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Hospitals play a strategic role in improving public health through professional, safe, and high-quality healthcare services. In modern healthcare organizations, service quality is not only determined by medical facilities and technology but also by the quality of human resources, particularly healthcare workers who directly interact with patients. This study aims to analyze the influence of authentic leadership on healthcare workers’ performance and hospital service quality. The study employed a quantitative explanatory research design involving 120 healthcare workers in a hospital setting. Data were collected using questionnaires and analyzed through multiple linear regression analysis. The findings demonstrate that authentic leadership has a positive and significant effect on healthcare workers’ performance, with a regression coefficient value of 0.648 and a significance level of 0.000. Furthermore, authentic leadership indirectly influences hospital service quality through healthcare workers’ performance, with an indirect effect value of 0.521. These findings indicate that leaders who demonstrate honesty, transparency, integrity, and interpersonal support are able to create a healthy work environment that enhances healthcare workers’ motivation, responsibility, and professionalism. Consequently, improved employee performance contributes to better hospital service quality, particularly in responsiveness, empathy, and communication with patients. This study highlights that authentic leadership is an effective leadership approach for strengthening healthcare human resources and improving hospital service quality in contemporary healthcare organizations.

Medication adherence among the elderly is an important factor in achieving successful therapy, particularly during the month of Ramadan when changes occur in meal patterns and medication schedules. Elderly patients with chronic diseases often experience difficulties in adjusting their medication timing, which may lead to poor adherence. This study aimed to implement a smart pill boxwith educational labels to improve knowledge and medication adherence among elderly individuals during fasting. The study involved 40 elderly respondents in a social care institution. The intervention consisted of training on the use of the smart pill box, educational labeling, and evaluation through observation, interviews, and checklist forms. The results showed that most respondents took medication twice daily (42.5%) and adjusted their medication schedules to sahur and iftar (45%). Before the intervention, 57.5% of respondents had not received information about medication use during fasting. The implementation of the smart pill boxwith educational labels improved the elderly’s understanding of medication use and supported better medication adherence during Ramadan.

Chronic Kidney Disease (CKD) is a growing global health concern that significantly affects patients’ quality of life. At Bhakti Asih General Hospital, Tangerang, the number of hemodialysis patients increased by 20.42% and dialysis procedures by 25.06% between 2023 and 2024. Despite this service expansion, preliminary findings revealed that 32% of patients reported poor quality of life, 31% experienced low engagement in care, 34% demonstrated low self-efficacy particularly in dietary and fluid management and 32% faced accessibility barriers. These findings indicate a gap between increased service volume and patient-centered outcomes. This study aimed to analyze the effects of patient engagement and self-efficacy on the quality of life of hemodialysis patients, with healthcare accessibility as a mediating variable. A quantitative cross-sectional design was employed. Active hemodialysis patients were selected using purposive sampling. Data were collected through structured questionnaires and analyzed using Structural Equation Modeling (SEM).The results demonstrated that patient engagement and self-efficacy had significant positive effects on quality of life, both directly and indirectly through accessibility. Accessibility also significantly influenced quality of life and strengthened the relationships between patient engagement, self-efficacy, and quality of life.These findings highlight the importance of integrating patient engagement strategies, strengthening self-efficacy through education, and improving service accessibility to enhance quality of life among hemodialysis patients

In response to the evolving landscape of public healthcare services, hospitals are expected not only to maintain operational efficiency but also to adapt to the shifting needs and expectations of patients as healthcare consumers. The presence of non-BPJS patients in regional public hospitals plays a strategic role not only contributing to revenue diversification but also reflecting service quality, institutional competitiveness, and shaping public perception. The declining trend in outpatient visits by general patients at RSUD Balaraja over the past three years highlights the need to understand the factors influencing consumer behavior in determining revisit intentions. This study examines the effect of co-creation and hospital image on the revisit intention of outpatient general patients at RSUD Balaraja, with patient experience as a mediating variable. The research employed a quantitative explanatory design involving 278 outpatient general patients selected through purposive sampling. Data were collected via structured questionnaires and analyzed using Structural Equation Modeling–Partial Least Squares (SEM-PLS). The results indicate that patient experience plays a significant mediating role in shaping revisit intention among general outpatients at RSUD Balaraja. These findings confirm that patient experience serves as a central factor in post-service evaluation processes, which ultimately drive patients’ intention to return. Therefore, hospitals need to enhance patient involvement in service processes (co-creation), improve public perception of institutional image (hospital image), and develop patient-centered service systems as a key strategy to increase revisit intention among general outpatients.

Patient loyalty is an important indicator of success in healthcare services because it reflects patients’ tendency to reuse healthcare services and recommend them to others. Patient loyalty in healthcare facilities is influenced by various factors, including doctor availability, cost bearer systems, and patient experience during the service process. This study aims to analyze the effect of doctor availability and cost bearer on patient loyalty with patient experience as a mediating variable among patients at the Dental Clinic of Hermina Galaxy Hospital.This research used a quantitative approach with a survey design. Data were collected through questionnaires using a Likert scale from 150 patients at the Dental Clinic of Hermina Galaxy Hospital selected through purposive sampling. Data analysis was conducted using Structural Equation Modeling (SEM) with the assistance of AMOS software to examine both direct and indirect relationships among the research variables.The results showed that doctor availability and cost bearer have a positive and significant effect on patient experience. Patient experience was also found to have a positive and significant effect on patient loyalty. In addition, doctor availability and cost bearer have a direct influence on patient loyalty and an indirect influence through patient experience as a mediating variable.In conclusion, improving patient loyalty can be achieved by enhancing doctor availability, managing financing systems effectively, and creating positive patient experiences. Hospital management should optimize these factors to improve service quality and maintain patient loyalty

The development of Digital Marketing and Electronic Word of Mouth (eWOM) has encouraged hospitals to adopt digital communication strategies to attract patients’ visit intentions. However, in public hospitals, the effectiveness of these strategies in influencing patient behavior still requires empirical validation. This study aims to analyze the influence of Digital Marketing and eWOM on patient visit intention, with Brand Awareness as an intervening variable at RSUD Cengkareng.This research employed a quantitative approach with an explanatory design. Data were collected from November to December 2025 from 100 general outpatient respondents selected using the Slovin formula and a simple random sampling technique. The data were gathered through structured questionnaires and analyzed using Structural Equation Modeling (SEM) with AMOS software.The results show that Digital Marketing and eWOM have a positive and significant effect on Brand Awareness. Both variables also significantly influence patient visit intention, with eWOM demonstrating the strongest effect. These findings indicate that information shared through digital platforms and patient recommendations plays an important role in shaping potential patients’ decisions to visit the hospital. However, Brand Awareness does not have a significant effect on patient visit intention and does not mediate the relationship between Digital Marketing, eWOM, and visit intention. This suggests that, in the context of RSUD Cengkareng as a public hospital, patients’ visit decisions are more directly influenced by digital information exposure and the credibility of online recommendations rather than by brand recognition alone.

The postpartum period following Sectio Caesarea is often accompanied by acute pain due to surgical incisions, which may interfere with mobilization, breastfeeding, and maternal recovery. Effective pain management is essential to prevent further complications and enhance maternal comfort. In addition to pharmacological therapy, non-pharmacological interventions such as Benson relaxation therapy can be implemented. This study aimed to evaluate the application of Benson relaxation therapy in reducing acute pain among postpartum Sectio Caesarea mothers.This study employed a case study design involving four postpartum Sectio Caesarea patients (Ny. R, Ny. A, Ny. Y, and Ny. S) treated in the Ayyub Ward of RS Roemani Muhammadiyah Semarang in 2026. Data were collected through comprehensive nursing assessments, pain intensity measurement using a numeric rating scale, observation of mobilization ability, and evaluation before and after intervention.The results showed that after regular implementation of Benson relaxation therapy, all patients experienced a gradual decrease in pain intensity (from scale 4–7 to ≤3), improved comfort, better breathing control, and increased ability to perform early mobilization. Consistent nursing education, therapeutic guidance, and family involvement supported the effectiveness of the intervention. It can be concluded that Benson relaxation therapy is an effective, safe, and easily applicable nursing intervention for reducing acute pain in postpartum Sectio Caesarea patients.

This study aims to analyze the effects of work motivation and career development on nurses’ performance through job satisfaction among nurses at Pertamina Balikpapan Hospital. Nurses’ performance is a key determinant of service quality and patient safety because nurses interact most intensively with patients and ensure continuity of nursing care. However, prior studies on the relationships among motivation, career development, job satisfaction, and performance have reported mixed findings. Therefore, further examination is needed by incorporating job satisfaction as a mediating variable to explain the mechanism of influence more comprehensively. This research employed an explanatory design with a quantitative approach. Primary data were collected using a Likert-scale questionnaire distributed to 165 permanent nurses selected through purposive sampling from a population of 292 nurses. Data were analyzed using variance-based SEM with SmartPLS 4, including outer model evaluation (convergent and discriminant validity) and construct reliability, as well as inner model assessment through the coefficient of determination, effect size, and hypothesis testing using bootstrapping. The results indicate that work motivation has a positive and significant effect on job satisfaction, and career development also has a positive and significant effect on job satisfaction. Job satisfaction has a positive and significant effect on nurses’ performance. In addition, work motivation and career development have positive and significant direct effects on nurses’ performance. Indirect effect testing confirms that job satisfaction mediates the relationship between work motivation and nurses’ performance and also mediates the relationship between career development and nurses’ performance. These findings emphasize that hospitals should strengthen strategies to enhance motivation and career development in a targeted manner while ensuring key sources of job satisfaction so that nurses’ performance improves sustainably.

The postpartum period is a critical phase with a high risk of complications, particularly perineal wound infection, especially in mothers with premature rupture of membranes (PROM). PROM increases the risk of microbial invasion into the birth canal, making infection prevention essential. Vulva hygiene is a non-pharmacological intervention that can help reduce this risk. This study aimed to evaluate the application of vulva hygiene in reducing the risk of perineal wound infection in postpartum mothers with PROM. This study used a case study design involving four postpartum mothers with PROM treated in the Wijaya Kusuma Ward of RSUD Limpung Batang in 2025. Data were collected through comprehensive nursing assessments, observation of perineal wound conditions, and evaluation of infection risk signs before and after the intervention. The results showed that regular implementation of vulva hygiene led to a reduction in infection risk signs, decreased perineal pain, and improved genital hygiene in all patients. Nursing education and assistance played a crucial role in the success of this intervention. It can be concluded that vulva hygiene is an effective nursing intervention in preventing perineal wound infection in postpartum mothers with PROM.

Chronic liver disease is a significant health problem and places a significant burden on healthcare services. Deaths from complications of chronic liver disease (cirrhosis and cancer) account for approximately 3.5% of all deaths worldwide each year. Hepatocellular carcinoma (HCC) is a primary liver tumor, accounting for 90% of all liver tumors. Due to limitations in liver transplantation, liver resection is considered the treatment of choice for HCC patients with a single tumor and sufficient liver function reserve. Liver resection and transplantation are the only curative treatment options available for HCC patients. Surgical procedures require anesthesia. General anesthesia is the preferred method for liver tumor resection. There are five main classes of anesthetic agents: intravenous (IV) anesthetics, inhalational anesthetics, IV sedatives, synthetic opioids, and neuromuscular blocking agents. Estimated health risks depend on the extent or severity of liver disease, the nature and timing of surgery, the type of anesthesia, and other comorbidities.

Background: One of the factors that can trigger diabetes mellitus is a diet high in carbohydrates. Therefore, it is important to educate the community to adopt a healthy lifestyle in order to prevent various diseases, particularly diabetes mellitus. Objective: The objective of this health education activity on the prevention and management of diabetes mellitus through the implementation of a healthy lifestyle is to improve the knowledge of families of diabetes mellitus patients regarding prevention and management by applying healthy lifestyle practices. Methods: The activity was carried out for patients and their families using demonstration and discussion methods supported by leaflet media. Results: The counseling activity successfully increased respondents’ knowledge about the importance of preventing and managing diabetes mellitus through the implementation of a healthy lifestyle.Conclusion: Of the four respondents who attended the health education session on the prevention and management of diabetes mellitus through healthy lifestyle implementation, all participants demonstrated an understanding of the importance of adopting a healthy lifestyle for preventing and managing diabetes mellitus.

Depression is one of the mental health problems that often arise in patients with chronic diseases, such as diabetes mellitus, hypertension, and chronic kidney failure. This condition not only impacts the patient's quality of life, but also affects the treatment process and the burden on the family. However, mental health literacy in the community is still low, so targeted preventive and curative efforts are needed. The Community Service Program (PKM) aims to improve people's mental health through educational interventions with scientific booklet media that are easy to understand and apply. The activity method is carried out in a participatory manner, including the preparation stage, socialization, educational implementation, and evaluation. Education is provided to the community with a focus on preventing depression through a healthy lifestyle, stress management skills, and early intervention efforts by seeking professional support. Evaluation is carried out through pre-post tests, observations, and group discussions. The results of the activity showed an increase in public knowledge about depression, a change in attitudes to be more open in expressing feelings, as well as practical skills in relaxation, maintaining sleep patterns, and building social support. Participants also better understand the importance of seeking professional help when depressive symptoms are getting worse. The conclusion of this PKM is that the scientific booklet has proven to be effective as a preventive and curative educational intervention medium, and can be an innovative strategy in improving the mental health of people affected by chronic diseases.

This study examines postpartum nursing care for mothers undergoing Sectio Caesarea (SC) with the primary nursing diagnosis of ineffective breastfeeding. The purpose is to evaluate the effectiveness of oxytocin massage intervention in improving breastfeeding outcomes in post-SC mothers. The study was conducted in Mawar Ward, RSUD dr. H. Soewondo Kendal, involving four patients experiencing delayed lactation, difficulty in baby latching, and psychological challenges such as anxiety and lack of confidence. The intervention was based on the Indonesian Nursing Intervention Standards (SIKI), focusing on observation, therapeutic actions, education, and collaboration with healthcare teams and family members. Oxytocin massage was performed 2–3 times daily, complemented by warm compresses, breastfeeding position training, and emotional support. The results indicated significant improvements: increased breast milk production, better baby latching, reduced maternal anxiety, and higher self-confidence in breastfeeding. This evidence-based approach highlights that comprehensive postpartum nursing care—integrating physical, psychological, and family support—plays a crucial role in ensuring breastfeeding success and overall maternal recovery after SC.

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

Acne vulgaris is one of the most prevalent dermatological disorders in Indonesia, often affecting adolescents and young adults. This condition not only causes visible skin lesions but also has a profound impact on psychological well-being, leading to decreased confidence and reduced quality of life. Effective management of acne vulgaris requires consistent use of prescribed medications, with doxycycline being one of the commonly recommended systemic antibiotics. This study aimed to evaluate the level of patient adherence to doxycycline therapy for acne vulgaris at Roels Clinic, Ponorogo, during the period of March to April 2025, and to identify factors that may influence this adherence. A descriptive research design was utilized, employing a structured questionnaire distributed to patients who met specific inclusion criteria. The adherence level was assessed using a 5-point Likert scale, and the average percentage was computed and classified into compliance categories. The findings revealed that among 50 respondents, 70.6% demonstrated a “fairly high” level of adherence to doxycycline treatment. These results suggest that most patients follow the prescribed regimen appropriately. High adherence is expected to improve therapeutic outcomes, accelerate recovery, and minimize the potential for antibiotic resistance, which remains a growing concern in dermatological and public health settings.

Myofascial pain syndrome (MPS) is a condition characterized by muscle or fascia pain, involving sensory, motor, or autonomic functions, linked to myofascial trigger points (MTrPs). Motor symptoms can include muscle weakness, limited movement, and stiffness. Sensory symptoms may involve tenderness, referred pain, hyperalgesia, or allodynia, while autonomic symptoms include sweating, changes in skin temperature, and salivation. MPS occurs due to increased sympathetic nervous system activity, which worsens pain. Physical therapy is vital in improving movement and function, with Active Exercise Therapy being a recommended treatment. MPS affects 36% of 431 patients, with pain intensity often developing within a week, and in Indonesia, it reaches 40% within a year. MPS is more common in females than males. Active Exercise Therapy, which can be performed at home or work, is essential for preventing MPS. On July 31, 2025, a community service activity was held at RT VIII Tanjung Mas Village, Semarang Utara, with 29 participants. The event included blood pressure checks, blood sugar tests, BMI measurements, and counseling on the importance of exercise therapy to prevent muscle fatigue, particularly in the neck area. The therapy, focusing on improving tendon and ligament strength and muscle strength, helps maintain joint stability and increase the range of motion. Strength training includes isotonic exercises and progressive resistance training, tailored to each individual's needs. The event provided education on managing muscle pain and fatigue through targeted exercise routines and home programs. These initiatives emphasize muscle recovery, physical health, and overall wellness, ensuring participants can manage and prevent MPS effectively. The event highlighted the critical role of regular physical activity in improving quality of life and preventing long-term musculoskeletal pain.

Osteoporosis is a metabolic bone disorder characterized by a decrease in bone density and strength, making bones more fragile and susceptible to fractures. People with osteoporosis often complain of pain. One of the pain management methods for osteoporosis patients is progressive muscle relaxation. This community service activity empowers the public to practice progressive muscle relaxation techniques. The pre-test results showed that the majority of the community’s knowledge about osteoporosis and pain management was in the poor category, at 79.5%. After education and simulation of the progressive muscle relaxation technique were conducted, there was an increase in the community’s knowledge about osteoporosis and pain management, with 61.4% in the good category. The conclusion of this community service activity is that empowering the community to independently perform progressive muscle relaxation techniques is very beneficial in reducing pain in people with osteoporosis.

Melanoma is a type of malignant skin cancer commonly found among fishing communities due to prolonged exposure to ultraviolet radiation. Initial observations in the coastal area of Galesong, Takalar, South Sulawesi, revealed that many fishermen exhibit symptoms of skin cancer yet have low levels of knowledge and awareness regarding prevention and treatment. This community service activity aimed to provide psychosocial education to improve the quality of life for patients and their families. The methods included health education sessions, group counseling, and the distribution of culturally relevant educational materials. The results showed increased participant understanding of melanoma skin cancer, strengthened family psychosocial support, and greater motivation to seek routine health check-ups. This program is expected to serve as a community-based promotive and preventive intervention model for addressing skin cancer in high-risk groups.

This study examines the various forms of trauma experienced by patients with mental disorders, particularly those caused by violence and loss, and explores the psychosocial approaches used in the recovery process at Prof. Dr. M. Ildrem Mental Hospital, Medan. The background of this study is based on the importance of understanding traumatic factors as one of the root causes of mental disorders, which are often overlooked in medical treatment. The research aims to describe the types of trauma experienced by patients and to evaluate the effectiveness of the psychosocial interventions provided by the hospital. A qualitative approach was employed, using field observation and in-depth interviews with rehabilitation staff, including psychologists, counselors, and therapists. The findings indicate that the majority of patients have a history of severe trauma, such as sexual violence, the loss of loved ones, and extreme life stress that was not properly addressed. The recovery process at the hospital is carried out holistically through occupational therapy, skills training, spiritual guidance, and psychological support from both professionals and peer counselors. The study concludes that an approach combining scientific methods with patients' real-life experiences can positively impact the recovery process. Therefore, strengthening professional capacity and providing counselor training are essential to enhance the effectiveness of the rehabilitation system.

This research was carried out at the Multipurpose Health Center, Sako District, Palembang City. The purpose of this study is to find out the health services provided to Healthy Indonesia Card (KIS) patients at the multivehicle health center and to find out what factors are obstacles in providing maximum service to Healthy Indonesia Card (KIS) patients at the health center. The method used in this study is a descriptive method with a qualitative approach. Data collection techniques include primary data collection in the form of interviews and field observations, as well as secondary data collection in the form of documentation and literature studies. The determination of informants in this study uses the purposive sampling technique. The result of the analysis of this study is Health Services for KIS Patients at the Multiwahana Health Center, Sako District, Palembang City based on PERMENKES Number 04 Article (3) of 2019 concerning Minimum Service Standards (SPM). Health is assessed from the number of quality goods/services, quantity and quality of infrastructure. Health human resources and procedures for meeting standards are running well, this can be seen from the free services provided to KIS participants, namely KIS participants get basic health services at the Puskesmas free of charge, including examinations, treatments, immunizations and maternal and child health services. The provision of medicines at the Puskesmas ensures the availability of essential medicines needed by KIS participants. However, the flow of procedures and services at the multipurpose health center is quite clear, simple, not convoluted, and the officers are friendly. Then, the inhibiting factor in providing services to KIS patients is that there are still many people or patients who are not interested in the Healthy Indonesia Card program.