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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.

Congestive heart failure (CHF) is a cardiovascular disease that frequently causes shortness of breath (dyspnea) and negatively impacts patients’ quality of life. The management of dyspnea involves not only pharmacological approaches but also nonpharmacological interventions, one of which is handheld fan therapy, which works by stimulating sensory receptors in the facial area. This study aims to describe the effect of handheld fan therapy on reducing shortness of breath in patients with CHF. This study employed a descriptive design using a case report method on a single 63-year-old female patient diagnosed with CHF. The intervention was conducted over four days, involving the use of a handheld fan for 10 minutes, held at a distance of 15–30 cm from the face and directed toward the nose and mouth. Measurements were taken before and after the intervention using respiratory rate and oxygen saturation as parameters. The results showed a gradual decrease in respiratory rate from 24 breaths/minute to 18 breaths/minute, as well as an increase in oxygen saturation from 91% to 96% during the intervention period. These findings indicate an improvement in breathing patterns and increased respiratory efficiency in the patient. Handheld fan therapy is effective as a nonpharmacological intervention for reducing shortness of breath and improving oxygenation in patients with CHF. This intervention is safe, easy to use, and can be implemented as a complementary therapy in nursing practice.

Turbinate hypertrophy is a condition characterized by abnormal enlargement of the nasal turbinate mucosa, which can lead to chronic nasal obstruction and decreased quality of life. This condition is associated with inflammatory processes in which eosinophils play a role as part of the immune response. This study aimed to determine the relationship between eosinophil levels and the degree of turbinate hypertrophy based on blood examination in hospitalized patients. This research used an observational analytic design with a cross-sectional approach involving 40 patients diagnosed with turbinate hypertrophy at Cut Meutia General Hospital, North Aceh. Data were obtained from medical records, including patient characteristics, eosinophil levels, and the degree of turbinate hypertrophy. The results showed that most patients were aged 17–25 years, predominantly female, and commonly had non-allergic underlying conditions. The majority of patients had normal eosinophil levels (80%), while most cases were classified as grade III turbinate hypertrophy (65%). Statistical analysis using Fisher’s Exact Test demonstrated no significant relationship between eosinophil levels and the degree of turbinate hypertrophy (p>0.05). These findings suggest that eosinophil levels may not be a reliable indicator in assessing the severity of turbinate hypertrophy, particularly in patients with non-allergic conditions. This study highlights the need to consider other contributing factors in the evaluation and management of turbinate hypertrophy to improve diagnostic accuracy and treatment outcomes.

Type 2 diabetes mellitus is a chronic condition marked by elevated blood glucose levels resulting from insulin resistance and decreased insulin secretion. Effective glycemic control is crucial to prevent complications, and HbA1c is commonly utilized as an indicator of long-term blood glucose levels. This study aimed to examine the relationship between HbA1c levels and blood glucose levels among patients with type 2 diabetes mellitus at Tilamuta Community Health Center, Boalemo Regency, Gorontalo Province. This study employed an analytical cross-sectional design using a total sampling method, involving 557 patients. Data were collected from laboratory records and analyzed through descriptive statistics, the Shapiro-Wilk test for normality, Spearman correlation, and chi-square test. The findings indicated that the average HbA1c level was 7.39%, while the mean blood glucose level was 205.85 mg/dL. A significant and very strong positive correlation was found between HbA1c and blood glucose levels (p=0.000; r=0.862). Furthermore, medication adherence showed a significant association with HbA1c status (p=0.000). These results underscore the role of HbA1c as a dependable marker for assessing glycemic control and highlight the importance of medication adherence in optimizing the management of type 2 diaType 2 diabetes mellitus is a chronic condition marked by elevated blood glucose levels resulting from insulin resistance and decreased insulin secretion. Effective glycemic control is crucial to prevent complications, and HbA1c is commonly utilized as an indicator of long-term blood glucose levels. This study aimed to examine the relationship between HbA1c levels and blood glucose levels among patients with type 2 diabetes mellitus at Tilamuta Community Health Center, Boalemo Regency, Gorontalo Province. This study employed an analytical cross-sectional design using a total sampling method, involving 557 patients. Data were collected from laboratory records and analyzed through descriptive statistics, the Shapiro-Wilk test for normality, Spearman correlation, and chi-square test. The findings indicated that the average HbA1c level was 7.39%, while the mean blood glucose level was 205.85 mg/dL. A significant and very strong positive correlation was found between HbA1c and blood glucose levels (p=0.000; r=0.862). Furthermore, medication adherence showed a significant association with HbA1c status (p=0.000). These results underscore the role of HbA1c as a dependable marker for assessing glycemic control and highlight the importance of medication adherence in optimizing the management of type 2 diabetes mellitus.betes mellitus.  

Meningitis is a serious infectious disease that can be prevented through vaccination; however, the vaccination process often causes anxiety in patients, especially during the pre-procedure phase. Uncontrolled anxiety can affect patient readiness and comfort. Therapeutic communication by nurses is one intervention that has the potential to reduce this level of anxiety. This study aims to determine the relationship between nurses’ therapeutic communication and the anxiety levels of patients prior to meningitis vaccination at Pambalah Batung Amuntai Regional General Hospital. This study used a quantitative analytic design with a cross-sectional approach. The sample consisted of 107 respondents selected using a convenience sampling technique. Data on therapeutic communication were collected using an observation sheet, while anxiety levels were measured using the DASS questionnaire (anxiety subscale). Data analysis was conducted using univariate and bivariate methods with the Chi-Square test at a significance level of 0.05. The results showed that most therapeutic communication was in the good category, and patient anxiety levels were predominantly in the normal category. Statistical test results indicated a significant relationship between nurses’ therapeutic communication and patient anxiety levels (p = 0.000 < 0.05). The better the therapeutic communication provided, the lower the patient’s anxiety level. In conclusion, nurses’ therapeutic communication plays an important role in reducing patient anxiety prior to meningitis vaccination and needs to be optimized in nursing practice.

Background: Anxiety can affect physiological functions in patients prior to surgery, including increased heart rate and respiration, changes in blood pressure and temperature, relaxation of smooth muscles in the bladder, cold and clammy skin, and dry mouth, which may reduce the patient’s energy level. Psychologically, anxiety can lead to increased postoperative pain, delayed wound healing, increased physical disability, and decreased quality of life. One effective non-pharmacological intervention to reduce anxiety is Benson relaxation therapy. Objective: This study aimed to determine the effect of benson relaxation therapy on reducing anxiety levels in pre operative. Methods: This study used a case study design involving one preoperative patient with anxiety symptoms in the Teratai Ward of Prof. Dr. Margono Soekarjo Hospital, Purwokerto. Benson relaxation therapy was administered for 3 days, twice daily, with a duration of 15 minutes per session. Anxiety levels were measured using the Zung Self-Rating Anxiety Scale (ZSAS) before and after the intervention. Results: The patient showed a decrease in anxiety score from 55 (moderate anxiety) to 40 (mild anxiety) after receiving Benson relaxation therapy. Subjectively, the patient reported feeling calmer, more accepting, and motivated. Objectively, there was a reduction in heart rate and physical signs of anxiety. Conclusion: Benson relaxation therapy is effective in reducing anxiety levels in preoperative patients. This intervention can be used as a non-pharmacological alternative to support psychological recovery of pre-operative patients.

Telemedicine is a technology-based healthcare innovation that can improve access and efficiency. The quality of service provided by human resources (HR) plays a crucial role in determining patient satisfaction. This study aims to analyze the influence of HR service quality on patient satisfaction among telemedicine users. The method used was a literature review using a qualitative descriptive approach through analysis of scientific articles from various databases published between 2020 and 2025. The results indicate that HR service quality significantly influences patient satisfaction, particularly through aspects of reliability, responsiveness, assurance, empathy, and effective communication. Patient satisfaction is also influenced by ease of access, time efficiency, and trust in the services provided. However, limitations such as the lack of in-person physical examinations remain a challenge in the implementation of telemedicine. Therefore, improving HR competency, particularly in digital communication and technology utilization, is essential to improving the quality of telemedicine services. Therefore, HR service quality is a key factor in increasing patient satisfaction and the successful development of digital healthcare services.

Chronic Obstructive Pulmonary Disease is a chronic respiratory disease characterized by progressive and not fully reversible airflow limitation. Dyspnea is the primary symptom experienced by COPD patients and significantly affects their quality of life, especially among those hospitalized. This condition may lead to activity limitation, psychological distress, and decreased social functioning. This study aimed to determine the relationship between the level of dyspnea and the quality of life of COPD patients in the pulmonary inpatient ward of Cut Nyak Dhien General Hospital Meulaboh. This study employed an analytical design with a cross-sectional approach. The sample consisted of hospitalized COPD patients selected using purposive sampling. Dyspnea severity was measured using the Modified Medical Research Council (mMRC) scale, while quality of life was assessed using the St. George’s Respiratory Questionnaire (SGRQ). Data were analyzed using the Spearman correlation test to determine the relationship between variables.The results showed that most respondents experienced moderate to severe dyspnea and had poor quality of life. Statistical analysis revealed a significant relationship between dyspnea level and quality of life (p < 0.05) with a negative correlation.In conclusion, there is a significant relationship between dyspnea severity and quality of life in COPD patients, where higher dyspnea levels are associated with lower quality of life.

Cholelithiasis is the formation of hardened bile deposits within the gallbladder due to an imbalance in the chemical composition of bile, which can cause symptoms ranging from abdominal pain to serious complications such as cholecystitis, biliary obstruction, and gallbladder infection. This study aimed to determine the relationship between patient characteristics and the length of hospital stay in cholelithiasis patients at Cut Meutia General Hospital. This study used an analytical observational design with a cross-sectional approach and a retrospective study, employing a total sampling technique with 50 patients. The results showed that most patients were female (52.0%), with the largest age group being late elderly (28.0%). The most common surgical technique was laparoscopic cholecystectomy (42.0%), and the majority of patients received surgical management (60.0%). Bivariate analysis using the Chi-Square test showed significant relationships between age (p=0.000), gender (p=0.044), surgical technique (p=0.029), and management (p=0.045) with the length of hospital stay in cholelithiasis patients. The conclusion of this study is that there is a relationship between patient characteristics and the length of hospital stay in cholelithiasis patients.

Diabetes mellitus type 2 is a chronic metabolic disorder that frequently affects elderly patients and is often accompanied by multiple comorbidities. The increasing prevalence of diabetes in the aging population contributes to higher morbidity and mortality, especially when complicated by geriatric syndromes, electrolyte imbalances, and infections such as pneumonia. This study aims to present a case of type 2 diabetes mellitus in an elderly patient with associated geriatric problems, electrolyte disturbances, and pneumonia. The method used is a descriptive case report based on clinical findings, laboratory examinations, and radiological assessment. A 76-year-old male presented with generalized weakness, weight loss, decreased appetite, respiratory symptoms, and functional decline. Physical examination and laboratory findings revealed uncontrolled diabetes, electrolyte imbalance, hypoalbuminemia, and signs of infection. Chest radiography confirmed pneumonia. Management included pharmacological therapy such as antibiotics, fluid and electrolyte correction, and supportive care, along with non-pharmacological interventions including dietary regulation and monitoring. The findings highlight the complexity of managing elderly patients with multiple comorbid conditions, emphasizing the need for a comprehensive and multidisciplinary approach. Early detection and appropriate management are essential to improve clinical outcomes and prevent further complications in geriatric patients with diabetes mellitus.

Nursing services are a fundamental part of the hospital service system because nurses interact frequently with patients, particularly in inpatient rooms. The quality of nursing services significantly impacts patient satisfaction. This study aims to determine the relationship between the quality of nursing services and patient satisfaction in the inpatient rooms of UMMI Hospital Bogor. This study used a correlational analytical research design with a cross-sectional approach. The population in the study were 1,944 inpatients at UMMI Hospital Bogor. The sample calculation used the Slovin formula with a simple random sampling technique and obtained 332 respondents. The research instrument for the quality of nursing services was based on the five dimensions of SERVQUAL (tangible, reliability, responsiveness, assurance, and empathy) and a patient satisfaction questionnaire. Data analysis was performed univariately and bivariately using the Chi-Square Test statistic. The results showed that the majority of respondents rated the quality of nursing services as good, namely 214 people (64.5%), while respondents who rated the quality of nursing services as poor were 118 people (35.5%). Patient satisfaction results revealed that of the 332 respondents, the majority (230 people or 69.3%) expressed satisfaction, while 102 (30.7%) expressed dissatisfaction. The statistical test results showed a p-value of 0.000 (p < 0.05). The conclusion of this study is that there is a significant relationship between the quality of nursing services and patient satisfaction in inpatient wards. Therefore, continuous improvement in the quality of nursing services is necessary to enhance patient satisfaction and the quality of hospital services.

A Normocytic normochromic anemia is one of the most common types of anemia found in geriatric patients with chronic diseases or acute bleeding. Upper gastrointestinal bleeding (UGIB) may cause continuous blood loss resulting in decreased hemoglobin levels. This case report discusses a 72-year-old woman who presented to the Emergency Department of Cut Meutia Regional General Hospital with complaints of black stools for four days prior to admission accompanied by epigastric pain, nausea, weakness, and pallor. The patient had a history of long-term use of analgesic and anti-gout medications due to chronic joint pain, which was suspected to be a risk factor for UGIB. Physical examination revealed pale conjunctiva and tachycardia, while laboratory findings showed hemoglobin of 7.1 g/dL, hematocrit of 23.3%, MCV of 82 fL, MCH of 29 pg, and uric acid level of 11.56 mg/dL, leading to the diagnosis of normocytic normochromic anemia caused by UGIB accompanied by gout arthritis. The patient received intravenous fluid therapy, proton pump inhibitors, antifibrinolytic agents, gastroprotective therapy, packed red cell transfusion, and other supportive treatments. During hospitalization, clinical improvement was observed, including cessation of gastrointestinal bleeding, reduced epigastric pain, and increased hemoglobin level to 8.6 g/dL. This case highlights the importance of early diagnosis and comprehensive management in geriatric patients with anemia caused by UGIB and comorbid gout arthritis.

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.

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.

Febrile seizures are seizure episodes that occur in association with an elevation in body temperature (rectal temperature >38°C) caused by an extracranial process. Febrile seizures are classified into two types: simple febrile seizures and complex febrile seizures. The World Health Organization (WHO) estimated that in 2019 there were 18.3 million cases of febrile seizures worldwide, with approximately 154,000 resulting in death. This case report discusses a patient, An YZ, a 1 year and 5-month-old female, who was brought to the emergency department of Cut Meutia Hospital with a chief complaint of seizures. The seizures began two days prior to hospital admission, characterized by generalized tonic stiffening and clonic movements involving the entire body. Each episode lasted approximately 5 minutes. The seizures occurred twice, initially at 7:00 PM and subsequently at 9:00 PM. The patient was diagnosed with complex febrile seizures associated with morbilli and very mild microcytic hypochromic anemia due to iron deficiency anemia. Pharmacological management included cefotaxime, ranitidine, ondansetron, paracetamol, ambroxol, cetirizine, diazepam (Stesolid), and vitamin D. After three days of hospitalization, the patient showed clinical improvement and was discharged.

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.  

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.

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.

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.