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Law Number 17 of 2023 concerning Health (the 2023 Health Law) serves as a fundamental regulation governing various aspects of health services in Indonesia, including the operations of private hospitals. For private hospitals whose shares are listed on the Indonesia Stock Exchange (IDX), the implementation of the 2023 Health Law has brought significant changes in both legal and operational dimensions. This study aims to examine the legal aspects of implementing the 2023 Health Law on the operations of IDX-listed private hospitals. Employing a normative legal research method with statutory and conceptual approaches, this study analyzes relevant regulations and doctrines. The results indicate that the 2023 Health Law expands the scope of hospitals' legal liability, comprehensively regulates the obligations and rights of both hospitals and patients, and imposes stricter sanctions for violations. Furthermore, the implementation of this regulation impacts the business and financial aspects of listed private hospitals, including expansion opportunities, shifts in cost structures, and stock market responses. However, challenges remain in its application, such as diverse interpretations of certain provisions and hospitals' readiness to comply with the established requirements.

Chronic Obstructive Pulmonary Disease (COPD) is a progressive chronic respiratory disease primarily caused by smoking and is one of the leading causes of death worldwide. In Pekanbaru City, 4,226 cases (5.7%) have been recorded, indicating a significant public health concern. Therefore, more effective prevention efforts are needed to reduce the incidence and impact of COPD in the community. The purpose of this study is to determine the relationship between the degree of smoking and the severity level of Chronic Obstructive Pulmonary Disease (COPD) at Garuda Public Health Center, Pekanbaru. This study uses a quantitative approach with a descriptive correlational design and a cross-sectional method. The results showed that among COPD patients with a mild smoking degree, 14 respondents (13.6%) had mild COPD severity, 31 respondents (30.1%) had moderate COPD severity, and 17 respondents (16.5%) had severe COPD. Meanwhile, among patients with a moderate smoking degree, 10 respondents (9.7%) had mild COPD severity, 11 respondents (10.7%) had moderate COPD severity, and 20 respondents (19.4%) had severe COPD. The chi-square test result showed a p-value of 0.04, which is less than 0.05, indicating a statistically significant relationship between smoking degree and the severity of COPD. There is a significant relationship between the degree of smoking and the severity of COPD. Patients with higher smoking degrees tend to have more severe COPD. It is recommended that healthcare workers enhance education and smoking cessation programs to prevent and reduce the severity of COPD in the community.

Patient satisfaction influences their desire to return to the same place, and if they are not satisfied, they will look for another place of health, prolonged helminths will result in patients experiencing psychological disorders and will result in the decline of patients caused by the threat of death, overall economic problems and medical problems. Cognitive factors can influence the health and well-being of patients with kidney failure because patients with kidney failure can feel psychologically tired because they have to undergo hemodialysis. The aim of this research is to determine the description of patient satisfaction undergoing hemodialysis at Santa Elisabeth Hospital. The design method for clinical treatment is delscrilptilf which will analyze or observe a picture of the population of patients who underwent hemodilalization at Rulmah Hospital Santa Ellilsabelth with a sample size of 50 respondents. The total sampling technique was taken. Research Results The results of this research were to determine the description of patient satisfaction undergoing hemodialysis at Santa Elisabeth Hospital in Medan with a total of 50 respondents. Where the research uses tables and provides an explanation of the frequency distribution of characteristics based on age, gender, religion, occupation, marital status, education. And this research was obtained from primary data obtained from the respondents themselves. After the data is obtained, it is processed and the results will be analyzed using univariate analysis.

Hypertension contributes to numerous complications such as heart disease, stroke, kidney failure, and is a risk factor of disability and death. Hypertension Prevalence in Jatinangor is 37.8%, that is higher than national rate. The control of hypertension is low and the education at the primary health facility is short. Therefore, another buffer system for education such as posbindu is needed. Activities that educate people with hypertension become very important, but need to be adjusted as needs. Aim of this study is to determine form and intensity of education preferred by hypertension patients Method: Qualitative descriptive with case study approach using focused group discussion (FGD) method, led by main moderator and assisted by a second moderator. Participants consisted of 15 people with hypertension chosen purposively with the inclusion criterias female and parallel to the research objective. The discussion used semi-structured questions. This study is conducted in two villages in Jatinangor, Desa Cipacing and Desa Cilayung from February to May 2017. Results: Participants wanted education in the form of traditional learning, game simulation, written notes, and video recording. The intensity of education preferred until patients understand, it tends to be performed more than once, and preferred place are performed within Posyandu (Integrated Health and Nutrition Post) with education frequency varies from once a week to once a month. Conclusion: Hypertension patients have variable preference of education forms and its intensity. Innovations in the development of methods in accordance with hypertension patients’ needs must be continued, so that interventions can become more effective for hypertension patients.

Achilles tendon rupture is a common lower extremity injury that significantly affects functional mobility and gait performance. Post-operative patients frequently experience pain, edema, limited range of motion (ROM), muscle weakness, and impaired ambulation. Physiotherapy rehabilitation plays a crucial role in restoring tissue integrity and functional capacity. This case study aimed to analyze the effectiveness of combined electrotherapy modalities and therapeutic exercises in a post-operative left Achilles tendon rupture patient. The intervention included ultrasound therapy, Transcutaneous Electrical Nerve Stimulation (TENS), infrared therapy, dry needling combined with Percutaneous Electrical Nerve Stimulation (PENS), and progressive therapeutic exercises such as isometric training and calf raises. Clinical outcomes were evaluated through ROM measurement, Manual Muscle Testing (MMT), edema observation, and gait analysis across four therapy sessions. Results demonstrated gradual improvement in dorsiflexion and plantarflexion ROM, reduction of edema, increased gastrocnemius-soleus muscle strength, and restoration of independent ambulation without assistive devices. The multimodal physiotherapy approach appears to support tendon healing, enhance neuromuscular activation, and accelerate functional recovery during the subacute post-operative phase.

Hypertension is a chronic disease with a high prevalence worldwide and is a major risk factor for cardiovascular diseases. The management of hypertension not only relies on pharmacological therapy but also requires non-pharmacological interventions as effective complementary therapy. This study aims to analyze the implementation of health education and acupressure therapy in lowering blood pressure in hypertensive patients. This descriptive study involved three hypertensive patients from RT 35 Lebung Jaya, Talang Betutu Village, Palembang. The intervention included structured health education and acupressure therapy given over three consecutive days, with a duration of 15-20 minutes per session. The results of this study showed a reduction in systolic blood pressure between 10-20 mmHg and diastolic blood pressure between 2-7 mmHg. Additionally, there was an increase in knowledge and medication adherence among the patients. From these results, it can be concluded that the integration of health education and acupressure therapy can be an effective nursing intervention for hypertension management, particularly in a community setting. The implementation of this method is expected to become an alternative approach in managing hypertension within the community with a more holistic approach.

Abstract: One of the most common harmful bacteria, particularly in hospitals, is Pseudomonasaeruginosa, which is also the most frequent cause of wound infections. Because it leads to antibioticresistance and persistent infections, one of the most significant virulence factors it produces isbiofilm. The goal of the current study is to prevent P. aeruginosa isolates from wound patients fromforming biofilms by using plantaricin, which is a peptide with broad-spectrum antibiotic generated byLactobacillus plantarum. In order to produce plantaricin, so that Lactobacillus plantarum isolates from rawbuffalo milk were screened. The plantaricin was then purified using ammonium salts and a gelfiltration column, with a final 40% recovery. The isolates of P. aeruginosa with more production tobiofilm from wound infections were tested for the inhibitory impact of pure plantaricin. The resultsshowed that the plantaricin reduced the development of biofilms in a dose-dependent manner, with alarger percentage of biofilm inhibition reaching 46–68% at 150 µg/ml.

A fracture occurs when bone continuity is disrupted due to external pressure or force that exceeds the bone's capacity. Fractures constitute a medical emergency requiring immediate treatment. A primary surgical intervention for this condition is the Open Reduction and Internal Fixation (ORIF) procedure, which aims to reposition broken bone fragments to their normal anatomy. This procedure is considered crucial for achieving proper bone union and minimizing the potential for postoperative complications. As a consequence of the surgical incision and tissue trauma, patients commonly experience postoperative pain. The management of this pain can broadly be categorized into two approaches: pharmacological and non-pharmacological. Among non-pharmacological methods, cold compress therapy has proven effective in alleviating pain in patients following ORIF surgery. The sensation of pain can be alleviated through the application of a cold pack by inhibiting sensory nerve conduction and suppressing local inflammation. Simultaneously, cryotherapy also reduces blood flow to the injury site, which in turn limits blood extravasation and the accumulation of edema fluid. A descriptive case study analysis of four patients with acute pain after lower extremity ORIF surgery. The effectiveness of the intervention was measured using the Numeric Rating Scale (NRS).: The application of cold compresses using cold packs for 3 days to 4 respondents before the cold compress was applied was on a pain scale of 6–7 (moderate to severe category), after the intervention the pain scale became 2–3 (mild category). The results indicate that cold compress therapy in patients with lower extremity post-ORIF fractures is effective in reducing pain levels. Therefore, cold compress therapy is recommended as a non-pharmacological therapy to reduce pain in patients with fractures after ORIF.

Patient loyalty is an important indicator of success in healthcare services because it reflects patients’ tendency to reuse healthcare services and recommend them to others. Patient loyalty in healthcare facilities is influenced by various factors, including doctor availability, cost bearer systems, and patient experience during the service process. This study aims to analyze the effect of doctor availability and cost bearer on patient loyalty with patient experience as a mediating variable among patients at the Dental Clinic of Hermina Galaxy Hospital.This research used a quantitative approach with a survey design. Data were collected through questionnaires using a Likert scale from 150 patients at the Dental Clinic of Hermina Galaxy Hospital selected through purposive sampling. Data analysis was conducted using Structural Equation Modeling (SEM) with the assistance of AMOS software to examine both direct and indirect relationships among the research variables.The results showed that doctor availability and cost bearer have a positive and significant effect on patient experience. Patient experience was also found to have a positive and significant effect on patient loyalty. In addition, doctor availability and cost bearer have a direct influence on patient loyalty and an indirect influence through patient experience as a mediating variable.In conclusion, improving patient loyalty can be achieved by enhancing doctor availability, managing financing systems effectively, and creating positive patient experiences. Hospital management should optimize these factors to improve service quality and maintain patient loyalty

The development of Digital Marketing and Electronic Word of Mouth (eWOM) has encouraged hospitals to adopt digital communication strategies to attract patients’ visit intentions. However, in public hospitals, the effectiveness of these strategies in influencing patient behavior still requires empirical validation. This study aims to analyze the influence of Digital Marketing and eWOM on patient visit intention, with Brand Awareness as an intervening variable at RSUD Cengkareng.This research employed a quantitative approach with an explanatory design. Data were collected from November to December 2025 from 100 general outpatient respondents selected using the Slovin formula and a simple random sampling technique. The data were gathered through structured questionnaires and analyzed using Structural Equation Modeling (SEM) with AMOS software.The results show that Digital Marketing and eWOM have a positive and significant effect on Brand Awareness. Both variables also significantly influence patient visit intention, with eWOM demonstrating the strongest effect. These findings indicate that information shared through digital platforms and patient recommendations plays an important role in shaping potential patients’ decisions to visit the hospital. However, Brand Awareness does not have a significant effect on patient visit intention and does not mediate the relationship between Digital Marketing, eWOM, and visit intention. This suggests that, in the context of RSUD Cengkareng as a public hospital, patients’ visit decisions are more directly influenced by digital information exposure and the credibility of online recommendations rather than by brand recognition alone.

Patient experience reflects patient’s comprehensive perceptions of service quality, the physical environment, and communication with healthcare providers. This study was motivated by the need to foster positive patient experience in the Pharmacy Installation of Graha Sehat Hospital, Probolinggo through improvements in service quality, servicescape, and effective communication. The objective of this research was to analyze the effects of service quality and servicescape on patient experience, with effective communication serving as an intervening variable. A quantitative approach was employed using Structural Equation Modeling (SEM) with AMOS. A total of 180 outpatient pharmacy patients were selected through voluntary sampling, with the sample size determined based on Hair’s method. The findings indicate that service quality, servicescape, and effective communication simultaneously exert a positive and significant effect on patient experience. Partially, service quality has a positive and significant effect on patient experience, while servicescape does not have a direct significant effect on patient experience. Effective communication, however, demonstrates a positive and significant influence on patient experience. Furthermore, effective communication significantly mediates the relationship between servicescape and patient experience, but it does not mediate the relationship between service quality and patient experience. The managerial implications for hospital management highlight the need to strengthen service quality improvement strategies, optimize spatial layout and environmental comfort in the pharmacy setting, and establish concise communication standards that include essential medication counseling points. Such measures are necessary to ensure that communication quality remains consistent, even during peak patient volume periods with limited-service time.

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.

Hospital nutrition services are an integral component of improving the quality of patient health. This descriptive observational study aims to evaluate the achievement of Minimum Service Standards (MSS) for nutrition at RSUD Dr. H. Slamet Martodirdjo Pamekasan, specifically focusing on the accuracy of diet types, timeliness of food distribution, and patient food waste. Data were collected over a single menu cycle (10 days) from November 24 to December 4, 2025, involving 44 patients per day. Research instruments included observation sheets and the Comstock visual method, with data analyzed based on the Decree of the Minister of Health (Kepmenkes) No. 129 of 2008. The results indicated that the timeliness of food distribution reached 96% and the accuracy of diet types reached 100%, both of which met the MSS requirements (≥ 90% and 100%, respectively). However, the average patient food waste was 25%, which does not yet meet the maximum standard of ≤ 20%. In conclusion, while logistical aspects have fulfilled the established standards, the hospital needs to conduct further evaluations regarding food flavor factors and patients' clinical conditions to reduce food waste in accordance with the applicable standards.

Tuberculosis (TB) remains a significant health issue in Indonesia, with the number of cases not showing a decline. Pediatric pulmonary tuberculosis is one of the leading causes of morbidity and mortality. In 2018, the number of TB cases in Aceh reached 41,595, with Aceh Utara having the highest number at 4,819 cases, followed by Bireuen with 3,636 cases, while Sabang recorded the lowest at 272 cases. The primary risk factor for pulmonary tuberculosis in children is a history of contact with adult TB patients, as children's immune systems are still weak, allowing the bacteria to enter their bodies easily. This study aims to examine the history of TB contact in children at the Pediatric Clinic of Cut Meutia General Hospital. The research used a descriptive observational design, with 105 respondents, and data was collected from medical records. The results showed that the majority of respondents were toddlers (47.6%), most were male (54.3%), and 58.1% had good nutritional status. A significant percentage of respondents (77.1%) had a history of contact with TB patients, and 83.8% did not receive BCG vaccination. These findings highlight that contact with TB patients is a key factor in the transmission to children.

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.

The digital transformation of health services through the Mobile JKN application was introduced by BPJS Kesehatan to provide easier access for the public in obtaining information, managing membership administration, and receiving health services more quickly and efficiently. This study aims to measure the readiness level of patients at Abdul Manap Regional Hospital, Jambi City, in adopting the Mobile JKN application using the HOT-Fit method, which covers three main components: Human, Organization, and Technology. Data were collected from 360 respondents through questionnaires and analyzed using Partial Least Square Structural Equation Modeling (PLS-SEM). The results indicate that technology factors—including system quality, information quality, and service quality— along with organizational support have a significant effect on system use and user satisfaction, which in turn positively influence the net benefits. The outer loading values of all indicators exceeded 0.7, with Composite Reliability above 0.8 and AVE above 0.6, confirming that the research instruments are valid and reliable. Overall, patients at Abdul Manap Hospital are categorized as ready to adopt Mobile JKN, although improvements in digital literacy and stronger organizational support are still required to optimize its utilization.

Hypertension is a major modifiable risk factor contributing to the development of Acute Coronary Syndrome (ACS), which includes STEMI, NSTEMI, and unstable angina. The increasing prevalence of hypertension worldwide raises concern regarding its impact on cardiovascular outcomes. This study aimed to describe the profile of ACS patients with hypertension receiving angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) therapy in the Intensive Coronary Care Unit (ICCU) of RSUD Dr. Soetomo Surabaya. Using a descriptive cross-sectional method, data from 91 patients treated between July 2021 and October 2024 were analyzed. Variables included demographic characteristics, clinical classification of ACS, hypertension degree, comorbidities, types and doses of ACEI/ARB administered. The results showed that most patients were male (73%) and aged over 65 years (40%). Chi-square analysis revealed no significant relationship between hypertension degree, ACS classification, or most comorbidities with drug selection or dosage (p>0.05), except for a significant association between coronary heart disease comorbidity and ARB selection. These findings suggest that in hypertensive ACS patients, the choice between ACEI and ARB therapy is predominantly based on individual comorbidity profiles rather than blood pressure severity or ACS type. The study highlights the importance of personalized treatment approaches considering patient comorbidities to optimize cardiovascular outcomes.

The problem that occurs in stroke patients is damage to the autonomic nervous system that regulates intestinal peristalsis, causing a decrease in the defecation reflex and leading to constipation. If constipation is not treated properly, it will affect the quality of life of stroke patients. Constipation can be treated pharmacologically and non-pharmacologically. One non-pharmacological treatment is abdominal massage. Abdominal massage can stimulate the parasympathetic nervous system, which can increase digestive system motility, reduce tension in the abdominal muscles, and have a relaxing effect on the sphincter. The design used in the preparation of the final scientific paper for the nursing study was a one-group pretest-posttest case study with abdominal massage intervention on three respondents who had experienced constipation for ≥ 72 hours. Abdominal massage was given once a day for 10-15 minutes for three consecutive days. The constipation scores using the Constipation Assessment Scale (CAS) were as follows: respondent 1, Mrs. L, from 13 to 6; Mrs. W, from 12 to 11; and Mrs. W, from 15 to 11. There was a decrease in the CAS score before and after the abdominal massage was administered, but it was not yet able to significantly alleviate constipation in stroke patients. The application of this EBP is expected to provide additional information on the administration of abdominal massage to stroke patients experiencing constipation for ≥72 hours.

The postpartum period following Sectio Caesarea is often accompanied by acute pain due to surgical incisions, which may interfere with mobilization, breastfeeding, and maternal recovery. Effective pain management is essential to prevent further complications and enhance maternal comfort. In addition to pharmacological therapy, non-pharmacological interventions such as Benson relaxation therapy can be implemented. This study aimed to evaluate the application of Benson relaxation therapy in reducing acute pain among postpartum Sectio Caesarea mothers.This study employed a case study design involving four postpartum Sectio Caesarea patients (Ny. R, Ny. A, Ny. Y, and Ny. S) treated in the Ayyub Ward of RS Roemani Muhammadiyah Semarang in 2026. Data were collected through comprehensive nursing assessments, pain intensity measurement using a numeric rating scale, observation of mobilization ability, and evaluation before and after intervention.The results showed that after regular implementation of Benson relaxation therapy, all patients experienced a gradual decrease in pain intensity (from scale 4–7 to ≤3), improved comfort, better breathing control, and increased ability to perform early mobilization. Consistent nursing education, therapeutic guidance, and family involvement supported the effectiveness of the intervention. It can be concluded that Benson relaxation therapy is an effective, safe, and easily applicable nursing intervention for reducing acute pain in postpartum Sectio Caesarea patients.