MAHESA : Malahayati Health Student Journal
Nama Jurnal: MAHESA : Malahayati Health Student Journal Initials: MAHESA Online ISSN: 2746-3486 Print ISSN: 2746-198X Editor in Chief: Dr. Aprina, M.Kes Frekuensi Terbitan: Setiap Bulan Publisher: Universitas Malahayati Lampung Terakreditasi Sinta 3 No: 152/E/KPT/2023 MAHESA : Malahayati Health Student Journal tekah terakreditasi SINTA 3 No: 152/E/KPT/2023, dengan nomor ISSN 2746-198X (Cetak) dan ISSN 2746-3486 (Online) adalah jurnal ilmiah yang diterbitkan oleh Universitas Malahayati Lampung. MAHESA : Malahayati Health Student Journal merupakan jurnal yang memiliki fokus utama pada hasil penelitian dan ilmu-ilmu di bidang kesehatan yang dikembangkan dengan pendekatan interdispliner dan multidisiplin. Proses penerimaan naskah selalu terbuka setiap waktu, naskah yang sudah disubmit oleh penulis akan direview oleh reviewer yang ahli dalam bidang kesehatan. MAHESA : Malahayati Health Student Journal telah menggunakan Open Journal System dimana penulis, editor dan reviewer bisa memantau proses naskah secara online. Dalam satu tahun MAHESA: Malahayati Health Student Journal sejak 2023 terbit setiap bulan, yang sebelumnya hanya 4 kali atau 3 bulanan. barbartoto barbartoto barbartoto barbartoto barbartoto barbartoto barbartoto barbartoto barbartoto barbartoto toto slot toto slot barbartoto barbartoto Strategy Mahjong Ways 2 Membangun Wild Confidence untuk Menemukan Versi Terbaik Diri Sendiri di Tahun 2025 Putaran Gratis Mahjong Ways 2 Masuk Tren Media Sosial Jadi Simbol Kebebasan Baru di Dunia Virtual Strategy Mahjong Ways 2 dan Budaya Fokus di Tengah Era Multitasking yang Melelahkan Strategy Mahjong Ways 2 Diperbincangkan di Forum Digital sebagai Metafora Hidup yang Tak Bisa Ditebak Mahjong Ways 3 dan Wild Harmony di Tengah Kehidupan Urban yang Penuh Tantangan dan Inspirasi Strategy Mahjong Ways 2 dan Semangat Hidup Minimalis yang Mulai Mendominasi Tren Perkotaan Mahjong Ways 3 Menyusup ke Dunia Mode dari Warna, Pola, hingga Filosofi Desain Modern barbartoto barbartoto barbartoto barbartoto barbartoto barbartoto barbartoto barbartoto barbartoto toto 4d toto 4d toto 4d toto slot slot toto slot thailand toto slot toto slot barbartoto barbartoto barbartoto barbartoto barbartoto barbartoto barbartoto slot777 slot88 cara main mahjong ways 2 bikin menang besar strategi menang jitu di mahjong ways 2 rahasia jackpot di game mahjong ways 2 trik jitu raih kemenangan besar di starlight princess starlight princess cara jitu dapatkan kemenangan besar strategi licik strategi menang besar gates of olympus hanya dalam 15 menit analisis mendalam mahjong wins 5 putaran naga strategi mahjong wins 5 barbartoto anti bangkrut jurus ampuh menang besar mahjong wins 3 ritme cepat bongkar kode manis sweet bonanza barbartoto kunci scatter mendapatkan scatter hitam di mahjong wins dan raih maxwin rp99626626 permainan pragmatic play maxwin miliaran situs slot mahjong ways 2 viral indonesia hujan maxwin orionid permainan slot mahjong wins
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Eksplorasi Transkultural Perilaku Pemberian Makan Balita: Studi Kualitatif di Masyarakat Pesisir
ABSTRACT Feeding behavior in children under five years is an important factor in nutritional needs that influence nutritional status and subsequent eating behavior. Parents' feeding behavior is also influenced by culture. The purpose of this study was to explore feeding behavior in children under five years in the context of coastal communities using a qualitative approach based on transcultural nursing theory. This study is qualitative in nature, employing a participatory action research approach. Ten mothers with children under five, two Posyandu cadres, and one midwife from Desa Gisikcemandi, Sidoarjo, participated in this study. Participants were selected using purposive sampling techniques. Data collection was conducted using focus group discussions (FGD) and in-depth interviews. The interview and FGD guides were developed based on the 7 components of the Sunrise Model from the transcultural nursing theory to explore parents' perceptions regarding feeding behaviors. The study identified 4 themes: feeding strategies for children, utilization and management of marine resources, economic and nutritional health challenges, and responses to health interventions. Keywords: Feeding, Under Five Years, Transcultural. ABSTRAK Perilaku pemberian makan pada Balita merupakan salah satu faktor penting untuk memenuhi kebutuhan nutrisi sehingga mempengaruhi status gizi dan perilaku makan anak selanjutnya. Perilaku orang tua dalam pemberian makan pada anak juga dipengaruhi budaya. Tujuan penelitian mengeksplorasi secara mendalam perilaku pemberian makan balita dalam konteks budaya masyarakat pesisir melalui pendekatan kualitatif berbasis teori keperawatan transkultural. Desain penelitian kualitatif dengan pendekatan participatory action research. Partisipan dalam penelitian ini adalah 10 orang ibu yang memiliki Balita, 2 kader posyandu dan 1 Bidan Desa di Desa Gisikcemandi Sidoarjo. Pemilihan partisipan dengan tehnik purposive sampling. Pengumpulan data dengan tehnik focus group discussion (FGD) dan wawancara mendalam. Panduan wawancara dan FGD disusun berdasarkan 7 komponen Sunrise Model dari teori transcultural nursing untuk mengeksplorasi persepsi orang tua terkait perilaku dalam pemberian makan. Hasil penelitian ditemukan 4 tema yaitu strategi pemberian makan anak, pemanfaatan dan pengelolaan sumber daya laut, tantangan ekonomi dan kesehatan gizi dan respon terhadap intervensi kesehatan. Kata Kunci: Pemberian Makan, Balita, Transkultural.
Upaya Memperbaiki Pola Napas Pada Pasien Asma Melalui Buteyko Breathing Technique
ABSTRACT Asthma is a problem that is close to the community because the number of people suffering from asthma is increasing. There are 300 million cases of asthma worldwide, and this number is predicted to increase to 400 million by 2030. Asthma can interfere with the fulfillment of needs and reduce the productivity of sufferers. This study aims to determine the efforts to improve breathing patterns in asthma patients through the Buteyko breathing technique. The method used in this study is a quasi-experiment with a nonequivalent control group design. The instruments used are observation sheets, oximeters, and stopwatches/timers. There are 30 respondents divided into 2 groups (15 intervention respondents and 15 control respondents) using purposive sampling. Data analysis used the paired t-test and independent t-test. The results showed that the Buteyko breathing technique was effective in improving breathing patterns in asthma patients. Health workers are advised to introduce and train asthma patients in the Buteyko Breathing Technique as part of non-pharmacological therapy and asthma management education programs in health centers and hospitals. Asthma sufferers are encouraged to practice BBT regularly to obtain optimal benefits in improving breathing patterns and preventing recurrence. Keywords: Breathing Pattern, Buteyko, Asthma, Oxygen Saturation. ABSTRAK Penyakit asma menjadi masalah yang dekat dengan masyarakat karena jumlah populasi yang menderita asma semakin bertambah. Kasus asma di seluruh dunia mencapai 300 juta jiwa dan diprediksi akan bertambah pada tahun 2030 menjadi 400 juta jiwa. Asma dapat mengakibatkan terganggunya pemenuhan kebutuhan dan menurunkan produktivitas penderitanya. Penelitian ini bertujuan untuk mengetahui upaya memperbaiki pola napas pada pasien asma melalui buteyko breathing technique. Metode yang digunakan dalam penelitian berupa quasi eksperimen dengan desain nonequivalent control group design. Instrumen yang digunakan berupa lembar observasi, oksimeter, stopwatch/timer. Jumlah responden sebanyak 30 yang terbagi menjadi 2 kelompok (15 responden intervensi dan 15 responden kontrol) dengan teknik purposive sampling. Analisa data menggunakan uji sample paired t test dan uji independent t test. Hasil penelitian menunjukkan teknik pernapasan buteyko efektif digunakan untuk memperbaiki pola napas pada pasien asma. Bagi tenaga kesehatan disarankan untuk memperkenalkan dan melatih pasien asma mengenai Buteyko Breathing Technique sebagai bagian dari terapi non farmakologis dan program edukasi manajemen asma di puskesmas maupun rumah sakit. Bagi penderita asma diharapkan dapat mempraktikkan BBT secara teratur untuk mendapatkan manfaat optimal dalam memperbaiki pola napas dan mencegah kekambuhan. Kata Kunci: Pola Napas, Buteyko, Asma, Saturasi Oksigen.
Analisis Faktor-Faktor yang Mempengaruhi Perilaku Pemanfaatan Kearifan Lokal sebagai Obat Tradisional Oleh Masyarakat Kabupaten Bogor
ABSTRACT Indonesia has natural resources that have been used as traditional medicine for generations. In rural areas, in particular, the use of traditional medicine is often the first solution to overcome minor health problems such as fever, flu, cough, colds, or other problems. This study aims to determine the factors that influence the behavior of using local wisdom as traditional medicine. The method used in this study is quantitative with a cross-sectional design. The instrument used was a questionnaire that was tested for validity and reliability. The number of respondents was 105 using a purposive sampling technique. Data analysis used univariate, bivariate, and multivariate tests. The results of the study indicate that there is an influence of the level of knowledge and attitude on the behavior of using local wisdom traditional medicine, but there is no influence of trust and accessibility on the behavior of using local wisdom traditional medicine. The attitude variable is the most dominant variable influencing behavior. Health workers and the government should implement a more contextual and culturally based educational approach to improve public health literacy, especially regarding the safe and rational use of traditional medicine, and provide an understanding of when to access medical health services. Keywords: Kowledge, Attitude, Trust, Accessibility, Behavior. ABSTRAK Indonesia memiliki sumber daya alam yang telah dimanfaatkan sebagai obat tradisional secara turun temurun. Di wilayah pedesaan khususnya, penggunaan obat tradisional seringkali menjadi solusi pertama dalam mengatasi gangguan kesehatan ringan seperti demam, flu, batuk, masuk angin atau masalah lainnya. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang mempengaruhi perilaku pemanfaatan kearifan lokal sebagai obat tradisional oleh masyarakat Kabupaten Bogor. Metode yang digunakan dalam penelitian berupa kuantitatif dengan desain cross sectional. Instrumen yang digunakan berupa kuesioner yang dilakukan uji validitas serta reliabilitas. Jumlah responden sebanyak 105 dengan teknik purposive sampling. Analisa data menggunakan uji univariat, bivariat dan multivariat. Hasil penelitian menunjukkan ada pengaruh tingkat pengetahuan dan sikap dengan perilaku pemanfaatan kearifan lokal obat tradisional serta tidak ada pengaruh kepercayaan dan aksesibilitas dengan perilaku pemanfaatan kearifan lokal obat tradisional. Variabel sikap merupakan variabel yang paling dominan mempengaruhi perilaku. Bagi tenaga kesehatan dan pemerintah untuk melakukan pendekatan edukatif yang lebih kontekstual dan berbasis budaya lokal untuk meningkatkan literasi kesehatan masyarakat, terutama dalam hal penggunaan obat tradisional yang aman dan rasional, serta memberikan pemahaman kapan harus mengakses pelayanan kesehatan medis. Kata Kunci: Pengetahuan, Sikap, Kepercayaan, Aksesibilitas, Perilaku.
Efek Terapi Kombinasi Postural Drainage dan Active Cycle of Breathing Technique Pada Pasien Tuberkulosis Paru
ABSTRACT Pulmonary tuberculosis (TB) frequently causes impaired airway clearance due to increased mucus production and ineffective mucociliary function, leading to respiratory symptoms and reduced oxygenation. Postural Drainage (PD) and the Active Cycle of Breathing Technique (ACBT) are airway-clearance interventions proven to enhance secretion mobilization and improve pulmonary function. To determine the effect of combined PD and ACBT therapy on oxygen saturation, sputum volume, and cough–sputum symptoms in patients with pulmonary tuberculosis. This study used a quasi-experimental design with a pre–post test without control group involving 15 TB pulmonary patients recruited through purposive sampling. The intervention consisted of three sessions of combined PD and ACBT. Outcome measures included oxygen saturation (SpO₂), sputum volume, and CASA-Q scores. Data were analyzed using the paired t-test. The combination therapy significantly increased SpO₂ (96.07% to 98.00%; p = 0.001), sputum volume (2.87 mL to 5.40 mL; p = 0.000), and all CASA-Q domains related to cough and sputum (p = 0.000). Combined PD and ACBT therapy is effective in improving airway clearance, respiratory symptoms, and oxygenation in pulmonary TB patients. This intervention can be recommended as a safe, low-cost, and practical non-pharmacological therapy in respiratory nursing care. Keywords: Active Cycle of Breathing Technique, Airway Clearance, Postural Drainage, Pulmonary Tuberculosis. ABSTRAK Tuberkulosis paru sering menimbulkan gangguan bersihan jalan napas akibat peningkatan produksi mukus dan disfungsi mukosilier, sehingga memicu gejala respirasi dan penurunan oksigenasi. Postural Drainage (PD) dan Active Cycle of Breathing Technique (ACBT) merupakan intervensi pembersihan jalan napas yang terbukti meningkatkan mobilisasi sekret serta fungsi paru. Mengetahui efek terapi kombinasi PD dan ACBT terhadap saturasi oksigen, jumlah sputum, serta gejala batuk dan sputum pada pasien tuberkulosis paru. Penelitian menggunakan desain quasi-eksperimen pre–post test tanpa kelompok kontrol pada 15 pasien TB paru yang dipilih secara purposive. Intervensi diberikan dalam tiga sesi. Pengukuran mencakup SpO₂, volume sputum, dan skor CASA-Q. Analisis data menggunakan paired t-test. Terapi kombinasi memberikan peningkatan signifikan pada saturasi oksigen (96,07% menjadi 98,00%; p = 0,001), jumlah sputum (2,87 mL menjadi 5,40 mL; p = 0,000), serta seluruh domain batuk dan sputum pada CASA-Q (p = 0,000). Kombinasi PD dan ACBT efektif meningkatkan bersihan jalan napas, memperbaiki gejala respirasi, dan meningkatkan oksigenasi pada pasien TB paru. Intervensi ini dapat direkomendasikan sebagai terapi nonfarmakologis yang aman, mudah diterapkan, dan mendukung praktik keperawatan respirasi. Kata Kunci: Active Cycle of Breathing Technique, Bersihan Jalan Napas, Postural Drainage, Tuberkulosis Paru.
Pengalaman Pembelajaran Transformatif Mahasiswa Keperawatan Selama Praktik Klinik: Studi Kualitatif Reflektif
ABSTRACT Clinical practice is a pivotal phase in nursing education and serves as a foundation for the formation of students’ professional identity. However, this phase is often accompanied by emotional tension, adaptation challenges, and complex learning dynamics that influence students’ readiness and personal transformation. This study aimed to explore the process of self-transformation among nursing students through their first clinical practice experience. A reflective qualitative design was employed, involving 34 undergraduate nursing students from classes IA and IC at the University of Timor (UNIMOR) who completed their initial clinical practice for the Fundamentals of Nursing course at Mgr. Gabriel Manek, SVD Hospital, Atambua, from 5 May to 28 June 2025. Data were obtained from in-depth written reflections and analyzed using reflective thematic analysis to identify patterns of personal and professional change. Four major themes emerged: (1) emotional transition from fear to confidence; (2) reframing the role and responsibilities of professional nurses; (3) strengthening communication skills, empathy, and self-regulation; and (4) professional identity formation through continuous reflection. Findings indicate that clinical practice plays a substantial role in shaping students’ emotional, ethical, and professional competencies. Clinical practice strengthens not only students’ technical abilities but also serves as a crucial space for personal transformation and the development of professional identity. Educational institutions are encouraged to enhance reflective support and emotional guidance to facilitate student growth during clinical placements. Keywords: Self-Transformation, Clinical Practice, Nursing Students, Reflection, Professional Identity. ABSTRAK Pengalaman praktik klinik merupakan fase fundamental dalam pendidikan keperawatan dan menjadi landasan pembentukan identitas profesional mahasiswa. Namun, fase ini sering disertai ketegangan emosional, tuntutan adaptasi, dan dinamika pembelajaran yang kompleks yang dapat memengaruhi kesiapan dan proses transformasi diri mahasiswa. Penelitian ini bertujuan mengeksplorasi proses transformasi diri mahasiswa keperawatan melalui pengalaman praktik klinik pertama. Penelitian menggunakan desain kualitatif reflektif dengan melibatkan 34 mahasiswa Program Studi Keperawatan UNIMOR dari kelas IA dan IC yang telah menyelesaikan praktik klinik perdana pada mata kuliah Keperawatan Dasar di RSUD Mgr. Gabriel Manek, SVD Atambua, periode 5 Mei–28 Juni 2025. Data dikumpulkan melalui refleksi tertulis mendalam dan dianalisis menggunakan analisis tematik reflektif untuk mengidentifikasi pola perubahan personal dan profesional selama praktik. Empat tema utama ditemukan, yaitu: (1) transisi emosional dari ketakutan menuju kepercayaan diri; (2) pemaknaan ulang peran dan tanggung jawab profesional perawat; (3) penguatan keterampilan komunikasi, empati, dan regulasi diri; dan (4) pembentukan identitas profesional melalui refleksi berkelanjutan. Temuan menunjukkan bahwa praktik klinik berperan signifikan dalam pengembangan kompetensi emosional, etis, dan profesional mahasiswa. Praktik klinik tidak hanya memperkuat keterampilan teknis, tetapi juga menjadi ruang penting bagi transformasi personal dan pembentukan identitas profesional mahasiswa keperawatan. Institusi pendidikan perlu memperkuat dukungan reflektif dan pembinaan emosional untuk memfasilitasi perkembangan mahasiswa selama praktik klinik. Kata Kunci: Transformasi Diri, Praktik Klinik, Mahasiswa Keperawatan, Refleksi, Identitas Profesional.
Clinicopathological Characteristics of Breast Carcinoma at RSUD Sayang Cianjur, West Java, 2022–2024
ABSTRACT Breast cancer is the most common malignancy in women and remains the leading cause of cancer-related mortality in Indonesia. As a referral hospital in West Java, RSUD Sayang Cianjur plays an essential role in the diagnosis and management of breast cancer. This study aims to describe the clinicopathological characteristics of breast carcinoma cases at RSUD Sayang Cianjur from January 2022 to December 2024. This research employed a retrospective descriptive design with total sampling using medical records and histopathological reports of patients diagnosed with breast carcinoma. Most patients were aged 55–64 years (34.0%), with tumors more frequently located in the left breast (55.9%). Mastectomy was the most common surgical procedure (83.3%), followed by excision biopsy (15.9%). Based on tumor staging, most cases were T1 (54.9%), while N1 was the most frequent lymph node stage (54.5%). The most common histopathological type was invasive carcinoma of no special type (NST), whereas lobular carcinoma accounted for 13.9% of cases. Grade 2 tumors were most prevalent (50.7%), followed by grade 3 (46.3%). Lymphovascular invasion was the most frequent invasive feature (41.0%), followed by fat invasion (25.0%), skin invasion (12.5%), lymph node invasion (7.6%), and perineural invasion (2.8%). In conclusion, breast carcinoma cases at RSUD Sayang Cianjur predominantly occurred in middle-aged to elderly women, with left-sided tumors, NST-type histopathology, and moderate to high histological grades. Keywords: Breast Cancer, Clinicopathological Characteristics, Carcinoma.
Penerapan SIK dalam Peningkatan Kinerja Layanan Kesehatan
ABSTRACT Digital transformation in the healthcare sector has become a fundamental necessity in the era of industrial revolution 4.0, where Health Information Systems (HIS) play a strategic role in optimizing medical service quality. This research aims to analyze the implementation of HIS, particularly Electronic Health Records (EHR) and Hospital Management Information Systems (HMIS), in improving healthcare service performance through a systematic literature review approach. The research method employed narrative synthesis of 20 selected scientific articles from the 2020-2024 publication period obtained through Google Scholar, PubMed, and ScienceDirect database searches. Research findings demonstrate that HIS implementation contributes significantly to operational efficiency improvement with service waiting time reduction up to 67%, clinical service quality enhancement through medication error reduction of 22-41%, and patient satisfaction elevation correlated with administrative process acceleration and more effective therapeutic communication. Determinant factors for successful implementation include top management support, reliable system quality, user competency, and continuous training programs. Main challenges identified encompass financial resource and infrastructure limitations, data security issues, digital literacy gaps, and resistance to change. This research concludes that effective HIS implementation requires a holistic approach integrating technological, organizational, and human factors aspects to achieve sustainable and comprehensive healthcare service performance optimization. Keywords: Health Information System, Healthcare Service Performance, Digital Transformatio. ABSTRAK Transformasi digital dalam sektor kesehatan telah menjadi kebutuhan fundamental di era revolusi industri 4.0, dimana Sistem Informasi Kesehatan (SIK) berperan strategis dalam mengoptimalkan mutu pelayanan medis. Penelitian ini bertujuan menganalisis penerapan SIK, khususnya Electronic Health Record (EHR) dan Sistem Informasi Manajemen Rumah Sakit (SIMRS), dalam meningkatkan kinerja layanan kesehatan melalui pendekatan tinjauan pustaka sistematis. Metode penelitian menggunakan sintesis naratif terhadap 20 artikel ilmiah terpilih dari periode publikasi 2020-2024 yang diperoleh melalui penelusuran basis data Google Scholar, PubMed, dan ScienceDirect. Hasil penelitian menunjukkan bahwa implementasi SIK berkontribusi signifikan terhadap peningkatan efisiensi operasional dengan reduksi waktu tunggu pelayanan hingga 67%, peningkatan kualitas pelayanan klinis melalui penurunan medication error sebesar 22-41%, serta elevasi kepuasan pasien yang berkorelasi dengan akselerasi proses administrasi dan komunikasi terapeutik yang lebih efektif. Faktor determinan keberhasilan implementasi meliputi dukungan manajemen puncak, kualitas sistem yang reliable, kompetensi pengguna, serta program pelatihan berkelanjutan. Tantangan utama yang teridentifikasi mencakup keterbatasan sumber daya finansial dan infrastruktur, isu keamanan data, kesenjangan literasi digital, serta resistensi terhadap perubahan. Penelitian ini menyimpulkan bahwa penerapan SIK yang efektif memerlukan pendekatan holistik yang mengintegrasikan aspek teknologi, organisasional, dan human factors untuk mencapai optimalisasi kinerja layanan kesehatan yang berkelanjutan dan komprehensif. Kata Kunci: Sistem Informasi Kesehatan, Kinerja Layanan Kesehatan, Transformasi Digital.
Hubungan Stunting Dengan Perkembangan Anak Usia Batita
ABSTRACT Stunting is a condition of growth retardation caused by chronic nutritional deficiencies over a prolonged period, resulting in a child’s height being lower than that of peers of the same age. This condition is considered a serious public health issue as it is associated with an increased risk of morbidity and mortality among children. This study aims to identify the relationship between stunting and child development, which includes aspects of gross motor skills, fine motor skills, language and speech abilities, social interaction, and independence among toddlers in the working area of Cikarang Utara Public Health Center, Bekasi Regency. The research employed a quantitative approach with a correlational design and a cross-sectional method. The study population consisted of 1,945 toddlers, with a sample of 96 children determined using the Slovin formula and selected through a non-probability purposive sampling technique. Data collection utilized the Developmental Pre-Screening Questionnaire (Kuesioner Pra Skrining Perkembangan/KPSP), and data analysis was conducted using the Chi-Square test. The results showed a significant relationship between stunting and child development across several domains, namely gross motor skills (p=0.028; PR=1.483; CI=1.042–2.109; CC=0.240), fine motor skills (p=0.020; PR=1.580; CI=1.070–2.335; CC=0.251), language and speech (p=0.022; PR=1.435; CI=1.048–1.996; CC=0.248), as well as socialization and independence (p=0.044; PR=1.448; CI=1.015–2.066; CC=0.222). Based on these findings, it can be concluded that stunting has a significant correlation with child development across multiple domains, including motor, language, and socio-independence aspects. Keywords: Stunting, Toddler Development. ABSTRAK Stunting merupakan suatu kondisi terhambatnya pertumbuhan yang disebabkan oleh defisiensi gizi kronis dalam jangka waktu panjang, yang berdampak pada tinggi badan anak yang lebih rendah dibandingkan dengan anak seusianya. Keadaan ini menjadi masalah kesehatan masyarakat yang serius karena berhubungan dengan peningkatan risiko morbiditas, mortalitas dan kematian pada anak. Penelitian ini bertujuan untuk mengidentifikasi hubungan antara kejadian stunting dan perkembangan anak yang meliputi aspek motorik kasar, motorik halus, kemampuan berbahasa dan berbicara, interaksi sosial, serta kemandirian pada anak usia batita di wilayah kerja Puskesmas Cikarang Utara, Kabupaten Bekasi. Penelitian menggunakan pendekatan kuantitatif dengan desain korelasional dan metode potong lintang (cross-sectional). Populasi penelitian terdiri atas 1.945 anak batita, dengan jumlah sampel sebanyak 96 anak yang ditentukan menggunakan rumus Slovin serta diambil melalui teknik non-probability purposive sampling. Pengumpulan data dilakukan menggunakan instrumen Kuesioner Pra Skrining Perkembangan (KPSP), sedangkan analisis data dilakukan dengan uji Chi-Square. Hasil analisis menunjukkan adanya hubungan yang bermakna antara stunting dan perkembangan anak pada berbagai aspek, yakni motorik kasar (p=0,028; PR=1,483; CI=1,042–2,109; CC=0,240), motorik halus (p=0,020; PR=1,580; CI=1,070–2,335; CC=0,251), bahasa dan bicara (p=0,022; PR=1,435; CI=1,048–1,996; CC=0,248), serta sosialisasi dan kemandirian (p=0,044; PR=1,448; CI=1,015–2,066; CC=0,222). Berdasarkan hasil tersebut, dapat disimpulkan bahwa kejadian stunting memiliki korelasi yang signifikan dengan perkembangan anak dalam berbagai domain, meliputi kemampuan motorik, bahasa, serta aspek sosial dan kemandirian. Kata Kunci: Stunting, Perkembangan Anak Usia Batita.
Analisis Faktor-Faktor yang Mempengaruhi Loyalitas Pasien Klinik Fisioterapi Bebas Cedera di Telkom Bsd Tangerang Selatan
ABSTRACT Patient loyalty plays a crucial role in the sustainability of physiotherapy services, especially amid increasing demands for high-quality and patient-centered care. Key determinants such as service quality, patient satisfaction, and trust are often identified as essential components in fostering long-term relationships between patients and healthcare providers. However, empirical evidence examining the interplay among these variables within physiotherapy clinic settings remains limited.This study aims to examine the relationship between service quality, patient satisfaction, and trust toward patient loyalty at the Bebas Cedera Physiotherapy Clinic in South Tangerang (Telkom BSD).A quantitative research design was employed using accidental sampling, involving 109 participants. Data were analyzed using multiple linear regression and mediation testing through PROCESS Macro Model 4. The study assessed the influence of service quality, patient satisfaction, and trust on patient loyalty.The results indicate that both service quality and trust have a positive and significant effect on patient loyalty. Patient satisfaction, while positive, shows an insignificant influence. Furthermore, patient satisfaction does not mediate the relationship between service quality or trust and patient loyalty. These findings highlight trust as the most dominant factor shaping patient loyalty. Trust emerges as a key determinant of patient loyalty in physiotherapy services. Enhancing communication, empathy, and consistent service delivery is recommended to strengthen long-term patient–clinic relationships. Keywords: Physiotherapy, Patient Satisfaction, Patient Trust, Patient Loyalty, Service Quality. ABSTRAK Patient loyalty merupakan aspek penting dalam keberlangsungan layanan fisioterapi, terutama dalam konteks meningkatnya kebutuhan pelayanan kesehatan yang berorientasi pada kualitas. Faktor-faktor seperti kualitas layanan, kepuasan pasien, dan kepercayaan menjadi determinan utama dalam membangun hubungan jangka panjang antara pasien dan penyedia layanan. Namun, bukti empiris mengenai hubungan di antara variabel-variabel tersebut dalam konteks klinik fisioterapi masih terbatas. Penelitian ini bertujuan untuk menguji hubungan antara kualitas layanan, kepuasan pasien, dan kepercayaan terhadap loyalitas pasien di Klinik Fisioterapi Bebas Cedera, South Tangerang (Telkom BSD). Penelitian kuantitatif ini menggunakan teknik accidental sampling dengan total 109 responden. Analisis data dilakukan menggunakan regresi linier berganda dan uji mediasi melalui PROCESS Macro Model 4. Variabel yang dianalisis meliputi kualitas layanan, kepuasan pasien, kepercayaan, serta loyalitas pasien. Hasil penelitian menunjukkan bahwa kualitas layanan dan kepercayaan berpengaruh positif dan signifikan terhadap loyalitas pasien. Sementara itu, kepuasan pasien berpengaruh positif tetapi tidak signifikan. Selain itu, kepuasan pasien tidak memediasi hubungan antara kualitas layanan maupun kepercayaan terhadap loyalitas. Temuan ini menegaskan bahwa kepercayaan merupakan faktor paling dominan dalam membentuk loyalitas pasien. Kepercayaan pasien menjadi faktor kunci dalam meningkatkan loyalitas pada layanan fisioterapi. Upaya meningkatkan komunikasi, empati, dan konsistensi pelayanan direkomendasikan untuk memperkuat hubungan jangka panjang antara pasien dan klinik. Kata Kunci: Fisioterapi, Kepuasan Pasien, Kepercayaan Pasien, Loyalitas Pasien, Kualitas Layanan.
Deteksi Dini Kanker Ovarium Menggunakan International Ovarian Tumor Analysis (IOTA)
ABSTRACT Ovarian cancer is one of the most lethal gynecological malignancies, with approximately 70% of cases diagnosed at an advanced stage. It ranks as the fourth leading cause of cancer-related deaths among women. The prognosis of ovarian cancer improves significantly when detected early, but the disease is often asymptomatic in its initial stages, leading to delayed diagnosis and poorer outcomes. Because of its low cost and accessibility, ultrasound has proved to be the most useful diagnostic tool for adnexal masses. Ultrasound can be used to distinguish benign from malignant adnexal masses using IOTA simple rules. Early detection of ovarian cancer is important for reducing mortality from ovarian cancer. A case report of Mrs. SW, a 34-year-old woman came to Arifin Achmad Hospital who presented with palpable of abdominal mass. The patient underwent a series of diagnostic tests, including physical examination, ultrasound, abdominal CT scan, and histopathology. On ultrasound examination, found an adnexal mass suspected ovarian cancer by using International Ovarian Tumor Analysis (IOTA). The IOTA simple rules describe five typical features of benigna (B) tumours and five typical features of malignant (M) tumours. It had high sensitvity and specificity for discriminating between malignant and benign adnexal tumour. Preoperative diagnose of malignant adnexal mass using IOTA simple rules were confirmed by postoperative pathology analysis shown a bilateral fibrosarcoma ovary. Early diagnosis is important for reducing mortality from ovarian cancer. Imaging techniques, such as ultrasound (US) have been used in the preoperative assessment of adnexal tumours. IOTA simple rules can distinguish benign from malignant adnexal masses. It can provide an important reference for clinical decision making. Keywords: Ovarian Cancer, International Ovarian Tumor Analysis (IOTA), Adnexal Mass.
Efektifitas Edukasi Tepid Water Sponge Terhadap Pengetahuan Ibu dalam Manajemen Demam Pada Balita
ABSTRACT Fever is a condition caused by infection or an imbalance between heat production and heat loss. One of the non-pharmacological therapies is the Tepid Water Sponge compress, a warm compress method that combines wiping techniques with block compress techniques. According to WHO data, in 2020 the number of fever cases in children worldwide reached 17,000,000, with an incidence ranging from 16,000,000 to 33,000,000 and a mortality rate of 500,000–600,000 annually. The purpose of this study was to determine the effect of health education about tepid water sponge on mothers’ knowledge in managing fever. This research used a quantitative method with a pre-experimental design, specifically a one-group pretest and posttest design. Sampling was conducted using purposive sampling with inclusion and exclusion criteria, resulting in a total of 24 respondents. Data analysis involved normality testing and hypothesis testing. The Shapiro-Wilk test was used for normality, and the Wilcoxon Signed Rank Test was applied for hypothesis testing. The results showed a p-value of 0.001, which means p < 0.005, thus Ha was accepted and Ho was rejected. It can be concluded that health education about Tepid Water Sponge has an effect on mothers’ knowledge in managing fever in toddlers. Keywords: Health Education, Knowledge, Tepid Water Sponge, Fever Management. ABSTRAK Demam merupakan suatu penyakit yang disebabkan karena infeksi atau adanya ketidakseimbangan antara produksi panas dan pengeluarannya Salah satu Terapi non-farmakologi yaitu Kompres Tepid Water Sponge metode kompres hangat yang manggabungkan teknik seka dengan Teknik kompres blok. Menurut WHO, berdasarkan data demam pada anak tahun 2020 jumlah kasus demam pada anak diseluruh dunia mencapai angka 17.000.000 dengan insidensi sebanyak 16.000.000 – 33.000.000 dan angka kematiaan 500.000 – 600.000 setiap tahunnya.tujuan penelitian ini adalah Untuk mengetahui pengaruh edukasi kesehatan tentang tepid water sponge terhadap pengetahuan ibu dalam manajeme demam. Metode penelitian ini menggunakan penelitian kuantitatif dengan desai pra eksperimen dengan rancangan one group pretest dan post test. Pengambilan sampel dengan cara purposive sampling dengan kriteria inklusi dan ekslusi responden penelitian dengan jumlah sampel 24 responden. Analisa data menggunakan normalitas dan Hipotesis. Teknik analisa menggunakan Uji Normalitas shapiro wilk dan Uji Hipotesis Wilcoxon Signed Rank Test. Didapatkan p-value 0,001 yang artinya p-value < 0,005 maka Ha diterima dan Ho di tolak. maka dapat disimpulakan adanya pengaruh edukasi kesehatan Tentang Tepid Water Sponge Terhadap Pengetahuan Ibu Dalam Manajemen Demam Pada Balita Kata Kunci: Edukasi Kesehatan, Pengetahuan, Tepid Water Sponge, Manajemen Demam.
Efektifitas Crossword Puzzle Therapy Terhadap Fungsi Kognitif Pada Lanjut Usia
ABSTRACT Data from the Indonesian Ministry of Health (2021) shows that the elderly population in Indonesia is projected to increase to 48.2 million people by 2035. According to WHO (2022), approximately 55 million older adults worldwide experience a decline in cognitive function, and around 7.7 million develop cognitive impairment each year. Various non-pharmacological interventions have been developed to maintain and improve cognitive function in the elderly, one of which is Crossword Puzzle Therapy (CPT). This therapy involves engaging in crossword puzzle activities that stimulate brain function, enhance memory, and train critical thinking skills. To determine the effectiveness of Crossword Puzzle Therapy on cognitive function in older adults. This study employed a pre-experimental design with a one-group pretest and posttest approach. The sample consisted of 16 respondents, with data collected through observation and administration of the MMSE test. The intervention group received CPT for 30–45 minutes, three times per week for four weeks. The hypothesis was tested using the Wilcoxon signed-rank test. There was a significant effect of Crossword Puzzle Therapy (CPT) on cognitive function in older adults, with a p-value of 0.000. CPT is effective in improving cognitive function in the elderly. This therapy can serve as a simple, low-cost, and accessible non-pharmacological intervention to help maintain the quality of life of older adults. Keywords: Crossword Puzzle Therapy, Elderly, MMSE. ABSTRAK Data Kemenkes RI tahun 2021 Populasi jumlah lansia di Indonesia pada tahun 2035 diperkirakan meningkat menjadi 48,2 juta orang. Data WHO (2022), ada sekitar 55 juta orang lansia mengalami penurunan kemampuan fungsi kognitif dan sekitar 7,7 juta lansia mengalami penurunan kemampuan kognitif per tahunnya. Berbagai intervensi non-farmakologis dikembangkan untuk mempertahankan dan meningkatkan fungsi kognitif pada lansia, salah satunya adalah Crossword Puzzle Therapy (CPT). Terapi ini melibatkan permainan teka-teki silang yang dapat merangsang kerja otak, meningkatkan daya ingat, serta melatih kemampuan berpikir kritis. Untuk mengetahui efektifitas Crossword Puzzle Therapy terhadap fungsi kognitif pada lanjut usia. Methods Desain penelitian ini pre-experimentaldengan pendekatan one group pretest and poststest design, Jumlah sampel 16 responden, teknik pengumpulan data menggunakan observasi, dan pengisian tes MMSE. Kelompok intervensi diberikan CPT selama 30–45 menit, 3 kali per minggu selama 4 minggu, dan uji hipotesis menggunakan uji wilcoxon signed rank test. Ada pengaruh Crossword Puzzle Therapy (CPT) dengan Fungsi Koqnitif pada Lansia, dengan nilai p-value 0.000 . CPT efektif dalam meningkatkan fungsi kognitif pada lansia. Terapi ini dapat menjadi intervensi non-farmakologis sederhana, murah, dan mudah dilakukan dalam upaya mempertahankan kualitas hidup lanjut usia. Keywords: Crossword Puzzle Therapy, Elderly, MMSE.
Pengaruh Ekstrak Kulit Rambutan (Nephelium Lappaceium L.) terhadap Peningkatan Kadar Hdl pada Tikus Obesitas
ABSTRACT Obesity is one of the major factors contributing to dyslipidemia, including a reduction in high-density lipoprotein (HDL) levels, which plays an essential role in reverse cholesterol transport. Rambutan peel extract (Nephelium lappaceium L.) contains various bioactive compounds such as polyphenols, ellagitannins, flavonoids, tannins, and saponins, which are known to improve lipid metabolism. This study aimed to evaluate the effect of rambutan peel extract on increasing HDL levels in obese rats and to compare its efficacy with ellagic acid, a commercial single active compound. A total of 25 male Sprague Dawley rats were divided into five groups: normal control (K−), obese control (K+), ellagic acid group (KP1), and rambutan peel extract groups at doses of 15 mg/kgBW (KP2) and 30 mg/kgBW (KP3). Obesity was induced using a high-fat–sucrose diet for 7 weeks. Treatments were administered orally for 30 days. HDL levels were measured using an enzymatic method, and data were analyzed using the Kruskal–Wallis test. The results showed that KP2 (15 mg/kgBW) exhibited the highest increase in HDL levels (49.8 ± 14.92 mg/dL), approaching normal values. The KP1 group receiving ellagic acid also showed improvement, although lower than the extract. Conversely, KP3 (30 mg/kgBW) demonstrated a decrease in HDL levels to 28.8 ± 2.49 mg/dL. This study concludes that rambutan peel extract has strong potential as a natural hypolipidemic agent capable of increasing HDL levels in obese rats, with the optimal dose being 15 mg/kgBW. The non-linear dose response suggests that the balance of bioactive components within the extract plays a crucial role in determining its effectiveness. Keywords: Rambutan Peel Extract, HDL Cholesterol, Obesity. ABSTRAK Obesitas merupakan salah satu faktor utama yang memicu terjadinya dislipidemia, termasuk penurunan kadar high-density lipoprotein (HDL) yang berperan penting dalam mekanisme transport kolesterol balik. Ekstrak kulit rambutan (Nephelium lappaceium L.) diketahui mengandung berbagai senyawa bioaktif seperti polifenol, ellagitannin, flavonoid, tanin, dan saponin yang berpotensi memperbaiki metabolisme lipid. Penelitian ini bertujuan untuk mengetahui pengaruh ekstrak kulit rambutan terhadap peningkatan kadar HDL pada tikus obesitas serta membandingkannya dengan pemberian ellagic acid (obat pasaran) sebagai senyawa aktif tunggal. Penelitian menggunakan 25 ekor tikus Sprague Dawley jantan yang dibagi menjadi lima kelompok: kontrol normal (K−), kontrol obesitas (K+), kelompok ellagic acid (KP1), serta kelompok ekstrak kulit rambutan dosis 15 mg/kgBB (KP2) dan 30 mg/kgBB (KP3). Obesitas diinduksi dengan diet tinggi lemak–sukrosa selama 7 minggu. Perlakuan diberikan secara oral selama 30 hari. Pemeriksaan kadar HDL dilakukan menggunakan metode enzimatis, dan data dianalisis menggunakan uji Kruskal–Wallis. Hasil penelitian menunjukkan bahwa kelompok KP2 (15 mg/kgBB) mengalami peningkatan HDL paling tinggi (49,8 ± 14,92 mg/dL), mendekati kondisi normal. Kelompok KP1 yang diberikan ellagic acid juga menunjukkan peningkatan, namun lebih rendah dibandingkan ekstrak. Sebaliknya, KP3 (30 mg/kgBB) mengalami penurunan HDL hingga 28,8 ± 2,49 mg/dL. Penelitian ini menyimpulkan bahwa ekstrak kulit rambutan memiliki potensi sebagai agen hipolipidemik alami yang efektif dalam meningkatkan kadar HDL pada tikus obesitas, dengan dosis optimal 15 mg/kgBB. Respons dosis yang tidak linear menunjukkan bahwa keseimbangan komponen bioaktif dalam ekstrak memengaruhi efektivitasnya. Kata Kunci: Ekstrak Kulit Rambutan, HDL, Obesitas.
From Service Quality To Patient Loyalty: A Scoping Review Of Healthcare Experience
ABSTRACT The global shift toward patient-centered care has prompted healthcare providers to prioritize medical effectiveness and the quality of patient experience. This scoping review aims to map the relationship between service quality, patient satisfaction, and loyalty within healthcare facilities and identify the underpinning theories. Guided by the PRISMA-ScR protocol, this study analyzes 15 primary research articles published between 2021 and 2024. Findings reveal that service quality, reliability, empathy, physical infrastructure, and effective communication are key determinants of patient satisfaction. Furthermore, trust, percept value, and service equity enhance this relationship and trigger long-term loyalty, mainly through word of mouth. The three main theoretical frameworks, Expectancy Disconfirmation Paradigm (EDP), Equity Theory, and Value Percept Theory, are confirmed as critical to explaining patient satisfaction and loyalty. This review highlights the necessity of a comprehensive service management strategy that integrates technical, emotional, and relational dimensions to sustain patient loyalty. Keywords: Service Quality, Patient Satisfaction, Loyalty, Healthcare Facility.
Readiness Analysis of Facility, Human Resources, and Marketing Strategies on The Increase in Medical Tourism Visits at BIMC Hospital Nusa Dua Bali
ABSTRACT The trend of medical tourism visits in various countries continues to increase. The high increase in medical tourism services must be accompanied by hospitals' readiness to maintain quality and patient loyalty. This study aims to analyse the readiness of facilities, human resources, and marketing strategies for increasing medical tourism visits at BIMC Hospital Nusa Dua. This study is a case study with qualitative data collection thru in-depth interviews and direct observation. The results of this study indicate that BIMC Hospital Nusa Dua has prepared facilities to increase medical tourism service visits by adding the number of operating room procedures and treatments, as well as some modern medical equipment. In addition, the hospital has also prepared transportation and accommodation in collaboration with travel agents. Human resource readiness can be seen by providing overseas training for doctors to improve their competence. In addition, nursing staff and other personnel have been given both internal and external training. Excellent service training is provided to all staff to deliver outstanding service to customers. The marketing strategy focuses on improving product/service quality, implementing competitive pricing, accessibility, and promoting thru websites and social media. Conclusion: The increase in medical tourism visits is a significant concern, as evidenced by the development of hospital facilities, improved human resource competency, and effective marketing strategies to maintain service quality and patient loyalty. Keywords: Medical Tourism, Facility Readiness, Human Resources, Marketing Strategy.
Evaluasi Determinan Gangguan Psikologis pada Karyawan dan Tenaga Kesehatan: Studi di Rumah Sakit Ibu dan Anak di Jakarta
ABSTRACT Healthcare workers in maternal–neonatal facilities face high workloads, emotional strain, and complex clinical demands. These conditions place them at increased risk of psychological disorders such as stress, anxiety, and depression. Work-related factors, including task intensity and emotional demands, are often major triggers of mental distress. Work stress and burnout are two key factors frequently associated with decreased psychological well-being among healthcare workers. This study aims to identify the determinants of psychological disorders among employees and healthcare workers in a Mother and Child Hospital in Jakarta by assessing the influence of age, work stress, and burnout on mental health outcomes. A cross-sectional design was employed involving 53 respondents who met the inclusion criteria. Data were collected using structured questionnaires measuring work stress, burnout, and symptoms of stress, anxiety, and depression. Correlation analysis and Partial Least Squares modelling were conducted to evaluate direct and indirect relationships among the study variables. Work stress demonstrated strong correlations with psychological disorders, including quantitative overload (r = 0.66), qualitative overload (r = 0.70), role conflict (r = 0.64), and role ambiguity (r = 0.63). Burnout showed significant associations through emotional exhaustion (r = 0.70) and depersonalization (r = 0.51). The SEM-PLS model indicated that work stress had a substantial direct effect on psychological disorders (β = 0.517) and an indirect effect through burnout (β = 0.240). Conversely, age showed no meaningful correlation with stress (r = –0.13), anxiety (r = –0.12), or depression (r = –0.13). Situational job-related factors exert a greater influence on psychological disorders than demographic characteristics. Organizational interventions focusing on workload management, emotional support, mental health monitoring, and burnout prevention programs are essential to improve healthcare workers’ well-being. Keywords: Anxiety, Burnout, Depression, Healthcare workers, Work stress. ABSTRAK Tenaga kesehatan di fasilitas maternal–neonatal menghadapi beban kerja tinggi, tekanan emosional, dan tuntutan klinis yang kompleks. Kondisi tersebut menjadikan mereka rentan mengalami gangguan psikologis seperti stres, ansietas, dan depresi. Faktor-faktor pekerjaan, termasuk intensitas tugas dan tuntutan emosional, sering menjadi pemicu utamanya. Stres kerja dan burnout merupakan dua faktor yang banyak dikaitkan dengan penurunan kesejahteraan psikologis tenaga kesehatan. Penelitian ini bertujuan mengidentifikasi determinan gangguan psikologis pada karyawan dan tenaga kesehatan di sebuah Rumah Sakit Ibu dan Anak di Jakarta, dengan menilai pengaruh usia, stres kerja, dan burnout terhadap kondisi mental. Penelitian menggunakan desain potong lintang dengan melibatkan 53 responden yang memenuhi kriteria inklusi. Data dikumpulkan menggunakan kuesioner terstruktur yang menilai stres kerja, burnout, serta gejala stres, ansietas, dan depresi. Analisis korelasi dan pemodelan Partial Least Squaresdigunakan untuk mengevaluasi hubungan langsung dan tidak langsung antarvariabel penelitian. Stres kerja menunjukkan korelasi kuat dengan gangguan psikologis, yaitu beban berlebih kuantitatif (r = 0,66), beban berlebih kualitatif (r = 0,70), konflik peran (r = 0,64), dan ketaksaan peran (r = 0,63). Burnout menggambarkan hubungan signifikan melalui kelelahan emosional (r = 0,70) dan depersonalisasi (r = 0,51). Model SEM-PLS menunjukkan bahwa stres kerja memiliki pengaruh langsung yang besar terhadap gangguan psikologis (β = 0,517) dan efek tidak langsung melalui burnout (β = 0,240). Sebaliknya, usia tidak menunjukkan korelasi berarti dengan stres (r = –0,13), ansietas (r = –0,12), maupun depresi (r = –0,13). Faktor pekerjaan yang bersifat situasional lebih berpengaruh terhadap gangguan psikologis dibandingkan faktor demografis. Intervensi organisasi melalui perbaikan sistem kerja, dukungan emosional, pemantauan kesehatan mental, serta program pencegahan burnout diperlukan untuk meningkatkan kesejahteraan tenaga kesehatan. Kata Kunci: Ansietas, Burnout, Depresi, Stres Kerja, Tenaga Kesehatan.
Effectiveness of Scoring Systems in Preventing Abdominal Trauma Emergencies
ABSTRACT Abdominal trauma is one of the leading causes of morbidity and mortality in emergency cases, with an incidence rate of 7-10% of all trauma cases. Accurate and timely assessment is crucial to determine the need for surgical intervention and prevent fatal complications. Evaluating the effect of scoring system-based abdominal assessment instruments on the prevention of emergencies and patient clinical outcomes. A systematic review of quantitative studies was conducted. Full-text articles were retrieved from four databases: Web of Science, ScienceDirect, ProQuest, and PubMed for the period 2020-2025. The keywords used were: Abdominal Trauma OR Abdominal Injury AND Assessment OR Scoring OR Initial Assessment OR Preliminary OR Evaluation AND Emergency. The quality of the studies was assessed using the Joanna Briggs Institute (JBI) criteria. A narrative analysis was conducted to present the effectiveness of scoring-based abdominal assessment in preventing emergencies. A comprehensive analysis of 15 studies evaluated five major scoring systems: CASS, BATSS, ISS, RTS, and TRISS. BATSS showed the best diagnostic performance with excellent surgical intervention prediction capabilities, achieving sensitivity of up to 100% and specificity of nearly 97%. CASS showed wider performance variability but still provided satisfactory prediction accuracy. ISS proved effective in predicting morbidity and mortality, with critical values indicating very high-risk patients. TRISS demonstrated superior performance as a predictor of mortality with near-perfect prediction accuracy, making it a highly reliable instrument for mortality risk stratification. Abdominal assessment instruments based on scoring systems significantly influence the prevention of emergencies through early identification of high-risk patients, optimization of the use of diagnostic modalities such as CT scans, and facilitation of timely clinical decision-making. BATSS shows superiority in predicting the need for surgical intervention, while TRISS excels in predicting mortality. Implementation of this scoring system can improve the quality of triage and initial management of abdominal trauma in the emergency room. Keywords: Abdominal Trauma , Assestment, Emergency.
Analisis Penerimaan Diri dengan Kualitas Hidup Pasien Kanker Payudara yang telah Menjalani Mastektomi
ABSTRACT Breast cancer is one of the types of cancer with a high global prevalence. According to data from the Breast Cancer Research Foundation, in 2020, 2.3 million women worldwide were diagnosed with breast cancer, with 670,000 dying from this disease (Arnold, 2022)Breast cancer is the most common cancer among women and significantly impacts physical, psychological aspects, and the quality of life of patients. One of the efforts to combat breast cancer is mastectomy, which involves removing part or all of the infected breast tissue. This research aims to examine the relationship between self-acceptance and the quality of life of breast cancer patients who have undergone mastectomy at RSUD Jenderal Ahmad Yani Kota Metro in 2025.The research was conducted from April 21 to May 19 using a quantitative descriptive analytic design with a cross-sectional approach. A total of 51 respondents were selected through purposive sampling.The results of the study show a significant relationship between self-acceptance and the quality of life of breast cancer patients who have undergone mastectomy, with a p-value of 0.001 (p < 0.05).This research provides in-depth information about the impact of self-acceptance on the quality of life of breast cancer patients through a psychological approach that supports their self-acceptance. Keywords: Breast Cancer, Mastectomy, Quality Of Life, Self-Acceptance. ABSTRAK Kanker payudara merupakan salah satu jenis kanker dengan prevalensi tinggi secara global. Menurut data dari Breast Cancer Research Foundation, pada tahun 2020 terdapat 2,3 juta perempuan di seluruh dunia yang didiagnosis menderita kanker payudara, dengan 670 ribu di antaranya meninggal dunia akibat penyakit ini (Arnold, 2022). Kanker payudara merupakan jenis kanker yang paling banyak terjadi pada perempuan dan berdampak besar pada aspek fisik, psikologis, serta kualitas hidup pasien. Salah satu dampak pengobatan kanker payudara adalah tindakan mastektomi yang dapat memengaruhi penerimaan diri pasien.Penelitian ini bertujuan untuk mengetahui hubungan antara penerimaan diri dan kualitas hidup pada pasien kanker payudara yang telah menjalani mastektomi di RSUD Jenderal Ahmad Yani Kota Metro tahun 2025. Penelitian ini lakukan pada tanggal 21 April-19 Mei 2025 dengan menggunakan menggunakan desain kuantitatif deskriptif analitik dengan pendekatan cross-sectional. Jumlah sampel sebanyak 51 responden, yang dipilih menggunakan teknik purposive sampling. Instrumen yang digunakan terdiri dari kuesioner penerimaan diri dan kuesioner kualitas hidup. Analisa data dilakukan secara univariat dan bivariat menggunakan uji chi square. Hasil penelitian menunjukkan terdapat hubungan yang signifikan antara penerimaan diri dan kualitas hidup dengan nilai p-value sebesar < 0,001 (lebih kecil dari 0,05). Penelitian ini diharapkan dapat memberikan informasi dan kontribusi dalam Upaya meningkatkan kualitas hidup pasien kanker payudara yang telah menjalani mastektomi melalui pendekatan psikologis yang mendukung penerimaan diri mereka. Kata kunci: Kanker Payudara, Kualitas Hidup, Mastektomi, Penerimaan Diri
Pengaruh Booklet Self-Management Berbasis Terapi Modalitas Terhadap Self-Care Penderita Hipertensi
ABSTRACT Hypertension remains a major chronic health problem in Indonesia, with low self-care adherence contributing to poor blood pressure control. Although various educational and complementary approaches have been introduced, evidence regarding the effectiveness of booklet-based educational media integrated with modality therapy is still limited. This study examined the effect of a self-management booklet incorporating Slow Deep Breathing (SDB) and ginger–turmeric herbal infusion on improving self-care among hypertensive patients. Using a quasi-experimental pretest–posttest control group design, 32 respondents were recruited through accidental sampling in Citimun Village and evenly assigned to intervention and control groups. Self-care was measured using the validated H-SCALE questionnaire (Cronbach’s alpha 0.79–0.89). Data were analyzed using paired t-tests, Mann–Whitney U tests for N-gain comparisons, and effect size calculations. Results showed a significant difference between the intervention and control groups (U = 42.00; p < 0.001), with a Hodges–Lehmann estimate of –0.509 and a strong effect size (ηp² = 0.230). These findings indicate that the self-management booklet integrating SDB and ginger–turmeric infusion significantly enhances self-care among individuals with hypertension. The study supports the use of print-based educational media combined with complementary therapy as an effective promotive–preventive strategy for hypertension control in rural communities. Keywords: Booklet, Self-Care, Self-Management, Hypertension. ABSTRAK Hipertensi merupakan masalah kesehatan kronis dengan tingkat kepatuhan self-care yang masih rendah di Indonesia, sehingga berkontribusi terhadap rendahnya pencapaian kontrol tekanan darah optimal. Berbagai pendekatan edukasi dan terapi komplementer telah dikembangkan untuk meningkatkan self-management pasien, namun efektivitas media edukasi berbasis booklet yang terintegrasi dengan terapi modalitas terhadap peningkatan self-care penderita hipertensi masih terbatas diteliti. Oleh karena itu, penelitian ini dilakukan untuk mengetahui pengaruh booklet self-management berbasis terapi modalitas Slow Deep Breathing (SDB) dan seduhan herbal jahe–kunyit terhadap peningkatan self-care penderita hipertensi. Penelitian ini menggunakan desain kuasi-eksperimental dengan pretest–posttest control group design yang dilaksanakan di Desa Citimun. Populasi sasaran adalah seluruh penderita hipertensi, yang diambil melalui accidental sampling dengan total sampel sebanyak 32 responden dan dibagi rata ke dalam kelompok perlakuan dan kelompok kontrol. Pengukuran self-care dilakukan menggunakan kuesioner H-SCALE Jean Warren-Findlow serta telah tervalidasi dan reliabel, dengan Cronbach’s Alpha ( ) 0,79 hingga 0,89. Analisis data menggunakan uji paired t-test untuk perbandingan pra–pasca dalam kelompok serta Mann–Whitney U Test untuk membandingkan perbedaan skor N-gain antar kelompok, serta analisis effect size untuk menilai besarnya pengaruh intervensi. Hasil uji Mann–Whitney U Test ditemukan peningkatan self-care yang signifikan (U = 42,00; p < 0,001), dengan estimasi Hodges–Lehmann –0,509 dan besar efek perubahan tergolong kuat (ηp² = 0,230). Hasil ini menunjukan bahwa booklet self-management berbasis terapi modalitas SDB dan seduhan herbal jahe–kunyit berpengaruh signifikan terhadap peningkatan self-care pada penderita hipertensi. Temuan ini mendukung integrasi pendekatan edukasi berbasis media cetak dan terapi komplementer sebagai bagian dari upaya promotif–preventif dalam pengendalian hipertensi pada komunitas masyarakat desa. Kata Kunci: Booklet, Perawatan Mandiri, Manajemen Diri, Hipertensi.
The Effectiveness of Soy Milk and Cow’s Milk in Reducing Dysmenorrhea Pain: A Systematic Literatur Review
ABSTRACT Primary dysmenorrhea is a common menstrual problem among adolescent girls and is often associated with elevated prostaglandin levels, which trigger excessive uterine contractions and pain. Nutritional interventions are increasingly explored as non-pharmacological alternatives to reduce dysmenorrhea, with soy milk and cow’s milk being two commonly studied options. This study aims to synthesize existing evidence on the effectiveness of soy milk and cow’smilk in reducing primary dysmenorrhea among adolescents. Method: This study used a Systematic Literature Review(SLR) based on the PICO framework—population (adolescent girls), intervention (milk consumption), comparison (soy milk vs. cow’s milk), and outcome (reduction in dysmenorrhea pain). Articles published from 2015–2025 were searched in Google Scholar, Scopus (via Publish or Perish), and PubMed using Boolean keywords related to adolescents, soy milk, cow’s milk, and dysmenorrhea. Eligible studies included original research on adolescents with primary dysmenorrhea, clear milk dosage and duration, standardized instruments, and full text in Indonesian or English. After duplicate removal, screening, and full-text assessment, data on study characteristics, milk type, dosage, duration, and pain reduction were narratively synthesized. The initial literature search identified 1,007 journals from After going through a selection process, 4 journals met the requirements for analysis.The synthesis revealed that both soy milk and cow’s milk reduce primary dysmenorrhea based on NRS score, but soy milk showed more consistent effects. Consumption of 250 ml soy milk once daily for 1–2 days reduced pain by 3–4 NRS points. This benefit is supported by its nutrient content, where 250 ml soy milk contains 25–40 mg isoflavones (genistein daidzein and glycitein) and 200–300 mg calcium, or up to 500 mg in fortified products. Cow’s milk also reduced pain, with the best effect at 1,000 mg calcium/day (reduction of 4–5 NRS points), but its results were less stable. Overall, soy milk was more consistently effective than cow’s milk. Soy milk is a simple, safe, and effective non-pharmacological option for managing primary dysmenorrhea in adolescents, offering stronger and more consistent results than cow’s milk. It may be recommended as part of menstrual health education and daily nutritional intake for adolescent girls. Keywords: Soy Milk, Cow’s Milk, Primary Dysmenorrhea, Isoflavones, Calcium.
Tinjauan Literatur tentang Faktor Penghambat dan Pendorong Imunisasi di Daerah yang Sulit Dijangkau
ABSTRACT Immunization coverage in rural and remote areas remains low due to geographical barriers, limited health resources, and socio-behavioral challenges. This review aims to identify key barriers and facilitators of immunization in hard-to-reach settings by synthesizing literature published between 2020 and 2025 retrieved from Scopus and PubMed. From 853 identified articles, nine met the inclusion criteria and were analyzed through narrative synthesis. Findings indicate that difficult geographic access, insufficient health infrastructure and workforce, low socioeconomic conditions, limited health literacy, and distrust toward vaccines constitute major barriers. In contrast, outreach and mobile services, strong community and family support, integration with maternal and child health services, effective health communication, and the use of mHealth technologies serve as important facilitators. This review concludes that improving immunization in remote areas requires comprehensive strategies that enhance service accessibility, strengthen the health workforce, build community trust, and adopt innovative, community-based approaches to achieve equitable and sustainable immunization coverage. Keywords: Immunization, Remote Areas, Health Access, Coverage. ABSTRAK Cakupan imunisasi di wilayah rural dan terpencil masih rendah karena hambatan geografis, keterbatasan sarana dan tenaga kesehatan, serta faktor sosial-ekonomi dan perilaku masyarakat. Kajian ini bertujuan mengidentifikasi faktor penghambat dan pendorong imunisasi di daerah sulit dijangkau melalui literature review terhadap publikasi tahun 2020–2025 yang ditelusuri pada Scopus dan PubMed. Dari 853 artikel yang ditemukan, proses seleksi ketat menghasilkan 9 artikel yang dianalisis menggunakan sintesis naratif. Hasil kajian menunjukkan bahwa jarak dan akses sulit, terbatasnya infrastruktur dan tenaga kesehatan, rendahnya literasi dan kepercayaan terhadap vaksin, serta kondisi sosial-ekonomi menjadi hambatan utama. Sebaliknya, layanan outreach dan mobile, dukungan komunitas dan keluarga, integrasi imunisasi dengan layanan ibu–anak, komunikasi kesehatan yang efektif, serta pemanfaatan teknologi seperti mHealth terbukti menjadi faktor pendorong penting. Kajian ini menyimpulkan bahwa peningkatan imunisasi di daerah terpencil memerlukan pendekatan komprehensif yang menggabungkan perbaikan akses layanan, penguatan kapasitas tenaga kesehatan, peningkatan kepercayaan masyarakat, dan inovasi layanan berbasis komunitas agar pemerataan imunisasi dapat tercapai secara berkelanjutan. Kata Kunci: Imunisasi, Daerah Terpencil, Akses Kesehatan, Cakupan Imunisasi.
Efektivitas Senam Anemiaction Terhadap Peningkatan Kadar Hemoglobin pada Remaja Putri
ABSTRACT Anemia remains a significant global public health issue affecting adolescent girls and contributing to reduced physical endurance, lowered cognitive focus, and long‑term reproductive risks. This study aims to evaluate the effectiveness of Anemiaction exercise as a low‑intensity aerobic activity designed to stimulate erythropoietin and improve hemoglobin levels. Using a one‑group pretest–posttest design involving 30 adolescent girls, hemoglobin levels were measured before and after four weeks of exercise performed three times weekly. Results showed an increase from 11.2 g/dL to 12.1 g/dL, indicating significant improvement. Anemiaction exercise can serve as an effective, non‑pharmacological school‑based intervention for anemia prevention. Keywords: Hemoglobin, Anemiaction Exercise, Anemia, Adolescent Girls. ABSTRAK Anemia merupakan masalah kesehatan global yang banyak dialami remaja putri dan berdampak pada penurunan konsentrasi belajar, daya tahan tubuh, serta risiko kesehatan reproduksi jangka panjang. Penelitian ini bertujuan menilai efektivitas senam Anemiaction sebagai aktivitas aerobik intensitas ringan yang dapat merangsang eritropoietin dan meningkatkan kadar hemoglobin. Desain penelitian menggunakan one‑group pretest–posttest dengan 30 remaja putri. Kadar hemoglobin diukur sebelum dan sesudah intervensi selama empat minggu. Hasil menunjukkan peningkatan dari 11,2 g/dL menjadi 12,1 g/dL. Senam Anemiaction efektif sebagai intervensi non‑farmakologis untuk pencegahan anemia berbasis sekolah Kata Kunci: Hemoglobin, Senam Anemiaction, Anemia, Remaja Putri.
Faktor – Faktor yang Mempengaruhi Kepuasan Pasien Terhadap Pelayanan Kesehatan di UPTD Puskesmas Jaka Mulya
ABSTRACT Patient satisfaction is a crucial indicator of healthcare quality, particularly in primary care facilities such as community health centers. This study used the Servqual model, which measures five dimensions: tangibles, reliability, responsiveness, assurance, and empathy. Initial data from interviews with 10 patients showed that satisfaction levels remained below the 95% Minimum Service Standard (SPM), with physical aspects being the most common complaint. Factors such as waiting time, staff friendliness, facility availability, and communication quality also influenced patient satisfaction. Knowing the factors that influence patient satisfaction with health services. Analytical with a cross-sectional design. The sample in this study was a portion of patients who visited the UPTD Jaka Mulya Community Health Center in November 2025, totaling 86 respondents. The sampling technique used was random sampling. The majority of respondents said they were satisfied (70.9%), had good reliability (67.4%), had good responsiveness (77.9%), had good empathy (72.1%), and had good tangibles (80.2%). Reliability, responsiveness, empathy, and tangibles significantly influenced patient satisfaction at the Jaka Mulya Community Health Center (UPTD), with a p-value of <0.05. Reliability, Responsiveness, Empathy, and Tangibility influence patient satisfaction at the Jaka Mulya Community Health Center (UPTD). It is hoped that the health department will address the needs of healthcare workers at each community health center to ensure optimal health services. Keywords: Satisfaction, Reliability, Responsiveness, Empathy, Tangibles. ABSTRAK Kepuasan pasien merupakan indikator penting dalam kualitas pelayanan kesehatan, khususnya pada fasilitas pelayanan primer seperti puskesmas. Model servqual digunakan dalam penelitian ini dengan lima dimensi penilaian yaitu tangibles, reliability, responsiveness, assurance, dan empathy. Data awal melalui wawancara pada 10 pasien menunjukkan bahwa tingkat kepuasan masih berada di bawah Standar Pelayanan Minimal (SPM) 95%, dengan aspek fisik menjadi keluhan terbesar. Faktor-faktor seperti waktu tunggu, keramahan petugas, ketersediaan fasilitas, serta kualitas komunikasi turut memengaruhi kepuasan pasien. Mengetahui faktor – faktor yang mempengaruhi kepuasan pasien terhadap pelayanan kesehatan. Analitik dengan rancangan cross sectional. Sampel dalam penelitian ini adalah sebagian pasien yang berkunjung di UPTD Puskesmas Jaka Mulya pada bulan November 2025 sebanyak 86 responden.Teknik pengambilan sampel menggunakan randoom sampling. Mayoritas responden mengatakan puas (70,9%), Reliability baik (67,4%), Responsiveness baik (77,9%), Empaty baik (72,1%) dan Tangible baik (80,2%). Ada pengaruh Reliability, Responsiveness, Empaty dan Tangible terhadap kepuasan pasien di UPTD Puskesmas Jaka Mulya, dengan nilai p value < 0,05. Ada pengaruh Reliability, Responsiveness, Empaty dan Tangible terhadap kepuasan pasien di UPTD Puskesmas Jaka Mulya. Diharapkan dinas kesehatan dapat memperhatikan kebutuhan tenaga kesehatan setiap puskesmas agar pelayanan kesehatan dapat berjalan sebagaimana mestinya. Kata Kunci: Kepuasan, Reliability, Responsiveness, Empaty, Tangible.
Potensi Ekstrak Kunyit (Curcuma Longa) Terhadap Kadar Prostaglandin dan Skala Nyeri Dismenore Remaja
ABSTRACT Dysmenorrhea is a common complaint among adolescents and can increase uterine contractions as well as prostaglandin hormone levels. Turmeric extract, which is rich in curcumin, possesses analgesic, antispasmodic, and anti-inflammatory properties, especially when formulated in capsules that support optimal absorption in the body. This study aimed to evaluate the potential of turmeric extract (Curcuma longa) on prostaglandin levels and dysmenorrhea pain scale in adolescents.This study used a quasi-experimental design involving a control group and an intervention group. The intervention group received turmeric extract capsules during the menstrual period. The measured variables included prostaglandin levels using ELISA and pain intensity using the Numeric Rating Scale (NRS). Data analysis was performed using the Wilcoxon and Mann-Whitney tests.The mean pain intensity in the intervention group decreased from 5.26 to 2.26 (p = 0.000), while in the control group it decreased from 5.00 to 3.00 (p = 0.000). The difference between the two groups was significant (p = 0.030) with a large effect size (d = 1.62). Prostaglandin levels in the intervention group also decreased from 170.67 to 118.20 pg/mL (p = 0.000), whereas in the control group they decreased from 156.47 to 108.48 pg/mL. The difference between groups was significant (p = 0.038) with a large effect size (d = 0.85). These findings indicate that turmeric extract capsules are effective in reducing both pain intensity and prostaglandin levels. Turmeric extract capsules are proven to effectively decrease dysmenorrhea pain and prostaglandin hormone levels in adolescents. This suggests that turmeric extract could be a potential non-pharmacological intervention for managing adolescent dysmenorrhea and alleviating menstrual complaints safely and naturally. Keywords: Turmeric Extract Capsule, Curcuma longa, Prostaglandin, Dysmenorrhea, Menstrual Pain, Adolescents. ABSTRAK Dismenore merupakan keluhan yang sering dialami remaja dan dapat meningkatkan kontraksi uterus serta kadar hormon prostaglandin. Ekstrak kunyit yang kaya akan kurkumin memiliki aktivitas analgesik, antispasmodik, dan antiinflamasi, terutama ketika diformulasikan dalam bentuk kapsul yang mendukung penyerapan optimal di dalam tubuh. Tujuan penelitian ini membuktikan adanya potensi ekstrak kunyit (curcuma longa) terhadap kadar prostaglandin dan skala nyeri dismenore remaja. Penelitian ini menggunakan desain quasi experiment dengan melibatkan kelompok kontrol dan kelompok intervensi. Pada kelompok intervensi diberikan kapsul ekstrak kunyit selama periode menstruasi. Variabel yang diukur meliputi kadar prostaglandin melalui pemeriksaan ELISA serta tingkat nyeri menggunakan skala NRS. Analisis data dilakukan menggunakan uji Wilcoxon dan Mann-Whitney. Rerata intensitas nyeri pada kelompok intervensi menurun dari 5.26 menjadi 2.26 (p=0.000), sementara pada kelompok kontrol turun dari 5.00 menjadi 3.00 (p=0.000). Perbedaan antara kedua kelompok menunjukkan hasil yang signifikan (p=0.030) dengan effect size besar (d=1.62). Kadar prostaglandin pada kelompok intervensi juga mengalami penurunan dari 170.67 menjadi 118.20 pg/mL (p=0.000), sedangkan pada kelompok kontrol hanya turun dari 156.47 menjadi 108.48 pg/mL. Perbedaan antar kelompok signifikan (p=0.038) dengan effect size besar (d=0.85). Temuan ini menunjukkan bahwa kapsul ekstrak kunyit efektif dalam menurunkan intensitas nyeri dan kadar prostaglandin. Kapsul ekstrak kunyit terbukti efektif menurunkan intensitas nyeri dismenore dan kadar hormon prostaglandin pada remaja. Temuan ini menunjukkan bahwa ekstrak kunyit dapat menjadi salah satu intervensi nonfarmakologis yang potensial dalam mengatasi dismenore remaja serta mengurangi keluhan menstruasi secara aman dan alami. Kata Kunci: Kapsul Ekstrak Kunyit, Curcuma Longa, Prostaglandin, Dismenore, Nyeri Haid, Remaja.
Fragmentasi Layanan dan Determinan Sosial: Analisis Kualitatif Kegagalan Discharge Planning dan Rekomendasi Model Kolaboratif Lintas Sektor (Sehati)
ABSTRACT High readmission rates among Patients with Mental Disorders (ODGJ) are often linked to Discharge Planning (DP) failures. This study aims to deeply explore systemic barriers and the need for community-based solutions to prevent DP from functioning as an effective Transitional Care (TC) mechanism at Naimata Mental Hospital, Kupang. This descriptive phenomenological qualitative research involved 14 key participants (Mental Hospital Health Personnel, Community Health Center Nurses, ODGJ Patients, and Families/Caregivers) through In-depth Interviews. Data were analyzed using thematic methods to identify major barriers in the post-discharge continuum of care. Eight main themes were found, which include: (1) Massive handoff failure, manifested as "Silent Discharge" due to the absence of formal coordination (WA Group) between the Mental Hospital and Community Health Centers (Puskesmas). (2) Medication non-adherence is triggered by Social Determinants of Health (SDH), especially the "Medication vs. Food" dilemma and high transportation costs. (3) Families experience an extreme Caregiver Burden crisis, inducing High Expressed Emotion (EE) due to inadequate Family Psychoeducation (FPE). (4) The analysis justifies the need for the SEHATI Collaborative Model as a bridging mechanism. Service fragmentation, coupled with unaddressed SDH and high Caregiver Burden, drives readmission. The SEHATI Model is recommended to formalize coordination, integrate local initiatives (Gentar Sejiwa), and provide holistic psychoeducation to prevent relapse. Keywords: Discharge Planning, Handoff Failure, Caregiver Burden, Social Determinants of Health, SEHATI Model. ABSTRAK Angka readmisi yang tinggi pada Pasien Dengan Gangguan Jiwa (ODGJ) sering dikaitkan dengan kegagalan Discharge Planning (DP). Penelitian ini bertujuan mengeksplorasi secara mendalam hambatan sistemik dan kebutuhan solusi berbasis komunitas yang mencegah DP berfungsi sebagai mekanisme Transitional Care (TC) yang efektif di RS Jiwa Naimata Kupang. Penelitian kualitatif fenomenologi deskriptif ini melibatkan 14 partisipan kunci (Tenaga Kesehatan RSJ, Perawat Puskesmas, Pasien ODGJ, dan Keluarga/Caregiver) melalui In-depth Interview. Data dianalisis menggunakan metode tematik untuk mengidentifikasi hambatan utama dalam kontinum layanan pasca-pulang. Ditemukan delapan tema utama, yang menunjukkan: (1) Kegagalan handoff yang masif, termanifestasi sebagai “Pulang Senyap” (Silent Discharge) karena ketiadaan koordinasi formal (WA Grup) antara RSJ dan Puskesmas. (2) Non-adherence obat dipicu oleh Determinan Sosial Kesehatan (SDH), terutama dilema "Obat vs. Nasi" dan tingginya biaya transportasi. (3) Keluarga mengalami krisis Beban Caregiver yang ekstrem, memicu High Expressed Emotion (EE) akibat kegagalan Family Psychoeducation (FPE). (4) Analisis memvalidasi kebutuhan Model Kolaboratif SEHATI sebagai mekanisme penghubung. Fragmentasi layanan, ditambah SDH yang terabaikan dan Caregiver Burden tinggi, mendorong readmisi. Model SEHATI direkomendasikan untuk memformalkan koordinasi, mengintegrasikan inisiatif lokal (Gentar Sejiwa), dan memberikan psikoedukasi holistik guna mencegah kekambuhan. Kata Kunci: Discharge Planning, Kegagalan Handoff, Beban Caregiver, Determinan Sosial Kesehatan, Model SEHATI.
Pemanfaatan Nano Patch Peppermint Terhadap Hormon Kortisol Saliva dan Skala Nyeri Disminore Pada Remaja
ABSTRACT Dysmenorrhea is a common complaint among adolescents and can trigger increased uterine contractions and elevated cortisol levels. Peppermint has analgesic, antispasmodic, and anti-inflammatory effects, particularly when formulated as a nano patch, which enhances skin absorption. This study aimed to determine the effect of peppermint nano patches on reducing cortisol levels and alleviating dysmenorrhea in adolescents.A quasi-experimental design with intervention and control groups was used. The intervention group received the peppermint nano patch during menstruation. Variables measured included pain intensity using a numerical rating scale and salivary cortisol levels assessed via ELISA. Data were analyzed using paired t-tests and independent t-tests.The results showed that the mean pain intensity in the intervention group decreased from 7.40 to 3.65 (p = 0.000), while in the control group it decreased from 6.40 to 6.00 (p = 0.000). The difference between groups was significant (p = 0.000) with a large effect size (d = 1.91). Salivary cortisol levels in the intervention group decreased from 17.02 to 15.84 ng/ml (p = 0.001), whereas in the control group it changed only from 11.08 to 11.00 ng/ml. The difference between groups was significant (p = 0.042) with a moderate effect size (d = 0.42).The peppermint nano patch was effective in reducing pain intensity and salivary cortisol levels. This intervention can be considered a non-pharmacological alternative for alleviating menstrual complaints in adolescents. Keywords: Peppermint Nano Patch, Salivary Cortisol, Dysmenorrhea, Menstrual Pain, Adolescents. ABSTRAK Dismenore merupakan keluhan yang sering dialami remaja dan dapat memicu peningkatan kontraksi uterus serta kadar hormon kortisol. Peppermint memiliki efek analgesik, antispasmodik, dan antiinflamasi, terutama ketika diformulasikan dalam bentuk nano patch yang meningkatkan absorpsi kulit. Penelitian ini bertujuan untuk mengetahui pengaruh nanopatch peppermint dalam menurunkan hormon kortisol dan menurunkan disminore pada remaja.Penelitian menggunakan desain quasi experiment dengan kelompok intervensi dan kontrol. Kelompok intervensi diberikan Nano Patch Peppermint selama menstruasi. Variabel yang diukur meliputi intensitas nyeri menggunakan skala numerik dan kadar hormon kortisol saliva melalui pemeriksaan ELISA. Analisis data menggunakan paired t-testdan independent t-test. Hasil penelitia rerata intensitas nyeri pada kelompok intervensi menurun dari 7,40 menjadi 3,65 (p=0,000), sedangkan pada kontrol dari 6,40 menjadi 6,00 (p=0,000). Perbedaan antar kelompok signifikan (p=0,000) dengan effect size besar (d=1,91). Kadar kortisol saliva pada kelompok intervensi turun dari 17,02 menjadi 15,84 ng/ml (p=0,001), sedangkan pada kontrol hanya dari 11,08 menjadi 11,00 ng/ml. Perbedaan antar kelompok signifikan (p=0,042) dengan effect size sedang (d=0,42). Nano Patch Peppermint efektif menurunkan nyeri dan kortisol saliva. Nano Patch Peppermint terbukti efektif menurunkan intensitas nyeri dismenore dan kadar hormon kortisol saliva pada remaja. Intervensi ini dapat menjadi alternatif nonfarmakologis dalam mengurangi keluhan menstruasi. Kata Kunci: Nano Patch Peppermint, Kortisol Saliva, Dismenore, Nyeri Haid, Remaja.
Hubungan Pendidikan dan Umur Ibu dengan Pemantauan Tumbuh Kembang Balita di Wilayah Kerja Puskesmas Banjar Bangkalan
ABSTRACT Growth monitoring achievements in Indonesia are still low, including in Bangkalan District, which ranks lowest in East Java, while the Banjar Bangkalan Community Health Center only recorded 2.34% of toddlers, or 22 toddlers, suffering from malnutrition. Low monitoring rates may be related to factors such as the mother's education and age, which affect knowledge, psychological readiness, and parenting practices. To date, there has been no research in Bangkalan analyzing the relationship between these two factors and growth monitoring based on Minister of Health Regulation No. 6 of 2024. This study used a quantitative cross-sectional design on 43 mothers with consecutive sampling, where data were collected through data collection sheets and analyzed using Fisher's Exact test. The results showed that most mothers had higher education (67.4%) and were aged ≥20 years (81.4%), but 65.1% did not monitor growth and development according to the standards. There was a weak positive relationship between education (p = 0.015) and maternal age (p = 0.036) with growth and development monitoring. These findings indicate a weak positive correlation between education and maternal age with growth monitoring of toddlers in the Banjar Bangkalan Community Health Center Working Area, making it important to provide assistance to mothers with low education and age <20 years so that growth monitoring of toddlers can be carried out optimally. Keywords: Maternal Education, Maternal Age, Growth Monitoring of Toddlers. ABSTRAK Capaian pemantauan tumbuh kembang di Indonesia masih rendah, termasuk di Kabupaten Bangkalan yang menempati posisi terendah di Jawa Timur, sementara Puskesmas Banjar Bangkalan hanya mencatat 2,34% balita dengan jumlah 22 balita yang mengalami gizi buruk. Rendahnya pemantauan dapat berkaitan dengan faktor pendidikan dan umur ibu, yang memengaruhi pengetahuan, kesiapan psikologis, serta praktik pengasuhan. Hingga saat ini, belum terdapat penelitian di Bangkalan yang menganalisis hubungan kedua faktor tersebut terhadap pemantauan tumbuh kembang berdasarkan Permenkes No. 6 Tahun 2024. Penelitian ini menggunakan desain kuantitatif cross sectional pada 43 ibu dengan teknik consecutive sampling, di mana data dikumpulkan melalui lembar pengumpulan data dan dianalisis menggunakan uji Fisher’s Exact. Hasil penelitian menunjukkan bahwa sebagian besar ibu memiliki pendidikan tinggi (67,4%) dan umur ≥20 tahun (81,4%), namun 65,1% tidak melakukan pemantauan tumbuh kembang sesuai standar. Terdapat hubungan positif lemah antara pendidikan (p = 0,015) dan umur ibu (p = 0,036) dengan pemantauan tumbuh kembang. Hal ini menandakan adanya hubungan positif lemah antara pendidikan dan umur ibu dengan pemantauan tumbuh kembang balita di Wilayah Kerja Puskesmas Banjar Bangkalan, sehingga penting memberikan pendampingan kepada ibu dengan pendidikan rendah dan umur <20 tahun agar pemantauan tumbuh kembang balita dapat berjalan secara optimal. Kata Kunci: Pendidikan Ibu, Umur Ibu, Pemantauan Tumbuh Kembang Balita.
Peranan Human Papiloma Virus Dalam Perkembangan Adenokarsinoma Serviks
ABSTRACT Cervical adenocarcinoma is a subtype of cervical carcinoma with a poor prognosis and is associated with Human Papillomavirus (HPV) infection. HPV contributes to the development of cervical adenocarcinoma through multiple mechanisms, primarily by modulating molecular pathways that regulate cell growth, survival, and immune responses. To analyze the role of HPV in the development of cervical adenocarcinoma by focusing on the molecular mechanisms involved, through a systematic review of previously published studies. The systematic literature review was conducted in accordance with the PRISMA 2020 guidelines. Literature searches were performed in PubMed Central, Google Scholar, and the Wiley Online Library for articles published between 2015 and 2025. The search strategy used combinations of terms related to the disease, exposure, and molecular pathways, connected with Boolean operators (AND/OR) and tailored to each database. A total of 16 articles met the eligibility criteria and were analyzed using a thematic narrative approach. The synthesis findings indicate that the HPV oncoproteins E6 and E7 play central roles in driving malignant transformation by disrupting cell-cycle regulation and DNA repair. In addition, HPV is known to modulate several keys signaling pathways—PI3K/Akt/mTOR, MAPK/ERK, and Wnt/β-catenin, which contribute to proliferation, invasion, and angiogenesis, inhibit cell death, and promote tumor formation. HPV influences the development of cervical adenocarcinoma through complex interactions involving the E6/E7 oncoproteins, HPV genome integration, and activation of key cellular signaling pathways. Therefore, a deeper understanding of these interactions mechanisms may facilitate the development of more effective, novel molecular therapeutic targets for cervical adenocarcinoma. Keywords: Cervical Adenocarcinoma, HPV, Molecular Pathways. ABSTRAK Adenokarsinoma serviks merupakan salah satu subtipe karsinoma serviks dengan prognosis yang buruk dan berhubungan dengan infeksi Human Papiloma Virus (HPV). HPV berperan dalam terjadinya adenokarsinoma serviks melalui berbagai mekanisme, terutama memodulasi sejumlah jalur molekular yang mengatur pertumbuhan, kelangsungan hidup, dan respon imun. Untuk menganalisis peran HPV dalam perkembangan adenokarsinoma serviks berdasarkan mekanisme molekuler yang terlibat melalui sistematik review dari berbagai penelitian yang sudah dilakukan. Sistematik literatur review dilakukan dengan mengikuti pedoman PRISMA 2020. Pencarian literatur dilakukan pada basis data PubMed Central, Google Scholar, dan Wiley Library pada artikel yang terbit dalam periode 2015-2025. Kata kunci yang digunakan adalah kombinasi istilah penyakit, paparan, dan jalur molekular yang digabungkan dengan operator Boolean (AND/OR) dan disesuaikan dengan masing-masing database. Sebanyak 16 artikel memenuhi kriteria dan dianalisis secara naratif tematik. Hasil sintesis menunjukan bahwa oncoprotein HPV E6 dan E7 memainkan peranan sentral dalam mendorong transformasi ke arah keganasan melalui gangguan regulasi siklus sel dan perbaikan DNA. Selain itu, HPV juga diketahui memodulasi beberapa jalur persinyalan utama, yaitu PI3K/Akt/mTOR, MAPK/ERK, dan Wnt/β-catenin yang berkontribusi terhadap proliferasi, invasi, angiogenesis, menghambat kematian sel dan memicu pembentukan tumor. HPV mempengaruhi perkembangan adenokarsinoma serviks melalui interaksi kompleks antara oncoprotein E6/E7, integrasi genom HPV, dan aktivasi jalur-jalur persinyalan seluler kunci. Oleh karena itu, pemahaman yang mendalam terhadap mekanisme interaksi tersebut, dapat membantu pengembangan target terapi molekuler baru yang lebih efektif untuk mengatasi adenokarsinoma serviks. Kata Kunci: Adenokarsinoma Serviks, HPV, Jalur Molecular.
Treatment of Angle Class I Malocclusion Type I and III Using Removable Orthodontic Appliances: Case Report
ABSTRACT Malocclusion is a dental and oral health problem that adolescents often experience. According to the World Health Organization (WHO), malocclusion is the third most common dental health problem after dental caries and periodontal disease. Malocclusion can cause several problems related to the face, including impaired facial aesthetics and dental issues such as difficulty moving the jaw, temporomandibular disorders, and problems with mastication, swallowing, and speaking. Malocclusion can appear in various forms, the most common being anterior teeth crowding, a condition reported by many patients seeking orthodontic treatment. Removable orthodontic appliances are a safe, easy, and aesthetically acceptable treatment alternative for mild crowding cases. This case report discusses the management of orthodontic treatment in the late mixed dentition period in a male patient with class I type I and type III malocclusion using a removable orthodontic appliance. A 13-year-old male patient came to RSGM Maranatha with complaints of crooked and crowded upper and lower front teeth, which made him insecure when smiling. The patient had never used a fixed or removable orthodontic appliance before. The patient reported no problems with chewing or speaking. There have been changes in the arrangement of the patient's maxillary teeth, but the resulting changes in the mandibular teeth have not been significant. Keywords: Class I Malocclusion, Anterior Crowding, Anterior Crossbite.
Severe Omphalocele, Exstrophy of The Cloaca, Imperforate Anus, and Spinal Defects (Oeis) : A Case Report
ABSTRACT The OEIS complex—comprising Omphalocele, Exstrophy of the cloaca, Imperforate anus, and Spinal defects—is one of the rarest and most severe congenital malformation syndromes, with an estimated incidence of 1 in 200,000–400,000 live births. Early prenatal detection plays a critical role in facilitating appropriate counseling and multidisciplinary perinatal planning. We report a prenatally diagnosed case of severe OEIS complex in a 21-year-old primiparous woman referred for suspected abdominal wall defect and fetal tachycardia. Ultrasound revealed a single live fetus at 32 weeks' gestation with a large omphalocele, protruding bowel loops, and features suggestive of cloacal exstrophy. Postnatal examination confirmed omphalocele, cloacal exstrophy, imperforate anus, ambiguous genitalia, and right-sided congenital talipes equinovarus. These findings were consistent with the classical presentation of severe OEIS. This case underscores the importance of early prenatal diagnosis and coordinated multidisciplinary management in severe OEIS complex. Timely recognition through imaging and delivery planning at a tertiary care center are crucial for optimizing immediate neonatal outcomes. Long-term prognosis remains dependent on the extent of anomalies and access to comprehensive surgical and supportive care. Keywords: OEIS, Omphalocele, Exstrophy of the Cloaca, Imperforate Anus, and Spinal Defects, Ccongenital Anomaly.
The Essence of Social Support, Psychological Well – Being, and Self – Love : A Key to Long – Term Marriage
ABSTRACT This study aims to examine the effect of social support, psychological well-being, and self-love on long-term marriage sustainability. A multiple regression analysis was used to test the relationship between the three independent variables and marital sustainability. The results show that social support and psychological well-being have a positive and significant influence on long-term marriage, with p-values below 0.05. This means that people who receive strong support from others and have good mental health are more likely to maintain a stable and lasting marriage. However, self-love does not have a significant effect (p > 0.05), suggesting that loving oneself alone may not be enough to keep a marriage strong without mutual care and relationship-focused behavior. The R-squared value of 0.873 indicates that the three variables explain 87.3% of the variation in long-term marriage sustainability. These findings highlight the importance of social and emotional support in building a lasting relationship. Keywords: Marriage Sustainability, Social Support, Psychological Well-Being, Self-Love, Multiple Regression.
Hubungan Status Gizi, Perilaku Cuci Tangan, dan Frekuensi Konsumsi Jajanan Sekolah Dengan Kejadian Diare Akut Siswa SD Islam Imama Semarang
ABSTRACT Acute diarrhea remains a major public health problem, especially among school-aged children, and can be influenced by various factors such as nutritional status, hygiene behavior, and unhygienic food consumption. Its condition requires attention because it can increase morbidity in children and negatively affect in health status. This study aimed to analyze the relationship between nutritional status, handwashing behavior, and frequency of school snack consumption with the incidence of acute diarrhea among students at Imama Islamic Elementary School. A cross-sectional design was used involving 90 respondents. Data were collected through anthropometric measurements and interviews using questionnaires and food frequency questionnaire (FFQ), then analyzed using the Chi-Square test. The results showed a significant relationship between nutritional status (p = 0.004), handwashing behavior (p = 0.002), and frequency of school snack consumption (p = 0.004) with the incidence of acute diarrhea in Imama Islamic elementary school. Keywords: Acute Diarrhea, Nutritional Status, Handwashing Behavior, School Snack Consumption. ABSTRAK Diare akut masih menjadi masalah kesehatan masyarakat yang tinggi, terutama pada anak usia sekolah, dan dapat dipengaruhi oleh berbagai faktor seperti status gizi, perilaku higiene, serta konsumsi jajanan sekolah yang tidak higienis. Kondisi ini perlu mendapat perhatian karena dapat meningkatkan angka kesakitan pada anak dan berdampak pada kualitas kesehatan. Penelitian ini bertujuan untuk menganalisis hubungan antara status gizi, perilaku cuci tangan, dan frekuensi konsumsi jajanan sekolah dengan kejadian diare akut pada siswa SD Islam Imama Semarang. Penelitian ini bertujuan untuk menganalisis hubungan status gizi, perilaku cuci tangan, dan frekuensi konsumsi jajanan sekolah dengan kejadian diare akut pada siswa SD Islam Imama Semarang menggunakan desain cross-sectionaldengan 90 responden. Data dikumpulkan melalui pengukuran antropometri serta wawancara menggunakan kuesioner dan FFQ, kemudian dianalisis menggunakan uji Chi-Square. Hasil penelitian menunjukkan adanya hubungan signifikan antara status gizi (p=0,004), perilaku cuci tangan (p=0,002), dan frekuensi konsumsi jajanan sekolah (p=0,004) dengan kejadian diare akut di SD Islam Imama. Kata Kunci: Diare Akut, Status Gizi, Perilaku Cuci Tangan, Konsumsi Jajanan Sekolah.
Integrasi Komunikasi Organisasi dan Teknologi Informasi dalam Pencegahan Fraud JKN: Sebuah Scoping Review
ABSTRACT Fraud in the implementation of the National Health Insurance (JKN) services is a serious challenge in Indonesia. Preventing fraud needs to be strengthened through a systemic organizational communication strategy based on digital technology, especially by improving information technology in hospitals, such as Hospital Management Information Systems (SIMRS) and the E-claim application. Previous studies have highlighted the role of these technologies in detecting fraud, but few have examined the role of internal communication across units in supporting the effectiveness of digital interventions for reporting and detecting fraud. This article uses a Scoping Review based on the Arksey & O’Malley (2005) framework and PRISMA-ScR reporting to map the literature on the integration of organizational communication and information technology in preventing fraud in JKN at hospitals. The thematic analysis based on CIMO (Context, Intervention, Mechanism, and Outcome) shows that the success of anti-fraud technology strongly depends on systemic internal communication mechanisms and an open organizational culture. The main recommendation is a fraud prevention strategy that integrates technology and organizational communication to achieve sustainable transparency and accountability. Keywords: Organizational Communication, JKN Fraud, Information Technology, SIMRS. ABSTRAK Fraud atau kecurangan dalam pelaksanaan layanan Jaminan Kesehatan Nasional (JKN) menjadi tantangan serius di Indonesia. Pencegahan fraud perlu diperkuat melalui strategi komunikasi organisasi sistemik berbasis digital, terutama dengan peningkatan teknologi informasi di rumah sakit, seperti SIMRS (Sistem Informasi Manajemen Rumah Sakit) dan aplikasi e-claim. Terdapat studi penelitian yang menyoroti peran teknologi tersebut dalam mendeteksi fraud, namun belum banyak yang mengkaji peran komunikasi internal lintas unit dalam mendukung efektivitas intervensi digital pada proses pelaporan dan deteksi fraud. Artikel ini menggunakan Scoping Review dengan kerangka Arksey & O’Malley(2005) dan pelaporan PRISMA-ScR untuk memetakan literatur tentang integrasi komunikasi organisasi dan teknologi informasi dalam pencegahan fraud JKN di rumah sakit. Analisis tematik berbasis CIMO (Context, Intervention, Mechanism dan Outcome) menunjukkan bahwa keberhasilan teknologi anti-fraud sangat tergantung pada mekanisme komunikasi internal dan budaya organisasi terbuka. Rekomendasi utama adalah strategi pencegahan fraud yang mengintegrasikan teknologi dan komunikasi organisasi untuk mencapai transparansi serta akuntabilitas yang berkelanjutan. Kata Kunci: Komunikasi Organisasi, Fraud JKN, Teknologi Informasi, SIMRS.
Analisis Determinan Inisiasi Menyusui Dini Pada Ibu Nifas di Kecamatan Tualang
ABSTRACT Early Initiation of Breastfeeding (EIBF) is a critical intervention recommended by WHO to reduce neonatal mortality and improve exclusive breastfeeding outcomes. Despite its proven benefits, EIBF coverage in Indonesia remains below the global target. Multiple social, economic, psychosocial, and health system factors influence EIBF success, yet comprehensive evidence remains limited in industrial regions such as Tualang District.To analyze the distal and intermediate determinants associated with successful EIBF among postpartum mothers in Tualang District, Siak Regency, in 2025.A cross-sectional analytical study was conducted using consecutive sampling. Data were collected through structured questionnaires and verified with delivery records. Statistical analysis included chi-square tests for bivariable associations and multivariable logistic regression to identify dominant determinants.EIBF success was significantly associated with parity, maternal knowledge, husband and family support, and health worker support. Logistic regression identified health worker support as the strongest determinant, followed by maternal knowledge and parity. Education, employment, and household income were significant in bivariable analysis but lost significance after controlling for intermediate determinants. Health worker support, maternal knowledge, and parity are the key determinants influencing EIBF success. Strengthening lactation education, improving health worker capacity, and involving husbands and families during antenatal and delivery care are essential strategies to enhance EIBF coverage. Keywords: Early Initiation of Breastfeeding, Social Determinants, Parity, Health Worker Support, Maternal Knowledge. ABSTRAK Inisiasi Menyusu Dini (IMD) merupakan intervensi penting yang direkomendasikan WHO untuk menurunkan mortalitas neonatal dan meningkatkan keberhasilan menyusui eksklusif. Namun, cakupan IMD di Indonesia masih di bawah target global. Faktor sosial, ekonomi, psikososial, dan kualitas layanan kesehatan berperan dalam keberhasilan IMD, namun belum banyak diteliti secara komprehensif di wilayah dengan karakteristik industri seperti Kecamatan Tualang. Menganalisis determinan jauh dan determinan antara yang memengaruhi keberhasilan IMD pada ibu nifas di Kecamatan Tualang, Kabupaten Siak, tahun 2025. Penelitian analitik dengan desain cross-sectional dilakukan pada ibu nifas menggunakan consecutive sampling. Data dikumpulkan melalui kuesioner terstruktur dan diverifikasi melalui catatan persalinan. Analisis data meliputi uji chi-square untuk menilai hubungan bivariat dan regresi logistik multivariat untuk menentukan faktor dominan. Keberhasilan IMD dipengaruhi oleh beberapa determinan, terutama paritas, pengetahuan ibu, dukungan suami, serta dukungan tenaga kesehatan. Regresi logistik menunjukkan bahwa dukungan tenaga kesehatan merupakan faktor paling dominan, diikuti oleh pengetahuan ibu dan paritas. Variabel pendidikan, pendapatan, dan pekerjaan signifikan pada analisis awal namun tidak berpengaruh setelah dikontrol oleh variabel antara. Faktor yang paling memengaruhi keberhasilan IMD adalah dukungan tenaga kesehatan, pengetahuan ibu, dan paritas. Intervensi untuk meningkatkan cakupan IMD perlu difokuskan pada penguatan edukasi laktasi, peningkatan kapasitas tenaga kesehatan, serta pelibatan suami dan keluarga dalam perawatan antenatal dan persalinan Kata Kunci: Inisiasi Menyusui Dini, Determinan Social, Paritas, Dukungan Tenaga Kesehatan, Pengetahuan Ibu.
Hubungan Kesadaran Interoseptif Dengan Kesadaran Hipoglikemia pada Penderita DM Tipe 2
ABSTRACT One condition frequently experienced by people with type 2 diabetes is hypoglycemia, which can drastically lower blood glucose levels. Undetected and untreated hypoglycemia can lead to serious complications, including seizures or loss of consciousness. However, many people with type 2 diabetes have difficulty recognizing the symptoms of hypoglycemia in its early stages. One factor thought to influence the ability to detect hypoglycemia symptoms is interoceptive awareness, which is a person's ability to perceive and identify internal bodily sensations, such as heartbeat, breathing, and changes in blood glucose levels. The purpose of this study was to explain the relationship between interoceptive awareness and hypoglycemia awareness in people with type 2 diabetes. This study used a cross-sectional design. The population comprised all 173 people with type 2 diabetes in the Mulyorejo Community Health Center (Puskesmas) in Surabaya in June 2025. A total of 110 people met the sample criteria. The instrument used to measure interoceptive awareness was the Multidimensional Assessment of Interoceptive Awareness–Version 2 (MAIA-2) questionnaire, and the HypoA-Q questionnaire was used for hypoglycemia awareness. Hypoglycemia awareness was low despite adequate interoceptive awareness. There was no relationship between interoceptive awareness and glycemia awareness in patients with type 2 diabetes. Nteroceptive awareness (the ability to perceive general body signals) is not always associated with hypoglycemia awareness due to different biological mechanisms and neurological adaptations. Keywords : Hypoglycemia Awareness, Interoceptive Awareness, Type 2 Diabetes Mellitus. ABSTRAK Salah satu kondisi yang sering dialami oleh penderita DM tipe 2 adalah hipoglikemia, yang dapat menurunkan kadar glukosa darah secara drastis. Hipoglikemia yang tidak terdeteksi dan tidak ditangani dengan cepat dapat menyebabkan komplikasi serius, termasuk kejang atau kehilangan kesadaran. Namun, banyak penderita DM tipe 2 yang kesulitan mengenali gejala hipoglikemia pada tahap awal. Salah satu faktor yang diduga mempengaruhi kemampuan deteksi gejala hipoglikemia adalah kesadaran interoseptif, yaitu kemampuan seseorang untuk merasakan dan mengidentifikasi sensasi tubuh internal, seperti detak jantung, pernapasan, dan perubahan kadar glukosa darah.Tujuan penelitian ini adalah untuk menjelaskan hubungan kesadaran interoseptif dengan kesadaran hipoglikemia pada penderita DM tipe 2. Penelitian ini menggunakan desain cross-sectional dengan jumlah populasi adalah seluruh penderita DM tipe 2 di wilayah kerja Puskemas Mulyorejo Surabaya pada bulan Juni 2025 sebanyak 173 orang. jumlah sampel yang memenuhi kriteria sebanyak 110 orang. Instrumen yang digunakan untuk variabel kesadaran interoseptif adalah kuesioner Multidimensional Assessment of Interoceptive Awareness–Version 2 (MAIA-2) dan variable kesadaran hipoglikemia menggunakan kuesioner HypoA-Q. Kesadaran hipoglikemianya rendah walaupun kesadaran interoseptifnya cukup. Tidak terdapat hubungan antara kesadaran interoseptif dengan kesadaran glikemia pada penderita DM tipe 2. Kesadaran interoseptif (kemampuan merasakan sinyal tubuh secara umum) tidak selalu berhubungan dengan kesadaran hipoglikemia karena adanya mekanisme biologis dan adaptasi neurologis yang berbeda. Kata Kunci: Kesadaran Interoseptif, Kesadaran Hipoglikemia, Diabetes Melitus Tipe 2.
Pengembangan Media Edukasi Video Animasi Sebagai Pendamping Ibu dan Kader Dalam Pemberian Makan Balita
ABSTRACT Nutrition during the First 1,000 Days of Life (DOHaD) is crucial for growth and development and is key to stunting prevention. However, field observations indicate that mothers and Posyandu cadres (community health workers) often face limited knowledge, educational media, and communication skills. The primary challenge is the low adherence to Complementary Feeding MP-ASI (guidelines regarding timely initiation, texture, portion size, food variety, and responsive feeding). This necessitates a concise, engaging, and easily reproducible educational approach. This study proposes the development of an animated video as a supplementary educational medium for mothers and a job-aid tool for cadres, utilizing a modified Research & Development approach (Borg & Gall). To create a media that is feasible, effective in increasing knowledge, and well-received by users. Methods: Included Focus Group Discussions (FGD) for needs analysis, script and storyboard design, production, expert validation, revision, and a limited pre-post-test trial involving mothers of toddlers (n=58) and cadres (n=21). Results: The media was rated as highly feasible (average 3.96/5); mothers knowledge significantly increased (61,07±15,65 → 68,39±12,18; p=0,0032; dz=0,40), and cadres' knowledge showed an greater improvement (57,88±16,43 → 71,97±11,41; p=0,0004; dz=0,92); cadre attitude was very positive (4.38/5). Discussion findings confirm that the video facilitates understanding and standardizes key messages, thereby having the potential to improve MP-ASI practices in the community. The animated video is feasible, effective, and acceptable. Recommended for integration into Posyandu Standard Operating Procedures (SOP) through short viewing/booster sessions and a one-page job-aid. Scientific article (target Sinta 1–4 journal), ready-to-use animated video product, concise job-aid sheet, and potential for Intellectual Property Rights (IPR)/cadre training module. Keywords: Animated Video, Toddler Mother’s, Cadres, Development. ABSTRAK Pemberian makan pada 1.000 Hari Pertama Kehidupan (HPK) menentukan tumbuh kembang dan pencegahan stunting, di lapangan ibu dan kader posyandu masih menghadapi keterbatasan pengetahuan, media edukasi, serta keterampilan komunikasi. Permasalahan utama adalah rendahnya kesesuaian praktik MP-ASI (waktu mulai, tekstur, porsi, variasi, responsivitas) dengan pedoman, sehingga diperlukan pendekatan edukasi yang ringkas, menarik, dan mudah diulang. Penelitian ini mengusulkan pengembangan video animasi sebagai media pendamping ibu dan alat bantu kader, dengan pendekatan Research & Development (Borg & Gall, dimodifikasi). Tujuan: menghasilkan media yang layak dan efektif meningkatkan pengetahuan serta diterima pengguna. Metode meliputi FGD untuk analisis kebutuhan, perancangan naskah–storyboard, produksi, validasi ahli, revisi, dan uji terbatas pra–pasca pada ibu balita (n=58) dan kader (n=21). Hasil menunjukkan media dinilai sangat layak (rerata 3,96/5); pengetahuan ibu meningkat (61,07±15,65 →68,39±12,18; p=0,0032; dz=0,40) dan kader meningkat lebih besar (57,88±16,43 → 71,97±11,41; p=0,0004; dz=0,92); sikap kader sangat positif (4,38/5). Pembahasan menegaskan video memfasilitasi pemahaman dan menyeragamkan pesan kunci, sehingga berpotensi memperbaiki praktik MP-ASI di komunitas. video animasi layak, efektif, dan diterima; disarankan integrasi dalam SOP posyandu melalui pemutaran singkat/booster dan job-aid satu halaman. Realisasi output: artikel ilmiah (target jurnal Sinta 1–4), produk video animasi siap pakai, lembar bantu ringkas, dan potensi HKI/modul pelatihan kader. Kata Kunci: Video Animasi, Ibu Balita, Kader, Pengembangan.