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Hypertension is categorized as one of the most widespread chronic non-infectious conditions among the elderly and can heighten the risk of serious complications. A non-pharmacological strategy that may be implemented to manage hypertension is the administration of boiled moringa leaves (Moringa oleifera), which are known among scientific communities for possessing antioxidant agents and potent bioactive molecules that function synergistically in maintaining cardiovascular stability and decreasing arterial pressure. This empirical study sought to examine how far the intake of boiled moringa leaves contributes to reducing blood pressure values in hypertensive older adults living within Meunasah Papeun Village, situated in Krueng Barona Jaya Subdistrict, Aceh Besar District. The statistical evaluation showed a significant p-value of 0.001 (p < 0.05), confirming a substantial effect under a quantitative quasi-experimental approach applying the One Group Pretest-Posttest model. The research sample included 20 participants chosen from a total population of 77 individuals through purposive sampling. The investigation took place from May 27 to June 25. Data were obtained using observation forms, standard operating procedures (SOP) for moringa leaf preparation, and manual sphygmomanometer readings. The findings revealed that prior to the application of treatment, the mean systolic blood pressure reached a level of 193.30 mmHg, whereas following the intervention it displayed a considerable decrease, it fell to 129.75 mmHg. The mean diastolic pressure also exhibited a decrease from 94.00 mmHg, confirming the notable influence of moringa leaf decoction in controlling hypertension. In summary, moringa leaf infusion proved effective in lowering blood pressure among elderly individuals suffering from hypertension. It is recommended that patients regularly consume boiled moringa leaves when experiencing increased blood pressure, that community health services provide education regarding non-pharmacological hypertension management through moringa leaf decoction, and that further research explore this topic with broader variables.

Obstetricians are often confronted with medical malpractice lawsuits, even when they have acted in accordance with professional standards, medical service standards, operational procedures, and medical ethics. Medical malpractice is generally defined as negligence or deviation from professional standards that results in serious harm to patients (Fiscina, 1999). This study aims to examine the application of the concept of medical malpractice along with its legal implications and to analyze the forms of legal protection available to obstetricians under Law Number 17 of 2023 on Health, viewed from the perspective of the principle of justice. Using a normative juridical method with descriptive-analytical specifications, the research employed a literature study and qualitative deductive analysis. The results indicate that legal protection for obstetricians consists of two dimensions: preventive and repressive. Preventive protection includes the implementation of informed consent, proper medical records, and compliance with standard operating procedures. Repressive protection involves legal defense mechanisms and institutional or professional organizational support. However, this protection remains suboptimal, as the decisions of the Indonesian Medical Disciplinary Board (MKDKI) are not always taken into account by the courts (Rahman, 2022). From the perspective of Rawls’ principle of justice, protection for obstetricians should ensure a balanced recognition of both patients’ and doctors’ rights, thereby promoting fairness and equitable justice for all parties (Rawls, 1971).

Impaired emotion regulation and decreased quality of life are common, yet often untreated, sequelae of stroke. Conventional rehabilitation primarily targets physical and cognitive recovery, leaving affective disturbances unaddressed. This study examined the efficacy of a structured Buddhist meditation program—Mindful Resilience After Stroke (MRAS)—for improving emotion regulation and quality of life in stroke survivors. Forty-two ischemic/hemorrhagic stroke patients (3–18 months post-onset) were consecutively recruited and randomly allocated to an intervention group (n = 21) receiving an 8-week MRAS protocol (1 × 60 min/week) or a control group (n = 21) receiving standard care only. Emotion regulation was assessed with the Difficulties in Emotion Regulation Scale-Short Form (DERS-SF) and quality of life with the Stroke-Specific Quality of Life Scale (SS-QOL). Between-group changes (Δ post-pre) were analyzed using independent t-tests or Mann–Whitney U tests (α = 0.05). The intervention group showed a significantly greater reduction in emotion-regulation difficulties than controls (ΔDERS-SF −18.4 ± 5.1 vs. −3.2 ± 4.3; p < 0.001; d = 1.62). Quality-of-life gains were also larger in the intervention group (ΔSS-QOL 35.7 ± 8.9 vs. 7.1 ± 6.5; p < 0.001; d = 1.89). The most improved sub-domains were emotional acceptance, emotional awareness, and impulse control (DERS-SF), as well as energy, mood, and social participation (SS-QOL). No intervention-related adverse events were reported. MRAS is an effective and safe adjunctive intervention to enhance emotion regulation and quality of life after stroke. Embedding mindfulness practices grounded in Buddhist tradition into stroke rehabilitation offers a holistic, culturally adaptable approach for neuropsychological services in Indonesia.

This study aimed to examine the relationship between nurses’ caring behavior and the satisfaction of inpatients at Banjarmasin Islamic Hospital. Caring is the core of nursing practice, encompassing a holistic concern for patients, while patient satisfaction is an important indicator of healthcare quality. This study employed a quantitative research design. The population consisted of all inpatients at Banjarmasin Islamic Hospital, resulting in a total of 100 respondents. The instruments used were a caring behavior questionnaire based on Jean Watson’s theory and a patient satisfaction questionnaire. Data were analyzed using the Spearman Rank test with a significance level of 0.01. The results showed that most nurses were perceived as having good caring behavior, and the majority of patients reported being satisfied with the services provided. Statistical testing revealed a significant relationship between nurses’ caring behavior and inpatient satisfaction (p-value = 0.01; r = 0.504), with the strength of the relationship categorized as moderate. The study concludes that the better the nurses’ caring behavior, the higher the level of patient satisfaction. It is recommended that the hospital continue to enhance nurses’ caring competence through training, supervision, and regular evaluation, so that the quality of nursing services and patient satisfaction can be continuously improved.

This study aims to analyze the implementation of internal control in the receivables audit process and evaluate its effectiveness in minimizing the risk of bad debts in a health center environment. Receivables, especially those originating from health services to JKN participants and general patients, can cause problematic receivables if not managed effectively. This study uses a descriptive qualitative approach with data collection through observation, interviews and documentation review during the audit by a public accounting firm. The results of the study indicate that there are still weaknesses in the internal control structure such as suboptimal separation of duties, an unintegrated receivables information system and a weak bad debt reserve policy. In addition, late payments by third parties and poor patient administration knowledge are also external factors that influence the high risk of bad debts. Therefore, improving the internal control system, implementing information technology and strengthening coordination with the guarantor are very important to reduce the risk of bad debts and increase accountability for financial management in the health center environment.

The Baayun Counseling Socialization Program at the Health Center is designed to improve the understanding and skills of health workers in implementing a more humane and local culture-based counseling approach. Baayun counseling is a therapeutic communication method that integrates cultural values in the interaction between health workers and patients, so that services become more personalized, empathetic, and meaningful. This program is carried out through several stages, namely needs analysis, socialization, and effectiveness evaluation. The main target is health workers in primary services who interact directly with patients. The expected results of this program include improving the competence of health workers in understanding and implementing Baayun Counseling, as well as increasing patient satisfaction and compliance with health services. Program evaluations show that this approach is able to create positive changes in communication patterns, strengthen the relationship between health workers and patients, and improve the overall quality of counseling services. By adopting Baayun Counseling, Puskesmas can strengthen the cultural dimension in health services, making them more relevant and responsive to the needs of local communities. The program also has the potential to be replicated in other culturally rich regions as part of a community-based health service quality improvement strategy.

Hospitals, as healthcare institutions, bear the responsibility of delivering safe, high-quality, and patient-centered services. Hospital accreditation serves as a crucial mechanism to ensure service quality and legal protection for patients, particularly in medical dispute cases. This study aims to analyze the impact of accreditation on patient legal protection, both preventively and repressively. The research employs a normative legal method with statutory and conceptual approaches, utilizing primary, secondary, and tertiary legal materials. Data were analyzed through document studies covering Law Number 17 of 2023 on Health, government regulations, presidential regulations, and technical regulations from the Ministry of Health regarding accreditation standards and procedures. The findings indicate that accreditation functions as a continuous evaluation mechanism to ensure medical services comply with safety standards and clinical governance, strengthens patients’ rights to information, informed consent, and quality care, and reduces the risk of medical disputes. However, implementation challenges exist, including limited resources, compliance performed as formalities, and inconsistent supervision. Therefore, accreditation is not merely an administrative symbol but a strategic legal instrument that enhances patient safety culture and hospital accountability, ensuring that healthcare delivery meets professional, ethical, and legal standards.

Hospitals in DKI Jakarta continue to face service quality challenges, including long waiting times, fragmented information systems, and limited patient access to digital health technologies. Although digital transformation and digital literacy are expected to enhance service quality, the mediating role of patient experience remains insufficiently explored. This study investigates the effects of digital transformation and digital literacy on service quality, with patient experience as a mediating variable. A quantitative explanatory design was applied using data from 200 outpatients. Measurements were based on validated indicators of digital transformation, digital literacy, patient experience, and service quality. Structural Equation Modeling (SEM) with AMOS was employed for analysis. The findings show that digital transformation significantly improves patient experience and service quality. Digital literacy positively affects patient experience but does not directly influence service quality. Patient experience fully mediates the relationship between digital literacy and service quality and partially mediates the effect of digital transformation. These results highlight the critical role of patient experience in translating digital capabilities into perceived service improvements. Hospitals are encouraged to strengthen digital transformation initiatives, enhance digital literacy support—especially for older adults—and design user-friendly digital services that facilitate communication and access. This study integrates the Technology Acceptance Model and Customer Experience Theory to provide empirical evidence on how digital-based interventions can advance hospital service quality.

Hidayah Boyolali General Hospital (RSU) was established by the Yayasan Dua September Boyolali and began operating since September 2, 2011 as a medical center, then officially became a hospital in May 2012 through the Decree of the Head of the Investment and Integrated Licensing Service Agency of Boyolali Regency No. 503/002/30 of 2012. As a type D private hospital, RSU Hidayah Boyolali is committed to providing professional health services that are oriented towards customer satisfaction. In the face of fierce competition between hospitals, especially in the Boyolali area, RSU Hidayah seeks to develop an effective marketing strategy to increase the number of patient visits. This Community Service activity aims to improve the knowledge and skills of the hospital development team related to marketing strategies through the Hospital Corporate Social Responsibility (CSR) approach. The solutions offered include education on CSR concepts and methods in hospital marketing, CSR implementation training, and assistance in developing strategies and user interfaces for customer data collection. The output of this activity includes the publication of the results of service in scientific journals, videos of online activities, increasing the knowledge and skills of the hospital development team, and integrating the results of the activities into the Hospital Marketing Management course. This activity is expected to be able to strengthen the ability of Hidayah Boyolali Hospital to compete and increase patient satisfaction and loyalty.

The Watu Kawula Health Center is one of the first level health service facilities that has an important role in providing health services to the community. However, in the implementation of administration, various obstacles are still found such as manual patient data recording, slow service data collection process, and difficulties in reporting and searching data. To overcome these problems, a computerized administrative information system is needed to improve efficiency and accuracy in data management.This research aims to design and build an integrated administrative information system at the Watu Kawula Health Center. The system development method used is the Waterfall model, which includes the stages of needs analysis, system design, implementation, testing, and maintenance. The system is designed using the MySQL database and PHP programming language, and is accessed through a web-based interface.The results of the development of the system show that this administrative information system is able to speed up the process of recording patient data, medical services, and making routine reports. In addition, the system also makes it easier for administrative officers to manage information in a structured and systematic manner. With this system, it is hoped that administrative services at the Watu Kawula Health Center can run more effectively and efficiently.

Hirschsprung’s disease is a congenital disorder caused by abnormal nerve cell development in the large intestine, leading to chronic intestinal obstruction in infants. This condition often manifests through symptoms such as constipation, abdominal distension, vomiting, and failure to thrive. The weak immune system of infants makes them highly susceptible to bacterial infections and further complications. At Bidadari General Hospital, there were 110 patients suspected of having Hirschsprung’s disease. One of the major challenges in managing these cases is the limited number of medical specialists, particularly pediatricians and pediatric surgeons, resulting in long waiting times for accurate diagnosis, especially during peak service hours. To address this issue, this study applies the Dempster-Shafer method in an expert system to assist in diagnosing Hirschsprung’s disease based on clinical symptoms. The method effectively handles uncertainty and combines multiple pieces of medical evidence to produce more accurate diagnostic probabilities. The analysis results show that from the selected symptoms, the highest diagnosis probability corresponds to short-segment Hirschsprung’s disease with a confidence level of 71.54%. These findings suggest that the Dempster-Shafer method can serve as an effective alternative tool to support early and accurate diagnosis of Hirschsprung’s disease in infants.

Introduction: Experiential marketing has become a growing trend in promotional activities by emphasizing personalization and active customer involvement. Preliminary observations indicate a decline in outpatient visits among patients with general insurance and non-JKN coverage in 2023, which may be influenced by a decrease in their intention to use outpatient services. This condition highlights the need for hospitals to implement experiential marketing strategies to enhance patient interest and experience. Objective: This study aims to empirically examine the influence of patient experience and service perception on the intention to use outpatient services, with Strategic Experiential Modules (SEMs) as an intervening variable. Methods: This quantitative research employs a causal design involving outpatient service users as the population. A non-probability sampling technique was used, yielding 249 respondents. Data were collected using a questionnaire and analyzed using Structural Equation Modeling (SEM) with AMOS software. Results: The findings reveal that patient experience and service perception simultaneously have a significant positive influence on the intention to use outpatient services through SEMs. Service perception directly shows a significant positive effect on both SEMs and intention to use outpatient services, while SEMs also significantly enhance usage intention. Service perception emerges as the dominant variable in increasing SEMs and usage intention, whereas patient experience has the weakest effect. Conclusion: Patient experience and service perception collectively influence the intention to use outpatient services with SEMs as an intervening variable. Strengthening Customer Relationship Management is essential by improving human resources and optimizing service asset.

The advancement of digital technology has transformed how people search for information and access health services. RSIA Clas C Cipondoh faces challenges related to its brand image, as indicated by low patient engagement with the hospital’s website and digital platforms, based on a preliminary survey. This study aims to analyze the simultaneous and partial effects of digital literacy, website quality, and ease of access on the brand image with digital marketing strategy as a moderating variable. A quantitative research method with a cross-sectional approach was employed. The study involved 152 outpatient respondents who had accessed the hospital website. Data were analyzed using index analysis with the Three Box Method and Moderated Regression Analysis (MRA) to test the moderating effect. Findings reveal that digital literacy, website quality, and ease of access simultaneously and significantly influence the hospital’s brand image. Partially, each of these variables also has a positive and significant effect on brand image. Moreover, the digital marketing strategy effectively moderates the relationships between digital literacy, website quality, and ease of access with brand image. The Three Box Method analysis indicates that although website quality falls into the high category, weaknesses remain in the interaction quality dimension. The study concludes that strengthening digital literacy, improving website quality, and ensuring ease of access supported by an effective digital marketing strategy can enhance the hospital’s brand image. Hospitals are advised to add interactive features such as chatboxes or live chat to improve patient engagement and online service experience.

Modern healthcare services are undergoing transformation toward a more humanistic and patient-centered approach, emphasizing hospitality based services in hospitals. However, many healthcare institutions, particularly in outpatient settings, have not fully adopted this concept. Patients often experience psychological distress, and when coupled with an unsupportive physical environment, their comfort and overall experience may be diminished. These conditions can negatively affect perceptions of service quality, patient satisfaction, and loyalty toward hospital services. This study aimed to analyze the influence of patients’ psychological conditions and the physical environment on hospitality-based services, with patient experience as an intervening variable, at the internal medicine outpatient clinic of BM Hospital. A quantitative research design using a cross-sectional approach was employed. The study involved 200 respondents selected through purposive sampling. Data were collected using structured questionnaires with Likert-scale items and analyzed with Structural Equation Modeling Partial Least Squares (SEM-PLS). The results showed that patients’ psychological conditions, the physical environment, and patient experience simultaneously and significantly influenced hospitality-based services. Hypothesis testing confirmed that both psychological conditions and the physical environment had a direct and significant impact on hospitality-based services. Furthermore, patient experience played a mediating role, strengthening the relationship between these factors and perceived service quality. The findings highlight the need for hospitals to integrate psychological support and a conducive physical environment into outpatient care delivery. Enhancing these dimensions can improve patient experience, foster greater satisfaction and comfort, and build stronger loyalty toward hospital services

The World Health Organization (WHO) reported in 2019 that 40 million people worldwide require palliative care, including those with cardiovascular disease (38%), cancer (34%), chronic lung disease (10.3%), AIDS (5.7%), and diabetes (4.6%). Palliative care aims to improve the quality of life of patients and families facing life-threatening illnesses by managing pain and physical, psychological, social, and spiritual problems. The main goal of this care is to reduce suffering and help patients cope with the limitations imposed by illness. The principles are to respect life, consider death a normal process, neither hasten nor delay death, and provide support until the end of life. This study aims to determine whether knowledge can influence the level of self-efficacy of nursing students at Awal Bros University. Using a correlational quantitative method, data were collected through the Palliative Care Quiz for Nursing and Self-efficacy Palliative Care Scale questionnaires. The results of the study show a significant relationship between knowledge and self-efficacy among students with p<0.005. These findings can be used as a basis for learning to improve the understanding of nursing students, especially in the context of palliative care, which is important for the quality of health services in the future.

Patients with chronic kidney disease (CKD) often experience shortness of breath, fatigue, and a decline in quality of life due to fluid imbalance, anemia, and reduced lung capacity. These conditions highlight the need for simple, safe, and effective non-pharmacological interventions. This community service program, titled “Napas Lega Bersama” (“Breathing Relief Together”), aimed to improve the knowledge and skills of CKD patients in applying pursed-lip breathing (PLB) techniques as a strategy to enhance breathing patterns and overall well-being. The activity was conducted at a partner hospital’s hemodialysis unit through educational sessions, live demonstrations, and guided PLB practice over a two-week period. Pre- and post-program assessments were performed using standardized questionnaires to measure participants’ knowledge and perceived quality of life. The results showed an 85% increase in participants’ understanding of PLB and a 70% improvement in perceived comfort and daily activity performance after the intervention. Participants also reported reduced shortness of breath and greater relaxation during dialysis sessions. This program demonstrates that pursed-lip breathing can serve as a simple and effective complementary therapy to improve the quality of life of CKD patients. It is recommended that this initiative be continued through routine mentoring and interdisciplinary collaboration to promote therapeutic breathing exercises across healthcare settings.

Community Health Centers (Puskesmas) serve as the frontline for basic healthcare services for the community. However, the services at Waimangura Community Health Center are not yet fully optimal due to several obstacles, particularly in patient data recording, which is essential for registering every individual who visits for health check-ups, registration, and medical record management. Therefore, an information technology-based system is needed to enhance the effectiveness and efficiency of services. This research aims to implement a healthcare service system at Waimangura Community Health Center using the CodeIgniter 3 framework by applying the MVC (Model, View, Controller) method. The MVC method was chosen because it can separate application logic, display, and data management, making the system more structured, easier to develop, and maintaining consistency. The research stages include needs analysis, system design, implementation, and testing. The implementation results show that the built system is capable of assisting officers in patient registration, medical record data management, and information services. Patients also benefit from more transparent and efficient services. Based on the trial results, the system operates according to user needs and can improve the quality of healthcare services at the Waimangura Community Health Center. Thus, the implementation of CodeIgniter 3 with the MVC method has proven effective in building a structured, easily maintainable healthcare service system that can be further developed to support digital-based healthcare services.

Patient satisfaction is a feeling that arises from the performance of health services that have been obtained after the patient compares it with what was expected. Rather than the reality that occurs there are still complaints about outpatient registration services based on electronic medical records, Frequent obstacles are if the network is disrupted, then access to the EMR can be hampered or cannot be accessed at all and the limited capacity of the waiting room is also an obstacle, especially with the large number of patients during peak hours so that many patients wait outside the waiting room. This study aims to determine the level of patient satisfaction in outpatient registration based on EMR. This study uses a quantitative method with a population of 13,750 and a sample of 99 outpatients. Based on the results of the study in 2025, it can be concluded that patient satisfaction with RME-based outpatient registration in the aspect of tangibles can be categorized as "Less Satisfied" especially regarding facilities such as AC/Television, from the aspect of reliability it can be categorized as "Satisfied" even though there are a few respondents who answered "Less Satisfied", from the aspect of responsiveness it can be categorized as "Satisfied" even though there are some patients who feel "Less Satisfied", from the aspect of assurance in RME-based outpatient registration it can be categorized as "Satisfied" but there are a small number of patients who answered "Less Satisfied" and from the aspect of empathy it can be categorized as "Satisfied" even though there are some patients who answered "Less Satisfied". So the researcher's suggestion is that the Hospital improves the quality of the waiting room, especially AC, television, increases the number of chairs and provides adequate seating for all patients, so that patients are more comfortable and avoid overcrowding

Patient satisfaction refers to the degree of emotion felt by an individual, arising from an assessment of the quality of medical care received, compared to initial expectations. Suspected dissatisfaction among visitors to the Huta Padang Community Health Center, Asahan Regency, appears to be due to the inadequacy of the primary care facilities provided at the institution. Information gathering was conducted from July to August 2023. This analytical study aimed to measure patient satisfaction with essential health care at the Regional Technical Implementation Unit (UPTD) of the Huta Padang Community Health Center, Asahan Regency. The target group of the study included all polyclinic patients visiting the Saribudolok Community Health Center. Respondents were selected using a purposive sampling technique, with a total of 64 participants. The study findings were summarized through a frequency distribution table, followed by statistical data processing via a Chi-square test at a 95% significance level (α = 0.05). The analysis revealed a relationship between primary care quality and patient satisfaction, indicated by a p-value of 0.018. Therefore, it is recommended for Community Health Center leaders to actively improve the standards of assistance provided, for example by providing encouragement or incentives for staff to carry out their duties optimally, so that they can realize patient anticipation.

Long outpatient waiting time is an indicator of suboptimal hospital administrative systems. The Hospital Management Information System (SIMRS) is designed to improve administrative efficiency; however, in practice, complaints about long patient waiting time still persist. This study aims to examine the relationship between the registration administrative system using SIMRS and the waiting time for outpatient services at RS Patria IKKT in 2025. A quantitative approach with a cross-sectional analytical design was employed. The sample consisted of 100 outpatient respondents selected using purposive sampling. Data were collected through questionnaires and analyzed using the Chi-Square test and Spearman correlation to determine the relationship between variables. The results show that the system quality, information quality, and service quality of SIMRS at RS Patria IKKT are categorized as good. Spearman correlation analysis reveals no significant relationship between system quality (p=0.281) and information quality (p=0.910) to waiting time. However, the Chi-Square test indicats a significant relationship between service quality (p=0.001) and outpatient waiting time. The implementation of SIMRS at RS Patria IKKT contributes to accelerating administrative processes and reducing outpatient waiting time. Nevertheless, improvements in service quality are necessary to achieve more optimal results.