INDOGENIUS

Case Report: Midwifery Care Management for A Newborn Infant (Mrs. D) with Caput Succedaneum at The Sarfina Sembiring Primary Clinic in 2026

Himawari Kirina Petranela Sriyani — 2026-10-01

Background & Objective: Caput succedaneum is a soft tissue edema on the newborn's scalp caused by mechanical pressure during labor. This condition is commonly found in prolonged labor or instrumental deliveries and requires appropriate monitoring to distinguish it from other complications such as cephalhematoma. This study aims to implement comprehensive midwifery care for newborns with caput succedaneum using the 7-step Varney midwifery management approach.

Method: This research used a descriptive method with a case study approach on baby "D" who was born with caput succedaneum at Sarfina Sembiring Primary Clinic in 2026. Data collection was conducted through anamnesis, physical examination, observation, and documentation. Data analysis used the 7-step Varney approach.

Result: The baby was born with macrosomia (birth weight 4500 grams), length 53 cm, head circumference 39 cm, accompanied by caput succedaneum that crossed the suture lines with soft consistency. Care provided included monitoring vital signs, umbilical cord care, early initiation of breastfeeding, administration of vitamin K and HB0 immunization, and maternal education. The caput succedaneum showed spontaneous resolution within 3 days without complications.

Conclusion: Comprehensive midwifery care with early detection, monitoring, and education is essential in the management of caput succedaneum. Appropriate management prevents complications and provides reassurance to the family.

Case Study: Application of the Active Cycle of Breathing Technique (ACBT) to Address Ineffective Airway Clearance in Patients with Pulmonary Tuberculosis at Jakarta Cempaka Putih Islamic Hospital

Nabila Wahyuningtyas — 2026-10-01

Background & Objective: Pulmonary tuberculosis (TB) is an infectious lung disease characterized by increased sputum production and impaired airway clearance, leading to dyspnea and decreased respiratory function. Effective non-pharmacological nursing interventions are needed to improve airway clearance. This study aimed to determine the effectiveness of Active Cycle of Breathing Technique (ACBT) in improving airway clearance in patients with pulmonary tuberculosis. Method: This study used a descriptive case study design with a pre–post test approach involving three pulmonary TB patients treated in an inpatient ward. Nursing care was conducted for 3×24 hours, including assessment, nursing diagnosis, planning, implementation of ACBT, and evaluation. Data were collected through observation, measurement using the Breathlessness, Cough, and Sputum Scale (BCSS), and oxygen saturation (SpO₂) using a pulse oximeter before and after intervention. Result: The results showed improvement in respiratory status, indicated by decreased dyspnea, more effective cough, reduced sputum retention, and decreased BCSS scores in all patients. Oxygen saturation also increased after intervention. Conclusion: ACBT is an effective non-pharmacological nursing intervention to improve airway clearance and respiratory status in pulmonary TB patients and can be applied as part of independent nursing care in clinical settings.

The Application of Music Therapy and Dhikr for Anger Management in the Context of Nursing Care for Clients at Risk of Violent Behavior in the Family of Mrs. S in RW 05, Rawasari

Ananda Rahayu — 2026-10-01

Background & Objective: The risk of violent behavior is a mental health nursing problem characterized by an individual's inability to control angry emotions, which may endanger themselves, others, and the environment. Management can be carried out through pharmacological and non-pharmacological therapies. Non-pharmacological interventions such as Mozart classical music therapy and dhikr (remembrance of Allah) are considered safe, easy to apply, and effective in providing relaxation and emotional calmness.

Method: This case study involved two clients diagnosed with the risk of violent behavior living in a home environment: Mrs. C (41 years old) and Mr. R (65 years old). Both clients were Muslim. The intervention consisted of Mozart classical music therapy and dhikr, administered as scheduled therapeutic activities for three days (January 19–21, 2026). Evaluation was performed using an observation sheet for signs and symptoms of violent behavior risk and measurement of vital signs before and after the intervention.

Result: After the implementation of the intervention, both clients demonstrated a reduction in signs and symptoms of violent behavior risk. Mrs. C's total score decreased from 31 (high risk) to 12 (stable). Mr. R's total score decreased from 29 (high risk) to 12 (stable). Both clients showed an improved ability to recognize early signs of anger, control emotions adaptively, and exhibited reduced aggressive behavior. Vital signs also showed a decreasing trend, particularly in blood pressure and pulse rate.

Conclusion: Mozart classical music therapy and dhikri are effective as non-pharmacological nursing interventions in reducing the risk of violent behavior among clients with mental disorders in the family setting.

Effect of Deep and Murotal Breathing Techniques on Post-Major Surgical Pain

Mutiara Rahma — 2026-10-01

Background & Objective: Fracture is a condition of bone injury that often occurs due to trauma and can cause significant pain after surgery so that it requires proper treatment so as not to interfere with the patient's recovery process. Postoperative fracture pain not only impacts the physical condition but also affects the psychological and comfort aspects of the patient, so a comprehensive pain management approach is required, including nonpharmacological therapies such as deep breath therapy and Qur'anic murottal.

Method: This study aims to determine the effect of Qur'anic murottal therapy on the reduction of pain scale in postoperative fracture patients.

Result: This study used a case study design with three adult patients’ post-major surgery at one of the regional hospitals, using the Numerical Rating Scale (NRS) instrument to measure pain intensity before and after the intervention of deep breathing therapy and murottal Surat Ar-Rahman for 15 minutes. Results: The results showed a decrease in pain intensity in all respondents, where the pain score before the intervention was in the moderate category (score 4–5) and decreased to the mild category (score 3–4) after being given deep breathing and murottal therapy.

Conclusion: Deep breathing therapy and murottal Al-Qur'an are effective as a nonpharmacological intervention in reducing pain intensity in postoperative fracture patients and can be used as companion therapy to improve patient comfort and quality of recovery.

The Use of Olive Oil in Pregnant Women in Their Third Trimester with Striae Gravidarum

Fauzia Daratista — 2026-10-01

Background & Objective: Striae gravidarum is a skin change that commonly occurs in pregnant women, especially in the second and third trimesters, characterized by the appearance of lines on the skin and often accompanied by itching and discomfort. The lack of knowledge among pregnant women regarding striae gravidarum care leads to improper management. One non-pharmacological therapy that is safe and easy to apply is the use of olive oil. The purpose of this scientific paper is to apply maternity nursing care through health education and the use of olive oil in reducing itching caused by striae gravidarum in pregnant women.

Method: The method used was a descriptive case study on two third-trimester pregnant women in the Marunda Makmur area, Kampung Bidara, North Jakarta. The intervention provided included health education about abdominal skin care during pregnancy and topical use of olive oil twice.

Result: The results showed an increase in pregnant women's knowledge, indicated by an increase in pre-test to post-test scores (Mrs. A from 9 to 14 and Mrs. N from 7 to 13). In addition, there was a gradual decrease in itching complaints, with the skin condition becoming more moisturized and reduced scratch marks on the third day of intervention.

Conclusion: The conclusion of this scientific paper is that health education accompanied by the routine use of olive oil is effective in increasing knowledge and reducing itching complaints in striae gravidarum, so it can be recommended as a non-pharmacological nursing intervention for pregnant women.

The Effect of the Rubber Ball Grip and Range of Motion on Hand Muscle Strength in Patients with Hemiparesis Following a Stroke: A Case Study

Ida Nurul Hidayati — 2026-10-01

Background & Objective: Stroke is one of the leading causes of disability, often resulting in hemiparesis, which leads to decreased muscle strength, particularly in the upper extremities. One non-pharmacological intervention that nurses can provide to improve hand muscle strength is the rubber ball grip exercise. This study aimed to determine the application of rubber ball grip exercise in nursing care to improve hand muscle strength in stroke patients with hemiparesis.

Method: This study employed a case series design with a nursing process approach, including assessment, nursing diagnosis, planning, implementation, and evaluation. The rubber ball grip exercise intervention was performed routinely according to standard procedures throughout the course of care. Muscle strength was measured using a muscle strength scale (Manual Muscle Testing/MMT) before and after the intervention. The study involved two patients in the An-Nisa 2 Ward: one patient receiving the rubber ball grip intervention and one control patient receiving standard care.

Result: After the rubber ball grip exercise intervention, the patient showed improved hand muscle strength, indicated by an increase in MMT score from 3 to 4, better grip ability, and reduced tremor. In contrast, the control group patient who only received standard care without the rubber ball grip intervention showed no significant change in muscle strength, with MMT scores remaining at 2.

Conclusion: The application of rubber ball grip exercises in nursing care is effective in improving hand muscle strength in stroke patients with hemiparesis. This intervention is easy to perform, safe, cost-effective, and can serve as a supportive therapy in stroke patient rehabilitation. It is recommended that this intervention be routinely implemented as part of independent nursing care to improve hand muscle strength in stroke patients in healthcare settings.

Progressive Muscle Relaxation in Managing Anxiety in Preoperative Patients

Nindya Dwi Pangestika — 2026-10-01

Background & Objective: Anxiety is commonly experienced by patients scheduled for surgery and can affect their physiological responses and readiness. This study aimed to determine the effect of progressive muscle relaxation on anxiety levels in patients scheduled for surgery.

Method: This study used a case study design involving three adult patients scheduled for non-emergency surgery at a regional hospital in Magelang. The sampling technique used was purposive sampling based on inclusion and exclusion criteria. Anxiety levels were measured before and after the intervention using a structured questionnaire instrument. The intervention consisted of progressive muscle relaxation performed for 25–30 minutes in a comfortable environment. Data were presented descriptively and analyzed by comparing pre- and post-intervention anxiety scores.

Result: All respondents experienced moderate to severe anxiety before the intervention. After the intervention, anxiety levels decreased in all respondents. The mean anxiety score decreased from 19.3 to 15.6, with a difference of 3.7 points. There was also a shift in anxiety categories from severe to moderate and from moderate to mild.

Conclusion: Progressive muscle relaxation is effective in reducing anxiety levels in preoperative patients and can be applied as a non-pharmacological nursing intervention to improve patient readiness for surgery.

The Effect Of Nature Sound Music Therapy On Adolescent Sleep Quality In Dasan Baru Hamlet

Nuri Handayani — 2026-10-01

Background & Objective: Adolescents are females or males who fall between childhood and adulthood. According to the World Health Organization (WHO), the age range for adolescence is 10 to 19 years. According to the United Nations (UN), the age range for adolescence is 15 to 24 years. To determine the effect of nature sound music therapy on the sleep quality of An. H in Dasan Baru Hamlet.

Methods: A case study design was conducted on a single participant, An. H (16 years old). The intervention consisted of repeated nature sound music therapy for 3 consecutive days, twice daily, for 30–45 minutes each session. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) questionnaire before and after the intervention.

Results: After receiving repeated nature sound music therapy for 3 days, there was an improvement in sleep quality, with the sleep quality score decreasing from 12 (poor) to 7 (good). The adolescents also reported better sleep quality, feelings of greater relaxation, and a reduction in headaches caused by insufficient sleep.

Conclusion: Nature sound music therapy has a positive effect on improving sleep quality in adolescents. Nature sound music therapy can serve as a nursing intervention that can be performed independently because it is easily accessible and simple to implement.

The Effectiveness of Balloon-Blowing Therapy in Improving Oxygen Saturation in Patients with Chronic Obstructive Pulmonary Disease (COPD): A Case Study

Wulan Nurhidayat — 2026-10-01

Background & Objective: Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease characterized by airflow limitation and impaired gas exchange, which leads to decreased oxygen saturation and dyspnea, requiring effective non-pharmacological nursing interventions to improve pulmonary ventilation. This study aimed to determine the effectiveness of balloon blowing therapy in increasing oxygen saturation in patients with COPD. Method: This study employed a case study design involving one COPD patient treated in the Marwah 2 Ward of RS Islam Jakarta Cempaka Putih, with nursing care provided for 3×24 hours, including subjective and objective assessment, determination of nursing diagnoses, planning, implementation of balloon blowing therapy, and evaluation. Result: The results showed an improvement in the patient’s respiratory condition, as indicated by reduced dyspnea, decreased respiratory rate, and increased oxygen saturation from 90–91% to 95–97% without supplemental oxygen. Conclusion: It can be concluded that balloon blowing therapy is an effective non-pharmacological nursing intervention to improve oxygen saturation and respiratory status in patients with COPD. It is recommended that balloon blowing therapy be routinely implemented as part of independent nursing care and considered an alternative non-pharmacological intervention to enhance oxygenation in patients with COPD in healthcare settings.

Case Study: The Effect of Range of Motion (ROM) Exercises on Muscle Strength Improvement in Patient Mrs. T with Ischemic Stroke at Jakarta Islamic Hospital Cempaka Putih

Ade Karizal Putra — 2026-10-01

Background & Objective : Ischemic stroke is one of the leading health issues and the primary cause of death and disability worldwide, including in Indonesia. The main impact of ischemic stroke is the occurrence of neurological disorders in the form of muscle weakness, which leads to limited mobility and reduced independence in performing daily activities. One non-pharmacological nursing intervention that can be implemented to address this issue is Range of Motion (ROM) exercises. Objective: The objective of this final research project is to determine the effectiveness of passive ROM exercises in improving muscle strength in patients with ischemic stroke.

Method: A case report was used, employing a nursing care approach that included assessment, determination of nursing diagnoses, planning, implementation, and evaluation of nursing care for one ischemic stroke patient (Mrs. T) admitted to Room Shafa 2 at RSIJ Cempaka Putih. Passive ROM interventions were administered regularly throughout the treatment period, with muscle strength monitored using the Medical Research Council (MRC) scale.

Results: The intervention demonstrated a gradual increase in muscle strength, marked by the emergence of movement in previously weak extremities, a reduction in joint stiffness, and improved patient tolerance for the exercises.

Conclusion: Consistent implementation of ROM exercises on the right upper and lower extremities over a three-day period has shown positive changes and can improve muscle strength.

Case Study: Nursing Care for a Patient with CHF and Ineffective Peripheral Perfusion Through Passive Range of Motion (ROM) Interventions for the Lower Extremities Combined with 30° Leg Elevation in the Intensive Cardiac Care Unit (ICCU) at Jakarta Cempaka Putih Islamic Hospital

Mufti Ibrahim — 2026-10-01

Background & Objective: The high incidence of CHF is inseparable from various etiological factors, one of which is valvular heart disease. Valvular heart disease, whether in the form of stenosis or regurgitation, can lead to disturbances in blood flow and a chronic increase in cardiac workload. In Indonesia, valvular heart disease remains a significant problem, particularly rheumatic heart disease, which is commonly found among individuals in the productive age group. One of the interventions that can be provided is passive ROM (Range of Motion) exercises on the lower extremities combined with 30° leg elevation. This final scientific paper aims to determine the effectiveness of passive ROM exercises on the lower extremities combined with 30° leg elevation in patients with CHF. Method: A case study was conducted using a nursing care approach that included assessment, determination of nursing diagnoses, planning, implementation, and evaluation for a patient with CHF (Mrs. M) who was treated in the ICCU of Jakarta Islamic Hospital Cempaka Putih. The intervention of passive ROM (Range of Motion) exercises on the lower extremities combined with 30° leg elevation was administered once daily for three consecutive days to monitor the patient’s peripheral circulation using the Ankle Brachial Index (ABI) as an indicator. Result: The passive ROM intervention administered over three days resulted in improvements in ABI values, increased peripheral pulses, shortened capillary refill time (CRT), warm extremities, reduced muscle weakness, and decreased peripheral edema. Conclusion: Passive ROM exercises of the lower extremities combined with 30° leg elevation are effective nursing interventions for improving ABI values, peripheral pulses, capillary refill time (CRT), extremity warmth, muscle weakness, and peripheral edema in patients with CHF. Consistent application of passive ROM interventions to the lower extremities can support the rehabilitation process.

Case Study: Nursing Care for a Post-Craniotomy Patient with an Endotracheal Tube (ETT) for the Nursing Diagnosis of Ventilator Weaning Difficulty, Including Chest Physical Therapy and Deep Suction in the ICU at Cempaka Putih Islamic Hospital

Melly Diah Ayu Permatasari — 2026-10-01

Background & Objective: Patients after craniotomy often require mechanical ventilation through the insertion of an endotracheal tube (ETT). This condition carries the risk of ventilator weaning disorders due to secretions buildup, decreased cough reflex, and respiratory muscle weakness. To implement nursing interventions in the form of chest physiotherapy and deep suction in an effort to maintain airway patency and support successful ventilator weaning.

Method: Describing nursing care for patients with ventilator weaning disorders through chest physiotherapy and deep suction interventions. This case study uses a descriptive case study with a nursing care approach to post craniotomy patients who use endotracheal tubes (ETT) and experience problems in the ventilator weaning process in the ICU of Cempaka Putih Islamic Hospital. The method used in this study is a combination of chest physiotherapy and deep suction twice a day for 3 consecutive days. The desired outcome of the intervention was weaning from the ventilator and additional criteria, namely ventilator assistance synchronization, use of accessory breathing muscles, shallow breathing, respiratory rate, breathing effort, SpO², rales, sputum production, and RR.

Results: After intervention, oxygen saturation increased from 96% to 100% and was maintained, sputum production decreased from 410 cc to 100 cc, and rales disappeared. CRT parameters also showed improvement from 4 seconds to 2 seconds.

Conclusion: The combination of chest physiotherapy and deep suction interventions was effective in increasing oxygen saturation, reducing secretion production, and improving respiratory parameters in post-craniotomy patients with ventilator weaning disorders.

Implementation of Lime and Honey for Children with Coughs in the Kalibaru Area North Jakarta

Khonsa Nur Azizah — 2026-10-01

Background & Objective : Cough is a common respiratory problem in children and may indicate impaired airway clearance when it persists and presents with changes in cough characteristics. In preschool-aged children, prolonged cough may disrupt comfort, sleep patterns, and physiological stability, requiring appropriate pediatric nursing care based on clinical assessment. Examine pediatric nursing care in children with cough through the application of lime and honey therapy using a clinical reasoning approach.

Methods: A case study method was conducted involving two preschool children with different cough characteristics. The pediatric nursing process was carried out systematically through comprehensive assessment, data analysis based on the child’s response, determination of nursing diagnoses according to the Indonesian Nursing Diagnosis Standard (SDKI), planning, implementation, and evaluation. Nursing care was provided in the family setting as the child’s daily care environment.

Results: The results demonstrated clinical improvement, indicated by a reduction in cough frequency and intensity and improved breathing comfort after three days of lime and honey therapy. The child with a longer duration of productive cough showed a relatively slower recovery process.

Conclusion: Lime and honey therapy can be used as a supportive non-pharmacological intervention in pediatric nursing care for children with cough when guided by accurate clinical assessment and critical nursing analysis. Pediatric nursing care focusing on the child’s physiological response and family involvement contributes to improved clinical outcomes.

Case Study: The Use of Storytelling Interventions to Reduce Hospitalization Anxiety in Preschool-Aged Children

Annisa Rachma Fitri — 2026-10-01

Background & Objective: Hospitalization is an experience that can cause anxiety in preschool-aged children due to separation from a familiar environment, exposure to medical procedures, and an unfamiliar hospital environment, which can disrupt the child's comfort, healing process, and emotional development. Therefore, atraumatic care nursing interventions appropriate to the child's developmental stage are needed, one of which is storytelling therapy as a non-pharmacological intervention, with the aim of explaining the application of storytelling therapy in reducing hospitalization anxiety in preschool-aged children.

Method: This study used a descriptive case study design conducted in the inpatient ward of a hospital in Central Jakarta on two preschool-aged children experiencing hospitalization anxiety, with a purposive sampling technique. The intervention was storytelling therapy for 10–15 minutes, performed once a day for three consecutive days with different stories. Anxiety levels were measured using a faces scale instrument five minutes before and after the intervention, and data were analyzed descriptively.

Result: The results showed a gradual decrease in anxiety levels in both children up to the third day, accompanied by increased eye contact, more cooperative behavior, and reduced restless responses.

Conclusion: Storytelling therapy is effective in reducing hospitalization anxiety in preschool-aged children and can be applied as an atraumatic care nursing intervention to improve children's comfort and cooperation during treatment.

The Implementation of Family Mental Health Nursing Care for Parents Experiencing Anxiety While Caring for Adult Children with Cerebral Palsy

Tri Fram Mungga — 2026-10-01

Background & Objective: Cerebral palsy is a permanent neurological disorder that requires long-term care into adulthood. This condition not only affects the child but also places a significant psychological burden on parents as primary caregivers, particularly in the form of anxiety related to caregiving responsibilities and concerns about the child’s future. This study aimed to describe the application of family mental health nursing care for parents experiencing anxiety while caring for an adult child with cerebral palsy.

Methods: The method used was a family mental health nursing care case study of Mr. W, who experienced moderate anxiety. The assessment was conducted using the Self Reporting Questionnaire-29 (SRQ-29) and the Depression Anxiety Stress Scale-21 (DASS-21). Nursing interventions included future planning, spiritual dhikr techniques, progressive muscle relaxation, guided imagery, anxiety education, and the regulation of the child’s daily activities.

Results: Evaluation results indicated a reduction in anxiety levels, as evidenced by a decrease in the DASS-21 anxiety score from 14 to 8. Parents also demonstrated improved understanding of anxiety management and reduced psychological burden following daily activity regulation for the child.

Conclusion: The implementation of family mental health nursing care through future planning, spiritual dhikr techniques, progressive muscle relaxation, guided imagery, and education effectively reduces anxiety among parents caring for adult children with cerebral palsy, while also supporting the gradual improvement of the child’s independence

The Use of Local Guava Juice to Increase Hemoglobin Levels in Pregnant Women with Anemia

Faisa Arsy Mellyana — 2026-10-01

Background & Objectives: Anemia in pregnant women is a global health issue, including in Indonesia, generally caused by iron deficiency due to increased nutritional needs during pregnancy. This condition can be exacerbated by other factors such as birth spacing, infections, and low adherence to iron supplementation. The administration of iron tablets as a preventive measure often faces obstacles, such as side effects and low adherence. Red guava juice is rich in vitamin C and has the potential to enhance iron absorption and hemoglobin levels in pregnant women. The use of local red guava juice aims to serve as an adjunct in increasing hemoglobin levels in anemic pregnant women.

Methods: This nursing care intervention employed a case study approach and was conducted on two pregnant women with anemia.

Results: The results showed that red guava juice administered over 7 days had an effect on both participants. The participant with anemia due to nutritional deficiency experienced an increase from 9.1 g/dL to 13.4 g/dL, with symptoms decreasing by day 3 and disappearing by day 5, while the respondent with anemia due to hereditary factors showed an increase from 10.2 g/dL to 11.1 g/dL, with symptoms decreasing by day 3 and disappearing by day 7.

Conclusion: Red guava juice is effective as a supplement for increasing hemoglobin levels due to its high vitamin C content, which aids in iron absorption.

Implementation of ROM to Improve Early Mobilization in Post-Operative Patients with General Anesthesia

Ana Aprilia Pradana — 2026-10-01

Background & Objectives : Prolonged immobilization following laparotomy under general anesthesia poses serious risks including muscle weakness, deep vein thrombosis, atelectasis, and extended hospital stays. To describe the implementation of ROM exercise to improve early mobilization in post-laparotomy patients under general anesthesia.

Methods: A descriptive qualitative case study involving two post-laparotomy patients under general anesthesia at the surgical ward of RSUD Daerah Kota Magelang (October-November 2025). ROM exercise was implemented for two consecutive days, initiated within 24 hours postoperatively. Mobility level was assessed using the Johns Hopkins Highest Level of Mobility (JH-HLM) scale (0-8), twice daily.

Results: The first patient (post exploratory laparotomy due to appendix perforation with peritonitis) showed a JH-HLM improvement from score 1 to score 5 (walking in room) within two days. The second patient (post laparotomy due to ovarian cyst with torsion) improved from score 1 to score 6 (walking in hallway) despite initial barriers of postoperative nausea and vomiting (PONV) and anxiety. Both patients demonstrated reduced pain NRS scores, and no complications were observed during implementation.

Conclusions: ROM exercise initiated within the first 24 hours after laparotomy under general anesthesia is proven effective and safe in promoting early mobilization. An integrated approach encompassing pain management, PONV treatment, and psychological support is essential to optimize implementation outcomes.

Analysis of Risk Factors for Miscarriage Among Pregnant Women in Rejosari Village, Wonokerto Community Health Center

Puji Widyasih — 2026-10-01

Background & Objective: Miscarriage is a reproductive health problem that contributes to increased maternal morbidity and mortality. Several factors are associated with miscarriage, including maternal age, parity, health status such as anemia, and history of disease. In Rejosari Village, within the working area of Wonokerto Community Health Center, miscarriage cases are still reported, highlighting the importance of identifying related risk factors. This study aimed to analyze the relationship between maternal age, parity, health status, and history of disease with the incidence of miscarriage.

Method: The research used an observational analytic design with a cross-sectional approach. The population consisted of women with a history of pregnancy, and 35 respondents were selected using purposive sampling. Data were collected through questionnaires and medical records, then analyzed using the Chi-square test and Odds Ratio (OR) with a 95% Confidence Interval (CI).

Result: The findings showed significant relationships between maternal age (p = 0.011; OR = 4.17), parity (p = 0.028; OR = 3.00), health status including anemia (p = 0.004; OR = 8.33), and history of disease (p = 0.038; OR = 3.89) with miscarriage incidence. Among all variables, health status was identified as the most dominant factor associated with miscarriage.

Conclusion: Maternal age, parity, health status, and history of disease were significantly related to miscarriage incidence. Therefore, preventive efforts should emphasize early risk detection, maternal health education, and improvement of antenatal care services to reduce miscarriage risk and improve maternal health outcomes.

The Relationship Between Family Support and Self-Efficacy on Treatment Compliance in Type 2 Diabetes Mellitus Patients at RSUD Kabupaten Tangerang

Fadila Fira Damayanti — 2026-10-01

Background & Objective: Type 2 Diabetes Mellitus is a chronic disease that requires long-term treatment. Treatment compliance is influenced by including family support and self-efficacy. To determine the relationship between family support and self-efficacy with treatment compliance in Type 2 Diabetes Mellitus patients.

Method: This quantitative study with a cross-sectional design involved 270 patients with Type 2 Diabetes Mellitus who were undergoing treatment. The sampling technique was purposive sampling. Data analysis was performed using the chi-square test.

Result: The analysis showed that the majority of Diabetes Mellitus patients had high family support 147 (54.4%), high self-efficacy 140 (51.9%), and high treatment compliance 159 (58.9%). The chi-square test results showed a p-value <0.001 (p <0.05) which means they are interrelated.

Conclusion: Family support and self-efficacy are closely related to medication adherence. The higher the family support and self-efficacy, the higher the adherence to medication. This indicates a relationship between family support and self-efficacy on medication adherence in Type 2 Diabetes Mellitus patients at Tangerang Regency Hospital.

Profile of Self-Sabotage Among First-Year Undergraduate Nursing Students

Indah Lutfiah Nur Solehah — 2026-10-01

Background & Objective: Undergraduate nursing students in their early years often face complex academic demands, such as adjusting to independent learning, understanding theoretical material, and mastering practical skills. These conditions have the potential to cause psychological stress that can develop into self-sabotage—that is, maladaptive thought patterns and behaviors that hinder academic progress. This study aims to describe self-sabotage among first-year undergraduate nursing students.

Method: This study employed a quantitative descriptive design with the population consisting of all undergraduate nursing students in the class of 2025. Total sampling was used, yielding a sample size of 159 students. Data were collected using a self-sabotage questionnaire distributed online. Data were presented in the form of frequency distributions and percentages, while data analysis utilized univariate statistics.

Result: The analysis revealed that the majority of first-year students fell into the moderate category of self-sabotage, accounting for 34.59 percent. These findings indicate that self-sabotage behaviors are already evident among first-year students, although they have not yet reached a severe level.

Conclusion: It can be concluded that first-year undergraduate nursing students generally exhibit moderate levels of self-sabotage; therefore, early academic attention and guidance are necessary to support their adjustment process and the development of their academic potential.

Management of Midwifery Care for Ms. S, Age 27, G3P2A0, with a Post-Term Pregnancy Complicated by Primary Postpartum Hemorrhage at the Salbiyana Primary Care Clinic in 2026

Katrin Sihite — 2026-10-01

Background & Objective: Postdate pregnancy is a pregnancy that lasts more than 42 weeks or 294 days and increases the risk of complications for both the mother and the fetus. Primary postpartum hemorrhage remains one of the leading causes of maternal mortality in Indonesia. This study aims to implement midwifery care in a case of postdate pregnancy complicated by primary postpartum hemorrhage using the 7-step Varney midwifery management approach.

Method: This research used a descriptive method with a case study approach on Mrs. S, 27 years old, G3P2A0, who experienced postdate pregnancy and primary postpartum hemorrhage at Salbiyana Primary Clinic in 2026. Data collection was conducted through anamnesis, physical examination, observation, and documentation of midwifery care.

Result: The patient presented with complaints of abdominal pain accompanied by mucus mixed with blood at 42+ weeks of gestation with cloudy amniotic fluid. Labor induction was performed using oxytocin drip and delivery proceeded spontaneously. The baby was born in good condition with a birth weight of 2900 grams and length of 48 cm. During the fourth stage of labor, primary postpartum hemorrhage occurred due to the cervix failing to close adequately. Immediate management was provided including oxytocin drip and misoprostol, followed by referral to the hospital.

Conclusion: Comprehensive midwifery care with close monitoring and early detection of complications is essential in postdate pregnancy cases. Prompt management of primary postpartum hemorrhage and appropriate referral decisions can prevent more severe complications and save maternal lives.

Differences In Anxiety Levels Among Primiparous And Multiparous Pregnant Women Before Childbirth In Sumedang Regency

Rifa Siti Nabila — 2026-10-01

Background & Objective: Anxiety is a common psychological problem experienced by pregnant women before childbirth. One factor that may influence anxiety levels is parity, as differences in pregnancy and childbirth experiences between primiparous and multiparous women can affect their readiness for labor. This study aimed to analyze the differences in anxiety levels between primiparous and multiparous pregnant women before childbirth in Sumedang Regency.

Method: This study employed a quantitative approach with a cross-sectional design. The sample consisted of 68 pregnant women, including 32 primiparous and 36 multiparous women, selected using a probability sampling technique. Data were collected using the Hamilton Anxiety Rating Scale (HARS) questionnaire and analyzed using the Mann–Whitney U test.

Result: The results showed that all primiparous pregnant women (100%) experienced very severe anxiety. Among multiparous women, 18 respondents (50%) experienced severe anxiety and 18 respondents (50%) experienced very severe anxiety. Statistical analysis using the Mann–Whitney U test yielded a value of U = 99.00 with p < 0.001, indicating a significant difference in anxiety levels between primiparous and multiparous pregnant women. The mean rank of the primiparous group (49.41) was higher than that of the multiparous group (21.25), indicating that primiparous women experienced higher anxiety levels.

Conclusion: There was a significant difference in anxiety levels between primiparous and multiparous pregnant women before childbirth in Sumedang Regency. Primiparous pregnant women experienced higher anxiety levels than multiparous pregnant women, suggesting that parity is an important factor associated with maternal anxiety prior to labor.

Experiences of Patients with Diabetic Ulcers Undergoing Wound Care with Modern Dressings at Rumah Rara Wonogiri Wound Care Center

Prita Marsela — 2026-10-01

Background & Objective: This study aimed to explore the experiences of patients with diabetic ulcers undergoing wound care using modern dressing.

Method: This study used a qualitative method with a phenomenological approach. Participants were selected using the purposive sampling technique and consisted of five patients with diabetic ulcers who underwent wound care using modern dressing at the Wound Care Rumah Rara, Wonogiri Regency. Data were collected through in-depth interviews and analyzed using the Colaizzi method.

Result: The study identified four main themes: (1) self-care efforts to maintain the condition of diabetic wounds, (2) changes in activities and daily life due to diabetic ulcers, (3) experiences of undergoing wound care using modern dressing, and (4) the meaning of the experience of having diabetic ulcers in the participants' lives. Participants demonstrated various self-care efforts, experienced changes in their daily activities, gained experiences throughout the wound care process, and developed greater awareness of maintaining their health after experiencing diabetic ulcers.

Conclusion: Patients' experiences of undergoing wound care using modern dressing are not only related to the wound healing process but also contribute to developing awareness to become more actively involved in managing diabetes mellitus and adopting healthy lifestyle behaviors. These findings are expected to serve as a foundation for nurses in providing more holistic and patient-centered nursing care.

Identification of Factors Affecting the Incidence of Wounds in Patients with Diabetes Mellitus

Bayu Brahmantia — 2026-10-01

Background & Objective: Wounds in patients with diabetes mellitus are a chronic complication that contributes to high rates of amputation, hospitalization, and a reduced quality of life, particularly in patients with a long duration of the disease and peripheral neuropathy. This study aims to identify factors that influence the occurrence of wounds in patients with diabetes mellitus based on the patients’ experiences.

Method: This study used a qualitative design with a descriptive approach. The study population consisted of patients with diabetes mellitus who had wounds on their lower extremities. The sample comprised three women aged 56–60 years who had had diabetes mellitus for 6–10 years and had peripheral neuropathy; they were selected using purposive sampling. Data were collected through semi-structured in-depth interviews using an interview guide as the research instrument. The data were presented in narrative form and analyzed using content analysis to identify key themes related to the factors contributing to wound occurrence.

Result: The study findings indicate that the duration of diabetes mellitus and the presence of peripheral neuropathy are dominant factors influencing the occurrence of wounds, as the loss of protective sensation causes minor injuries to go unnoticed until they develop into hard-to-heal ulcers. In addition, the lack of routine foot examinations and low understanding of foot care also increase the risk of complications.

Conclusion: The occurrence of wounds in patients with diabetes mellitus is the result of an interaction between clinical factors and patients’ preventive behaviors. Glycemic control, periodic neuropathy screening, and foot care education are important strategies in prevention efforts to reduce the risk of wounds and amputations.

The Relationship Between Mothers' Knowledge of Nutritional Status And Supplementary Feeding Practices (PMT) For Toddlers in Mangunrejo Village

Yesita Ragil Kusumaningrum — 2026-10-01

Background & Objective: Nutritional problems in toddlers remain a public health issue in Indonesia. According to WHO (2022), approximately 42 million toddlers worldwide are underweight. Based on SSGI 2024, the prevalence of underweight among Indonesian toddlers reached 16.8%. In Grobogan Regency, underweight toddlers based on the BB/A index in 2025 was 7.12% (5,046 cases), while in the Pulokulon II Community Health Center working area, there were 178 toddlers below the red line (BGM).

Method: This quantitative study used a cross-sectional design with a correlation approach. The sample was 42 mothers of BGM toddlers in Mangunrejo Village, selected using total sampling. Data were collected using questionnaires on maternal knowledge about nutritional status and supplementary feeding practices (PMT). Bivariate analysis used the Spearman-Rank test.

Result: The Spearman Rank Test showed a p-value of 0.000 (<0.05) with a correlation coefficient of r = 0.566, indicating Ha was accepted and HO was rejected. There was a relationship between maternal knowledge about nutritional status and supplementary feeding practices (PMT) for BGM toddlers in Mangunrejo Village.

Conclusion: There is a relationship between maternal knowledge about nutritional status and supplementary feeding practices (PMT) for BGM toddlers in Mangunrejo Village, Grobogan Regency.

Study of Pekalongan Public Knowledge Level Regarding the Use of Turmeric Rhizome (Curcuma domestica Val.) Herbal Medicine as an Alternative to Traditional Anti-Inflammatory Treatment

Nur Kholifah — 2026-10-01

Background & Objective: Herbal medicine is still widely used in Indonesia as an alternative to traditional medicine. One commonly used herbal plant is turmeric rhizome (Curcuma domestica Val), which is known to have anti-inflammatory activity. However, the use of herbal medicine is often not accompanied by adequate knowledge regarding its benefits, dosage, and proper use. This study aims to determine the level of knowledge among the people of Pekalongan regarding the use of turmeric rhizome as an alternative traditional anti-inflammatory treatment.

Method: This research is a descriptive survey method using a closed-ended questionnaire that has been tested for validity and reliability. The number of respondents in this study was 50 people.

Result: The research results showed that 22 respondents (44%) had good knowledge, 15 respondents (30%) had fair knowledge, and 13 respondents (26%) had poor knowledge. These results indicate that the majority of the public has a good understanding of the use of turmeric as a traditional anti-inflammatory medicine. Increased education is still needed to minimize misuse of herbal medicines in the community.

Conclusion: The level of knowledge of the Pekalongan community regarding the use of turmeric rhizomes (Curcuma domestica Val) as an alternative traditional anti-inflammatory treatment is considered quite good. The majority of respondents (44%) were in the good knowledge category, but there were still respondents with sufficient knowledge (30%) and less (26%).

The Correlation Between Patient Empowerment and Self-Management Among Patients with Type 2 Diabetes Mellitus at Gading Rejo Community Healthcenter

Septiana Anggrianingsih — 2026-10-01

Background & Objective: Diabetes mellitus is a chronic disease that can lead to serious complications and death if not properly managed. Therefore, patients require effective self-management behaviors, which are influenced by patient empowerment. This study aimed to determine the correlation between patient empowerment and self-management among patients with type 2 diabetes mellitus at Gading Rejo Community Health Center. Method: This study used a quantitative method with a descriptive correlational design and a cross-sectional approach. The population consisted of all patients with type 2 diabetes mellitus registered at the health center. The sample included 54 respondents selected using purposive sampling. Data were collected using the Diabetes Empowerment Scale and the Diabetes Self-Management Questionnaire. Data analysis was performed using the Gamma test. Result: The results showed a significant correlation between patient empowerment and self-management, with a p-value of 0.001 and a correlation coefficient of 0.771, indicating a strong relationship. Conclusion: In conclusion, better patient empowerment is associated with better self-management among patients with type 2 diabetes mellitus. Therefore, it is important for healthcare services to enhance patient empowerment through continuous education, family support, and active patient involvement in decision-making.

The Effectiveness of Warm Lemongrass and Cinnamon Compresses to Reduce Acute Pain in Elderly Patients with Gout in Padang Cermin Village Way Khilau District

Andi Kurniyawan — 2026-10-01

Background & Objective: Gouty arthritis is an inflammatory joint disease commonly experienced by the elderly and characterized by increased uric acid levels and acute pain. Non-pharmacological interventions such as warm compresses made from lemongrass and cinnamon are considered effective in reducing pain through their anti-inflammatory and vasodilatory effects. This study aims to determine the effectiveness of warm compresses made from lemongrass and cinnamon in reducing pain levels in elderly people with gouty arthritis in Padang Cermin Village, Way Khilau District. Method: The method used was a case study with a nursing process approach, including assessment, diagnosis, planning, implementation, and evaluation. The intervention was carried out for 7 days with a frequency of once a day for 20 minutes. Result: The results showed a significant decrease in pain scale in both clients: Client 1 experienced a decrease from a pain scale of 6 to 2, while Client 2 experienced a decrease from a pain scale of 5 to 1 after the intervention. In addition, clients reported an increase in comfort and mobility.

The Effectiveness of Progressive Muscle Relaxation (PMR) in Older Adults with Hypertension in RW 07, Rawasari Village

Neneng Kurwiyah — 2026-10-01

Background & Objective: Hypertension is a common non-communicable disease among the elderly that can cause serious complications if blood pressure is poorly controlled. Management includes pharmacological therapy (antihypertensive drugs) and non-pharmacological therapy as a complement, such as lifestyle modification, dietary adjustment, physical activity, stress management, and complementary therapies like Progressive Muscle Relaxation (PMR). This study aimed to determine the effectiveness of PMR on blood pressure in elderly people with hypertension in RW 07, Rawasari Village.

Method: Nursing care was provided to three elderly hypertensive patients using the nursing process: assessment, diagnosis, intervention, implementation, and evaluation. PMR was performed for 3 consecutive days according to the SOP at each elderly person's home.

Result: On the first day, the average blood pressure decrease was 5 mmHg for both systolic and diastolic pressure. On the second day, the average decrease was 7.3 mmHg, and on the third day, it was 8.7 mmHg. The average decrease in the pain scale over three days was 1. These findings prove that PMR is effective in reducing blood pressure and pain in elderly individuals with hypertension.

Conclusion: The application of Progressive Muscle Relaxation (PMR) in elderly hypertensive patients with pain problems is proven effective. This non-pharmacological therapy can be recommended as a nursing intervention in the management of hypertension in the elderly.

The Effectiveness of the Nesting Method in Increasing Body Weight in Low Birth Weight (LBW) Infants: A Literature Review

Ayu Indri Juliana — 2026-10-01

Background & Objective: Low Birth Weight (LBW) infants remain a major cause of neonatal morbidity and mortality in Indonesia. LBW infants are vulnerable to physiological stress and increased energy expenditure that hinder growth. The nesting method is a nonpharmacological nursing intervention that maintains the infant's physiological flexed position and potentially supports weight gain. The objective of this study was to analyze the effectiveness of the nesting method in increasing body weight in LBW infants.

Method: This study used a literature review method with a descriptive-analytic approach. A total of 10 national and international journals were selected using purposive sampling technique based on inclusion and exclusion criteria. Data were obtained from electronic databases Google Scholar, Garuda, and the National Journal Portal, then analyzed using content analysis.

Results: The results of the review of 10 journals showed that the nesting method is effective in increasing the body weight of LBW infants. Weight gain ranged from a few grams in 3 days to more than 300 grams after 7 days of intervention. Nesting also contributed to physiological stability including oxygen saturation, respiratory rate, heart rate, and body temperature.

Conclusion: The nesting method has been proven effective as a nonpharmacological nursing intervention in increasing body weight, stabilizing physiological parameters, and improving the comfort of LBW infants, and is recommended to be applied routinely in perinatology rooms and NICU.

Infant Massage on the Growth and Development of Premature Infants: A Literature Review

Ririn Aliya Putri — 2026-10-01

Background & Objective: Premature infants are infants born before 37 weeks of gestation and are at high risk of experiencing growth disorders and developmental delays due to organ system immaturity. One of the nonpharmacological nursing interventions widely used to support the growth and development of premature infants is infant massage. The objective of this study was to analyze the effectiveness of infant massage on the growth and development of premature infants through a literature review.

Method: This study used a literature review method with a descriptive-analytic approach. A total of 15 national and international articles were selected according to inclusion and exclusion criteria through searches in the Google Scholar, PubMed, and ScienceDirect databases. Data were analyzed descriptively based on relevant research results regarding the effectiveness of infant massage in premature infants.

Results: The results of the review showed that infant massage is effective in improving the growth and development of premature infants. Most studies reported a significant increase in body weight, improved sleep quality, increased oxygen saturation, better motor and neurological development, increased bonding attachment between mother and infant, and reduced length of stay in the NICU. Several studies also showed that infant massage helps improve digestive function through vagus nerve stimulation so that nutrient absorption becomes more optimal.

Conclusion: Infant massage has been proven effective as a nonpharmacological nursing intervention that supports the growth and development of premature infants through increased body weight, sleep quality, physiological stability, motor development, and the emotional relationship between mother and infant. Therefore, infant massage is recommended as part of routine care for premature infants both in perinatology rooms, NICU, and at home with assistance from health workers.

Literature Review: The Importance of Evidence-Based Practice Learning and Undergraduate Nursing Students’ Knowledge of Wound Care Evidence

Dina Alfiana Ikhwani — 2026-10-01

Background & Objective: EBP is a combination of the best research evidence, the experience and professional skills of nurses, as well as patients’ values and desires (Cardoso et al., 2021). One of the medical fields that greatly requires an EBP approach is wound care. Wound care has undergone significant evolution, from conventional methods (such as allowing wounds to dry or using antiseptics that damage tissue) to modern wound care (moist wound healing). Therefore, assessing undergraduate nursing students’ knowledge of evidence-based wound care is an important indicator in evaluating the success of educational institutions in implementing an EBP-based curriculum.

Method: This study uses a literature study method. The aim is to examine the latest evidence regarding the importance of evidence-based learning.

Result: Evidence-Based Practice (EBP) learning is an essential pillar in modern undergraduate nursing education. In the context of wound care, EBP has shifted the old paradigm that harmed patients toward moist wound healing methods, which scientifically accelerate healing.

Conclusion: Currently, the level of nursing students’ knowledge regarding wound care evidence is at an intermediate level, where the theory they have mastered is not yet fully aligned with their ability to apply it in the field. The greatest barriers stem from differences in practice culture between the academic environment and the reality in hospitals, as well as the lack of clinical role models who implement modern wound care (Lommi et al., 2023).

The Effectiveness of Ginger and Honey Decoction Administration on Secretion Expulsion in Patients with Acute Respiratory Infection: A Literature Review

Queeneera Adelcia Angelista Zeca — 2026-10-01

Background & Objective: Acute Respiratory Infection (ARI) is one of the diseases that frequently occurs in toddlers and can cause increased secretion production, thereby disrupting airway clearance. One of the nonpharmacological therapies that can be used is the administration of ginger and honey decoction. The objective of this study was to analyze the effectiveness of ginger and honey decoction administration on secretion expulsion in ARI patients through a literature review.

Method: This study used a literature review method with a descriptive-analytic approach. A total of 10 national and international research articles were selected based on inclusion and exclusion criteria. Data were obtained through searches in the Google Scholar, PubMed, and various national and international journal databases, then analyzed using content analysis.

Results: The results of the review of 10 articles showed that the administration of ginger and honey decoction is effective in helping reduce ARI symptoms, such as cough, runny nose, secretion accumulation, and airway clearance disorders. Most studies showed a decrease in cough frequency, reduced secretion production, normalization of respiratory rate, and increased airway clearance with statistically significant results (p < 0.05). The combination of ginger and honey also provides anti-inflammatory, antimicrobial, antioxidant, and expectorant effects that support the secretion expulsion process.

Conclusion: The administration of ginger and honey decoction has been proven effective as a nonpharmacological adjunctive therapy in helping secretion expulsion and improving airway clearance in ARI patients. This intervention is safe, easily obtained, economical, and can be considered as complementary therapy, but it still does not replace the main medical therapy, especially in patients with severe symptoms.

Analysis Of Aromatherapy Effectiveness In Reducing Pain Levels Among Hypertensive Patients

Ayu Indri Juliana — 2026-10-01

Background & Objective: Hypertension is a major global health problem that can cause complications such as pain, discomfort, and decreased quality of life. Non-pharmacological therapies, including aromatherapy, are increasingly used as complementary interventions. This study aimed to analyze the effectiveness of aromatherapy in reducing blood pressure, alleviating pain, and improving comfort in patients with hypertension. Method: This study used a literature review design with a descriptive analytic approach. The population consisted of research articles on aromatherapy in hypertensive patients. A purposive sampling technique was used based on inclusion and exclusion criteria, resulting in 25 selected articles published between 2022 and 2026. Data were obtained from electronic databases including Google Scholar, PubMed, and ScienceDirect. Data were presented in tabular and narrative forms and analyzed using content analysis. The research instrument was a literature review checklist. Result: The findings showed that aromatherapy, particularly lavender, significantly reduced systolic and diastolic blood pressure with most studies reporting p-values less than 0.05. Aromatherapy also reduced pain intensity from moderate to mild levels and improved psychological conditions such as anxiety, sleep quality, and overall comfort. Combination therapies with relaxation techniques demonstrated greater effectiveness. Conclusion: Aromatherapy is an effective, safe, and complementary therapy in managing hypertension by reducing blood pressure, alleviating pain, and improving patient comfort, although further research with stronger designs is recommended.

Literature Review: Analysis of Spiritual Well-Being and Quality of Life in Patients with Chronic Kidney Disease Undergoing Hemodialysis

Yuyun Solihatin — 2026-10-01

Background & Objective: Chronic Kidney Disease (CKD) patients undergoing hemodialysis represent a chronic condition that can affect patients' quality of life physically, psychologically, socially, and spiritually. Spiritual well-being is one of the important aspects that can help patients find meaning in life, maintain hope, accept their disease condition, and develop adaptive coping during hemodialysis. This review article aims to analyze the relationship between spiritual well-being and quality of life in CKD patients undergoing hemodialysis based on research findings.

Method: The review was conducted on 8 articles within the 2023–2025 range with various research designs and instruments for measuring spiritual well-being and quality of life.

Result: The review results indicate that spiritual well-being consistently has a positive relationship with the quality of life of CKD patients undergoing hemodialysis. Better spiritual well-being is associated with more adaptive coping abilities, emotional stability, acceptance of the disease, as well as increased hope and quality of life. Family support and spiritual coping were also found to play a role in strengthening this relationship.

Conclusion: This review demonstrates that spiritual aspects need to be considered in providing holistic nursing care to support the improvement of quality of life in CKD patients undergoing hemodialysis.