Journal of Public Health Science (JoPHS) is a national journal for scientific research on public health practices, epidemiology, health promotion, health service effectiveness, disease prevention, and public health evaluation. nutrition, family health, infectious diseases, research health services, gerontology, child health, adolescent health, behavioral medicine, rural health, chronic disease, promotion Health evaluation and intervention, health policies and management of public health, health economics, occupational health and environmental health, environmental health, health and safety at work, health administration and policy, nutrition science, biostatistics, reproductive health, hospital management, and health information systems. Nama Jurnal : Journal of Public Health Science Inisial : JoPHS Frekuensi : 4 Issues pertahun ( March, June, September, December) DOI Prefix : 10.70248 e-ISSN : 3047-3632 Penerbit : Yayasan Nuraini Ibrahim Mandiri Citasi : Garuda, Copernicus, Google Scholar, Dimensions
CORNUAL ECTOPIC PREGNANCIES IN RECURRENT ECTOPIC PREGNANCIES AFTER SALPINECTOMY: CASE REPORTS
Ectopic pregnancy remains a major cause of maternal morbidity and mortality in early pregnancy. Recurrent ectopic pregnancy represents a significant clinical challenge, particularly in women with a previous history of ectopic pregnancy and tubal surgery such as salpingectomy. Cornual or interstitial ectopic pregnancy is a rare form of ectopic implantation, accounting for approximately 2–4% of all ectopic pregnancies. Despite its rarity, this condition carries a higher risk of severe hemorrhage due to its location within the highly vascularized uterine cornua. Case Presentasion: A 34-year-old woman with a history of ectopic pregnancy treated with salpingectomy presented with worsening lower abdominal pain in early pregnancy. Physical examination, laboratory evaluation and ultrasonography suggested a suspected ectopic pregnancy. Emergency laparoscopy confirmed a cornual ectopic pregnancy with hematoma and pelvic adhesions. Laparoscopic cornual resection, hematoma evacuation, hystero-raphy, and adhesiolysis were performed successfully without complications. The patient recovered well and was discharged in stable condition. Discussion: Recurrent ectopic pregnancy is a known complication in patients with a prior history of ectopic pregnancy and tubal surgery. Although salpingectomy reduces the likelihood of tubal ectopic pregnancy on the affected side, implantation may still occur in other locations, including the interstitial or cornual region. Cornual ectopic pregnancy can grow longer before rupture due to the surrounding myometrial tissue, which may delay diagnosis but increases the risk of catastrophic bleeding once rupture occurs. Laparoscopic management is preferred in hemodynamically stable patients because it offers less surgical trauma, shorter hospital stay, and faster recovery. Conclusion: Cornual ectopic pregnancy may occur as a recurrent ectopic pregnancy even after salpingectomy. Early recognition and prompt surgical intervention are essential to prevent life-threatening complications. Laparoscopic management provides an effective and minimally invasive treatment option with favorable clinical outcomes.
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SUCCESS OF PREGNANCY AND CHILDBIRTH IN SYNDROME HERLYN-WERNER-WUNDERLICH (HWW)/ SYNDROME OHVIRA: LAPORAN KASUS LANGKA
Herlyn-Werner-Wunderlich (HWW) syndrome also known as OHVIRA (Obstructed HemiVagina and Ipsilateral Renal Agenesis) syndrome is a rare form of Müllerian Duct Anomalies (MDA). Uterine malformations may be associated with adverse obstetric outcomes, including increased rates of miscarriage, malpresentation, and preterm birth. Case Illustration: A 29-year-old woman at 36-37 weeks' gestation was diagnosed with Premature Rupture of Membranes with OHVIRA syndrome. The patient underwent a cesarean section under spinal anesthesia. A baby girl was born with a birth weight of 2980 grams and an Apgar score of 8/9. The uterus appeared didelphysic. Discussion: This case study examines a nulliparous woman with premature rupture of membranes (PROM) and OHVIRA syndrome. Delivery was assisted by cesarean section. Conclusion: OHVIRA syndrome is a rare condition that carries many risks in pregnancy. However, there have been several cases of successful pregnancies and deliveries. Suggestion: A multidisciplinary approach and patient education are needed to increase the success of pregnancy and childbirth.
THE RELATIONSHIP BETWEEN FAMILY SUPPORT AND ANTENATAL CARE COMPLIANCE AND K8 COVERAGE AT PMB ANA IMROATUS KLAKAH
Pregnancy is a period that is vulnerable to health problems. One effort to maintain maternal and fetal health is through antenatal care (ANC) examinations. Non-compliance with ANC visits can lead to decreased maternal health status and contribute to an increased maternal mortality rate. One of the factors influencing compliance with ANC visits is family support. Family support plays an important role in preventing high-risk pregnancies through the fulfillment of complete antenatal care visits, including K8 coverage. This study aimed to determine the relationship between family support and pregnant women’s compliance in undergoing antenatal care examinations to achieve K8 coverage at PMB Ana Imroatus. This study used an observational analytic design with a cross-sectional approach. The study population consisted of all pregnant women who underwent examinations at PMB Ana Imroatus, with a total sample of 31 respondents selected using total sampling technique. Data were analyzed using the Chi-Square test. The results showed that 51.6% of pregnant women received good family support and 61.3% were compliant with antenatal care examinations. The Chi-Square test results showed a p-value of 0.015 (p<0.05), indicating that there is a significant relationship between family support and pregnant women’s compliance in undergoing antenatal care examinations to achieve K8 coverage.
THE EFFECT OF COMMUNITY PARTICIPATION ON THE PREVENTION OF DENGUE FEVER
Dengue Hemorrhagic Fever is one of the most common health problems in the community that causes various health problems. This study aims to determine the influence of community participation on the implementation of Dengue Fever prevention programs at the Tanjung Morawa Community Health Center, Deli Serdang Regency. This study is a quantitative analytical survey study with a cross-sectional design. The sample used was 270 people. Data analysis used univariate analysis, bivariate analysis and multivariate analysis. The results of statistical tests using chi-square analysis showed no relationship between age (p = 0.851), education level (p = 0.688), occupation (p = 0.336), attitude (p = 0.167), stakeholder role (p = 1.000) with community participation in the implementation of DHF prevention, while there was a relationship between gender (p = 0.019), knowledge (p = 0.002) and information sources (p = <0.001) with community participation in the implementation of DHF prevention. The conclusion of this study is that there is a relationship between gender and information sources and community participation in implementing dengue prevention.
THE EFFECT OF WARM COMPRESSES AND EFFLEURAGE MASSAGE ON LOWER BACK PAIN IN PREGNANT WOMEN IN THE THIRD MONTH OF PREGNANCY IN THE DONOMULYO COMMUNITY HEALTH CENTER WORK AREA
Lower back pain is one of the most common discomforts experienced by pregnant women during the third trimester due to physiological and postural changes during pregnancy. Safe and effective non-pharmacological interventions are needed to help reduce pain. This study aimed to analyze the effect of warm compresses and effleurage massage on lower back pain among third-trimester pregnant women in the Donomulyo Community Health Center area Methods: A pre-experimental study with a one-group pretest–posttest design was conducted involving 20 third-trimester pregnant women selected through purposive sampling. Pain intensity was measured before and after the intervention using the Numeric Rating Scale (NRS). Data were analyzed using the Wilcoxon Signed Rank Test with a significance level of 0.05. Before the intervention, most respondents experienced moderate to severe lower back pain. After receiving warm compresses and effleurage massage, pain intensity decreased, with most respondents reporting mild pain or no pain. Statistical analysis showed a p-value of <0.05, indicating a significant reduction in pain following the intervention. Warm compresses and effleurage massage were effective in reducing lower back pain among third-trimester pregnant women. These interventions can be considered safe, simple, and non-pharmacological alternatives for pain management during pregnancy.
THE EFFECT OF LAVENDER AROMATHERAPY ON SLEEP QUALITY IN PREGNANT WOMEN IN THE THIRD PERIOD IN THE PAGAK COMMUNITY HEALTH CENTER, MALANG REGENCY
Sleep quality disorders are a common health problem that can negatively affect physical, psychological, and social well-being. Non-pharmacological interventions such as lavender aromatherapy have been widely used to promote relaxation and improve sleep quality Objective: This study aimed to determine the effect of lavender aromatherapy on sleep quality among respondents with poor sleep quality. A pre-experimental study with a one-group pretest–posttest design was conducted involving 20 respondents who had poor sleep quality at baseline. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) as the primary measurement instrument. Respondents received lavender aromatherapy intervention, and sleep quality was reassessed after the intervention. The data were analyzed using the Wilcoxon Signed-Rank Test with a significance level of 0.05. Before the intervention, all respondents (100%) had poor sleep quality based on PSQI scores. After receiving lavender aromatherapy, sleep quality improved, with 11 respondents (55%) achieving good sleep quality and 9 respondents (45%) remaining in the poor sleep quality category. Statistical analysis showed a significant difference between pretest and posttest PSQI scores (Wilcoxon Signed-Rank Test, p < 0.05), indicating that lavender aromatherapy significantly improved sleep quality among respondents. Lavender aromatherapy has a significant positive effect on improving sleep quality. The relaxing properties of lavender, particularly its active compounds linalool and linalyl acetate, may contribute to improved sleep quality. Therefore, lavender aromatherapy can be considered an effective non-pharmacological intervention for individuals experiencing sleep quality disturbances.
PENGARUH KUALITAS REKAM MEDIS ELEKTRONIK TERHADAP KINERJA PEGAWAI DAN KEPUASAN KERJA DENGAN KEPATUHAN SEBAGAI VARIABEL INTERVENING: LITERATURE REVIEW
Penelitian ini dilatarbelakangi oleh pentingnya kualitas rekam medis elektronik (RME) dalam mendukung efektivitas pelayanan kesehatan serta kinerja tenaga kesehatan di rumah sakit. Permasalahan utama dalam penelitian ini adalah masih adanya inkonsistensi hasil penelitian terkait pengaruh kualitas RME terhadap kinerja pegawai dan kepuasan kerja, serta belum optimalnya peran kepatuhan tenaga kesehatan sebagai variabel intervening. Penelitian ini bertujuan untuk menganalisis dan mensintesis temuan empiris mengenai pengaruh kualitas RME terhadap kinerja pegawai dan kepuasan kerja dengan kepatuhan sebagai variabel intervening. Metode yang digunakan adalah Systematic Literature Review (SLR) dengan pendekatan PRISMA melalui penelusuran artikel pada database Google Scholar, Scopus, dan ScienceDirect dengan rentang tahun publikasi 2021–2026. Berdasarkan hasil seleksi, diperoleh 16 artikel empiris yang relevan untuk dianalisis. Hasil penelitian menunjukkan bahwa kualitas RME berpengaruh positif dan signifikan terhadap kinerja pegawai dan kepuasan kerja, baik secara langsung maupun tidak langsung. Kepatuhan tenaga kesehatan terbukti berperan sebagai variabel intervening yang memperkuat hubungan antara kualitas RME dengan outcome organisasi, meskipun pada beberapa penelitian peran mediasi tersebut menunjukkan inkonsistensi. Selain itu, faktor kontekstual seperti pelatihan, dukungan manajemen, serta kesiapan infrastruktur teknologi turut mempengaruhi efektivitas implementasi RME. Secara keseluruhan, keberhasilan implementasi rekam medis elektronik tidak hanya ditentukan oleh kualitas sistem, tetapi juga oleh kepatuhan pengguna dan dukungan organisasi. Oleh karena itu, diperlukan pendekatan integratif dalam pengelolaan sistem informasi kesehatan guna meningkatkan kinerja dan kepuasan tenaga kesehatan
MACHINE LEARNING MODELS FOR PREDICTING LIVE BIRTH IN WOMEN WITH PCOS UNDERGOING IVF/ICSI: A SYSTEMATIC REVIEW
Introduction. Polycystic Ovary Syndrome (PCOS) merupakan salah satu gangguan endokrin paling umum pada wanita usia reproduktif, dengan prevalensi sekitar 6–20% tergantung kriteria diagnostik yang digunakan. PCOS ditandai oleh disfungsi ovulasi, hiperandrogenisme, dan gangguan metabolik seperti resistensi insulin yang berkontribusi terhadap infertilitas. Banyak pasien PCOS memerlukan Assisted Reproductive Technology (ART), termasuk IVF dan ICSI, namun outcome utama yaitu live birth masih sulit diprediksi karena dipengaruhi banyak faktor. Perkembangan Artificial Intelligence (AI) dan Machine Learning (ML) menawarkan pendekatan baru dalam prediksi outcome klinis, namun sebagian besar model masih memiliki keterbatasan metodologis dan kurangnya validasi eksternal. Method. Penelitian ini merupakan systematic review yang bertujuan mengidentifikasi dan mengevaluasi model machine learning untuk memprediksi live birth pada pasien PCOS yang menjalani IVF/ICSI. Pencarian literatur dilakukan pada PubMed, ScienceDirect, dan OpenAlex sesuai pedoman PRISMA 2020. Result. Dari 115 studi yang diidentifikasi, tiga studi memenuhi kriteria inklusi. Model machine learning yang dilaporkan meliputi XGBoost, Random Forest, dan model berbasis regresi logistik. XGBoost menunjukkan performa terbaik dengan AUC 0,822, Random Forest dengan AUC 0,60, dan model regresi logistik sekitar AUC 0,80. Faktor prediktor yang konsisten meliputi usia, BMI, durasi infertilitas, kualitas embrio, dan parameter hormonal. Namun, seluruh studi masih terbatas pada validasi internal tanpa validasi eksternal yang memadai. Conclusion. Model machine learning menunjukkan potensi dalam memprediksi live birth pada pasien PCOS yang menjalani IVF/ICSI, namun belum terdapat model yang benar-benar superior dan tervalidasi secara luas. Diperlukan pengembangan model dengan validasi eksternal multi-center serta evaluasi risiko bias yang lebih ketat sebelum implementasi klinis.
PENGARUH LEADERSHIP, WORK MOTIVATION, AND WORK DISCIPLINE TERHADAP EMPLOYEE PERFORMANCE: LITERATURE REVIEW
Penelitian ini bertujuan untuk menganalisis dan mensintesis temuan empiris mengenai pengaruh leadership, work motivation, dan work discipline terhadap employee performance berdasarkan kajian literature review menggunakan pendekatan Systematic Literature Review (SLR) dan metode Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Penelitian dilakukan melalui penelusuran artikel pada database Google Scholar, SINTA, DOAJ, dan jurnal internasional bereputasi dengan rentang publikasi tahun 2021–2025. Berdasarkan proses seleksi literatur, diperoleh 18 artikel empiris yang memenuhi kriteria inklusi untuk dianalisis. Hasil penelitian menunjukkan bahwa leadership, work motivation, dan work discipline memiliki hubungan yang saling berkaitan dalam memengaruhi employee performance. Leadership terbukti mampu meningkatkan motivasi kerja, disiplin kerja, dan produktivitas karyawan, meskipun pengaruhnya terhadap employee performance tidak selalu signifikan secara langsung. Work motivation menjadi variabel yang paling konsisten memengaruhi employee performance, baik sebagai variabel independen maupun variabel mediasi dalam hubungan antara leadership dan employee performance. Selain itu, work discipline terbukti memiliki pengaruh positif dan signifikan terhadap employee performance karena berkaitan langsung dengan kepatuhan, tanggung jawab, dan konsistensi kerja karyawan. Penelitian ini menunjukkan bahwa peningkatan employee performance membutuhkan pendekatan integratif melalui kepemimpinan yang efektif, motivasi kerja yang tinggi, dan disiplin kerja yang konsisten. Penelitian ini juga memberikan kontribusi konseptual dalam pengembangan model employee performance yang lebih komprehensif pada bidang manajemen sumber daya manusia dan perilaku organisasi.
ANALYSIS CORRELATION SUPPORT HUSBAND WITH PARTICIPATION OF MOTHERS IN PREGNANT WOMEN'S CLASSES IN THE WORK AREA VILLAGE HEALTH POST KALIPARE MALANG REGENCY
Pregnancy is a physiological process that requires attention special Because can accompanied by various risk dangerous complications​ Mother and fetus . One of the effort improvement health Mother pregnant is through class Mother pregnancy with the aim of increase knowledge , readiness childbirth , as well as detection early complications pregnancy . However , participation Mother in class Mother pregnant Still not optimal. One of the influencing factors​ participation Mother is support husband . Research This aim For analyze correlation support husband with participation Mother in class Mother pregnant in the work area Village Health Post Kalipare Malang Regency . Research This use design quantitative with cross-sectional approach . Population in study This is all over Mother pregnant in the work area Village Health Post Kalipare Malang Regency with amount sample A total of 30 respondents were taken use purposive sampling technique . Data collection using questionnaire support husband and sheet observation participation class Mother pregnant . Data analysis used the Spearman Rank test. The results of the study show part big respondents get support husband category sufficient (43.3%) and some big Mother No active follow class Mother pregnant (60.0%). The Spearman Rank test results obtained p- value <0.001 with a correlation coefficient of 0.710 which indicates there is connection strong between support husband with participation Mother in class Mother pregnant . Support husband play a role important in increase participation Mother follow class Mother pregnant
TREATMENT OUTCOMES OF PELVIC ORGAN PROLAPSE IN WOMEN WITH FRAILTY AND COGNITIVE IMPAIRMENT: A SYSTEMATIC REVIEW
Introduction. Pelvic organ prolapse (POP) merupakan kondisi yang sering ditemukan pada wanita usia lanjut dan dapat memerlukan terapi konservatif maupun pembedahan. Frailty dan gangguan kognitif termasuk faktor penting yang dapat memengaruhi hasil terapi pada populasi geriatri. Namun, bukti mengenai pengaruh kedua kondisi tersebut terhadap luaran terapi pada pasien POP masih terbatas. Tinjauan sistematis ini bertujuan untuk mengevaluasi luaran terapi pelvic organ prolapse pada wanita dengan gangguan kognitif dan/atau frailty. Method. Pencarian literatur dilakukan secara sistematis pada basis data PubMed, OpenAlex, dan ScienceDirect untuk artikel yang dipublikasikan dalam 10 tahun terakhir. Studi yang memenuhi kriteria inklusi adalah wanita dewasa dengan diagnosis POP yang memiliki gangguan kognitif dan/atau frailty serta menjalani terapi konservatif maupun pembedahan. Hasil yang dievaluasi meliputi keberhasilan atau kegagalan terapi, rekurensi POP, komplikasi, reoperasi, rawat inap ulang, mortalitas, dan kualitas hidup. Seleksi studi dilakukan berdasarkan kriteria inklusi dan eksklusi yang telah ditetapkan. Result. Dari 163 studi yang diperolah, dijumpai sebanyak dua studi yang memenuhi kriteria inklusi penelitian. Frailty secara konsisten berhubungan dengan hasil terapi yang lebih buruk. Pada studi kohort prospektif, pasien frail memiliki risiko kegagalan terapi dua kali lebih tinggi dibandingkan pasien non-frail (adjusted hazard ratio [aHR] 2,06), meskipun seluruh kelompok menunjukkan perbaikan kualitas hidup yang berkelanjutan selama masa tindak lanjut. Pada studi kohort retrospektif berskala besar, peningkatan tingkat frailty berhubungan dengan meningkatnya komplikasi pascaoperasi, termasuk infeksi saluran kemih dan komplikasi kardiovaskular, serta lama rawat inap yang lebih panjang. Kedua studi menunjukkan bahwa frailty merupakan prediktor luaran yang lebih kuat dibandingkan usia kronologis. Conclusion. Bukti menunjukkan bahwa frailty merupakan faktor penting yang memengaruhi hasil terapi pada wanita dengan POP. Integrasi penilaian frailty dalam evaluasi klinis dapat membantu stratifikasi risiko dan pengambilan keputusan terapeutik. Namun, jumlah penelitian yang tersedia masih terbatas sehingga diperlukan studi lebih lanjut untuk mengevaluasi peran frailty dan gangguan kognitif terhadap luaran terapi pada pasien POP.
THE EFFECT OF RELAXATION MUSIC ON PAIN LEVELS IN THE FIRST STAGE OF ACTIVE LABOR AT THE KARTIKA HUSADA CLINIC
Labor pain in the active phase of the first stage of labor is a physiological condition caused by uterine contractions and cervical dilation, which may lead to discomfort and increased maternal anxiety. One non-pharmacological intervention that can be used to reduce labor pain is relaxation music therapy using the sound of trickling water, which has a calming effect. This study aimed to determine the effect of trickling water music therapy on reducing pain levels during the active phase of the first stage of labor. This study employed a quantitative method with a quasi-experimental design using a Posttest-Only Control Group Design approach. The sample consisted of 30 mothers in the active phase of the first stage of labor, divided into an intervention group (n = 15) and a control group (n = 15), selected through purposive sampling. Pain intensity was measured once after the intervention using the Numeric Rating Scale (NRS). The intervention group received trickling water music therapy, while the control group received standard care. The results showed that pain levels in the intervention group were lower than those in the control group. Statistical analysis using the Mann-Whitney U Test revealed a significant difference between the two groups (U = 6.000; Z = -4.491; p < 0.001). The intervention group had a lower mean rank (8.40) compared to the control group (22.60), indicating lower pain intensity following the intervention. The study concludes that trickling water music therapy is effective in reducing labor pain during the active phase of the first stage of labor.
INFLUENCE MASSAGE BABY TO FREQUENCY SPITTING UP IN BABIES 1-3 MONTHS OLD AT GRIYA HEALTHY MIDWIFE MOTHER KEPANJEN
Spitting up is frequent conditions​ occurs in babies age 1–3 months consequence Not yet ripe system digestion , especially sphincter esophagus part below . Frequency high spit up can cause discomfort in babies as well as anxiety in parents . One of the intervention non-pharmacological which can done For help lower frequency spit up is massage baby . Research This aim For know effectiveness massage baby to decline frequency spit up in babies 1–3 months old at Griya Healthy Midwife Mother Kepanjen . Research This use method quantitative with quasi-experimental design through pretest-posttest control group design approach . Sample study totaling 30 babies aged 1–3 months who experience spit up and share become group interventions and groups control of 15 respondents each . The sampling technique sample using purposive sampling. Group intervention given massage baby twice a week for 30 days , while group control only get maintenance routine without massage baby . Data collection was carried out use sheet observation frequency spit up before and after intervention . Data analysis using the Mann Whitney U Test with level significance α = 0.05. Research results show that before given intervention all over baby on both group experience spit up category heavy . After being given massage baby , happened decline frequency spit up in groups intervention become category mild and moderate , while in the group control part big baby still is in the category weight . Analysis results statistics show there is significant difference​ between group interventions and groups control after treatment given (p-value <0.05). Can concluded that massage baby effective as intervention non-pharmacological in lower frequency spit up in babies age 1–3 months .
THE INFLUENCE OF FAMILY SUPPORT ON THE PREVENTION OF EARLY MARRIAGE IN DONOMULYO DISTRICT, MALANG REGENCY
Early marriage, which occurs during adolescence before reaching the recommended age for marriage, remains a significant social issue in Indonesia because of its adverse effects on adolescents' health, education, and social well-being. Family support is considered one of the key factors influencing efforts to prevent early marriage. This study aimed to examine the effect of family support on the prevention of early marriage among adolescents in Donomulyo District, Malang Regency. A quantitative correlational study with a cross-sectional design was conducted involving 35 adolescents selected through total sampling. Data were collected using validated family support and early marriage prevention questionnaires and analyzed using simple linear regression with IBM SPSS Statistics. The findings indicated that both family support and early marriage prevention were predominantly at a moderate level. Regression analysis demonstrated a very strong positive relationship between family support and early marriage prevention (R = 0.995), with family support explaining 98.9% of the variance in early marriage prevention (R² = 0.989). The regression model was statistically significant (F = 2998.831, p < 0.001), and family support had a significant positive effect on early marriage prevention (β = 0.995; B = 0.991; t = 54.762; p < 0.001). These findings indicate that stronger family support is associated with greater adolescent readiness to delay marriage through improved awareness of education, reproductive health, and psychosocial maturity. Therefore, family-centered interventions that strengthen parental communication, emotional support, and reproductive health education should be prioritized as practical strategies to reduce the risk of early marriage among adolescents.
PENGARUH KOMBINASI EFFLEURAGE MASSAGE DAN TEKNIK LAMAZE TERHADAP PENURUNAN SKALA NYERI KALA 1 FASE AKTIF
Nyeri persalinan pada ibu bersalin kala I fase aktif merupakan kondisi fisiologis yang terjadi akibat kontraksi uterus dan proses dilatasi serviks yang dapat menimbulkan rasa tidak nyaman serta meningkatkan kecemasan pada ibu. Nyeri yang tidak ditangani dengan baik dapat berdampak pada peningkatan stres, kelelahan, serta mengganggu kelancaran proses persalinan. Salah satu upaya non-farmakologis yang dapat dilakukan adalah kombinasi Effleurage Massage dan Teknik Lamaze yang bertujuan untuk mengurangi persepsi nyeri melalui mekanisme relaksasi, stimulasi sentuhan, serta pengaturan pernapasan. Penelitian ini bertujuan untuk mengetahui pengaruh kombinasi Effleurage Massage dan Teknik Lamaze terhadap penurunan skala nyeri pada ibu bersalin kala I fase aktif. Penelitian ini menggunakan metode kuantitatif dengan desain quasi-experimental melalui pendekatan Posttest-Only Control Group Design. Sampel penelitian berjumlah 30 responden yang dibagi menjadi dua kelompok, yaitu kelompok intervensi dan kelompok kontrol, masing-masing terdiri dari 15 responden yang dipilih menggunakan teknik purposive sampling berdasarkan kriteria inklusi dan eksklusi. Pengukuran skala nyeri dilakukan satu kali pada kedua kelompok setelah pemberian intervensi menggunakan instrumen Numeric Rating Scale (NRS). Hasil penelitian menunjukkan bahwa tingkat nyeri pada kelompok intervensi lebih rendah dibandingkan dengan kelompok kontrol. Hasil analisis statistik menggunakan uji Mann-Whitney U Test menunjukkan adanya perbedaan yang bermakna antara kedua kelompok. Hal ini menunjukkan bahwa kombinasi Effleurage Massage dan Teknik Lamaze efektif dalam menurunkan skala nyeri persalinan kala I fase aktif.
THE EFFECT OF PREGNANCY YOGA ON THE SLEEP QUALITY OF PREGNANT WOMEN IN THE THIRD TRIMESTER AT THE MULYOASRI VILLAGE HEALTH CENTER
During the third trimester of pregnancy, various physiological and psychological changes occur that can lead to poor sleep quality, such as back pain, increased nocturnal urination, and anxiety before childbirth. These conditions may negatively affect both maternal and fetal health if not properly managed. One of the recommended non-pharmacological interventions is prenatal yoga. This study aimed to determine the effect of prenatal yoga on sleep quality among third trimester pregnant women in the working area of Mulyoasri Village Auxiliary Health Center. This study used a quasi-experimental design with a Non-Equivalent Control Group Design. A total of 30 respondents were selected using purposive sampling and divided into two groups: 15 in the intervention group and 15 in the control group. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using the Paired Sample t-test. The results showed that all respondents in the intervention group (100%) had poor sleep quality during the pretest. After receiving prenatal yoga intervention, 53.3% of respondents improved to good sleep quality. Statistical analysis showed a p-value of <0.001, indicating a significant effect. Meanwhile, the control group showed no significant change (p=0.670). In conclusion, prenatal yoga is an effective non-pharmacological intervention to improve sleep quality in third trimester pregnant women through both physiological and psychological relaxation mechanisms.
THE EFFECT OF CLINICAL COMPETENCE AND WORKLOAD ON THE QUALITY OF NURSING CARE AND NURSE PERFORMANCE IN HOSPITALS: A LITERATURE REVIEW
Service quality is a fundamental indicator in evaluating hospital performance. Nurses have frequent interaction with patients, so the quality of nursing care is the primary determinant of hospital service quality. This study aims to identify the influence of clinical competence and workload on the quality of nursing care and nurse performance in hospitals through literature analysis. The design uses a literature review approach guided by the PRISMA procedure. Articles are collected using search engines such as PubMed, ScienceDirect, and Google Scholar. The articles used were published from 2018-2025 that met the inclusion and exclusion criteria (n=14). Based on the collected articles, high workload is associated with low self-efficacy, fatigue, and decreased nursing competence, which negatively affect nurses' quality and performance. A competent nurse manager effectively improves the nurses' work environment, reduces missed care, and improves the quality of care. Some studies report the positive effects of clinical competence and motivation on nursing performance. In contrast, the effects of workload vary; some studies have not found a significant direct impact due to adaptive factors (n=3). Excessive workload increases emotional fatigue, which mediates a decrease in the quality of care. Clinical competence and workload are the main factors affecting the quality of nursing care and nurses' performance in hospitals. High clinical competence optimizes task execution and patient recovery; conversely, excessive workload leads to chronic fatigue, which then reduces the quality of care and nursing performance.
THE EFFECT OF PROVIDING REPRODUCTIVE HEALTH EDUCATION ON THE KNOWLEDGE AND ATTITUDES OF ADOLESCENT GIRLS AT NU DONOMULYO VOCATIONAL SCHOOL
Adolescence is a crucial stage in reproductive health development, characterized by physical, psychological, and social changes. Inadequate knowledge and attitudes regarding reproductive health may increase adolescents' vulnerability to risky behaviors. This study aimed to determine the effect of reproductive health education delivered through video media on the knowledge and attitudes of adolescent girls at SMK NU Donomulyo. This quantitative study employed a pre-experimental one-group pretest–posttest design. A total of 30 adolescent girls were selected using purposive sampling. Data were collected using validated knowledge and attitude questionnaires administered before and after the intervention. The intervention consisted of reproductive health education delivered through educational videos via a WhatsApp group. Data were analyzed using the Paired Sample t-test. The results showed that participants' knowledge improved from predominantly poor (66.7%) before the intervention to predominantly good (80.0%) after the intervention, while attitudes improved from predominantly sufficient (66.7%) to good (96.7%). The Paired Sample t-test demonstrated significant improvements in both knowledge (mean difference = -1.500; t = -7.644; p < 0.001) and attitude (mean difference = -11.400; t = -9.630; p < 0.001) following the intervention. These findings indicate that reproductive health education delivered through video media is effective in improving knowledge and fostering positive attitudes among adolescent girls. Therefore, educational video media can be considered an effective and engaging approach for adolescent reproductive health education.
DIFFERENCES IN INTERMITTENT AND CONTINUOUS PHOTOTHERAPY ADMINISTRATION ON BILIRUBIN LEVELS IN NEONATAL JAUNDICE IN THE PERINATOLOGY ROOM, BRAWIJAYA UNIVERSITY HOSPITAL, MALANG
Neonatal jaundice is a common condition in newborns caused by elevated bilirubin levels due to immature liver function. Phototherapy is the primary treatment to reduce bilirubin levels and can be administered intermittently or continuously. This study aimed to compare the effectiveness of intermittent and continuous phototherapy in reducing bilirubin levels among neonates with jaundice in the Perinatology Ward of Brawijaya University Hospital, Malang. This study employed a quasi-experimental design using a non-equivalent control group design. The sample consisted of 30 neonates, with 15 assigned to the intermittent phototherapy group and 15 to the continuous phototherapy group. Data were analyzed using the Shapiro–Wilk normality test, Paired Sample t-test, and Mann–Whitney test. The mean bilirubin level in the intermittent phototherapy group decreased from 15.82 mg/dL before the intervention to 10.94 mg/dL after the intervention, while the continuous phototherapy group showed a decrease from 15.67 mg/dL to 10.61 mg/dL. Both intermittent and continuous phototherapy significantly reduced bilirubin levels after treatment. However, there was no statistically significant difference in effectiveness between the two methods based on the Mann–Whitney test (p = 0.713). In conclusion, intermittent and continuous phototherapy are equally effective in reducing bilirubin levels in neonates with jaundice and may be selected according to the neonate's clinical condition and hospital policy..
PEMANFAATAN ARTIFICIAL INTELLIGENCE DALAM PENYUSUNAN PERENCANAAN KESEHATAN TERINTEGRASI PADA DINAS KESEHATAN KABUPATEN MAJENE: TINJAUAN LITERATUR SISTEMATIS
Penyusunan perencanaan pada dinas kesehatan kabupaten masih menghadapi persoalan fragmentasi data dan lemahnya kapasitas analisis prediktif. Persoalan ini diperberat oleh keterbatasan integrasi antar-dokumen perencanaan (RPJMD, Renstra, Renja, dan hasil Musrenbang). Kabupaten Majene, Provinsi Sulawesi Barat, sebagai daerah dengan prevalensi stunting tertinggi di provinsinya (mencapai 40,6% pada 2022), menggambarkan kebutuhan mendesak akan perencanaan berbasis bukti. Penelitian ini bertujuan menelaah secara sistematis bagaimana Artificial Intelligence (AI) dapat dimanfaatkan untuk memecahkan masalah penyusunan perencanaan kesehatan terintegrasi pada tingkat pemerintah daerah. Metode: studi ini menggunakan pendekatan Systematic Literature Review (SLR) mengikuti protokol PRISMA 2020 terhadap artikel terindeks Scopus, PubMed/MEDLINE, dan basis data nasional pada rentang 2018–2025. Dari proses seleksi diperoleh 22 artikel (n = 22) yang memenuhi kriteria inklusi, kemudian dianalisis dengan kerangka Unified Theory of Acceptance and Use of Technology (UTAUT). Hasil: AI berkontribusi pada empat fungsi perencanaan, yaitu (1) integrasi dan pembersihan data lintas-sumber, (2) peramalan kebutuhan layanan dan beban penyakit, (3) optimalisasi alokasi sumber daya dan distribusi tenaga kesehatan, serta (4) dukungan pengambilan keputusan berbasis bukti. Tantangan utama meliputi kesiapan infrastruktur digital, tata kelola dan kualitas data, kompetensi sumber daya manusia, serta aspek etika dan regulasi. Kesimpulan: pemanfaatan AI berpotensi memperkuat perencanaan kesehatan terintegrasi pada Dinas Kesehatan Kabupaten Majene apabila diterapkan secara bertahap melalui kesiapan sistem (system readiness), penguatan tata kelola data, dan peningkatan kapasitas SDM.
ANALYSIS OF THE SUCCESS OF TUBERCULOSIS TREATMENT THROUGH THE DOTS (DIRECTLY OBSERVED TREATMENT SHORTCOURSE) APPROACH AT THESANGURARA PUBLIC HEALTH CENTER IN PALU CITY
ABSTRACT Tuberculosis disease is still a serious global public health problem characterized by high incidence, morbidity, and mortality that requires special attention and ongoing intervention from various parties. Therefore, the implementation of the Directly Observed Treatment Shortcourse (DOTS) strategy is one of the efforts to control TB that has proven to be effective globally in overcoming the problem of tuberculosis disease. The Sangurara Health Center Working Area has a high incidence of TB cases and there are still challenges in achieving optimal treatment success. Of the 13 existing health centers, Sangurara Health Center is the health center with the highest number of TB cases in Palu City. This condition shows the importance of identifying specific factors that can affect the success of the TB program in this Working Area. This study aims to analyze the relationship between treatment regularity, knowledge of tuberculosis and DOTS, and the role of PMO with treatment success. This type of research is quantitative with an analytical survey design and a cross-sectional approach. The population in this study is all TB patients who have successfully treated or failed in 2023 in the Sangurara Health Center Working Area of 53 people, with questionnaires as a data collection instrument. The results showed that the variables of regularity of treatment (p = 0.000), knowledge of TB and DOTS (p = 0.000), and the role of PMO (p = 0.000) had a significant relationship with the success of treatment of TB patients. The conclusion of this study is that the Directly Observed Treatment Shortcourse Strategy has a significant relationship with the Success of Treatment of Tuberculosis Patients in the Working Area of the Sangurara Health Center, Palu City.
INFLAMASI SISTEMIK DAN PRURITUS KRONIK PADA DIABETES MELITUS TIPE 2: TINJAUAN LITERATUR MULTIDISIPLIN Ar
Pruritus kronik merupakan salah satu manifestasi dermatologis yang sering ditemukan tetapi masih kurang mendapat perhatian pada pasien Type 2 Diabetes Mellitus. Kondisi ini tidak hanya menurunkan kualitas hidup pasien, tetapi juga berkaitan dengan gangguan tidur, stres psikologis, serta peningkatan morbiditas kronik. Berbagai penelitian menunjukkan bahwa pruritus kronik pada diabetes melitus tipe 2 memiliki mekanisme multifaktorial yang melibatkan inflamasi sistemik, stres oksidatif, neuropati perifer, serta gangguan sawar kulit. Hiperglikemia kronik diketahui meningkatkan produksi sitokin proinflamasi seperti interleukin-6 (IL-6) dan tumor necrosis factor-alpha (TNF-α) yang berperan dalam proses neuroinflamasi dan aktivasi jalur pruritogenik . Artikel ini merupakan narrative narrative reviewyang bertujuan menganalisis peran inflamasi sistemik sebagai prediktor pruritus kronik pada pasien diabetes melitus tipe 2 melalui pendekatan multidisiplin penyakit dalam, dermatologi, anestesi, dan farmakologi. Penelusuran literatur dilakukan melalui database PubMed, Scopus, ScienceDirect, dan Google Scholar menggunakan kata kunci terkait diabetes melitus tipe 2, inflamasi sistemik, neuroinflamasi, dan pruritus kronik. Literatur yang digunakan merupakan artikel publikasi tahun 2014–2025 yang relevan dengan topik penelitian. Hasil telaah menunjukkan bahwa peningkatan inflamasi sistemik dan stres oksidatif berhubungan erat dengan aktivasi serabut saraf perifer, xerosis kulit, gangguan mikrosirkulasi, dan kerusakan sawar kulit yang berkontribusi terhadap munculnya pruritus kronik. Selain itu, pendekatan terapi modern mulai berkembang ke arah penggunaan neuromodulator, antioksidan, serta terapi berbasis sitokin inflamasi untuk meningkatkan kualitas hidup pasien diabetes dengan pruritus kronik . Disimpulkan bahwa inflamasi sistemik memiliki peran penting dalam patogenesis pruritus kronik pada diabetes melitus tipe 2. Pendekatan multidisiplin diperlukan untuk memahami mekanisme penyakit secara lebih komprehensif serta mendukung pengembangan strategi terapi yang lebih efektif dan individual.
THE EFFECT OF INFANT EXERCISE ON WEIGHT GAIN BY AGE IN INFANTS AGED 6–12 MONTHS IN TULUNGREJO VILLAGE
Growth baby is indicator important health and nutritional status , one of which is assessed through improvement appropriate weight​ age . Babies aged 6–12 months ideally experience increase weight of around 340–560 grams per month . One of the intervention non-pharmacological which can support growth is infant exercise, which is thought to capable increase activity physical , quality sleep , and lust Eat baby . Research This aim For analyze the effect of infant exercise on improvement weight according to age in babies 6–12 months of age . Research use quasi-experimental design with non-randomized control group pretest–posttest design approach . Sample A total of 28 babies met criteria inclusion , consisting of over 14 babies in the group treatment and 14 babies in the control group control group​ treatment given infant exercise during four week , while group control get maintenance routine . Body weight is measured before and after intervention . Data analysis using Paired t-test and Independent t-test with level 5 % significance show that group treatment experience improvement overweight​​ tall compared to group control . Paired t-test shows difference meaningful before and after intervention (p = 0.000), while the Independent t-test also showed difference improvement significant weight gain between second group (p = 0.000). Conclusion: Infant exercise is proven to effective increase weight according to age in babies age 6–12 months
PERAN FAMILY CAREGIVER PADA LANSIA DEMENSIA
Penelitian ini bertujuan untuk mengetahui peran family caregiver pada lansia demensia di Dusun Ngremang, Blimbing, Rejotangan, Tulungagung. Metode penelitian yang digunakan adalah desain deskriptif dengan populasi seluruh keluarga yang memiliki lansia demensia di wilayah Dusun Ngremang. Sampel penelitian berjumlah 26 responden yang dipilih menggunakan teknik total sampling. Pengumpulan data menggunakan kuesioner peran family caregiver yang terdiri dari 18 pertanyaan meliputi perawatan pribadi, perawatan kesehatan, pemberian pengobatan, menjadwalkan janji temu, memberikan dukungan, manajemen rumah tangga, komunikasi, menenangkan pasien, dan membantu kebutuhan nutrisi. Data dianalisis menggunakan rumus persentase dan diinterpretasikan secara kuantitatif. Hasil penelitian menunjukkan bahwa sebagian besar family caregiver memiliki peran dalam kategori baik sebanyak 15 responden (58%), kategori cukup sebanyak 11 responden (42%), dan tidak terdapat responden dengan kategori kurang. Peran family caregiver dengan nilai tertinggi terdapat pada aspek perawatan pribadi, sedangkan nilai terendah terdapat pada aspek perawatan kesehatan. Simpulan penelitian ini adalah peran family caregiver pada lansia demensia sebagian besar berada dalam kategori baik, namun peningkatan edukasi dan pendampingan keluarga masih diperlukan terutama dalam pemantauan kesehatan lansia secara rutin untuk meningkatkan kualitas hidup lansia dengan demensia.
PENGARUH MEDIA EDUKASI BOOKLET TERHADAP PENGETAHUAN REMAJA TENTANG KEHAMILAN REMAJA DI SMPN 38 KOTA PEKANBARU
Penelitian ini bertujuan untuk menganalisis pengaruh media edukasi booklet terhadap tingkat pengetahuan remaja tentang kehamilan remaja di SMPN 38 Kota Pekanbaru. Metode penelitian yang digunakan adalah penelitian kuantitatif dengan desain pre-experimental menggunakan rancangan One-Group Pretest-Posttest Design. Penelitian dilaksanakan pada bulan Juni–Juli 2025 dengan jumlah sampel sebanyak 50 siswi yang dipilih menggunakan teknik proportionate random sampling. Pengumpulan data dilakukan menggunakan kuesioner pengetahuan sebelum dan sesudah diberikan intervensi media edukasi booklet, kemudian dianalisis menggunakan uji Wilcoxon Signed Ranks Test dengan tingkat kemaknaan α=0,05. Hasil penelitian menunjukkan bahwa sebelum pemberian booklet sebagian besar responden memiliki tingkat pengetahuan kategori kurang sebanyak 28 siswi (56,0%), sedangkan setelah diberikan edukasi menggunakan booklet terjadi peningkatan pengetahuan dengan kategori baik sebanyak 43 siswi (86,0%). Hasil uji Wilcoxon menunjukkan nilai Z sebesar -6,154 dengan nilai Asymp. Sig. (2-tailed) sebesar 0,000 (p<0,05), yang berarti terdapat pengaruh signifikan media edukasi booklet terhadap peningkatan pengetahuan remaja tentang kehamilan remaja. Simpulan penelitian ini adalah media edukasi booklet efektif meningkatkan pengetahuan remaja putri mengenai kehamilan remaja sehingga dapat digunakan sebagai salah satu media promosi kesehatan berbasis sekolah.
FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEBERHASILAN TOILET TRAINING PADA ANAK USIA 3-5 TAHUN DI PAUD RAUDHATUL JANNAH ALWASHLIYAH PEKANBARU
Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan keberhasilan toilet training pada anak usia 3–5 tahun di PAUD Raudhatul Jannah Alwashliyah Pekanbaru. Metode penelitian yang digunakan adalah penelitian kuantitatif dengan desain cross sectional. Penelitian dilaksanakan di PAUD Raudhatul Jannah Alwashliyah Pekanbaru dengan jumlah populasi sebanyak 72 orang tua yang memiliki anak usia 3–5 tahun dan diperoleh sampel sebanyak 61 responden menggunakan teknik Simple Random Sampling. Pengumpulan data dilakukan menggunakan kuesioner mengenai keberhasilan toilet training, pola asuh orang tua, pengetahuan orang tua, dan peran keluarga. Analisis data dilakukan secara univariat dan bivariat menggunakan uji Fisher Exact Test. Hasil penelitian menunjukkan bahwa sebagian besar anak berhasil melakukan toilet training yaitu sebanyak 53 anak (86,9%), dengan mayoritas responden menerapkan pola asuh demokratis sebanyak 53 orang (86,9%), memiliki pengetahuan baik sebanyak 54 orang (88,5%), dan menyatakan peran keluarga dalam kategori baik sebanyak 41 orang (67,2%). Hasil analisis menunjukkan terdapat hubungan antara pola asuh orang tua dengan keberhasilan toilet training (p-value=0,007) dan terdapat hubungan antara pengetahuan orang tua dengan keberhasilan toilet training (p-value=0,042). Sedangkan peran keluarga tidak menunjukkan hubungan yang signifikan dengan keberhasilan toilet training (p-value=0,128). Simpulan penelitian ini adalah pola asuh orang tua dan pengetahuan orang tua berhubungan dengan keberhasilan toilet training pada anak usia 3–5 tahun, sedangkan peran keluarga tidak berhubungan secara signifikan. Oleh karena itu, diperlukan peningkatan edukasi kepada orang tua mengenai pola pengasuhan dan pelaksanaan toilet training untuk mendukung kemandirian anak.
FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KESIAPAN PERSALINAN IBU HAMIL TRIMESTER III DI PUSKESMAS SIDOMULYO
Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan kesiapan ibu hamil trimester III dalam menghadapi persalinan di Puskesmas Sidomulyo Kota Pekanbaru. Metode penelitian yang digunakan adalah penelitian kuantitatif dengan desain cross-sectional. Populasi penelitian adalah seluruh ibu hamil trimester III yang melakukan pemeriksaan kehamilan di Puskesmas Sidomulyo dengan jumlah sampel sebanyak 42 responden yang dipilih menggunakan teknik total sampling. Pengumpulan data dilakukan menggunakan kuesioner, kemudian dianalisis secara univariat dan bivariat menggunakan uji Chi-Square dengan tingkat kemaknaan α=0,05 serta analisis kekuatan hubungan menggunakan Odds Ratio (OR). Hasil penelitian menunjukkan bahwa terdapat hubungan yang signifikan antara pengetahuan dengan kesiapan persalinan (p=0,016; OR=4,950), usia dengan kesiapan persalinan (p=0,038; OR=4,000), paritas dengan kesiapan persalinan (p=0,002; OR=9,167), dan dukungan suami dengan kesiapan persalinan (p=0,000; OR=17,812). Faktor yang memiliki hubungan paling kuat terhadap kesiapan persalinan adalah dukungan suami. Simpulan penelitian ini adalah pengetahuan, usia, paritas, dan dukungan suami berhubungan secara signifikan dengan kesiapan persalinan ibu hamil trimester III di Puskesmas Sidomulyo Kota Pekanbaru. Peningkatan edukasi, pendampingan ibu hamil, serta keterlibatan aktif suami dalam pelayanan antenatal diperlukan untuk meningkatkan kesiapan persalinan.
EFEKTIVITAS KOMBINASI PIJAT OKSITOSIN DAN AKUPRESUR ST 18 TERHADAP KELANCARAN PRODUKSI ASI PADA IBU MENYUSUI DI PMB DINCE SAFRINA KOTA PEKANBARU
Penelitian ini bertujuan untuk menganalisis efektivitas kombinasi pijat oksitosin dan akupresur titik ST18 terhadap kelancaran produksi ASI pada ibu menyusui di PMB Dince Safrina Kota Pekanbaru. Metode penelitian yang digunakan adalah desain pre-eksperimental dengan pendekatan one-group pretest-posttest design. Penelitian dilaksanakan di PMB Dince Safrina Kota Pekanbaru tahun 2025 dengan jumlah sampel sebanyak 18 ibu menyusui yang dipilih menggunakan teknik total sampling. Intervensi berupa kombinasi pijat oksitosin selama 10–15 menit dan akupresur titik ST18 selama 1–2 menit pada setiap titik, dilakukan dua kali sehari selama tujuh hari berturut-turut. Pengukuran kelancaran produksi ASI dilakukan menggunakan lembar observasi dengan 9 indikator penilaian sebelum dan sesudah intervensi. Analisis data menggunakan uji Wilcoxon Signed-Rank Test. Hasil penelitian menunjukkan bahwa sebelum diberikan intervensi sebagian besar responden memiliki kelancaran produksi ASI kategori sedikit sebanyak 10 responden (55,6%), sedangkan setelah intervensi sebagian besar responden berada pada kategori banyak sebanyak 14 responden (77,8%). Terdapat peningkatan median skor kelancaran produksi ASI dari 3 (IQR 2,25–5,00) menjadi 8 (IQR 7,00–8,00) setelah pemberian intervensi dengan nilai p-value = 0,001 (p < 0,05). Simpulan penelitian ini adalah kombinasi pijat oksitosin dan akupresur titik ST18 efektif meningkatkan kelancaran produksi ASI pada ibu menyusui di PMB Dince Safrina Kota Pekanbaru.
WORK-BASED LEARNING IN MIDWIFERY COMMUNITY PRACTICE AND ITS IMPACT ON STUDENT COMPETENCE
Midwifery education requires curriculum transformation, as approximately 35% to 42% of new graduates face adaptation challenges in primary care. Community practice often faces barriers to achieving initial competency targets, amounting to 20% to 30%. This study aims to analyze the effect of implementing Work-Based Learning (WBL) in midwifery community practice on improving student competency, encompassing knowledge, attitudes, and skills. The study used a quasi-experimental design with a one-group pretest-posttest design. The study population was all 43 students of the Undergraduate Midwifery Study Program at Hang Tuah University, Pekanbaru, in the regular academic year of 2025/2026. The sampling technique used was total sampling. Bivariate data analysis used a Paired Sample T-Test. The results showed a significance value of p = 0.000 (p < 0.05) for all aspects, confirming a significant effect of WBL implementation on improving student competency. The average score for knowledge increased from 68.42 to 86.75 with mean difference is 18.33, for attitudes from 71.15 to 89.20 with mean difference is 18.05, and for skills from 64.80 to 85.10 with mean difference is 20.30. It can be concluded that the WBL model has proven effective in bridging theory and field practice and enhancing students' clinical independence and cultural sensitivity. Recommendations for future research include using a control group and measuring the long-term retention of graduate competencies in the workplace.
PENGARUH EDUKASI BOOKLET NURTURING CARE TERHADAP PENGETAHUAN DAN SIKAP IBU DI PAUD AL-FAIQ
Anak usia dini berisiko mengalami hambatan perkembangan apabila tidak memperoleh pengasuhan, stimulasi, kesehatan, gizi, serta rasa aman yang memadai. Penelitian ini bertujuan menganalisis pengaruh edukasi menggunakan booklet Nurturing Care terhadap pengetahuan dan sikap ibu di PAUD Al-Faiq Kota Pekanbaru. Penelitian menggunakan desain pre-eksperimental one group pretest-posttest dengan total sampling sebanyak 20 responden. Data dikumpulkan menggunakan kuesioner pengetahuan dan sikap yang masing-masing terdiri atas 15 butir, kemudian dianalisis menggunakan uji Wilcoxon. Sebelum intervensi, 9 ibu (45,0%) memiliki pengetahuan kurang dan 12 ibu (60,0%) menunjukkan sikap negatif. Setelah edukasi, 19 ibu (95,0%) memiliki pengetahuan baik dan 18 ibu (90,0%) menunjukkan sikap positif. Median skor pengetahuan meningkat dari 10,50 (IQR: 8,00–13,00) menjadi 15,00 (IQR: 13,00–15,00), sedangkan median skor sikap meningkat dari 47,50 (IQR: 46,00–50,00) menjadi 53,00 (IQR: 50,00–55,00). Uji Wilcoxon menunjukkan perubahan bermakna pada pengetahuan dan sikap (p<0,001). Edukasi menggunakan booklet Nurturing Care menunjukkan peningkatan pengetahuan dan sikap ibu pada konteks PAUD Al-Faiq Kota Pekanbar
ANALYSIS OF MATERNAL AGE AND GESTATIONAL HYPERTENSION FACTORS ON THE RISK OF BBLR OCCURRENCE AT MEDICA CLINIC EAST MEDAN DISTRICT IN 2026
Maternalhealthhasabigroleindeterminingchildren'shealth.AccordingtotheHealthProfile, the InfantMortalityRate(AKB)inIndonesiahasdecreased,but it stillneedstoaccelerateeffortssothat the targetof16/1,000livebirthscanbe achieved.The biggest contributors of deathin2022wereLowBirthWeight(BBLR)(28.2%)andAsphyxia(25.3%).Thisresearchmethodusesquantitativeresearchwithacasecontroldesign..ThepurposeofthisstudyistodeterminetheRelationship between AgeandHypertensioninPregnantWomenwiththeIncidenceofBBLRattheKasihClinic,EastMedanDistrict,NorthSumatraProvincein2026.SamplingtechniquewithTotalSamplingwith100populationandsamples.Theresults of theChi-Squeretestshowedthattheage of pregnantwomenwithp-value=0.000(<0.05)andhypertensioninpregnantwomenwithp-value=0.010(<0.05).Theconclusion of thestudystatedthatthereisarelationship between ageandhypertensioninpregnantwomenandtheincidenceofBBLRat the KasihClinic,EastMedanDistrict,NorthSumatraProvincein2026.
DENTIFICATION OF MATERNAL FACTORS AND NUTRITIONAL STATUS ON THE RISK OF GROWTH AND DEVELOPMENT DISORDERS OF TODDLERS IN THE WORKING AREA OF THE SEKUPANG HEALTH CENTER IN 2026
This study aimed to identify the relationship between maternal knowledge, maternal attitudes, maternal educational level, and toddlers’ nutritional status with the risk of growth and developmental disorders among toddlers in the working area of the Sekupang Health Center, Batam City, in 2026. The study employed an analytical observational design with a cross-sectional approach involving 40 mother–toddler pairs selected using an accidental sampling technique. Primary data were collected through structured questionnaires, anthropometric measurements, and child health records. Data were analyzed using univariate analysis to describe respondent characteristics and Chi-square tests to examine the relationships between the independent and dependent variables at a significance level of 0.05. The results showed that most mothers had a moderate level of knowledge (75%), negative attitudes toward child growth and development (60%), elementary or senior high school educational backgrounds (35% each), and most toddlers had normal nutritional status (67.5%). Bivariate analysis indicated that maternal knowledge (p = 0.012), maternal attitude (p = 0.010), maternal educational level (p = 0.018), and toddlers’ nutritional status (p = 0.025) were significantly associated with the risk of growth and developmental disorders among toddlers. In conclusion, maternal factors and toddlers’ nutritional status are important determinants of the risk of growth and developmental disorders, highlighting the need to strengthen maternal health education, improve positive parenting attitudes, and optimize nutritional interventions through primary health care services to support optimal child growth and development.
ANALISIS PENERAPAN ASUHAN BERKELANJUTAN (CONTINUITY OF CARE) TERHADAP KOMPETENSI MAHASISWA KEBIDANAN
Banyak masalah masih ada dalam layanan kesehatan ibu dan anak. Masalah rendahnya pengetahuan publik dan peningkatan kemampuan siswa dalam praktik kebidanan adalah yang paling menonjol. Solusi untuk meningkatkan kualitas layanan dapat berupa pendekatan perawatan berkelanjutan (COC). Klinik ini juga dapat digunakan untuk mengajar klinik mahasiswa. Penelitian ini bertujuan untuk mengevaluasi pelaksanaan COC pada tahun 2026 untuk meningkatkan kemampuan praktik kebidanan dan pengetahuan komunitas siswa Bangun Rejo. Studi ini menggunakan pendekatan penampang sebagai desain deskriptif analitik. Dengan teknik pengambilan sampel total, populasi studi terdiri dari wanita hamil (±30 orang), ibu pasca melahirkan (±20 orang), keluarga balita (±35 keluarga), dan tenaga kesehatan (±10 orang). Alat penelitian meliputi daftar periksa kompetensi, lembar observasi, dan kuesioner pengetahuan (pra-tes-pasca-tes). Data diuji dengan uji t berpasangan dan uji chi-kuadrat. Studi ini menemukan hubungan signifikan antara implementasi COC dan kompetensi siswa (p = 0,002) dan peningkatan pengetahuan komunitas (p = 0,05). Selain itu, penerapan COC dalam kategori baik adalah 65% dan kompetensi mahasiswa sebesar 68%. Penerapan Continuity of Care berhasil meningkatkan keterampilan obstetri siswa dan pengetahuan komunitas mereka.
MANAGEMENT OF APPLICATION-BASED MIDWIFERY CARE DOCUMENTATION IN INDEPENDENT MIDWIFERY PRACTICES IN CIREBON REGENCY, INDONESIA
The implementation of Electronic Medical Records (EMR) has become mandatory for all healthcare facilities in Indonesia following the enactment of the Indonesian Ministry of Health Regulation Number 24 of 2022. Independent Midwifery Practices (Praktik Bidan Mandiri/PBM) are required to improve the quality of midwifery documentation by adopting digital documentation systems. However, the readiness of PBM in managing application-based documentation remains inadequately explored. Objective: This study aimed to describe the management of application-based midwifery care documentation in Independent Midwifery Practices in Cirebon Regency. Methods: A descriptive study with a formative evaluation approach and a cross-sectional design was conducted in 2024. The study involved 30 Independent Midwifery Practices selected through purposive sampling from 612 registered PBMs in Cirebon Regency. Data were collected through direct observation of the implementation of the SIM Klinik application using a structured observation checklist. Observations were conducted by reviewing the completeness of digital midwifery documentation and observing documentation practices performed by midwives during routine healthcare services in Independent Midwifery Practices. Data were analyzed using descriptive statistics. The findings revealed that 20 of 30 Independent Midwifery Practices (66.7%) had a moderately complete documentation system, while 4 of 30 practices (13.3%) demonstrated very complete documentation. Regarding the implementation of the SIM Klinik application, 18 of 30 practices (60.0%) performed documentation very well, 7 practices (23.3%) performed well, and 5 practices (16.7%) performed adequately. These findings indicate that although documentation completeness still requires improvement, the implementation of the SIM Klinik application has supported the transition toward Electronic Medical Records (EMR) in Independent Midwifery Practices. The findings may serve as evidence for the Cirebon District Health Office to strengthen technical assistance and digital health policies for primary midwifery services... Regarding documentation implementation, 60.0% of the practices performed documentation very well, 23.3% performed well, and 16.7% performed adequately. Despite these encouraging findings, several practices still experienced challenges in maintaining complete documentation due to workload, time constraints, and the transition from manual documentation to application-based systems. Conclusion: Most Independent Midwifery Practices in Cirebon Regency have demonstrated satisfactory readiness in implementing application-based documentation. Nevertheless, strengthening digital infrastructure, continuous training, and technical assistance are essential to optimize Electronic Medical Record implementation and improve the quality of midwifery services. .
FAKTOR – FAKTOR YANG MEMPENGARUHI KELENGKAPAN IMUNISASI TETANUS TOXOID PADA IBU HAMIL DI PUSKESMAS KOTA BANDA ACEH
Tetanus toxoid (TT) immunization is particularly important in developing countries, especially for pregnant women, to prevent tetanus in mothers and newborns. Immunization is a process of building immunity to prevent tetanus infection. The tetanus vaccine contains an inactivated tetanus toxin. The coverage of tetanus immunization (Td+2) among pregnant women in Banda Aceh City remains low, with 1,606 pregnant women reported to have received incomplete immunization, which may contribute to increased maternal morbidity and mortality. This study employed a quantitative cross-sectional study design. The samples were selected using purposive sampling, involving 107 pregnant women from three community health centers (Puskesmas) in Aceh Province. The results showed that the majority of respondents were in the third trimester, comprising 44 respondents (41.1%). All respondents had attended antenatal care (ANC) visits, totaling 107 respondents (100%). Most respondents attended ANC according to the recommended standard of six visits, totaling 93 respondents (86.9%). The majority of respondents received education regarding TT immunization during ANC visits, totaling 99 respondents (92.5%). However, most respondents did not receive TT immunization during ANC visits, totaling 74 respondents (69.2%). All respondents had previously received TT immunization (107 respondents; 100%). Most respondents had received TT immunization only before marriage, totaling 44 respondents (41.1%). Furthermore, the majority of respondents had incomplete TT immunization status (TT1–TT4), totaling 97 respondents (90.7%). It is expected that healthcare providers will provide motivation to pregnant women and education to families regarding the importance of completing tetanus toxoid immunization to prevent infection and reduce maternal and neonatal morbidity and mortality.