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Children with special needs, particularly those with intellectual disabilities, often experience difficulties in emotional development, communication skills, and social interaction. These conditions may make it challenging for them to express their feelings, regulate their emotions, and adapt to their surroundings. Based on observations conducted at SLBN Pembina Kupang, several children were found to be easily angered, lacking in self-confidence, and experiencing difficulties in social interaction. The implementation of this program consisted of three stages: preparation, implementation, and evaluation. The program began with coordination with the school, the preparation of coloring materials and equipment, and the selection of participants. Subsequently, the children participated in play therapy through coloring activities under the guidance of the service team and teachers. Evaluation was carried out by observing the children's participation, changes in emotional expression, and social interaction skills throughout the activities. The results showed that play therapy through coloring activities had a positive impact on the children's emotional development. The children became calmer, more confident, and better able to express their feelings. In addition, the activities helped improve their social skills, cooperation, concentration, discipline, and fine motor skills. Therefore, play therapy through coloring activities can serve as an effective, simple, and sustainable intervention to support the emotional development of children with special needs at SLBN Pembina Kupang.

Communication is a crucial element in the learning process, particularly in the education of students with special needs who possess diverse characteristics, abilities, and communication requirements. These differences require teachers to implement adaptive communication strategies to ensure that learning messages are effectively conveyed and understood by students. This study aims to analyze the communication at SLB YPAC Medan. The subjects of this study specifically focused on third-grade students with intellectual disabilities (tunagrahita) and slow learners. The. The study adopted a qualitative approach using a case study method. Data were collected through observation, in-depth interviews, and documentation, and analyzed using the Miles and Huberman model, which includes data reduction, data display, and conclusion drawing. The findings reveal that teachers apply communication strategies through a combination of verbal and nonverbal communication. Verbal communication involves the use of simple language, repetition of learning materials, and step-by-step instructions tailored to students’ abilities. Meanwhile, nonverbal communication is expressed through facial expressions, body movements, eye contact, and the use of visual learning media to clarify instructional messages. In addition, interpersonal approaches emphasizing patience, attention, empathy, and emotional closeness were found to enhance the effectiveness of teacher–student interactions. Supporting factors include adequate school facilities, psychological services, and therapy programs, while inhibiting factors involve differences in students’ characteristics and limitations in their communication abilities. This study concludes that adaptive communication strategies that accommodate individual student needs play a significant role in creating an effective, comfortable, and supportive learning environment for students with special needs.

This study is grounded in the observation that online game addiction has emerged among learners at SMP Muhammadiyah Bantul. In the present digital era, playing games through the internet has become tightly woven into adolescents' everyday routines. Easy accessibility together with the broad spectrum of entertainment provided has pushed the popularity of online games upward. However, immoderate engagement may foster addictive patterns that adversely affect students' academic performance, social interaction, physical condition, and mental well-being. Hence, a workable intervention is required to lower the level of dependence. The purpose of this research is to decrease learners' online game addiction by means of group counseling services that draw on the Cognitive Behavioral Therapy (CBT) framework combined with cognitive restructuring techniques. A one-group pretest-posttest experimental scheme was adopted in this work. The findings reveal a notable reduction in the students' online game addiction scores, evidenced by the paired sample t-test significance value (two-tailed) of 0.000, which falls below 0.05. It can therefore be inferred that group counseling rooted in the Cognitive Behavioral Therapy approach with cognitive restructuring techniques is effective for reducing online game addiction in seventh-grade learners at SMP Muhammadiyah Bantul.

Hypertension is a condition in which systolic blood pressure exceeds 140 mmHg and diastolic blood pressure is above 90 mmHg. Hypertension is the leading chronic non-communicable disease among adults in Indonesia, with a prevalence of 26.5%, and tends to increase with age. Family nursing care plays an important role in helping patients manage hypertension through education, pharmacological and non-pharmacological interventions, and ongoing monitoring. This case study aimed to describe comprehensive nursing care for Ny. K, a 66-year-old patient from the family of Tn. I, diagnosed with hypertension in Desa Tonjong RT 02 RW 04, Kecamatan Tonjong, Kabupaten Brebes. Nursing care was conducted from December 27 to 29, 2025, using interview, physical examination, observation, and documentation methods. Two nursing diagnoses were identified: (1) Risk of ineffective cerebral tissue perfusion, and (2) Knowledge deficit related to hypertension. Nursing interventions included vital sign monitoring, oral medication administration (Amlodipine 10 mg), health education on hypertension, and non-pharmacological therapy using bay leaf (Syzygium polyanthum) decoction. Evaluation results showed that the knowledge deficit was resolved after one session of health education, while the risk of ineffective cerebral tissue perfusion was partially resolved, with blood pressure decreasing from 180/100 mmHg to 165/90 mmHg over three home visits. It is recommended that families continue the bay leaf decoction therapy for one week and maintain regular blood pressure monitoring at the nearest health facility.

Pneumonia is one of the leading causes of morbidity and mortality among children aged 0–18 years worldwide. Appropriate treatment is crucial for improving treatment outcomes and preventing complications and antibiotic resistance. This literature review aims to analyze treatment options for pneumonia in pediatric patients based on articles published in PubMed from 2024 to 2025. The method used involved searching for articles with the keywords “(Case Reports) AND (pneumonia) AND (in children)” using filters for free full text, case reports, English language, human subjects, and the 0–18-year-old age group. Of the 71 articles identified, 10 met the inclusion criteria. The review results indicate that pneumonia treatment in children is dominated by the use of antibiotics and supportive care. In cases of severe pneumonia and necrotizing pneumonia, intensive antimicrobial therapy, close monitoring, and management of complications are required. Modern diagnostic tests such as bronchoalveolar lavage fluid (BALF), rapid syndromic arrays, and metagenomic next-generation sequencing (mNGS) help identify pathogens more quickly and accurately, thereby allowing for more targeted therapy. Additionally, corticosteroids and immunoglobulins are used as adjunctive therapies in cases of severe inflammation. Accurate diagnosis and individualized therapy selection play a crucial role in improving clinical outcomes for pediatric pneumonia patients. 

Pneumonia is one of the leading causes of morbidity and mortality among children aged 0–18 years worldwide. Appropriate treatment is crucial for improving treatment outcomes and preventing complications and antibiotic resistance. This literature review aims to analyze treatment options for pneumonia in pediatric patients based on articles published in PubMed from 2024 to 2025. The method used involved searching for articles with the keywords “(Case Reports) AND (pneumonia) AND (in children)” using filters for free full text, case reports, English language, human subjects, and the 0–18-year-old age group. Of the 71 articles identified, 10 met the inclusion criteria. The review results indicate that pneumonia treatment in children is dominated by the use of antibiotics and supportive care. In cases of severe pneumonia and necrotizing pneumonia, intensive antimicrobial therapy, close monitoring, and management of complications are required. Modern diagnostic tests such as bronchoalveolar lavage fluid (BALF), rapid syndromic arrays, and metagenomic next-generation sequencing (mNGS) help identify pathogens more quickly and accurately, thereby allowing for more targeted therapy. Additionally, corticosteroids and immunoglobulins are used as adjunctive therapies in cases of severe inflammation. Accurate diagnosis and individualized therapy selection play a crucial role in improving clinical outcomes for pediatric pneumonia patients. 

This study aims to analyze the education of children with special physical needs, particularly children with speech impairment, at TK Harsya Ceria Banda Aceh. The study used a qualitative method with a descriptive approach to describe the learning process, fulfillment of physical needs, teacher assistance, family support, and obstacles faced in inclusive education. Data were collected through observation, interviews, and documentation involving school principals, teachers, parents, and children with speech impairment. The results showed that TK Harsya Ceria has implemented inclusive education by providing equal learning opportunities for children with special needs alongside regular students. Teachers use visual media, body language, educational games, and individual assistance to support children’s communication and learning processes. Family support also plays an important role in developing children’s independence, communication skills, and social interaction. However, several obstacles were found, including communication barriers, limited facilities, lack of special assistants, and high therapy costs. Therefore, collaboration between schools, families, health workers, and the government is needed to support the optimal development of children with speech impairment in inclusive education environments.

Children with intellectual disabilities experience limitations in intellectual functioning and adaptive abilities, which impact their independence in daily activities, including buttoning clothes. This skill requires fine motor coordination, concentration, and a proper understanding of task sequences. This case study aims to determine the effectiveness of button board play therapy in improving fine motor skills in children with intellectual disabilities. The method used was descriptive with a case study approach involving two children with moderate intellectual disabilities aged 8 and 9 years at SLB Bhakti Luhur Maumere. Data were collected through interviews, observations, and documentation. The intervention consisted of button board play therapy conducted for 6 days, with a duration of 15–30 minutes per day, implemented gradually and repeatedly. The results showed that before the intervention, both children were unable to button their clothes independently. After the intervention, there was an improvement in their ability, as the children began to button some buttons (2–3 buttons) with better motor coordination, although they still required assistance and supervision. In conclusion, button board play therapy is effective in gradually improving fine motor skills and independence in children with intellectual disabilities. It is recommended that the intervention be carried out consistently and involve parents to achieve optimal results.

Health communication plays a crucial role in dental practice, particularly in conveying sensitive clinical information or bad news. Barriers to communication can increase patient anxiety, decrease adherence to therapy, and impact the quality of healthcare services. The SPIKES protocol presents a six-stage, systematic and empathetic communication model for conveying clinical information. This study aims to analyze the implementation of the SPIKES protocol as a health communication model in dental practice. The study used a systematic literature review method with data sources from the Scopus, PubMed, and Web of Science databases for the period 2020–2025. Article selection was carried out using the PRISMA approach based on inclusion and exclusion criteria. The results of the study indicate that the implementation of the SPIKES protocol can improve the clarity of information delivery, strengthen the relationship between healthcare professionals and patients, and reduce patient anxiety. In addition, the empathetic approach in SPIKES contributes to increased patient satisfaction and adherence to treatment plans. In conclusion, the implementation of the SPIKES protocol can support the improvement of the quality of clinical communication in dental practice through the delivery of targeted, humanistic, and patient-centered information.

Health communication plays a crucial role in dental practice, particularly in conveying sensitive clinical information or bad news. Barriers to communication can increase patient anxiety, decrease adherence to therapy, and impact the quality of healthcare services. The SPIKES protocol presents a six-stage, systematic and empathetic communication model for conveying clinical information. This study aims to analyze the implementation of the SPIKES protocol as a health communication model in dental practice. The study used a systematic literature review method with data sources from the Scopus, PubMed, and Web of Science databases for the period 2020–2025. Article selection was carried out using the PRISMA approach based on inclusion and exclusion criteria. The results of the study indicate that the implementation of the SPIKES protocol can improve the clarity of information delivery, strengthen the relationship between healthcare professionals and patients, and reduce patient anxiety. In addition, the empathetic approach in SPIKES contributes to increased patient satisfaction and adherence to treatment plans. In conclusion, the implementation of the SPIKES protocol can support the improvement of the quality of clinical communication in dental practice through the delivery of targeted, humanistic, and patient-centered information.

Patients with ANSD may have hearing thresholds that vary from normal to severe hearing loss, but they often have difficulty understanding speech, especially in noisy environments. This condition can be caused by various factors, including genetic mutations (such as in the OTOF gene), preterm birth, perinatal hypoxia, and hyperbilirubinemia. Some adult patients have been reported to develop ANSD following autoimmune disorders such as sensorimotor neuropathy or after chemotherapy with ototoxic agents such as cisplatin. Diagnosis of Auditory Neuropathy Spectrum Disorder (ANSD) begins with a comprehensive medical history to identify risk factors that play a role. A history of preterm birth, severe hyperbilirubinemia requiring exchange transfusion, perinatal hypoxia, ventilator use, and a family history of infection or genetic disorders are major risk factors. In addition, patients or parents often report delayed speech development, inability to understand speech (especially in noisy environments), or a discrepancy between previous hearing test results and the child’s behavioral response. The gold standard for diagnosing ANSD is a combination of: (1) positive OAE and/or CM, (2) absent or abnormal ABR, and (3) absent acoustic reflex. This diagnosis is established only if there is evidence that the cochlea is functioning normally but there is a disruption in auditory nerve transmission. Routine monitoring is conducted to assess hearing and language development and adjust devices and therapy methods according to the patient’s needs. Counseling and education for families are also crucial components to provide optimal support at home and improve the patient’s quality of life. A comprehensive multidisciplinary approach is essential to ensure effective management of ANSD and achieve the best possible outcomes.

Chronic kidney disease is one of the global health problems that requires long-term therapy, one of which is through hemodialysis. According to the World Health Organization (WHO), adherence to treatment and diet is a key factor in improving the quality of life for patients with chronic diseases. An appropriate diet plays an important role in controlling electrolyte levels, fluids, and toxic substances in the body. This study aims to describe the knowledge and dietary compliance of patients undergoing hemodialysis at Santa Elisabeth Hospital Medan in 2025.This research used a descriptive quantitative design with a cross-sectional approach. The sample consisted of 36 patients selected using purposive sampling techniques. The research instrument was a questionnaire developed based on dietary guidelines for hemodialysis patients according to WHO and the Indonesian Ministry of Health standards. The results showed that among the 36 hemodialysis patients, 15 respondents (41.7%) had a good level of knowledge, 14 respondents (38.9%) had a moderate level, and 7 respondents (19.4%) had a low level of knowledge. Regarding dietary compliance, 13 respondents (36.1%) were compliant, 18 respondents (50.0%) were moderately compliant, and 3 respondents (13.9%) were non-compliant. There was a tendency showing that higher knowledge levels were positively correlated with better dietary compliance, in line with WHO’s principle that health education is an essential intervention in managing chronic diseases. This study recommends strengthening ongoing educational programs by healthcare professionals, particularly in delivering accurate and easy-to-understand information about diet management for hemodialysis patients.

Chronic kidney disease is one of the global health problems that requires long-term therapy, one of which is through hemodialysis. According to the World Health Organization (WHO), adherence to treatment and diet is a key factor in improving the quality of life for patients with chronic diseases. An appropriate diet plays an important role in controlling electrolyte levels, fluids, and toxic substances in the body. This study aims to describe the knowledge and dietary compliance of patients undergoing hemodialysis at Santa Elisabeth Hospital Medan in 2025.This research used a descriptive quantitative design with a cross-sectional approach. The sample consisted of 36 patients selected using purposive sampling techniques. The research instrument was a questionnaire developed based on dietary guidelines for hemodialysis patients according to WHO and the Indonesian Ministry of Health standards. The results showed that among the 36 hemodialysis patients, 15 respondents (41.7%) had a good level of knowledge, 14 respondents (38.9%) had a moderate level, and 7 respondents (19.4%) had a low level of knowledge. Regarding dietary compliance, 13 respondents (36.1%) were compliant, 18 respondents (50.0%) were moderately compliant, and 3 respondents (13.9%) were non-compliant. There was a tendency showing that higher knowledge levels were positively correlated with better dietary compliance, in line with WHO’s principle that health education is an essential intervention in managing chronic diseases. This study recommends strengthening ongoing educational programs by healthcare professionals, particularly in delivering accurate and easy-to-understand information about diet management for hemodialysis patients.

Chronic Coronary Syndrome (CCS) is a contemporary term that replaces stable coronary artery disease (CAD) and describes a spectrum of clinical conditions resulting from chronic abnormalities of the coronary arteries. This condition is characterized by a mismatch between myocardial oxygen supply and demand that is transient and reversible, commonly presenting as stable angina pectoris. CCS contributes significantly to global cardiovascular morbidity and mortality, including in Indonesia. The underlying pathophysiology primarily involves atherosclerosis and microvascular dysfunction leading to myocardial ischemia. Diagnosis is established through comprehensive history taking, physical examination, and both invasive and non-invasive investigations such as electrocardiography, stress testing, and cardiac imaging. Risk stratification using pre-test probability plays a crucial role in guiding further diagnostic evaluation. The management of CCS aims to relieve symptoms and prevent adverse cardiovascular events through pharmacological and non-pharmacological approaches, as well as revascularization when indicated. Pharmacological therapy includes antianginal agents, antiplatelet drugs, and lipid-lowering agents, while lifestyle modifications such as smoking cessation, healthy diet, and regular physical activity are essential in preventing disease progression. With accurate diagnosis and comprehensive management, the morbidity and mortality associated with CCS can be reduced.

Children with Autism Spectrum Disorder (ASD) face unique challenges in building attachment relationships, due to ASD children experiencing impairments in communication, social interaction, and emotional regulation. This study aims to identify effective intervention strategies to improve the quality of attachment between parents and children with ASD through a Systematic Literature Review (SLR) approach. The review findings indicate that several interventions have proven effective in enhancing attachment between parents or primary caregivers and children with ASD, including the following interventions: DIR/Floortime, Focused Playtime Intervention (FPI), Parent-Child Interaction Therapy (PCIT), Circle of Security (COS), Positive Behavior Support (PBS), play training, massage therapy, and psychoeducation. The results of these interventions show that changes occur before and after the intervention, including strengthening two-way communication, increasing parental sensitivity, and improving the child's emotional responses. These findings have practical implications for parents, educators, and therapists in designing attachment-based approaches to support the social and emotional development of children with ASD. Responsive and supportive designing attachment-based approaches to support the social and emotional development of children with ASD. Responsive and supportive relationship-based interventions can build secure attachments between children with ASD and their parents and serve as an important reference in attachment-based parenting and therapy practices.

Stroke often causes hemiparesis, which impairs hand motor skills and independence in daily activities. Mirror therapy is a rehabilitation intervention that stimulates motor function through visual feedback, while patient motivation plays a crucial role in exercise adherence. This study aims to analyze the effect of mirror therapy and patient motivation on hand motor skills in patients with hemiparesis.The study used a quasi-experimental design with a pretest–posttest approach in 30 hemiparesis patients undergoing rehabilitation at the Ciherang Community Health Center. Mirror therapy intervention was administered for 20–30 minutes, three times per week for four weeks. Hand motor skills were measured using Manual Muscle Testing on a scale of 0–5, while patient motivation was assessed using a questionnaire.The results showed a significant increase in hand motor skills after mirror therapy (p < 0.05) and higher patient motivation was associated with greater motor score improvement (p < 0.05). Mirror therapy and patient motivation have been shown to have a positive effect on hand motor skills in hemiparesis patients, so this combined intervention can be considered as part of a stroke rehabilitation program.

Non-hemorrhagic cerebrovascular disease (CVD) results from blood flow obstruction in the brain due to thrombus or embolus formation, often leading to balance disorders that affect standing and walking. This loss of motor function increases the risk of falls and fractures, which are major complications. Additionally, reduced physical activity can lead to depression. Active exercise has been shown to improve motor function in CVD patients, with nurses playing a key role in supporting these exercises. One effective intervention is the bridging exercise (BE), used for lumbopelvic stabilization, which enhances muscle strength and coordination. BE is particularly beneficial for improving balance in post-CVD patients with hemiplegia. This case study examines the effects of evidence-based bridging exercise (EBP) on balance in three hospitalized non-hemorrhagic CVD patients. Over eight 15-minute sessions, balance was assessed using the Berg Balance Scale (BBS). All patients showed significant balance improvement, with an average BBS score increase of 40 points. These results highlight the effectiveness of non-pharmacological bridging exercises in enhancing balance in CVD patients and recommend BE as a routine therapy to continue at home after discharge.

This is a worrying issue in the digital age and has been shown to significantly contribute to low student academic achievement. This research aims to examine the role of Guidance and Counseling (BK) services in addressing social media addiction in students with low academic achievement. The method used in this research is library research with a qualitative approach through content analysis and literature synthesis techniques sourced from various scientific references published between 2020 and 2025. The results show that students addicted to social media have low self-control, resulting in academic procrastination and a consistent decline in learning achievement. GC services have proven to play a strategic role through preventive, curative, and developmental functions implemented through classical guidance, individual counseling, and group counseling. The Cognitive Behavioral Therapy (CBT) approach and self-management technique have proven most effective in helping students reduce social media addiction and improve learning discipline. However, the effectiveness of GC services is still constrained by the non-ideal ratio of counseling teachers, the lack of digital literacy-based GC programs, and students' negative stigma toward counseling services. This study recommends developing GC programs specifically designed to address digital addiction by involving the entire school ecosystem consistently.

The elderly are a vulnerable group to experience decreased physical and cognitive function, such as hypertension and dementia, which can affect their quality of life. The Activity Therapy Program aims to improve the well-being of the elderly through laughter therapy, listening to music, and playing guess the word. The method used is group dynamics, which involves fun activities to stimulate the cognitive and social of the elderly. This activity is expected to increase social interaction, sensory stimulation, and improve the cognitive function of the elderly. The implementation of therapy was carried out involving 60 elderly people, with stages that included orientation, work, and termination. Evaluations showed that 60% of participants actively participated in laughter and guess therapy, as well as being able to express their feelings. This program has shown success in improving the quality of life of the elderly by encouraging them to be more active and social. In conclusion, TAK can be an effective solution to improve the quality of life of the elderly through physical and cognitive stimulation. It is recommended that this program be carried out regularly to maintain the memory and social health of the elderly.

This study aims to explore the effectiveness of various intervention strategies, including counseling services, learning strategies, and occupational therapy in treating children with Attention Deficit Hyperactivity Disorder (ADHD). Through a qualitative method based on literature studies, this study applies systematic data processing to evaluate the impact of a holistic approach on children's behavior and concentration. Analysis is carried out through data reduction procedures, data presentation, and verification of conclusions to measure the extent to which a holistic approach influences the development of children's behavior and concentration abilities. The results of the study indicate that multimodal approaches, such as Cognitive Behavior Therapy (CBT) and occupational therapy, are effective in improving children's self-control, emotional regulation, and motor skills. In addition, the implementation of an Individual Learning Program (IPP) in schools and intensive collaboration with parents play a major role in creating a supportive environment for children with ADHD. This study concludes that integrated treatment between behavioral interventions and the success of optimizing children's potential depends heavily on the integration of professional behavioral treatment with active support from the family.