Journal Title: Jurnal Kesehatan Amanah Initials: JKA Frequency: Mei dan Oktober Print ISSN: 2580-4189 Online ISSN: 2962-6366 Editor in Chief: Ns. Bayu Dwi Setyo. S.Kep.,M.Kep DOI: 10.57214 Publisher: LPPM Universitas Muhammadiyah Manado Jurnal Kesehatan Amanah ISSN: 2580-4189 (cetak), ISSN: 2962-6366 (online) merupakan kumpulan artikel-artikel ilmiah baik penelitian maupun non penelitian mengenai bidang ilmu kesehatan pada umumnya, jurnal ini terbit dua kali dalam satu tahun yaitu Mei dan Oktober. Selain menerbitkan artikel artikel yang di tulis oleh dosen Universitas Muhammadiyah Manado sendiri, kami juga menerima Submission artikel-artikel yang di tulis oleh dosen di luar Universitas Muhammadiyah Manado Indexed by : Journal Sponsors and Partners :
Teknik Pemeriksaan Radiografi Os Femur pada Kasus Fraktur Femur di Instalasi Radiologi RSUP Dr. Sardjito
Examination of the femur bone for femur fracture at the Radiology Installation of RSUP dr. Sardjito Yogyakarta was performed using a lateral projection with the central ray angled 30 degrees towards the cranial direction. However, according to several theories, it is stated that the use of lateral projection does not involve angling the central ray. The purpose of this study is to understand the examination procedure for femur bone fractures and the reasons for using the lateral projection at the Radiology Installation of RSUP dr. Sardjito Yogyakarta. The research method used in this study is qualitative research with a descriptive method and a case study approach. The research was conducted at the Radiology Installation of RSUP dr. Sardjito Yogyakarta in February-March 2025 with research subjects consisting of 3 radiographers and 1 radiology specialist doctor. The data collection methods used were observation, interviews, documentation, and literature study. Data analysis was carried out by data collection, data reduction, data presentation, and then conclusions were drawn. The results of the study show how radiographic examination of the femur in fracture cases at RSUP dr. Sardjito uses Anteroposterior and Lateral Crosstable projections to obtain optimal visualization of the anatomy of the femur, especially in uncooperative patients. The Lateral Crosstable technique was chosen because it allows clearer visualization of the proximal part of the femur without having to move the injured extremity.
Copyright (c) 2025 Jurnal Kesehatan Amanah https://creativecommons.org/licenses/by-sa/4.0
Studi Kasus Pemeriksaan Radiografi Kegawatdaruratan Abdomen Akut pada Kasus Ileus Obstruktif di RSI Sultan Agung Semarang
The abdomen is a part of the body with the upper limit of the diaphragm and the lower limit of the pubic symphysis, inside there are three organ systems. One of the pathologies of the acute abdomen is obstructive ileus, which occurs when the contents of the lumen of the digestive tract cannot be passed to the anus due to obstruction. In acute abdominal radiographic examination in cases of obstructive ileus using AnteroPosterior (AP), Left Lateral Decubitus (LLD), and upright AP projections, the exposure waiting time is 5 or 10 to 20 minutes. At the RSI Sultan Agung Semarang Installation, AP and LLD projections are used, and the exposure waiting time is 5 minutes. The aim is to determine the procedure for examining the acute abdomen in cases of obstructive ileus, the Ap and LLD projections used and the exposure waiting time is 5 minutes. The type of descriptive qualitative research with a case study approach. The subjects of the study were 3 radiographers, 1 radiology specialist, 1 referring doctor. The objects of the study were patients undergoing acute abdominal examination. Data collection methods were observation, interviews, and documentation. The data were analyzed by means of transcription, reduction, categorization tables, open coding, and conclusions were drawn. Results acute abdominal examination in cases of ileus has no special preparation, only removing metal objects that can interfere with the radiograph results, the projections used are AP and LLD. LLD projection can clarify the visualization of the Air Fluid Level level, the use of the LLD position can help establish a more accurate diagnosis of obstructive ileus. The exposure waiting time is 5 minutes, with that time it has shown free air in the abdominal cavity.
Penyakit Parkinson : Tinjauan Terpadu Biomedis dan Kemajuan Terapi Terkini
Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by the degeneration of dopaminergic neurons in the substantia nigra pars compacta, which plays a crucial role in regulating movement. The hallmark pathology of PD is the formation of Lewy bodies, abnormal protein aggregates composed primarily of α-synuclein. The pathophysiological mechanisms of this disease are multifactorial, involving a complex interaction between genetic and environmental factors. Molecularly, several key mechanisms involved include mitochondrial dysfunction, oxidative stress, chronic neuroinflammation, and genetic mutations in the LRRK2, DJ-1, PINK1, and SNCA genes, which have been shown to influence susceptibility to PD. In addition to genetic factors, the risk of developing PD is also influenced by environmental exposures, including pesticides, heavy metals, and exposure to certain toxins that can accelerate neuronal damage. The clinical manifestations of PD are characterized by classic motor symptoms, namely resting tremor, bradykinesia, rigidity, and gait disturbances, which are often accompanied by non-motor symptoms such as sleep disturbances, depression, autonomic dysfunction, and cognitive decline. Diagnosis generally follows the UK Brain Bank clinical criteria, supported by neuroimaging techniques such as DaTSCAN and MRI, and the development of biomarkers based on α-synuclein detection to improve the accuracy of early diagnosis. The main treatment option currently is pharmacological therapy, particularly levodopa, often combined with dopamine agonists or MAO-B inhibitors to optimize symptom control. In advanced cases, surgery in the form of deep brain stimulation can provide significant improvement. Innovative therapies such as gene therapy, stem cell therapy, and the integration of wearable devices and artificial intelligence are being developed to improve symptom monitoring and personalize treatment. Current research focuses on the development of more sensitive diagnostic methods and neuroprotective therapies that can slow disease progression.
Lemak Viseral, Bukan Lemak Biasa : Faktor Dominan dalam Regulasi Oil, Water, dan Hidrasi Kulit pada Dokter Muda
Visceral fat is metabolically active adipose tissue and plays a key role in the pathogenesis of various cardiometabolic diseases. The accumulation of visceral fat not only impacts systemic health but is also thought to be linked to the condition of the skin, which is the body's largest organ and sensitive to metabolic changes. This study aimed to explore the relationship between visceral fat and skin health indicators, including oil content, water content, and skin hydration in a population of young physicians. This group was selected because, although relatively clinically healthy, they are susceptible to subclinical metabolic disorders due to suboptimal work patterns and lifestyles. The study used a cross-sectional design on 96 young physicians at the Faculty of Medicine, Tarumanagara University. Data were collected through anthropometric measurements, body composition analysis using bioimpedance, skin examination with a skin analyzer, and blood lipid profiles. Spearman correlation analysis was used to assess the relationship between the study variables. The results showed that visceral fat had a significant positive correlation with oil content (r = 0.331; p = 0.001), skin water content (r = 0.338; p = 0.001), and skin hydration (r = 0.297; p = 0.004). This makes visceral fat the only body parameter that correlates consistently with all indicators of skin health. In contrast, blood LDL levels were negatively correlated with skin hydration (r = -0.222; p = 0.030), while other parameters did not show a significant relationship (p > 0.05). The conclusion of this study is that increased visceral fat is closely related to increased oil, water, and skin hydration levels through metabolic and inflammatory mechanisms, even in young, apparently healthy individuals. These findings emphasize the importance of visceral fat screening and the implementation of healthy lifestyle interventions as preventive measures to maintain skin health while reducing the risk of metabolic disorders.
Fenomena Quiet Quitting pada Tenaga Kesehatan dalam Konteks Lingkungan Kerja dan Motivasi Intrinsik: Scoping Review
Hospitals are currently facing a serious challenge with the phenomenon of quiet quitting, in which employees perform only minimal tasks without active engagement in their work. This situation has the potential to lower the quality standards of healthcare services and increase the risks of burnout and turnover. The aim of this scoping review is to map work environment factors, the role of intrinsic motivation, and indicators of quiet quitting among healthcare professionals. The method applied in this review followed the Arksey and O’Malley framework and adhered to PRISMA-ScR guidelines. Relevant articles were searched in PubMed, Scopus, and ProQuest databases using specific keywords, screened based on inclusion and exclusion criteria, and analyzed narratively. The results showed that out of 772 identified articles, only 7 met the eligibility criteria and were included for review. The findings revealed that excessive workload, lack of organizational support, weak leadership, role ambiguity, and negative organizational culture are dominant work environment factors consistently linked to quiet quitting. Psychosocial aspects such as burnout and poor work–life balance further reinforce this tendency. On the other hand, intrinsic motivation particularly meaning at work, autonomy, a sense of relatedness, and opportunities for growth emerged as protective elements that can reduce the risk of minimal engagement. Indicators of quiet quitting include low involvement, lack of initiative, limited communication, and performing only tasks stated in formal contracts. The discussion highlights that this phenomenon negatively affects patient care quality, decreases job satisfaction, and increases turnover intention. Therefore, healthcare organizations need to create a supportive work environment, strengthen intrinsic motivation, and provide managerial interventions that promote psychological well-being and autonomy at work as preventive strategies.
Hubungan Indeks Massa Tubuh, Hemoglobin, Hematokrit Pendonor dengan Kualitas Darah
The quality of blood products, particularly Packed Red Cells (PRC), is a crucial factor in ensuring safe and effective blood transfusions. Donor conditions are thought to influence the quality of produced blood components, including factors such as Body Mass Index (BMI), hemoglobin (Hb), and hematocrit levels. This study aimed to analyze the relationship between donor BMI, hemoglobin, and hematocrit levels with the quality of PRC products, which include PRC volume, hemoglobin content, and hematocrit. This was an analytical observational study with a cross-sectional design, involving 30 blood donors at the Blood Transfusion Unit of the Indonesian Red Cross (PMI) in Gunungkidul. Donor BMI was calculated from weight and height measurements, while hemoglobin and hematocrit levels were examined from capillary blood samples. The volume, hemoglobin, hematocrit, and physical appearance of PRC were evaluated according to standard procedures and analyzed using the Pearson correlation test at a 95% confidence level (α = 0.05). The results showed that the donors had an average BMI of 26.58 kg/m², hemoglobin 14.62 g/dL, and hematocrit 43.17%. Meanwhile, the PRC units had an average volume of 200.76 mL, hemoglobin content of 37.38 g/unit, and hematocrit of 54.33%, with all plasma samples appearing clear. Statistical analysis revealed no significant correlation between donor BMI, hemoglobin, and hematocrit with PRC volume (p>0.05), PRC hemoglobin (p>0.05), or PRC hematocrit (p>0.05). These findings indicate that variations in donor BMI and baseline hematological parameters do not affect the quality of PRC products. This study concludes that donor BMI, hemoglobin, and hematocrit are not associated with PRC quality. Future studies are recommended to include additional parameters, such as triglyceride levels, to provide a more comprehensive understanding of donor factors affecting blood product quality.
Faktor Gaya Hidup yang Berhubungan dengan Hipertensi di Puskesmas Sudiang
Hypertension is a major public health problem worldwide that can lead to severe and life-threatening complications such as stroke, heart disease, kidney failure, and other cardiovascular disorders if not properly managed. This study aimed to analyze in greater depth the relationship between obesity, physical activity, and sleep patterns with the incidence of hypertension in the working area of the Sudiang Health Center in Makassar City. A quantitative approach with a cross-sectional design was employed to ensure a comprehensive overview of the risk factors. A total of 100 respondents were selected from a population of 22,572 people using the Slovin formula with a ten percent margin of error and purposive sampling based on predetermined inclusion criteria. Data collection was conducted using structured questionnaires combined with medical records to increase the accuracy of the information obtained. The collected data were analyzed using the Chi-Square test with a significance level set at 0.05. The results showed a significant relationship between obesity (p = 0.000), physical activity (p = 0.023), and sleep patterns (p = 0.019) with the incidence of hypertension. Respondents who were obese, performed low levels of physical activity, and had poor sleep patterns were more likely to develop hypertension. This study highlights the importance of maintaining an ideal body weight, increasing regular physical activity, and improving sleep patterns. Health professionals are expected to strengthen education, counseling, and regular monitoring to control modifiable lifestyle risk factors within the community effectively.
Hubungan Kadar Profil Lipid dengan Homosistein pada Pasien Dislipidemia di Laboratorium Klinik Prodia Tangerang
Dyslipidemia is one of the causes of coronary heart disease and stroke. Hypercholesterolemia can cause atherosclerosis. In recent years, there has been an independent risk factor that is an important factor in the presence of blood vessel wall abnormalities, namely homocysteine. Increased homocysteine has been shown to increase the risk of cardiovascular disease independently. This study is an observational analytical study using a cross-sectional design with a retrospective approach. The sample used was 33 respondents selected through a total sampling technique The results of the test on the relationship between Lipid Profile and homocysteine using statistical testing methods, namely Spearman's Rho, yielded the following results: there is no significant relationship between Total Cholesterol and homocysteine with a Sig value of 0.791 (>0.05) and a correlation coefficient of 0.048; there is no significant relationship between LDL Cholesterol and homocysteine with a Sig value of 0.272 (>0.05) and a correlation coefficient of -0.197; there is a significant relationship between HDL Cholesterol and homocysteine with a Sig value of 0.004 (<0.05) and a correlation coefficient of -0.487; there is a significant relationship between Triglycerides and Homocysteine with a Sig value of 0.047 (<0.05) and a correlation coefficient of 0.348. The conclusion of this study is that there is a significant relationship between HDL Cholesterol and Triglycerides to homocysteine in patients with Dyslipidemia at Prodia Clinical Laboratory Tangerang. Further research is needed with a larger sample size focusing on the gender and age of the respondents.
Hubungan Kadar Vitamin D terhadap Nilai N-Mid Osteocalcin dan C-Terminal Telopeptida di Laboratorium Klinik Prodia Bekasi
Vitamin D deficiency can lead to various bone diseases, such as osteoporosis. Standard laboratory tests used to assess bone turnover and formation activity are the N-Mid Osteocalcin (N-Mid) and C-Terminal Telopeptide (C-Tx) tests. Imbalance in N-Mid and C-Tx levels can result in bone health disorders. This study aims to analyze the relationship between Vitamin D levels and N-Mid and C-Tx values. This research used an analytical observational design with a cross-sectional retrospective approach. A total of 32 respondents were selected using total sampling technique. Statistical analysis was performed using Spearman’s Rho test to examine the relationship between Vitamin D levels and N-Mid and C-Tx values. The results showed no significant relationship between Vitamin D levels and N-Mid values (p > 0.05), and no significant relationship between Vitamin D levels and C-Tx values (p > 0.05). The conclusion of this study is that there is no significant relationship between Vitamin D levels and N-Mid Osteocalcin or C-Terminal Telopeptide in patients tested at Laboratorium Klinik Prodia Bekasi. This study provides insights into the importance of monitoring Vitamin D levels in bone disease prevention, even though the results indicate no significant relationship with N-Mid and C-Tx parameters.
Determinasi Maternal pada Kasus Stunting Balita 6–24 Bulan di Aceh Selatan
Stunting is a serious public health problem that has a long-term impact on the quality of life of future generations, especially in terms of physical, cognitive, and productivity growth. This study aims to analyze maternal factors that affect the incidence of stunting in toddlers aged 6–24 months in South Aceh Regency, the area with the highest prevalence of stunting in Aceh Province. The research design used a case-control study involving 228 respondents, consisting of 114 stunted toddlers as the case group and 114 non-stunted toddlers as the control group. Data were obtained through maternal health records (KIA book), observations, and e-PPGBM data, then analyzed using multiple logistic regression. The results of the study showed that maternal factors that had a significant effect on the incidence of stunting were the age of at-risk mothers (<20 years or >35 years), the number of children, pregnancy anemia, and chronic energy deficiency (KEK). The SEZ factor during pregnancy was the most dominant determinant with a 4.46 times greater risk of giving birth to stunted children compared to mothers with normal nutritional status (p=0.014; 95% CI=1.35–14.73). These findings confirm the importance of maternal nutrition interventions from pre-conception to pregnancy, optimization of antenatal care (ANC) visits, and appropriate family planning as a stunting prevention strategy based on local contexts.
Perbedaan Pengaruh Ischemic Compression dengan Static Stretching pada Myofascial Pain Syndrome Muscle Upper Trapezius di SMP Negeri 3 Suruh
Myofascial Pain Syndrome (MPS) of the Upper Trapezius is a common musculoskeletal disorder often caused by prolonged smartphone use with non-ergonomic Posture. This condition is frequently experienced by adolescents and may lead to pain, limited range of motion, and reduced functional activity. Management of Myofascial Pain Syndrome can be carried out through various physiotherapy interventions, such as Ischemic Compression and Static Stretching. Design: The Design of this study was to determine the difference in the effects of Ischemic Compression and Static Stretching on Myofascial Pain Syndrome of the Upper Trapezius muscle. The research design used was a quasi-experimental study with a two-group Pre-test and Post-test design. A total of 20 respondents with MPS of the upper trapezius were randomly divided into two groups, each consisting of 10 participants. The first group received Ischemic Compression, while the second group received Static Stretching, with a frequency of three times per week for four weeks. Pain intensity was measured using the Quadruple Visual Analogue Scale (QVAS) before and after the intervention. Results: The results showed that both interventions significantly reduced pain levels in Myofascial Pain Syndrome (p < 0.05). However, Ischemic Compression demonstrated a more significant reduction in pain compared to Static Stretching. Result of the research: There is a difference in the effects of Ischemic Compression and Static Stretching on reducing pain in Myofascial Pain Syndrome of the Upper Trapezius, with Ischemic Compression being more effective. This technique may be recommended as a physiotherapy intervention in managing Myofascial Pain Syndrome-related pain among adolescents.
Analisis Pelaksanaan Manajemen Pelayanan Rumah Sakit terhadap Kepuasan Pasien Rawat Jalan Peserta BPJS di RSUD Cut Nyak Dhien Meulaboh
Patient satisfaction is an important indicator in assessing the quality of hospital services, especially for National Health Insurance (JKN) participants. This study aims to analyze the influence of planning, organizing, implementing, and controlling management functions on the satisfaction of outpatients of BPJS participants at Cut Nyak Dhien Meulaboh Hospital. The approach used was quantitative with a cross sectional design, involving 100 respondents selected through accidental sampling techniques. Data collection was carried out using a closed questionnaire that has been tested for validity and reliability. Data analysis was carried out using a double logistics regression test. The results showed that the four management functions had a significant influence on patient satisfaction (p < 0.05). Among these variables, service implementation was the most dominant factor with an odds ratio (OR) value of 445,949. This shows that the implementation of services that are procedural, fast, and communicative greatly determines the level of patient satisfaction. These findings underscore the importance of service management that is structured, patient-oriented, and supported by continuous evaluation and supervision. Therefore, strengthening the implementation and organizing function needs to be a priority in efforts to improve the quality of services in hospitals.
Evaluasi Strategi Kebijakan tentang Bullying dan Dampaknya terhadap Kesehatan Mental Remaja di SMA Negeri 1 Plus Matauli Pandan
Bullying is a global problem that affects adolescents' mental health as well as the quality of education. This study aims to evaluate the anti-bullying policy at SMA Negeri 1 Plus Matauli Pandan and identify its impact on the psychological well-being of students. The research method uses a qualitative approach with a phenomenological design. A total of nine informants were selected through purposive sampling, consisting of key, main, supportive, and triangulated informants. Data was obtained through in-depth interviews and document review, then analyzed using the CIPP (Context, Input, Process, Product) evaluation model. The findings of the study show that anti-bullying policies are rooted in the vision, mission, and Student Honor Code of Conduct that rejects all forms of bullying. In terms of input, the involvement of BK teachers, homeroom teachers, students, and parents plays an important role, although the limited number of counselors is still an obstacle. The implementation process is carried out through socialization, routine supervision, and counseling with an emphasis on prevention and rehabilitation aspects. Product evaluations showed a significant decrease in cases of physical bullying, although verbal behavior was still found. This policy has a positive impact by increasing students' sense of security, confidence, and learning comfort, while encouraging changes in the attitude of perpetrators. Based on these results, the study recommends strengthening anti-bullying literacy, consistency in the implementation of sanctions, and developing broader psychosocial services. These efforts are needed to ensure the sustainability of the policy while supporting adolescent mental health.
Evaluasi Implementasi Aplikasi P-Care dengan Metode Task Technology Fit di Puskesmas Kota Blangkejeren
Advances in information technology in the health sector encourage the use of digital applications to improve service efficiency. One of them is the Primary Care (P-Care) application developed by BPJS Kesehatan to support the implementation of National Health Insurance (JKN) in first-level health facilities. This study aims to evaluate the implementation of P-Care at the Blangkejeren City Treatment Center using the Task Technology Fit (TTF) approach. This study uses a descriptive qualitative method with a narrative approach. Data was collected through in-depth interviews with the heads of health centers, medical personnel, and patients, and analyzed interactively through the stages of reduction, presentation, and drawing conclusions. The results of the study show that the perception of health workers on the ease of use and benefits of P-Care is quite positive, although it is still constrained by system disruptions and infrastructure limitations. Attitudes and interest in use remain high, but actual usage is not fully optimal because there is still a combination of digital and manual processes. The conclusion of this study states that although P-Care has supported service improvement, optimization of application features and infrastructure improvements are urgently needed. Training support and strengthening internal management at health centers are important factors to ensure the sustainability of the implementation of the application as a whole.
Pengaruh Supervisi Kepala Ruangan terhadap Kinerja Perawat Pelaksana di Ruang Rawat Inap Rumah Sakit Umum Wira Husada Kisaran Tahun 2025
Hospitals have the main responsibility in providing quality, effective, and efficient health services. The performance of the implementing nurse is an important indicator to ensure the quality of service and patient safety. The supervision of the head of the room as part of the managerial function includes planning, organizing, guidance, direction, supervision, evaluation, as well as recording and reporting, all of which are aimed at ensuring that nursing care is carried out according to standards. This study is focused on analyzing the influence of head of room supervision on the performance of implementing nurses in the inpatient room of Wira Husada Kisaran Hospital in 2025. The study used a quantitative approach with a cross sectional design. All 86 implementing nurses were sampled through the total sampling method. Data were collected with questionnaires on supervision and performance, then analyzed using univariate, bivariate with Chi-Square, and multivariate tests through multiple linear regression. The results showed that the functions of planning, supervision, evaluation, and recording and reporting had a significant effect on nurse performance (p<0.05). On the other hand, the organizing and directing functions did not have a significant effect, while guidance showed a negative direction. The most dominant variables were recording and reporting. Thus, it can be concluded that the supervision of the head of the room has a strategic role in improving nurse performance, so it is necessary to implement consistent, structured, and continuous supervision.
Pengaruh Metode Ekstraksi Maserasi dan Infudasi terhadap Kadar Flavonoid Total serta Aktivitas Antioksidan Daun Kunyit (Curcuma Longa L.)
Free radicals are known to contribute to a variety of degenerative diseases, including diabetes, cancer, and cardiovascular disease, as well as to the acceleration of the aging process. To counteract these effects, antioxidant compounds capable of neutralizing free radicals are essential. Turmeric leaf (Curcuma longa L.) is a promising source of natural antioxidants, as it is rich in flavonoid compounds that offer a range of important biological benefits. This study aimed to evaluate how different extraction methods influence the total flavonoid content and antioxidant activity of turmeric leaf extract, in order to identify the most effective technique. Two methods were used: maceration and infusion. The total flavonoid content was determined using the AlCl₃ colorimetric method, with quercetin serving as the standard. In vitro antioxidant activity was assessed using the ABTS method, and the results were measured by the total flavonoid content (expressed in mg quercetin equivalent (QE)/g of extract) and the IC₅₀ value, which indicates the strength of the antioxidant activity. The findings showed that the maceration method produced the highest flavonoid content, at 27.850 mg QE/g, and the best antioxidant activity, with an IC₅₀ value of 44.224 μg/mL. In contrast, the infusion method resulted in lower flavonoid content and antioxidant activity. This leads to the conclusion that the extraction method significantly impacts the quality of turmeric leaf extract, and maceration is the most effective technique for obtaining an extract with high flavonoid content and potent antioxidant activity.
Gambaran Sikap Petugas Administrasi terhadap Pasien Rawat Jalan di Rumah Sakit Umum Bhakti Asih Tahun 2025
Administrative officers are the frontline of hospital service systems, playing not only an administrative role but also shaping first impressions, influencing trust, and serving as key determinants of initial patient satisfaction within the dynamic and time-sensitive context of outpatient care. This study aims to describe the attitudes of administrative staff toward outpatients at Bhakti Asih General Hospital in 2025. The research employed a descriptive quantitative method using accidental sampling. A total of 50 patients from the internal medicine and cardiology clinics served as respondents. The results showed that the affective dimension was rated as good by 33 respondents (66.0%), the cognitive dimension by 33 respondents (66,0%), and the behavioral dimension by 33 respondents (66,0%). Although most responses were in the “good” category, some respondents gave “fairly good” ratings, particularly regarding emotional communication, information delivery, and responsiveness. In conclusion, the attitudes of administrative staff are generally good, although improvements are still needed to ensure equitable service quality.
Faktor yang Mempengaruhi Mutu Pelayanan Keperawatan terhadap Tingkat Kepuasan Pasien di Rawat Inap Penyakit Dalam RSUD Pirngadi Kota Medan
Nursing services are an important component in the hospital system and are one of the main indicators of the quality of health services. This study aims to analyze the influence of the quality of nursing services on the satisfaction of inpatients at Dr. Pirngadi Hospital, Medan City. The research design used an analytical approach with a cross sectional design, involving 97 inpatient respondents in the internal medicine section selected through purposive sampling techniques. The research instrument is in the form of a structured questionnaire that measures five dimensions of service quality based on the SERVQUAL model (tangible, reliability, responsiveness, assurance, empathy). Data analysis used multivariate logistic regression to identify the dominant factors influencing patient satisfaction. The results showed that all dimensions of nursing service quality were significantly related to patient satisfaction (p < 0.05). The most dominant factor is assurance with an Odds Ratio (OR) value of 23,292, which shows that service assurance, sense of security, and competence of health workers are the main determinants of patient satisfaction. This study emphasizes that improving the quality of nursing services as a whole, especially in the aspects of assurance and empathy, is an important strategy in increasing patient satisfaction and hospital competitiveness.
Determinan Stunting pada Anak Usia 6–24 Bulan di Puskesmas Hutaimbaru, Padang Lawas Utara
Stunting is a condition of long-term malnutrition that can seriously interfere with children's growth and development. Children aged 6–24 months who are stunted are at risk of brain development delays, intellectual disorders, stunted physical growth, and metabolic problems. This research was conducted in the working area of the Hutaimbaru Health Center, Halongonan District, North Padang Lawas Regency, by involving 100 stunted children under five as respondents. The method used is an analytical survey with a cross-cutting approach. Data analysis included univariate, chi-square, and logistic regression tests. The results showed that knowledge, attitudes, pregnancy checks (ANC), and husband support had a significant effect on stunting incidence. The most powerful factor is the husband's support. Mothers without partner support are 10 times more likely to have stunted children. These findings confirm the importance of the role of the family, especially the husband, in supporting the fulfillment of nutrition and optimal child care.
Penggunaan Pitch Rendah pada Pemeriksaan CT Scan Kepala pada Kasus Trauma di RSUD Banyumas
RSUD (Regional General Hospital) Banyumas is a healthcare institution offering radiology services, such as head CT scans for trauma cases. The application of CT scan pitch parameters is essential for generating high-quality images while reducing the radiation exposure to the patient. This study employed a descriptive qualitative methodology utilizing a case study approach. The author presents an analysis of low pitch utilization in head CT scans for trauma cases at RSUD Banyumas. The research was carried out between May and June 2025. The participants included three radiographers and one radiologist. The methods employed for data collection comprised observation, interviews, and documentation. The study results demonstrate that the CT scan procedure for head trauma at RSUD Banyumas was executed with the patient in a supine head-first position and a pitch parameter set at 0.55. Employing a lower pitch enhances image detail and noise, although with the potential for increased radiation exposure. This study concludes that appropriate pitch utilization in head trauma CT scans at RSUD Banyumas significantly affects image quality.
Faktor-Faktor yang Berhubungan dengan Kecelakaan Kerja pada Proyek Pembangunan Mal di PT X Tahun 2025
Work accidents remain a significant issue in the construction sector and can be caused by various factors, including basic causes (knowledge and length of service), lack of control (supervision), and immediate causes (housekeeping). A preliminary study indicated that 53% of respondents had experienced accidents of varying severity. This study aims to analyze factors related to work accidents in the mal construction project at PT X in 2025. The research employed an analytic cross-sectional design with 84 workers selected using simple random sampling. Data were collected using a questionnaire and analyzed through univariate and bivariate methods with the chi-square test. The study was conducted from May to July 2025. Univariate results showed the highest proportion in workers who had experienced accidents (57 respondents; 67.9%), had high knowledge (52 respondents; 61.9%), long work experience (51 respondents; 60.7%), high supervision (52 respondents; 61.9%), and conducive housekeeping (49 respondents; 58.7%). Bivariate analysis revealed significant relationships between knowledge (p=0.000), supervision (p=0.043), and housekeeping (p=0.044) with work accidents, while length of service (p=0.596) showed no relationship. These findings are expected to serve as a basis for preventing work accidents at PT X.
Hubungan Kelainan Letak dan Paritas dengan Kejadian Ketuban Pecah Dini di Rumah Sakit Harapan Bunda Kota Batam Tahun 2024
Premature Rupture of Membranes (PROM)s a condition where the amniotic sac breaks before labor begins. This can occurn full-term pregnancies (≥37 weeks) or preterm pregnancies (<37 weeks), whichs also known as preterm PROM. PROMs one of the main risk factors for complicationsn both the mother and the baby, during and after childbirth. Therefore,tsmportant todentify the factors associated with the occurrence of PROM. This study aims to examine the relationship between fetal malpresentation and parity with thencidence of PROM at Harapan Bunda Hospitaln Batam Cityn 2024. The research used a quantitative approach with a retrospective case - control design. A total of 42 mothersn labor were selected using purposive sampling based on specific criteria. Analysis using the chi-square test showed a p-value of 0.000 (<0.05),ndicating a significant relationship between fetal malpresentation and maternal parity with the occurrence of PROM.t can be concluded that abnormal fetal position and the number of previous births (parity) are strongly related to the risk of premature rupture of membranes among mothers giving birth at Harapan Bunda Hospital.
Efektivitas Pijat Oksitosin terhadap Produksi Asi pada Ibu Nifas Hari ke 1-3
Breast milk is a natural food for newborns that can influence their growth and development. Breast milk is given without any additives to babies from zero to six months of age. The WHO recommends exclusive breastfeeding from zero to six months of age, but implementation remains uneven in some regions. According to the Indonesian Ministry of Health, national exclusive breastfeeding coverage in 2022 was 67.96%, below the RPJMN target of 70%. In the Special Region of Yogyakarta (DIY) Province, the figure reached 76.8% in 2022, with Yogyakarta City having the lowest achievement compared to other regencies. This results in suboptimal breast milk production. To increase breast milk production in mothers, oxytocin massage techniques can be used.. This method was chosen because it is non-pharmacological, easy to do and proven to be able to stimulate the hormone oxytocin. easy to do and proven to be able to stimulate the hormone oxytocin. This study aims to determine the effectiveness of oxytocin massage in influencing breast milk production in postpartum mothers at Nur Hidayah Hospital. Quantitative research method with quasi-experimental design, Respondents were 30 people obtained through accidental sampling. Data collection used a directed observation sheet and measuring cup (cc). The results of the Independent Sample T Test analysis showed a significance value of 0.001 (p <0.05) meaning that there is effectiveness of oxytocin massage on breast milk production in postpartum mothers on days 1-3. The conclusion of the study is that there is effectiveness of oxytocin massage on breast milk production in postpartum mothers on days 1-3.
Gambaran Tingkat Pengetahuan Tentang Anemia pada Remaja Putri di Pesantren Dar Maryam Aceh Besar
Anemia is a global public health problem that has a serious impact, especially on young children, adolescent girls, pregnant women, and postpartum women. This condition is characterized by lower than normal hemoglobin (Hb) levels in the blood, thus interfering with the function of body tissues due to lack of oxygen. The impact includes a decrease in learning concentration, productivity, and endurance. This study aims to determine the level of knowledge of adolescent girls about anemia at the Dar Maryam Aceh Besar Islamic Boarding School. The study used a descriptive approach with a purposive sampling technique, involving 38 respondents. Data was collected through interviews using questionnaires. The results showed that 6 people (16%) had very good knowledge, 24 people (63%) had good knowledge, and 8 people (21%) had poor knowledge. Good knowledge plays an important role in increasing adolescents' awareness of nutritious food consumption patterns and healthy living behaviors. This study recommends increasing nutrition education, regular consumption of blood-boosting tablets, and periodic health check-ups with the assistance of medical personnel. This effort is expected to be able to increase knowledge and prevent anemia in adolescent girls in a sustainable manner.
Hubungan Konsumsi Protein dengan Kadar Hemoglobin Remaja Putri di Kabupaten Bekasi
Hemoglobin plays a vital role in transporting oxygen throughout the body. A decrease in hemoglobin levels can lead to oxygen deficiency in tissues, potentially causing anemia. Anemia is characterized by symptoms such as fatigue, dizziness, and reduced concentration, and is a health issue that must be addressed, especially among adolescent girls. This is a quantitative study using an analytical observational method with a cross-sectional design. The study population consisted of 516 female students aged 15–18 years at SMAN 3 Cikarang Utara, with 92 students selected as samples using purposive sampling. The research was conducted in June 2025. Data analysis was performed using the chi-square test. The findings revealed that 33 students (35.9%) experienced anemia out of the 92 participants. Furthermore, 45 students (48.9%) had inadequate protein intake, 39 students (42.4%) engaged in heavy physical activity, and 37 students (40.2%) were categorized as food insecure. Significant associations were found between protein intake (p = 0.000), physical activity (p = 0.000), and household food security (p = 0.047) with hemoglobin levels in adolescent girls. There is a relationship between protein intake, physical activity, and household food security with hemoglobin levels among adolescent girls.
Efektivitas Teknik Bedah Laparoskopi Dibandingkan Bedah Konvensional pada Pasien Apendisitis Akut di Rumah Sakit
Penelitian ini bertujuan untuk menganalisis efektivitas teknik bedah laparoskopi dibandingkan dengan bedah konvensional pada pasien apendisitis akut di rumah sakit dengan pendekatan bibliometrik menggunakan perangkat lunak VOSviewer. Teknik laparoskopi semakin banyak digunakan karena dianggap memberikan hasil klinis yang lebih baik, seperti waktu pemulihan yang lebih cepat, nyeri pascaoperasi yang lebih ringan, dan masa rawat inap yang lebih singkat. Data bibliometrik diambil dari database Scopus dengan kata kunci "laparoscopic appendectomy", "conventional appendectomy", dan "acute appendicitis" untuk publikasi antara tahun 2015–2025. Analisis VOSviewer menunjukkan tren peningkatan penelitian pada teknik laparoskopi, dengan kata kunci yang paling sering muncul meliputi minimally invasive surgery, hospital stay, postoperative pain, dan surgical outcomes. Hasil telaah pustaka menunjukkan bahwa bedah laparoskopi memiliki keunggulan dibandingkan bedah konvensional dalam hal durasi rawat inap dan pemulihan pascaoperasi, meskipun masih terdapat kontroversi dalam hal biaya dan waktu operasi. Dengan demikian, teknik laparoskopi direkomendasikan sebagai pilihan utama dalam penanganan apendisitis akut, terutama di rumah sakit dengan fasilitas dan tenaga medis yang memadai. Penelitian ini juga menyoroti perlunya kajian lokal yang lebih kontekstual terhadap penerapan teknik ini di rumah sakit di Indonesia.(translate inggris)
Determinan Kejadian Stunting pada Anak Usia 0- 59 Bulan di Wilayah Kerja Puskesmas Dalu Sepuluh Desa Dalu 10 A Kecamatan Tanjung Morawa Kabupaten Deli Serdang
Stunting is a growth failure condition in toddlers caused by chronic malnutrition, making children shorter than their age. Stunting is a public health issue that requires serious attention due to its long-term impact on children’s development. Based on observations at Puskesmas Dalu Sepuluh, the prevalence of stunting was recorded at 52 children in 2022 and 35 children in 2023 out of a total of 6,737 toddlers. In addition, 8 children were identified as stunted during this research. This study aims to analyze the determinants of stunting in children aged 0–59 months in the working area of Puskesmas Dalu Sepuluh, Dalu 10 A Village, Tanjung Morawa District, Deli Serdang Regency. The research design used was observational analytic with a cross-sectional approach. The population consisted of 445 toddlers, and a sample of 211 respondents was selected using the Slovin formula with probability random sampling. Data were analyzed using the Chi-Square test, Fisher’s Exact test, and Multiple Logistic Regression Enter Method at a 95% confidence level. The findings showed that complementary feeding (OR = 9.13, 95% CI: 1.39–76.01) reduces the risk of stunting, while family income (OR = 12.92, 95% CI: 1.56–106.91) and parenting patterns (OR = 11.56, 95% CI: 1.39–96.01) increase the risk. Addressing these factors is vital to reduce stunting prevalence in toddlers.
Faktor yang Memengaruhi Tindakan Ibu Hamil dalam Mengatasi Kurang Energi Kronik di Wilayah Kerja Puskesmas Perawatan Pining Kecamatan Pining
Chronic Energy Deficiency (CED) is a condition in which a person’s nutritional status is poor due to a prolonged or chronic lack of consumption of energy-rich foods containing macronutrients. The purpose of this study was to determine the factors that influence the prevention of chronic energy deficiency (CED) in pregnant women in the Pining Health Center Work Area, Pining District, Gayo Lues Regency. The type of research is quantitative with a cross-sectional design. The population in this study was 72 respondents with the sample being the total sampling. Data analysis used univariate, biavariate analysis using chi-square and multivariate test statistik with logistic regression test statistics at a confidence level of 95% (α=0.05). Based on the research results of the study, it shows that there is an influence of income on overcoming CED (p= 0,002), knowledge about overcoming CED (p= 0,000), attitudes about overcoming CED (p= 0,007), and family support on overcoming CED (p= 0,002) in the working area of the Pining Care Health Center, Pining District, Gayo Lues Regency. The conclusion of this research is that income, knowledge, attitude, and family support have an effect on the prevetion of chronic energy deficiency (CED). It is recommended that pregnant women’s knowledge be continuously improved, both by seeking health information every time the importance of consuming a diverse diet to meet the mothers nutrition needs so that nutritional needs can be met
Faktor yang Memengaruhi Status Gizi pada Balita di Wilayah Kerja Puskesmas Perawatan Pining Kecamatan Pining Kabupaten Gayo Lues Kota Aceh
Nutrition status is a condition of the body as a result of food consumption and the use of nutrients that are very much needed by the body as a source of energi, grouth and maintenance of body tissues, and regulators of body processes. The purpose of this study was to determine the factors that influence malnutrition in toddlers in the Pining Health Center Work Area, Pining District, Gayo Lues Regency, Aceh City. The type of research is quantitative with a cross-sectional design. The population in this study was 234 respondents with the sample being the purposive sampling. Data analysis used univariate, biavariate analysis using chi-square and multivariate test statistik with logistic regression test statistics at a confidence level of 95% (α=0.05). Based on the research results, it shows that there is an infuluence of feeding practices (p=0.002), parenting practices (p=0.002), hygiene practices (p=0.001), and health care practices (p=0.008) on malnutrition in toddlers in the Pining Health Center Work Area, Pining District, Gayo Lues Regency, Aceh City. The conclusion of this study is that health care practices are the most influence with malnutrition. It is recommended to increase community empowerment in each village in malnutrition to improve nutrition and improve the health of the community, especially toddlers who are malnourished.
Inovasi Manajemen Organisasi Kesehatan dalam Meningkatkan Mutu Layanan di Era Digital
Innovation in healthcare organization management in the digital era plays a crucial role in enhancing the efficiency, accessibility, and quality of healthcare services. As digital technologies continue to evolve, healthcare institutions are increasingly adopting systems such as Electronic Medical Records (EMR), Hospital Management Information Systems (HMIS or SIMRS), telemedicine platforms, mobile health applications, Big Data analytics, and Artificial Intelligence (AI) to streamline operations and improve patient outcomes. This literature review highlights how the implementation of these technologies can accelerate service delivery, reduce administrative burdens, support data-driven clinical and managerial decision-making, and enable remote healthcare access—particularly beneficial in rural or underserved areas. For instance, EMRs improve the accuracy and availability of patient data, while AI can assist in diagnostics and predictive analytics for disease prevention. However, despite these promising developments, several significant challenges persist. These include limited digital infrastructure in some regions, low levels of digital literacy among healthcare professionals, high implementation and maintenance costs, organizational resistance to technological change, and concerns over data privacy and cybersecurity. Therefore, successful digital transformation in healthcare is not solely dependent on technology itself. It also requires strong organizational readiness, supportive regulatory frameworks, investment in workforce training and development, and effective change management strategies. Collaborative efforts between government, private sector, and healthcare providers are essential to overcome these barriers. In conclusion, innovation in healthcare management must be holistic—integrating technological advancements with human, organizational, and policy-level adaptations—to ensure the delivery of high-quality, efficient, and sustainable healthcare services in the digital age.
Hubungan Durasi Pembedahan dengan Nyeri Tenggorokan pada Pasien Post General Anestesi Teknik Intubasi Endotracheal Tube di RSI Purwokerto
Surgery is one of the medical procedures divided into three periods of pre operative, intra operative, and post operative. At least 11% of the global disease burden comes from conditions that can actually be addressed through surgery. Surgical procedures will certainly require anesthesia, one of which is general anesthesia with the Endotracheal Tube (ETT) intubation technique. Endotracheal Tube (ETT) intubation can cause various complications, the most common being postoperative sore throat. One of the risk factors for sore throat after Endotracheal Tube (ETT) intubation is the duration of surgery. This research is a quantitative study with a descriptive correlational design and a cross-sectional approach. The sample in this study consisted of 30 patients undergoing surgery with general anesthesia using the Endotracheal Tube (ETT) intubation technique, determined by quota sampling. The research instruments used were a clock to measure the duration of surgery and an observation sheet containing the measurement of sore throat level using the Numeric Rating Scale (NRS). Data analysis in this study included univariate and bivariate analyses, with the latter tested using the Spearman rank test. The results of the Spearman rank test between the variables of surgical duration and postoperative sore throat in general anesthesia with the Endotracheal Tube (ETT) intubation technique showed a p = 0.000 and an r = 0.912, which means that the two variables have a significant and positive relationship in line with a very strong correlation strength. This indicates that the longer the duration of surgery, the higher the postoperative sore throat scale in general anesthesia with the Endotracheal Tube (ETT) intubation technique.
Perbedaan Kejadian Shivering pada Pasien Sectio Caesarea dengan Metode Spinal Anastesi Enhanced Recovery After Caesarean Surgery (ERACS) dengan Non ERACS
Background: The use of spinal anaesthesia is favoured over general anaesthesia due to the ease of monitoring the risk of complications. Shivering is known as a frequent complication in patients undergoing surgery with spinal anaesthesia with an incidence of 40-70%. The occurrence of shivering must be immediately prevented and overcome so as not to pose a risk that harms the patient, one of which is by implementing Enhanced Recovery After Caesarean Surgery (ERACS). Research purposes: To determine the difference in the incidence of shivering in sectio caesarean patients with spinal anaesthesia method ERACS with Non ERACS. Research method: This study is a comparative descriptive quantitative study with a case control design. The sample was sectio caesarean delivery patients at the Regional Hospital in 2025 as many as 60 people who were divided into two groups, namely the ERACS and Non ERACS groups of 30 people each with quota sampling technique. Data analysis used univariate and bivariate analysis with the Man Whitney test. Results: There is a difference in the incidence of shivering in sectio caesarea patients with spinal anaesthesia method ERACS with Non ERACS (pvalue = 0.035). Suggestion: Sectio caesarea patients are advised to choose the ERACS spinal anaesthesia method so that the incidence of shivering can be minimized
Pengaruh Posisi Trendelenburg dengan Posisi Supine terhadap Hipotensi Pasca Spinal Anestesi di RS Bhayangkara TK III Padang
Hypotension is the most common complication following spinal anesthesia due to sympathetic nerve blockade, which leads to vasodilation and decreased venous return. One of the preventive measures is patient positioning, such as Trendelenburg and supine positions. This study aimed to determine the effect of both positions on the incidence of post-spinal hypotension at Bhayangkara Hospital TK III Padang. This research applied a quantitative observational analytic design involving 55 elective surgical patients, consisting of Trendelenburg position (n=32) and supine position (n=23). Data were collected through direct observation and blood pressure measurement using NIBP. Data analysis included univariate, bivariate with Spearman Rank test, and Mann-Whitney U test. The results showed that most respondents were female (60%) and classified as ASA I (56.4%). Post-spinal hypotension occurred in 41.8% of patients with systolic <90 mmHg, 27.3% with diastolic <60 mmHg, and 30.9% with a ≥20% decrease from baseline. Bivariate analysis revealed a significant association between patient position and hypotension (p<0.001; rho=0.466). The Mann-Whitney U test showed a significant increase in blood pressure in both positions (p<0.001), but the Trendelenburg position was more protective compared to supine. In conclusion, patient position has a significant effect on the incidence of hypotension after spinal anesthesia. The Trendelenburg position is more effective in preventing hypotension than the supine position, making it a valuable clinical consideration in anesthetic practice.
Hubungan Penempatan Kerja dengan Kinerja Sumber Daya Manusia Kesehatan di Rumah Sakit Pinna Bekasi Tahun 2025
Job placement in accordance with the competence of health workers is a key factor in improving the quality of hospital services. However, there is still a mismatch in placement that has an impact on the low quality of service. This study aims to analyze the relationship between job placement, which includes education, knowledge, skills, and work experience, with the performance of health human resources (HRH) at Pinna Hospital Bekasi. The study used a quantitative approach with a cross-sectional design. The research sample was taken by total sampling method, involving 100 respondents from various health worker professions. Data were collected through questionnaires and analyzed with the Spearman correlation test. Univariate results showed 97% of SDMK had been placed according to their field of expertise, while the performance of SDMK reached 100%. Spearman test showed significant relationships between: education and performance (p-value <0.001; r=0.377), job knowledge and performance (p-value <0.001; r=0.469), job skills and performance (p-value <0.001; r=0.593), work experience and performance (p-value <0.001; r=0.489), and job placement and performance (p-value <0.001; r=0.574). It can be concluded that job placement in accordance with the competence of health workers plays an important role in improving the performance of HRK at Pinna Bekasi Hospital. Hospitals are advised to maintain the existing placement system and provide ongoing training to improve performance
Hubungan Beban Kerja dengan Turnover Intention pada Sumber Daya Manusia Kesehatan di Rumah Sakit Pinna Bekasi Tahun 2025
The high turnover rate of healthcare workers can impact the smoothness and stability of hospital services. This study aims to determine the relationship between the dimensions of workload time load, mental effect load, and psychological stress load with turnover intention in healthcare workers at Pinna Hospital Bekasi in 2025. The study used a quantitative method with a cross-sectional study design, involving 92 respondents selected through total sampling. Data were collected through questionnaires and analyzed univariately and bivariately using the Spearman test. The results showed a significant relationship between workload and turnover intention (p = 0.049), as well as a significant relationship in each workload dimension with turnover intention. Only the psychological stress load dimension had a significant relationship with turnover intention (p = 0.001). Meanwhile, the time load dimension (p = 0.303) and mental effect load (p = 0.394) did not show a significant relationship. The higher the workload, especially psychological stress, the greater the tendency of healthcare workers to intend to change jobs. The results of the bivariate test on the workload variable indicate a positive and significant relationship between workload and turnover intention, a relationship that illustrates that the heavier the workload perceived by healthcare workers, the higher their intention to move or leave their jobs, although the strength of the relationship is relatively weak. Therefore, hospital management is expected to review the work system and pay attention to staff welfare to reduce turnover rates.
Hubungan Kualitas Layanan Elektronik SIMRS dengan Kinerja SDM di RS X
The quality of SIMRS electronic services is expected to make the performance of existing human resources at Hospital X work optimally. Hospital services have entered the digitalization era, where all human resources are required to be able to operate the system used. This study aims to see whether there is a relationship between system quality and human resource performance at Hospital X, because now services are done digitally. The sampling technique used total sampling with a total of 53 respondents. The data in this study were analyzed univariately to see the picture per indicator and bivariate analysis with Spearman correlation to see the relationship. The results of the study showed that the relationship between the two variables is interconnected with a high correlation level of 0.700 with a p-value of 0.01. The results of the existing data indicate that the quality of SIMRS has a positive and statistically significant relationship with human resource performance. The results of the study from looking at the relationship between system quality indicators and human resource performance show a relationship between 3 of the 4 indicators with human resource performance. These indicators are system flexibility, system integrity, and response time
Cost Effectivie Analysis (CEA) Pengobatan Tunggal dan Kombinasi pada Pasien Tuberkulosis Paru di RSUD dr. La Palaloi Kabupaten Maros
TB treatment requires long-term therapy using anti-tuberculosis drugs (OTAs), either singly or in combination. The use of combination therapy is considered more effective in preventing drug resistance and increasing treatment success. However, the choice of therapy method is also influenced by economic considerations, considering the continuing increase in health care costs. Therefore, a pharmacoeconomic analysis is needed, specifically a Cost Effectiveness Analysis (CEA) to compare the costs and effectiveness of two treatment alternatives, namely single OAT therapy and combination therapy. Cost Effectiveness Analysis (CEA) is a type of pharmacoeconomic analysis in which all costs are compared with the effects of two or more treatment options. Single OAT treatment is a medical action undertaken by tuberculosis patients, while combination treatment is a treatment method consisting of two or more drugs or treatment techniques used simultaneously to increase treatment effectiveness, reduce the risk of resistance, or improve clinical outcomes. The research method is a descriptive non-experimental, the data studied are retrospective using secondary data from patient medical records. The results showed that treatment of pulmonary tuberculosis using combination therapy (rifampicin and isoniazid) is more cost-effective with an ACER value of Rp132. 182 compared to single therapy (ethambutol) with an ACER value of Rp. 170,536 and an ICER value of combination and single therapy of Rp. 119,857.
Analisis Kadar Flavonoid Total dan Aktivitas Antioksidan dari Ekstrak Etanol Serta Fraksi dari Gagang Cengkeh (Syzygium Aromaticum (L)).
Antioxidants are substances that can inhibit oxidation caused by free radicals. Flavonoids are effective natural antioxidants due to their unique chemical structure. Both have a hydroxyl group (-OH) attached to an aromatic ring. This hydroxyl group can donate hydrogen or electrons to free radicals. Clove stems (Syzygium aromaticum (L.)) are known to possess bioactive compounds, including flavonoids like quercetin and kaempferol, which act as antioxidants in protecting cells from free radicals. Maceration is a commonly used extraction method to obtain therapeutic compounds from plants. The process involves soaking the finely or coarsely ground plant material in a solvent (liquid thinner) in a closed container. Fractionation is a method for separating chemical components in an extract based on differences in their polarity or solubility. This process uses two immiscible solvents. This study is an experimental research aimed at determining the total flavonoid content (TFC) and the IC50​ value of the antioxidant activity present in the ethanol extract and fractions of clove stems (Syzygium aromaticum (L.)) using the ABTS method. The tests utilized maceration extraction with 96% ethanol as the solvent, and liquid-liquid fractionation using N-hexane, ethyl acetate, and water as solvents, along with UV-Vis spectrophotometry analysis. The results showed that the highest flavonoid content was in the ethanol extract, with a TFC value of 51.000 mgQE/g, and the highest antioxidant activity was in the ethyl acetate fraction, with an IC50​ value of 23.716 µg/mL, indicating a strong potential as a source of natural antioxidants.
Korelasi Teknik Menyusui Ibu dalam Mengaktifkan Hormon Oksitosin terhadap Produksi Air Susu Ibu
Correct breastfeeding technique significantly influences milk production due to the influence of the hormone oxytocin. With the wrong breastfeeding technique, breast milk intake to the baby will not be effective because the baby cannot suckle strongly and slowly, which can hinder the process of breast milk production. Implementing proper breastfeeding technique can facilitate breastfeeding and provide comfort during breastfeeding, thus preventing problems such as soreness and back pain. Examining the correlation between breastfeeding techniques and hormone activation on milk production. This study employed a quantitative analytical design using primary data through a cross-sectional approach. The sample was drawn using accidental sampling. The sample size for this study was 30. The data analysis used the Pearson Product Moment correlation test. The results showed a correlation of 0.512 > 0.361. The results of this study recommend that other researchers who intend to conduct research on the Correlation of Mother's Breastfeeding Techniques to Breast Milk Production. There is a relationship between the two variables which has a positive correlation direction. To involve more samples and variables studied with different designs and use instruments that have standard validity and reliability values.
Gambaran Persepsi Peserta Badan Penyelenggara Jaminan Sosial (BPJS) terhadap Efektivitas dan Peningkatan Layanan Mobile JKN di Kantor BPJS Kesehatan Cabang Jakarta Utara
The development of digital technology in public services has encouraged BPJS Health to innovate through the Mobile JKN application, aiming to facilitate public access to health services. This study aims to describe the perceptions of BPJS participants regarding the effectiveness and improvement of services through the Mobile JKN application, as well as to identify challenges in its implementation. A qualitative method with a case study approach was employed at the North Jakarta Branch Office of BPJS Health. Data were collected through in-depth interviews with BPJS participants who had used the Mobile JKN application. The findings indicate that while the application provides convenience in accessing services such as participant data checking, premium payments, and online queue registration, there are still several obstacles, including limited user understanding, technical issues, and lack of education from BPJS officers. Moreover, some features of the application are not fully optimized and still require participants to visit the BPJS office in person. The study concludes that the effectiveness of Mobile JKN in improving health services still needs enhancement in terms of technical performance, public outreach, and the quality of digital services to be more responsive and aligned with participants’ needs.
Hubungan Pengetahuan dengan Pencegahan Rheumatoid Arthritis pada Lansia di Posyandu Lansia Kelurahan Pendahara
Rheumatoid Arthritis (RA) is one of the most common diseases experienced by the elderly. Adequate knowledge about RA, including risk factors, early symptoms, and preventive measures, plays a crucial role in mitigating the disease. RA prevention can be achieved through exercise, maintaining a healthy weight, proper diet, avoiding smoking, injury, maintaining posture, limiting alcohol consumption, and avoiding excessive pollution. In the Elderly Posyandu of Pendahara Village, many elderly individuals complain of joint pain, yet most are unaware of how to prevent RA. This study aims to examine the relationship between knowledge and RA prevention in the elderly at the Elderly Posyandu of Pendahara Village. The research uses a quantitative design with a descriptive correlational approach and a cross-sectional study. The population of this study is 157 elderly individuals, with a sample of 35 elderly individuals selected using purposive sampling. Data were analyzed using univariate and bivariate analysis with Spearman Rank tests. The results showed that the better the knowledge about RA, the better the preventive measures taken. Bivariate analysis indicated a significant relationship (p-value = 0.000 < 0.05) between knowledge and RA prevention in the elderly at the Elderly Posyandu of Pendahara Village.
Cellulitis is a bacterial skin and subcutaneous infection caused by the disruption of the skin barrier, immune dysfunction, and/or circulation disorders. It has various risk factors, one of which is uncontrolled diabetes mellitus. Hygiene is also crucial for prevention and long-term management to prevent reinfection. A 52-year-old male presented with decreased consciousness 2 days prior admission. He also had bulla, edema, and pain in his right lower limbs. He had a history of uncontrolled diabetes mellitus. He appeared severely ill with a Glasgow Coma Scale (GCS) of 8 (E2M4V2), hypotension, and tachycardia. At 1/3 distal right cruris and right dorsum of the foot, there were erythematous and ill-defined red-to-purplish black hyperpigmentation with multiple plaque-sized bullae with irregular margins and warmth on palpation. The laboratory examination demonstrated hyperglycemia (733 mg/dL). He was treated in the Intensive Care Unit (ICU) with multidisciplinary therapy. Cellulitis is a significant health burden because it is associated with increased hospitalization rates and medical costs. If prompt treatment is not given, it can lead to severe infection or sepsis. A holistic therapy is required, including controlling the predisposing factors, maintaining hygiene, symptomatic therapies, and antibiotics to prevent reinfection and improve the outcomes of cellulitis. Risk factor control and hygiene maintenance are crucial since they are effective preventive measures and long-term management of cellulitis, leading to patients’ improved health conditions and quality of life, also lowering the incidence of cellulitis and health burdens.
Analisis Kadar Vitamin C Bawang Putih Majemuk Bawang Hitam dan Bawang Putih Tunggal Serta Aktivitas Antioksidan dengan Metode ABTS
Antioxidants are compounds that can neutralize free radicals and inhibit the continuation of oxidation processes that may cause cellular damage. Vitamin C acts as an antioxidant by protecting biological molecules from oxidative stress. Garlic, both compound and single types, as well as black garlic, are known to contain vitamin C and play a significant role as natural antioxidants in combating free radicals that can damage cells and body tissues. This study aimed to determine the vitamin C content and antioxidant activity of compound garlic (Allium sativum L.), black garlic, and single garlic (Allium sativum L.). The vitamin C content was measured using UV-Vis spectrophotometry, while antioxidant activity was evaluated by the ABTS method, expressed in IC₅₀ values. The results showed that black garlic extract had the highest vitamin C content of 51.516 mg/100 g. In the ABTS assay, black garlic also demonstrated the lowest IC₅₀ value of 25.99 μg/mL, indicating a very strong antioxidant activity. These findings suggest that the fermentation process of garlic into black garlic significantly increases its vitamin C levels as well as enhances its antioxidant properties. Therefore, black garlic has great potential to be developed as a natural antioxidant source, contributing to the prevention of oxidative stress-related cellular damage and supporting overall health
Hubungan Kelelahan dan Ketegangan Emosional dengan Baby Blues pada Ibu Postpartum
Baby blues is a mild and temporary mood disorder commonly experienced by mothers after childbirth. It is characterized by emotional instability, including sadness, anxiety, irritability, and frequent crying, which may interfere with maternal-infant bonding. This condition is often triggered by a combination of physical and psychological factors, such as hormonal changes, fatigue, and emotional tension. This study aims to examine the relationship between fatigue and emotional tension with the occurrence of baby blues among postpartum mothers at Klinik Pratama Annisa Medika 1. A quantitative research method with a cross-sectional design was employed. A total of 45 postpartum mothers were selected using purposive sampling. Data were collected through structured questionnaires measuring fatigue, emotional tension, and baby blues symptoms. The results were analyzed using the Chi-Square test with a significance level set at p<0.05. The findings indicate a statistically significant relationship between fatigue and the incidence of baby blues (p=0.019), as well as between emotional tension and baby blues (p=0.000). These results suggest that both physical and emotional well-being are crucial factors influencing postpartum mental health. The implications of this study highlight the importance of early identification and management of fatigue and emotional stress in postpartum mothers. Healthcare providers should prioritize psychological support, routine mental health screening, and postpartum education to help prevent the onset of baby blues. Early intervention may improve maternal well-being and promote healthier mother-infant interactions.
Leadership Style dengan Kinerja Perawat Pelaksana di Rumah Sakit Santa Elisabeth Medan Tahun 2024
The role of a leader has a relationship with the performance and success of implementing nurses. Effective leaders can influence in various ways with their leadership style. Leaders provide direction and goals to members with their leadership style. Leadership style is able to influence, be smart in encouraging, motivating, and facilitating their subordinates so that their goals are achieved. According to Lippits and K. White, there are 3 leadership styles, namely authoritarian, democratic, and laissez-faire. This leadership style influences the loyalty of a implementing nurse's performance in implementing nursing care which can be seen in the quality of service provided to patients. Quantitative research, correlational design. Cross-sectional approach measuring the independent variable of the ward head's leadership style and the dependent variable of the implementing nurse's performance and the relationship between the ward head's leadership style and the implementing nurse's performance were carried out once at the same time. The results of the research showed that the majority of democratic leadership styles were 116 respondents (81.1%), the performance of the majority of nurses was in the good category as many as 118 respondents (82.5%), and the relationship between the leadership style of the head of the room and the performance of the implementing nurses in the chi square test with a p value of 0.533 > alpha (0.05), then Ho = There is no relationship between the leadership style of the head of the room and the performance of implementing nurses at Santa Elisabeth Hospital Medan. For implementing nurses who still have the performance of implementing nurses in the sufficient category, they should increase their self-motivation to be more responsible in carrying out their duties as nurses which is part of their work profession.
Formulasi dan Evaluasi Liposom Krim Ekstrak Daun Ubi Jalar Ungu (Lpomoea Batatas L.)
Liposomes are good carriers that can be used to reduce toxic effects, increase drug effectiveness, increase the solubility of materials and permeability penetration of the compounds they carry, liposomes can also have potential as a system for controlling and targeting drug delivery. The aim of this research was to design a liposomal cream formula from purple sweet potato leaf extract (Ipomoea batatas L.) and to determine the quality of a liposomal cream preparation from purple sweet potato leaf extract (LPomoea batatas L.). The method used in this research uses a laboratory experimental method which aims to produce a liposomal cream preparation of purple sweet potato leaf extract (Ipomoea batatas L.). Liposome preparations were made with a concentration of 1% purple sweet potato leaf extract, the results obtained were ball-shaped liposomes and some were oval-shaped, then the liposomes were used as an active substance to make cream with concentrations of 1%, 3% and 5%, then the liposomal cream formula was tested organoleptic, pH test, homogeneity test, spreadability test, adhesion test and stability test. The results of the stability test show that in F0, F1, F2 and F3 after storage at temperatures of 2°C and 35°C there was no change in the test. organoleptic, homogeneity test and pH test which means that the preparation is able to survive within the specified limits. However, in the test the spreading power of F0, F1, F2, and F3 experienced changes which meant that the preparation was not able to survive with a spreading power that remained within the specified limits.
Evaluasi Higiene Industri Rumah Makan Khas Batak Kelurahan Besar Kecamatan Medan Labuhan
Food hygiene is a critical factor that must be considered when consuming food sold to the public. Improper food handling and processing may lead to contamination by harmful microorganisms. This study aimed to evaluate the hygiene practices of traditional Batak restaurants located in Kelurahan Besar, Medan Labuhan Subdistrict. This research was a descriptive survey study. Data collection was carried out through direct observation, field notes, and interviews with food handlers regarding industrial hygiene in Batak restaurants. The study used a qualitative research design with a phenomenological approach to explore hygiene practices in depth. The findings revealed that Restaurant A had mostly complied with hygiene standards in various aspects such as: location and building conditions, food ingredient selection, raw food storage, food preparation/cooking, cooked food storage, transportation of cooked food, and food serving. These practices were aligned with the guidelines outlined in the Regulation of the Minister of Health of the Republic of Indonesia No. 2 of 2023 on Environmental Health, particularly concerning hygiene and sanitation requirements for restaurants and food establishments. In contrast, Restaurant B had not met most of the hygiene standards in those same areas. The restaurant’s location and building conditions, ingredient selection, food storage, cooking process, food transportation, and serving methods were found to be below the acceptable standard as per the same Ministry of Health regulation. Conclusion: The study concluded that adherence to food hygiene standards plays a crucial role in ensuring food safety. Restaurant owners are advised to consistently maintain hygiene in terms of location and infrastructure, food selection, storage, cooking, transportation, and serving practices.
Efektivitas Senam Otak sebagai Upaya Preventif Pengendalian Demensia pada Lansia di Posyandu Lansia Handayani 2 Dukuhwaluh
Dementia is a progressive syndrome of cognitive decline frequently experienced by older adults, characterized by impairments in memory, behavior, and daily living activities. Its prevalence continues to rise globally and regionally, including in Southeast Asia. Non-pharmacological efforts such as brain gym are considered beneficial to maintain brain activity, stimulate motor coordination, and reduce the risk of cognitive impairment. This community service program was implemented to address the low level of knowledge about dementia and brain gym among older adults at Posyandu Lansia Handayani 2 Dukuhwaluh, Banyumas. The intervention was conducted in three sessions involving 21 elderly participants. In the first session, cognitive function was assessed using the Mini Mental State Examination (MMSE) and a pre-test of knowledge, followed by dementia education, brain gym demonstration, and distribution of monitoring sheets for family use at home. The second and third sessions repeated MMSE and post-test assessments, performed additional brain gym demonstrations, and, in the final session, measured participants’ interest in the activity. Results showed a gradual increase in MMSE scores from an average of 26 to 28 and finally 30, indicating all participants reached the normal category. Knowledge levels improved markedly from predominantly low to predominantly high (mean score 93). Participants’ skills in demonstrating five brain gym movements also improved over time, although some movements were initially perceived as difficult. At the end of the program, 57% of older adults expressed high interest and 43% moderate interest in continuing brain gym independently. These findings confirm that dementia education combined with brain gym demonstration is effective in improving cognitive function, knowledge, skills, and interest among older adults and can serve as a preventive strategy for dementia control at the community level.
Faktor-Faktor yang Mempengaruhi Terjadinya Pernikahan Dini pada Remaja di Desa Pelimbangan, Kecamatan Cengal, Kabupaten Ogan Komering Ilir Tahun 2025
Early marriage in Indonesia, including in Desa Pelimbangan, Kecamatan Cengal, Kabupaten Ogan Komering Ilir, remains a significant reproductive health issue. This phenomenon leads to negative impacts such as the disruption of education, reproductive health problems, high divorce rates, and intergenerational poverty. This study aims to identify the factors influencing early marriage among adolescents in Desa Pelimbangan in 2025. The factors examined include knowledge, socio-cultural factors, and parental involvement in prevention. This study uses a quantitative approach with a cross-sectional design, involving 95 couples who married between 2022–2024. Data collection was done using a questionnaire that was tested for validity and reliability. The results show that low knowledge is significantly associated with early marriage (p = 0.026; OR = 3.275), with adolescents having low knowledge being 3.275 times more likely to marry early. Socio-cultural factors were not significantly related (p = 0.053; OR = 2.865), while parental involvement was significantly associated (p = 0.018; OR = 3.358). The conclusion of this study suggests enhancing reproductive health education and strengthening parental roles as effective and sustainable strategies to prevent early marriage.