Jurnal Penelitian Kesehatan "SUARA FORIKES" (Journal of Health Research "Forikes Voice")
___________________________________________________________________________________________________________________________________ Jurnal Penelitian Kesehatan Suara Forikes (Journal of Health Research Forikes Voice) is a media for the publication of articles on research and non-research, such as book review, case report, commentary, information, letter to editor, literature review, opinion, scientific news, tutorial and others. We accept articles in the areas of health such as: biomedical sciences (anatomy, physiology, pathology, immunology, microbiology, biochemistry, medical physics, mollecular biology and others); public health (epidemiology, demography, biostatistics, health behavior, occupational health and safety, environmental health, health education, health policy, health information systems, health management and others); medicine (internal medicine, pediatrics, obstetrics and gynecology, neurology; psychiatrics, surgery and others); dentistry (orthodontics, oral surgery, dental conservation, community dentistry and others); nursing (medical-surgical nursing, community nursing, maternity nursing, pediatrics nursing, and others); midwifery (antenatal midwifery care, intranatal midwifery care, postnatal midwifery care; reproduction health, family planning and others); nutrition (clinical nutrition, public nutrition and others); pharmaceutical, physiotherapy, psychology, health technology, medical laboratories, medical record and popular health. ___________________________________________________________________________________________________________________________________
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Salep Daun Pegagan dan Karamunting Terbukti Mempercepat Penyembuhan Luka Sayat pada Mencit
Wound healing consists of the inflammatory, proliferation, and tissue remodeling phases. It is known that traditional plants such as pegagan (Centella asiatica) and karamunting (Rhodomyrtus tomentosa) contain active compounds triterpenoids, flavonoids, and tannins that can accelerate wound healing. The purpose of this study was to test the effectiveness of administering pegagan leaf ointment and karamunting leaf ointment for healing cuts in mice. This study was a laboratory experimental study with a post-test only design with a control group, which was conducted on 24 male mice, which were divided into 4 groups: negative control, positive control (10% povidone iodine), pegagan ointment treatment, and karamunting ointment treatment. A two-centimeter long cut wound was made on the back of the mice. After that, the healing was observed macroscopically to identify erythema, scabs, and wound closure, and the length was measured until the 10th day. Data were analyzed using the normality test, homogeneity test, and t-test. The analysis results showed that wounds in the treatment group (gotu kola and karamunting) healed faster than the positive control group, with an average time of ten days. According to the t-test results, there was no significant difference between the povidone iodine, gotu kola, and karamunting groups (p>0.05). However, there was a significant difference between the negative control group and all treatment groups (p<0.05). Furthermore, it can be concluded that the ointment of gotu kola and karamunting leaves has been proven to accelerate the healing of cuts in mice, even better than povidone iodine. Keywords: wound healing; Centella asiatica; Rhodomyrtus tomentosa; herbal ointment ABSTRAK Penyembuhan luka terdiri dari fase inflamasi, proliferasi, dan remodeling jaringan. Diketahui bahwa tanaman tradisional seperti pegagan (Centella asiatica) dan karamunting (Rhodomyrtus tomentosa) memiliki senyawa aktif triterpenoid, flavonoid, dan tanin yang dapat mempercepat penyembuhan luka. Tujuan penelitian ini adalah untuk menguji efektivitas pemberian salep daun pegagan dan salep daun karamunting untuk penyembuhan luka sayat pada mencit. Penelitian ini merupakan studi eksperimen laboratoris dengan desain post-test only with control group, yang dilakukan pada 24 ekor mencit jantan, yang dibagi menjadi 4 kelompok yaitu kontrol negatif, kontrol positif (povidone iodine 10%), perlakuan salep pegagan, dan perlakuan salep karamunting. Luka sayat sepanjang dua sentimeter pada punggung mencit dibuat. Setelah itu, penyembuhannya diamati secara makroskopis untuk mengidentifikasi eritema, keropeng, dan penutupan luka, dan panjangnya diukur hingga hari ke-10. Data dianalisis dengan uji normalitas, uji homogenitas, dan uji t. Hasil analisis menunjukkan bahwa luka pada kelompok perlakuan (pegagan dan karamunting) sembuh lebih cepat daripada kontrol positif dalam waktu rata-rata sepuluh hari. Menurut hasil uji t, tidak ada perbedaan signifikan antara kelompok povidone iodine, pegagan, dan karamunting (p >0,05). Namun, ada perbedaan signifikan antara kelompok kontrol negatif dan seluruh kelompok perlakuan (p <0,05). Selanjutnya dapat disimpulkan bahwa salep daun pegagan dan karamunting terbukti mempercepat penyembuhan luka sayat pada mencit, bahkan lebih baik daripada povidone iodine. Kata kunci: penyembuhan luka; Centella asiatica; Rhodomyrtus tomentosa; salep herbal
Copyright (c) 2025 Dr. Tri Johan Agus Agus Yuswanto, SKp.MKep., Mimin - Lestari, Supriandi - -, Nang Randu Utama http://creativecommons.org/licenses/by-nc-nd/4.0
Mobile JKN as an Application to Improve Service Quality of Social Security Administration Agency for Health in Hemodialysis Unit
Digital transformation in healthcare services is a major focus of BPJS Kesehatan (Social Security Administration Agency for Health) through the Mobile JKN application. This study aimed to evaluate the quality of BPJS services using Mobile JKN in the Hemodialysis Unit of Dr. Pirngadi Regional General Hospital in Medan, using a mixed methods approach (quantitative and qualitative). The quantitative method was conducted by distributing questionnaires to 109 patients who use Mobile JKN. The results showed that the aspect of ease of access scored an average of 3.72, service speed 4.0, application features 3.35, and patient satisfaction 3.77. These findings indicate that the majority of patients feel helped by the existence of Mobile JKN, especially in terms of queue efficiency and ease of administration. However, there are still obstacles such as limited digital literacy, technical difficulties in logging in, and low utilization of additional features such as changing health facilities and online consultations. In-depth interviews supported the quantitative data, in which most elderly respondents experienced difficulties in using the application without assistance. BPJS Kesehatan officers and medical personnel play an important role in assisting the application usage process. It can be concluded that Mobile JKN has significantly improved BPJS Kesehatan services, but optimizing its utilization still requires improvements in education and assistance as well as technical system improvements. Keywords: digital health services; hemodialysis unit; service quality
Copyright (c) 2025 Obed Andy F Manalu, Ermi Girsang, Ali Napiah Nasution http://creativecommons.org/licenses/by-nc-nd/4.0
Unit Cost Analysis of Sectio Caesarea Using Activity-Based Costing
Determining medical service tariffs, particularly for Sectio Caesarea (SC), is a critical decision that directly affects hospital profitability. To generate accurate cost information, an appropriate accounting system is essential, one of which is the Activity-Based Costing (ABC) method. This method is considered more precise than traditional approaches because it utilizes multiple cost drivers and allocates expenses based on actual activities. This study aimed to analyze the unit cost of SC procedures at RSU Royal Prima Medan using the ABC method. Conducted between April and June 2025, the study examined a one-year sample of 72 SC patients. Costs were categorized and analyzed across three activity levels: unit-level, batch-level, and facility-level. The findings revealed a total cost of SC services amounting to IDR 1,220,572,338, with an average cost per patient of IDR 16,952,394. After applying a 15% profit margin, the recommended tariff was IDR 19,495,253 per patient—lower than the hospital’s current rate of IDR 20,141,176, resulting in a difference of IDR 645,923. This discrepancy indicates that the ABC method offers a more realistic and accurate representation of actual costs, making it a valuable tool for evaluating operational efficiency and revising service tariffs. In conclusion, the application of the ABC method in determining C-section service rates enables hospitals to set tariffs that more accurately reflect resource consumption. It is recommended that hospitals adopt the ABC method comprehensively across all service units to enhance efficiency and promote cost transparency. Keywords: activity-based costing; unit cost; sectio caesarea; cost driver; cost efficiency
Copyright (c) 2025 Andi Kurniawan, Ermi Girsang, Sri Lestari Ramadhani Nasution http://creativecommons.org/licenses/by-nc-nd/4.0
Penerapan Safewards Intervention dalam Mengurangi Tanda dan Gejala Perilaku Kekerasan Pasien Skizofrenia
Schizophrenia, both in the acute and chronic phases, can lead to violent behavior. An intervention currently being developed extensively is the Safewards Intervention. The purpose of this study was to analyze the effectiveness of the safewards intervention in reducing signs and symptoms of violent behavior in schizophrenia patients. The study design was a one-group pretest and posttest, involving 11 schizophrenia patients with violent behavior, selected using a total sampling technique. They were given the safewards intervention, and in the pre- and post-intervention phases, signs and symptoms of violence were measured using questionnaires and observation sheets. A paired samples t-test was then used to compare the signs and symptoms of violence before and after the intervention. The results showed that the mean signs and symptoms in the pre- and post-intervention phases were 114.73 and 43.64, respectively. The p-value of the comparative analysis was 0.000, indicating a significant difference in signs and symptoms of violence between the two measurements. Therefore, it can be concluded that the safewards intervention is effective in reducing signs and symptoms of violent behavior in schizophrenia patients treated in a psychiatric hospital. Keywords: schizophrenia; violent behavior; safewards intervention ABSTRAK Skizofrenia pada fase akut maupun fase kronis dapat menimbulkan perilaku kekerasan. Intervensi yang saat ini sedang dikembangkan secara masif adalah Safewards Intervention. Tujuan penelitian ini adalah menganalisis efektivitas safewards intervention untuk mengurangi tanda dan gejala perilaku kekerasan pada pasien skizofrenia. Rancangan penelitian ini adalah one group pretest and posttest, yang melibatkan 11 pasien skizofrenia dengan perilaku kekerasan, yang dipilih dengan teknik total sampling. Mereka diberikan safewards intervention, dan pada fase sebelum dan sesudah intervensi dilakukan pengukuran tanda dan gejala kekerasan menggunakan kuesioner dan lembar observasi. Selanjutnya dilakukan analisis perbandingan tanda dan gejala kekerasan antara sebelum dan sesudah intervensi menggunakan paired samples t-test. Hasil analisis menunjukkan bahwa rerata tanda dan gejala pada fase sebelum dan sesudah intervensi, masing-masing adalah 114,73 dan 43,64. Nilai p dari analisis perbandingan adalah 0,000, yang bisa dimaknai bahwa ada perbedaan tanda dan gejala kekerasan secara signifikan antara kedua pengukuran tersebut. Dengan demikian, bisa disimpulkan bahwa safewards intervention efektif untuk mengurangi tanda dan gejala perilaku kekerasan pada pasien skizofrenia yang dirawat di rumah sakit jiwa. Kata kunci: skizofrenia; perilaku kekerasan; safewards intervention
Copyright (c) 2025 Rukiyah Harahap, Ulfa Suryani, Guslinda Guslinda, Surya Efendi http://creativecommons.org/licenses/by-nc-nd/4.0
Faktor Lingkungan Sebagai Determinan Dominan Burnout Syndrome pada Perawat Puskesmas
Burnout syndrome often occurs in nurses due to prolonged stress, which impacts mental and physical well-being and the quality of healthcare services. The purpose of this study was to determine the dominant factors most influential in the incidence of burnout syndrome among nurses in community health centers. This study used a cross-sectional design, with 58 nurses as respondents. Data were collected through personal questionnaires adapted from Bortner, modified psychological questionnaires from Maslach & Leiter, environmental questionnaires from Nursalamet, spiritual questionnaires (SWBS) from Ellison and Paloutzia, and Burnout questionnaires (MBI-HSS-MP) from Maslach. The collected data were analyzed using the Spearman rank test and multiple linear regression. The results showed that psychological and spiritual factors had p-values greater than 0.05, while environmental factors (inadequate rewards) had a p-value of 0.000. Therefore, it can be concluded that the most dominant factor associated with the incidence of burnout syndrome among nurses in community health centers is environmental factors. Keywords: nurses; burnout syndrome; environment ABSTRAK Burnout syndrome sering terjadi pada perawat akibat stres berkepanjangan, yang dampat berdampak pada kesejahteraan mental dan fisik serta kualitas pelayanan kesehatan. Tujuan penelitian ini adalah untuk mengetahui faktor dominan yang paling berpengaruh dengan kejadian burnout syndrome pada perawat di puskesmas. Penelitian ini menggunakan desain cross-sectional, dengan jumlah responden 58 perawat. Pengumpulan data dilakukan melalui pengisian kuesioner personal yang diadaptasi dari Bortner, modifikasi kuesioner psikologis dari Maslach & Leiter, kuesioner lingkungan dari Nursalamet, kuesioner spiritual (SWBS) dari Ellison dan Paloutzia, dan kuesioner Burnout (MBI-HSS-MP) dari Maslach. Data yang telah terkumpul dianalisis menggunakan uji Spearman rank dan uji regresi linier berganda. Hasil penelitian menunjukkan bahwa faktor psikologis dan faktor spiritual memiliki nilai p lebih besar darpada 0,05, sedangkan faktor lingkungan (penghargaan yang tidak memadai) memiliki nilai p 0,000. Dengan demikian bisa disimpulkan bahwa faktor yang paling dominan berhubungan dengan kejadian burnout syndrome pada perawat di puskesmas adalah faktor lingkungan. Kata kunci: perawat; burnout syndrome; lingkungan
Copyright (c) 2025 Moh Fadhil Raihan http://creativecommons.org/licenses/by-nc-nd/4.0
Kualitas Tidur Sebagai Faktor Pengendali Tekanan Darah Pasien Hipertensi pada Usia Produktif
Hypertension remains a common health problem among people of productive age. One contributing factor to increased blood pressure is poor sleep quality, which can affect the nervous system and cardiovascular function. The purpose of this study was to analyze the correlation between sleep quality and increased blood pressure in hypertensive patients of productive age. This study employed a cross-sectional approach, involving 73 hypertensive patients at a community health center. Data were obtained through questionnaires about sleep quality and direct blood pressure measurements. A correlation analysis using Fisher's exact test was then performed. The analysis showed a value of 0.000, indicating a significant correlation between sleep quality and blood pressure in hypertensive patients. The poorer the sleep quality, the higher the blood pressure. Therefore, it can be concluded that sleep quality plays a role in controlling blood pressure in hypertensive patients at the community health center. Keywords: blood pressure; hypertension; productive age; sleep quality ABSTRAK Hipertensi masih menjadi masalah kesehatan yang umum dialami oleh masyarakat usia produktif. Salah satu faktor berkontribusi terhadap peningkatan tekanan darah yaitu kualitas tidur yang buruk, yang bisa memengaruhi sistem saraf dan fungsi kardiovaskular. Tujuan penelitian ini adalah untuk menganalisis korelasi antara kualitas tidur dengan peningkatan tekanan darah pada pasien hipertensi usia produktif. Penelitian ini menerapkan pendekatan cross-sectional, dengan melibatkan 73 pasien hipertensi di puskesmas. Data diperoleh melalui pengisian kuesioner tentang kualitas tidur serta pengukuran tekanan darah secara langsung. Selanjutnya dilakukan analisis korelasi dengan Fisher’s exact test. Hasil analisis menunjukkan nilai 0,000, sehingga bisa dimaknai bahwa ada korelasi yang sgnifikan antara kualitas tidur dan tekanan darah pada pasien hipertensi. Semakin buruk kualitas tidur, maka tekanan darah semakin meningkat. Dengan demikian bisa disimpulkan bahwa kualitas tidur merupakan pengendali tekanan darah pasien hipertensi di puskesmas. Kata kunci: tekanan darah; hipertensi; usia produktif; kualitas tidur
Copyright (c) 2025 akhida laila, Nur Isnaini http://creativecommons.org/licenses/by-nc-nd/4.0
Upaya Penurunan Risiko Jatuh pada Lansia melalui Program OLORE
Falls in the elderly are a serious global health problem, with more than 80% of cases occurring in those over 60 years of age. Elderly people in nursing homes have a higher risk of falls than those living in the community. The purpose of this study was to test the effectiveness of the OLORE program in reducing the risk of falls in elderly people in nursing homes. This was an experimental study with a pretest-posttest design with a control group. It was applied to 98 elderly people in two nursing homes for 12 weeks. The intervention provided was the OLORE program, which was conducted three times per week. Data collection on falls was carried out using the Morse Fall Scale (MFS) questionnaire in the pre- and post-intervention phases in both groups. Data analysis was performed using a t-test. The results showed that the group receiving the OLORE program experienced a decrease in fall risk scores of 8.57 points; while in the control group it was only 2.55 points. The p-value for each group was 0.001 and 0.096, respectively, which means that there was a significant difference in fall risk between before and after the intervention only for the group receiving the OLORE program. In conclusion, the OLORE program is effective in reducing the risk of falls in elderly residents of nursing homes. Keywords: elderly; fall risk; weight training; physical exercise ABSTRAK Jatuh pada lansia merupakan masalah kesehatan global yang serius, dengan lebih dari 80% kasus terjadi pada usia di atas 60 tahun. Lansia di panti wreda memiliki risiko jatuh lebih tinggi dibandingkan yang tinggal di komunitas. Tujuan penelitian ini adalah menguji efektivitas program OLORE untuk menurunkan risiko jatuh pada lansia di panti wreda. Penelitian ini adalah studi eksperimental dengan rancangan pretest-posttest with control group. Yang diterapkan pada 98 lansia di dua panti wreda selama 12 minggu. Intervensi yang diberikan adalah program OLORE yang dilakukan 3 kali per minggu. Pengumpulan data tentang jatuh dilakukan menggunakan kuesioner Morse Fall Scale (MFS) pda fase sebelum dan sesudah intervensi pada kedua kelompok. Analisis data dilakukan dengan t-test. Hasil analisis menunjukkan bahwa kelompok yang mendapatkan program OLORE mengalami penurunan skor risiko jatuh sebesar 8,57 poin; sedangkan pada kelompok kontrol hanya 2,55 poin. Nilai p untuk masing-masing kelompok adalah 0,001 dan 0,096, yang berarti bahwa ada perbedaan risiko jatuh secara signifikan antara sebelum dan sesudah intervensi hanya untuk kelompok yang mendapatkan program OLORE. Sebagai kesimpulan, program OLORE efektif untuk menurunkan risiko jatuh pada lansia di panti wreda. Kata kunci: lansia; risiko jatuh; latihan beban; latihan fisik
Copyright (c) 2025 Dewi Srimauli Simorangkir, Junaiti Sahar, Yossie Susanti Eka Putri, Etty Rekawati, Shinta Silaswati http://creativecommons.org/licenses/by-nc-nd/4.0
Appropriate Work Schedule Management and Social Support Among Nurse Colleagues Function as Crucial Factors in Reducing Work Fatigue
Nurse burnout is a significant issue affecting the quality of care and patient safety. This study aimed to analyze factors associated with nurse burnout in the inpatient ward of Royal Prima Medan General Hospital in 2025. The study used a cross-sectional design. The sample consisted of 138 nurses selected using total sampling technique according to the inclusion criteria. The variables studied included length of service, work shift, work environment, and coworker support. Data were obtained through the Subjective Self Rating Test (SSRT) questionnaire and analyzed multivariately using logistic regression. The results showed that most nurses were female (90.6%), under 36 years old (85.5%), and D3 Nursing graduates (73.9%). The majority experienced moderate levels of burnout (84.8%). Multivariate analysis showed that work shifts were the most dominant risk factor with an odds ratio of 8.506 (p=0.002), while coworker support had a protective effect with an odds ratio of 0.085 (p=0.000). As conclusion, these findings confirm that appropriate work schedule management and social support among nurse colleagues are crucial for reducing work fatigue. Hospitals are advised to strengthen healthy shift rotation programs and develop a supportive work culture to maintain nurse well-being and patient safety. Keywords: nurses; work fatigue; coworker support; work environment; work shifts
Copyright (c) 2025 Fauziah Yasmin Nur, Ermi Girsang, Ali Napiah Nasution http://creativecommons.org/licenses/by-nc-nd/4.0
Communication and the Monitoring, Analysis, Evaluation, and Control of Risk as Predictors of Clinical Risk Management Implementation
Clinical Risk Management (CRM) is a systematic approach to identifying, analyzing, evaluating, and controlling risks to improve the quality and safety of patient care in hospitals. This study aimed to analyze the factors associated with the implementation of CRM at Pertamina Hospital Pangkalan Brandan, particularly in terms of organizational systems, leadership, culture, training, communication, and risk control. This study used a quantitative approach with a cross-sectional design. The sample consisted of 180 healthcare workers at Pertamina Hospital Pangkalan Brandan. Data were collected using a structured questionnaire and analyzed using multiple logistic regression tests to identify the dominant factors influencing CRM implementation. Bivariate analysis indicated that all independent variables; organizational systems (p = 0.000), leadership (p = 0.000), cultural understanding (p = 0.000), training (p = 0.000), communication (p = 0.000), and monitoring, analysis, evaluation, and risk control (p = 0.000) were significantly associated with CRM. Multivariate analysis revealed that the most influential variables in CRM implementation were communication (OR = 18.991) and monitoring, analysis, evaluation, and risk control (OR = 56.403). As conclusion, the dominant predictors of the implementation of CRM at Pertamina Hospital, Pangkalan Brandan are communication and the monitoring, analysis, evaluation, and control of risk. Keywords: clinical risk management; communication; risk control; hospital; service quality
Copyright (c) 2025 Fadli Ahmad, Ermi Girsang, Sri Lestari Ramadhani Nasution http://creativecommons.org/licenses/by-nc-nd/4.0
Perancangan dan Pengklonaan Gen Iron-Dependent Repressor and Activator Mycobacterium tuberculosis pada Vektor pMV261
Mycobacterium tuberculosis, which causes tuberculosis, is the leading cause of death among infectious diseases worldwide. The problem with tuberculosis is the unique self-defense mechanism of M. tuberculosis so that it remains dormant and lives inside phagocytic cells. The aim of this research was to design and clone the Iron-dependent Repressor and Activator (ideR) gene into the pMV261 plasmid vector, which will be used for further research to see the phenotypic and functional characterization of the ideR gene. The research method was carried out in several stages, namely: designing the construction of the ideR gene fragment in the pMV261 plasmid vector in silico, amplifying the ideR gene fragment from the M. tuberculosis genome, constructing the ideR gene fragment into the pMV261 plasmid vector in vitro, cloning the recombinant plasmid pMV261-ideR in competent E. coli cells, and validating the recombinant plasmid pMV261-ideR using PCR or genomic sequencing methods. The research results demonstrated that the ideR gene fragment was successfully cloned into the pMV261 plasmid vector both in silico and in vitro, as demonstrated by 1% agarose gel electrophoresis analysis. This study concluded that the recombinant plasmid pMV261-ideR was successfully cloned. Keywords: Mycobacterium; overexpression; M. tuberculosis; IdeR; pMV261 ABSTRAK Mycobacterium tuberculosis yang menyebabkan tuberkulosis adalah penyebab utama kematian di antara penyakit menular di seluruh dunia. Permasalahan pada tuberkulosis adalah mekanisme pertahanan diri M. tuberculosis yang unik sehingga tetap dorman dan hidup di dalam sel-sel fagosit. Tujuan riset ini yaitu merancang dan mengklona gen Iron-dependent Repressor and Activator (ideR) ke dalam vektor plasmid pMV261, yang akan digunakan untuk riset tahap selanjutnya untuk melihat gambaran karakterisasi fenotip dan fungsional gen ideR. Metode riset dilakukan dengan beberapa tahapan yaitu: merancang konstruksi fragmen gen ideR pada vektor plasmid pMV261 secara in silico, mengamplifikasi fragmen gen ideR dari genom M. tuberculosis, mengonstruksi fragmen gen ideR ke dalam vektor plasmid pMV261 secara in vitro, mengklona plasmid rekombinan pMV261-ideR pada sel kompeten E. coli, dan memvalidasi plasmid rekombinan pMV261-ideR dengan menggunakan metode PCR atau sekuensing genomik. Hasil riset yang dicapai menunjukkan bahwa fragmen gen ideR berhasil diklona ke dalam vektor plasmid pMV261 secara in silico dan in vitro, yang ditunjukkan dengan hasil analisis elektroforesis jel agarosa 1%. Pada riset ini dapat disimpulkan bahwa plasmid rekombinan pMV261-ideR telah berhasil diklona. Kata kunci: Mycobacterium; overekspresi; M.tuberculosis; IdeR; pMV261
Copyright (c) 2025 Erlan Pradan, Ryan Fadillah Pasya, Bunail Isna Alfarisi, Chiara Maharani Arihta Sebayang, Adam Yulianto, Tegar Adriansyah Putra Siregar http://creativecommons.org/licenses/by-nc-nd/4.0
Multidimensional Challenges in the Implementation of the Acute Appendicitis Clinical Pathway
Acute appendicitis is a common cause of acute abdominal pain that requires immediate intervention to prevent complications, especially among vulnerable groups such as children and the elderly. The clinical pathway is used to standardize care, improve efficiency, and reduce costs. This study aimed to analyze the implementation of the acute appendicitis clinical pathway at Pertamina Hospital Pangkalan Brandan. The research used a qualitative phenomenological approach involving six informants (two key, two main, and two supporting). Data were collected through observation, in-depth interviews, and document review, then analyzed descriptively through data reduction, presentation, and conclusion drawing. The results showed that the implementation of the acute appendicitis clinical pathway still faces challenges in unstructured interprofessional communication, limited human resources such as case managers and clinical pharmacists, and the absence of an adequate information and logistics system. Resistance also occurs due to low understanding, entrenched old practices, and lack of incentives. Internal evaluations have not significantly influenced behavioral change, while supervision and inter-unit coordination remain weak. As conclusion, the implementation of the acute appendicitis clinical pathway at Pertamina Hospital Pangkalan Brandan faces interrelated, multidimensional challenges across communication, resources, disposition, and bureaucratic structure aspects. Keywords: hospital; clinical pathway; acute appendicitis
Copyright (c) 2025 Firli Yan Arsil, Ermi Girsang, Sri Lestari Ramadhani Nasution http://creativecommons.org/licenses/by-nc-nd/4.0
Kepuasan Sebagai Prediktor Utama Lost Patient pada Peserta Prolanis di Pusat Kesehatan Masyarakat
Non-communicable diseases are the leading cause of death worldwide, with hypertension being a major risk factor. The Chronic Disease Management Program (Prolanis) is a government effort to prevent complications and improve the quality of life for patients with hypertension and type 2 diabetes mellitus. However, the phenomenon of lost patients or loss of control remains a challenge to the program's success. The purpose of this study was to analyze factors associated with lost patients among Prolanis participants at community health centers. This study used a cross-sectional design, involving 95 Prolanis participants selected using simple random sampling. Independent variables included knowledge, attitudes, behaviors, treatment side effects, service satisfaction, service access, family support, and the role of health workers. Data analysis was performed using multiple binary logistic regression. The results showed that knowledge, attitudes, health behaviors, satisfaction with services, and family support significantly influenced lost patients (p<0.05), with service satisfaction being the most dominant factor (Exp(B) = 14.659). In conclusion, satisfaction is the primary predictor of lost patients among Prolanis participants at community health centers. Keywords: Prolanis (chronic disease management program), lost patient; community health center ABSTRAK Penyakit tidak menular merupakan penyebab utama kematian di dunia, dengan hipertensi sebagai salah satu faktor risiko terbesar. Program Pengelolaan Penyakit Kronis (Prolanis) merupakan upaya pemerintah untuk mencegah komplikasi dan meningkatkan kualitas hidup pasien hipertensi dan diabetes mellitus tipe 2. Namun, fenomena lost patient atau putus kontrol masih menjadi tantangan dalam keberhasilan program. Tujuan penelitian ini adalah menganalisis faktor-faktor yang berhubungan dengan kejadian lost patient pada peserta Prolanis di pusat kesehatan masyarakat. Penelitian ini menggunakan desain cross-sectional, yang melibatkan 95 peserta Prolanis yang dipilih dengan teknik simple random sampling. Variabel independen mencakup pengetahuan, sikap, perilaku, efek samping pengobatan, kepuasan pelayanan, akses pelayanan, dukungan keluarga, dan peran tenaga kesehatan. Analisis data dilakukan dengan uji regresi logistik biner berganda. Hasil penelitian menunjukkan bahwa faktor pengetahuan, sikap, perilaku kesehatan, kepuasan terhadap pelayanan, dan dukungan keluarga berpengaruh secara signifikan terhadap kejadian lost patient (p<0,05), dengan kepuasan pelayanan menjadi faktor paling dominan (Exp(B) = 14,659). Sebagai kesimpulan, kepuasan merupakan predictor utama lost patient pada peserta Prolanis di pusat kesehatan masyarakat. Kata kunci: Prolanis (program pengelolaan penyakit kronis), lost patient; pusat kesehatan masyarakat
Copyright (c) 2025 Zulkifli Walangadi, Nurfalia Harfah, Azharatul Jannah http://creativecommons.org/licenses/by-nc-nd/4.0
Quality of Health Services as a Determinant of Patient Satisfaction in Specialist Outpatient Clinics
Patient satisfaction at specialist clinics is an important indicator in ensuring the quality of healthcare services. The level of patient satisfaction also determines the competitiveness and sustainability of healthcare institutions. The purpose of this study was to analyze the influence of healthcare service quality on patient satisfaction at specialist clinics. This study was conducted using a cross-sectional design, involving 177 outpatients selected using purposive sampling. Data were collected through questionnaires, then analyzed descriptively, using the Chi-Square test, and finally using multiple logistic regression. The results showed that variables that significantly influenced patient satisfaction were dignity (p = 0.040), confidentiality (p = 0.034), communication (p = 0.026), autonomy (p = 0.029), prompt attention (p = 0.005), quality of basic facilities (p = 0.001), and access to social support (p = 0.011). Meanwhile, choice of service provider did not show a significant influence (p = 0.208). Of all these variables, the quality of basic facilities had the greatest influence on patient satisfaction (odds ratio = 3.406). Furthermore, it was concluded that the quality of healthcare services is a determinant of patient satisfaction in specialist clinics. Management is expected to improve the quality of communication and education between healthcare workers and patients through training, educational media, and an empathetic approach to enhance patient satisfaction. Keywords: quality of healthcare services; patient satisfaction; specialist clinics
Copyright (c) 2025 Rofiqah Azmi, Ermi Girsang, Sri Lestari Ramadhani Nasution http://creativecommons.org/licenses/by-nc-nd/4.0
Masa Kerja, Postur Kerja dan Aktivitas Berulang Sebagai Determinan Musculoskeletal Disorders pada Pekerja Laundry
Musculoskeletal disorders are an occupational health problem in informal sectors such as laundries, which are prone to occur due to unergonomic work postures, repetitive activities, and long work durations. The purpose of this study was to analyze the relationship between work posture, repetitive activities, length of service, and body mass index (BMI) with the incidence of musculoskeletal disorders in laundry workers. This study used a cross-sectional design, involving 82 workers selected using a proportional stratified random sampling method. Data collection was conducted using the Rapid Entire Body Assessment (REBA) worksheet, the Nordic Body Map (NBM), and questionnaires according to the variables. Data were analyzed using the Chi-square test. The analysis results showed that the p-value for each independent variable was work posture = 0.023, repetitive activities 0.029, work period 0.001, and body mass index = 0.744. Therefore, it can be concluded that the determinants of musculoskeletal disorders in laundry workers in this location are length of service, work posture, and repetitive activities. Keywords: musculoskeletal disorders; length of service; work posture; repetitive activities ABSTRAK Musculoskeletal disorders merupakan masalah kesehatan kerja pada sektor informal seperti laundry yang rentan terjadi akibat postur kerja tidak ergonomis, aktivitas berulang, dan durasi kerja yang panjang. Tujuan penelitian ini adalah menganalisis hubungan antara postur kerja, aktivitas berulang, masa kerja, dan indeks massa tubuh dengan kejadian musculoskeletal disorders pada pekerja laundry. Penelitian ini menggunakan desain cross- sectional, dengan melibatkan 82 pekerja yang dipilih menggunakan metode proporsional stratified random sampling. Pengumpulan data dilakukan dengan menggunakan Rapid Entire Body Assessment (REBA) worksheet, Nordic Body Map (NBM), dan kuesioner sesuai variabel. Data dianalisis menggunakan uji Chi-square. Hasil analisis menunjukkan bahwa nilai p untuk masing-masing variabel independen adalah postur kerja = 0,023, aktivitas berulang 0,029, masa kerja 0,001 dan indeks massa tubuh = 0,744. Dengan demikian dapat disimpulkan bahwa determinan kejadian musculoskeletal disorders pada pekerja laundry di lokus ini adalah masa kerja, postur kerja dan aktivitas berulang. Kata kunci: musculoskeletal disorders; masa kerja; postur kerja; aktivitas berulang
Copyright (c) 2025 Munairah budi aswin usi lanita http://creativecommons.org/licenses/by-nc-nd/4.0
Kombinasi Massage Endorphin Dan Kompres Air Jahe Hangat Untuk Menurunkan Nyeri Punggung Ibu Hamil Trimester III
During pregnancy, the body undergoes physiological changes that cause discomfort, one of which is back pain. Non-pharmacological treatments such as endorphin massage and warm ginger compresses can be used to address this issue. The purpose of this study was to analyze the effectiveness of a combination of endorphin massage and warm ginger compresses to reduce back pain in pregnant women in their third trimester. This study employed a pretest-posttest design with a control group. The sample consisted of 24 pregnant women in their third trimester who were examined at the Poka Rumah Tiga Community Health Center, selected using consecutive sampling. Pain intensity was measured before and after the intervention using a Numeric Rating Scale. The reduction in pain intensity between the two groups was then compared using an independent samples t-test. The p-value for the comparison was <0.001, indicating a difference in pain reduction between the two groups, with a greater reduction in the treatment group. Therefore, it can be concluded that the combination of endorphin massage and warm ginger compresses is effective in reducing back pain in pregnant women in their third trimester. Keywords: endorphin massage; warm ginger compress; back pain; pregnant women ABSTRAK Selama masa kehamilan tubuh akan mengalami perubahan fisiologi yang menimbulkan ketidaknyamanan, yang salah satunya adalah nyeri punggung. Untuk mengatasi masalah tersebut dapat dilakukan upaya penanganan non farmakologis seperti endorphin massage dan kompres air jahe hangat.Tujuan penelitian ini adalah menganalisis efektivitas kombinasi endorphin massage dan kompres air jahe hangat untuk menurunkan intensitas nyeri punggung pada ibu hamil trimester III. Penelitian ini menerapkan rancangan pretest-posttest with control group. Sampel dalam penelitian ini adalah 24 ibu hamil trimester III yang datang menjalani pemeriksaan di Puskesmas Poka Rumah Tiga, yang dipilih dengan teknik consecutive sampling. Sebelum dan seudah intervensi dilakukan pengukuran intensitas nyeri menggunakan Numeric Rating Scale. Selanjutnya penurunan intensitas nyeri dari kedua kelompok dibandingkan dengan independent samples t-test. Nilai p dari hasil perbandingan adalah <0,001, sehingga diinterpretasikan bahwa ada perbedaan penurunan intensitas nyeri antara kedua kelompok, dengan penurunan lebih besar pada kelompok perlakuan. Dengan demikian bisa disimpulkan bahwa kombinasi endorphin massage dan kompres air jahe hangat efektif untuk menurunkan intensitas nyeri punggung pada ibu hamil trimester III. Kata kunci: endorphin massage; kompres jahe hangat; nyeri punggung; ibu hamil
Copyright (c) 2025 Meilany Laisouw http://creativecommons.org/licenses/by-nc-nd/4.0
Edukasi Perawatan Diri Orem Meningkatkan Kebersihan Luka Post Operasi Fraktur Ekstremitas
Postoperative wound hygiene for lower extremity fractures is a key factor in preventing infection and accelerating healing. Self-care education based on Orem's Theory designed to empower patients is expected to improve independence and wound hygiene. The purpose of this study was to analyze the effect of self-care education based on Orem's Theory on postoperative wound hygiene for lower extremity fractures. This study used a pretest-posttest approach with a control group. This study involved 100 randomly selected postoperative lower extremity fracture patients. The intervention group received self-care education based on Orem's Theory, while the control group received conventional education. The research instrument was a wound hygiene observation sheet applied to both groups. The wound hygiene of the two groups was then compared. The Wilcoxon test results showed a p-value of 0.000 in the intervention group, indicating a significant improvement in wound hygiene. The proportion of patients with improved wound hygiene in the intervention group (42%) was significantly higher than in the control group (8%). The Mann-Whitney test showed a p-value of 0.000, with a mean rank of 62.00 for the intervention group and 39.00 for the control group. This study concluded that self-care education based on Orem's Theory significantly improved wound hygiene in patients with postoperative lower extremity fractures and was more effective than conventional education. Keywords: self-care education; Orem's Theory; wound hygiene; postoperative; lower extremity fractures ABSTRAK Kebersihan luka pasca operasi fraktur ekstremitas bawah merupakan faktor kunci dalam mencegah infeksi dan mempercepat penyembuhan. Edukasi perawatan diri berbasis Teori Orem yang dirancang untuk memberdayakan pasien diharapkan dapat meningkatkan kemandirian dan kebersihan luka. Tujuan penelitian ini adalah menganalisis pengaruh edukasi perawatan diri berbasis teori Orem terhadap kebersihan luka pasca operasi fraktur ekstremitas bawah. Penelitian ini menggunakan pendekatan pretest-posttest with control group. Studi ini melibatkan 100 pasien pasca operasi fraktur ekstremitas bawah yang dipilih secara acak. Kelompok intervensi menerima edukasi perawatan diri berbasis Teori Orem, sedangkan kelompok kontrol menerima edukasi konvensional. Instrumen penelitian ini adalah lembar observasi kebersihan luka yang diterapkan pada kedua kelompok. Selanjutnya kebersihan luka kedua kelompok dibandingkan. Hasil uji Wilcoxon menunjukkan nilai p 0,000 pada kelompok intervensi, yang menunjukkan adanya peningkatan kebersihan luka secara signifikan. Proporsi pasien dengan peningkatan kebersihan luka pada kelompok intervensi (42%) secara signifikan lebih tinggi dibandingkan kelompok kontrol (8%). Uji Mann-Whitney menunjukkan nilai p 0,000, dengan mean rank 62,00 untuk kelompok intervensi dan 39,00 untuk kelompok kontrol. Penelitian ini menyimpulkan bahwa edukasi perawatan diri berbasis Teori Orem secara signifikan dapat meningkatkan kebersihan luka pada pasien fraktur ekstremitas bawah pasca operasi dan lebih efektif dibandingkan edukasi konvensional. Kata kunci: edukasi perawatan diri; Teori Orem; kebersihan luka; pasca operasi; fraktur ekstremitas bawah
Copyright (c) 2025 Dr. Tri Johan Agus Agus Yuswanto, SKp.MKep., Janessa Fatiha Bisma Balqis http://creativecommons.org/licenses/by-nc-nd/4.0
Pendidikan Kesehatan Berbasis Teori Hildegard Pelau Meningkatkan Pemahaman Perawatan Luka Mandiri pada Pasien Pasca Operasi Caesar
Health education is an important intervention in improving patient understanding and independence in postoperative wound care. The purpose of this study was to test the effectiveness of health education based on Hildegard Peplau's theory to improve understanding and independence in wound care in post-cesarean section patients. The study design was a pre-test and post-test with a control group. A total of 100 post-cesarean section patients were selected and divided into a treatment group and a control group, each with 50 patients. The instruments for measuring patient understanding and independence were questionnaires and observation sheets. Data were analyzed using a t-test. The results of the paired samples t-test showed a significant difference in understanding and wound care between before and after the intervention in the treatment group (p = 0.000), with an average increase of 10.16. A significant difference was also found in the control group (p = 0.000), although the average increase was only 5.76. Independent samples t-test showed a significant difference between the treatment and control groups after the intervention, with a p value of 0.000 and an average difference of 8.40. Thus, it can be concluded that health education based on Hildegard Peplau's theory is effective in increasing patient understanding and independence in post-cesarean wound care. Keywords: health education; Hildegard Peplau's theory; self-care for wounds; cesarean section. ABSTRAK Pendidikan kesehatan merupakan intervensi penting dalam meningkatkan pemahaman dan kemandirian pasien dalam perawatan luka pasca operasi. Tujuan penelitian ini adalah menguji efektivitas pendidikan kesehatan berdasarkan teori Hildegard Peplau untuk meningkatkan pemahaman dan kemandirian perawatan luka pada pasien pasca operasi caesar. Rancangan penelitian ini adalah pre-test and post-test with control group. Sebanyak 100 pasien pasca operasi caesar dipilih dan dibagi menjadi kelompok perlakuan dan kelompok kontrol, masing-masing 50 pasien. Alat pengukur pemahaman dan kemandirian pasien adalah kuesioner dan lembar observasi. Data dianalisis menggunakan uji t. Hasil paired samples t-test menunjukkan adanya perbedaan yang signifikan dalam pemahaman dan perawatan luka antara sebelum dan sesudah ontervensi pada kelompok perlakuan (p = 0,000), dengan rerata peningkatan adalah 10,16. Perbedaan yang signifikan juga ditemukan pada kelompok kontrol (p = 0,000), meskipun rerata peningkatan hanya 5,76. Independent samples t-test menunjukkan perbedaan yang signifikan antara kelompok perlakuan dan kontrol setelah intervensi, dengan nilai p 0,000 dan rerata selisih adalah 8,40. Dengan demikian dapat disimpulkan bahwa pendidikan kesehatan berdasarkan teori Hildegard Peplau efektif dalam meningkatkan pemahaman dan kemandirian pasien dalam perawatan luka pasca operasi caesar. Kata kunci: pendidikan kesehatan; Teori Hildegard Peplau; perawatan luka mandiri; operasi caesar
Copyright (c) 2025 Dr. Tri Johan Agus Agus Yuswanto, SKp.MKep., Elvina Eka Nur Azmi http://creativecommons.org/licenses/by-nc-nd/4.0
Integrasi Strategi Berbasis Akar Penyebab dan Perbaikan Berkelanjutan untuk Menurunkan Risiko Kerja dan Meningkatkan Efisiensi Pengelolaan Lingkungan Tambang Secara Sistemik
The coal mining industry is a vital sector for national energy security, but it carries a high risk of workplace accidents and environmental damage. The objective of this study is to explore an integrative strategy between occupational health and safety systems and environmental management with a continuous improvement approach at coal mine sites. This study employed a qualitative approach. Data collection techniques used were observation, interviews, and document analysis. Analytical instruments used included a Fishbone diagram to identify root causes and a SWOT–TOWS Matrix to formulate improvement strategies. The results showed a 68% increase in workplace accidents by 2023 due to a weak safety culture, lack of comprehensive training, and indecisive field supervision. The Fishbone analysis identified five main categories of causes: Man, Method, Material, Machine, and Environment. Furthermore, the SWOT analysis revealed internal strengths such as the existence of a mining safety management system and experienced supervisors, but significant weaknesses were found in the reporting culture and monitoring infrastructure. The combined TOWS strategy recommended the integration of safety technology, digital training, and the establishment of an anonymous and participatory incident reporting system. Internal programs have been shown to support safety culture transformation and strengthened operational oversight. This study concludes that the integration of root cause-based strategies, SWOT–TOWS analysis, and a continuous improvement approach can reduce occupational risks and increase the efficiency of mine environmental management systematically. Keywords: occupational health and safety; environmental management; continuous improvement; coal mine ABSTRAK Industri pertambangan batubara merupakan sektor vital dalam ketahanan energi nasional, namun memiliki tingkat risiko tinggi terhadap kecelakaan kerja dan kerusakan lingkungan. Tujuan penelitian ini adalah mengeksplorasi strategi integratif antara sistem kesehatan dan keselamatan kerja dan pengelolaan lingkungan dengan pendekatan perbaikan berkelanjutan di lokasi tambang batubara. Studi ini menggunakan pendekatan kualitatif, Teknik pengumpulan data yang digunakan adalah observasi, wawancara, dan analisis dokumen. Instrumen analisis yang digunakan meliputi diagram Fishbone untuk identifikasi akar masalah dan SWOT–TOWS Matrix untuk merumuskan strategi peningkatan. Hasil penelitian menunjukkan peningkatan angka kecelakaan kerja sebesar 68% selama 2023 yang disebabkan oleh lemahnya budaya keselamatan, minimnya pelatihan menyeluruh, serta ketidaktegasan pengawasan lapangan. Analisis Fishbone mengidentifikasi lima kategori penyebab utama yaitu Man, Method, Material, Machine, dan Environment. Selanjutnya, analisis SWOT menunjukkan kekuatan internal seperti adanya sistem manajemen keselamatan pertambangan dan pengawas berpengalaman, namun kelemahan signifikan ditemukan dalam budaya pelaporan dan infrastruktur monitoring. Kombinasi strategi TOWS merekomendasikan integrasi teknologi keselamatan, pelatihan digital, serta pembentukan sistem pelaporan insiden yang bersifat anonim dan partisipatif. Program internal terbukti mendukung transformasi budaya keselamatan dan penguatan pengawasan operasional. Penelitian ini menyimpulkan bahwa integrasi strategi berbasis akar penyebab, analisis SWOT–TOWS, dan pendekatan continuous improvement mampu menurunkan risiko kerja dan meningkatkan efisiensi pengelolaan lingkungan tambang secara sistemik. Kata kunci: kesehatan dan keselamatan kerja; pengelolaan lingkungan; perbaikan berkelanjutan; tambang batubara
Copyright (c) 2025 Dedy Waliyan, Rahmat Wahyudi Putra http://creativecommons.org/licenses/by-nc-nd/4.0
Pemberian Edukasi Berbasis Teori Betty Neuman untuk Meningkatkan Kesiapan Pasien dalam Menghadapi Operasi
Patients undergoing surgery often experience fear and anxiety, which can affect their preparedness. Preoperative education is expected to improve patient preparedness. The purpose of this study was to analyze the effect of Betty Neuman's theory-based education on patient preparedness for surgery in the hospital. This study used a two-group pretest–posttest design. A total of 112 respondents were selected using a simple random sampling technique. Patient preparedness was measured by completing a questionnaire. Data analysis was performed using the Wilcoxon and Mann–Whitney tests. The results of the hypothesis test regarding differences in patient preparedness for surgery in the control and intervention groups showed a p-value of 0.001 for administrative, physical, and mental preparedness, indicating a difference in patient preparedness for surgery between the groups. In this case, after receiving Betty Neuman's theory-based education, patient preparedness improved. The conclusion of this study states that Betty Neuman's theory-based education is effective in improving patient preparedness for surgery. Keywords: Betty Neuman's theory; education; patient preparedness; preoperative ABSTRAK Pasien yang akan menjalani operasi sering mengalami ketakutan dan kecemasan yang dapat memengaruhi kesiapan pasien. Edukasi praoperasi diharapkan dapat meningkatkan kesiapan pasien. Tujuan penelitian ini adalah menganalisis pengaruh edukasi berbasis teori Betty Neuman terhadap kesiapan pasien dalam menghadapi operasi di rumah sakit. Penelitian ini menggunakan desain two-group pretest–posttest. Sebanyak 112 responden dipilih menggunakan teknik simple random sampling. Kesiapan pasien diukur melalui pengisian kuesioner. Analisis data dilakukan menggunakan uji Wilcoxon dan Mann–Whitney. Hasil uji hipotesis tentang perbedaan kesiapan pasien dalam menghadapi operasi pada kelompok kontrol dan kelompok intervensi menunjukkan nilai p = 0,001 pada kesiapan administrasi, fisik, dan mental, yang artinya ada perbedaan kesiapan pasien dalam menghadapi operasi antara kelompok. Dalam hal ini, setelah diberikan edukasi berbasis teori Betty Neuman terbentuk kesiapan pasien yang lebih baik. Kesimpulan penelitian ini menyatakan bahwa edukasi berbasis teori Betty Neuman efektif untuk meningkatkan kesiapan pasien dalam menghadapi operasi. Kata kunci: teori Betty Neuman; edukasi; kesiapan pasien; pra operasi
Copyright (c) 2026 Yunita Indah Sari http://creativecommons.org/licenses/by-nc-nd/4.0
Pemetaan Kepadatan Penduduk, Status Vaksinasi dan Kejadian Gigitan Hewan Penular Rabies
Rabies is a zoonotic disease that attacks the central nervous system and is almost always fatal. Spatial analysis is important to understand the distribution of rabies-transmitting animal bite cases and the factors that influence them. The purpose of this study was to determine the distribution of rabies-transmitting animal bite cases based on vaccination status and population density, as well as spatial distribution patterns. This research was an analytical study with an ecological approach, a population study of 79 respondents who received rabies-transmitting animal bite cases. Primary data were collected through field observations and questionnaires, while spatial analysis was conducted using GeoDa software with a spatially weighted regression method. The results showed that the animals that transmit rabies are dogs (80%), cats (19%), and monkeys (1%). The most cases occurred in Petobo Village (60.8%), and the rest in South Birobuli (39.2%). A total of 51.9% of cases had incomplete vaccination status. Spatial analysis showed that population density (p = 0.000) and vaccination status (p = 0.000) significantly influenced the incidence of rabies-transmitting animal bites. The spatial distribution pattern was shown to be clustered with a p-value of 0.002309. In conclusion, population density and vaccination status are important factors influencing the incidence of rabies-transmitting animal bites, with cases tending to be clustered. Keywords: rabies-transmitting animal bites; rabies; spatial analysis; population density; vaccine ABSTRAK Rabies adalah penyakit zoonosis yang menyerang sistem saraf pusat dan hampir selalu berakibat fatal. Analisis spasial menjadi penting untuk memahami pola penyebaran kasus gigitan hewan penular rabies dan faktor yang memengaruhinya. Tujuan penelitian ini adalah mengetahui distribusi kasus gigitan hewan penular rabies berdasarkan status vaksinasi dan kepadatan penduduk, serta pola sebaran spasial. Penelitian ini merupakan studi analitik dengan pendekatan ekologi, merupakan studi populasi terhadap 79 responden kasus gigitan hewan penular rabies. Data primer dikumpulkan melalui observasi lapangan dan kuesioner, sedangkan analisis spasial dilakukan menggunakan perangkat lunak GeoDa dengan metode spatially weighted regression. Hasil penelitian menunjukkan hewan penular rabies adalah anjing (80%), kucing (19%) dan kera (1%). Kasus terbanyak terjadi di Kelurahan Petobo (60,8%) dan sisanya di Birobuli Selatan (39,2%). Sebanyak 51,9% kasus memiliki status vaksinasi tidak lengkap. Analisis spasial menunjukkan kepadatan penduduk (p = 0,000) dan status vaksinasi (p = 0,000) berpengaruh secara signifikan terhadap kejadian gigitan hewan penular rabies. Pola distribusi spasial terbukti clustered dengan nilai p = 0,002309. Sebagai kesimpulannya, kepadatan penduduk dan status vaksinasi merupakan faktor penting yang memengaruhi kejadian gigitan hewan penular rabies, dengan distribusi kasus cenderung berkelompok. Kata kunci: gigitan hewan penular rabies; rabies; analisis spasial; kepadatan penduduk; vaksin
Copyright (c) 2026 Nur Hikmah Buchair, Dilla Srikandi Syahadat, Stefiani Bengan Laba, Marselina Palinggi, Nur Fadhilah Sari, Nur Azizah Azzahra http://creativecommons.org/licenses/by-nc-nd/4.0
Human Resources, Work Culture, Leadership and Infrastructure as Aspects of Readiness for Implementing Electronic Medical Records in Dental and Oral Hospital
Electronic medical records play a crucial role in the efficiency, accuracy, and quality of service, so its implementation requires readiness from various aspects. This study aimed to analyze the readiness of electronic medical records implementation at Dental and Oral Hospital of the University of North Sumatera based on four main aspects: human resources, organizational work culture, leadership governance, and information technology infrastructure. The study was conducted at Dental and Oral Hospital of the University of North Sumatera from November to December 2024 with a quantitative analytical approach using a cross-sectional design. A sample of 71 people was selected through purposive sampling, consisting of healthcare and non-healthcare workers directly involved with the electronic medical records system. The research instrument used a questionnaire based on the DOQ-IT method and was analyzed using SmartPLS. The results showed that the readiness for implementing electronic medical records at Dental and Oral Hospital of the University of North Sumatera was in the "very ready" category, with outer loading values >0.9, Average Variance Extracted >0.5, and Composite Reliability and Cronbach's Alpha values >0.7 for all variables. In conclusion, Dental and Oral Hospital of the University of North Sumatera has a high level of readiness in implementing electronic medical records, both in terms of human resources, work culture, leadership, and infrastructure. Keywords: electronic medical records; implementation; readiness
Copyright (c) 2026 Brilianti Haditya Lareshya, Ermi Girsang, Sri Lestari Ramadhani Nasution http://creativecommons.org/licenses/by-nc-nd/4.0
Terapi Rendam Kaki Air Hangat Campuran Garam dan Kencur untuk Menurunkan Tekanan Darah Sistolik Lansia dengan Hipertensi
Hypertension is a major health problem frequently experienced by the elderly, which can increase the risk of cardiovascular complications such as stroke and heart disease. The purpose of this study was to determine the effect of warm water foot soak therapy mixed with salt and galangal on blood pressure in elderly hypertensive patients. This study used a one-group pretest-posttest design. The sample consisted of 30 elderly patients with hypertension selected using a purposive sampling technique. The intervention was carried out by soaking the feet in warm water at a temperature of 38-40°C mixed with 15 grams of salt and 100 grams of galangal for 10-20 minutes every day for 7 days. Blood pressure measurements were taken before and after the intervention using a digital sphygmomanometer. The results of this study showed a significant decrease in blood pressure after the intervention. The Wilcoxon test showed a p-value of <0.001, which means there was a difference in blood pressure between before and after the warm water foot soak therapy mixed with salt and galangal. Thus, there is a significant effect of warm water foot soak therapy mixed with salt and galangal on reducing blood pressure in elderly hypertensive patients. In conclusion, warm water foot soak therapy with a mixture of salt and galangal is an effective method for lowering blood pressure in elderly people with hypertension. Keywords: hypertension; elderly; warm water foot soak therapy; salt; galangal ABSTRAK Hipertensi merupakan salah satu masalah kesehatan utama yang sering dialami oleh lansia, yang dapat meningkatkan risiko komplikasi kardiovaskular seperti stroke dan penyakit jantung. Tujuan penelitian ini adalah mengetahui pengaruh terapi rendam kaki air hangat campuran garam dan kencur terhadap tekanan darah lansia hipertensi. Penelitian ini menggunakan desain one group pretest-posttest. Sampel terdiri dari 30 lansia dengan hipertensi yang dipilih menggunakan teknik purposive sampling. Intervensi dilakukan dengan merendam kaki menggunakan air hangat bersuhu 38-40°C yang dicampur dengan 15 gram garam dan 100 gram kencur selama 10-20 menit setiap hari selama 7 hari. Pengukuran tekanan darah dilakukan sebelum dan sesudah intervensi menggunakan tensimeter digital. Hasil penelitian ini menunjukkan adanya penurunan signifikan pada tekanan darah sesudah intervensi. Uji Wilcoxon menunjukkan nilai p <0,001, yang berarti terdapat perbedaan tekanan darah antara sebelum dan sesudah terapi rendam kaki air hangat campuran garam dan kencur. Dengan demikian, ada pengaruh signifikan dari terapi rendam kaki air hangat campuran garam dan kencur terhadap penurunan tekanan darah lansia hipertensi. Sebagai kesimpulan, terapi rendam kaki air hangat campuran garam dan kencur merupakan metode yang efektif untuk menurunkan tekanan darah pada lansia dengan hipertensi. Kata kunci: hipertensi; lansia; terapi rendam kaki air hangat; garam; kencur
Copyright (c) 2025 Elma Khoerunnisa, Dava Dio Muhammad Sais, Yulta Kadang, Tri Wahyuni Ismoyowati http://creativecommons.org/licenses/by-nc-nd/4.0
Habbatussauda (Nigella sativa) Sebagai Supresan Nefrotoksisitas pada Tikus Akibat Etilen glikol Ditinjau dari Kadar Kreatinin
Acute renal failure is a kidney disease that occurs acutely and is reversible. This disease is becoming widespread due to the ethylene glycol content in children's syrups, which is harmful to the body and can cause stone buildup, increased serum creatinine, impaired kidney function, and even death. Therefore, materials capable of reducing toxicity caused by ethylene glycol are needed, one of which is black seed (Nigella sativa) which contains thymoquinone compounds to help improve kidney function due to this toxic substance. The purpose of this study was to observe the suppressive factor of black seed against nephrotoxicity due to ethylene glycol in rats as seen from their creatinine levels. This type of research is an experimental analytic with divided control groups (without randomization) using a post-test with control design. Samples were taken at the end of treatment and data were analyzed using the Kruskal-Wallis test. Based on the results of the Kruskal-Wallis statistical test, a p-value of 0.000 was obtained, indicating a difference in creatinine levels in each group, as well as a decrease in creatinine levels after oral administration of black seed extract with a tube at two different doses. Furthermore, it was concluded that administration of black seed extract (Nigella sativa) was proven to be effective as a suppressant against ethylene glycol-induced nephrotoxicity in rats, as assessed by serum creatinine levels. Keywords: kidney disorders; nephrotoxicity; ethylene glycol; black seed; creatinine ABSTRAK Gagal ginjal akut merupakan salah satu penyakit pada ginjal yang terjadi secara akut dan reversibel. Penyakit ini menjadi marak akibat kandungan etilen glikol pada obat sirop anak-anak yang berbahaya bagi tubuh yang dapat menyebabkan penumpukan batu, peningkatan serum kreatinin, gangguan fungsi ginjal, hingga kematian, sehingga diperlukan bahan yang mampu menurunkan toksisitas yang disebabkan oleh etilen glikol, salah satunya habbatussauda (Nigella sativa) yang mengandung senyawa timokuinon untuk membantu memperbaiki fungsi ginjal akibat zat toksik tersebut. Tujuan penelitian ini adalah mengamati faktor supresif habbatussauda terhadap nefrotoksisitas akibat etilen glikol pada tikus ditinjau dari kadar kreatininnya. Jenis penelitian ini adalah analitik eksperimental dengan kontrol terbagi atas kelompok (tanpa randomisasi) menggunakan rancangan post-test with control design. Sampel diambil pada akhir perlakuan dan data dianalisis menggunakan uji Kruskal-Wallis. Berdasarkan hasil uji statistik Kruskal-Wallis diperoleh nilai p = 0,000, yang menunjukkan adanya perbedaan kadar kreatinin pada setiap kelompok, serta terjadi penurunan kadar kreatinin setelah pemberian ekstrak habbatussauda per oral dengan sonde pada dua dosis yang berbeda. Selanjutnya disimpulkan bahwa pemberian ekstrak Habbatussauda (Nigella sativa) terbukti memiliki efektivitas sebagai supresan terhadap nefrotoksisitas yang diinduksi oleh etilen glikol pada tikus, ditinjau dari kadar kreatinin serum. Kata kunci: gangguan ginjal; nefrotoksisitas; etilen glikol; habbatussauda; kreatinin
Copyright (c) 2026 Aqsha Isham, Isra Thristy http://creativecommons.org/licenses/by-nc-nd/4.0
Edukasi dan Konseling Berbasis Gender dalam Pencegahan Kekerasan Seksual pada Remaja
Sexual violence against adolescents is a serious problem that requires gender-based education and counseling interventions in schools. The purpose of this study was to analyze the effectiveness of gender-based education and counseling in improving adolescents' knowledge and attitudes regarding sexual violence prevention. The study used a one-group pre-test–post-test design with 50 proportionally selected female students in grades X–XII. Knowledge and attitude variables were measured using a structured questionnaire that had been tested for validity and reliability. Data were analyzed descriptively and using the Wilcoxon test. The results showed an increase in the mean knowledge score from 70 to 80 and in the attitude score from 62.5 to 74 after the implementation of gender-based education and counseling. The Wilcoxon test showed a significant difference between the knowledge scores before and after the intervention (p = 0.001) and between the attitude scores before and after the intervention (p <0.001). This difference aligns with the increase in the mean score, indicating a positive direction of change. It can be concluded that gender-based education and counseling successfully improved adolescents' knowledge and attitudes regarding sexual violence prevention, and therefore deserves to be recommended as a school-based sexual violence prevention strategy. Keywords: sexual violence; teenagers; education; knowledge; attitude ABSTRAK Kekerasan seksual pada remaja merupakan masalah serius yang menuntut adanya intervensi edukasi dan konseling berbasis gender di lingkungan sekolah. Tujuan penelitian ini adalah menganalisis efektivitas edukasi dan konseling berbasis gender dalam meningkatkan pengetahuan dan sikap remaja tentang pencegahan kekerasan seksual. Penelitian menggunakan desain one-group pre-test–post-test pada 50 siswi kelas X–XII yang dipilih secara proporsional. Variabel pengetahuan dan sikap diukur menggunakan kuesioner terstruktur yang telah diuji validitas dan reliabilitasnya. Data dianalisis secara deskriptif dan dengan uji Wilcoxon. Hasil penelitian ini menunjukkan adanya peningkatan skor rerata pengetahuan dari 70 menjadi 80 dan sikap dari 62,5 menjadi 74 setelah pelaksanaan edukasi dan konseling berbasis gender. Uji Wilcoxon menunjukkan bahwa terdapat perbedaan yang bermakna antara skor pengetahuan sebelum dan sesudah intervensi (p = 0,001) serta antara skor sikap sebelum dan sesudah intervensi (p <0,001). Perbedaan ini sejalan dengan peningkatan skor rerata sehingga menunjukkan arah perubahan yang positif. Dapat disimpulkan bahwa edukasi dan konseling berbasis gender berhasil meningkatkan pengetahuan dan sikap remaja tentang pencegahan kekerasan seksual, sehingga layak direkomendasikan sebagai salah satu strategi pencegahan kekerasan seksual berbasis sekolah. Kata kunci: kekerasan seksual; remaja; edukasi; pengetahuan; sikap
Copyright (c) 2026 Mona Lisa http://creativecommons.org/licenses/by-nc-nd/4.0
Pengetahuan Pasien tentang Karies Gigi di Poli Gigi Puskesmas Kangayan Kepulauan Kangean
The main oral health problem among dental clinic patients is dental caries. A lack of understanding of the etiology of dental caries can contribute to its development. The purpose of this study was to determine the level of understanding of dental caries among dental clinic patients. This descriptive study focused on dental caries among dental clinic patients at the Kangayan Community Health Center in the Kangean Islands. Data were collected through questionnaires, which were then analyzed using descriptive statistics in the form of frequencies and percentages. The findings of this study indicate that the highest level of patient understanding for each component of knowledge is as follows: the importance of dental caries is in the good category (82%), the causes of dental caries are in the sufficient category (73%), the impact of dental caries is in the sufficient category (60%), the prevention of dental caries is in the sufficient category (67%), and the treatment of dental caries is in the low category (48%). It can be concluded that the level of knowledge of dental clinic patients about dental caries at the Kangayan Community Health Center in the Kangean Islands is in the sufficient category. Keywords: dental caries; patients; dental clinic; knowledge ABSTRAK Masalah kesehatan gigi dan mulut yang utama pada pasien poli gigi adalah karies gigi. Kurangnya pemahaman tentang etiologi karies gigi dapat menyebabkan perkembangannya. Tujuan dari penelitian ini adalah untuk mengetahui tingkat pemahaman tentang karies gigi pada pasien di poli gigi. Penelitian ini merupakan studi deskriptif yang berfokus pada karies gigi pada pasien poli gigi di Puskesmas Kangayan di Kepulauan Kangean. Data dikumpulkan melalui pengisian kuesioner, yang selanjutnya dianalisis dengan metode statistika deskriptif berupa frekuensi dan persentase. Temuan penelitian ini menunjukkan Tingkat pemahaman pasien yang paling besar pada masing-masing komponen pengetahuan adalah sebagai berikut: pentingnya karies gigi dalam kategori baik (82%), penyebab karies gigi dalam kategori cukup (73%), dampak karies gigi dalam kategori cukup (60%), pencegahan karies gigi berada dalam kategori cukup (67%), terapi karies gigi dalam kategori rendah (48%). Dapat disimpulkan bahwa tingkat pengetahuan pasien klinik gigi tentang karies gigi di Puskesmas Kangayan Kepulauan Kangean berada pada kategori cukup. Kata kunci: karies gigi; pasien; poli gigi; pengetahuan
Copyright (c) 2026 Lutviana Mardlatillah http://creativecommons.org/licenses/by-nc-nd/4.0
Screen Time Sebagai Prediktor Kejadian Gerakan Tutup Mulut pada Anak Usia Toddler
Covering your mouth is a common eating problem in toddlers and can interfere with nutritional needs. Meanwhile, screen time exposure is increasing and is often associated with passive eating behavior. The purpose of this study was to analyze the relationship between screen time and the occurrence of cover-up movements in toddlers. The study used a cross-sectional design, involving 83 toddlers selected through cluster purposive sampling. Screen time data were collected based on American Academy of Pediatrics categories, while cover-up movements were measured using the CEBQ questionnaire with 24 Likert-scale items (validity test r = 0.383–0.716; Cronbach's α = 0.887). Analysis was performed using the Spearman correlation test. The results showed a significant relationship between screen time and the occurrence of cover-up movements, with a correlation coefficient of r = 0.751 and p = 0.000. The longer the duration of screen time, the higher the likelihood of children experiencing GTM. This study concludes that screen time duration is a determinant of cover-up movements in toddlers. Keywords: screen time; gadgets; cover-up movements; toddler ABSTRAK Gerakan tutup mulut merupakan masalah makan yang umum terjadi pada anak usia toddler dan dapat mengganggu pemenuhan nutrisi, sementara paparan screen time semakin meningkat dan sering dikaitkan dengan perilaku makan pasif. Tujuan penelitian ini adalah menganalisis hubungan anara screen time dengan kejadian gerakan tutup mulut pada anak usia toddler. Penelitian menggunakan desain cross-sectional, yang melibatkan 83 toddler, yang dipilih melalui teknik cluster purposive sampling. Data screen time dikumpulkan berdasarkan kategori American Academy of Pediatrics, sedangkan gerakan tutup mulut diukur menggunakan kuesioner CEBQ dengan 24 item skala Likert (uji validitas r = 0,383–0,716; cronbach α = 0,887). Analisis dilakukan menggunakan uji korelasi Spearman. Hasil penelitian menunjukkan adanya hubungan yang signifikan antara screen time dan kejadian gerakan tutup mulut dengan koefisien korelasi r = 0,751 dan p = 0,000. Semakin tinggi durasi screen time, semakin tinggi kecenderungan anak mengalami GTM. Penelitian ini menyimpulkan bahwa durasi screen time merupakan determinan gerakan tutup mulut pada toddler. Kata kunci: screen time; gawai; gerakan tutup mulut; toddler
Copyright (c) 2026 Putri Kartika Dewi, Iis Aisyah, Rafika Rosyda http://creativecommons.org/licenses/by-nc-nd/4.0
Strategi Intervensi Peningkatan Kualitas Hidup Orang dengan HIV/AIDS
Quality of life in people with HIV/AIDS is influenced by various factors, including stigma, adherence to antiretroviral therapy, and social support. The aim of this study was to synthesize interventions that have been implemented to improve quality of life in people with HIV/AIDS based on recent primary research. This systematic review included articles published between January 2018 and August 2022, retrieved from seven databases: ScienceDirect, SAGE Journals, EBSCOHost, PubMed, Scopus, ProQuest, and Wiley Online. Inclusion criteria included randomized controlled trials involving people with HIV/AIDS, articles in English, and full-text submissions. Of the 965 articles identified, 10 met the inclusion criteria. Reported interventions included telemonitoring, yoga, cognitive behavioral therapy, community empowerment, and social support. Most interventions demonstrated a positive impact on quality of life, particularly in the psychological, social, and spiritual domains. The interventions lasted three to six months, with better outcomes in longer-term programs. Family involvement and interdisciplinary collaboration were concluded as key contributing factors to the success of the interventions. Keywords: people with HIV/AIDS; quality of life; antiretroviral therapy; social support ABSTRAK Kualitas hidup pada orang dengan HIV/AIDS dipengaruhi oleh berbagai faktor, termasuk stigma, kepatuhan terhadap terapi antiretroviral, dan dukungan sosial. Tujuan studi ini adalah mensintesis berbagai intervensi yang telah diterapkan untuk meningkatkan kualitas hidup pada orang dengan HIV/AIDS berdasarkan penelitian primer terbaru. Tinjauan sistematis ini mencakup artikel yang diterbitkan antara Januari 2018 hingga Agustus 2022, yang didapatkan dari tujuh database yaitu ScienceDirect, SAGE Journals, EBSCOHost, PubMed, Scopus, ProQuest, dan Wiley Online. Kriteria inklusi meliputi randomized controlled trial dengan melibatkan orang dengan HIV/AIDS, artikel berbahasa Inggris dan memuat teks lengkap. Dari 965 artikel yang diidentifikasi, 10 artikel memenuhi kriteria inklusi. Intervensi yang dilaporkan meliputi telemonitoring, yoga, cognitive behavioral therapy, pemberdayaan komunitas, dan dukungan sosial. Sebagian besar intervensi menunjukkan dampak positif pada kualitas hidup, terutama dalam domain psikologis, sosial, dan spiritual. Durasi intervensi adalah tiga hingga enam bulan, dengan hasil yang lebih baik pada program jangka panjang. Disimpulkan bahwa keterlibatan keluarga dan kolaborasi lintas disiplin menjadi faktor pendukung utama keberhasilan intervensi. Kata kunci: orang dengan HIV/AIDS; kualitas hidup; terapi antiretroviral; dukungan sosial
Copyright (c) 2026 Zunaidi Ahmad http://creativecommons.org/licenses/by-nc-nd/4.0