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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.

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.

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.

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.

Prescription service wait times are an indicator of pharmacy service quality that directly impacts patient satisfaction and the Hospital Minimum Service Standards (SPM). The Kraton Regional General Hospital in Pekalongan Regency has implemented an electronic prescribing system (e-prescribing) to improve efficiency and reduce prescribing errors. However, with prescription volumes reaching hundreds per day, periodic evaluation is necessary to ensure that services remain in compliance with standards. This study aims to evaluate the waiting time for electronic prescription services among outpatients at the Pharmacy Department of RSUD Kraton, Pekalongan Regency, and to compare it with the Ministry of Health’s standards. This is a descriptive observational study using a quantitative approach. The study sample consisted of 300 prescriptions (74 compounded prescriptions and 226 non-compounded prescriptions) selected via simple random sampling from medical records for the period August–October 2025. Research instruments included an observation sheet and an interview guide to support observational data. Data analysis was conducted descriptively to calculate the average service waiting time. The results showed that the average service time for non-compounded prescriptions was 7 minutes and 42 seconds, while for compounded prescriptions it reached 28 minutes and 11 seconds. All samples examined met the established waiting time standards, namely ≤30 minutes for non-compounded prescriptions and ≤60 minutes for compounded prescriptions, in accordance with Ministry of Health Regulation No. 4 of 2019 and Ministry of Health Decree No. 129/2008. The electronic prescription service at Kraton District General Hospital in Pekalongan Regency has been operating very efficiently and meets the Minimum Service Standards (SPM). The implementation of e-prescribing technology has significantly contributed to maintaining the speed and quality of pharmaceutical services on an ongoing basis.

Non-hemorrhagic cerebrovascular disease (CVD) results from blood flow obstruction in the brain due to thrombus or embolus formation, often leading to balance disorders that affect standing and walking. This loss of motor function increases the risk of falls and fractures, which are major complications. Additionally, reduced physical activity can lead to depression. Active exercise has been shown to improve motor function in CVD patients, with nurses playing a key role in supporting these exercises. One effective intervention is the bridging exercise (BE), used for lumbopelvic stabilization, which enhances muscle strength and coordination. BE is particularly beneficial for improving balance in post-CVD patients with hemiplegia. This case study examines the effects of evidence-based bridging exercise (EBP) on balance in three hospitalized non-hemorrhagic CVD patients. Over eight 15-minute sessions, balance was assessed using the Berg Balance Scale (BBS). All patients showed significant balance improvement, with an average BBS score increase of 40 points. These results highlight the effectiveness of non-pharmacological bridging exercises in enhancing balance in CVD patients and recommend BE as a routine therapy to continue at home after discharge.

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.

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.

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.

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.

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 risk of violent behavior is a condition where a person commits an act that can be physically dangerous, either to themselves, others or their own family. To overcome this, a special therapy is needed. Laughter therapy will release endorphins so that the body becomes more comfortable, relaxed and makes the client's emotional state better so that it can suppress the desire to get angry. This study uses a descriptive case study with a nursing process approach to 5 respondents. With laughter therapy intervention for 20-30 minutes. The intervention was carried out on June 4 to 6, 2025, located at the Palembang ODGJ shelter. Client 1(Mr. H) before the intervention there were 9 signs and symptoms of the risk of violent behavior and after the intervention it became 1. In client 2 (Mr. L) before the intervention there were 9 signs and symptoms after the intervention 0 signs and symptoms. In client 3 (Mr. A) before the intervention there were 8 signs and symptoms after the intervention 1 sign and symptom. Client 4 (Mr. F) had 7 signs and symptoms before the intervention, but after the intervention, it became 1. Client 5 (Mr. S) had 5 signs and symptoms before the intervention, but after the intervention, it became 1 sign and symptom.

Hypertension has become a chronic disease known as the silent killer because it often does not show symptoms but can cause serious complications such as stroke, heart disease, and kidney failure. According to WHO, hypertension is one of the leading causes of death worldwide and its prevalence continues to rise. Sleep disturbances can increase sympathetic nervous system activity and stress hormones, which impact blood pressure elevation. Depression is characterized by prolonged feelings of sadness, loss of interest, and decreased energy. Physiologically, depression can increase stress hormones and cause autonomic nervous system imbalance, leading to elevated blood pressure. To determine the relationship between sleep pattern disturbances and depression levels with blood pressure in hypertensive patients in the outpatient department of RS Permata Medika Semarang. Quantitative research with a correlational design using a cross-sectional approach. The sampling technique used was consecutive sampling with a sample size of 79 respondents. The instruments used are the PSQI questionnaire for sleep pattern disturbances and the DASS-42 for depression levels. Ethics test no 03/EC-LPPM/UWHS/II-2026. Data analysis used the Spearman Rank test. The research results show that there is a significant relationship between sleep pattern disturbances and blood pressure in hypertensive patients (p=0.000; rho=0.826). Respondents with poor sleep patterns mostly have high blood pressure, indicating a very strong and positive relationship, where the worse the sleep pattern, the more uncontrolled the blood pressure tends to be. Additionally, there is a significant relationship between the level of depression and blood pressure (p=0.000; rho=0.808). Respondents with severe and very severe depression mostly have high blood pressure, which means that the higher the level of depression, the more the blood pressure increases or becomes uncontrolled. There is a relationship between sleep pattern disturbances and depression levels with blood pressure in hypertensive patients in the outpatient department of Permata Medika Hospital Semarang.

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.

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.

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.

Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia resulting from impaired insulin secretion, insulin action, or both. Globally, DM continues to pose a growing health challenge, particularly type 2 DM, which is closely associated with insulin resistance. In this condition, body cells fail to respond effectively to insulin, so even though the pancreas initially produces sufficient or excessive amounts of insulin, its effectiveness gradually declines. Over time, pancreatic beta-cell function deteriorates, further exacerbating chronic hyperglycemia. This persistent condition may lead to long-term complications, including nephropathy, retinopathy, neuropathy, and cardiovascular diseases, through mechanisms such as oxidative stress, inflammation, and the formation of advanced glycation end products (AGEs). The prevalence of type 2 DM is expected to continue rising, including in Indonesia, highlighting the need for comprehensive management strategies. An important aspect of DM management is the assessment of health-related quality of life. Quality of life reflects an individual’s perception of their health status within social and cultural contexts. This can be evaluated using generic instruments such as the WHOQOL-BREF questionnaire. In this case report, the quality of life of a patient with type 2 DM was assessed using the WHOQOL-BREF to provide a comprehensive understanding of the disease’s impact on the patient’s daily life.

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.  

Spinal anesthesia is one of the regional anesthesia methods that is often chosen in various surgical procedures, especially in the area of the lower extremities, pelvis, and lower abdomen. The most common complication encountered in this technique is the occurrence of hypotension, which can affect tissue perfusion and hemodynamic stability of the patient. This study aims to examine the incidence of hypotension in spinal anesthesia, including mechanisms, risk factors, and management. The method used in this study is literature review with a scientific source search process conducted through various databases PUBMED, Sciencedirect, Researchgate, and Google Scholar with a publication year range of 2016 to 2026. The results showed that hypotension arises as a consequence of an obstacle in the sympathetic nervous system, which provokes dilation of blood vessels as well as reduced venous return. Risk factors include age, body mass index, patient position, block height, duration of surgery, fluid status, Injection Point, and type of anesthetic drug used. Management is carried out by administering fluids, vasopressors, as well as strict hemodynamic monitoring. A good understanding of the risk factors and mechanisms of hypotension is expected to improve patient safety during spinal anesthesia..

Diabetic ketoacidosis (DKA) is a life-threatening acute metabolic complication of diabetes mellitus characterized by hyperglycemia, metabolic acidosis, and ketosis due to absolute or relative insulin deficiency. DKA may present as the initial manifestation of previously undiagnosed diabetes, particularly in young adults. We report a case of a 27-year-old male who presented with decreased consciousness preceded by shortness of breath. The patient had a three-month history of polyuria, polydipsia, polyphagia, and significant weight loss. Physical examination revealed a Glasgow Coma Scale score of 9 and signs of dehydration. Laboratory findings showed severe hyperglycemia (426 mg/dL), elevated HbA1c (8.5%), leukocytosis, and severe metabolic acidosis (pH 6.8; HCO₃⁻ 5.8 mmol/L). The diagnosis of DKA was established based on clinical and laboratory criteria. Management included aggressive fluid resuscitation, continuous intravenous insulin infusion, electrolyte correction, and antibiotic therapy for suspected infection. The patient showed gradual clinical improvement. This case highlights the importance of early recognition, identification of precipitating factors, and prompt management to reduce morbidity and mortality associated with DKA.