemic index diet and a balanced diet have been shown to reduce HbA1c levels and the risk of complications; a multicomponent program combining diet and exercise produces synergistic effects on glucose control, physical function,and quality of life.Structured nutrition education (DSME) and family involvement improve satisfaction and metabolic outcomes.The use of technology (mobile apps) shows potential in monitoring intake and glucose,although digital literacy challenges and limited sample size and study design are often limitations.Conclusion: Targeted nutrition interventions, especially when combined with exercise, education,family support,and age-friendly technology,have the potential to improve metabolic control and quality of life in older adults with T2DM.Recommendation: Large-scale RCTs and more robust longitudinal studies are needed to establish the long-term effectiveness and cost-effectiveness of multicomponent nutrition interventions and technology adaptations for older adults with multimorbidity.

This study aims to develop a pop-up book learning medium with the theme “Einkaufen” (Shopping) as a German language instructional medium for Grade XI students at SMA Negeri 3 Binjai. The background of this study is the low level of students’ understanding of the learning materials and their lack of learning motivation due to the use of monotonous conventional media. This research employs a Research and Development (R&D) approach using the ADDIE development model, which includes the stages of Analysis, Design, Development, Implementation, and Evaluation. The results of the implementation stage indicate that 98.3% of students agreed that the pop-up book is effective for use in German language learning, and 96.7% stated that the material content is easy to understand. The pop-up book consists of six pages containing learning materials and exercises that focus on reading, writing, and speaking skills. Validation by material and media experts yielded a score of 90, categorized as very good. These findings demonstrate that the developed pop-up book medium is not only visually engaging but also capable of enhancing students’ motivation and comprehension in an integrative German language learning process. This medium can serve as an effective alternative for improving the quality of foreign language learning at the secondary school level.

Exercise is a planned physical activity that not only contributes to physical fitness but also plays a significant role in maintaining and improving mental health. This study aims to explore the relationship between physical exercise and mental well-being among adolescents and university students with diverse backgrounds of physical activity. The research employs a qualitative approach using in-depth interviews with five informants, consisting of university students who engage in recreational exercise, recreational runners, middle- and long-distance runners, and a sprinter. Data collection was conducted in several public sports spaces in the city of Bandung, focusing on participants’ subjective experiences related to their psychological conditions before and after engaging in exercise. The findings indicate that all participants perceive exercise as an effective means of emotional regulation. Physical activity is consistently associated with improved mood, reduced stress, enhanced sleep quality, stable energy levels, and increased academic concentration and focus. In addition, exercise contributes to the development of self-confidence, self-efficacy, and self-control through structured routines. The social aspects of exercise, such as support from peers, communities, and coaches, were shown to strengthen the sustainability of physical activity while also providing essential emotional support for mental health. However, among competitive athletes, performance-related pressure was identified as a factor that may negatively affect psychological well-being, although this effect can be moderated by adequate social support. Overall, the findings of this study emphasize that exercise functions as an adaptive coping mechanism operating through biological, psychological, and social pathways, and highlight the importance of consistency and balance in physical activity to achieve optimal mental health benefits.  

The "Desa Sehat Berdaya: Digital-Based Health and Local Economy Innovation" program was implemented in Bulawan 2 Village to address low awareness of preventive health, Clean and Healthy Living Behaviors (PHBS), and limited social education for children and adolescents on bullying, early marriage, and drug abuse (NAPZA). The goal was to improve public health through promotive-preventive interventions, enhance health cadre capacity for sustainable village programs, and increase understanding of healthy behaviors and social risks among youth. A participatory-collaborative approach was used, involving community organization, multi-party coordination, program presentation, intervention implementation, evaluation, and follow-up with health cadres, alongside simple digital media utilization. Results showed increased community participation in posyandu, healthy exercises, and free health checkups, as well as improved cadre capacity through MP-ASI training. For youth, PHBS socialization, anti-bullying, early marriage education, and NAPZA awareness enhanced understanding of healthy behaviors and social issues. Collaboration with Karang Taruna strengthened youth participation and social cohesion.

Financial literacy is an important skill that needs to be introduced from an early age so that children can understand the value of money and manage it wisely. This activity aims to improve basic financial literacy among children at LKSA Santa Anna Bojonegoro through a participatory educational approach. The implementation method included pre tests, interactive material delivery, discussions, and simple case studies on priority scales and budgeting. Of the 37 participants, 20 children aged 8–18 were sampled. The pre-test results showed an average understanding of basic financial literacy concepts of 73.6%. After the activity, there was an increase in understanding, indicated by the participants' ability to differentiate needs from wants, develop spending plans, and foster savings awareness. The facilitator also found that the main issue among participants was self-control over consumptive behavior, which was addressed through reflective exercises and the implementation of strategies for delaying purchasing decisions. This activity was well-received and proven effective in fostering a rational mindset regarding pocket money management. Overall, this socialization of basic financial literacy can be the first step in developing responsible financial habits from an early age.

This study explores the use of English movies as an alternative approach to English language learning for university students, examining its impact on language skills, learning motivation, and cultural awareness. A qualitative narrative inquiry method was employed to capture students' experiences and perspectives on learning through films. The research involved eight university students, selected purposefully, and data was gathered through in-depth interviews. The findings suggest that watching English movies significantly improves students' listening and speaking skills, vocabulary, fluency, and real-world language usage. English subtitles were found to play a critical role in enhancing students' understanding of sentence structures, spelling, and contextual meanings. Additionally, films were perceived as an engaging learning tool that reduced monotony and boosted motivation compared to traditional methods reliant on textbooks and grammar exercises. Moreover, students reported an increased understanding of cultural nuances, as films exposed them to authentic communication styles, expressions, and social contexts. However, the effectiveness of film-based learning depends on its consistent integration, the careful selection of films that match students' language proficiency levels, and structured pedagogical support. This study concludes that films, when systematically implemented, offer a dynamic and relevant method to engage students and enhance their language learning experience, making it a promising educational tool in higher education.

Health education at the elementary school level represents a long-term investment in developing a stronger and more capable generation. By fostering a proper understanding from an early age, children are expected to build a resilient defense against various health threats. This community service program aims to broaden the knowledge and awareness of students at SDN 054945 Dogang Village, Gebang District, Langkat Regency, North Sumatra, regarding Clean and Healthy Living Behavior (known as PHBS). As a promotive and preventive strategy, PHBS is essential to instill from childhood to cultivate healthy habits and prevent various health disorders. This study utilizes a qualitative approach, applying the Miles and Huberman interactive analysis model. The activity, conducted on July 20, 2024, involved 77 fourth and fifth-grade students and followed three main stages: preparation, implementation, and evaluation. Socialization was carried out interactively through handwashing tutorial videos, physical exercises, PHBS-themed songs and rhythmic clapping, and Q&A sessions. The results indicated an improvement in students' understanding of various PHBS indicators, including handwashing habits, waste management, healthy food consumption, physical activity, growth monitoring, avoiding tobacco smoke, maintaining toilet cleanliness, and eradicating mosquito larvae. The active participation shown by the students reflects a heightened awareness of practicing PHBS within the school environment. In conclusion, this educational initiative has delivered a positive impact on student knowledge and holds the potential to foster a sustainable culture of clean and healthy living, both at school and in their daily lives.

Listening skills are frequently regarded as the most challenging aspect of English language acquisition due to the complexity of the cognitive processes involved. In an orphanage environment, limited access to learning resources remains a primary obstacle to the development of this competence. This community outreach initiative aims to sharpen the listening skills of children at the Bonang Orphanage in Banjarmasin through the integration of subtitled YouTube videos and interactive repetition drill techniques. The implementation method involved 20 children selected via purposive sampling, utilizing a one-group pretest-posttest design. The intervention procedure encompassed the presentation of listening strategies, interactive discussions, and structured repetition exercises designed to build phonological automaticity. Quantitative evaluation results indicated a significant improvement, with the participants' mean score rising from 82.9 on the pretest to 86.7 on the posttest, with a maximum achievement score of 94. The discussion reveals that the use of subtitles serves as a visual scaffolding mechanism that facilitates sound-to-form mapping, while repetition drills strengthen the participants' working memory. Overall, the utilization of digital media and repetitive exercises proved effective in lowering cognitive barriers and increasing the participants' active engagement in English language learning.

This community service activity aims to enhance students' literacy skills through creative writing training. The target group consists of students at MTsN 2 INHIL Riau who are still in the early stages of developing writing abilities. The method of implementation includes interactive lectures on the fundamental concepts of creative writing, writing exercises on specific themes, group discussions, and intensive mentoring in creating simple written works. The results of the training show a significant improvement in students' motivation to write, their ability to express ideas in written form, and the production of creative works such as poetry and short stories. Additionally, this activity has sparked a sustained interest in developing a culture of literacy within the school environment, encouraging students to actively engage with writing beyond the training sessions. This indicates that creative writing training is not only effective in developing student potential but also contributes to the strengthening of the madrasah literacy movement, creating a lasting impact on students' literacy habits.

The advancement of digital technology has made computer literacy and language comprehension increasingly important. Playing games has become a daily habit for young children. Scratch is an innovative and child-friendly platform. This community service program aims to introduce basic programming concepts to sixth-grade students of Bulupasar Elementary School, Kediri, using the Scratch platform. This program adopts the Direct Instruction method, also known as hands-on learning. This one-day session involved 43 students who underwent a structured process consisting of a pre-test, material delivery, hands-on practice, such as using code blocks, introducing sprites, and creating a simple game, which was explained clearly and structured. During the project implementation phase, each student successfully created a simple animation project with the theme "Catch the Apple" and then conducted practical exercises to try it out on their own with direct guidance. This community service activity was successful, according to the analysis of the pre-test and post-test results. The resources used to create the simple game showed positive results and confirmed the importance of introducing children to the digital world from an early age. Qualitative evaluations revealed positive responses from all participants. Student comments reflected high enthusiasm for learning to code, with the majority expressing a desire to continue exploring Scratch independently. Several students expressed interest in creating future projects, suggesting the program has potential for implementation in other schools to encourage early introduction to programming and help prepare them for the future in an era of ever-evolving technology.

Non-hemorrhagic stroke occurs due to blockage of blood flow to the brain by a thrombus or embolus. The blockage results in focal neurological disorders that affect the musculoskeletal system, namely weakness in the extremities, which gives rise to nursing problems of impaired physical mobility. To overcome the problem of impaired physical mobility, rubber ball grip exercises (ball squeezing) are given. These exercises have been shown to increase muscle strength, prevent joint stiffness, and improve blood circulation. This scientific paper was conducted to determine the description of nursing care for non-hemorrhagic stroke patients with nursing problems of impaired physical mobility. During the meeting, the nurse provided rubber ball grip exercises (ball squeezing) for 10-15 minutes for 3 times in 24 hours. Evaluation of these actions showed that the patient who initially experienced weakness in the upper extremities with muscle strength 2-3 and after being given rubber ball grip exercises (ball squeezing), the problem of impaired physical mobility was resolved, as evidenced by the patient being able to perform therapy, the extremities feeling slightly lighter, and muscle strength 4. Therefore, it is recommended that non-hemorrhagic stroke patients be given rubber ball grip exercises (ball squeezing) to overcome impaired physical mobility.

Stroke is a major cause of long-term disability and frequently results in balance impairment that limits functional mobility and increases the risk of falls. Impaired trunk control and postural instability are common consequences of stroke, highlighting the need for effective rehabilitation strategies. This study aimed to analyze the effect of Core Stability Exercise on balance improvement in stroke patients undergoing rehabilitation at the Medical Rehabilitation Polyclinic of RS Adhyaksa Jakarta. A case study design with a pretest–posttest approach was applied to three patients with ischemic stroke who presented with balance disorders. The intervention consisted of Core Stability Exercise, including bridging, bird-dog exercise, and seated balance exercise, conducted three times per week for eight sessions. Balance performance was measured using the Berg Balance Scale before and after the intervention. The findings demonstrated a consistent increase in Berg Balance Scale scores in all patients, indicating improvements in static and dynamic balance as well as a reduction in fall risk. Patients with better initial motor control showed faster and greater improvement, although positive changes were also observed in patients with more severe impairments. These results suggest that Core Stability Exercise contributes to enhanced trunk stability, postural control, and functional balance in stroke patients. The study implies that integrating Core Stability Exercise into routine physiotherapy programs may support more comprehensive and individualized stroke rehabilitation, particularly in addressing balance-related functional limitations.

Pregnancy is a crucial period that requires intensive maternal health monitoring. Prenatal exercise is a non-medical intervention that is beneficial for improving physical fitness, reducing pregnancy complaints, and preparing mothers for childbirth. This study aims to determine whether there is a relationship between the knowledge and attitudes of pregnant women and the implementation of prenatal exercise at the Dolik Community Health Center. This study design was quantitative descriptive analytic with a cross-sectional approach. The sample consisted of 28 pregnant women selected using purposive sampling. Data were collected through a structured questionnaire regarding knowledge, attitudes, and implementation of prenatal exercise, then analyzed using the Chi-Square test. The results showed that the majority of pregnant women had good knowledge (60.7 %) and a positive attitude towards prenatal exercise (64.3%). Bivariate analysis showed a significant relationship between knowledge and implementation of prenatal exercise (p = 0.021) and between attitude and implementation of prenatal exercise (p = 0.034). Mothers with good knowledge and positive attitudes were more likely to regularly participate in prenatal exercise. This study shows a relationship between knowledge and attitudes and implementation of prenatal exercise, so increasing education and fostering positive attitudes are important strategies to encourage participation of pregnant women.

Hypertension is a public health problem that requires educational approaches and nonpharmacological interventions. This community service activity aimed to improve knowledge and support community-based hypertension management through health education, hypertension exercise, and cucumber juice therapy in RT 03 RW 08 Lenteng Agung, South Jakarta. The activity was conducted in three stages. The preparation stage included site selection, door-to-door screening of individuals with hypertension, which identified 32 hypertensive residents, obtaining informed consent, and preparing the instruments. The implementation stage consisted of hypertension education with pre-test and post-test knowledge assessments, as well as demonstrations of hypertension exercise and cucumber juice preparation involving 29 participants. Participants were encouraged to perform the exercise and consume cucumber juice regularly for seven days at home. The evaluation stage assessed changes in blood pressure after the intervention. The results showed improved knowledge and reduced blood pressure in most participants. This activity was effective in supporting hypertension management in the community.