JURNAL ILMIAH KEPERAWATAN ALTRUISTIK

Exploration of Early Warning Score (EWS) Implementation in Adult Inpatient Wards at Kebumen Hospital: A Qualitative Study

2026-03-17T06:37:25+00:00

Introduction: One of the systems used in inpatient wards to reduce patient deterioration is the Early Warning Score (EWS) (Passa, 2021). The measurement is carried out using six clinical physiological parameters (Royal College of Physicians, 2017). Inappropriate implementation of EWS may negatively affect both patients and nurses in providing nursing care. Inaccuracy in applying EWS can influence the rate of unexpected mortality (Cerly, 2020). A preliminary study conducted through interviews with two nurses in the adult inpatient ward revealed inconsistencies between monitoring frequency and the algorithm. In addition, delays in documenting EWS parameters in the Integrated Patient Progress Notes (CPPT) were also identified. The purpose of this study was to explore the implementation of EWS among nurses in the adult inpatient ward of Kebumen Hospital.

Methods: This study employed a qualitative design with purposive sampling until saturation, involving five respondents. Primary data were collected through semi-structured in-depth interviews, with the researcher as the main instrument. Data validity was ensured through credibility, transferability, dependability, and confirmability. Data were analyzed using Content Analysis.

Results: The study identified two main themes: factors contributing to successful implementation and barriers to applying EWS in high-score conditions. Theme 1 includes three categories: internal human resource factors, continuous coordination, and managerial involvement. Theme 2 includes resource limitations, early identification of high scores, and algorithm mismatch.

Conclusion: The implementation of Early Warning Score (EWS) in adult inpatient wards is influenced by internal human resources, interprofessional coordination, and management support. Barriers include limited resources, documentation noncompliance, and algorithm incompatibility in certain cases.

Recommendation: Optimization of EWS requires strengthened training, adequate facility provision, and algorithm adjustment to support early detection of patient deterioration.

The Effectiveness of Yoga in Reducing Menopausal Symptoms

2026-03-17T04:00:43+00:00

Background: Menopause is a natural phase marked by the permanent cessation of ovarian function and a decline in reproductive hormones, which is often accompanied by hot flashes, sleep disturbances, mood changes, joint pain, and urogenital complaints that affect quality of life. Although hormonal therapy is effective, it carries certain risks; therefore, yoga as a non-pharmacological intervention is considered a potential alternative. Objective: To determine the effectiveness of yoga in reducing menopausal symptoms based on the Menopause Rating Scale (MRS). Methods: This study employed a single case study design involving a 52-year-old woman who had experienced menopause for six months and reported hot flashes, joint pain, vaginal dryness, sleep disturbances, and decreased daily comfort. The yoga intervention was provided through several sessions consisting of breathing techniques, relaxation, and yoga postures adjusted to the patient’s condition. Evaluation of menopausal symptoms was conducted using the MRS before and after the intervention. Results: The MRS score decreased from 16 (upper-moderate category) to 6 (mild category) following the yoga intervention, accompanied by a reduction in somatic and urogenital complaints and improvement in daily comfort. Conclusion: Yoga contributes to the reduction of menopausal symptoms and improvement of patient comfort, making it a safe and effective non-pharmacological intervention. Further studies with larger sample sizes and longer intervention periods are recommended to strengthen these findings.

JENIS KELAMIN, AKTIVITAS , KEPATUHAN PENGOBATAN, DUKUNGAN KELUARGA DAN PENGHASILAN BUKAN PENYEBAB RELAPS GANGGUAN JIWA

2026-03-17T06:42:13+00:00

Introduction: Mental disorders are chronic, incurable diseases, so patients with mental disorders often experience relapse. The incidence of relapse has increased from 54% in 2021 to 80% over the past five years. The causes of relapse vary widely, including non-adherence to treatment, family support, economic problems, and social stigma. This study aims to identify the dominant factors that cause relapse in patients with mental disorders. Methods: This study used a quantitative method with a cross-sectional approach. The sample size was 40 with a consecutive sampling technique. The measuring instruments used were a questionnaire on family support, medication adherence, and respondent characteristics. Results: The results of the study showed a relationship between gender and the incidence of relapse p value 0.398 (> 0.05); income with the incidence of relapse p value 0.071 (> 0.05), scheduled activities were not related to the incidence of relapse p value 0.94 (> 0.05); Family support was not related to the incidence of relapse p value 0.168 (> 0.05); Treatment adherence and relapse incidence p-value 0.629 (>0.05). Conclusion: Gender, income, and scheduled activities are not associated with relapse incidence in patients with mental disorders. Recommendation: Based on the study results, it is recommended that research be conducted on the relationship between duration of mental illness, family knowledge of mental disorders, and social acceptance.

The Effect of a Combination of Modern Wound Care and Dietary Management on the Healing of Diabetic Foot Wounds in Kendari City

2026-03-17T06:33:51+00:00

Background: Diabetes mellitus is also called a chronic disease because patients will suffer from it for life and have a progression that will continue to run so that over time it will cause complications, one of which is diabetic foot wounds or diabetic ulcers. The purpose of this study was to determine the effect of a combination of modern wound care and dietary management on the healing of diabetic foot wounds in Kendari City. Research method Quantitative research, with a pre-experimental one group pre-post-test design. The research sample was 36 diabetes mellitus patients recruited by non-probability sampling type consecutive sampling. Data are presented in descriptive statistics and significant findings are calculated using the paired sample t test. Results and Analysis: Analysis of the paired t test, showed a significant value at p = 0.000 <? = 0.05). Before the intervention, the average diabetic foot wound healing rate was 11.78, categorized as moderate diabetic foot wounds, with a standard deviation of 2.344. After the intervention, there was an improvement in the average diabetic foot wound healing rate, reaching 3.83, categorized as mild diabetic foot wounds, with a standard deviation of 1.920. Conclusion: The combined intervention of modern wound care and dietary management has an effect on the healing of diabetic foot wounds in Kendari City. Nurses are expected to utilize the combination of modern wound care and dietary management as an independent nursing intervention because it is easy and safe.

THE EFFECT OF THE FRUIT-VEGETABLE FUN TECHNIQUE ON IMPROVING NUTRITIONAL STATUS IN CHILDREN AGED 2-5 YEARS IN THE WORKING AREA OF THE CIPINANG BESAR UTARA COMMUNITY HEALTH CENTER, EAST JAKARTA

2026-03-17T06:13:26+00:00

Good growth and development are essential requirements for achieving optimal health. Growth and development disorders will hinder the creation of quality human resources as a determinant of the future development of the nation and state. In 2021, the nutritional status of underweight and poor toddlers based on weight/age was generally 20.4%, with a proportion of 17.94% experiencing undernutrition and 2.46% experiencing severe malnutrition out of a total of 3,802 toddlers. Although the percentage has increased, this number has reached the national target of the nutrition improvement program, which is 20% (Serang Regency Health Office, 2021). This is due to factors such as habits and nutritional fulfillment in these children that are still lacking, both external and internal factors are among the causes. Fruit-Vegetable Fun learning is a form of introduction to nutritious foods by mothers who are expected to play a vital role in improving the nutritional status of early childhood. The purpose of this study was to determine the effect of the Fruit-Vegetable Fun technique on improving the nutritional status of children aged 2-5 years in the working area of ??the Cipinang Besar Utara Community Health Center, East Jakarta. The study design used a quasi-experimental approach with a pre- and post-test without control. The sampling of this study was conducted using a purposive sampling technique. The number of respondents in this study was 50 children. Respondents' mothers were given an observation form for eating patterns and frequencies, as well as a Child Feeding Questionnaire (CFQ). Respondents were given a Fruit-Vegetable Fun game using flashcards of fruits and vegetables that are classified as nutritious foods and explaining the benefits of these foods. The results of the study showed that there was an increase in nutritional status in children aged 2-5 years after being given the Fruit-Vegetable Fun game which was known from the observation sheet for children's eating frequencies and patterns. Suggestions for health workers, especially nurses at community health centers, are to be able to provide routine programs using interesting methods for children to increase children's appetite so that it has an impact on improving nutritional status in children aged 2-5 years.

REDUCING ANXIETY IN PRE-OPERATING CATARACT PATIENTS THROUGH THINKING, FEELING, AND ACTING COUNSELING: A CASE STUDY

2026-03-17T03:55:34+00:00

Background: Surgical procedures are a stressor that triggers anxiety. Previous surgical experiences and uncertainty about the outcome of the procedure increase anxiety. Increased anxiety in patients results in changes in their hemodynamic status, characterized by increased blood pressure, heart rate, and respiratory rate. One way to manage anxiety is through counseling using a thinking, feeling, and acting approach. Therefore, this study aimed to determine the effect of counseling using a thinking, feeling, and acting approach on preoperative anxiety and blood pressure levels in patients. Case Description: Mr. Y, 63, presented to the eye clinic at KMU Eye Hospital in Lamongan with complaints of blurry and cloudy left eye for the past three months. The patient reported a history of controlled hypertension and diabetes mellitus and had previously undergone cataract surgery in his right eye. The patient stated that the previous surgery was very long and painful, making the planned second surgery very anxious. The main problem was anxiety, which contributed to the patient's increased blood pressure. The patient's anxiety level was measured at 43, categorized as mild anxiety, and his blood pressure was 169/96 mmHg. Counseling, using a thinking, feeling, and acting approach, was conducted for 30 minutes before cataract surgery. Results: The study revealed a decrease in anxiety levels, indicated by a decrease in verbalization of anxiety, anxious behavior, and blood pressure. The anxiety level also decreased from 43 (mild anxiety) to 31 (no anxiety). Conclusion: Counseling using a thinking, feeling, and acting approach can reduce anxiety levels and blood pressure in pre-cataract surgery patients.

THE RELATIONSHIP BETWEEN ONLINE GAME ADDICTION AND SLEEP QUALITY AND LEARNING ACHIEVEMENT OF 9TH GRADE ADOLESCENTS AT SMPN 5 CIKARANG UTARA

2026-03-17T03:32:22+00:00

Online game addiction is a behavioral problem in adolescents that can impact health and academic achievement. Objective: This study aims to analyze the relationship between online game addiction and sleep quality and academic achievement in 9th grade adolescents at SMPN 5 Cikarang Utara. Method: This study used an analytical design with a cross-sectional approach. The sample consisted of 70 9th grade students selected by total sampling. The research instruments included the Game Addiction Scale (GAS) questionnaire for online game addiction, the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, and report card scores for academic achievement. Data analysis was performed using the Chi-Square test. Results: A total of 67 students (95.7%) actively played online games, and 36 students (51.4%) reported often staying up late due to playing games. There was a significant relationship between the level of online game addiction and sleep quality (p < 0.05) and academic achievement (p < 0.05).

Factors of Patient's Family Anxiety in Intensive Care at RSUD Raden Mattaher Jambi Province

2026-03-17T06:39:07+00:00

Family anxiety during intensive care treatment is a common psychological response arising from patients’ critical conditions and uncertainty in the care process. Unmanaged anxiety may negatively affect family well-being and interfere with clinical decision-making. This study aimed to identify factors associated with family anxiety among patients receiving intensive care at RSUD Raden Mattaher, Jambi Province. A quantitative cross-sectional design was employed involving 81 family members selected through consecutive sampling. Data were collected using a demographic characteristics questionnaire and the Hamilton Anxiety Rating Scale (HARS). Data analysis consisted of univariate and bivariate analyses using Spearman’s rank correlation and Chi-square tests. The results showed significant associations between family anxiety levels and age (p = 0.005), gender (p = 0.023), socioeconomic status (p < 0.001), and prior experience caring for a family member in the Intensive Care Unit (p = 0.036). In contrast, educational level (p = 0.667) and perceived nurses’ roles (p = 0.847) were not significantly associated with family anxiety. These findings highlight the importance of early psychosocial assessment and strengthening family-centered nursing approaches to reduce anxiety among families of patients receiving intensive care.

Keywords: family anxiety; Intensive Care Unit; determinant factors; family nursing.