Journal of Medical Practice and Research
Essentia: Journal of Medical Practice and Research is a peer-reviewed scientific journal published biannually (June and December) by CV SCRIPTA INTELEKTUAL MANDIRI. It focuses on publishing research and innovative practices in medicine and health sciences, including clinical medicine, public health, nursing, pharmacy, biomedical sciences, medical education, health management, and complementary medicine. All articles are open access under a CC BY-SA 4.0 license, with no article processing charges (APC-free).
The Effect of Self-Affirmation on Anxiety Levels in Preoperative Patients
Anxiety is a common psychological response experienced by preoperative patients, arising from concerns about surgical outcomes, pain, potential complications, and fear of death. This condition can affect both physiological and psychological stability and may hinder the recovery process. One simple intervention to reduce anxiety is self-affirmation, a cognitive-behavioral approach that utilizes positive statements. This study aims to analyze the effect of self-affirmation on anxiety levels among preoperative patients in the Mawar ward of RSUD Kajen. The study employed a pre-experimental method with a pretest-posttest design. A total of 60 respondents were selected using purposive sampling. The instruments used included a standard operating procedure (SOP) for self-affirmation and the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Data were analyzed using the Wilcoxon test. The results showed that all respondents experienced moderate anxiety before the intervention, which decreased after self-affirmation to mild anxiety (16.7%) and moderate anxiety (83.3%). Statistical analysis indicated that all respondents experienced a reduction in anxiety (negative rank = 60) with a p-value of 0.000 (p < 0.05). It is concluded that self-affirmation is effective in reducing anxiety among preoperative patients.
Anxiety, Preoperative patients, Pretest-posttest, Psychological techniques, Self-affirmation.
Copyright (c) 2026 Sri Saptiningsih, Endang Supriyanti (Author) https://creativecommons.org/licenses/by-sa/4.0
Management of Stage 1 Hypertension in a 38-Year-Old Female Patient Using a Family Medicine Approach at the Nisam Community Health Center in North Aceh Regency
This study aimed to analyze the implementation of a family medicine approach in managing stage 1 hypertension in a 38-year-old female patient at a primary healthcare facility. The research employed an empirical case report design with a qualitative descriptive approach, integrating clinical assessment, behavioral evaluation, and family-based analysis. Data were collected through in-depth anamnesis, physical examination, home visits, and the use of family medicine instruments, including genogram, APGAR, and SCREEM. The findings demonstrated that comprehensive management combining pharmacological therapy, lifestyle modification, and family involvement contributed to improved blood pressure control and enhanced patient adherence. Behavioral changes were observed in dietary patterns, physical activity, and stress management, supported by strengthened family support systems. The integration of patient-centered care and contextual family assessment enabled more sustainable health outcomes compared to conventional approaches. These results highlight the importance of holistic, continuous, and family-oriented care in managing hypertension at the primary care level, particularly among productive-age patients with modifiable risk factors and complex psychosocial backgrounds.
Hypertension, Family Medicine, Primary Care, Lifestyle Modification, Patient-Centered Care.
Copyright (c) 2026 Aida Fitri Harahap, Noviana Zara (Author) https://creativecommons.org/licenses/by-sa/4.0
Management of Tinea Corporis and Grade II Obesity in a 50-Year-Old Female Patient Using a Family Medicine Approach at the Nisam Community Health Center in North Aceh Regency
Tinea corporis represents a common superficial dermatophyte infection in tropical regions, often exacerbated by behavioral, environmental, and metabolic risk factors. This study aimed to comprehensively analyze the management of tinea corporis with grade II obesity in a 50-year-old female patient using a family medicine approach at a primary healthcare facility. The study employed an empirical descriptive case report design integrating clinical findings, structured anamnesis, physical examination, and home visit assessment to identify multidimensional determinants of disease. Results demonstrated chronic pruritic annular lesions with characteristic scaling and central healing, supported by stable vital signs and absence of systemic involvement. Behavioral factors such as habitual scratching, shared personal items, and limited health literacy were identified alongside environmental contributors including household density. Obesity further influenced disease persistence through increased skin moisture. A comprehensive intervention combining antifungal therapy and family-based education improved disease management outcomes. The findings highlight the importance of integrating clinical, behavioral, and familial dimensions to enhance therapeutic effectiveness. The family medicine approach provides a strategic framework for addressing chronic dermatological conditions through holistic, patient-centered care.
Tinea Corporis, Obesity, Family Medicine, Risk Factors, Holistic Therapy.
Copyright (c) 2026 Yolanda Agtari, Noviana Zara (Author) https://creativecommons.org/licenses/by-sa/4.0
Cardiovascular Disease Risk Score Correlates with Glomerular Filtration Rate in Hemodialysis Patients: A Cross-Sectional Pilot Study
Chronic kidney disease is closely linked to an elevated risk of cardiovascular morbidity and mortality, particularly among patients undergoing hemodialysis. This study aimed to examine the relationship between cardiovascular disease risk scores and renal function using an empirical cross-sectional design. A total of 72 eligible patients receiving hemodialysis were assessed using the World Health Organization Risk Prediction Chart for Southeast Asia Region B to estimate 10-year cardiovascular risk. Renal function was evaluated using the Cockcroft–Gault equation to determine glomerular filtration rate values. Descriptive analysis demonstrated a predominance of high cardiovascular risk categories alongside severely reduced renal function. Inferential analysis using the Spearman rank correlation test revealed a statistically significant inverse relationship between cardiovascular risk score and glomerular filtration rate (r = -0.637; p = 0.000). These findings indicate that higher cardiovascular risk is associated with more severe renal impairment. The results support the integration of cardiovascular risk assessment into routine clinical evaluation of patients with chronic kidney disease undergoing hemodialysis to improve early risk stratification and management strategies.
Chronic Kidney Disease, Cardiovascular Risk, Glomerular Filtration Rate, Hemodialysis, SEAR B Score.
Copyright (c) 2026 Nabil Hajar, Bintang Adhiyoso Wicaksono, Zulfachmi Wahab, Shofa Chasani, Galih Prakasa Adhyatma, Nabila Nuralya Joveazhari, Zeidan Ahmad Fahdalhaq (Author) https://creativecommons.org/licenses/by-sa/4.0
The Effect of Ankle Pump Exercise Combined with 30-Degree Leg Elevation on the Severity of Edema in Patients with Chronic Kidney Disease at Roemani Muhammadiyah Hospital in Semarang
Chronic kidney disease is frequently associated with fluid imbalance leading to peripheral edema, which negatively affects patient comfort and functional capacity. This study aimed to evaluate the effectiveness of ankle pump exercise combined with 30° leg elevation in reducing edema severity among patients undergoing hemodialysis. An empirical case study design with a one group pretest–posttest approach was applied to five patients diagnosed with chronic kidney disease and lower extremity edema at Roemani Muhammadiyah Hospital, Semarang. Data were collected through structured clinical observation using standardized edema grading before and after a three-day intervention protocol consisting of dorsiflexion and plantarflexion movements followed by leg elevation. The findings demonstrated a consistent reduction in edema degree across all participants, with clinical improvement observed both in measurement scale and categorical severity. The results suggest that the intervention facilitates venous return and reduces interstitial fluid accumulation through mechanical and gravitational mechanisms. This study highlights the clinical relevance of simple, non-pharmacological interventions as supportive strategies in managing edema among chronic kidney disease patients.
Ankle Pump Exercise, Elevasi Kaki 30 Derajat, Edema, Gagal Ginjal Kronik, Hemodialisa.
Copyright (c) 2026 Siti Kurniatun, Rahayu Winarti P (Author) https://creativecommons.org/licenses/by-sa/4.0
The Effect of Early Mobilization on Post-Cesarean Section Mothers on the Reduction of Postoperative Pain in the Postpartum Ward at Budi Rahayu Hospital, Pekalongan, in 2025
This study aimed to analyze the effect of early mobilization on postoperative pain reduction among post-cesarean mothers in the maternity ward of Budi Rahayu Hospital Pekalongan in 2025. A quasi-experimental design with a one-group pretest–posttest approach was applied involving post-cesarean mothers within 24–48 hours after surgery. Data were collected using the Numeric Rating Scale to measure pain intensity and observational sheets to assess functional mobility. The findings indicated a significant decrease in pain intensity following the implementation of early mobilization, supported by physiological mechanisms such as improved blood circulation, reduced muscle tension, and endorphin stimulation. In addition, several determinants including family support, patient knowledge, and healthcare provider involvement contributed to the effectiveness of the intervention. Early mobilization also demonstrated clinical implications in preventing postoperative complications and enhancing functional recovery. These results highlight the importance of integrating physical, psychological, and social approaches in nursing care to optimize recovery outcomes among post-cesarean patients.
Early Mobilization, Post Cesarean Section, Postoperative Pain, Maternal Nursing Care, Recovery Outcome.
Copyright (c) 2026 Lutfiyaningsih Lutfiyaningsih, Desi Risqiani, Dumilah Urip, Elisabet Indah Lestari, Heni Prasetyorini (Author) https://creativecommons.org/licenses/by-sa/4.0
The Relationship Between Self-Efficacy and Stress Coping Among Cancer Patients at Colombia Asia Hospital in Semarang
This study examines the relationship between self-efficacy and stress coping strategies among cancer patients at Columbia Asia Hospital Semarang using a quantitative correlational design with a cross-sectional approach. The study involved 30 cancer patients selected through non-probability sampling based on predefined inclusion criteria. Data were collected using validated instruments, namely the General Self-Efficacy Scale (GSE) and Brief COPE Inventory, and analyzed using univariate and Spearman rank correlation tests. The findings indicate that most patients demonstrated moderate levels of self-efficacy and coping strategies, reflecting an ongoing psychological adaptation process to disease-related stressors. A statistically significant and very strong positive correlation (ρ = 0.926; p < 0.05) was identified between self-efficacy and coping strategies, suggesting that higher self-efficacy is associated with more adaptive coping mechanisms. These results highlight the critical role of self-efficacy as a psychological determinant in managing stress among cancer patients. The study underscores the need for integrating psychosocial interventions into oncology care to enhance patients’ adaptive capacity, improve treatment adherence, and promote overall well-being.
Self-Efficacy, Coping Stress, Cancer Patients, Psychological Adaptation, Oncology Care.
Copyright (c) 2026 Budi Lestari, Dwi Retnaningsih, Menik Kustriyani (Author) https://creativecommons.org/licenses/by-sa/4.0
Midwives’ Knowledge and Practices in Implementing Respectful Maternity Care in Antenatal Care: A Systematic Literature Review
This study aimed to systematically synthesize evidence regarding midwives’ knowledge and practices in implementing Respectful Maternity Care (RMC) within antenatal care (ANC) services. A non-empirical approach using a systematic literature review was conducted by analyzing peer-reviewed articles retrieved from major international databases, guided by the PICO framework and PRISMA protocol. The findings indicate that midwives generally demonstrate moderate levels of knowledge regarding RMC, yet this understanding does not consistently translate into respectful clinical practices. Variability in implementation is influenced by interpersonal competencies, professional values, and contextual constraints within healthcare systems. Evidence also reveals that structural determinants, including institutional policies, resource availability, and organizational culture, significantly shape the extent to which RMC principles are applied in routine care. Moreover, women’s preferences for more personalized and respectful services highlight the importance of relational dimensions in maternal healthcare. These findings underscore the need for integrated strategies that combine continuous professional education, ethical reinforcement, and systemic reform to ensure the consistent application of RMC. Strengthening these dimensions is essential for improving maternal care quality and advancing global maternal health outcomes.
Respectful Maternity Care, Antenatal Care, Midwives, Knowledge, Practice.
Copyright (c) 2026 Apria Hartina Aghna, Endang Surani (Author) https://creativecommons.org/licenses/by-sa/4.0
The Effect of Combining IMD and KMC with a Long Coat on Physiological Stress Responses and Sucking Reflexes in Infants with Mild Asphyxia at the Bawang Maternity Clinic
Acute pain is a common clinical problem experienced by patients after undergoing breast surgery such as Mastectomy, which may affect comfort, mobility, and recovery during the postoperative period. Effective pain management is essential in nursing care, and non-pharmacological approaches are increasingly utilized to complement pharmacological therapy. This study aimed to analyze the implementation of the Benson relaxation technique in reducing acute pain among post-mastectomy patients treated at Bougenville 1 Ward of SMC Telogorejo Hospital Semarang. The research employed an empirical clinical case study design involving four patients selected through purposive sampling based on predetermined inclusion and exclusion criteria. The intervention consisted of the Benson relaxation technique performed for 10–15 minutes daily for three consecutive days. Pain intensity was measured using the Numeric Rating Scale before and after each intervention session. The findings demonstrated a gradual decrease in pain intensity among all participants, shifting from moderate–severe pain before intervention to mild pain by the third day. These results suggest that Benson relaxation can serve as an effective complementary nursing intervention for postoperative pain management.
Benson Relaxation, Acute Pain, Mastectomy, Nursing Intervention, Pain Management
Copyright (c) 2026 Daryati Daryati (Author) https://creativecommons.org/licenses/by-sa/4.0
The Relationship Between Spiritual Well-Being and Quality of Life Among Patients with Type 2 Diabetes Mellitus at the Petungkriyono Community Health Center in Pekalongan Regency
Type 2 diabetes mellitus represents a chronic metabolic disorder that may affect patients’ physical, psychological, and social well-being, thereby influencing their overall quality of life. Spiritual well-being has been recognized as an important psychosocial resource that may support coping and adaptation among individuals living with chronic illness. This study aimed to examine the relationship between spiritual well-being and quality of life among patients with type 2 diabetes mellitus receiving primary healthcare services at Puskesmas Petungkriyono, Pekalongan Regency. A quantitative cross-sectional design was employed involving 41 respondents selected through consecutive sampling. Data were collected using the Spiritual Well-Being Scale (SWBS) and the Diabetes Quality of Life (DQOL) instrument. Statistical analysis was conducted using the Spearman rank correlation test with a significance level of p < 0.05. The findings indicated that most participants demonstrated high levels of spiritual well-being and good quality of life. Statistical analysis revealed a significant positive correlation between spiritual well-being and quality of life (p = 0.006; r = 0.423). These results highlight the importance of incorporating spiritual dimensions within holistic healthcare approaches to enhance psychosocial adaptation and well-being among individuals living with type 2 diabetes mellitus.
Spiritual Well-Being, Quality Of Life, Type 2 Diabetes Mellitus, Chronic Illness, Primary Healthcare.
Copyright (c) 2026 Dirgantara Dwi Saputra, Menik Kustriyani, Rahayu Winarti P (Author) https://creativecommons.org/licenses/by-sa/4.0
An Overview of Obesity Among Adolescents in Junior and Senior High Schools Under the Jurisdiction of the Gilingan Community Health Center in Surakarta
Background: Obesity in adolescents has become a serious global health issue as it increases the risk of various degenerative diseases. Based on Health Office data, the Gilingan Public Health Center recorded the highest prevalence of adolescent obesity in the Surakarta City area. Objective: This study aims to determine the profile of obesity incidence among Junior High (SMP) and Senior High (SMA) students under the jurisdiction of Gilingan Public Health Center. Methods: This study utilized a descriptive design with a quantitative approach. The population included 2,483 students across nine schools. The sampling technique employed was total sampling using secondary data from health screening results, including body weight, height, gender, and age. Results: The study showed that the majority of respondents were middle adolescents aged 14-16 (1,280 respondents; 51.6%) and were dominated by females (1,357 respondents; 54.7%). Based on BMI categories, most of the sample experienced Class I Obesity, totaling 901 respondents (36.3%). Conclusion: The incidence of obesity in schools managed by the Gilingan Public Health Center is dominated by female adolescents and the middle adolescent age group, the majority of whom experience Class I Obesity.
Adolescent Obesity, Nutritional Status, Lifestyle Behavior, School Health, Public Health.
Copyright (c) 2026 Fakha Putri Vivian, Zulfa Mahdiatur Rasyida (Author) https://creativecommons.org/licenses/by-sa/4.0
Psychosocial Factors Associated with Depression among Elderly with Chronic Disease
Depression represents a significant mental health concern among elderly individuals living with chronic diseases, particularly in community healthcare settings where long-term illness management may generate psychological stress. This study aimed to examine the association between psychosocial factors and depression among older adults with chronic diseases. A quantitative analytic study with a cross-sectional design was conducted among 52 elderly individuals diagnosed with hypertension or type 2 diabetes mellitus in the working area of Patuk II Primary Health Care, Gunungkidul Regency, Indonesia. Data were collected using standardized instruments including the Brief COPE Inventory, the Family Support Scale, and the Patient Health Questionnaire-9 (PHQ-9). Descriptive analysis indicated that most participants demonstrated high coping mechanisms and moderate to high levels of family support, while depressive symptoms were present in a smaller proportion of respondents. Spearman rank correlation analysis revealed significant negative associations between coping mechanisms and depression (r = −0.523; p < 0.001) as well as between family support and depression (r = −0.499; p < 0.001). These findings highlight the importance of strengthening psychosocial resources in order to reduce depression risk and promote psychological well-being among elderly individuals with chronic diseases.
Coping Mechanisms, Family Support, Depression, Elderly, Chronic Disease.
Copyright (c) 2026 Pradana Satya Kiran, Rafli Bagas Nugroho, Ahmad Qolbiy https://creativecommons.org/licenses/by-sa/4.0
The Application of the Benson Relaxation Technique for Acute Pain in Post-Mastectomy Patients at SMC Telogorejo Hospital
Copyright (c) 2026 Surani Suci Pratiwi, Rahayu Winarti (Author) https://creativecommons.org/licenses/by-sa/4.0
Literature Review: Characteristics of Mothers with Cesarean Section (CS) Delivery
Cesarean section has become one of the most frequently performed obstetric procedures worldwide and reflects complex interactions between maternal characteristics, reproductive history, and clinical conditions that emerge during pregnancy and childbirth. This study aimed to analyze the profile of mothers undergoing cesarean delivery through a descriptive literature review of scientific publications and national health reports. Relevant literature was obtained from reputable academic databases and official health documents to identify consistent patterns in maternal characteristics associated with cesarean delivery. The synthesis indicates that demographic attributes such as maternal age, education level, and socioeconomic conditions shape access to healthcare services and influence patterns of delivery management. Obstetric history, including parity, gestational age, and previous delivery experiences, also contributes to variations in delivery pathways and clinical decision-making. In addition, several medical indications, including hypertensive disorders of pregnancy, fetal distress, and other obstetric complications, represent important determinants underlying the performance of cesarean procedures. These interconnected factors demonstrate that cesarean delivery reflects not only clinical necessity but also broader maternal health profiles within healthcare systems. Understanding these multidimensional characteristics provides an important foundation for strengthening maternal health strategies and improving evidence-based obstetric care.
Cesarean Section, Maternal Characteristics, Obstetric Factors, Maternal Health, Delivery Outcomes.
Copyright (c) 2026 Suliswanti Suliswanti, Endang Surani (Author) https://creativecommons.org/licenses/by-sa/4.0
Impacts of Air Pollution and Microplastics on Environmental Health in the Era of Climate Change
Environmental health challenges in the twenty-first century increasingly arise from the interaction between atmospheric pollution, plastic contamination, and climate change. This study examines the impacts of air pollution and microplastic exposure on environmental health using a quantitative descriptive approach combined with a systematic literature review based on secondary data. Scientific articles were retrieved from PubMed, Scopus, and ScienceDirect, resulting in 156 initial publications, of which 38 studies met the inclusion criteria and were analyzed. The synthesis integrates global datasets from the World Health Organization, Institute for Health Metrics and Evaluation, OECD reports, and national environmental statistics. Findings indicate that ambient air pollution contributes to approximately 6.67 million premature deaths annually, with average PM₂.₅ exposure reaching 29 µg/m³, substantially exceeding the WHO recommended limit of 5 µg/m³. Global plastic production increased dramatically from 2 million tons in 1950 to 460 million tons in 2021, while only 9% of plastic waste is recycled, facilitating the formation of microplastics detected in human blood, lungs, and gastrointestinal samples. Plastic production also generates approximately 1.8 gigatons of CO₂ emissions annually, strengthening the linkage between pollution and climate change. The results highlight synergistic environmental health risks arising from combined exposure to particulate pollution and microplastics, emphasizing the importance of integrated environmental health policies and climate mitigation strategies..
Air Pollution, Climate Change, Environmental Health, Microplastics, One Health.
Copyright (c) 2026 Rafidha Nur Alifah, Akhmal Raziq Kharazi, Umi Masviroh (Author) https://creativecommons.org/licenses/by-sa/4.0
Application of Oxytocin Massage to Increase Breast Milk Production in Post-Cesarean Patients at Alamanda Room, PKU Muhammadiyah Pekajangan Hospital
This empirical descriptive case study explored the implementation of oxytocin massage to improve breast milk flow among post–Sectio Caesarea mothers in the Alamanda Ward of RSI PKU Muhammadiyah Pekajangan. Five participants were selected through purposive sampling based on predefined inclusion and exclusion criteria. Data were collected using structured observation sheets assessing lactation indicators, clinical responses, and implementation quality over three consecutive days. Findings indicate that oxytocin massage was associated with progressive stabilization of postoperative physiological conditions, enhanced maternal readiness for breastfeeding, and consistent clinical implementation aligned with institutional standard operating procedures. The integration of structured monitoring and complete documentation supported reliable evaluation of lactation outcomes within the case-study framework. The results highlight that effective implementation quality plays a crucial role in maximizing the neurohormonal mechanisms underlying milk ejection reflexes in post-surgical mothers. These findings support the incorporation of oxytocin massage as an evidence-informed, non-pharmacological nursing intervention to optimize lactation management in post–Sectio Caesarea care settings.
Oxytocin Massage, Breast Milk Flow, Post Cesarean Section, Lactation Management, Nursing Intervention.
Copyright (c) 2026 Pitriasih Handayani, Nuzulia Fitriani, Iskandar yusuf, Shisca Octavia Maharani, Yuliati Yuliati, Wahyuningsih Wahyuningsih (Author) https://creativecommons.org/licenses/by-sa/4.0
Effectiveness of Imagery Relaxation Therapy on Blood Pressure Levels Among Elderly Patients with Hypertension
Hypertension remains a leading contributor to cardiovascular morbidity among older adults, particularly in rural populations with limited access to comprehensive management strategies. This study examined the effectiveness of imagery relaxation therapy on blood pressure levels among elderly patients with hypertension using a quantitative pre-experimental one-group pretest–posttest design. Forty-nine participants aged 60–70 years underwent a structured 10–15 minute imagery relaxation session, and blood pressure was measured immediately before and after the intervention. Paired sample t-tests revealed a significant reduction in systolic blood pressure (mean difference = 17.43 mmHg; 95% CI: 13.76–21.10; p < 0.001) and diastolic blood pressure (mean difference = 7.71 mmHg; 95% CI: 6.56–8.87; p < 0.001). Additionally, 69.4% of participants demonstrated improvement in blood pressure category, with no cases of deterioration observed. These findings indicate that imagery relaxation therapy yields clinically meaningful hemodynamic benefits and may serve as an effective adjunctive intervention within community-based hypertension management for elderly populations.
Imagery Relaxation Therapy, Hypertension, Elderly, Blood Pressure, Non-Pharmacological Intervention.
Copyright (c) 2026 Aulia Pradana Satya Kiran, Suri Salmiyati, Zubaida Rohmawati (Author) https://creativecommons.org/licenses/by-sa/4.0
The Effect of Ar-Rahman Surah Recitation Therapy and Lavender Aromatherapy on Sleep Quality in Chronic Kidney Failure Patients Undergoing Hemodialysis at Sari Asih Hospital, Ciputat
Introduction: Hemodialysis is a treatment for chronic kidney failure, one of the side effects of which is sleep disturbance. The purpose of this study was to determine the effect of murottal therapy of Surah Ar-Rahman and lavender aromatherapy on sleep quality in chronic kidney failure patients undergoing hemodialysis. Methods: This type of research is a pre-experimental study with a pretest-posttest design without a control group using a purposive sampling technique with 32 respondents. Data collection used the PSQI questionnaire. Data were collected before and after the intervention was given and then processed statistically using the Wilcoxon test. Results: There is an effect of murottal therapy of the Ar-Rahman letter and lavender aromatherapy on sleep quality in patients with chronic kidney failure undergoing hemodialysis with a p value of 0.000. Conclusions: The application of murottal therapy of the Ar-Rahman letter and lavender aromatherapy can improve the quality of sleep of chronic kidney failure patients undergoing hemodialysis and this intervention can be recommended.
Chronic Kidney Disease, Hemodialysis, Qur’anic Murottal Therapy of Surah Ar-Rahman, Lavender Aromatherapy, Sleep Quality.
Copyright (c) 2026 Nur Sri Tuti, Hernandia Distinarista, Tutik Rahayu (Author) https://creativecommons.org/licenses/by-sa/4.0
The Relationship Between Effective Communication and Service Quality at Sultan Agung Islamic Hospital in Semarang
Background: Effective communication is an essential element in patient-centered healthcare, as it functions to build trust, reduce anxiety, and improve patient adherence to the treatment plan. However, communication gaps between healthcare providers and patients are still found, which can negatively impact treatment success and patient satisfaction. A preliminary study at RSI Sultan Agung Semarang showed that 80% of respondents stated they were satisfied with the communication and quality of services provided, making this research important to deeply examine the relationship between the two variables. Objective: This study aims to analyze the relationship between effective communication and the quality of services perceived by hospitalized patients at Rumah Sakit Islam Sultan Agung Semarang. Method: This research used an analytical observational design with a cross-sectional approach and a quantitative research type. The independent variable studied was effective communication and the dependent variable was service quality. The total number of respondents in this study was 118 people. Data were collected using questionnaires and analyzed using the Spearman’s rho correlation test to examine the relationship between variables. Results: The results of the bivariate analysis using the Spearman’s rho test indicated a significant relationship between effective communication and service quality. A correlation coefficient (ρ) value of 0.515 was obtained with a significance value of p = 0.000 (p < 0.05).
Effective Communication, Service Quality, Patient Satisfaction, Nursing Care, Patient-Centered Care.
Copyright (c) 2026 Husnul Mubarok, Dyah Wiji Puspita Sari, Retno Issroviatiningrum (Author) https://creativecommons.org/licenses/by-sa/4.0
Application of Progressive Muscle Relaxation Therapy for Preoperative Anxiety in Cesarean Section at Kajen Regional General Hospital, Pekalongan Regency
Background: Sectio Caesarea is a major surgical procedure that often causes anxiety in preoperative patients. Unmanaged anxiety can negatively affect patients’ physiological and psychological conditions and influence their readiness for surgery. One non-pharmacological intervention that nurses can apply to reduce anxiety is Progressive Muscle Relaxation (PMR) therapy, a relaxation technique performed by systematically tensing and relaxing muscle groups to achieve a relaxed state. Methods: This study used a descriptive method with a case study approach employing a one group pre-test and post-test without control design. The subjects consisted of five preoperative Sectio Caesarea patients who met the inclusion criteria. Anxiety levels were measured using the Hamilton Rating Scale for Anxiety (HRS-A) before and after the PMR intervention. The PMR therapy was administered twice, namely on the night before surgery and in the morning before the patient was transferred to the operating room, with a duration of approximately 20 minutes per session. Results: The results showed that prior to the PMR intervention, all respondents were in the moderate anxiety category. After the PMR intervention, anxiety levels decreased in all respondents to the mild anxiety category, as indicated by a consistent reduction in HRS-A scores for each patient.
Progressive Muscle Relaxation, Preoperative Anxiety, Cesarean Section, Non-Pharmacological Intervention, Perioperative Nursing Care.
Copyright (c) 2026 Rizki Nurcahyati, Dyah Restuning Prihati (Author) https://creativecommons.org/licenses/by-sa/4.0
The Effectiveness of Educational Storytelling in Improving Children's Knowledge and Awareness of Healthy Eating Patterns
Childhood nutritional literacy is an important determinant of long-term health behavior, particularly in shaping healthy eating awareness during early school age development. This study aimed to examine the effectiveness of educational storytelling intervention in improving knowledge and awareness of healthy eating patterns among elementary school children using a pre-experimental one group pretest-posttest design. The study was conducted at SDN Sambirejo 02 Semarang City involving lower grade students selected through purposive sampling. Data were collected using a picture-based knowledge questionnaire and structured observation of eating awareness behavior, which had previously been tested for validity and reliability. Statistical analysis using paired sample t-test showed significant improvement in both knowledge and awareness scores after storytelling intervention with p-value < 0.001. The results indicate that narrative-based health education can enhance cognitive understanding and emotional engagement of children in learning nutrition concepts. Storytelling intervention provides an effective and child-friendly communication approach for promoting healthy dietary behavior in primary school settings
Storytelling Education, Child Nutrition Literacy, Healthy Eating Behavior, School Health Promotion, Pediatric Health Education.
Copyright (c) 2026 Nanda Verika, Indra Tri Astuti, Herry Susanto (Author) https://creativecommons.org/licenses/by-sa/4.0
Overview of Depression, Anxiety, and Stress Levels in Type 2 Diabetes Mellitus Patients at the Pucakwangi Community Health Center in Pati Regency
Type 2 diabetes mellitus is a chronic disease that not only affects physical condition but also affects the psychological health of sufferers, including depression, anxiety, and stress. This study aims to describe the levels of depression, anxiety, and stress in people with type 2 diabetes mellitus at the Pucakwangi Community Health Center in Pati Regency. This study used a descriptive observational design with a cross-sectional approach involving 117 respondents through total sampling. Data collection was conducted using the Depression Anxiety Stress Scale-21 (DASS-21) questionnaire. The results showed that most respondents experienced anxiety (82 patients, 70.0%), the majority did not experience stress (97 patients, 83.0%), and some respondents experienced varying levels of depression. The psychological conditions experienced by patients have the potential to affect blood glucose control and adherence to treatment and therapy. This picture shows that the management of Type 2 Diabetes Mellitus needs to consider psychological aspects as part of efforts to improve the quality of life of patients. A comprehensive approach between physical and psychological aspects is expected to support the success of therapy and prevent long-term complications
Type 2 Diabetes Mellitus, Depression, Anxiety, Stress, DASS-2.
Copyright (c) 2026 Izabela Ayu Pasya, Moch. Aspihan, Iskim Luthfa (Author) https://creativecommons.org/licenses/by-sa/4.0
Profile of Chronic Tonsillitis Patients Undergoing Tonsillectomy
Tonsillitis is an inflammation of the palatine tonsils, an important part of Waldeyer's ring that plays a role in defending the mucous membranes of the respiratory and digestive tracts. Chronic tonsillitis is prolonged inflammation of the tonsils, usually after several episodes of recurrent acute tonsillitis, at least seven times a year. Treatment can be conservative (medical) or surgical, such as tonsillectomy. This study aims to determine the characteristics of patients with chronic tonsillitis who underwent tonsillectomy at Saiful Anwar General Hospital during the period of 2022-2024. This study aims to describe the demographic characteristics, clinical presentations, surgical indications, procedures and postoperative outcome of patients with chronic tonsillitis who underwent tonsillectomy at Saiful Anwar General Hospital during the period of 2022-2024. This study is a retrospective descriptive observational study with data collected from medical records of patients diagnosed with chronic tonsillitis who underwent surgery. A total of 135 patients were recorded. The most common age group was around 5–11 years (42.2%). There were more male patients than female, with 84 men (62.2%) and a ratio of 1,6:1. The most common chief complaint was throat pain (53.3%). The most frequently observed tonsil size was T3 (43.7%), and (45.2%) of patients also had adenoid hypertrophy. The most common indication for surgery was infection (49.6%), with the most frequently performed procedure being adenotonsillectomy (73.3%). The most commonly used surgical technique was cold dissection (65.2%). Postoperative bleeding complications occurred in 3 patients (2.2%). The most common length of hospital stay was 2 days (38.5%). Most patients with chronic tonsillitis who underwent surgery were children aged around 5–11 years, predominantly male, with T3 tonsil sized and associated adenoid hypertrophy. The most common indication for surgery was infection, with adenotonsillectomy using the cold dissection technique as the primary method, demonstrating minimal complications and a short hospital stay.
Tonsillitis, Chronic Tonsillitis, Adenotonsillectomy, Cold Dissection, Palatine Tonsils, Waldeyer’s Ring.
Copyright (c) 2026 Mohammad Dwijo Murdiyo, Bio Swadi Ghutama (Author) https://creativecommons.org/licenses/by-sa/4.0
Evaluation of Antibiotic Appropriateness Assessed by Changes in C-Reactive Protein (CRP) Levels in Patients with Deep Neck Abscesses
Deep neck abscesses are potentially life-threatening infections requiring prompt surgical drainage and appropriate antimicrobial therapy. This retrospective analytic study evaluated antibiotic appropriateness using early changes in C-reactive protein (CRP) levels as a biomarker of therapeutic response. From 38 eligible cases, 19 patients with confirmed bacterial isolates and documented antibiotic sensitivity results were included. Patients were stratified according to concordance between empirical antibiotics and culture sensitivity findings. Gram-positive organisms predominated (68.42%), with Streptococcus anginosus identified most frequently (36.84%). In the culture-concordant group, mean CRP decreased from 23.10 mg/L to 10.13 mg/L within 72 hours (mean reduction 12.97 mg/L; p=0.001), exceeding the minimal clinically important difference (2.85 mg/L). In contrast, the discordant group demonstrated a non-significant reduction from 14.10 mg/L to 9.43 mg/L (mean reduction 4.67 mg/L; p=0.206). These findings indicate that CRP kinetics provide quantifiable evidence of antibiotic appropriateness and may serve as an objective adjunct in guiding early antimicrobial stewardship in deep neck abscess management.
Deep Neck Abscess, C-Reactive Protein, Antibiotic Appropriateness, Microbiological Concordance, Inflammatory Kinetics.
Copyright (c) 2026 Mohammad Dwijo Murdiyo, I Made Indra Wijaya (Author) https://creativecommons.org/licenses/by-sa/4.0
Application of Olive Oil Hand Massage on Anxiety in Preoperative Laparotomy Patients at Telogorejo Hospital, Semarang
Preoperative anxiety is a common psychological response among patients undergoing laparotomy and may negatively affect physiological stability and surgical outcomes. This study aimed to evaluate the effectiveness of olive oil hand massage in reducing anxiety levels among preoperative laparotomy patients at RS Telogorejo Semarang. A pre-experimental one-group pretest–posttest case study design was applied to four participants who met inclusion criteria. The intervention consisted of hand massage using olive oil administered once daily for 10 minutes over three consecutive days. Anxiety levels were measured using the Hamilton Anxiety Rating Scale (HARS) before and after each intervention session. The findings demonstrated a consistent decrease in HARS scores across all participants, with anxiety levels declining from moderate to mild and, in one case, to no anxiety. Improvements in physiological parameters, including blood pressure and pulse rate, were also observed. These results indicate that olive oil hand massage may serve as a simple, safe, and effective nursing intervention to alleviate preoperative anxiety. Further research with larger samples and controlled designs is recommended to strengthen the evidence base.
Hand Massage, Olive Oil, Preoperative Anxiety, Laparotomy, Nursing Intervention.
Copyright (c) 2026 Siti Nur Khasanah, Rahayu Winarti (Author) https://creativecommons.org/licenses/by-sa/4.0
The Relationship Between Events and Types of Anemia with the Occurrence of Hyperemesis Gravidarum in Pregnant Women: An Observational Study at Dr. Amino Gondohutomo Regional Mental Hospital for the Period 2022-2025
Hyperemesis gravidarum is an incident of persistent nausea and vomiting that begins early in pregnancy and continues until 20 weeks of gestation. The causes of hyperemesis gravidarum are influenced by many factors, including maternal nutrition and physiological changes, which can be characterized by anemia and the type of anemia. This study aims to determine the relationship between the incidence of anemia and the type of anemia with the incidence of hyperemesis gravidarum in pregnant women at Dr. Amino Gondohutomo Mental Hospital, Semarang. This observational study used a case-control method using secondary data from the medical records of pregnant women at Dr. Amino Gondohutomo Mental Hospital. Sampling was performed using consecutive sampling, meeting inclusion and exclusion criteria during period from 2022 to 2025. Data were analyzed using the chi-square test for anemia incidence and Fisher's exact test for anemia type. The sample size was 68 pregnant women: 34 with hyperemesis gravidarum and 34 without hyperemesis gravidarum. The test results showed a significant relationship with a p-value of 0.028 (p < 0.05) between the incidence of anemia and HEG. The most common type of anemia is normocytic normochromic, and the test results showed a significant relationship between the type of anemia and HEG at p = 0.001 (p < 0.05).
Hyperemesis Gravidarum, Anemia, Type of Anemia, Pregnant Women, Case-Control.
Copyright (c) 2026 Fabella Ade Kusumawati, Njoo, Yulice Soraya Nur Intan (Author) https://creativecommons.org/licenses/by-sa/4.0
The Relationship Between Maternal Age and Parity Status on the Incidence of Hyperemesis Gravidarum: An Analytical Observational Study at Permata Hati Kudus Maternity Hospital
Hyperemesis gravidarum (HEG) is a condition characterized by severe nausea and vomiting in early pregnancy that can lead to dehydration, electrolyte imbalance, and significant weight loss. Maternal age and parity status are suspected to play a role in increasing the risk of HEG. This study aimed to determine the relationship between maternal age and parity status and the incidence of hyperemesis gravidarum at RSIA Permata Hati Kudus during the 2021–2025 period. This research was an observational analytic study with a cross-sectional design using secondary data obtained from medical records. The sample consisted of 227 pregnant women who met the inclusion and exclusion criteria. The independent variables were maternal age (at risk: <20 years or >35 years; not at risk: 20–35 years) and parity (primiparous and multiparous), while the dependent variable was the incidence of HEG. Data were analyzed using the Chi-Square test with a significance level of 0.05. The results showed a significant relationship between maternal age and the incidence of HEG (p=0.000; OR=10.452), indicating that mothers in the at-risk age group were more likely to experience HEG compared to those in the non-risk age group. In addition, there was a significant relationship between parity and the incidence of HEG (p=0.000; OR=15.66), with primiparous mothers being at higher risk of experiencing HEG compared to multiparous mothers.
Hyperemesis Gravidarum, Maternal Age, Parity Status, First Trimester Pregnancy, Obstetric Risk Factors.
Copyright (c) 2026 Anindya Kinowneka Dewanti, Yulice Soraya Nur Intan (Author) https://creativecommons.org/licenses/by-sa/4.0
The Relationship Between Parenting Styles and Depression Levels in Adolescents
Background: Adolescence is a transitional period marked by physical, emotional, and social changes. During this phase, adolescents often experience mental stress that can lead to depression. One factor that impacts a teenager's emotional well-being is their parenting style. Good parenting methods are expected to foster a balanced personality in adolescents and reduce the likelihood of depression. Method: This study employed a quantitative design with a cross-sectional method. The target population was all 327 eleventh-grade students at MAN 1 Pati. Proportional random sampling was used to select the sample, with a total sample size of 136 respondents. Data were collected through a questionnaire on parenting patterns and a questionnaire measuring depression levels (Beck Depression Inventory). The Spearman Rank test was used for data analysis. Results: The results of this study revealed that the most common parenting style adopted by parents was democratic parenting (44.9%), while the most common level of depression experienced by adolescents was moderate depression (54.4%). The Spearman Rank test yielded a ρ value of -0.512 with p = 0.000 (p < 0.05). Conclusion: There is a significant relationship between parental parenting styles and levels of depression in adolescents at MAN 1 Pati.
Parental Parenting Style, Adolescent Depression Level, Mental Health Outcomes, Psychosocial Development.
Copyright (c) 2026 Manda Virasifani, Betie Febriana, Wahyu Endang Setyowati (Author) https://creativecommons.org/licenses/by-sa/4.0
Wise Sugar Consumption Education Based on Animated Images to Prevent Diabetes Mellitus in Teenagers at Kesatrian 2 High School in Semarang
Background: Diabetes Mellitus is a non-communicable disease with an increasing prevalence, including among adolescents. Excessive sugar consumption is one of the major risk factors. Preventive efforts can be carried out through health education using engaging media, such as animation-based media, to improve adolescents’ knowledge regarding Diabetes Mellitus prevention.us. Methods: This study employed a pre-experimental design with a one group pretest–posttest approach. The sample consisted of 37 tenth-grade students of Kesatrian 2 Senior High School Semarang selected based on inclusion and exclusion criteria. The research instrument was a knowledge questionnaire consisting of 20 true/false statements. Data were analyzed using the Wilcoxon Signed Rank Test to determine differences in knowledge levels before and after the intervention. Results: The results of the study showed an increase in the level of knowledge of adolescents after being given education on wise sugar consumption based on animated media. Before being given education, respondents in the category of not understanding were 40.54% and those in the category of understanding were 59.46%. After being given education based on animated media, respondents in the category of not understanding decreased to 8.11% and those in the category of understanding increased to 91.89%. The results of the Wilcoxon test showed a Z value = -3.878 with a p-value = 0.000 (p < 0.05), which means there was a significant change and increase in the level of knowledge before and after the intervention.
Health Education, Sugar Consumption, Animated Media, Diabetes Mellitus, Adolescents.
Copyright (c) 2026 Ulinnuha Nur Riza, Abrori Abrori, Iwan Ardian (Author) https://creativecommons.org/licenses/by-sa/4.0
The Relationship between Parental Communication Patterns and Adolescents' Knowledge and Attitudes about Reproductive Health at SMPN 02 Moga Warungpring, Pemalang Regency
Adolescence is a phase where children experience significant physiological and psychological changes during the transition from childhood to adulthood. Limited access to information about reproductive health impacts adolescents' knowledge and sexual behavior. Good communication between families and teenagers concerning reproductive health is very important to Mitigate hazardous sexual conduct. This research aims to analyze the The correlation between parental communication styles and teenagers' understanding and perspectives on reproductive health. at SMPN 02 Moga, Warungpring, Pemalang Regency. The research used a quantitative design with a cross-sectional methodology. The sample used in this research was 161 students. Obtained through the method. The tools a questionnaire about parenting communication patterns, a questionnaire on adolescents' knowledge about reproductive health, and a questionnaire on adolescents' attitudes about reproductive health. Data were analyzed using the Somers' D examination. The outcomes of the static test from the Somers' D test analysis, patterns of communication with teenagers' understanding of reproductive health was declared significant with a p-value (Approximate Significance) of 0.000, which is less than α = 0.05. The correlation between communication patterns and teenage views on reproductive health was shown to be significant, with a p-value of 0.033 (<0.05).
Parental Interpersonal Communication, Adolescent Reproductive Health Literacy, Sexual Health Attitudes, Family Relational Dynamics, Preventive Health Behavior.
Copyright (c) 2026 Ziadatul Mukaromah, Iskim Luthfa, Abrori Abrori (Author) https://creativecommons.org/licenses/by-sa/4.0