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Schizophrenia is a severe mental disorder often accompanied by auditory hallucinations and has a significant impact on patients’ psychosocial functioning. This condition can reduce medication adherence, thereby increasing the risk of relapse. In this context, the role of caregivers is crucial in supporting treatment success. This study aims to describe psychiatric nursing care for patients with auditory hallucinations in improving medication adherence through caregiver involvement. The method used is a case study with a nursing process approach, including assessment, nursing diagnosis, planning, implementation, and evaluation. Interventions focus on hallucination management, psychoeducation, and caregiver involvement in care. The results show an increase in patients’ and families’ knowledge regarding the illness and its treatment, improved medication adherence, and enhanced patient ability to control responses to auditory hallucinations. Caregiver involvement has been shown to assist in supervision and providing support to patients. Therefore, comprehensive psychiatric nursing care through hallucination management, psychoeducation, and caregiver involvement is effective in improving medication adherence and controlling symptoms in patients with auditory hallucinations.

Critically ill patients are individuals with unstable health conditions who require close monitoring of hemodynamic parameters. The high mortality rate among critically ill patients treated in intensive care units reaches 36.5% of 33,148 patients. Hemodynamic instability in critically ill patients can be influenced by underlying diseases, medical interventions, as well as physical and psychological stress responses during treatment. Therefore, in addition to pharmacological therapy, non-pharmacological interventions such as Asmaul Husna dhikr therapy are needed, as they can provide a relaxation effect and help stabilize hemodynamic parameters in critically ill patients. To determine the outcomes of the implementation of Asmaul Husna dhikr therapy. This study used a descriptive case study method involving two critically ill patients with unstable non-invasive hemodynamic parameters. Changes in non-invasive hemodynamic parameters were observed in both respondents after the implementation of Asmaul Husna dhikr therapy. In respondent 1, the hemodynamic status was initially categorized as increased and became stable after the intervention. Similarly, in respondent 2, the hemodynamic status changed from increased before the intervention to stable after the intervention. The implementation of Asmaul Husna dhikr therapy can be used as a complementary therapy to help stabilize hemodynamic parameters in critically ill patients.

Pressure ulcers are a common complication in patients with impaired consciousness due to prolonged immobilization. This condition can increase morbidity and prolong the length of stay, thus requiring effective preventive interventions such as progressive mobilization. To determine the outcomes of implementing progressive mobilization on the incidence of pressure ulcers in patients with impaired consciousness at the Anggrek 2 High Care Unit (HCU) of Dr. Moewardi General Hospital. This study employed a case study design involving two participants with impaired consciousness. The intervention, consisting of progressive mobilization, was conducted over 3 days with monitoring of skin condition and pressure ulcer risk. Findings: Following the implementation of progressive mobilization, both participants showed improvement in skin condition and a reduction in the risk of pressure ulcers, as evidenced by the absence of progression to more severe wounds and an increase in skin integrity. The application of progressive mobilization is effective in preventing and reducing the risk of pressure ulcers in patients with impaired consciousness. This intervention can serve as a safe and planned nursing intervention in the intensive care unit.

Telemedicine is a technology-based healthcare innovation that can improve access and efficiency. The quality of service provided by human resources (HR) plays a crucial role in determining patient satisfaction. This study aims to analyze the influence of HR service quality on patient satisfaction among telemedicine users. The method used was a literature review using a qualitative descriptive approach through analysis of scientific articles from various databases published between 2020 and 2025. The results indicate that HR service quality significantly influences patient satisfaction, particularly through aspects of reliability, responsiveness, assurance, empathy, and effective communication. Patient satisfaction is also influenced by ease of access, time efficiency, and trust in the services provided. However, limitations such as the lack of in-person physical examinations remain a challenge in the implementation of telemedicine. Therefore, improving HR competency, particularly in digital communication and technology utilization, is essential to improving the quality of telemedicine services. Therefore, HR service quality is a key factor in increasing patient satisfaction and the successful development of digital healthcare services.

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.

Meningitis is a serious infectious disease that can be prevented through vaccination; however, the vaccination process often causes anxiety in patients, especially during the pre-procedure phase. Uncontrolled anxiety can affect patient readiness and comfort. Therapeutic communication by nurses is one intervention that has the potential to reduce this level of anxiety. This study aims to determine the relationship between nurses’ therapeutic communication and the anxiety levels of patients prior to meningitis vaccination at Pambalah Batung Amuntai Regional General Hospital. This study used a quantitative analytic design with a cross-sectional approach. The sample consisted of 107 respondents selected using a convenience sampling technique. Data on therapeutic communication were collected using an observation sheet, while anxiety levels were measured using the DASS questionnaire (anxiety subscale). Data analysis was conducted using univariate and bivariate methods with the Chi-Square test at a significance level of 0.05. The results showed that most therapeutic communication was in the good category, and patient anxiety levels were predominantly in the normal category. Statistical test results indicated a significant relationship between nurses’ therapeutic communication and patient anxiety levels (p = 0.000 < 0.05). The better the therapeutic communication provided, the lower the patient’s anxiety level. In conclusion, nurses’ therapeutic communication plays an important role in reducing patient anxiety prior to meningitis vaccination and needs to be optimized in nursing practice.

Type 2 diabetes mellitus is a chronic condition marked by elevated blood glucose levels resulting from insulin resistance and decreased insulin secretion. Effective glycemic control is crucial to prevent complications, and HbA1c is commonly utilized as an indicator of long-term blood glucose levels. This study aimed to examine the relationship between HbA1c levels and blood glucose levels among patients with type 2 diabetes mellitus at Tilamuta Community Health Center, Boalemo Regency, Gorontalo Province. This study employed an analytical cross-sectional design using a total sampling method, involving 557 patients. Data were collected from laboratory records and analyzed through descriptive statistics, the Shapiro-Wilk test for normality, Spearman correlation, and chi-square test. The findings indicated that the average HbA1c level was 7.39%, while the mean blood glucose level was 205.85 mg/dL. A significant and very strong positive correlation was found between HbA1c and blood glucose levels (p=0.000; r=0.862). Furthermore, medication adherence showed a significant association with HbA1c status (p=0.000). These results underscore the role of HbA1c as a dependable marker for assessing glycemic control and highlight the importance of medication adherence in optimizing the management of type 2 diaType 2 diabetes mellitus is a chronic condition marked by elevated blood glucose levels resulting from insulin resistance and decreased insulin secretion. Effective glycemic control is crucial to prevent complications, and HbA1c is commonly utilized as an indicator of long-term blood glucose levels. This study aimed to examine the relationship between HbA1c levels and blood glucose levels among patients with type 2 diabetes mellitus at Tilamuta Community Health Center, Boalemo Regency, Gorontalo Province. This study employed an analytical cross-sectional design using a total sampling method, involving 557 patients. Data were collected from laboratory records and analyzed through descriptive statistics, the Shapiro-Wilk test for normality, Spearman correlation, and chi-square test. The findings indicated that the average HbA1c level was 7.39%, while the mean blood glucose level was 205.85 mg/dL. A significant and very strong positive correlation was found between HbA1c and blood glucose levels (p=0.000; r=0.862). Furthermore, medication adherence showed a significant association with HbA1c status (p=0.000). These results underscore the role of HbA1c as a dependable marker for assessing glycemic control and highlight the importance of medication adherence in optimizing the management of type 2 diabetes mellitus.betes mellitus.  

Turbinate hypertrophy is a condition characterized by abnormal enlargement of the nasal turbinate mucosa, which can lead to chronic nasal obstruction and decreased quality of life. This condition is associated with inflammatory processes in which eosinophils play a role as part of the immune response. This study aimed to determine the relationship between eosinophil levels and the degree of turbinate hypertrophy based on blood examination in hospitalized patients. This research used an observational analytic design with a cross-sectional approach involving 40 patients diagnosed with turbinate hypertrophy at Cut Meutia General Hospital, North Aceh. Data were obtained from medical records, including patient characteristics, eosinophil levels, and the degree of turbinate hypertrophy. The results showed that most patients were aged 17–25 years, predominantly female, and commonly had non-allergic underlying conditions. The majority of patients had normal eosinophil levels (80%), while most cases were classified as grade III turbinate hypertrophy (65%). Statistical analysis using Fisher’s Exact Test demonstrated no significant relationship between eosinophil levels and the degree of turbinate hypertrophy (p>0.05). These findings suggest that eosinophil levels may not be a reliable indicator in assessing the severity of turbinate hypertrophy, particularly in patients with non-allergic conditions. This study highlights the need to consider other contributing factors in the evaluation and management of turbinate hypertrophy to improve diagnostic accuracy and treatment outcomes.

Congestive heart failure (CHF) is a cardiovascular disease that frequently causes shortness of breath (dyspnea) and negatively impacts patients’ quality of life. The management of dyspnea involves not only pharmacological approaches but also nonpharmacological interventions, one of which is handheld fan therapy, which works by stimulating sensory receptors in the facial area. This study aims to describe the effect of handheld fan therapy on reducing shortness of breath in patients with CHF. This study employed a descriptive design using a case report method on a single 63-year-old female patient diagnosed with CHF. The intervention was conducted over four days, involving the use of a handheld fan for 10 minutes, held at a distance of 15–30 cm from the face and directed toward the nose and mouth. Measurements were taken before and after the intervention using respiratory rate and oxygen saturation as parameters. The results showed a gradual decrease in respiratory rate from 24 breaths/minute to 18 breaths/minute, as well as an increase in oxygen saturation from 91% to 96% during the intervention period. These findings indicate an improvement in breathing patterns and increased respiratory efficiency in the patient. Handheld fan therapy is effective as a nonpharmacological intervention for reducing shortness of breath and improving oxygenation in patients with CHF. This intervention is safe, easy to use, and can be implemented as a complementary therapy in nursing practice.

Hypertension is a major public health concern with a high prevalence and a significant risk of complications if left uncontrolled. Effective management requires not only pharmacological treatment but also non-pharmacological approaches and active family involvement. One potential non-pharmacological therapy is the use of celery (Apium graveolens), which is believed to lower blood pressure. This study aimed to evaluate the effectiveness of family education combined with celery decoction administration in reducing blood pressure among patients with hypertension. A descriptive case study design was employed using a family nursing care approach over three home visits, each lasting 30–45 minutes. The intervention included health education on hypertension and a demonstration of how to prepare and administer celery decoction, which was consumed twice daily. Data were collected through interviews, observation, and blood pressure measurements. The results showed a reduction in blood pressure from 159/90 mmHg to 130/80 mmHg, along with a decrease in symptoms such as headaches and dizziness. In addition, there was an improvement in family knowledge, caregiving skills, and the ability to modify the home environment. In conclusion, family-based education combined with the administration of celery decoction appears to be effective in reducing blood pressure and enhancing the family’s role in managing hypertension.

Background: Knee osteoarthritis is a degenerative joint disease that often occurs in the geriatric population and causes pain, limited movement, and decreased function. In advanced conditions, management is carried out with Total Knee Replacement (TKR). However, post-surgery patients still experience functional limitations so that physiotherapy intervention is needed. Objective: To determine the effectiveness of static bicycle and quadriceps strengthening exercises on pain, range of motion, muscle strength, functional mobility, and quality of life in post-TKR patients. Methods: This study used a case study design in one patient with post-TKR dextra et causa bilateral knee osteoarthritis. The intervention was given for 3 weeks with a frequency of 2 times per week. Evaluation was carried out using the Numeric Rating Scale (NRS), goniometer, Manual Muscle Testing (MMT), Timed Up and Go Test (TUG), and the Knee Osteoarthritis Outcome Score (KOOS). Results: Results showed a decrease in motion pain from NRS 6 to 4 and stationary pain from 3 to 2. Knee range of motion increased from 75° to 90° of flexion and from -5° to 0° of extension. Muscle strength increased from MMT 3 to 4 in the quadriceps muscle. Functional mobility also improved, with TUG time decreasing from 22 seconds to 18 seconds. However, the KOOS score remained relatively unchanged at 38.84. Conclusion: Static bicycle and quadriceps strengthening exercises were effective in reducing pain, increasing ROM, muscle strength, and functional mobility in post-TKR patients. However, the improvement in quality of life as measured by the KOOS was not significant, requiring a longer rehabilitation period.

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.

The quality of interaction between physicians and patients plays a crucial role in the healthcare system, as it directly affects patient satisfaction. Ineffective communication by physicians may reduce patient satisfaction and increase the risk of complaints and medical disputes. This study aims to analyze the relationship between doctor–patient communication patterns and patient satisfaction in outpatient services. This research employed a quantitative approach with an observational analytic design using a cross-sectional method. The study population included all outpatient patients, with a sample of 110 respondents selected through accidental sampling. The independent variable was doctor–patient communication, while the dependent variable was patient satisfaction. Data were collected using a questionnaire, and analysis was performed using the Chi-Square test with a 95% confidence level. The results showed that the majority of respondents rated doctor–patient communication as good (80.9%) and reported high levels of satisfaction (75.5%). The analysis revealed that among respondents who experienced good communication, 84.3% reported high satisfaction, whereas the proportion of high satisfaction decreased significantly in the groups with moderate and poor communication. In conclusion, there is a significant relationship between the quality of doctor–patient communication and patient satisfaction in outpatient services, where improvements in communication quality are consistently associated with increased patient satisfaction.

The Application Of Hallucination Management Using The Shutting-Out Technique For The Control Of Auditory Hallucinations In Schizophrenia Patients In The Angruk Ward Of Prof. Dr. Margono Soekarjo General Hospital, Purwokerto. Schizophrenia is a severe mental disorder often accompanied by auditory hallucinations. Auditory hallucinations may cause patients to talk to themselves, appear restless, and experience difficulty in controlling responses to internal stimuli. One non-pharmacological nursing intervention that can be applied is the rebuking technique, a strategy used to firmly reject or dismiss hallucinatory voices. This study aimed to examine the application of the rebuking technique in controlling auditory hallucinations in patients with schizophrenia. This research employed a descriptive case study design using a nursing process approach and was conducted from February 17 to 19, 2026, on a patient diagnosed with schizophrenia experiencing auditory hallucinations. The intervention was implemented over three days, with one session per day lasting approximately 15–20 minutes. The results showed an improvement in the patient’s ability to recognize and control hallucinations, as indicated by a reduction in self-talking behavior, increased awareness of hallucination onset, and the ability to independently apply the rebuking technique. In conclusion, the rebuking technique is an effective nursing intervention to assist patients with schizophrenia in controlling auditory hallucinations.

Introduction: Appendectomy is a relatively safe surgical procedure. One important aspect of this stage is maintaining the patient's mental stability, especially before administering anesthesia. However, anesthesia often causes anxiety in patients. Mindfulness-based cognitive therapy has been shown to significantly improve quality of life by minimizing anxiety. Objective: This study analyzed the effect of Mindfulness-based cognitive therapy (MCT) in reducing pre-anesthetic anxiety in appendectomy patients. Methods: This study used a case study design with a nursing care process approach. The subjects in this case study were two patients who met the inclusion criteria. The instrument used was an observation sheet according to the Indonesian Society for Anesthesia and Clinical Trials (SLKI). Results: The results of the case study showed that both patients experienced pre-anesthetic anxiety. After receiving Mindfulness-based cognitive therapy, pre-anesthetic anxiety decreased. Conclusion: This case study demonstrated that pre-anesthetic anxiety decreased after Mindfulness-based cognitive therapy.

Asthma is a heterogeneous disease characterized by chronic inflammation of the airways and respiratory symptoms such as wheezing, shortness of breath, chest tightness, and cough, which vary over time in both frequency and severity. This condition is accompanied by limitations in expiratory airflow, which can be either reversible or persistent. In asthma patients, especially those treated in the Emergency Department (ED), a common nursing problem is ineffective airway clearance due to mucus accumulation and bronchospasm. One strategy to address this is the administration of warm drinking water, aimed at improving airway clearance. The design used in this final nursing scientific paper is a qualitative case study with an intervention of warm water intake. The subjects of this study consisted of 3 asthma patients in the ED, and the intervention was conducted from January 3-11, 2026, at the Emergency Department of Charitas Hospital Km.7 Palembang. Airway clearance was measured before and after the intervention, which involved giving 200 ml of warm water at 38ºC, without a control group. After the intervention, all three patients showed improved airway clearance, indicated by more effective coughing, decreased sputum production, reduced wheezing, improved breathing patterns, and improved respiratory rate. The implementation of this evidence-based practice (EBP) is expected to provide additional information regarding the use of nonpharmacological therapy, specifically the administration of warm drinking water, in asthma patients with ineffective airway clearance.

This study aims to develop a web-based Electronic Medical Record (EMR) application to improve the efficiency and accuracy of patient data recording at Elopada Community Health Center. The research adopts a system development approach using the waterfall model, including requirements analysis, system design, implementation, and testing. Data were collected through observation, interviews, and documentation. The developed system was evaluated using Black Box Testing to verify the conformity between input and output without considering internal program structures. The results indicate that the EMR system enhances data processing speed, improves recording accuracy, and facilitates access to patient information. These findings are consistent with prior studies showing that EMR implementation improves the quality and efficiency of clinical documentation . Therefore, the proposed system is considered feasible to support the advancement of digital healthcare services.

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.

Asthma is a chronic inflammatory disease of the airways characterized by reversible bronchoconstriction, mucus hypersecretion, and bronchial hyperresponsiveness. This condition causes shortness of breath, coughing, wheezing, and increased respiratory rate which impacts increased respiratory muscle work. One of the non-pharmacological interventions that can be applied in nursing practice is diaphragmatic breathing relaxation to help improve breathing patterns and increase respiratory muscle relaxation. Objective: To analyze the application of diaphragmatic breathing relaxation in improving respiratory muscle relaxation in asthma patients in the inpatient ward. Method: The study used a case study design with an Evidence Based Practice (EBP) approach. The research subjects were three asthma patients who experienced increased respiratory frequency. The intervention was carried out for three days in the form of structured diaphragmatic breathing exercises. Data were collected through nursing assessment, observation of respiratory frequency before and after the intervention, and evaluation of patient responses. Results: Before the intervention, all respondents experienced tachypnea with the use of accessory respiratory muscles. After three days of diaphragmatic breathing relaxation, the respiratory rates of all three respondents returned to normal (12–20 breaths/minute), respiratory muscle tension decreased, and the patients appeared more relaxed. Conclusion: Diaphragmatic breathing relaxation is effective in increasing respiratory muscle relaxation and stabilizing respiratory rate in asthmatic patients. This intervention can be used as part of non-pharmacological nursing care for patients with respiratory system disorders.

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