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Hospitalization is a condition that requires a child to be admitted to the hospital. This situation causes children to experience anxiety, restlessness, and fear. One of the nursing interventions to reduce anxiety due to hospitalization is play therapy. A form of play therapy appropriate for preschool children is puzzle play therapy. Puzzle play therapy is an activity in which children arrange pieces of pictures or specific shapes to form a complete image. This therapy encourages children to develop patience, stimulates concentration, and provides feelings of comfort and enjoyment, thereby reducing anxiety. The method used in preparing this Final Nursing Scientific Paper was a descriptive case study with the implementation of puzzle play therapy. The respondents consisted of three children experiencing anxiety due to hospitalization. Puzzle play materials and the Facial Image Scale (FIS) were used as measurement tools. The intervention was conducted over three consecutive days, with a duration of 15 minutes per session. The results showed a decrease in anxiety levels after puzzle play therapy: respondent 1 decreased from anxiety scale 5 to scale 1, respondent 2 from scale 4 to scale 1, and respondent 3 from scale 5 to scale 1. It can be concluded that puzzle play therapy is effective in reducing anxiety due to hospitalization in preschool children with dengue hemorrhagic fever. The implementation of puzzle play therapy is expected to become a routine nursing intervention to reduce hospitalization-related anxiety in preschool children with dengue hemorrhagic fever.

Background: Diabetes Mellitus (DM) is a disease that cannot be completely cured or cannot even be completely cured. The vile shard plant is empirically used by the community to treat diabetes (DM). This study aims to conduct phytochemical screening and test the activity of 96% ethanol extract of kejibeling leaves (Strobilanthes crispus (L.) Bl.) as a herbal antidiabetic in male white mice (Mus musculus) with alloxan induction. Method: This research is an experimental laboratory research with a true experimental posttest control design using a completely randomized design (CRD) with 5 treatments and 5 replications. Treatment P1 (without treatment) as normal control (N), P2 as positive control (+), P3 as negative control (-), P4 kejibeling leaf extract 250 mg/kg BW, P5 kejibeling leaf extract 500 mg/kg BW. Result:The results of phytochemical screening showed the presence of alkaloids, flavonoids, tannins, saponins, terpenoids and steroids. SPSS results show that the data is normally distributed (p>0.05) and homogeneous (p>0.05). The results of the ANOVA on the treatment of giving keji beling leaf extract 250 mg/Kg BW showed a sig. 0.393 (p>0.05) and treatment of 500 mg/Kg BW obtained a sig value. 0.517 (p>0.05). Conclusion:The conclusion from the research results shows that administering doses of 250 mg/kg BW and 500 mg/kg BW of keji beling leaf extract can reduce blood sugar levels in mice. It is hoped that the results of this research will be useful for the community as an antidiabetic therapy using kejibeling leaves (Strobilanthes crispus (L.) Bl.).

The IV infusion process will cause pain that can be disturbing for children. Pain is a form of uncomfortable sensation that is felt personally by each individual. In addition, there will be changes in vital signs such as increased pulse, blood pressure, and respiration so that it will be an unpleasant experience for children. Non-pharmacological therapy as an intervention to reduce pain perception in children and increase comfort during medical procedures. One form of non-pharmacological technique is audio visual distraction using a smart book. Smart books are fun and interactive play therapy that can support cognitive, fine motor, and sensory aspects in children and to divert children's attention from pain by displaying more pleasant and interesting images and musical sounds so that it can reduce the pain scale after IV installation. The design used in the preparation of this Final Scientific Paper for Nurses is a case study with an intervention in the form of audio visual distraction using a smart book for ± 10 minutes. The number of respondents was 3 people, the intervention was carried out on September 14, October 7, and November 24, 2025, located in the Theresia Charitas Hospital Palembang room. After the smart book audio visual distraction therapy, there was a decrease in the pain scale for 3 respondents, namely in An. A from a pain scale of 7 to a pain scale of 4, An. G from a pain scale of 10 to a pain scale of 4, and An. R from a pain scale of 7 to a pain scale of 4. The application of EBP smart book audio visual distraction therapy can be used to reduce the pain scale in preschoolers after IV installation.

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.

Hyperemesis gravidarum is a common complication in early pregnancy characterized by excessive nausea and vomiting that can negatively affect maternal health and quality of life. Although pharmacological management is widely used, concerns regarding medication safety during pregnancy have increased interest in complementary and non-pharmacological interventions. One such approach is aromatherapy, particularly the use of lavender essential oil, which is known for its calming and antiemetic properties. This study aimed to evaluate the effectiveness of lavender aromatherapy in reducing the frequency of hyperemesis gravidarum among pregnant women at RSUD Tikep. This research employed a quantitative quasi-experimental design with a pretest–posttest approach. A total of 30 first-trimester pregnant women experiencing hyperemesis gravidarum were selected using purposive sampling. The intervention involved inhalation of lavender aromatherapy administered for a predetermined duration and frequency. The frequency of nausea and vomiting was measured before and after the intervention using observation sheets and self-reported records. Data were analyzed using SPSS software, including descriptive statistics, normality tests, and paired sample t-tests. The results demonstrated a significant reduction in the mean frequency of hyperemesis gravidarum following the administration of lavender aromatherapy. Statistical analysis revealed a p-value of less than 0.05, indicating a significant difference between pre-intervention and post-intervention measurements. These findings suggest that lavender aromatherapy effectively reduces the frequency of nausea and vomiting in pregnant women. In conclusion, lavender aromatherapy is a safe, low-cost, and effective complementary therapy for managing hyperemesis gravidarum. Its integration into routine antenatal care may enhance maternal comfort and support holistic, patient-centered maternity services, particularly in regional healthcare settings.

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.

Adolescents affected by parental divorce face increased risks of mental health challenges, often exacerbated by custody disputes, post-separation abuse, and institutional inadequacies. This study aims to evaluate the effectiveness of trauma-informed, family-based interventions and custody-related policy reforms that promote adolescent mental health, with a focus on the integration of the Islamic principle of maslahah as an ethical framework. A systematic review was conducted using three databases (ScienceDirect, PubMed, Scopus) covering publications from 2000 to 2024. Inclusion criteria focused on empirical studies addressing interventions, custody policies, and mental health outcomes in adolescents aged 10–21. Findings reveal that Treatment Foster Care Oregon (TFCO) reduces behavioral issues and improves emotional regulation; Multisystemic Therapy and Wraparound Services prevent custody relinquishment and support family cohesion. Legislative reforms like the Family First Prevention Services Act have shown promise in redirecting funding toward prevention, yet face significant implementation disparities. Reports of healthcare obstruction and court-induced trauma remain critical threats to adolescent well-being. The review also found that custody loss, particularly among adolescent parents, correlates with increased substance use and long-term psychosocial instability. The integration of maslahah into legal and mental health frameworks provides a culturally grounded approach to trauma-informed reform. These findings emphasize the need for cross-sectoral collaboration, standardized trauma protocols, and culturally responsive service models. This study advances a holistic understanding of adolescent welfare in custody contexts and identifies pathways for ethical and sustainable reform.

Herpes zoster is a skin infection caused by the reactivation of the varicella-zoster virus, characterized by unilateral skin lesions corresponding to dermatome distribution and complaints of pain or itching. This disease is more common in adults and the elderly, especially in individuals with reduced immunity due to stress or work overload. A case was reported of a 40-year-old woman who worked as a nurse and came to a primary health care facility complaining of itching and red spots on her right breast area that had spread to the surrounding area two weeks before the examination and had worsened in the last few days. Physical examination revealed unilateral red skin lesions in a dermatomal pattern without crossing the midline of the body, consistent with the early phase of herpes zoster. Management was comprehensive, including medication, patient education about the disease and skin care, prevention of complications, and family support. A holistic approach is necessary to improve the success of therapy and the patient's quality of life.

Breast milk is the optimal source of nutrition for infants, and adequate milk production is essential to support infant growth and development. However, many breastfeeding mothers experience difficulties in milk production, particularly during the early postpartum period. Rolling massage is a non-pharmacological intervention that is believed to stimulate the release of oxytocin and prolactin hormones, thereby enhancing breast milk production. This study aimed to determine the effect of rolling massage on breast milk production in breastfeeding mothers at Tidore City Hospital.This research employed a pre-experimental design with a one-group pretest–posttest approach. A total of 30 breastfeeding mothers were selected as the sample using purposive sampling techniques. Breast milk production was assessed before and after the implementation of rolling massage. The intervention was performed according to standardized procedures. Data were analyzed using the Wilcoxon signed-rank test to evaluate differences in breast milk production before and after the intervention.The results showed a significant increase in breast milk production after the rolling massage intervention. Statistical analysis using the Wilcoxon signed-rank test revealed a p-value of 0.000 (p < 0.05), indicating a significant effect of rolling massage on breast milk production in breastfeeding mothers.In conclusion, rolling massage has a significant positive effect on increasing breast milk production among breastfeeding mothers. This intervention can be recommended as a simple, safe, and effective complementary therapy to support successful breastfeeding, particularly in the early postpartum period.

The incidence of hypertension at the Tadoy Community Health Center reached 29.4%, with 78 cases reported among pregnant women in 2023, half of which were pregnancy-induced hypertension (HDK). Hypertension during pregnancy poses short-term risks to both mother and fetus. In addition to pharmacological treatment, non-pharmacological therapies such as warm water foot soaking and Ambon banana consumption are considered beneficial. This study aimed to examine the effects of these two interventions on reducing blood pressure in pregnant women with hypertension. This research employed a qualitative method with a case study approach involving two pregnant women diagnosed with hypertension. The results showed that warm water foot soaking significantly reduced blood pressure from 150/90 mmHg at the first visit to 130/85 mmHg at the second visit, and further to 120/75 mmHg. Similarly, Ambon banana consumption reduced blood pressure from 150/90 mmHg to 140/90 mmHg, and eventually to 120/80 mmHg. Although both interventions were effective, warm water therapy demonstrated greater effectiveness in lowering blood pressure compared to banana consumption. These findings suggest that simple, non-pharmacological interventions can help manage hypertension in pregnancy. It is recommended that pregnant women apply warm water foot soaking independently to help control blood pressure and reduce pregnancy-related risks.

This study aims to analyze the application of reality therapy counseling in improving students’ learning motivation influenced by social and family environmental factors. This research uses a qualitative approach with a literature study method supported by interview data as complementary information. Data were collected through the analysis of relevant scientific literature and supported by interviews with parents to describe students’ daily behavior. The results show that low learning motivation is influenced by an unfavorable social environment and lack of family supervision, leading to behaviors that do not support learning activities, such as poor time management and low engagement in academic tasks. The application of reality therapy using the WDEP technique (wants, doing, evaluation, planning) helps students develop self-awareness, evaluate their behavior, and plan more adaptive actions. The findings indicate that reality therapy contributes positively to improving students’ learning motivation through behavioral change and increased personal responsibility. This study concludes that reality therapy can be used as an alternative approach in helping students overcome learning motivation problems.

Medical personnel compliance in prescribing drugs according to the National Formulary (ForNas) is essential to ensure rational therapy, improve service quality, and enhance efficiency in health financing at government health facilities. However, compliance remains a challenge at Johar Baru Regional General Hospital, Central Jakarta. This study aimed to analyze factors influencing medical personnel compliance with ForNas-based prescribing, including drug availability, management policies, and the knowledge, attitudes, norms, and perceptions of medical staff.A qualitative approach was used through in-depth interviews with medical personnel, heads of supporting service sections, and pharmacy unit leaders. The study also involved observation and review of hospital formulary documents, minimum service standards reports for 2024, and monitoring and evaluation reports on prescribing compliance for 2024 and January June 2025. Data were analyzed using thematic analysis supported by NVivo software.The findings indicate that compliance is influenced by medical personnel’s understanding of ForNas policies, clinical experience, and professional attitudes toward prescribing standards. Management factors such as supervision, technological support, and procurement systems also play important roles. Limited drug stocks and suboptimal control systems were identified as major obstacles.The hospital is recommended to strengthen compliance by updating clinical practice guidelines, developing a ForNas-based hospital formulary, improving management support, optimizing information technology systems, ensuring drug availability, and proposing additional ForNas drugs to the Ministry of Health.

Childhood tuberculosis remains a significant public health challenge, particularly in developing countries where malnutrition and limited diagnostic resources increase disease severity and mortality. Children are at high risk of rapid progression from latent infection to active disease due to immature immune systems. We report a case of a 1-year-old girl presenting with cough, fever, shortness of breath, and poor growth. Chest radiograph showed consolidation and infiltrates in the right paracardial area consistent with pulmonary tuberculosis. The patient was treated with first-line anti-tuberculosis drugs, including rifampicin and pyrazinamide, along with nutritional support, resulting in significant clinical improvement and discharge on day eight. This case emphasizes the importance of early recognition and management of tuberculosis in young children with risk factors such as malnutrition and incomplete immunization. Preventive strategies such as BCG vaccination, contact screening, family education, and access to tuberculosis preventive therapy are essential to reduce morbidity and mortality in childhood TB.

Wounds can be defined as the loss and damage of anatomical cells or skin function. Wound healing consists of coagulation, inflammation, proliferation, and remodeling stages. This study aims to determine the effectiveness of the leaf fraction of the thick (Glochidion superbum) on wound healing in male white mice (Mus musculus). This study is experimental. This study used 24 male mice that were given a 10 mm long cut wound. Fractionation was carried out using the liquid-liquid extraction method. Fractionation used 3 different types of solvents, namely methanol, ethyl acetate, and n-hexane. The results showed that the ethyl acetate fraction had a faster wound healing effectiveness than the other groups. The ethyl acetate fraction contains a phenolic compound, namely methyl gallate. Methyl gallate has an important role in wound healing. Methyl gallate has the potential to be an antibacterial, antioxidant, and anti-inflammatory. The results of the Bonferroni post-hoc statistical analysis confirmed the effectiveness of the ethyl acetate fraction in faster wound healing. The thick leaf fraction was effective in healing incisions in male white mice. The ethyl acetate fraction was more effective in accelerating incision healing.

This study systematically analyzes the effectiveness of school-based resilience programs designed for Palestinian children in the West Bank through a systematic review of 47 programs implemented over the period 2010–2023. The meta-analysis encompasses 12,847 participants aged 6–18 years from 89 schools and demonstrates a significant increase in resilience scores with a large effect size (d = 0.76, p < .001), accompanied by a substantial reduction in psychological trauma symptoms (r = -0.64, p < .001) and marked improvements in academic functioning (β = 0.58, p < .01). Programs integrating mindfulness approaches and psychosocial support exhibited the strongest effects (η² = 0.42), followed by expressive arts interventions (η² = 0.38) and play therapy (η² = 0.35), collectively underscoring the critical importance of non-conventional approaches in contexts of protracted conflict. Multilevel regression analysis revealed that a minimum program duration of 12 weeks and the level of family engagement contributed significantly to enhanced intervention effectiveness (R² = 0.67, p < .001). These findings extend the results of Qouta (2020) and Jabr et al. (2013) on child resilience in conflict zones, while offering an original contribution through the identification of specific program components most responsive to the Palestinian context. In particular, the integration of local cultural elements and the strengthening of collective identity were shown to increase program effectiveness by up to 43% compared with universal approaches, a pattern that has not been systematically documented in the previous literature.

RFA treatments, pain is a frequent issue that might interfere with comfort and postpone recovery. Pharmacological treatment continues to be the mainstay of pain management after RFA, whereas non-pharmacological nursing treatments like cold compress therapy are not regularly used. The purpose of this research was to investigate how cold compress therapy affects pain severity in individuals following radiofrequency ablation. At the central general hospital in central Java, a quantitative quasi-experimental design was used, employing a one-group pre-test and post-test methodology. Twenty-eight participants were chosen using purposive sampling. The NRS was used to assess the intensity of pain both before and after applying a cold compress for 15–20 minutes. The Wilcoxon Signed Rank Test was used to examine the data. Following the intervention, the median pain scores fell from 5 (moderate pain) to 2 (mild pain), which was a statistically significant change (p = 0.001). These results suggest that cold compress therapy can be advised as a non-pharmacological nursing intervention in post-procedural treatment since it helps lessen post-RFA pain

Background: The elderly are individuals who have reached the age of 60 and above. For most elderly people, loss or limitation of resources is a factor that can trigger anxiety. Anxiety is a complex emotional condition associated with feelings of fear and often accompanied by physical symptoms such as rapid heartbeat, shortness of breath, or chest pain. The role of nurses as care providers in reducing complaints in anxious clients uses independent nursing interventions, one of which is the application of non- pharmacological therapy. Non-pharmacological therapy is diversionary therapy. Objective: To determine the effectiveness of diversionary therapy in reducing anxiety levels in elderly people at the Abiyoso Yogyakarta BPSTW unit .Method: The design of this case study is descriptive. This study conducted treatment or intervention on clients to observe changes before and after using the HARS questionnaire .Results: All three forms of diversion therapy administered showed a decrease in anxiety levels in Mr. B. Measurements using the HARS instrument showed a decrease in scores  from an initial 19 to 13 after three interventions. Conclusion: The intervention, administered over three consecutive days, showed positive  changes with a decrease in anxiety scores.

Dementia is a progressive neurocognitive disorder often accompanied by behavioral and psychological symptoms such as agitation, anxiety, and depression. Pharmacological treatments provide only modest benefits while introducing significant risks, which highlights the need for safer, non-pharmacological alternatives. This literature review examines the role of virtual reality in dementia care, with a focus on its integration with therapies such as music, reminiscence, sensory stimulation, and cognitive training. Evidence from prior research suggests that virtual reality can enhance cognitive functions, reduce symptoms, and improve emotional well-being while also strengthening patient–caregiver interaction. However, challenges related to usability, accessibility, cost, and long-term effectiveness continue to limit adoption. Gaps in research, including limited cultural diversity, inconsistent reporting of intervention design, and a lack of large-scale longitudinal trials, emphasize the need for future work exploring cross-cultural feasibility and AI-driven personalization. Overall, virtual reality represents a promising and evolving non-pharmacological intervention that has the potential to transform dementia care by improving quality of life and reducing reliance on medication.

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.