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Complementary therapy has recently become an important issue in many countries. Its use has increased due to several factors, including personal beliefs, cost considerations, the side effects of chemical medications, and expectations of recovery. One of the complementary therapies that is often chosen is warm water foot soaking combined with foot massage. This therapy has the potential to reduce blood pressure through relaxation mechanisms and peripheral vasodilation, which have been supported by scientific evidence.This study aimed to analyze the application of Evidence-Based Practice (EBP) of warm water foot soaking and foot massage therapy in hypertensive patients within nursing care. The method used was an EBP-based case study design involving three patients with hypertension. The intervention consisted of warm water foot soaking using approximately 2 liters of water at a temperature of 38–40°C combined with foot massage, administered once daily for three days. Blood pressure was measured before and after the intervention.The results showed a decrease in blood pressure: Mrs. S from 170/100 mmHg to 150/80 mmHg, Mrs. L from 170/80 mmHg to 150/80 mmHg, and Mr. F from 165/90 mmHg to 130/70 mmHg. Warm water foot soaking and foot massage were effective as non-pharmacological interventions to reduce blood pressure and improve comfort in patients with hypertension. ase study design involving three patients with hypertension. The intervention consisted of warm water foot soaking using approximately 2 liters of water at a temperature of 38–40°C combined with foot massage, administered once daily for three days. Blood pressure was measured before and after the intervention.The results showed a decrease in blood pressure: Mrs. S from 170/100 mmHg to 150/80 mmHg, Mrs. L from 170/80 mmHg to 150/80 mmHg, and Mr. F from 165/90 mmHg to 130/70 mmHg. Warm water foot soaking and foot massage were effective as non-pharmacological interventions to reduce blood pressure and improve comfort in patients with hypertension.

Healthcare institutions worldwide are undergoing digital transformation to improve efficiency and patient experiences. While many studies focus on clinical applications of information technology (IT), its impact on administrative service quality remains limited, even though administrative services are patients’ primary point of contact. This study examines how IT adoption influences administrative service quality in Indonesian healthcare institutions, focusing on relationships between IT implementation levels and service quality dimensions, as well as mediating and moderating factors. Using a mixed-methods sequential explanatory design, quantitative data were collected from 385 patients and 127 administrative staff across 24 hospitals, supported by 32 in-depth interviews. Service quality was measured using SERVQUAL dimensions: tangibles, reliability, responsiveness, assurance, and empathy. The findings show significant positive relationships between IT adoption and all service quality dimensions, with the strongest effects on reliability and responsiveness. Staff digital competency and system usability partially mediate these relationships, while implementation quality acts as a key moderating factor. Well-implemented systems yield substantially higher service improvements than poorly implemented ones. Most patients prefer digital services when functioning properly, although many report frustration when systems fail or staff lack competency. This study highlights the importance of effective IT implementation to enhance administrative service quality and offers practical insights for healthcare management.

Chronic Kidney Disease (CKD) is a structural or functional abnormality of the kidneys that lasts ≥3 months with the criteria of eGFR <60 mL/min/1.73 m² or the presence of kidney damage such as albuminuria and urinary abnormalities (Kidney International, 2024). CKD patients, especially those treated in intensive care units, often experience gastrointestinal disorders such as increased volume of gastric residues. Giving enteral nutrition to patients with NGT can increase the volume of gastric residue which is at risk of causing complications. One of the non-pharmacological interventions that can be carried out is abdominal massage, which is a light massage technique in the abdominal area that can stimulate intestinal peristalsis and improve gastrointestinal motility. The purpose of this case study was to determine the effect of  giving abdominal massage on reducing the volume of gastric residue in CKD patients in the ICU. This scientific paper uses a case study design using abdominal mass therapy. The number of respondents was 3 people, the intervention was carried out for 3 days with a time of 10-15 minutes. The application of abdominal massage therapy in the three respondents showed a decrease in the volume of gastric residue after admixture was carried out  for three consecutive days with an average decrease in the volume of gastric residue, which was 50 cc - 75 cc. Abdominal massage is a safe and effective nonpharmacological nursing intervention to help reduce gastric residue volume and support enteral nutrient tolerance in CKD patients in the ICU.

Hypertension is a global health issue and major risk factor for cardiovascular disease, requiring lifelong medication. In addition to pharmacological treatment, healthy lifestyle changes and non pharmacological therapies such as warm water foot soaks, can help prevent complications by inducing vasodilation to lower blood pressure. This study aims to describe nursing care for hypertensive patients, focusing on the application of warm water foot soaks to reduce blood pressure in an inpatient setting. Methods a descriptive case study approach was used three hypertensive respondents. The intervention involved 15 minute warm water foot soaks at a temperature of 39-40°C, conducted once daily for three days. Data were collected using digital sphygmomanometers and observation sheets, with measurements taken before and after the intervention. Results, after the therapy, all respondents showed an average reduction in blood pressure, with systolic pressure decreasing by 6,6 mmHg and diastolic by 2,3 mmHg. Respondents also reported felling more relaxed and experiencing lighter sensations in their legs. Conclusion, warm water foot soak therapy is an effective, safe, and cost efficient non pharmacological intervention for hypertensive nursing care, suitable for implementation by both nurses dan families.

Patient satisfaction is a key requirement for successful hospital services, influenced by factors such as mismatched expectations, nurses' personal behavior, high costs, and an unsupportive environment. Nurses' therapeutic communication plays a crucial role in increasing satisfaction in the inpatient ward by building trust and reducing misunderstandings in multicultural patients. Objective: To determine the relationship between nurses' therapeutic communication and patient satisfaction in the Inpatient Ward of Khidmat Sehat Afiat (KiSA) Regional General Hospital, Depok City in 2025. Method: A quantitative, analytical correlational study with a cross-sectional approach. The adult patient population was 120 people from August to October 2025, with a sample of 97 respondents via simple random sampling (with a 5% dropout rate). Data were collected using a questionnaire at KiSA Regional General Hospital, Depok (October-November 2025), and analyzed using chi-square for categorical variables. Results: 87.6% of nurses used good therapeutic communication; patient satisfaction was 79.3% satisfied, 27.3% quite satisfied, and 0% dissatisfied. The chi-square test yielded a p-value of 0.008 <0.05, indicating a significant relationship. Conclusion: There is a relationship between nurses' therapeutic communication and patient satisfaction levels in the Asoka Inpatient Ward of KiSA Regional General Hospital. Suggestion: Nurses should improve their skills through active listening, verbal empathy, information clarification, self-evaluation, and shift discussions for multicultural patients in Depok.

Hallucinations are false sensory perceptions unrelated to real external stimuli. Patients will have difficulty distinguishing whether the stimuli they experience originate internally (thoughts or feelings) or externally. This condition may affect any of the five senses. The most common type of hallucination is auditory hallucinations. One way to reduce the signs and symptoms of auditory hallucinations is through Art Therapy: freehand painting. To determine nursing care with the application of free painting therapy in patients with auditory hallucinations at the Mitra Mulia Husada Foundation, Palembang. The design used was a case study describing the cases of four patients with auditory hallucinations. Subjects were selected according to inclusion and exclusion criteria. The intervention provided was free-drawing therapy for four days, each lasting 30 minutes.After the intervention of applying free painting therapy for 4 days with a time of 30 minutes per visit, it was found that there was a decrease in signs and symptoms of hallucinations as shown through the results of the observation sheet in each patient. Mr. A. originally 9 became 3 signs of symptoms, Mr. S originally 7 became 3 signs of symptoms, Mr. AJ originally 9 became 3 signs of symptoms and Mr. M originally 10 became 5 signs of symptoms of auditory hallucinations. There was a decrease in auditory hallucination scores in each patient after being given Art Therapy: free painting. For future researchers, it is hoped that they can conduct research on the application of free painting therapy so that it can be carried out more frequently so that the therapy carried out is more effective in reducing the signs and symptoms of hallucinations and also add respondents so that the application of the therapy given is more effective in reducing the signs and symptoms experienced by patients.

Bronchopneumonia is a lower respiratory tract infection that remains a major health problem, especially in children, which can cause impaired gas exchange and ultimately decrease oxygen saturation. This condition, if not immediately treated, can lead to hypoxia and improve the patient's clinical condition. One intervention frequently administered in the emergency room is nebulizer therapy, which functions to help widen the airways, reduce secretion production, and improve pulmonary ventilation. This study aims to determine the effect of nebulizer therapy on increasing oxygen saturation in bronchopneumonia patients in the emergency room of Dr. Dody Sardjoto Air Force Hospital. This study used a quasi-experimental design with a one-group pretest-posttest approach. The study sample was bronchopneumonia patients who received nebulizer therapy intervention in the emergency room. The results showed an increase in oxygen saturation after nebulizer therapy with a p-value of 0.000 (p < 0.05), indicating a significant effect. Thus, nebulizer therapy is proven effective in increasing oxygen saturation and can be used as a treatment intervention in the management of oxygenation disorders in bronchopneumonia patients.  

Hypertension is a chronic health problem whose prevalence continues to increase and is a major risk factor for cardiovascular disease. In addition to pharmacological therapy, non-pharmacological interventions are needed to help control blood pressure safely and sustainably. One complementary therapy that has the potential to lower blood pressure is Slow Stroke Back Massage (SSBM), which works through relaxation mechanisms and modulation of the autonomic nervous system. This study aims to determine the effect of SSBM therapy on reducing blood pressure in hypertensive patients in the Camar Room of RSKD Dadi, South Sulawesi Province. The study used a quantitative quasi-experimental design with a two-group pretest–posttest design. A sample of 32 respondents was selected using a purposive sampling technique, divided into an intervention group and a control group. Data collection was carried out by measuring systolic and diastolic blood pressure before and after the intervention using a standard sphygmomanometer. The results showed a significant decrease in systolic and diastolic blood pressure in the group receiving SSBM therapy compared to the control group. Thus, SSBM therapy has a significant effect on reducing blood pressure in hypertensive patients and can be recommended as a complementary therapy in nursing care.

Ankle sprain is one of the most common musculoskeletal injuries in sports activities and often results in pain, limited range of motion, muscle weakness, and decreased functional ability. Appropriate physiotherapy management is essential to accelerate recovery and restore ankle function. This study aims to analyze the effectiveness of combining electrotherapy modalities and exercise therapy in the rehabilitation of bilateral grade II ankle sprain caused by sports injury. The research used a case study approach with physiotherapy interventions conducted through several treatment sessions. The interventions consisted of electrotherapy modalities combined with therapeutic exercises designed to reduce pain, improve joint mobility, and increase muscle strength and functional stability of the ankle. Clinical evaluation was carried out through observation of pain levels, range of motion, and functional ability during the therapy period. The findings indicated a gradual improvement in the patient’s condition, including decreased pain, increased ankle range of motion, improved muscle strength, and better functional performance during daily activities. These results suggest that the integration of electrotherapy and exercise therapy can provide a comprehensive rehabilitation approach for ankle sprain injuries. The combined intervention not only supports pain reduction but also enhances joint stability and functional recovery, enabling patients to return safely to their physical activities and reducing the risk of recurrent injury.

Stroke is one of the leading causes of death and long-term disability worldwide. Early detection and prompt first aid during the golden period are essential to improve patient outcomes, yet family knowledge regarding stroke management is often limited. This study aimed to analyze the effect of health education media, specifically audio-visual and leaflet, on family knowledge of early detection and first aid for stroke patients in the working area of Tamamaung Public Health Center, Makassar. This study used a quasi-experimental design with a two-group pre-test post-test approach. A total of 64 respondents were selected using purposive sampling and divided into audio-visual and leaflet groups. Data were collected using a structured questionnaire and analyzed using the Wilcoxon and Mann-Whitney tests. The results showed a significant increase in knowledge in both groups after the intervention (p = 0.000), with a significant difference between groups (p = 0.016), where audio-visual media was more effective than leaflets. These findings indicate that both media improve family knowledge, but audio-visual media is more effective and can be recommended as a primary educational tool to improve family preparedness in stroke emergencies.

Head injury remains a leading cause of mortality, increasing intracranial pressure and requiring craniectomy. Postoperative patients on ventilators are at risk of respiratory distress due to secretion accumulation, which can lead to decreased oxygen saturation. This study aimed to determine the effect of suction on oxygen saturation in post-craniectomy patients on ventilators in the ICU of Dadi Regional General Hospital, South Sulawesi Province. This study used a quasi-experimental design with a one-group pretest-posttest approach. The sampling technique used purposive sampling. Oxygen saturation measurements were taken before and after suctioning and analyzed statistically. The results showed that the average oxygen saturation before suctioning was 94.14% and after suctioning increased to 99.81%. Most respondents experienced an increase in oxygen saturation after the intervention. The results of this statistical test indicate a significant effect between suctioning on increasing oxygen saturation (p = 0.000) with an effect size indicating a large impact. It is hoped that this action will be an effective intervention in increasing oxygen saturation in post-craniectomy patients who are on ventilators in the ICU.

The quality of nursing services is not solely determined by nurses’ technical competence in providing clinical care, but is also influenced by their ability to establish therapeutic communication with patients. Therapeutic communication is a professional interaction process aimed at helping patients understand their health conditions, express their feelings, and develop a trusting relationship with nurses. Effective communication between nurses and patients can increase patients’ comfort during hospitalization and may influence their level of satisfaction with the nursing services provided. This study aimed to determine the relationship between nurses’ therapeutic communication and patient satisfaction in the inpatient ward of Grha Permata Ibu Hospital in 2025. This study used an observational analytic design with a cross-sectional approach. The sample consisted of 182 patients selected using a purposive sampling technique. Data were collected using a therapeutic communication questionnaire and the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ) to assess patient satisfaction with nursing care. Data analysis was conducted using the Spearman Rank correlation test to determine the relationship between the two variables. Most respondents assessed nurses’ therapeutic communication as good (87%). However, the majority of patients reported poor satisfaction levels (79.7%). The results of the Spearman Rank analysis showed a Sig. (2-tailed) value of <0.001 with a correlation coefficient of rs = −0.438, indicating a statistically significant relationship with a moderate correlation strength between nurses’ therapeutic communication and patient satisfaction. There is a significant relationship between nurses’ therapeutic communication and patient satisfaction in the inpatient ward of Grha Permata Ibu Hospital.

Digital transformation in healthcare services is a strategic approach to improve access, efficiency, and service quality, particularly within Indonesia’s National Health Insurance (JKN) system. BPJS Kesehatan has introduced an online queue feature through the Mobile JKN application to minimize manual queuing and reduce waiting times in outpatient services. However, despite the widespread ownership of the application, its actual utilization for online queuing remains relatively low, including in a regional public hospital (RSUD) in West Bandung. This condition reflects a gap between the availability of digital health technology and patients’ actual usage behavior, highlighting the need to examine factors influencing adoption.This study aims to analyze the effects of perceived ease of use, social influence, and facilitating conditions on the actual use of the Mobile JKN online queue, with behavioral intention as an intervening variable among outpatients. A quantitative cross-sectional design was applied, involving 255 JKN outpatient participants selected through purposive sampling. Data were collected using structured questionnaires and analyzed using Structural Equation Modeling (SEM) with AMOS version 24, based on the Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT). Data analysis included descriptive statistics, validity and reliability testing, normality assessment, goodness-of-fit evaluation, Three Box Method, and hypothesis testing.

The increasing competition in the healthcare industry requires hospitals to establish effective relationship strategies to enhance patient loyalty. This study aims to examine the effect of Customer Relationship Management (CRM) on patient loyalty, with brand salience and customer engagement behavior (CEB) as mediating variables. The research adopts a quantitative approach using Partial Least Squares Structural Equation Modeling (PLS-SEM). Data were collected from 155 outpatients at Cengkareng General Hospital (RSAR) who had experienced CRM-related services, using a structured questionnaire measured on a four-point Likert scale. The findings reveal that CRM has a significant positive effect on brand salience, customer engagement behavior, and patient loyalty. Among these relationships, CRM demonstrates the strongest influence on customer engagement behavior, indicating that relationship-based strategies effectively encourage active patient involvement. Furthermore, customer engagement behavior significantly affects patient loyalty, suggesting that patients who are more engaged—through feedback, recommendations, and participation—are more likely to develop stronger loyalty toward healthcare providers. In contrast, brand salience does not have a significant effect on patient loyalty, indicating that brand awareness alone is insufficient to drive loyalty in the healthcare context. Mediation analysis shows that customer engagement behavior partially mediates the relationship between CRM and patient loyalty, whereas brand salience does not act as a mediator. These results suggest that CRM enhances patient loyalty not only directly but also indirectly through strengthening engagement behavior. This study contributes to healthcare marketing literature by integrating relationship marketing and customer engagement perspectives, highlighting engagement as a more critical mechanism than brand salience in fostering sustainable patient loyalty.

Dengue fever is a disease commonly found in tropical and subtropical regions. This disease can cause severe symptoms, such as very high fever, accompanied by nausea, vomiting, headache, abdominal pain, and leukopenia (decrease in white blood cells). This infectious disease, known as dengue hemorrhagic fever (DHF), is a viral infection transmitted by the Aedes Aegyppti mosquito. This study aims to classify dengue-prone areas using the K-Means Algorithm, and to classify the factors that cause dengue in Purwodadi District, Grobogan Regency. The clustering results using the K-Means algorithm with Rapidminer tool from 266 data produced 3 clusters: cluster 0 (blue) with 138 patients dominated by Kuripan, Purwodadi, Ngambak villages, cluster 1 (green) with 31 patients in Ngraji, Nambuhan, Cingkrong villages, and cluster 2 (orange) with 97 patients in Danyang, Kalongan, Pulorejo villages. This study is expected to provide additional information for stakeholders in controlling dengue cases and increase awareness of the importance of environmental cleanliness as a preventive measure.

Chronic Kidney Disease (CKD) is a growing global health concern that significantly affects patients’ quality of life. At Bhakti Asih General Hospital, Tangerang, the number of hemodialysis patients increased by 20.42% and dialysis procedures by 25.06% between 2023 and 2024. Despite this service expansion, preliminary findings revealed that 32% of patients reported poor quality of life, 31% experienced low engagement in care, 34% demonstrated low self-efficacy particularly in dietary and fluid management and 32% faced accessibility barriers. These findings indicate a gap between increased service volume and patient-centered outcomes. This study aimed to analyze the effects of patient engagement and self-efficacy on the quality of life of hemodialysis patients, with healthcare accessibility as a mediating variable. A quantitative cross-sectional design was employed. Active hemodialysis patients were selected using purposive sampling. Data were collected through structured questionnaires and analyzed using Structural Equation Modeling (SEM).The results demonstrated that patient engagement and self-efficacy had significant positive effects on quality of life, both directly and indirectly through accessibility. Accessibility also significantly influenced quality of life and strengthened the relationships between patient engagement, self-efficacy, and quality of life.These findings highlight the importance of integrating patient engagement strategies, strengthening self-efficacy through education, and improving service accessibility to enhance quality of life among hemodialysis patients

In response to the evolving landscape of public healthcare services, hospitals are expected not only to maintain operational efficiency but also to adapt to the shifting needs and expectations of patients as healthcare consumers. The presence of non-BPJS patients in regional public hospitals plays a strategic role not only contributing to revenue diversification but also reflecting service quality, institutional competitiveness, and shaping public perception. The declining trend in outpatient visits by general patients at RSUD Balaraja over the past three years highlights the need to understand the factors influencing consumer behavior in determining revisit intentions. This study examines the effect of co-creation and hospital image on the revisit intention of outpatient general patients at RSUD Balaraja, with patient experience as a mediating variable. The research employed a quantitative explanatory design involving 278 outpatient general patients selected through purposive sampling. Data were collected via structured questionnaires and analyzed using Structural Equation Modeling–Partial Least Squares (SEM-PLS). The results indicate that patient experience plays a significant mediating role in shaping revisit intention among general outpatients at RSUD Balaraja. These findings confirm that patient experience serves as a central factor in post-service evaluation processes, which ultimately drive patients’ intention to return. Therefore, hospitals need to enhance patient involvement in service processes (co-creation), improve public perception of institutional image (hospital image), and develop patient-centered service systems as a key strategy to increase revisit intention among general outpatients.

Surgery is a medical procedure performed by opening a part of the body and ending with the closure or suturing of the wound. This procedure often causes anxiety in preoperative patients. One non-pharmacological intervention that can be used to reduce anxiety is classical music therapy, which helps promote relaxation and supports the healing process. This study aims to determine the effect of classical music therapy on reducing anxiety levels in preoperative patients in the implementation of nursing care. The method used was a case study design with a nursing care approach involving three preoperative patients experiencing anxiety. The intervention consisted of classical music therapy delivered through headphones for 5 minutes and administered twice to each respondent. The results showed that after receiving classical music therapy, the anxiety levels of all three patients decreased from severe anxiety with an average score of 19 to moderate to mild anxiety with scores ranging from 7–13. In addition, symptoms such as worry, restlessness, and tension also appeared to decrease after the intervention. It can be concluded that classical music therapy is effective in reducing anxiety levels in preoperative patients during the nursing care process. Therefore, nurses are expected to apply classical music therapy as one of the interventions for patients experiencing anxiety.

Hypertension is a non-communicable disease that can lead to cardiovascular complications and requires both pharmacological and non-pharmacological management. One of the non-pharmacological therapies that can be applied is warm water foot soaking and progressive muscle relaxation, which may help reduce blood pressure through peripheral vasodilation, stimulation of the parasympathetic nervous system, and decreased sympathetic nervous system activity. This study aimed to analyze the implementation of nursing care through warm water foot soaking therapy and progressive muscle relaxation to reduce blood pressure in patients with hypertension. The method used was a case study with a pre-experimental design using a one group pre-test post-testapproach involving three hypertensive patients, with the intervention administered once daily for three days. The results showed a decrease in blood pressure in all patients. The average systolic reduction was 5.3 mmHg, 12.3 mmHg, and 5.6 mmHg, while the diastolic reduction was 1.6 mmHg, 2.6 mmHg, and 4 mmHg, respectively. In addition, all patients reported a reduction in pain scale. It can be concluded that warm water foot soaking therapy combined with progressive muscle relaxation is effective as a complementary nursing intervention to help reduce blood pressure in patients with hypertension.

Pulmonary Tuberculosis is a disease cause an infection by Mycobacterium tuberculosis which attacking the lungs. The problem that often appears is Respiratory system disorder that this symptomatically happens with shortness.  Shortness occurs due to an imbalance between oxygen demand and supply, thereby increasing respiratory effort and reducing patient comfort. A non-pharmacological measure to reduce shortness of breath is orthopnea positioning.This therapy aims to increase lung expansion, improve ventilation, and relax the respiratory muscles, thereby helping to reduce Asphyxiate in patients with pulmonary tuberculosis. To determine the effectiveness of orthopneic positioning in reducing dyspnea in patients with pulmonary tuberculosis. Case study design with 3 respondents who were placed in the orthopneic position for 5 minutes with a stopwatch used to measure respiratory rate The results of this study show that the orthopneic position is effective in reducing shortness of breath, as evidenced by Mr. R, who had a respiratory rate of 24 breaths per minute before being placed in the orthopnea position. After being placed in the orthopneic position, his respiratory rate decreased to19 breaths per minute. Mr. K's respiratory rate was 24 breaths per minute before being placed in the orthopneic position and decreased to 20 breaths per minute after being placed in the orthopneic position. Mr. M's respiratory rate was 24 breaths per minute before being placed in the orthopneic position and decreased to 19 breaths per minute after being placed in the orthopneic position