Publication Search

Background: Dietary adherence is a crucial component in the management of patients with chronic kidney disease (CKD) undergoing hemodialysis. Non-adherence may lead to metabolic imbalance, increased morbidity, and reduced quality of life.Objective: To identify factors associated with dietary non-adherence among patients with CKD undergoing hemodialysis at Imelda Hospital, Medan. Methods: A cross-sectional study was conducted among patients undergoing routine hemodialysis. Data were collected using structured questionnaires assessing knowledge, attitudes, and family support related to dietary adherence. Statistical analysis was performed using chi-square tests and logistic regression with a significance level of p < 0.05. Results: Knowledge, attitudes, and family support were significantly associated with dietary non-adherence (p < 0.05). Family support was identified as the most influential factor. Conclusion: Dietary non-adherence among hemodialysis patients is influenced by knowledge, attitudes, and family support. Strengthening patient education and family-centered nursing interventions is essential to improve dietary adherence.

Improving service quality is a primary priority in hospital management. Service quality can be improved by reducing the percentage of non-value added activities through the Lean Hospital approach. This study aims to identify activities and analyze the root causes of critical waste in the drug distribution and utilization processes at the Outpatient Pharmacy Installation of Karanganyar Regency Hospital. This study is a non-experimental research with a qualitative descriptive design. Critical waste was obtained through the distribution of a waste weighting questionnaire assessed by all personnel involved in the drug distribution and utilization processes. The results show that the Value Stream Mapping calculation for the drug distribution process obtained a lead time of 147.41 minutes and a VAR value of 36%, while in the drug utilization process, compounded prescription service obtained a lead time of 128.53 minutes and a VAR of 24%, and non-compounded prescription service obtained a lead time of 75.8 minutes and a VAR of 26%. The critical waste questionnaire calculation using the Borda method in the drug distribution process showed overproduction 60%, inventory 53.33%, and waiting 43.33%, while in the drug utilization process, waiting 43.75%, overproduction 42.85%, and defect 39.70%. The 5S method, a Lean method, was used to eliminate waste in the service process at the Outpatient Pharmacy Installation of Karanganyar Regency Hospital.

The incidence of degenerative diseases, which are part of Non-Communicable Diseases (NCDs), remains a major cause of death worldwide and in many regions of Indonesia. Meanwhile, efforts to prevent degenerative diseases affecting the adolescent age group are still rare, such as the establishment of a Youth Posyandu, including in Sungai Duren Village. There is no health post that provides youth care services in Sungai Duren Village, while there are many teenagers living there (students under 21 years old) with various lifestyles that are at risk of degenerative diseases. This study aims to analyze the increase in adolescent knowledge about CERDIK between before and after the establishment of the Youth Posyandu in order to prevent degenerative diseases early. This study is a quasi-experimental study involving 30 adolescents by measuring the dependent variable of knowledge. The research instrument used is a questionnaire. Computerized data processing and analysis were conducted through descriptive statistical analysis and T-test analysis. The results showed a significant difference in respondents' knowledge of CERDIK before and after the establishment of the Youth Posyandu in Sungai Duren Village (p=0.000). This study indicates that structured health education can improve adolescents' understanding of CERDIK and can be used as an effective promotive and preventive strategy.

The study was conducted at Middle Technical University (College of Health & Medical Techniques, Baghdad) from 29Th October 2024 to 15Th January 2025, enrolling 148 students aged 20–24 years (47.3%), 25–29 years (41.9%), 30–39 years (9.5%), and over 40 years (1.4%), Participants completed a structured questionnaire to assess attitudes toward drug abuse. Regarding protective attitudes, 66.2% agreed that educational programs aid prevention, 68.9% viewed better education as protective, 58.8% cited close family ties, and 72.2% recommended avoiding friends who use drugs, Departmental analysis showed the highest proportion of ―good knowledge in Anesthesia Techniques (95.3%) and the lowest in Physical Therapy Techniques (80.2%) While overall awareness of drug abuse is high among health and medical students, misconceptions regarding its symptoms and effects persist. Targeted educational interventions—especially within departments showing lower knowledge—and reinforcement of accurate prevention and treatment strategies are recommended to strengthen students’ competencies in addressing drug abuse.

This study examines how integrating local ecological wisdom and eco-literacy education fosters environmental awareness, behavioral transformation, and health outcomes among Indonesian primary school students. The research responds to the ecological paradox of rapid technological growth amid worsening environmental degradation, where youth eco-literacy remains below 45%, indicating a gap between environmental knowledge and sustainable action. The study aims to develop a culturally responsive model of sustainability education that connects environmental ethics, cultural identity, and public health. Using a qualitative case study design, the research was conducted at SD Islam Kreatif Mutiara Anak Sholeh, Sidoarjo, East Java, from July to August 2025, involving 60 students and six teachers. Data were collected through semi-structured interviews, observations, and document analysis. Four major themes emerged: (1) cultural narratives as catalysts for environmental awareness, (2) eco-literacy as experiential and behavioral transformation, (3) collaborative learning as collective environmental agency, and (4) eco-health as psychosocial and physical well-being. Findings show that integrating Majapahit-era ecological values and local storytelling into eco-brick and composting projects enhanced students’ responsibility, cooperation, and emotional balance. The study synthesizes Eco-pedagogy, Constructivism, and Eco-health frameworks into a Culturally Responsive Eco-Health Pedagogy, demonstrating that sustainability learning rooted in culture and participation promotes both environmental and health outcomes. This model contributes to the global Education for Sustainable Development (ESD) 2030 agenda by linking culture, ecology, and well-being in primary education.

Low back pain is a common complaint among pregnant women in the second and third trimesters due to biomechanical and hormonal changes. Non-pharmacological interventions like prenatal exercise are believed to be effective, though evidence from controlled trials is limited. This study aimed to evaluate the effectiveness of prenatal exercise in reducing low back pain intensity. A quasi-experimental pretest–posttest control group design was used with 30 pregnant women (15 in the intervention group, 15 in the control group), selected by purposive sampling. The inclusion criteria were gestational age of 20–36 weeks, no medical contraindications, and willingness to participate. The intervention group performed prenatal exercises twice a week for 8 weeks (45 minutes per session), while the control group received health education without physical exercise. Pain intensity was measured using the Visual Analogue Scale (VAS). Data analysis was conducted using paired t-test, independent t-test/Mann–Whitney, and ANCOVA to control for age, parity, and BMI. Both groups had homogeneous baseline characteristics (p > 0.05). The intervention group’s pain score decreased from 6.9 ± 1.1 to 3.6 ± 1.0 (Δ = -3.3; p < 0.001), while the control group’s pain score decreased from 6.8 ± 1.2 to 6.3 ± 1.1 (Δ = -0.5; p = 0.09). The difference in pain reduction between groups was significant (p < 0.001). ANCOVA confirmed that prenatal exercise was significantly effective after adjusting for confounders (β = -2.8; p < 0.001). Prenatal exercise is an effective, safe, and affordable intervention for reducing low back pain in pregnant women.

Early childhood is a critical period for growth and development, characterized by rapid changes in neurological, motor, sensory, and emotional systems. Stimulation during this stage plays a vital role, and non-pharmacological interventions such as massage and aromatherapy may enhance developmental outcomes. This quasi-experimental study employed a pretest–posttest control group design to evaluate the effectiveness of infant massage combined with aromatherapy. Twenty infants aged 3–12 months who met inclusion and exclusion criteria were recruited and assigned to either a control group (infant massage only) or an intervention group (infant massage with aromatherapy). Growth parameters (weight, length, head circumference) and developmental outcomes were measured using the Developmental Pre-Screening Questionnaire, covering gross motor, fine motor, language, and personal-social domains. Infants in the intervention group demonstrated significantly greater improvements in body weight, body length, head circumference, and developmental scores compared to the control group. These findings indicate that the addition of aromatherapy to infant massage provides measurable benefits for both physical growth and developmental progress. Combined infant massage and aromatherapy represent effective non-pharmacological strategies for early stimulation, supporting optimal growth and developmental trajectories in infants.

Gross motor development is an important aspect of an infant’s growth. Infants aged 6–12 months are in a golden period where physical stimulation plays a vital role in supporting coordination, balance, and muscle strength. Hydrotherapy provides an experience of free movement in water with light resistance, which can strengthen muscles and improve body control. This study aimed to determine the effect of hydrotherapy on the gross motor development of infants aged 6–12 months at Posyandu Dahlia, Palembang City. This research used a quasi-experimental design with a pretest–posttest control group involving 30 infants (15 intervention and 15 control). The intervention was conducted twice a week for four weeks in water with temperatures of 36–37°C. The Denver II instrument was used for assessment. Data were analyzed using paired t-tests and independent t-tests with a significance level of 0.05The average gross motor development score increased significantly in the intervention group from 45.2 to 60.4 (p = 0.001), while the control group showed no significant change (p = 0.094). Hydrotherapy has a significant effect on improving the gross motor development of infants aged 6–12 months. Health workers are encouraged to use this therapy as an alternative stimulation for early childhood development in community health centers.

Diabetes mellitus (DM) is one of the global health challenges that continues to rise, including in Indonesia. However, the lack of education and counseling from pharmacists regarding the use of natural ingredients medicines has the potential to affect the effectiveness of treatment and the management of DM. This study aims to measure the level of knowledge, attitudes, and behaviour of DM patients, related to the use of natural ingredient drugs in DM management. This study uses a cross-sectional method design, starting with the collection of quantitative data. Sampling was conducted using purposive sampling technique over a period of four months. The research involved 101 DM patients from 15 pharmacies in Kendal Regency. The level of knowledge (44.6%), attitude (66.3%), and behaviour (39.6%) of patients in the moderate category. However, the limited knowledge of pharmacists remains a barrier to optimizing pharmaceutical services related to educating patients about natural ingredient medications.

Diabetes mellitus is a non-communicable disease that causes global health problems in society. The International Diabetes Federation predicts that the prevalence of diabetes worldwide will increase to 853 million by 2050. The increase in the number of diabetes patients is due to unhealthy lifestyle habits, such as lack of physical activity. Therefore, interventions such as foot exercises and warm water baths are needed to help control blood glucose levels. The purpose of this study was to determine the effectiveness of a combination of foot exercises and warm water baths in reducing blood glucose levels in patients with diabetes mellitus. The study design used a descriptive case study. The sample size was n=2 people, conducted from May 25, 2025, to May 27, 2025, in the Sukoanyar Village RT 03/RW 03 area, Pakis District, Malang City. The results of this study showed that after three consecutive days of intervention, there was a decrease in blood glucose levels in both research subjects. In Mrs. S, the initial GDS level of 360 mg/dl decreased to 240 mg/dl after the third day of intervention. Meanwhile, in Mr. D, the initial GDS level of 349 mg/dl decreased to 220 mg/dl after the same intervention. Thus, the combination therapy intervention of foot exercises and foot soaking in warm water can lower blood glucose levels in diabetes mellitus patients.

Type 2 diabetes mellitus (DM type 2) is a chronic metabolic disorder marked by elevated blood glucose due to insulin resistance and impaired insulin secretion. Its prevalence continues to rise worldwide, including in Indonesia. Psychological stress is known to worsen glycemic control by activating the sympathetic nervous system and increasing cortisol levels, which can cause fluctuations in blood glucose. This case report aims to describe the effect of combining Benson relaxation techniques with warm foot soaking on blood glucose regulation in a type 2 DM patient. The subject was Mrs. M, a 52-year-old woman diagnosed with type 2 DM. The intervention was conducted for seven consecutive days and consisted of daily Benson relaxation followed by warm foot soaking for 15–20 minutes. Blood glucose levels were measured before and after each session using a glucometer and analyzed descriptively. After seven days, the patient’s blood glucose level decreased from 248 mg/dL to 186 mg/dL. She also reported improved relaxation, better sleep quality, reduced anxiety, and decreased fatigue. These findings suggest that Benson relaxation helps activate the parasympathetic response and reduce stress hormones, while warm foot soaking supports improved circulation and metabolic processes. In conclusion, the combination of Benson relaxation and warm foot soaking is a simple, safe, and effective complementary therapy to support blood glucose regulation in type 2 DM patients. This intervention can be integrated into self-care routines and community nursing practice as part of evidence-based non-pharmacological management.

The prevalence of chronic diseases in Jambi City has tended to increase in the last three years, especially hypertension and diabetes mellitus. Chronic diseases that are high risk, high volume and high cost have an impact on the household economy of sufferers who tend to incur health costs that exceed the family's financial capacity (catastrophic). The existence of the Chronic Disease Management Program (Prolanis) from BPJS Health should contribute to reducing the number of chronic diseases, reducing the burden of disease and improving the social relations of chronic disease sufferers, however the coverage of Prolanis activity is still low and several responses from community experience indicate there are problems with the acceptability of the program. This research aims to measure the level of community acceptability of health interventions and social relations in the Prolanis practice as assessed by analyzing affective attitudes, burden, ethics, intervention coherence, costs, perceived effectiveness and self-confidence of chronic disease sufferers in Jambi City in 2023. The research was conducted with Quantitative research methods use a cross-sectional design. Respondents were selected based on a purposive sampling technique totaling 180 respondents spread across five Puskesmas work areas in Jambi City. The research instrument is a questionnaire. The research results show that the indicators of burden, ethics and effectiveness are the most dominant factors in influencing the acceptability of Prolanis participants. As a recommendation, it is suggested to the government and BPJS Health to increase public understanding of the importance of using Prolanis in an effort to reduce the number of chronic diseases in Jambi City.

Acute Respiratory Infections (ARI) in the working area of Mulyorejo Public Health Center, where an aluminum factory is located, rank first among the ten most common diseases. This study aims to analyze the influence of sociodemographic characteristics and PM2.5 exposure on ARI complaints in the aluminum factory area of Payageli Village, Deli Serdang Regency. The cross-sectional observational study involved 160 housewives living within a radius of 10–1500 meters from the factory’s chimney. The analysis included univariate, bivariate, and multivariate methods. Results showed that 58.1% of respondents experienced ARI symptoms in the past month. The average ambient (outdoor) PM2.5 concentration measured from three sampling points was 12.3 µg/m³, which did not exceed the WHO standard (<15 µg/m³). The highest concentration was recorded in the southern direction (15.5 µg/m³). Bivariate analysis indicated that education (p = 0.010), direction of house location (p = 0.001), and indoor PM2.5 concentration (p = 0.006) were significantly associated with ARI. Multivariate logistic regression analysis showed that the most dominant factor influencing ARI was indoor PM2.5 concentration (p = 0.039), followed by education (p = 0.013) and direction of house location (p = 0.001). This study provides a scientific basis for air quality control and housing environment improvement to reduce the risk of environmentally related diseases in industrial zones.

This study explores the satisfaction levels of health science students with their clinical practice experiences at Prabumulih City General Hospital. Clinical practice serves as a vital component of health education, enabling students to apply theoretical knowledge in real healthcare settings. Using a qualitative phenomenological approach, the research sought to gain an in-depth understanding of students’ subjective experiences. Data were collected through in-depth interviews, focus group discussions, and participatory observations with students undergoing clinical practice. Thematic analysis and data triangulation ensured the validity of findings. Results revealed that students’ satisfaction was influenced by hospital facility quality, guidance from medical staff and lecturers, and interactions with patients and their families. Moreover, challenges in managing clinical cases and the social support received also shaped students’ satisfaction. The study recommends improving clinical practice facilities, strengthening supervision and mentoring by medical personnel, and providing greater institutional support. It also suggests that health education institutions design clinical practice programs more closely aligned with student needs and professional expectations.

Toxoplasma gondii (T. gondii), intracellular parasite that cause abortion in infected pregnant women with the parasite. Aim of the study: the present investigation aimed to assessment the prevalence of T. gondii in aborted women and evaluated level of interferon- gamma, Toll-like receptor 2 (TLR2) and lactoferrin. Materials and methods: From September 2024 to May 2025, we examined 90 women, 70 of them spontaneous abortion, while an additional 20 blood samples were obtained from healthy individuals serving as controls, in Tikrit Teaching hospital and many private hospitals in Tikrit city. Result: The incidence of parasite infection in aborted women was 56 (80%) out of a total of 70%. The level of IFN, TLR2, and Lactoferrin in the group of aborted women infected with T. gondii (45.4 ±7.1, 17.04 ±2.28, 59.6±12.6), as compared with control group (19.4 ±2.12, 8.2 ±2.1, 29.2±9.4). Conclusion: The present study concluded increase prevalence of toxoplasma gondi in aborted woman may indicate the main cause of abortion. Furthermore, increase level of immunological parameters that may indicate resolve the parasite infection.

Forgiveness is a challenging process that requires effort and mental streangth as it inovoles complex emotions influenced by external factors. Some group may act harmfully due to unresolved past grievances. While many religious teach selflessness and geniune forgiveness, people often forgive without real intent, wich can lead to continude unhappiness. Studies show that forgiveness can enhance mental helath by reducing feelings like anger and anxiety. Islamic teachings higlight forgiveness’s role in personal and social well-being, lingking it to rewards from Allah and happiness. The study uses the Scopus and PubMed database to analyze research on forgiveness in psychology from 2020to 2025. A total of 2,136 articles on this topic were found. The research offers insights for policymakers and emphasizes the importance of international partnerships for further studies in this area. It also aims to assess research quality, guiding future policies and funding. Overall, this bibliometric analysis effectively identifies research gaps in the field.

This study aimed to examine the relationship between maternal anxiety levels and the timing of Early Initiation of Breastfeeding (EIBF) among primiparous mothers. EIBF, also known as Inisiasi Menyusu Dini (IMD), is a vital procedure that supports the establishment of effective breastfeeding and is recommended globally. Nevertheless, various maternal factors, particularly psychological conditions, may influence the implementation of EIBF. The main objective of this research was to determine whether increased anxiety during the peripartum period is associated with delays in initiating breastfeeding. A correlational analytic design with a cross-sectional approach was utilized in this investigation. The study population consisted of 77 eligible participants, while the final sample included 69 primiparous mothers who met the inclusion and exclusion criteria. Participants were chosen through purposive sampling. The independent variable was the maternal anxiety level, and the dependent variable was the timing of EIBF implementation. Data were gathered using a structured self-administered questionnaire designed to measure both variables. Statistical analysis was conducted using the Mann-Whitney U test. The findings demonstrated a p-value of 0.0389, which was below the significance threshold of 0.05 (p < 0.05), indicating the rejection of the null hypothesis. Therefore, the results revealed a significant relationship between anxiety levels and the timing of EIBF among primiparous mothers. Elevated anxiety was identified as a factor contributing to delayed initiation of breastfeeding. These findings highlight the importance of regular psychological screening and effective anxiety management for first-time mothers during childbirth to facilitate optimal postnatal care, particularly the timely initiation of EIBF.

Background: Patient safety culture forms the cornerstone of safe and high-quality healthcare delivery. However, its implementation often encounters barriers, particularly the persistence of a blaming culture that discourages staff from reporting patient safety incidents. Clinical leadership and the intensity of incident reporting are believed to play a pivotal role in shaping and sustaining a positive patient safety culture.Objective: This study aims to examine the influence of clinical leadership and patient safety incident reporting intensity on patient safety culture, with blaming culture serving as an intervening variable at Sentra Medika Cikarang Hospital.Methods: A quantitative research approach with an explanatory design was applied. The study involved 147 nurses selected through stratified random sampling. Data were collected using structured questionnaires and analyzed using Structural Equation Modeling (SEM) with the Partial Least Squares (PLS) method to test the direct and indirect relationships among variables. Results: The findings revealed that both clinical leadership and incident reporting intensity significantly influence patient safety culture, both directly and indirectly, through the mediation of blaming culture. Strong clinical leadership and a high level of incident reporting were associated with a more positive patient safety culture, while a high blaming culture weakened this relationship. Conclusion: The study underscores the importance of fostering supportive clinical leadership and cultivating a non-punitive reporting environment to strengthen patient safety culture. Hospital management should focus on leadership development and the creation of open, blame-free communication systems to enhance safety outcomes.

The third trimester of pregnancy is a phase prone to anxiety due to physical and psychological changes and preparation for childbirth. Knowledge of pregnant women plays an important role in shaping mental readiness and reducing anxiety. This study aims to determine the relationship between knowledge levels and anxiety levels of pregnant women in the third trimester. The study used a quantitative correlational approach with 24 respondents selected through accidental sampling technique at Jatirogo Community Health Center, Central Kalimantan. Data were collected using a closed questionnaire and analyzed univariately and bivariately using the Chi-Square test. The results showed that 41.7 % of respondents had good knowledge and 66.7% did not experience anxiety. The Chi-Square test produced a significance value of p = 0.018, indicating a significant relationship between knowledge levels and anxiety of pregnant women. In conclusion, the higher the level of knowledge, the lower the anxiety experienced by pregnant women in the third trimester.

Cytokines and Vitamin K in crohn’s disease patients have been evaluated to discover the conceivable via biomarkers of diagnosed patients compared to control. Sera samples of Eighty patients and control of both genders. forty patients diagnosed crohn’s which the span of age between (20-36) years and 40 healthy volunteers as a control with span age (18-39) years. The patient were guests to Marjan hospital in Babylon city during the period (1/July/2025 to 1/September/2025). The current results showed a significant difference in statistic marks at (P<0.05). Vitamin K in patients below control. There is significance different between values of patients and controls in Magnesium, Calcium, Vitamin K, InterL10 and Toll-like receptor 4. According to word axel, there is magnitude significant relationship among cytokine InterL10 and Toll-like receptor 4, Magnesium, Calcium, & Vitamin K. The cytokines both InterL10 and Toll-like receptor 4 patients’ levels larger than control levels. Calcium and Magnesium which there is significance variance between both patients and Control