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Background: Labor is a physiological process that is commonly accompanied by pain, causing discomfort, anxiety, and fear that may interfere with maternal well-being and labor progress. Effleurage massage is a complementary, non-pharmacological intervention used to reduce labor pain. Purpose: This study aimed to evaluate the effectiveness of effleurage massage in reducing pain intensity during the first stage of labor. Method: A literature review was conducted using articles retrieved from Google Scholar. An initial search identified 45 articles, and after screening based on publication year (2021–2026), relevance, and inclusion criteria, 10 research articles were included for analysis. Data were extracted and synthesized descriptively. Results: The findings consistently showed that effleurage massage reduced labor pain by promoting relaxation, decreasing muscle tension, improving blood circulation, and stimulating endorphin release through the gate control mechanism. Most studies also reported improved maternal comfort during labor. Conclusion: In conclusion, effleurage massage is an effective, safe, affordable, and easy-to-apply complementary therapy that can be integrated into midwifery care to reduce labor pain and enhance maternal comfort.  

- Background: The rate of cesarean section (CS) deliveries continues to increase in Indonesia. Bali Province ranks first nationally, with a cesarean delivery rate of 53.2%. Cesarean section results in surgical wounds that cause pain in postpartum mothers. One non-pharmacological intervention to reduce pain is early mobilization through video media. Objective: This study aimed to determine the differences in pain intensity among post-cesarean mothers before and after receiving early mobilization through video media. Methods: This study employed a quantitative approach with a pre-experimental one-group pretest-posttest design. The study population consisted of post-cesarean mothers at Singasana Regional General Hospital. A total of 26 respondents who met the inclusion and exclusion criteria were recruited. Pain intensity was measured using the Numeric Rating Scale (NRS) before and after the intervention. The intervention consisted of early mobilization delivered through a 3-minute and 23-second video, accompanied by healthcare personnel. Data were analyzed using the Wilcoxon test. Results: Most respondents were aged 20–35 years, multiparous, had completed senior high school, and were employed. The median pain intensity decreased from 5.00 before the intervention to 3.00 after the intervention. The Wilcoxon test showed a p-value of 0.000 (p < 0.05), indicating a significant difference in pain intensity before and after the intervention. Conclusion: Early mobilization through video media was effective in reducing pain intensity among post-cesarean mothers. Video media can be utilized as an educational tool to support the implementation of early mobilization in healthcare settings..

Background: Non-communicable diseases (NCDs) are diseases caused by changes in human organs or degenerative diseases (age factor). Rheumatoid arthritis is a chronic autoimmune disease that occurs when the body's immune system mistakenly attacks joint tissues. According to WHO 2025, rheumatoid arthritis sufferers reach 355 million people worldwide. Method: This scientific paper uses a descriptive narrative method, namely by providing an overview of family nursing care to patients through a nursing process approach. The general objective of this paper is to understand and apply family nursing care to patients with Musculoskeletal System Disorders: Rheumatoid Arthritis. Results: Nursing diagnoses that appear in patients with Musculoskeletal System Disorders: Rheumatoid Arthritis include chronic pain and knowledge deficit. Conclusion: After nursing implementation for 2 days, the chronic pain diagnosis was partially resolved and the knowledge deficit was resolved, so the author performed routine discharge planning by doing warm compresses using ginger.

Background: Lymphadenopathy is an enlargement of the lymph nodes commonly caused by infection or inflammatory processes, which may lead to pain and risk of postoperative complications. This study aims to provide a comprehensive description of nursing care for a patient following left-sided lymphadenopathy surgery. Method: This case study used a nursing process approach, encompassing data collection through interviews, observation, physical examination, and documentation review of medical records conducted in Mawar 2 Ward at RSUD dr. Soeselo, Tegal Regency. Results: Based on assessment, three primary nursing diagnoses were identified: acute pain, knowledge deficit, and risk of infection. Following standard nursing interventions, pain was reduced, patient knowledge improved, and the wound was maintained without signs of infection. Conclusion: The systematic application of nursing care can help reduce patient complaints and prevent postoperative complications of lymphadenopathy.

Background: Community nursing is a specialty field that combines nursing science skills, public health sciences, and social assistance in addressing individual and family health problems, including non-communicable diseases such as gout arthritis. Gout arthritis is a metabolic disease characterized by pain and joint inflammation due to the accumulation of purine crystals (hyperuricemia). The WHO reports a prevalence of gout arthritis reaching 3.74% globally, while in Indonesia the prevalence reaches 11.9% based on health worker diagnosis. In Brebes Regency, the prevalence reaches 13.67%, with 3,078 sufferers out of 22,550 productive-age population. Objective: To provide comprehensive community nursing care to Ny. R with musculoskeletal system disorder: gout arthritis in Tonjong Village, Tonjong District, Brebes Regency. Method: This study uses a case study approach with data collection through interview, observation, physical examination, and documentation study conducted on December 26–28, 2025. Results: Assessment findings showed that Ny. R, a 60-year-old woman, had a history of gout arthritis for 3 months with uric acid levels of 9.6 mg/dL, complaining of pain and aching in the left foot with pain scale 3. Two nursing diagnoses were established: acute pain and knowledge deficit. Nursing interventions included pain management, uric acid level monitoring, lemongrass stem decoction foot soak complementary therapy, and health education using leaflets. After 2 days of implementation, uric acid levels decreased to 8.2 mg/dL and pain scale decreased to 2. Conclusion: Community nursing care through complementary therapy (lemongrass stem decoction foot soak) and health education effectively reduced pain and improved knowledge about gout arthritis in Ny. R.

Background: Sectio Caesarea (SC) is a surgical procedure to deliver the fetus through an incision in the abdominal and uterine wall. Patients with a history of previous sectio caesarea frequently experience acute pain, risk of infection, and lack of knowledge regarding post-SC contraception, requiring comprehensive nursing care. Objective: To describe the application of nursing care in a patient with post-operative sectio caesarea with a history of sectio caesarea indication. Methods: This study used a descriptive method with a case study approach. Data were collected through interviews, observation, documentation, and relevant literature review. Results: Assessment of Ny. S revealed three nursing diagnoses: acute pain, knowledge deficit, and risk of infection. Interventions included pain management, family planning (KB) health education, and infection prevention through wound care. Following nursing interventions, the knowledge deficit resolved completely, while acute pain and risk of infection were partially resolved. Conclusion: Systematic nursing care can effectively address nursing problems in post-SC patients and improve patient health outcomes.

Background: Gout arthritis is a metabolic disease caused by excessive uric acid levels in the blood (hyperuricemia), which leads to monosodium urate crystal deposition in the joints. Globally, the prevalence of gout arthritis ranges from 1–4% of the general population. In Indonesia, the national prevalence reaches approximately 7.3% based on medical diagnosis, and in Brebes Regency, cases reach 62.4%. At the Tonjong Health Center service area, the prevalence of gout arthritis in Karanganyar Hamlet, Tonjong Village, reaches 2.04%. Gout arthritis requires comprehensive nursing care including pain management and health education to prevent recurrence. Objective: To implement nursing care for Ny. S, family of Tn. S, with musculoskeletal system disorder: gout arthritis in Karanganyar Hamlet, Tonjong Village, Tonjong District, Brebes Regency. Method: This study used a case study design with a single patient/family subject. Data collection was conducted through interview, observation, physical examination, and study documentation on December 26–27, 2025 at the patient's home. Results: Assessment revealed Ny. S (72 years) experienced acute pain in the right knee joint with a pain scale of 3/10 and uric acid level of 7.3 mg/dL, along with knowledge deficit regarding gout arthritis. Two nursing diagnoses were established: acute pain and knowledge deficit. Nursing interventions included pain management education, non-pharmacological therapy (turmeric decoction), pharmacological therapy (allopurinol), and health education. Implementation was conducted over two visits. Evaluation results showed that acute pain was partially resolved (pain scale reduced to 2/10, uric acid 7.2 mg/dL) and knowledge deficit was resolved. Conclusion: Nursing care for patients with gout arthritis through pain management and health education can reduce pain intensity and improve family knowledge about the disease. Non-pharmacological intervention with turmeric decoction contributed to decreasing uric acid levels and pain. Keywords: gout arthritis, acute pain, knowledge deficit, family nursing care, non-pharmacological therapy

Background: Acute pharyngitis is an inflammation of the pharynx caused by viral or bacterial infections, frequently resulting in sore throat, fever, and dysphagia. This condition is among the most prevalent acute respiratory tract infections in children and adolescents worldwide, contributing significantly to morbidity and the burden of healthcare services. Objective: This case study aimed to describe the comprehensive nursing care provided to patient An. F with acute pharyngitis at Ward Anggrek 1, RSUD dr. Soeselo, Tegal Regency. Methods: A descriptive study design with a nursing process approach was employed. Data were collected through anamnesis, physical examination, observation, and documentation review. The nursing process encompassed assessment, nursing diagnosis, intervention planning, implementation, and evaluation. Results: Assessment revealed chief complaints of throat pain (NRS scale 5), fever (38.8°C), erythematous tonsils, and nutritional deficit. Three nursing diagnoses were established: acute pain related to physiological injury, hyperthermia related to disease process, and knowledge deficit related to insufficient information exposure. Interventions included pain management, hyperthermia management, and health education. Following two days of nursing care, the patient’s condition significantly improved, with pain scale reduced from 5 to 3 and body temperature normalized to 37.7°C. Conclusion: Comprehensive nursing care incorporating pharmacological and non-pharmacological approaches effectively reduced pain and fever, and improved patient and family health literacy regarding acute pharyngitis.

Background: Non-communicable diseases (NCDs) are a major global public health concern, with hypertension affecting an estimated 1.4 billion adults worldwide. In Indonesia, the prevalence of hypertension among individuals aged 18 years and above reached 30.8% in 2023. In Kecamatan Tonjong, Kabupaten Brebes, the number of hypertension sufferers aged 15 years and above reached 15,951 people in 2025. Objective: To implement comprehensive family nursing care for Ny. S, family of Tn. F, who experienced cardiovascular system disorders due to hypertension in Desa Karang Jati RT 01 RW 05, Kecamatan Tonjong, Kabupaten Brebes. Method: This study used a descriptive narrative method with a nursing process approach (assessment, diagnosis, intervention, implementation, and evaluation), conducted through home visits over three days from December 26–28, 2025. Data were collected through interviews, observation, physical examination, and documentation. Results: Two nursing diagnoses were identified: acute pain related to hypertension and knowledge deficit regarding hypertension. Nursing interventions included pain management, oral medication administration (captopril 25 mg), and health education. Complementary non-pharmacological therapy using cucumber juice was applied once daily for three days. Conclusion: After three days of nursing implementation, both nursing diagnoses were fully resolved. Blood pressure decreased from 165/90 mmHg to 132/77 mmHg and the pain scale reduced from 4 to 1. Discharge planning was provided including recommendations for routine blood pressure monitoring, healthy lifestyle, and consistent medication adherence.

Background: Distal radius fracture is the most common fracture of the radius bone near the wrist joint. The prevalence of fractures in Indonesia in 2024 was 3.8%, indicating that approximately 20 million people experienced fractures. Therefore, nursing care planning is required to address musculoskeletal disorders. Objective: To describe the nursing care for patients with Musculoskeletal System Disorders: Post-Op ORIF Fracture of One-Third Distal Radius Dextra. Method: This study used a descriptive narrative method by providing an overview of nursing care through a nursing process approach. Results: Nursing diagnoses that emerged in the patient included acute pain, impaired physical mobility, risk of infection, and knowledge deficit. Interventions performed included pain management, mobilization support, infection prevention, and health education. Conclusion: After two days of nursing implementation, one diagnosis was fully resolved and three diagnoses were partially resolved due to time constraints. Discharge planning was provided including deep breathing relaxation techniques, passive ROM exercises, and wound dressing changes every two days.  

 Background: Perineal pain due to episiotomy is a common complaint experienced by postpartum mothers and can affect patient comfort, mobility, and recovery. Nonpharmacological pain management is needed to help reduce discomfort with minimal risk of side effects. Objective: This study aimed to determine the effectiveness of applying cold compresses using ice packs in reducing perineal pain intensity in postpartum mothers with episiotomy. Methods: The study used a descriptive case study design in three vaginal postpartum patients with episiotomy who were treated in the postpartum ward. The intervention involved applying cold compresses using ice packs to the perineal area for 10–15 minutes, as per nursing procedures. Pain was measured using the Numeric Rating Scale (NRS) before and after the intervention. Findings: The results showed a decrease in pain intensity in all patients after the application of cold compresses. Patient P1 experienced a decrease in pain score from 5 to 4, patient P2 from 6 to 5, and patient P3 from 5 to 4, with an average decrease of 1 point. Implications: Cold compresses using ice packs have the potential to be an effective non-pharmacological nursing intervention to help reduce perineal pain and improve the comfort of postpartum mothers with episiotomies during the care period.

Background: Sectio caesarea can delay physical function recovery in postpartum mothers, affecting daily activities. Early mobilization is an intervention that may accelerate recovery. Purpose: To analyze the effectiveness of early mobilization in accelerating physical function recovery in post-sectio caesarea patients at RS Muhammadiyah Selogiri. Method: Quasi-experimental design with a non-equivalent control group pretest-posttest design. Thirty-four postpartum mothers were divided into intervention (n=17) and control (n=17) groups. The Barthel Index, Numeric Rating Scale (NRS), and observation sheets were used. Results: The intervention group showed faster recovery with significant improvements in Barthel Index scores, time to ambulate independently, and pain reduction (p<0.001). Conclusion: Early mobilization effectively accelerates physical function recovery in post-sectio caesarea patients.

Background: Sectio caesarea can delay physical function recovery in postpartum mothers, affecting daily activities. Early mobilization is an intervention that may accelerate recovery. Purpose: To analyze the effectiveness of early mobilization in accelerating physical function recovery in post-sectio caesarea patients at RS Muhammadiyah Selogiri. Method: Quasi-experimental design with a non-equivalent control group pretest-posttest design. Thirty-four postpartum mothers were divided into intervention (n=17) and control (n=17) groups. The Barthel Index, Numeric Rating Scale (NRS), and observation sheets were used. Results: The intervention group showed faster recovery with significant improvements in Barthel Index scores, time to ambulate independently, and pain reduction (p<0.001). Conclusion: Early mobilization effectively accelerates physical function recovery in post-sectio caesarea patients.

Uterine myoma is a benign smooth muscle tumor of the uterus commonly found in women of reproductive age and may cause symptoms related to mass effect and hematologic disturbances. We report the case of a 41-year-old woman presenting with progressive vaginal pain for 3 months, accompanied by low back pain and impaired daily activities, without vaginal bleeding, vaginal discharge, fever, or urinary or defecatory symptoms. Laboratory examination revealed severe microcytic hypochromic anemia with a hemoglobin level of 4.7 g/dL, while ultrasonography demonstrated a 9.93 × 10.32 cm mass described as symmetric, well circumscribed, and hyperechoic, leading to a working diagnosis of uterine myoma with anemia. The patient was managed with general condition monitoring, intravenous fluids, analgesics, transfusion of four units of packed red cells, and laparotomy as definitive intervention. Following transfusion and surgery, the hemoglobin level increased to 9.4 g/dL and subsequently to 11.0 g/dL, accompanied by improvement in postoperative symptoms and clinical condition. This case demonstrates that a large uterine myoma may present predominantly with pelvic pain and functional impairment in the absence of vaginal bleeding. A comprehensive approach involving systematic evaluation, preoperative correction of anemia, appropriate surgical intervention, and postoperative monitoring is essential to improve safety and clinical outcomes in patients with symptomatic pelvic masses.

This case report examines the effectiveness of a combined pulmonary rehabilitation and musculoskeletal physiotherapy program for a 26-year-old male post-pulmonary tuberculosis patient with lumbar tuberculous spondylitis. The patient, who had completed anti-tuberculosis treatment, presented with low back pain, shortness of breath, fatigue, and limited mobility. Spirometry indicated severe restrictive ventilatory impairment (FVC 1.28 L, 32% of predicted), and lower extremity muscle strength was reduced (MMT 2-3/5). The patient used a TLSO brace and walking aid. Over a three-week physiotherapy program, the patient participated in breathing exercises, spinal mobilization, muscle strengthening, functional exercises, and education on brace use. Evaluation occurred at the first, second, and third weeks. After treatment, pain intensity decreased from VAS 6 to VAS 3, FVC improved to 1.72 L, chest expansion increased, muscle strength improved to MMT 4/5, and performance on the Five-Times Sit-to-Stand Test showed progress. The Functional Independence Measure (FIM) score increased from 98 to 115, reflecting improved functional independence. These findings suggest that the combination of pulmonary and musculoskeletal physiotherapy effectively improved respiratory function, muscle strength, and the patient’s overall functional capacity.

Background: Carpal Tunnel Syndrome (CTS) is a condition caused by compression of the median nerve at the wrist, resulting in pain, paresthesia, and decreased hand function. This condition is commonly experienced by individuals who perform repetitive wrist activities. Objective: To determine the effectiveness of a combination of neural mobilization exercises and electrotherapy modalities in improving hand function, increasing muscle strength, and reducing pain in a patient with Carpal Tunnel Syndrome. Methods: This study used a case report design involving a 57-year-old female patient (Mrs. Q) who presented with pain and sensory disturbances in the right hand. The intervention was administered for four weeks and consisted of ultrasound therapy, Transcutaneous Electrical Nerve Stimulation (TENS), grip strengthening exercises, and nerve gliding exercises. Outcome measures included pain intensity assessed using the Numeric Rating Scale (NRS), muscle strength evaluated using Manual Muscle Testing (MMT), and functional ability measured using the Wrist Hand Disability Index (WHDI). Results: The evaluation showed a reduction in pain intensity, with resting pain at 0/10, tenderness at 4/10, and movement pain at 4/10. Muscle strength improved from grade 3 to grade 4 based on MMT. Functional ability also improved, as indicated by a 20% reduction in the WHDI score. The combination of these interventions proved effective as a conservative management approach for Carpal Tunnel Syndrome. Conclusion: The administration of ultrasound, TENS, grip strengthening exercises, and nerve gliding exercises over four therapy sessions in Mrs. Q resulted in decreased pain, increased muscle strength, and improved hand functional ability.

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, an obligate intracellular bacterium that affects the skin, peripheral nerves, upper respiratory mucosa, and eyes. Type 2 diabetes mellitus (T2DM) is a comorbidity that can worsen the course of leprosy. The female patient, Mrs. D, aged 55 years came to the emergency room of Cut Meutia Hospital with the main complaint of red bumps accompanied by pain on the face, hands, chest, and back since 3 days ago and additional complaints such as fever, joint pain, and numbness and loss of feeling in the legs, weakness, frequent thirst, and frequent urination. Dermatologic status is obtained in the facial region in the form of erythema nodules with firm boundaries with numular size, multiple. Laboratory examination showed anemia and leukocytosis. The therapy given was MDT MB package, ferrous sulfate 1x325 mg and PRC transfusion 3 kolf. Complaints arose acutely after the patient resumed taking MDT (multidrug therapy) leprosy drugs which had previously been stopped for more than 3 months. Based on the time of onset of symptoms, history of leprosy treatment, and the manifestation of systemic inflammatory lesions with signs of neurotropism, it can be suspected that the patient is experiencing a type 2 leprosy reaction or Erythema Nodosum Leprosum (ENL).

Background: Dysmenorrhea is a problem that women often experience during menstruation, in the form of dull pain in the lower abdomen because the uterine muscles contract. This pain can appear before menstruation, during menstruation, or after menstruation is finished. Dysmenorrhea refers to pain or discomfort that occurs during menstruation and can interfere with daily work. Objective: The aim of this study was to determine the effect of abdominal stretching exercises and deep breathing relaxation techniques on the level of dysmenorrhea pain in adolescent girls. Methods: This type of research is quantitative research using a quasi-experimental design with a pre-test and post-test nonequivalent control group design with a purposive sampling technique, with a sample size of 80 female respondents from class X. The data collection tool used was an observation sheet with an NRS measuring instrument. Data were processed and analyzed using SPSS 23 with intergroup analysis using the Mann-Whitney test. Results: The results of the bivariate analysis of the Wilcoxon test in the experimental group showed a p value of 0.000 where (p<0.05), then the Mann-Whitney test showed a p value of 0.000 where (p<0.05) so that H0 was rejected and Ha was accepted, which means there is a significant influence and difference. Conclusion: This shows that there is an influence of Abdominal Stretching Exercise and Deep Breathing Relaxation Techniques on the Level of Dysmenorrhea Pain in Young Women (Research Study Conducted at SMK Negeri 1 Kubutambahan).

Background: Class II restoration according to the classification of Greene Vardiman Black is one of the procedures in dental conservation that often presents a challenge for operators or dentists during treatment. Class II restorations have their own level of difficulty, particularly during the placement of restorative materials into the cavity. One of the possible failures in Class II restorative treatment is marginal leakage, which can lead to microleakage at the restoration margins. Purpose: To report the success of class II restoration with composite resin using tofflmire matrix. Case report: A 23-year-old female patient came with a complaint of cavities, the complaint was felt since 1 year ago in the lower left back tooth, there was no pain and had never been treated. In the case, preparation and restoration were carried out using composite resin with isolation using tofflmire matrix, applied using an Incremental technique. Discussion: Class II posterior tooth restorations have challenges such as leakage due to the techniques and materials used. Composite resin is chosen because of its good adaptation, esthetics, and wear resistance. Incremental techniques are preferred because they reduce polymerization stress and provide optimal curing results. Tofflemire matrix is ​​used for stability and soft tissue protection.Conclusion: The selection of composite resin with an Incremental technique and the use of a Tofflemire matrix provides more optimal, aesthetic, and minimal risk of failure results for class II posterior tooth restorations.

Background: Anxiety can affect physiological functions in patients prior to surgery, including increased heart rate and respiration, changes in blood pressure and temperature, relaxation of smooth muscles in the bladder, cold and clammy skin, and dry mouth, which may reduce the patient’s energy level. Psychologically, anxiety can lead to increased postoperative pain, delayed wound healing, increased physical disability, and decreased quality of life. One effective non-pharmacological intervention to reduce anxiety is Benson relaxation therapy. Objective: This study aimed to determine the effect of benson relaxation therapy on reducing anxiety levels in pre operative. Methods: This study used a case study design involving one preoperative patient with anxiety symptoms in the Teratai Ward of Prof. Dr. Margono Soekarjo Hospital, Purwokerto. Benson relaxation therapy was administered for 3 days, twice daily, with a duration of 15 minutes per session. Anxiety levels were measured using the Zung Self-Rating Anxiety Scale (ZSAS) before and after the intervention. Results: The patient showed a decrease in anxiety score from 55 (moderate anxiety) to 40 (mild anxiety) after receiving Benson relaxation therapy. Subjectively, the patient reported feeling calmer, more accepting, and motivated. Objectively, there was a reduction in heart rate and physical signs of anxiety. Conclusion: Benson relaxation therapy is effective in reducing anxiety levels in preoperative patients. This intervention can be used as a non-pharmacological alternative to support psychological recovery of pre-operative patients.