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Sleep duration and sleep quality are essential physiological needs that play a significant role in the emotional and behavioral development of children aged 3–6 years. Adequate sleep supports brain development, cognitive functioning, emotional regulation, and social interaction skills in early childhood. Conversely, poor sleep duration and low sleep quality may negatively affect children’s attention, mood stability, and ability to interact socially with peers and caregivers. This article is a literature review using a systematic review approach that analyzes 10 scientific articles published between 2016–2026 to evaluate the relationship between sleep duration and sleep quality with emotional and behavioral problems in preschool children. The article selection process followed the PRISMA flow diagram, with articles sourced from Google Scholar, PubMed, and ScienceDirect databases. The findings consistently indicate that inadequate sleep duration and poor sleep quality are associated with increased emotional and behavioral problems, including hyperactivity, anxiety, emotional dysregulation, and difficulties in social interaction among children. Furthermore, sleep disturbances were found to negatively influence children’s emotional self-regulation abilities, which are crucial for adaptive behavior. Therefore, ensuring adequate sleep duration and improving sleep quality are important strategies to support optimal emotional and behavioral development in preschool-aged children.

Hypertension is one of the most common chronic diseases among the elderly and is often accompanied by insomnia. This condition can increase anxiety and reduce quality of life. Progressive Muscle Relaxation (PMR) is an effective non-pharmacological therapy to lower blood pressure and improve sleep quality. This paper describes nursing care for elderly patients with hypertension and insomnia through PMR application at RSUD Embung Fatimah Batam City in 2025. A case study approach was used through the nursing process, including assessment, nursing diagnosis, intervention, implementation, and evaluation. The main nursing diagnosis was sleep pattern disturbance related to physical discomfort and anxiety. Interventions included education and PMR exercises for six consecutive days. Results showed blood pressure decreased from 180/100 mmHg to 130/80 mmHg, sleep quality improved from difficulty sleeping to 6–7 hours per night, and anxiety levels reduced. Progressive muscle relaxation therapy proved effective as an independent nursing intervention to reduce blood pressure and improve sleep quality in elderly patients with hypertension and insomnia. Nurses should use this therapy as a routine non-pharmacological intervention in gerontological nursing practice.

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.

This study aims to analyze the difference in anxiety levels before and after the administration of Qur’anic murottal therapy among third-trimester pregnant women. The third trimester is often associated with increased physical discomfort and psychological stress, which may lead to higher anxiety levels. This research employed a pre-experimental design using a one-group pretest-posttest approach involving 25 respondents selected through purposive sampling. Anxiety levels were measured using the Perinatal Anxiety Screening Scale (PASS), and the data were analyzed using the Wilcoxon Signed Ranks Test. The findings showed that before the intervention, 48% of respondents experienced moderate anxiety and 52% experienced severe anxiety. After the intervention, 40% experienced mild anxiety, 48% moderate, and only 12% severe anxiety. The statistical test result indicated a Z value of -4.376 with a p-value of 0.000 (p < 0.05), which means there was a significant difference in anxiety levels before and after the intervention. These results suggest that murottal therapy is effective in reducing anxiety among third-trimester pregnant women and can be considered as a safe non-pharmacological intervention.

Online games are one of the digital entertainment activities widely favored by adolescents; however, high-intensity use can lead to psychological impacts, one of which is anxiety. Anxiety in adolescents is characterized by feelings of restlessness, irritability, difficulty concentrating, and sleep disturbances, especially when they are unable to play online games or when they experience defeat in the game. This study aimed to determine the relationship between the intensity of online game use and the level of anxiety among adolescents. This study used a quantitative design with a cross-sectional approach, involving 113 respondents selected using a cluster sampling technique. The research instruments used were the DASS questionnaire and an online game usage intensity questionnaire, and the data were analyzed using univariate and bivariate analysis. The respondents in this study were adolescents from SMAN 1 Wanadadi, most of whom were 16 years old (49.6%) and predominantly female (61.9%). The intensity of online game use was mostly in the moderate category (55.8%), while the level of anxiety was mostly in the mild category (89.0%). The results showed that most respondents had a moderate level of online game usage intensity and a mild level of anxiety. Bivariate analysis indicated that there was no significant relationship between the intensity of online game use and the level of anxiety among adolescents, with a p-value of 0.425 and a contingency coefficient value of 0.076. Therefore, it can be concluded that there is no relationship between the intensity of online game use and the level of anxiety among adolescents.

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.

Regular physical activity is known to play an important role in maintaining overall health, including improving immune system function and mental health. Lack of physical activity remains a public health issue, making it important to understand the impact of physical activity on the immune system and mental health. This study aimed to review the effect of regular physical activity on the immune system and mental health using a literature review method. The literature sources were obtained from publications within the last five years using databases such as Google Scholar, PubMed, and ScienceDirect. The articles were then screened and selected based on inclusion and exclusion criteria, resulting in nine relevant articles for analysis. The selection results indicate that regular physical activity can increase the mobilization and activity of immune cells such as lymphocytes, neutrophils, and natural killer cells, and also modify the adaptive immune system through changes in T cells and B cells. In addition, physical activity also improves mental health through neurobiological mechanisms such as increased endorphin, dopamine, and serotonin levels, which can reduce stress, anxiety, and depression, as well as improve sleep quality and psychological well-being. Therefore, regular physical activity has a positive effect on the immune system and mental health and can be used as a promotive and preventive strategy to maintain overall health.

Dysmenorrhea or menstrual pain, is a common health issue among adolescent girls, often disrupting daily activities and quality of life. Effective management of dysmenorrhea is strongly influenced by the level of knowledge and attitudes of adolescent girls toward this condition. This literature review aims to analyze the relationship between knowledge and attitudes regarding the management of menstrual pain among adolescent girls. Various studies indicate that while adequate knowledge about dysmenorrhea is important, the correlation between knowledge and attitude is not always significant. Some research finds that good knowledge does not necessarily translate into a positive attitude towards pain management, as other factors such as stress, anxiety, and reluctance to take action also play a role. However, there are studies that show a positive relationship between increased knowledge and better attitudes toward dysmenorrhea management,  although the strength of this association is very weak. Most adolescents tend to choose non-pharmacological management, such as rest and warm compresses, but many still ignore menstrual pain due to a lack of knowledge and information. Therefore, educational interventions and counseling in schools are essential to improve knowledge and foster positive attitudes in managing dysmenorrhea among adolescent girls. These efforts are expected to help adolescent girls manage menstrual pain more effectively and enhance their quality of life.

This meta-analytic study aims to comprehensively examine the relationship between mental health, learning capacity among health education students, and competencies in nosocomial disease risk management through cross-contextual empirical synthesis. An analysis of 47 studies involving 12,847 participants from 15 countries demonstrates a strong, statistically significant association between students' mental health and competencies in nosocomial infection prevention, as reflected by a correlation coefficient of r=0.68 (p<0.001) and a 95% confidence interval of 0.61-0.74. Students with high mental health scores (M=78.4; SD=8.2) exhibited substantially superior understanding of infection prevention protocols, namely 43% higher than the control group (M=54.7; SD=12.1; t(846)=18.42; p<0.001; d=2.31). Structural equation modeling confirmed learning capacity as a significant partial mediator (β=0.52; p<0.001), with an indirect effect reaching 35.4% and a 95% CI range of 28.6-42.1%. Mindfulness-based psychoeducational interventions were shown to enhance nosocomial risk identification abilities by 38.7% (F(2,564)=42.18; p<0.001; η²=0.41) while reducing clinical anxiety by 31.2% (t(382)=9.84; p<0.001). These findings extend the frameworks proposed by Song (2024) and Schutte et al. (2025), which primarily emphasize cognitive aspects, by demonstrating that the integration of psychological dimensions yields a multidimensional predictive model explaining 64.3% of the variance in risk management competence (R²=0.643; F(5,841)=304.76; p<0.001), surpassing conventional models that account for only 38-45% of the variance.

This research aims to develop a customized chatbot based on a local large language model (LLM) using Ollama Anything as a form of psychosocial support for Pencak Silat athletes. Mental toughness is a critical factor for Pencak Silat athletes, particularly when coping with competitive failure or sports-related injuries. Injuries sustained in Pencak Silat competitions often involve psychological consequences, including trauma, fear, anxiety, and disturbances in self-identity. To address these challenges, the proposed chatbot functions as a screen-integrated psychosocial support system for athletes. This research used an experimental method combined with Natural Language Processing (NLP) techniques was employed to construct a digital twin chatbot capable of simulating athlete-centered conversations. The Pencak Silat Athlete Chatbot is designed to assist athletes by providing responsive support when they experience defeat or performance setbacks during competitions. The research findings indicate that, although the chatbot is functional, its conversational responses remain relatively rigid, access times are prolonged, and further testing with Pencak Silat athletes in controlled settings is required. Overall, the development of the Pencak Silat Athlete Digital Twin Chatbot represents an ongoing effort to advance digital innovation and strengthen the ecosystem of sports achivements development in Indonesia.

Anxiety is a prevalent mental health issue that affects psychological well-being and daily functioning. In Muslim communities, Islamic spiritual practices are commonly used as coping strategies, yet empirical evidence regarding their effectiveness in reducing anxiety has not been systematically consolidated. This study aimed to synthesize scientific evidence on Islamic spiritual interventions for anxiety reduction. A systematic literature review was conducted in accordance with PRISMA guidelines by searching Google Scholar, PubMed, ScienceDirect, and Elsevier. Observational studies published between 2019 and 2026 that examined Islamic spiritual interventions and reported anxiety outcomes were included and analyzed narratively. Ten eligible articles were identified. The review demonstrates that Islamic spiritual interventions, such as dhikr, prayer, Qur’an recitation, and Islamic spiritual counseling, are consistently associated with reductions in anxiety across diverse populations and settings. Although the magnitude of effects varied, the overall findings indicate a beneficial role of Islamic spiritual practices in anxiety management. These results suggest that Islamic spiritual interventions may be integrated as complementary approaches within mental health and public health services for Muslim populations, while further methodologically rigorous studies are required to strengthen the evidence base.

Background: Anxiety in postpartum mothers is a psychological problem that can negatively impact maternal mental health, marital relationships, and the lactation process. This psychological disorder can inhibit the production and let-down of breast milk, which, if not addressed promptly, can lead to physical complications such as breast engorgement or mastitis, as well as hinder the fulfillment of the infant's nutritional needs. Objective: This study aimed to determine the relationship between anxiety levels and delayed breast milk let-down in postpartum mothers at Prof. Dr. R.D. Kandou General Hospital Manado. Methods: This research is an analytical survey with a cross-sectional design. The sample consisted of 30 postpartum mothers selected using non-probability sampling. Research instruments included questionnaires and interviews, with data analysis using the chi-square test. Results: The majority of respondents experienced moderate anxiety (60.0%) and had non-smooth breast milk let-down (53.3%). Statistical test results showed a p-value = 0.030, indicating a significant relationship between anxiety levels and delayed breast milk let-down. Conclusion: High anxiety levels in postpartum mothers contribute to delayed breast milk let-down. Psychological support for postpartum mothers is needed to maintain the smoothness of the breastfeeding process.

Expressive feelings therapy is a form of mental health nursing modality therapy that aims to help individuals express their thoughts and emotions openly without violating the rights of others. This study aims to explore the effectiveness of cognitive therapy focused on “expressing feelings” in improving emotional expression abilities among female patients in the recovery phase at the Anggrek Ward of the Aceh Government Mental Hospital. This descriptive qualitative study was conducted through group therapy activities with structured stages, using media such as emotion expression picture cards and a spin-the-bottle game as interaction stimuli. The population consisted of 18 patient in the Anggrek ward, with a sample of 12 patients who were cooperative, psychologically stable, able to communicate bidirectionally, and willing to participate in group therapy. The results showed that participants experienced an improvement in their ability to express emotions such as happiness, sadness, anger, and anxiety more openly, accompanied by increased social interaction and reduced emotional tension. The therapy also encouraged greater self-confidence and a sense of emotional relief. These findings support that expressive feelings therapy can be incorporated as part of routine nursing interventions for patients who experience difficulties in emotional regulation. It is recommended that further research be conducted over a longer duration and with a broader scope to strengthen the validity of the findings.

The rapid development of digital technology has significantly increased public access to online activities, including online gambling, which has emerged as a serious social problem in Indonesia. This study aims to analyze the impact of online gambling on the mental health and social behavior of young people. This research employed a descriptive method with a survey approach. Data were collected through questionnaires distributed to young respondents who had experience or exposure to online gambling activities. The findings indicate that involvement in online gambling has a significant impact on mental health disorders such as stress, anxiety, and depressive symptoms. In addition, online gambling contributes to a decline in social interaction quality, increased family conflict, social withdrawal, and reduced productivity. Behavioral changes such as impulsivity and decreased self-control were also identified among respondents. These results demonstrate that online gambling not only affects individuals psychologically but also disrupts social relationships and family harmony. Therefore, comprehensive preventive efforts are needed through digital literacy enhancement, family involvement, and psychological support services to protect young people from the negative consequences of online gambling.

Anxiety among family member in the Intensive Care Unit (ICU) is a common psychological issue. This situation arises from the uncertainty about the patient’s condition. Effective therapeutic communication by nurses is one of the key strategies to help reduce anxiety. This study was conducted from June 4 to July 20, 2025. This study aims to analyze the relationship between nurses’ therapeutic communication and the anxiety levels of family members in the ICU of RSUD Meuraxa, Banda Aceh. This research employed a quantitative, correlational design. The population consisted of 66 family members of ICU patients, with a sample of 57 respondents selected using a purposive sampling technique. The results showed that most families received therapeutic communication at a moderate level (50.9%) and a good level (49.1%). The anxiety levels experienced by the families were mostly moderate (54.4%) and mild (45.6%). The analysis revealed a p-value of 0.003, indicating a statistically significant relationship between nurses’ therapeutic communication and the anxiety levels of family member. These findings prove that therapeutic communication given by nurses plays a vital role in influencing the anxiety levels of patients’ families in the ICU. Therefore, the hospital management is encouraged to improve nurses’ therapeutic communication skills and establish supportive communication policies to enhance services and reduce anxiety among the family members in the ICU.

Mental health problems, particularly anxiety disorders, are increasingly prevalent among adolescents and have become a significant concern for the church as a spiritual community. This study aims to analyze the role of God’s servants in preventing and addressing anxiety disorders among adolescents at GKSI Maranatha Anugrah Sewan, Tangerang. The research employs a qualitative method through direct observation of youth ministry activities and informal interviews with participants. The findings reveal that church ministers play a strategic role in enhancing adolescents’ mental well-being through practical biblical teaching, empathetic pastoral counseling, and the establishment of prayer and openness communities. The application of Scripture Therapy, devotional counseling, and Healing Prayer Circles has proven effective in reducing anxiety levels, strengthening spiritual security, and fostering healthy social relationships. A holistic and collaborative pastoral approach involving professional support is essential for the church to create a safe environment that promotes recovery and spiritual growth among youth.

This study examines the role of teachers as Islamic counselors in addressing various psychological problems experienced by students, such as learning anxiety, academic stress, low self-confidence, difficulty controlling emotions, and social problems such as bullying. Teachers serve not only as instructors, but also as murabbi, mursyid, and moral role models in guiding students' spiritual and emotional development. The study used a qualitative method with a library study approach, where data were obtained through relevant literature related to Islamic counseling, Islamic education, and student psychology. The results of the study indicate that the implementation of Islamic counseling through strategies such as mau'izhah hasanah, tazkiyah an-nafs, prayer and dhikr, empathy development, and collaboration with guidance and counseling teachers and parents has been proven to reduce students' anxiety and stress levels, increase learning motivation, strengthen morals and character, and provide spiritual peace. Thus, teachers play a strategic role in creating a holistic educational environment and supporting students' psychological well-being. In addition, the implementation of Islamic counseling also plays a role in building students' mental resilience in facing academic and social pressures. In the long term, this will strengthen the Islamic values ​​applied in students, while creating a more resilient and noble generation.

Anxiety is an emotional response to uncertainty or threats that cause feelings of anxiety, worry, excessive tension, which are continuous and can interfere with the patient's process of action and healing, therefore it is necessary to have good and correct therapeutic communication, to build a relationship of mutual trust, empathy, support and help the patient in problem solving. This study aims to identify the Relationship between Nurse Therapeutic Communication and Anxiety Level in Preoperative Patients at Santa Elisabeth Hospital Medan in 2024. The research design uses correlational with a cross sectional approach, purposive sampling technique with a sample of 64 respondents. The instruments used were the nurse therapeutic communication questionnaire and the anxiety questionnaire. The results of the study showed that the majority of therapeutic communication among nurses in the inpatient room of Santa Elisabeth Hospital Medan was in the good category as many as 34 respondents (53.1%), and the level of anxiety of preoperative patients was majority in the medium category as many as 30 respondents (46.9%). The spearman rank statistical test on SPSS obtained a P-Value = 0.000 which means that there is a relationship between the therapeutic communication of nurses and the level of patient anxiety at Santa Elisabeth Hospital Medan. It is expected that the nurses in Pauline's room will further improve therapeutic communication to pre-operative patients.

Background: Cardiac catheterization is the most widely used diagnostic and hemodynamic intervention procedure in the world for the treatment of coronary heart disease (CHD). Cardiac catheterization can cause anxiety in patients who will undergo it. Objective: To analyze the factors that influence the anxiety of patients who will undergo cardiac catheterization. Method: This study is a descriptive analytical study with a cross-sectional approach conducted at Murni Teguh Memorial Hospital Medan. The study population was 40 people, and all of them were used as samples (total sampling). The research instrument was a questionnaire. Data analysis was carried out univariately and bivariately using the Chi-Square test with a significance level of 95% (= 0.05). Results: This study shows that there is a significant influence between knowledge, family support, past experience, and education level on the anxiety of patients who will undergo cardiac catheterization at Murni Teguh Hospital Medan. This is proven by the chi square test with p values for each knowledge (p = 0.000); family support (p = 0.002); past experience (p = 0.003); and education (p=0.003) which are all less than 0.005. Conclusion: Cardiac catheterization patient anxiety is influenced by knowledge, family support, past experience, and education level. Suggestion: It is recommended that further researchers increase the number of samples and independent variables, considering that many factors influence patient anxiety before cardiac catheterization/angiography