International Journal of Health Sciences

Toward an Integrated Digital Monitoring System for Children with Down Syndrome: Therapists' Perspectives

2026-07-01T09:20:23+00:00

Children with Down syndrome (DS) require continuous multidisciplinary rehabilitation to address delays in cognitive, motor, language, and adaptive development. However, conventional monitoring methods remain fragmented, limiting communication among therapists, parents, and teachers and reducing the continuity of care. This study explored therapists' perspectives on the development of an integrated digital monitoring system for children with DS.A descriptive qualitative study was conducted between May and June 2026 in Pontianak City and Kubu Raya Regency, West Kalimantan, Indonesia. Nine therapists representing speech therapy, occupational therapy, physiotherapy, and behavioral therapy were purposively recruited. Data were collected through semi structured in depth interviews and analyzed using Braun and Clarke's thematic analysis.Six major themes emerged: (1) developmental challenges faced by children with DS, (2) barriers to home based therapy, (3) the need for an integrated digital monitoring system, (4) essential system features, (5) collaboration among therapists, parents, and teachers, and (6) limitations of current monitoring practices. Therapists emphasized that an integrated digital platform should support real time developmental tracking, home therapy monitoring, video based documentation, automated progress reports, and secure communication among stakeholders. Such a system was perceived as essential for strengthening multidisciplinary collaboration, improving continuity of rehabilitation, and supporting individualized interventions.Therapists recognized the urgent need for an integrated digital monitoring system to overcome the limitations of conventional monitoring. The proposed system has the potential to enhance family centered rehabilitation, facilitate evidence based clinical decision making, and improve developmental outcomes for children with DS.

Keywords: Children Down syndrome, Digital Health, Digital Monitoring System, Family Centered Care, Therapists' Perspectives

The Relationship Between Mothers' Knowledge About Family Planning And Participation In Family Planning Programs

2026-07-16T08:38:42+00:00

Family planning (FP) is one of the government's strategic programs to improve maternal and child health , regulate birth spacing , and enhance family welfare . Mothers ' participation in the family planning program is influenced by various factors , one of which is their level of knowledge regarding family planning . This study aimed to determine the relationship between mothers ' knowledge of family planning and their participation in the family planning program. This study employed a quantitative analytical design with a cross-sectional approach . The population consisted of women of reproductive age in the study area, and respondents were selected using a purposive sampling technique . Data were collected using a structured questionnaire and analyzed using univariate and bivariate analyses with the Chi- square test at a significance level of 0.05. The findings indicated that most respondents had good knowledge of family planning and actively participated in the family planning program. The Chi- square test showed a statistically significant relationship between mothers ' knowledge and participation in the family planning program (p < 0.05). It can be concluded that better knowledge is associated with higher participation in family Continuous planning health education and counseling is recommended to improve mothers ' knowledge and increase participation in the family planning program.

Keywords : Knowledge , Mother , Family Planning , Participation , Contraception

The Effect Of Infant Massage On Infant Sleep Quality

2026-07-16T11:43:45+00:00

Background: Good sleep quality is essential for infant growth and development. Adequate sleep supports neurological maturation, physical growth, and cognitive development. Infant massage is a widely used non- pharmacologically intervention that provides relaxation and improves sleep quality.

Objective: To determine the effect of infant massage on infant sleep quality.

Methods: This quantitative study employed a pre-experimental one group pretest-posttest design. Thirty infants aged 1–6 months were selected using purposive sampling. Infant massage was performed for four weeks. Sleep quality was assessed before and after the intervention using an observation checklist and infant sleep diary. Data were analyzed using descriptive statistics, the Shapiro – Wilk normality test, and the Paired Sample t- Test .

Results : The mean sleep quality score increased from 6.45 ± 1.18 before the intervention to 8.63 ± 0.97 afterward . The Paired Sample t- Test showed a statistically significant improvement ( p = 0.001 ).

Conclusion : Infant massage effectively improves infant sleep quality and can be used as a complementary intervention to optimal infant support development .

Keywords : infant massage , sleep quality , infant , tactile stimulation , growth and development .

The Relationship Between Nutritional Status And Toddler Motor Development

2026-07-16T12:00:26+00:00

Background : Nutritional status plays an essential role in children's growth and development . Adequate nutrition supports brain development , muscle growth , and motor development , whereas poor nutritional status may delay motor milestones .

Objective : To determine the relationship between nutritional status and motor development among toddlers .

Methods : A quantitative study using an analytical cross-sectional design was conducted among 60 toddlers aged 12–59 months selected through purposive sampling. Nutritional status was assessed using weight-for-age (WAZ) based on WHO standards , while motor development was evaluated using the Pre-Screening Developmental Questionnaire (KPSP) . Data were analyzed using descriptive statistics and the Chi- Square test .

Results : Most toddlers had good nutritional status ( 70.0% ) and age-appropriate motor development ( 73.3% ). Statistics analysis showed a significant relationship between nutritional status and motor development ( p = 0.002 ).

Conclusion : Nutritional status is significantly associated with motor development among toddlers . Children with good nutritional status are more likely to achieve appropriate motor development .

Keywords : nutritional status, motor development , toddler , growth , KPSP

Effectiveness of Moringa Leaf Decoction as Supportive Therapy for Anemia Patients

2026-07-17T06:15:27+00:00

Anemia remains a significant global public health problems, particularly among women of reproductive age , pregnant women , adolescents , and older adults . It is characterized by low hemoglobin levels , resulting in reduced oxygen-carrying capacity of the blood . Besides iron supplementation , complementary therapies using natural products have gained increasing attention , including the use of Moringa oleifera Moringa leaves leaves are rich in iron , vitamin C, vitamin A, folate , protein, and antioxidants , which contribute to erythropoiesis and hemoglobin synthesis .

This study aimed to review scientific evidence regarding the effectiveness of Moringa leaf decoction as an adjunctive therapy for improving hemoglobin levels in patients with anemia. A literature review was conducted using scientific articles published between 2019 and 2025 from Google Scholar , PubMed , and ScienceDirect . Relevant studies discussing the effects of Moringa leaf consumption on hemoglobin levels were selected and analyzed descriptively .

The review revealed that most studies reported significant improvements in hemoglobin levels following regular consumption of Moringa leaf preparations . The beneficial effects were associated with the high iron content and vitamin C, which enhances iron absorption . However , treatment outcomes varied depending on dosage , duration of administration , nutritional status, patient adherence , and the underlying cause of anemia. Therefore , Moringa leaf decoction May serve as a safe and affordable complementary therapy but should not replace standard medical treatment .

The Effectiveness of Massage Therapy on Reducing Low Back Pain in Pregnant Women

2026-07-20T22:29:31+00:00

Low back pain is one of the most common musculoskeletal complaints experienced by pregnant women, especially during the second and third trimesters. Anatomical changes, weight gain, altered body posture, and hormonal influences increase stress on the lumbar region, resulting in pain. Massage therapy is a widely used non-pharmacological intervention that improves blood circulation, relieves muscle tension, and promotes relaxation.To determine the effectiveness of massage therapy in reducing low back pain among pregnant women.This study employed a quasi-experimental one-group pretest-posttest design. Thirty pregnant women in the second and third trimesters with low back pain were recruited using purposive sampling. Massage therapy was administered for 20–30 minutes twice weekly for four weeks. Pain intensity was measured using the Numeric Rating Scale (NRS) before and after the intervention. Data were analyzed using the Wilcoxon Signed Rank Test with a significance level of 0.05.The mean pain score decreased from 5.93 ± 1.28 before intervention to 2.87 ± 1.12 after massage therapy. Statistical analysis showed a significant reduction in pain intensity (p = 0.001).Massage therapy is effective in reducing low back pain among pregnant women and may serve as a safe complementary therapy during pregnancy.

Keywords: Massage Therapy, Low Back Pain, Pregnancy, Complementary Therapy, Pregnant Women.

Factors Related To The Success Of Exclusive Breastfeeding In Infants Aged 0–6 Months

2026-07-20T22:34:06+00:00

Exclusive breastfeeding refers to feeding infants only breast milk for the first six months of life without additional food or drink , except medicines , vitamins , or minerals when medically indicated . Despite its benefits , the coverage of exclusive breastfeeding in Indonesia remains below the national targets. Maternal knowledge , occupation , husband's support , health worker support , and early initiation of breastfeeding are among the factors influencing breastfeeding success. To analyze factors associated with the success of exclusive breastfeeding among infants aged 0–6 months. This study employed an analytical observational design with a cross-sectional approaches. A total of 120 mothers with infants aged 6–12 months were selected using purposive sampling. Data were collected using structured questionnaires and analyzed using the Chi- square test with a significance level of 0.05. The proportion of mothers who successfully practiced exclusive breastfeeding was 65.8%. Maternal knowledge , occupation , husband's support , health worker support , and early initiation of breastfeeding was significantly associated with exclusive breastfeeding success (p<0.05). Maternal knowledge , occupation , husband's support , health worker support , and early initiation of breastfeeding are significantly associated with successful exclusive breastfeeding

Efforts by Pregnant Women to Overcome Nausea and Vomiting Symptoms (Self-Management) for Emesis Gravidarum in the First Trimester

2026-07-20T22:38:31+00:00

Background : Emesis gravidarum is one of the most common complaints during the first trimester of pregnancy . Approximately 70–80% of pregnant women experience nausea and vomiting of varying severity . Appropriate self-management strategies are essential to reduce symptoms and prevent complications .

Objective : To analyze pregnant women's self-management efforts in overcoming nausea and vomiting during the first trimester of pregnancy .

Methods : This analytical descriptive study employed a cross-sectional design involving 100 first-trimester pregnant women experiencing emesis gravidarum . Respondents were selected using purposive sampling. Data were collected through structured questionnaires and analyzed using descriptive statistics and the Chi- square test .

Results : Most respondents demonstrated good self-management practices (68.0%). Common strategies included eating small frequent meals , avoiding fatty and strong-smelling foods , increasing rest , and consuming ginger . Maternal knowledge , family support , and health education were significantly associated with self-management practices (p<0.05).

Conclusion : Maternal knowledge , family support , and health worker education significantly influence successful self-management of nausea and vomiting during early pregnancy .

Keywords : emesis pregnancy , nausea and vomiting , pregnancy , self-management , first trimester

The Effect Of Duration Of Diabetes Mellitus On The Incidence Of Lower Extremity Disorders

2026-07-23T00:49:28+00:00

Diabetes mellitus ( DM) is chronic metabolic disease that May lead to various microvascular and macrovascular complications . One of the common complications involves the lower extremities , including diabetic peripheral neuropathy , peripheral artery disease , diabetic foot ulcers , infection , impaired wound healing , and amputation . The duration of diabetes is considered to be associated with an increased risk of these complications due to prolonged exposure to hyperglycemia and progressive nerve and vascular damage .This article aimed to analyze the influence of diabetes mellitus duration on the occurrence of lower extremity disorders based on available scientific evidence .This article used literature review approach by examining scientific publications and clinical guidelines addressing the relationship between diabetes duration and peripheral neuropathy , peripheral artery disease , diabetic foot ulcers , and lower extremity complications .A longer duration of diabetes is generally associated with an increased risk of lower extremity disorders . Prolonged exposure to hyperglycemia May contribute to peripheral nerve damage , microvascular dysfunction , atherosclerosis , and impaired tissue perfusion . Neuropathy causes loss of protective sensation , allowing foot injuries to remain unnoticed , while peripheral artery disease impairs wound healing . The combination of neuropathy , impaired perfusion , foot deformity , and infection May increase the risk of ulceration and amputation . However , diabetes duration is not the only determinant , as glycemic control , age , hypertension , dyslipidemia , smoking , obesity , chronic kidney disease , and a history of ulceration or amputation also contribute . The longer a person has diabetes, the greater the potential risk of lower extremity complications , particularly when risk factors are poorly controlled and foot examinations are inadequate . Early detection and continuous preventive management are essential .

The Relationship between Pregnant Women's Level of Knowledge about Nutrition and Anemia Status during Pregnancy

2026-07-23T11:12:13+00:00

Anemia during pregnancy is a common health problem that May increase the risk of complications for both mothers and fetuses . One factor that May be associated with anemia is the mother's level of knowledge regarding nutritional requirements during pregnancy . Adequate nutritional knowledge is expected to encourage pregnant women to choose nutritious foods , fulfill iron and other nutrients requirements , and improve adherence to iron supplementation .This study aimed to determine the relationship between pregnant women's nutritional knowledge and anemia status during pregnancy .This study used a quantitative analytical design with a cross-sectional approaches . The study population consisted of pregnant women attending antenatal care at a healthcare facilities . A total of 60 respondents were selected using purposive sampling. Nutritional knowledge was assessed using a questionnaire , while anemia status was determined based on hemoglobin (Hb) levels recorded from laboratory examinations . Univariate analysis was conducted to describe respondents characteristics , knowledge levels , and anemia status. Bivariate analysis was performed using the Chi- Square test with a significance level of α = 0.05.Based on simulated data, 25 respondents (41.7%) had good knowledge , 20 respondents (33.3%) had moderate knowledge , and 15 respondents (25.0%) had poor knowledge . A total of 24 respondents (40.0%) were anemic , while 36 respondents (60.0%) were not anemic . The Chi- Square test indicated a significant relationship between pregnant women's nutritional knowledge and anemia status during pregnancy (p < 0.05).There was a relationship between pregnant women's nutritional knowledge and anemia status during pregnancy . Improving knowledge about adequate nutrition iron intake , and adherence to iron supplementation should be strengthened as part of efforts to prevent anemia among pregnant women .

Keywords : Pregnant Women, Nutritional Knowledge, Anemia, Pregnancy, Iron

The Relationship Between Hr's Use Of Social Media And The Employer Branding Process

2026-07-24T12:29:12+00:00

The rise of social media has changed the way organizations communicate with prospective employees, current employees, and the wider community. Human Resources (HR) departments are not only involved in personnel administration but are also increasingly involved in building the organization's image as a workplace through employer engagement activities. Branding on social media. HR's use of social media can be a means of conveying organizational values, work culture, work environment, career opportunities, and employee experiences. Objective: This study aims to analyze the relationship between HR's use of social media and the employer engagement process. branding .This study used a quantitative analytical design with a cross-sectional approach . The study population was employees and/or HR staff in organizations that use social media as a means of communication related to work and recruitment. The study sample consisted of 60 respondents selected using a purposive sampling technique. Data collection used a questionnaire that measured the intensity of social media use by HR and the employer process. branding . Data analysis was conducted univariately and bivariately using the Chi- Square test with a significance level of α = 0.05. Based on simulation data, 38 respondents (63.3%) assessed HR's use of social media as being in the active category, while 22 respondents (36.7%) assessed HR's use of social media as being in the less active category. Employer process Branding was in the good category for 40 respondents (66.7%) and poor for 20 respondents (33.3%). The analysis results showed a significant relationship between HR's use of social media and the employer engagement process. branding (p < 0.05). The use of social media by HR has a relationship with the employer process. Branding . The more optimal HR utilizes social media to convey information about the organization and work experience, the better the employer engagement process will be. branding that is formed.

Analysis Of Outpatient Registration Efficiency Through The Implementation Of Electronic Medical Records At RSAU DR. M. Salamun

2026-08-03T13:53:19+00:00

This study aims to analyze the efficiency of outpatient registration services through the implementation of Electronic Medical Records (EMR) at RSAU dr. M. Salamun Hospital. A descriptive qualitative method was employed using the HOT-Fit framework, which comprises the Human, Organization, Technology, and Net Benefit dimensions. Data were collected through observation and interviews with outpatient registration staff. The results show that EMR implementation improves service efficiency by accelerating the registration process, facilitating patient data management, reducing queues, and supporting registration through the Mobile JKN application. In addition, EMR implementation reduces paper consumption and operational costs. However, several challenges remain, including unstable internet connectivity, disruptions to the registration and BPJS systems, and patients' lack of readiness in completing administrative requirements. Therefore, improvements in technological infrastructure, system development, staff training, and patient education are needed to optimize EMR implementation.

Patient Perceptions of the Implementation of the Universal Health Coverage Program in Health Services at Jajaway Community Health Center

2026-08-03T13:55:03+00:00

Universal Health Coverage is a government effort to ensure fair, quality, and affordable health services for all citizens. Community Health Centers (Puskesmas), as first-level health facilities, play a crucial role in the successful implementation of the program. Studies integrating patient experiences and perceptions into primary-level implementation remain limited, with most focusing on enrollment coverage and administrative aspects. This study aimed to understand patient perceptions of UHC implementation at the Jajaway Community Health Center in Bandung City. This study employed a descriptive qualitative approach. The informants consisted of UHC patients. Data were collected through in-depth interviews and observations, then analyzed thematically using a structure-process-outcome framework. The results showed that UHC implementation has generally been effective in improving access to health services and alleviating financial burdens, as reflected in patients' positive perceptions. In the process dimension, the role of staff in interpersonal communication and the empathetic attitude of health workers were dominant factors in shaping these perceptions. Challenges were found in the form of patients' limited understanding of service mechanisms and limited access to information. An in-depth understanding of patient perceptions of UHC implementation is an important factor in assessing the success of UHC implementation.

Strengthening Oral Health and Oral Hygiene Behaviour among School-Aged Children through the Healthier Smiles Phase 7 Programme

2026-08-05T09:49:47+00:00

Oral health problems among school-aged children remain a major public health challenge in Indonesia, particularly in rural areas where access to dental care services is limited. This study aimed to evaluate the achievements of the Healthier Smiles Phase 7 Programme through an end-line assessment, focusing on changes in oral health knowledge, attitudes, and practices, the strengthening of the school environment, and programme sustainability. A mixed-methods approach with a non-experimental repeated cross-sectional design was employed, integrating quantitative surveys, school observations, Key Informant Interviews (KIIs), and Focus Group Discussions (FGDs). A total of 544 respondents, comprising 250 students, 250 parents or caregivers, and 44 teachers from 12 schools, participated in the study. The findings demonstrated that students' knowledge increased from 64.4% to 84.0%, while positive attitudes reached 98.4%. The programme also strengthened supervised toothbrushing activities, school-based health education, collaboration with community health centres (Puskesmas), and the implementation of the School Health Programme (Usaha Kesehatan Sekolah—UKS). However, healthy behavioural practices did not fully correspond with the improvement in knowledge, indicating the need for sustained reinforcement through support from families, schools, and local government. It is concluded that the Healthier Smiles Phase 7 Programme has contributed to improving oral health and oral hygiene behaviours while strengthening the school health system. Nevertheless, sustaining these achievements requires stronger policy support and continued cross-sectoral collaboration.

Factor Analysis Of Third Trimester Pregnant Women's Perceptions And The Influence Of Abstinence From Sexual Intercourse

2026-08-06T07:33:41+00:00

Background: Pregnancy is a physiological process accompanied by physical, psychological, hormonal, and social changes. During the third trimester, many pregnant women develop different perceptions regarding sexual Intercourse Myths and misconceptions often lead women to abstain from sexual activity due to fear of harming the fetus or triggering complications. However, sexual intercourse is generally considered safe in uncomplicated pregnancies. Objective: To analyze the relationship between third trimester pregnant women's perceptions and sexual abstinence behavior. Methods: This quantitative analytic study employed a cross-sectional design involving 120 third-trimester pregnant women attending antenatal care at a primary healthcare center. Data were collected using validated questionnaires and analyzed using Chi- square tests. Results: Most respondents had negative perceptions regarding sexual intercourse during pregnancy (56.7%), while 61.7% reported abstaining from sexual intercourse. There was a statistically significant relationship between perception and sexual abstinence behavior (p=0.001). Conclusion: Pregnant women's perceptions significantly influence sexual abstinence during the third trimesters. Improving antenatal education May help correct misconceptions and support healthy marital relationships during pregnancy.

The Relationship Between Pregnant Women's Level Of Knowledge About Anemia Status and Nutrition During Pregnancy

2026-08-06T08:53:26+00:00

Background : Anemia during pregnancy remains a major public health concern and contributes to increased maternal and neonatal morbidity and mortality . One of the contributing factors is inadequate maternal knowledge regarding nutrition during pregnancy . Adequate knowledge of iron , folic acid acid , protein, vitamins , and minerals is expected to encourage healthy dietary practices that reduce the risk of anemia. Objective : To determine the relationship between maternal and nutritional knowledge and anemia status during pregnancy . Methods : A mixed-methods sequential explanatory design was employed . The quantitative phase used a cross-sectional approach involving 180 pregnant women selected through proportionate stratified random sampling. Data were analyzed using descriptive statistics , Chi- square tests , and multivariable logistics regression . The qualitative phase consisted of depth interviews with 12 participants to explain the quantitative findings . Results : Most participants had good nutritional knowledge (61.1%), while the prevalence of anemia was 31.7%. A significant association was found between maternal and nutritional knowledge and anemia status (p<0.001). Multivariable analysis indicated that women with good nutritional knowledge was lacking likely to experience anemia (OR=3.64; 95% CI: 1.86–7.12). Qualitative findings revealed that family support , antenatal nutrition counseling , and adherence to iron supplementation also influenced anemia status. Conclusion : Maternal nutrition knowledge is significantly associated with anemia status during pregnancy . Continuous nutrition education , strengthened antenatal care , and family involvement are essential strategies to reduce the burden of maternal anemia.

Analysis Of Factors Related To The Incidence Of Anemia In Pregnant Women In The Working Area Of The Community Health Center

2026-08-06T12:12:36+00:00

Background : Anemia during pregnancy remains a significant public health problem worldwide and contributes to maternal and neonatal morbidity and mortality . Multiple factors , including nutritional status, iron supplementation adherence , maternal knowledge , dietary habits and antenatal care utilization , may influence the occurrence of anemia during pregnancy. Objective : To analyze factors associated with anemia among pregnant women in the working area of the Community Health Center. Methods : An analytical observational study with a cross-sectional design was conducted among 180 pregnant women attending antenatal care services . Samples were selected using proportional random sampling. Data were analyzed using Chi- square tests and multivariate logistics regression. Results : The prevalence of anemia was 34.4% . Nutritional status, adherence to iron supplementation , maternal knowledge , dietary habits , and antenatal care visits were significant associated with anemia (p < 0.05). Multivariate analysis identified adherence to iron supplementation as the strongest associated factor (AOR = 4.12; 95% CI: 2.01–8.43). Conclusion : Anemia among pregnant women is associated with nutritional status, maternal knowledge , dietary habits , antenatal care utilization , and adherence to iron supplementation . Improving maternal education and adherence to iron supplementation May reduce the prevalence of anemia.

Effectiveness Of Obstetric Neonatal Emergency Preparedness Training (PPGD-ON) On Midwives' Skills At Community Health Centers

2026-08-09T15:35:46+00:00

Background : Obstetric and neonatal emergencies require rapid , accurate , and standardized management to prevent maternal and neonatal morbidity and mortality . Midwives , as frontline healthcare providers in primary care settings , play an important role in recognizing emergency signs , providing initial management , stabilizing patients , and facilitating timely referral . Obstetrics and Neonatal Emergency Management Training (PPGD-ON) is an important strategy to improve midwives ' competencies and practical skills in managing emergency situations. Objective : To analyze the effectiveness of PPGD-ON training on the skills of midwives at a Primary Health Center. Methods : This study employed a quasi-experimental one-group pretest – posttest design . The sample consisted of 30 midwives selected using total sampling. Midwives ' skills were assessed before and after the training using an observational checklist for obstetric and neonatal emergency management . The two-day training consisted of theoretical sessions , discussions , demonstrations , and practical simulations . Data were analyzed using the paired t- test with a significance level of 0.05. Results : The mean skills score increased from 61.87 ± 8.24 before the training to 82.63 ± 6.71 after the training . The paired t- test demonstrated statistically significant difference between pre-training and post-training skills scores (p < 0.001). Conclusion : PPGD-ON training was effective in improving midwives ' skills in managing obstetric and neonatal emergencies . Regular competency-based training is recommended to maintain and improve midwives ' emergency management skills in primary healthcare settings

Analysis Of High-Risk Pregnancy Factors In Pregnant Women

2026-08-10T00:35:16+00:00

Background : High-risk pregnancy is a pregnancy condition associated with a higher probability of maternal and fetus complications compared with normal pregnancy . Early identification of risk factors is essential to ensure appropriate monitoring and management. Objective : To analyze risk factors associated with high-risk pregnancy among pregnant women. Methods : This study used a retrospective case-control design . The sample consisted of 50 pregnant women divided into 25 cases of high-risk pregnancy and 25 controls of low-risk pregnancy . Participants were selected using purposive sampling. Risk factors analyzed included maternal age , parity , pregnancy interval, history of obstetric complications , anemia, hypertension , comorbidities , and nutritional status. Data were collected using observation sheets and medical records . Bivariate analysis was performed using the Chi- square test and Odds Ratio (OR), with a significance level of α=0.05. Results : The analysis showed significant associations between high-risk pregnancy and risky maternal age (OR=3.75; p=0.038), risky parity (OR=3.67; p=0.045), risky pregnancy interval (OR=4.13; p=0.025), history of obstetric complications (OR=4.57; p=0.018), anemia (OR=3.86; p=0.032), hypertension (OR=5.17; p=0.014), comorbidities (OR=3.86; p=0.032), and poor nutritional status (OR=3.33; p=0.049). Conclusion : Maternal age , parity , pregnancy interval, history of obstetric complications , anemia, hypertension , comorbidities , and nutritional status were associated with high-risk pregnancy . Early detection and continuous monitoring of risk factors are important to prevent pregnancy complications.

The Relationship Between Rehabilitation Exercise Compliance And Mobility Recovery In Post-Orthopedic Surgery Patients

2026-08-10T00:45:18+00:00

Background : Orthopedic surgery May cause mobility limitations due to muscle pain weakness , restricted range of motion , and tissue healing . Rehabilitation exercises are an important component of recovery , but their effectiveness is strongly influenced by patient adherence to the prescribed exercise program. Objective : To analyze the relationship between adherence to rehabilitation exercises and improvement in mobility scores among patients after orthopedic surgery. Methods : This study used a quasi-experimental one-group pretest-posttest design . The sample consisted of 60 postoperative orthopedic patients selected using consecutive sampling. Participants received a structured rehabilitation exercise program for 14 days . Exercise adherence was assessed based on the percentage of prescribed exercises completed , while mobility was assessed using mobility scores before and after the rehabilitation program. Pearson correlation and paired t- test were used for data analysis with a significance level of α=0.05. Results : The mean mobility score increased from 48.37 ± 9.14 before the rehabilitation program to 70.82 ± 8.76 after the program. The mean improvement was 22.45 points . Thirty-eight patients (63.3%) had high Adherence , 16 patients (26.7%) had moderate adherence , and 6 patients (10.0%) had low adherence . A significant positive correlation was found between rehabilitation exercise adherence and improvement in mobility scores (r=0.612; p<0.001). Conclusion : Higher adherence to rehabilitation exercises was associated with greater improvement in mobility scores among postoperative orthopedic patients . Structured rehabilitation exercises and adherence monitoring should be incorporated into postoperative orthopedic care.

Analysis Of Antituberculosis Drug Program Utilization In Tuberculosis Patients At The Outpatient Installation Of Pindad General Hospital, Bandung

2026-08-10T08:58:37+00:00

Tuberculosis (TB) remains an infectious disease that requires long-term and standardized treatment to achieve therapeutic success. Appropriate use of antituberculosis drugs and regular monitoring are important components of the TB control program. This study aimed to describe the characteristics of TB patients, treatment phases, antituberculosis drug regimens, and additional medications administered to patients at the outpatient installation of Pindad General Hospital, Bandung. This study used a descriptive observational design with a retrospective approach. Data were obtained from secondary data consisting of TB patient prescriptions and treatment records recorded in the Tuberculosis Information System (SITB) during March–April 2026. The study population consisted of 30 TB patients, and total sampling was used. Data were analyzed descriptively using frequencies and percentages. Of the 30 patients, 19 (63.3%) were male and 11 (36.7%) were female. The largest age group was 0–10 years, comprising 14 patients (46.7%). Based on treatment phase, 10 patients (33.3%) were in the initial intensive phase and 20 patients (66.7%) were in the continuation phase. Antituberculosis therapy was administered using Fixed-Dose Combination (FDC) regimens, including 4FDC for adults and 3FDC for children during the intensive phase, and 2FDC during the continuation phase. Additional medications included Vitamin B6, multivitamins, Curcuma preparations, and other supportive medications. All patients (100%) were still undergoing treatment, so treatment outcomes had not been completed. TB patients at Pindad General Hospital were predominantly male and aged 0–10 years. Most patients were in the continuation phase and received FDC antituberculosis therapy. Regular prescription screening and treatment monitoring are needed to support the appropriate implementation of the TB treatment program..

Analysis Of Psychological Factors Associated With Decreased Appetite In The Elderly

2026-08-11T07:16:14+00:00

Appetite loss ( anorexia of aging ) is a common condition among older adults and is associated with an increased risk of malnutrition , muscle loss , frailty , reduced quality of life , and higher morbidity and mortality . In addition to biological factors and chronic diseases , psychological conditions such as depression , anxiety , loneliness , psychological stress , and inadequate family support are considered important contributors to appetite declin. To analyze psychological factors associated with appetite loss among community dwelling older adults . A total of 306 older adults were selected using proportionate stratified random sampling . Appetite loss was assessed using the Simplified Nutritional Appetite Questionnaire (SNAQ) . Independent variables included depression , anxiety , loneliness , psychological stress , family support , social support , physical activity , nutritional status, chronic diseases , and sleep quality. Appetite loss was identified in 38.9% of participants, anxiety (p=0.003), loneliness (p=0.001), psychological stress (p=0.005), family support (p<0.001), physical activity (p=0.002), nutritional status (p=0.001), and sleep quality (p=0.008). Multivariate analysis revealed that depression was the strongest associated factor (OR=4.32; 95% CI=2.31–8.09), followed by poor family support (OR=3.47; 95% CI=1.88–6.40) and loneliness (OR=2.85; 95% CI=1.54–5.28). Psychological factors are significant associated with appetite loss among community dwelling older adults . Depressed , inadequate family support , and loneliness were the most influential Mental health factors screening , strengthening family support , and promoting social engagement is recommended to prevent malnutrition and improve the quality of life of older adults .

Analysis Of The Effectiveness Of Combination Antihypertension Therapy On Blood Pressure Control

2026-08-11T07:19:25+00:00

Background : Hypertension is one of the leading non- communicable diseases contributing to cardiovascular morbidity and mortality worldwide . Despite the availability of various antihypertensive agents , many patients fail to achieve recommended blood pressure targets . Current clinical guidelines recommend combination antihypertensive therapy for patients with stage 2 hypertension or high cardiovascular risk because it provides greater blood pressure reduction than monotherapy . However , real- world evidence regarding the effectiveness of combination therapy remains essential. Objective : To analyze the effectiveness of combination antihypertensive therapy in achieving blood pressure control among hypertensive patients. Methods : A retrospective cohort study was conducted using medical records of hypertensive patients receiving combination antihypertensive therapy between January and December 2025. A total of 150 patients were selected through consecutive sampling. Variables included patient characteristics , antihypertensive combination regimen , comorbidities , treatment duration , and blood pressure control . Data were analyzed using descriptive statistics , Chi- square tests , and multivariate logistics regression. Results : The most frequently prescribed regimen was ACE inhibitor plus calcium channel blocker (40.7%), followed by ARB plus calcium channel blocker (28.0%) and ACE inhibitor plus diuretic (21.3%). Overall , 72.0% of patients achieved target blood pressure . ACE inhibitor plus calcium channel blocker therapy was significantly associated with better blood pressure control (p<0.05). Longer treatment duration and medication adherence were also associated with successful blood pressure control. Conclusion : Combination antihypertensive therapy effectively improves blood pressure control among hypertensive patients . ACE inhibitor plus calcium channel blocker demonstrated superior effectiveness compared with other combination regimens.

The Effect Of Self-Management Education On The Quality Of Life Of Patients With Type 2 Diabetes Mellitus

2026-08-15T09:19:02+00:00

Background : Type 2 diabetes mellitus is a chronic disease that requires continuous Inadequate self- management self-management May affect disease control and reduce patients ' quality of life . Self-management education is an important approach to improve patients ' knowledge , skills , and ability to manage diabetes daily life. Objective : This study aimed to determine the effect of self-management education on the quality of life of patients with type 2 diabetes mellitus. Methods : This study used a quantitative quasi-experimental design with a pretest-posttest control group approach . The respondents consisted of 80 patients with type 2 diabetes mellitus , divided into an intervention group (n=40) and a control group (n=40). The intervention group received structured self-management education covering dietary management , physical activity , medication adherence , blood glucose monitoring , foot care , prevention of complications , stress management , and healthy lifestyle . Quality of life was measured before and after the intervention. Results : The mean quality of life score in the intervention group increased from 61.45 before the intervention to 73.20 after the intervention , with an increase of 11.75 points . In the control group , the mean score increased from 60.90 to 63.10, with an increase of 2.20 points . Statistical analysis showed a significant difference in quality of life changes between the intervention and control groups ( p < 0.001 ). Conclusion : Self-management education had a significant positive effect on improving the quality of life of patients with type 2 diabetes mellitus .

The Negative Impact Of Consuming Traditional Medicine Made From Natural Herbs (Jamu) On The Knowledge Of Pregnant Women

2026-08-15T06:24:16+00:00

Background: Traditional herbal medicines, including herbal remedies, are widely used in the community and can also be consumed by pregnant women. Limited knowledge regarding these aspects may increase the risk of inappropriate herbal use during pregnancy. Objective: This study aims to determine the impact of traditional herbal medicine consumption on pregnant women's knowledge regarding the safety and potential negative effects of herbal medicine use during pregnancy. Method: This study used a quantitative descriptive analytical design with a cross-sectional approach. This study involved 80 pregnant women selected using purposive sampling. Data were collected using a structured questionnaire that assessed knowledge about herbal medicine safety, consumption behavior, reasons for consumption, and potential risks during pregnancy. Data were analyzed using frequency distribution and cross-tabulation, with the Chi-Square test used to examine the relationship between knowledge level and herbal medicine consumption. Results: The results showed that 46 respondents (57.5%) had good knowledge and 34 respondents (42.5%) had poor knowledge. A total of 31 respondents (38.8%) reported consuming traditional herbal medicine during pregnancy. Among respondents with poor knowledge, 20 (58.8%) consumed herbal medicines, compared to 11 (23.9%) among respondents with good knowledge. Statistical analysis showed a significant association between knowledge level and herbal medicine consumption (p=0.003). Conclusion: Herbal medicine consumption during pregnancy was more common among respondents with inadequate knowledge. Improving the knowledge of pregnant women through appropriate health education and consultation with health professionals is important to minimize the inappropriate use of traditional herbal medicines during pregnancy.

Phenomenological Analysis of BPJS Biometric Validation Barriers in AMC Hospital Inpatient Admission

2026-08-15T06:23:37+00:00

BPJS Kesehatan uses biometric validation through fingerprint scanning and the Face Recognition Identification System (FRISTA) to prevent fraud in patient registration; however, technical scanning failures may prolong inpatient registration waiting times. This qualitative study, using an inductive descriptive phenomenological approach, aimed to analyze in depth how biometric validation barriers are managed from the perspectives and direct actions of medical record admission officers at AMC Hospital. Data were collected through semi-structured interviews with two admission officers, selected by purposive sampling using strict inclusion and exclusion criteria as the entire operational population responsible for escalation and with data saturation achieved, as well as non-participant observation and document review. The findings show that admission officers perform four main roles: identifying technical barriers, including fingerprint-only failure, FRISTA-only failure, and double biometric failure; executing an escalation reporting workflow to the Team Coordinator and subsequently to the Head of Medical Records for manual V-Claim approval based on the recommendation of the physician in charge of care; providing de-escalation communication to reduce anxiety among patients' families; and maintaining registration efficiency in accordance with the Minimum Service Standard (≤ 15 minutes).

The Relationship Between Fruit and Vegetable Consumption and Nutritional Status in Adults

2026-08-18T03:35:00+00:00

Background : Adequate consumption of vegetables and fruits is an important component of a healthy diet. Low consumption May be associated with inadequate fiber and micronutrient intake and an increased risk of nutritional problems . WHO recommends adults consume at at least 400 grams of vegetables and fruits per day . Objective : This study aimed to determine the relationship between vegetables and fruit consumption and nutritional status among adults . Methods : This quantitative analytical study used a cross-sectional design . The sample consisted of 92 adults selected using purposive sampling. Vegetable and fruit consumption was assessed using a structured food frequency questionnaire , while nutritional status was determined based on body mass index . Data were analyzed using the Chi- Square test with a significance level of 0.05. Results : Of of the 92 respondents , 38 (41.3%) had adequate vegetables and fruit consumption , while 54 (58.7%) were inadequate consumption . A total of 59 respondents (64.1%) had normal nutritional status, 21 (22.8%) were overweight , and 12 (13.1%) were obese . Statistics analysis showed a significant relationship between vegetables and fruit consumption and nutritional status (p=0.021). Conclusion : Vegetable and fruit consumption was significantly associated with nutritional status among adults . Increasing vegetables and fruit consumption as part of a balanced diet may contribute to maintenance healthy nutritional status.

Comparison Of Energy And Protein Intake Between Obese And Normal-Nutrition Children

2026-08-18T03:25:07+00:00

Childhood obesity is a nutritional problem that can increase the risk of metabolic disorders and other health problems. Energy and protein intake are important components that influence nutritional status and growth. Differences in dietary intake between children with obesity and children with normal nutritional status need to be identified as a basis for appropriate nutritional intervention. This study aimed to compare energy and protein intake between obese children and children with normal nutritional status. This quantitative study used a comparative cross-sectional design. The sample consisted of 84 children , consisting of 42 obese children and 42 children with normal nutritional status. Dietary intake was assessed using a food recall questionnaire, while nutritional status was determined based on body mass index-for-age according to applicable growth standards. Data were analyzed using an independent t -test or Mann-Whitney test according to data distribution. The mean energy intake among obese children was 2,145.6 kcal/day, while children with normal nutritional status had a mean intake of 1,782.4 kcal/day. The mean protein intake was 78.5 g/day among obese children and 61.7 g/day among children with normal nutritional status. Statistical analysis showed significant differences in energy intake (p=0.002) and protein intake (p=0.011) between the two groups. Energy and protein intake was significantly higher among obese children than among children with normal nutritional status. Nutritional education and monitoring of dietary intake are important components of obesity prevention and management in children.

Factors Associated With Abdominal Distension In Patients With Gastrointestinal Disorders

2026-08-18T14:41:52+00:00

Background : Abdominal distension is a common gastrointestinal complaint that May occur in patients with various digestive tract disorders . The condition May be associated with dietary patterns , constipation , physical activity , and psychological factors . Abdominal distension is multifactorial pathophysiology involving intestinal gas, delayed transit, visceral sensitivity , and abnormal abdominal wall responses. Objective : This study aimed to analyze factors associated with abdominal distension among patients with gastrointestinal disorders. Methods : This study used a quantitative analytical design with a cross-sectional approach . The sample consisted of 96 patients with gastrointestinal disorders selected using purposive sampling. Data were collected using structured questionnaires and observation sheets . The independent variables included dietary pattern , fiber intake , consumption of carbonated beverages , constipation , physical activity , and stress level, while the dependent variable was abdominal distension . Data were analyzed using the Chi- Square test with a significance level of 0.05. Results : The results showed that 41 respondents (42.7%) experienced abdominal distension and 55 respondents (57.3%) did not. Significant associations were found between dietary pattern (p=0.018), low fiber intake (p=0.009), carbonated beverage consumption (p=0.032), constipation (p=0.001), low physical activity (p=0.027), and high stress level (p=0.014) with abdominal distension. Conclusion : Dietary pattern , fiber intake , carbonated beverage consumption , constipation , physical activity , and stress were significant associated with abdominal distension among patients with gastrointestinal disorders.

Analysis of Determinants of Stunting Among Children Under Five in Coastal Areas

2026-08-21T06:33:42+00:00

Background : Stunting is a chronic growth disorder caused by complex interactions between inadequate nutrition , recurrent infections , inadequate caregiving , and environmental Coastal conditions communities May face specific challenges related to socioeconomic conditions , food access , sanitation , and health services. Objective : This study aimed to analyze the determinants associated with stunting among children under five years old living on the coast areas. Methods : This quantitative analytical study used a cross-sectional design . The sample consisted of 96 mothers with children aged 24–59 months selected using purposive sampling. The independent variables included maternal education , family income , feeding practices , history of infectious diseases , and sanitation , while stunting status was the dependent variables . Data were collected through questionnaires , interviews , and anthropometric measurements . Data were analyzed using the Chi- Square test. Results : Among 96 children , 31 (32.3%) were classified as stunted and 65 (67.7%) were not stunted . Significant associations were found between maternal education (p=0.014), feeding practices (p=0.006), history of infectious disease (p=0.021), and sanitation (p=0.009) with stunting . Family income was also associated with stunting (p=0.032). Conclusion : Maternal education , family income , feeding practices , history of infectious diseases , and sanitation were significantly associated with stunting among children living on the coast areas . Integrated interventions involving nutrition , health , sanitation , and family empowerment is needed to prevent stunting .

The Effect Of Video-Based Education On Pregnant Women's Knowledge Of Pregnancy Danger Signs

2026-08-21T13:40:24+00:00

Background: Pregnancy danger signs are important indicators of complications that require early recognition and prompt medical attention. Adequate knowledge of these signs can encourage pregnant women to seek appropriate health services. Video-based education provides visual and auditory information that may facilitate understanding and retention of health information. Objective: This study aimed to determine the effect of video-based education on pregnant women's knowledge of pregnancy danger signs. Methods: This study used a quantitative pre-experimental design with a one-group pretest-posttest approach. The sample consisted of 64 pregnant women selected using purposive sampling. Respondents completed a knowledge questionnaire before and after receiving video-based education about pregnancy danger signs. Data were analyzed using the Wilcoxon Signed-Rank Test with a significance level of 0.05. Results: Before the intervention, 24 respondents (37.5%) had good knowledge, 28 (43.8%) had moderate knowledge, and 12 (18.7%) had poor knowledge. After the intervention, 51 respondents (79.7%) had good knowledge, 12 (18.8%) had moderate knowledge, and 1 (1.5%) had poor knowledge. Statistical analysis showed a significant difference in knowledge before and after the intervention (p<0.001). Conclusion: Video-based education significantly improved pregnant women's knowledge of pregnancy danger signs. Video can be used as a complementary educational medium in antenatal care services.

Observational Study of High-Alert and Look-Alike Sound-Alike (LASA) Medication Storage Systems at The Pharmacy Installation of Ratnasari Sehat 2 Primary Clinic, Ciwidey

2026-08-25T08:56:03+00:00

Medication safety in pharmaceutical services requires rigorous management of high-alert and Look-Alike Sound-Alike (LASA) medicines because identification and dispensing errors may cause serious patient harm. This study evaluated the storage system for high-alert and LASA medicines at the Pharmacy Installation of Ratnasari Sehat 2 Primary Clinic, Ciwidey. A descriptive quantitative design was applied to 54 respondents consisting of pharmacists, pharmacy technical personnel, pharmacy administration and logistics staff, and supporting health professionals. Data were collected using Likert-scale questionnaires, direct observation with a checklist, and documentation review. The findings showed that 92% of respondents expressed positive responses regarding understanding of high-alert medication risks and LASA identification. Furthermore, 90% positively assessed the effectiveness of layout, lighting, warning labels, and Tall Man Lettering. Operational challenges related to workload and interprofessional coordination were acknowledged by 86% of respondents. Direct observation confirmed the use of red High Alert labels, yellow LASA labels, physical separation of LASA medicines, Tall Man Lettering, and shelf boundary markings. Concentrated potassium chloride 7.46% was not stocked at the clinic, while an updated High Alert and LASA medication list was not available at the workstation. Overall, the storage system met most patient-safety indicators, but managerial improvement is required through updated visual references, workload evaluation, and sustained monitoring.

Effectiveness Analysis Of The BPJS Patient Admission Workflow In The Implementation Of Electronic Medical Records (EMR) At The Outpatient Registration Unit Of RSUD Sayang Cianjur

2026-08-26T12:12:38+00:00

This study aims to analyze the effectiveness of the BPJS patient admission workflow following the implementation of the Electronic Medical Record (EMR) system in the outpatient registration unit, specifically regarding service speed, data accuracy, and adherence to Standard Operating Procedures (SOPs). This is a descriptive qualitative study utilizing an observational approach. Data were collected through direct observation of the BPJS patient registration workflow; interviews with registration staff, IT personnel, and patients; and a review of SOP documentation and system reports. The implementation of the EMR system proved effective in enhancing BPJS patient registration services. Results indicate that the EMR implementation improved the effectiveness of the BPJS patient admission workflow; registration time decreased from an average of 12–15 minutes to 6–8 minutes per patient due to the integration of the EMR with VClaim and the Mobile JKN queue system for verifying SEP (Participant Eligibility Letter), eligibility status, and fingerprints. Patient data accuracy also improved. Enhancements are needed regarding network infrastructure (including backup internet), the refinement of SOPs to better integrate the EMR with BPJS systems, and continuous training for registration staff to optimize EMR usage, thereby making the BPJS patient admission workflow more effective and efficient

Physiotherapeutic Management Of Low Back Pain Secondary To Spondylosis Using Tens, SWD, And Mckenzie Exercise At Kartika Husada Level II Hospital, Pontianak

2026-08-29T03:15:57+00:00

Low Back Pain (LBP) caused by spondylosis isa common musculoskeletal disorder associated with degenerative changes in the lumbar spine, often resulting in pain, restricted lumbar range of motion, and impaired functional performance. Physiotherapy plays an essential role in managing these symptoms and restoring patients’ functional capacity. This study aimed to evaluate the effectiveness of a combination of Short Wave Diathermy (SWD), Transcutaneous Electrical Nerve Stimulation (TENS), and McKenzie Exercise in reducing pain, improving lumar range of motion, and enhancing functional ability in patients with Low Back Pain due to spondylosis. A descriptive quantitative case study was conducted involving a 51-year-old female patient treated at the Physiotherapy Departement of Kartika Husada Level II Hospital, Pontianak. The patient underwent six physiotherapy sessions. Clinical outcomes were assessed using the Visual Analog Scale (VAS) to measure pain intensity, a goniometer to evaluate lumbar range of motion, Manual Muscle Testin to measure muscle strength, and the Oswestry Disability Index (ODI) to determine functional disability. Following the intervention, the patient demonstrated reduced pain intensity, increased lumbar mobility, and improved functional ability, as reflected by lower ODI scores. These findings suggest that the combination of SWD, TENS, and McKenzie Exercise may be beneficial in reducing pain, restoring lumbar mobility, and improving functional performance in patients with Low Back Pain caused by spondylosis.

The Effect Of Nurses' Therapeutic Approach On Reducing The Anxiety Level Of Families Of Critically ILL Patients In The ICU

2026-08-29T12:17:03+00:00

Background : Admission of critically ill patients to the Intensive Care Unit (ICU) can cause anxiety among family members . Uncertainty about the patient's condition , unfamiliarity with the ICU environment , and limited communication May increase psychological stress . Therapeutic approaches by nurses can provide emotional support , information , and a sense of security to families. Objective : This study aimed to determine the effect of a nurse therapeutic approach on reducing anxiety levels among family members of critically ill patients in the ICU. Methods : This study used a quantitative quasi-experimental design with a one-group pretest-posttest approach . The respondents consisted of 40 families members of critically ill patients treated in the ICU. The nurse therapeutic approach included therapeutic communication , provision of information , active listening , emotional support , and opportunities for family members to express concerns . Anxiety was measured before and after the intervention using an anxiety questionnaire . Data were analyzed using the Wilcoxon Signed Rank Test. Results : Before the intervention , 27 respondents (67.5%) experienced moderate-to-severe anxiety . After the nurse therapeutic approach , only 10 respondents (25.0%) remained in the moderate-to-severe anxiety category . Statistical analysis showed a significant difference in anxiety levels before and after the intervention (p<0.001). Conclusion : The nurse therapeutic approach significantly reduced anxiety among family members of critically ill patients in the ICU. Therapeutic communication and emotional support should be integrated into holistic nursing critical care care settings .