Proceedings of International Health Conference
Proceedings of the International Health Conference Faculty of Health Sciences Galuh University is a scientific publication that contains a collection of papers or articles presented at the International Health Conference organized by the Faculty of Health Sciences, Galuh University. This conference is a forum for academics, researchers, practitioners, and stakeholders in the health field to present and share the latest research findings, discoveries, and ideas related to various topics in health sciences. These proceedings are published periodically, usually after the conference. Its contents cover various topics relevant to the health field, such as medicine, nursing, midwifery, nutrition, public health, and other related disciplines. The papers included in these proceedings have gone through a rigorous selection and review process by the scientific committee and editorial board to ensure the quality and relevance of their content. The Proceedings of the International Health Conference Faculty of Health Sciences Galuh University serve as an important reference source for academics, researchers, and practitioners in the health field to access the latest findings and contribute to the development of knowledge in this field. In addition, these proceedings can also serve as a medium for establishing cooperation and collaboration among researchers from various institutions and countries in developing research and practices in the health sector.
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Head Nurse Supervision in Nursing Care Documentation: A Literature Review
Nursing care documentation is a key indicator of service quality, patient safety, interprofessional communication, and nurses' legal accountability. However, documentation completeness remains suboptimal in both global and Indonesian health-care settings. Head nurse supervision is a managerial factor that may improve nurses' performance through direction, coaching, monitoring, evaluation, and continuous feedback. This literature review aimed to identify the role of head nurse supervision in nurses' performance in nursing care documentation. The article search was conducted using the PICOS framework in Google Scholar, ScienceDirect, and PubMed for studies published from 2018 to 2026 and selected according to the PRISMA flow. From 2,210 initially identified records, 15 articles met the eligibility criteria and were appraised critically. The review found that 14 articles (93.3%) reported an association or effect of head nurse supervision on nurses' documentation performance, while one article (6.7%) did not show a direct effect. Mixed supervision, combining direct and indirect approaches, was the most frequently used form. Structured, educational, consistent, and sustainable head nurse supervision is recommended to strengthen nurses' documentation performance and nursing service quality.Nursingcaredocumentationisakeyindicatorof servicequality,patient safety,interprofessionalcommunication,and nurses'legalaccountability.However,documentationcompleteness remains suboptimalinbothglobalandIndonesian health-caresettings.Headnursesupervisionis amanagerialfactor thatmayimprovenurses'performancethrough direction, coaching, monitoring, evaluation, andcontinuousfeedback. Thisliteraturereviewaimedtoidentifythe roleof headnursesupervisioninnurses'performanceinnursingcaredocumentation.The articlesearchwasconductedusing thePICOSframeworkinGoogleScholar,ScienceDirect,and PubMedfor studies publishedfrom2018to2026and selectedaccordingtothePRISMAflow.From2,210initiallyidentified records, 15articlesmettheeligibilitycriteriaand wereappraisedcritically.Thereviewfoundthat 14articles(93.3%)reportedanassociationoreffectofheadnurse supervisiononnurses'documentationperformance,whileonearticle(6.7%)didnot showadirecteffect.Mixed supervision,combiningdirectandindirectapproaches,was themostfrequentlyusedform.Structured,educational, consistent,andsustainableheadnursesupervisionis recommendedtostrengthennurses'documentationperformance andnursingservicequality.
Early Mental Health Screening through the MENTARI Application and Classical Music Therapy
Background: Anxiety is commonly experienced by final-year nursing students due to academic workload, clinical practice, and thesis completion demands. Early mental health screening combined with non-pharmacological interventions is needed to support students’ psychological well-being. Objective: This study aimed to analyze the effectiveness of classical music therapy integrated into the MENTARI application for reducing anxiety among nursing students. Methods: This study used a quantitative approach with a quasi-experimental one-group pretest-posttest design. Participants were selected using purposive criterion sampling based on anxiety screening results. Anxiety levels were measured using the Mini MindHEAR Youth Scale Version 1 (MMYS V.1). Respondents received Mozart classical piano music therapy for 10–15 minutes daily for seven consecutive days through the MENTARI application. Results: The intervention showed a decrease in anxiety scores after therapy, indicating improved emotional relaxation among students. Conclusion: The MENTARI application integrated with classical music therapy has potential as an accessible digital intervention for early mental health screening and anxiety management among nursing students.
WhatsApp Education to Increase Family Planning Participation with Local Cultural Perspectives in 2026
This community-based research was conducted in Sukamulya Village to evaluate the effectiveness of WhatsApp-based education in increasing participation in family planning programs through a local cultural and social conservation approach. The study used a pre-experimental one-group pretest–posttest design involving village health cadres and reproductive-age couples. Educational interventions were delivered through a WhatsApp group containing health information, interactive discussions, counseling, videos, and culturally adapted infographics related to family planning. Data were collected using questionnaires before and after the intervention and analyzed to assess changes in participants’ knowledge, skills, and attitudes. The results showed a significant improvement in all assessment domains. Knowledge about family planning increased from a mean score of 5.33 to 7.53 (41.25%; p<0.001), skills in using WhatsApp as an educational medium increased from 6.27 to 7.90 (26.06%; p<0.01), and attitudes toward participation and consultation in family planning improved from 3.83 to 4.33 (13.06%; p=0.018). The total score increased from 15.43 to 19.76 (28.08%; p<0.001). These findings indicate that WhatsApp-based education effectively improves community participation in family planning programs and can serve as an innovative strategy for health promotion in rural communities.
Telelactation Implementation Among Postpartum Mothers In Primary Healthcare
Background: Breastfeeding problems remain one of the causes of unsuccessful exclusive breastfeeding during the postpartum period. The advancement of digital technology enables lactation assistance services to be conducted remotely through telelactation. Aim: This study aimed to describe the implementation of telelactation among postpartum mothers in the working area of Baregbeg Public Health Center. Methods: This study used a descriptive quantitative design. The research was conducted at Baregbeg Public Health Center involving 22 postpartum mothers selected using purposive sampling techniques. Data were collected using a structured questionnaire consisting of maternal characteristics, access to telelactation services, frequency of consultation, types of breastfeeding complaints, and maternal satisfaction toward telelactation services. Data were analyzed using descriptive statistics. Result: The results showed that most respondents were aged 20–35 years (68%), multiparous (56%), and had secondary education (60%). The majority of mothers accessed telelactation services through WhatsApp (82%). The most common breastfeeding problems were improper breastfeeding attachment (46%), low milk production (32%), and nipple pain (22%). Most respondents stated that telelactation services were easy to access (88%), helped solve breastfeeding problems (84%), and increased breastfeeding confidence (80%). Conclusion : Telelactation implementation was considered beneficial in supporting postpartum mothers during breastfeeding, especially in improving access to lactation counseling services. Telelactation can be developed as an innovative maternal health service in primary healthcare settings.
Local Food Utilization to Support PMT among Pregnant Women with CED
Background: Chronic Energy Deficiency (CED) among pregnant women remains a public health problem affecting maternal and fetal health outcomes. Local food utilization as part of Supplementary Feeding Programs (PMT) may serve as an alternative strategy to support maternal nutrition because it is accessible, affordable, and culturally appropriate. Objective: This study aimed to describe local food utilization among pregnant women with CED in supporting PMT programs. Methods: A quantitative descriptive design was used. The study population consisted of all 25 pregnant women with CED using a total sampling technique. Data were collected using validated and reliable structured questionnaires and analyzed descriptively using frequency and percentage distributions. Results: The results showed that most respondents had poor knowledge (40%), followed by moderate knowledge (32%) and good knowledge (28%). Regarding attitudes, 56% of respondents showed negative attitudes, while 44% demonstrated positive attitudes toward local food utilization in supporting PMT programs. Conclusion: Local food utilization in supporting PMT programs among pregnant women with CED remains suboptimal. Strengthening nutrition education and continuous assistance from healthcare providers, particularly midwives, are needed to improve maternal knowledge and positive attitudes toward local food utilization during pregnancy.
The Effect of Digital Advertising in the Stunting Detection Calculator (Kalkulating) Application on Visits to Obstetrics and Gynecology Clinics
Stunting is one of the health problems with long-term impacts on the quality of human resources and regional economic growth. Globally, 22% of children are affected by stunting, with 19,8% in Indonesia, 15,9% in West Java, and 20,3% in Ciamis Regency. Digital transformation in the health sector offers a potential approach to improve access to and utilization of health services. This study aims to analyze the effect of digital advertising through the Stunting Detection Calculator (Kalkulating) application on the increase in visits to the Obstetrics and Gynecology Clinic at RSU Al-Arif Ciamis. The Kalkulating application has been used as a promotional medium since October 2024. This study applied a quantitative approach using secondary data on patient visits from July 2024 to March 2025. The average number of visits before the advertisement was 106, which increased to 138.33 after the advertisement. The t-test result showed a t-value of 3.93 and a p-value of 0.0095, indicating a statistically significant difference. These findings suggest that digital health promotion can improve the utilization of health services. The implication of this study recommends expanding the use of digital media in public health promotion strategies to support stunting reduction efforts and strengthen sustainable regional health systems.
The Relationship Between Coping Strategies and Emotional Mental Disorders Among University Students
Background: Emotional mental disorders (EMDs) are common among university students, with approximately 12.7% of students experiencing such conditions. Psychological problems in students may reduce productivity and quality of life and interfere with the learning process. Objective: To determine the relationship between coping strategies and emotional mental disorders among university students. Methods: This study employed a descriptive correlational design with a cross-sectional approach. The study population consisted of students at Universitas Sebelas April. A total of 373 respondents were selected using a non-probability sampling technique. Coping strategies were measured using the Brief COPE questionnaire, while emotional mental disorders were assessed using the Self- Report Questionnaire (SRQ-20). Results: Most respondents were female (67.8%) and aged 18–21 years (55.0%). The majority used problem-focused coping strategies (74.0%), and 61.7% showed indications of emotional mental disorders. Bivariate analysis showed a significant relationship between coping strategies and emotional mental disorders (p = 0.001). Conclusion: There is a significant relationship between coping strategies and emotional mental disorders among university students. Students who used emotion-focused coping had a 5.753 times greater risk of experiencing emotional mental disorders compared with those using problem-focused coping. Recommendation: Universities should implement mental health policies and support systems to promote student well-being.
Determinants of Anemia Among Pregnant Women Attending Antenatal Care
Anemia during pregnancy remains a major maternal health problem because it increases the risk of adverse outcomes for mothers and infants. This study aimed to identify determinants of anemia among pregnant women attending antenatal care. This study used an analytical cross-sectional design based on aggregated maternal health data from 50 pregnant women in Sukamulya Village, Ciamis, Indonesia. The sample consisted of 25 pregnant women with anemia and 25 pregnant women without anemia. Anemia was defined as hemoglobin level below 11 g/dL. The variables analyzed were maternal age, education, occupation, gestational age, parity, mid-upper arm circumference, iron tablet adherence, number of antenatal care visits, and pregnancy interval. Data were analyzed using descriptive statistics, chi-square tests, and odds ratios for selected two-category variables. The results showed that maternal age and pregnancy interval were significantly associated with anemia. Education, occupation, gestational age, parity, nutritional status based on mid-upper arm circumference, iron tablet adherence, and antenatal care visits were not significantly associated with anemia in this dataset. Although low mid-upper arm circumference and non-adherence to iron tablets showed higher odds of anemia, these associations did not reach statistical significance. These findings indicate that maternal age and pregnancy interval should receive greater attention in antenatal anemia screening, while nutritional assessment and iron tablet counseling should continue as essential components of anemia prevention during pregnancy.
Analysis of Relationship Between Anemia Knowledge and Iron Tablet Consumption Adherence Among Pregnant Women
Maternal anemia continues to be a major public health issue because it is associated with adverse maternal and neonatal outcomes during pregnancy and childbirth. Iron supplementation through Fe tablets is one of the recommended interventions to reduce the occurrence of anemia; however, adherence to tablet consumption among pregnant women remains unsatisfactory. Knowledge regarding anemia may play an important role in influencing adherence behavior. This study investigated the association between pregnant women’s knowledge of anemia and their compliance with Fe tablet intake.A quantitative analytical study using a cross-sectional design was conducted. Knowledge of anemia served as the independent variable, while adherence to Fe tablet consumption was treated as the dependent variable. The study population comprised 681 pregnant women attending antenatal care services at Sindangkasih Public Health Center, Ciamis Regency. A total of 87 participants were selected through simple random sampling using the Slovin formula. Data were obtained using an anemia knowledge questionnaire and the Morisky Medication Adherence Scale (MMAS-8). Statistical analysis was performed using Spearman’s rank correlation test.The findings revealed that nearly half of the respondents demonstrated a moderate level of anemia-related knowledge (49.4%). Furthermore, 42.6% of participants were categorized as having low adherence to Fe tablet consumption. Correlation analysis showed a significant positive association between knowledge and adherence (ρ = 0.681; p < 0.001).These findings indicate that better knowledge regarding anemia is associated with greater compliance in consuming Fe tablets during pregnancy. Strengthening educational interventions may therefore contribute to improving adherence and reducing the risk of anemia among pregnant women.
Evaluating Caregiver-Led Asthma Management for Preschool Children with Uncontrolled Asthma in Makkah: Quasi-Experimental Study
Uncontrolled asthma remains a significant public health problem among preschool children in Makkah, Saudi Arabia, because young children depend entirely on caregivers for medication administration, symptom monitoring, and trigger avoidance. This study aims to evaluate the effectiveness of a caregiver-led asthma management program for preschool children with uncontrolled asthma. A quasi-experimental pretest-posttest design with intervention and control groups will be used. A total of 120 caregivers will participate, with 60 caregivers in each group. Data will be collected using a caregiver knowledge and practice questionnaire, the Childhood Asthma Control Test, and the Test for Respiratory and Asthma Control in Kids. The intervention will include structured caregiver education on asthma triggers, medication adherence, inhaler technique, symptom monitoring, and home-based management. The study is expected to strengthen caregiver knowledge, improve asthma symptom control, reduce emergency visits, and support family-centered asthma care in Saudi primary healthcare settings.
Islamic Religious Coping and Mental Health Resilience Among Health Students in the Digital Era
Health students, particularly final-semester students completing their thesis, often experience academic pressure, chronic stress, and emotional fatigue. In the digital era, academic demands combined with intensive social media exposure create additional psychological challenges that may affect students’ mental well-being. This study aims to explore the role of Islamic religious coping in strengthening mental health resilience among health students at STIKes Bina Putera Banjar. This study employed a descriptive qualitative approach involving five eighth-semester students from nursing, public health, and midwifery programs as key informants. Data were collected through semi-structured interviews, observation, documentation, and supported by relevant literature. The findings indicate that Islamic spiritual practices such as shalat (prayer), dzikir (remembrance of God), doa (supplication), and Quranic recitation were perceived to support emotional regulation and psychological resilience in dealing with academic stress. Islamic values including tawakal (trust in God), ikhtiar (persistent effort), sabar (patience), and the Quranic principle “inna ma’al ‘usri yusra” (with hardship comes ease) contributed to students’ coping processes and motivational resilience. Furthermore, digital technology demonstrated a dual impact: excessive social media exposure increased psychological pressure, while purposeful digital engagement supported academic productivity and spiritual reinforcement. These findings highlight the potential contribution of Islamic psycho-spiritual approaches in supporting student mental health and resilience within health higher education settings.
Evaluating The Effectiveness of A Childhood Fever Awareness Program For Caregivers on Knowledge, Attitude, Practices, and Health Literacy in Primary Health Care Centers in Ha’il, Saudi Arabia
Childhood fever was one of the most common symptoms prompting healthcare consultations worldwide. Although fever was recognized as a normal physiological response to infection, the literature consistently showed that caregivers frequently misinterpreted it as a dangerous condition. This study aimed to evalate the effectiveness of a structured Childhood Fever Awareness Program (CFAP) in improving caregivers’ knowledge, attitudes, practices, and health literacy related to childhood fever management, and in promoting appropriate healthcare-seeking behavior among caregivers attending Primary Health Care Centers (PHCCs) in Ha’il, Saudi Arabia. A quasi-experimental, non-randomized, two-group pretest/post-test/follow-up design with cluster allocation will be implemented. The intervention group (n = 50) will be recruited from Al-Naqrah PHCC and will participate in the CFAP, while the control group (n = 50) will be recruited from Qufar and North Airport PHCCs and will receive treatment as usual (TAU). Data will be collected at baseline (T1), immediately post-intervention (T2), and at an 8–12-week follow-up (T3). A total sample of 100 caregivers will be determined based on power analysis (α = 0.05, power = 0.80, moderate effect size), with allowance for potential attrition. Validated instruments will be used to assess knowledge, attitudes, practices, and health literacy outcomes. It is anticipated that caregivers in the intervention group will demonstrate significant improvements in knowledge, attitudes, practices, and health literacy compared to the control group, with sustained effects at follow-up. The Childhood Fever Awareness Program is expected to provide evidence supporting structured, health literacy–focused educational interventions in primary healthcare settings to improve fever management and optimize healthcare utilization.
The Impact of Nurse Self-Efficacy and Transformational Leadership on Nursing Practice Improvements in Hail Cluster: The Mediating Role of Collaborative Teamwork
Quality of nursing practice and effective group healthcare are fundamental pillars of modern healthcare delivery, particularly within the evolving landscape of the Saudi healthcare system. In the Hail Health Cluster, the high demands placed on nursing staff require not only clinical proficiency but also strong psychological and organizational support to ensure patient safety and operational excellence. This study aimed to evaluate the impact of nurse self-efficacy and transformational leadership on nursing practice improvements, specifically examining the mediating role of collaborative teamwork. Using a quantitative, cross-sectional design, data were collected from 278 registered nurses within the Hail Health Cluster. The research model was analyzed using SmartPLS 4 to assess both the measurement and structural models, ensuring high reliability and validity of the constructs. The results demonstrated that both transformational leadership and nurse self-efficacy have a significant positive influence on nursing practice improvements. Notably, collaborative teamwork was found to be a critical mediator, indicating that leadership and individual confidence drive practice enhancements primarily by fostering a cooperative and communicative team environment. Additionally, the study found that ethical leadership styles contribute to organizational justice, thereby reducing negative workplace dynamics such as bullying. These findings suggest that to achieve the goals of Saudi Vision 2030, healthcare administrators must prioritize leadership development and team-based interventions. This integrated approach ensures that personal self-belief and organizational guidance translate into superior clinical outcomes and a healthier professional work environment.
Analysis of Adolescent Girls’ Understanding of Anemia
Background: Anemia remains a major public health problem among adolescent girls, and limited evidence regarding their knowledge in rural senior high schools in Indonesia may hinder the development of effective school-based prevention programs. Objective: This study aimed to analyze the level of knowledge regarding anemia among adolescent girls at SMAN 1 Cihaurbeuti, Ciamis, West Java, Indonesia. Methods: A descriptive quantitative study with a cross-sectional design was conducted from January to March 2026 involving all 46 eligible adolescent girls using a total sampling technique. Data were collected using a structured questionnaire assessing knowledge of anemia, including its definition, causes, signs and symptoms, consequences, and preventive measures. Data were analyzed descriptively and presented as frequencies and percentages. Results: Most respondents were 17 years old (46.8%) and had regular menstrual cycles (69.6%). Low adherence to iron supplementation was reported by 54.3% of respondents, while 39.1% had poor dietary patterns. Overall, 71.7% of respondents were not anemic, whereas 28.3% experienced varying degrees of anemia. Regarding knowledge, 19 respondents (41.3%) demonstrated good knowledge, 12 (26.1%) had moderate knowledge, and 15 (32.6%) had poor knowledge of anemia. Conclusion: Although most respondents demonstrated good knowledge regarding anemia, nearly one-third still had inadequate understanding. Strengthening school-based nutrition education and promoting adherence to iron supplementation programs are recommended to improve anemia prevention among adolescent girls.
Effectiveness Of Audiovisual Media On Mother’s Knowledge Of Basic Complete Immunization In Salopa Community Health Care Tasikmalaya
The World Health Organization (2022) reported that 14.3 million children had not received the initial dose of DPT immunization, while another 6.2 million children received only partial immunization. Banjarwaringin Village, located within the working area of Salopa Community Health Care, has the lowest immunization coverage at 70%. Several toddlers have not completed basic immunization because mothers lack knowledge regarding complete basic immunization. Therefore, the use of audiovisual media in health education may improve mothers’ knowledge and attitudes toward immunization. This study aimed to determine the effectiveness of audiovisual media on mothers’ knowledge of complete basic immunization in Banjarwaringin Village, Salopa Community Health Care, Tasikmalaya. This study used a pre-experimental method with a one-group pretest-posttest design. The sample consisted of 30 respondents, and the data were analyzed using normality and Wilcoxon signed-rank tests. The results showed improved knowledge before intervention, with 56.7% having moderate knowledge and 21.6% low knowledge, and after intervention, 86.3% had good knowledge while only 2.0% remained low. Audiovisual media was proven effective with a p-value of 0.000 (<0.05). In conclusion audiovisual health education significantly increased mothers’ understanding of complete basic immunization in Banjarwaringin Village and may support childhood immunization coverage in the Salopa Community Health Care.
Differences In The Effectiveness of The Modification Syringe Method and The Syringe Method In Handling Inverted Nipples In Post-Caesarean Mothers At Bandung Kiwari Regional General Hospital In 2023
Background: Exclusive breastfeeding achievement at RSUD Bandung Kiwari has not yet been reached. This is partly due to complaints of inverted nipples. Therefore, handling of inverted nipples is needed, one of which is through the Modification Syringe method and the syringe method. Objective: To determine the difference in effectiveness between the Modification Syringe method and the syringe method in handling inverted nipples in postpartum mothers post-cesarean section at RSUD Bandung Kiwari in 2023. Method: The research method used was quasi-experimental with a two-group posttest-only design. The population consisted of 230 postpartum mothers post-cesarean section. The sample consisted of 25 mothers in the Modification Syringe method group and 25 mothers in the syringe method group. Data analysis was conducted using univariate and bivariate analysis with the Mann-Whitney test. Results: It took 5 sessions using the vacuum pump method to address inverted nipples, and it took 6 sessions using the syringe method to address inverted nipples. The p-value obtained was 0.033 < 0.05, which means there is a difference in the effectiveness of the vacuum pump method and the syringe method in managing inverted nipples in postpartum mothers after cesarean section. Conclusion: There is a difference in the effectiveness of the vacuum pump method and the syringe method in managing inverted nipples in postpartum mothers after cesarean section. It is recommended that hospitals consider the vacuum pump method as an alternative procedure for handling inverted nipple problems.
The Effectiveness of Telenursing "My Nursing" on Self- Care Knowledge, Attitude, and Practice Among Non- Communicable Disease Patients
Non-communicable diseases (NCDs) such as hypertension and diabetes mellitus require effective self-care management to prevent complications. This study aimed to evaluate the effectiveness of the "My Nursing" telenursing application on knowledge, attitude, and self-care practice among NCD patients in Indonesia. A quasi-experimental design with control and intervention groups was employed involving 101 participants (50 control, 51 intervention) selected from community health centers in Pekalongan, Indonesia. The intervention group received telenursing services through the "My Nursing" Android application for eight weeks, while the control group received standard care. Data were analyzed using Mann- Whitney U test. Results showed significant differences between intervention and control groups in knowledge (p=0.000), attitude (p=0.000), and self-care practice (p=0.000). Telenursing effectively improved knowledge, attitude, and self-care practices among NCD patients. This innovative approach addresses healthcare access gaps particularly in rural areas and supports chronic disease management through digital health technology.
RURAL ADOLESCENTS’ VULNERABILITY TO EARLY MARRIAGE: A Community Nursing Perspective
Early marriage among rural adolescents remains a significant public health issue affecting reproductive health, educational attainment, and the psychosocial well-being of adolescent girls. Rural adolescents’ vulnerability to early marriage is influenced by multiple factors, including knowledge level, family economic conditions, cultural values, and social environment. This study aimed to analyze the vulnerability of rural adolescents to early marriage from a community nursing perspective based on knowledge level, family economic status, cultural influences, and peer environment. A comparative quantitative study with a cross-sectional approach was conducted involving 69 respondents who experienced early marriage in rural areas. The sampling technique used was total sampling, and data were collected using structured questionnaires. Data analysis was performed using univariate and bivariate analyses with the Chi-square test at a significance level of p<0.05. The results revealed significant differences in knowledge level (p=0.012), cultural influence (p=0.018), and peer environment (p=0.021) based on family economic status. Adolescents from low-income families tended to have lower levels of knowledge, were more strongly influenced by cultural norms supporting early marriage, and experienced more negative peer environments. The findings indicate that early marriage among rural adolescents is a multidimensional phenomenon requiring comprehensive community nursing interventions through reproductive health education, family empowerment, culturally sensitive approaches, and strengthening peer education programs to prevent early marriage among adolescents.
Health Literacy, Social Determinants, And Workplace Stroke Prevention Among Indonesian Civil Servants
Stroke remains one of the leading causes of disability and premature mortality worldwide and represents an important public health challenge among working-age populations, including Indonesian civil servants. Workplace-based prevention is increasingly recognized as a strategic approach for early detection and risk reduction. This study aimed to examine the role of health literacy and social determinants in predicting higher stroke risk categories and to translate these findings into practical workplace prevention strategies for civil servants. A cross-sectional study was conducted among 387 Indonesian civil servants aged 40 years and above. Stroke risk was categorized into four ordinal levels: very low, low, moderate, and high risk. Health literacy and social determinants were measured using structured questionnaires, and ordinal logistic regression was used for analysis. Most participants were classified as very low risk (80.6%), followed by low risk (9.6%), moderate risk (6.7%), and high risk (3.1%). The overall model was statistically significant (p = 0.006). Health literacy showed a significant effect on stroke risk category progression (p = 0.010), while social determinants were not statistically significant in the final model. The Nagelkerke R-square value was 0.035, indicating that non-clinical factors explained a modest but meaningful proportion of risk variation. These findings highlight health literacy as an actionable entry point for workplace-based stroke prevention policies. Integrating routine education, targeted risk communication, and early screening programs within civil servant institutions may strengthen preventive health strategies.
Integrating Local Wisdom Into Community Nursing Interventions For Environmental Conservation and NCD Prevention: Literature Review
The increasing burden of non-communicable diseases (NCDs) and the growing concern over environmental degradation highlight the need for integrated and sustainable health strategies. Conventional health interventions often overlook the role of local wisdom, cultural practices, and environmental contexts in shaping health behaviors and long-term outcomes. This literature review aims to examine the integration of local wisdom into community nursing interventions for environmental conservation and NCD prevention. A systematic search of peer-reviewed articles published between 2020 and 2025 was conducted, resulting in the inclusion of twelve studies that met the predefined criteria. The findings indicate that traditional dietary practices, particularly plant-based and minimally processed foods, are associated with reduced metabolic and cardiovascular risks. Cultural values and indigenous knowledge systems significantly influence health behaviors and improve adherence to preventive practices. Environmental determinants, including food systems and built environments, shape lifestyle patterns and disease risk. In addition, culturally tailored and community-based interventions demonstrate greater effectiveness in promoting behavioral change and improving health outcomes. The integration of local wisdom into community nursing interventions provides a holistic and sustainable framework that supports both NCD prevention and environmental conservation. This approach enhances cultural relevance, strengthens intervention effectiveness, and contributes to long-term public health sustainability.
Analysis of Information Technology Readiness and Implementation of A Child Nutrition Anthropometry Application (ANA) For Health Optimization
The Nutritoion Optimization of Health Program requires a high-precision monitoring system to ensure its effectiveness in improving children's nutritional status. This study aims to analyze information technology readiness through the development and implementation of the Children's Nutritional Anthropometry (ANA) application. The methodology employs an action research approach involving IT training for 100 health volunteers, digital nutritional counseling, and physical examinations of 500 children. The primary focus of this article is to evaluate how digital infrastructure readiness and technology literacy at the village level influence the accuracy of nutritional monitoring data. The results indicate that the integration of the ANA application significantly accelerates nutritional status reporting and facilitates the distribution of targeted nutritional interventions. Furthermore, the enhancement of IT readiness among health volunteers reduces human error in data entry, ensuring that the health program is supported by a robust and reliable decision support system.
The Role of Digital Health Engagement in Improving Self-Care Behavior among Patients with Heart Failure
Heart failure is a chronic disease with high rates of morbidity and rehospitalization, requiring effective management strategies. Digital health engagement has emerged as an innovative approach to improving self-care behaviour through the utilization of digital technologies such as mHealth, telehealth, and telemonitoring. This study aimed to analyze the role of digital health engagement on self-care behaviour among patients with heart failure using a systematic literature review method based on the PRISMA guidelines. The literature search was conducted using the PubMed, ScienceDirect, Scopus, and Google Scholar databases with a publication range from 2022 to 2026. Article selection was performed using inclusion and exclusion criteria, and quality assessment was conducted using the Joanna Briggs Institute (JBI) appraisal tool. A total of eight articles with Randomized Controlled Trial (RCT) designs were analyzed in this study. The synthesis results showed that digital interventions, including mobile applications, telemonitoring, wearable devices, virtual health coaching, and telerehabilitation, were effective in improving self-care behaviour, adherence to health monitoring, symptom management, physical activity, and patients’ quality of life. Interventions based on personalized feedback and real-time monitoring demonstrated more optimal outcomes. In addition, digital health also improved self-efficacy and reduced caregiver stress. However, its effectiveness on long-term clinical outcomes still demonstrated variable results. Digital health engagement has the potential to support patient-centered care management for heart failure.
Culturally Adaptive Digital Maternal Monitoring In Asean: A Collaborative Qualitative Exploration
Maternal mortality remains a major public health challenge in ASEAN countries, particularly in developing countries where disparities in maternal healthcare quality and access still exist. Digital maternal monitoring, including the implementation of digital partographs, has emerged as an important strategy to improve maternal safety, clinical documentation, and decision-making during labor. However, the implementation of digital health systems in maternal care still faces several challenges, including low digital literacy, limited infrastructure, and lack of cultural adaptation. This study aimed to explore perceptions, readiness, acceptability, and cultural factors related to the implementation of digital partographs among healthcare students and maternal healthcare stakeholders in Indonesia and Malaysia. This study used a collaborative qualitative exploratory design involving Universitas Galuh Indonesia and MAHSA University Malaysia. Data were collected through in-depth interviews, Focus Group Discussions (FGD), and preliminary questionnaires involving Diploma in Nursing students from MAHSA University. The findings showed that most participants had positive perceptions toward digital partographs and demonstrated strong readiness for digital health implementation. Participants believed that digital partographs could improve documentation efficiency, support clinical decision-making, and enhance maternal monitoring. However, cultural factors, family involvement, communication approaches, and local values remained important determinants influencing technology acceptance. The study highlights the importance of integrating cultural adaptation into digital maternal monitoring systems. The development of a culturally adaptive enhancement model for digital partographs has the potential to improve usability, acceptability, and sustainability of maternal healthcare technology in ASEAN countries.
Psychosocial Determinants of Antenatal Class Participation: An Integrative Analysis of Health Literacy, Self-Efficacy, And Spousal Support
Background: Maternal mortality remains a major public health challenge, particularly in developing countries. Antenatal classes are effective promotive and preventive interventions to improve maternal preparedness, early detection of pregnancy complications, and utilization of maternal healthcare services. However, participation in antenatal education programs remains suboptimal. Psychosocial factors, including health literacy, self-efficacy, and spousal support, may influence maternal participation in antenatal classes. Objective: This study aimed to analyze the psychosocial determinants of antenatal class participation among pregnant women at Puskesmas Kasihan II. Methods: A quantitative analytic study with a cross-sectional design was conducted among 35 pregnant women. Participants were recruited using total sampling. Data were collected using validated structured questionnaires assessing health literacy, self-efficacy, and spousal support. Antenatal class participation was evaluated using attendance records. Data were analyzed using Chi-square and multivariate logistic regression tests with a significance level of p<0.05.Results: Significant associations were found between health literacy (p=0.021), self-efficacy (p=0.013), spousal support (p=0.004), and antenatal class participation. Women with higher health literacy, stronger self-efficacy, and better spousal support were more likely to actively participate in antenatal classes. Spousal support was identified as the strongest predictor (OR=4.21; 95% CI=1.32–13.44; p=0.002). Conclusion: Psychosocial determinants significantly influence antenatal class participation. Family-centered maternal interventions are essential to improve maternal health outcomes.
The Role of Maternal Knowledge About Animal Protein in The Incidence of Stunting Among Toddlers
Stunting remains a major health problem among children under five in Indonesia because it affects physical growth, cognitive development, immunity, and future productivity. Limited maternal knowledge regarding nutrition, especially animal protein intake as a source of essential amino acids, is considered one of the contributing factors to stunting. This study aimed to analyze the relationship between maternal knowledge of animal protein and the incidence of stunting among toddlers in Sadananya Village, Sadananya Sub-district, Ciamis Regency, in 2025. A quantitative correlational design with a cross-sectional approach was used. The population consisted of 182 mothers of children under five, and 65 mothers with children aged 24–59 months were selected using purposive sampling. Data were collected using a valid and reliable closed-ended questionnaire and analyzed using the Spearman Rank test. The results showed a significant relationship between maternal knowledge of animal protein and the incidence of stunting (p < 0.05). Mothers with better knowledge tended to have children with normal nutritional status. These findings highlight the importance of strengthening maternal nutrition education, particularly regarding animal protein consumption, as an effort to prevent stunting effectively and sustainably.
The Effect of Slow Stroke Back Massage (SSBM) Therapy on Blood Pressure in Hypertensive Patients
Background: Hypertension is a global health problem that is the leading cause of death. WHO data for 2023 shows that around 1.28 billion adults aged 30–79 years in the world suffer from hypertension, with only 42% diagnosed and treated. In Indonesia, the prevalence of hypertension reaches 23.7% (WHO, 2022) and in West Java it is 32.6% (SKI, 2023). Uncontrolled hypertension can lead to serious complications such as stroke and kidney failure. The management of hypertension can be done pharmacologically and non-pharmacologically. One of the effective non-pharmacological therapies is Slow Stroke Back Massage (SSBM), which is a gentle massage technique in the back area to provide a relaxing effect and lower blood pressure. Objective: Aim to identify scientific journals that explain the effect of SSBM therapy on blood pressure in hypertensive patients. Method: This study is a literature review study that was searched through the ResearchGate, ScienceDirect, and Google Scholar databases with a publication deadline of 2015– 2025. Of the 1,134 journals selected using the inclusion criteria of PICOS and PRISMA, 10 journals were analyzed. Results: review showed that SSBM therapy significantly lowered systolic and diastolic blood pressure in hypertensive patients, especially if it was done routinely for several days or weeks. Conclusion: SSBM is an effective, safe, and efficient non-pharmacological therapy in helping to lower blood pressure in hypertensive patients and provide a relaxation effect that supports patient welfare.
The Use of Gadgets and Child Development Aged 2–5 Years in Dusun Watulangkah Ambarketawang, Gamping
Children’s use of gadgets has become a major concern in recent years, and can have complex effects on their development. In Sleman Regency in 2022, the prevalence of toddlers undergoing growth and development monitoring stood at 51.67%. Therefore, efforts are needed to monitor growth and development in order to detect at an early stage any instances of inappropriate development. To investigate the relationship between gadget use and the development of children aged 2–5 years in Watulangkah hamlet, Ambarketawang, Gamping. This study is a non-experimental quantitative study using a cross-sectional approach. The sampling technique used was non-probability sampling, with a sample size of 42 respondents. The research instruments used were a demographic questionnaire, a gadget usage questionnaire, and the KPSP. The bivariate analysis in this study was the Spearman rank test. Results: The results of the statistical test indicate a relationship between gadget use and the development of children aged 2–5 years, with a p-value of 0.001, a correlation coefficient of 0.626, and an odds ratio of 6.21. Conclusion: There is an association between gadget use and the development of children aged 2–5 years in Watulangkah Hamlet, Ambarketawang, Gamping, Sleman.
Characteristics of Breastfeeding Mothers Regarding The Consumption Behavior of Local Foods Kepok Banana Blossom Nuggets
The consumption of local foods such as kepok banana blossom nuggets has the potential to improve the nutrition of breastfeeding mothers in rural areas. However, the consumption habits of breastfeeding mothers have not yet been studied. This study analyzes the consumption patterns of breastfeeding mothers in the village of Sukamulya, Ciamis County. The aim of the study is to investigate the characteristics of breastfeeding mothers' consumption patterns with regard to kepok banana blossom nuggets. It is expected that the results of this study will provide practical and sustainable solutions for increasing breast milk production while supporting the conservation of local resources through the use of kepok banana blossoms. The study was conducted as a one-off, non-repeated survey. The population comprised all breastfeeding mothers in the village of Sukamulya, Baregbeg District, Ciamis Prefecture, a total of 39 respondents. The results of this study indicate that the characteristics of breastfeeding mothers in Sukamulya favor the adoption of local foods. Expanding these measures has the potential to reduce dependence on imports by 30% and the growth lag by 28% to 20%.
Anemia among adolescent girls remains an important public health problem because it may affect fitness, learning concentration, productivity, and reproductive health readiness during the preconception period. This study aimed to describe anemia risk indicators and learning focus among adolescent girls and to analyze menstrual factors, dietary patterns, iron supplementation tablet consumption, tea/coffee intake, vitamin C-rich fruit consumption, and screen time as school-based prevention indicators. An observational analytic study with a cross-sectional approach was conducted among 140 female senior high school students. Data were collected using a structured questionnaire and analyzed descriptively and bivariately. The mean age was 15.55 years and the mean age at menarche was 11.72 years. Previous anemia was reported by 35.7% of respondents. Most respondents had menstrual cycles <28 days (67.9%), menstrual duration of 5-10 days (69.3%), and moderate-to-severe menstrual complaints (51.4%). Weekly iron supplementation tablet consumption was reported by 70.0%, but 30.7% still often forgot to take the tablets. The mean learning focus score was 24.41 out of 40, and 51.4% had good learning focus. Menstrual duration, menstrual complaints, and breakfast frequency were significantly associated with learning focus. School-based anemia prevention should integrate nutrition education, iron supplementation monitoring, breakfast habituation, menstrual health support, and balanced screen time education.
Analysis of Vasomotor Symptoms in Perimenopausal Women Based on the Menopause Rating Scale (MRS)
Background: Perimenopause is a transitional phase experienced by women before menopause and is often accompanied by vasomotor symptoms such as hot flushes, excessive sweating, and sleep disturbances. Vasomotor symptoms may affect women’s quality of life physically and psychologically. Menopause Rating Scale (MRS) is an internationally standardized instrument frequently used to assess menopause symptoms. Aim: This study aimed to describe vasomotor symptoms among perimenopausal women using Menopause Rating Scale (MRS). Methods: This study used a descriptive quantitative design with a cross-sectional approach. The participants were women aged 40–55 years experiencing perimenopausal symptoms. Data were collected using the Menopause Rating Scale (MRS) questionnaire. Sampling was conducted using consecutive sampling. Data analysis was performed descriptively to identify the distribution and severity of vasomotor symptoms. Results: Most respondents experienced moderate vasomotor symptoms characterized by hot flushes, night sweats, and sleep disturbances. Several respondents also reported psychological complaints accompanying vasomotor symptoms. The MRS instrument was able to identify the severity level of symptoms experienced by respondents effectively. Conclusion: Vasomotor symptoms are commonly experienced by perimenopausal women and may affect their quality of life. The use of MRS is useful for early identification and monitoring of menopause symptoms among women in primary health care settings.
The Effect of Glycine Max (L.) Merrill Consumption On Breast Milk Production In Breastfeeding Mothers At Puskesmas Cangkuang, Bandung Regency, 2025
Exclusive breastfeeding is breastfeeding to babies without accompanying foods and drinks (including orange water, honey, sugar water), starting from newborn to 6 months of age. the achievement of Exclusive Breastfeeding in Bandung Regency in 2024 is 77.7% and in the Cangkuang Health Center Working Area in 2024 is 58%. This study aims to analyze "The Effect of Glycin max (L) Merril Administration on Breast Milk Production in Breastfeeding Mothers in the Working Area of the Cangkuang Health Center, Bandung Regency in 2025". This type of research is Experiment with one group pretest posttest design.. The number of research samples was 30 respondents who were selected using the total sampling technique. Data were collected using primary data from observations and secondary data from the book Kesehatan Ibu Anak. Data analysis was carried out using the paired t-dependent test with a significance level of p<0.05. The results of the study showed that there was an Effect of Glycin Max (L) Merril Administration on Breast Milk Production in Breastfeeding Mothers in the Working Area of the Cangkuang Health Center, Bandung Regency in 2025 with the results of a statistical test of p-value = 0.001. Breastfeeding mothers can improve their knowledge and practice of breastfeeding by utilizing nutritious food sources, one of which is Merrill Glycin max (L) to help facilitate breast milk production and Health Institutions continue to provide more optimal support for breastfeeding programs with education on the use of local food.
The Effect Of Cerdik Education Using Video Media On Adolescents Knowledge Of Obesity Prevention
Obesity among adolescents has become a significant public health problem due to unhealthy lifestyles, lack of physical activity, and poor dietary habits. Inadequate knowledge regarding obesity prevention may increase the risk of obesity and non-communicable diseases in adolescence. CERDIK is a healthy lifestyle program promoted by the Indonesian Ministry of Health consisting of regular health checks, avoiding cigarette smoke, engaging in physical activity, consuming balanced nutrition, getting adequate rest, and managing stress. This study aimed to determine the effect of CERDIK education using video media on adolescents’ knowledge regarding obesity prevention among grade XI students at SMA Negeri 3 Banjar. This study employed a quantitative pre-experimental design using a one-group pretest-posttest approach. The population consisted of 227 students, and 69 respondents were selected using purposive sampling. Data were collected using a validated questionnaire and analyzed using the Wilcoxon test with a significance level of α = 0.05. The results showed that the average knowledge score before intervention was 72.39 and increased to 83.30 after the intervention. Statistical analysis showed a p-value of 0.000 (p < 0.05), indicating a significant effect of CERDIK education using video media on adolescents’ knowledge regarding obesity prevention. Video-based CERDIK education can effectively improve adolescents’ understanding of healthy lifestyles and obesity prevention. Health workers and schools are encouraged to implement innovative educational media to support obesity prevention programs among adolescents.
Coping Mechanisms and Stress Among Informal Caregivers of Ischemic Stroke Patients
Ischemic stroke patients are at risk of recurrence, which may increase dependency and require the role of informal caregivers in patient care. “This condition can cause stress that may be influenced by the caregivers’ coping mechanisms. This study aimed to determine the relationship between coping mechanisms and stress levels among informal caregivers of ischemic stroke patients at RSKD Dadi Makassar. This quantitative study used a non-probability sampling technique with a consecutive sampling method involving 138 informal caregivers of recurrent ischemic stroke patients. Data were collected using the Brief COPE Scale and Perceived Stress Scale-10 (PSS-10), then analyzed using the Chi-square test because the data were not normally distributed. The results showed no significant relationship between coping mechanisms and stress levels among informal caregivers of ischemic stroke patients (p = 0.110). However, descriptively, caregivers with adaptive coping mechanisms tended to experience lower stress levels compared to those with maladaptive coping mechanisms. This study indicates that caregiver stress levels may also be influenced by other factors such as patient characteristics, the number of caregivers involved in patient care, and social support.
Scoping Review of the Canadian Triage and Acuity Scale (CTAS) Implementation, Reliability, Challenges, and Impact in Saudi Arabian Emergency Departments
Background: Emergency department overcrowding and increasing patient demand highlight the need for reliable triage systems to prioritize patients according to clinical urgency. The Canadian Triage and Acuity Scale (CTAS) has been implemented in Saudi Arabian emergency departments, but evidence regarding its reliability, implementation, challenges, and operational impact remains fragmented. Methods: A scoping review was conducted following the Arksey and O’Malley framework, subsequent recommendations by Levac et al., Joanna Briggs Institute guidance, and PRISMA-ScR reporting standards. Literature was searched in PubMed, MEDLINE, CINAHL, Scopus, Web of Science, Google Scholar, Saudi Medical Journal, Eastern Mediterranean Health Journal, and Saudi Ministry of Health publications for studies published from January 2015 to March 2026. Eligible studies examined CTAS implementation in Saudi Arabian emergency departments or urgent care settings. Data were synthesized using descriptive numerical and thematic analyses. Results: Thirteen studies were included from 1,134 identified records. CTAS demonstrated good to excellent inter-rater reliability, with Cohen’s kappa coefficients ranging from 0.77 to 0.87. Implementation was associated with reductions in emergency department waiting times of approximately 40–50% in some institutions. However, 42–75% of visits were classified as non-urgent (CTAS Levels IV–V), contributing to persistent overcrowding. Digital CTAS improved documentation and workflow, while training and competency-based education improved nurses’ triage accuracy. Key challenges included workforce shortages, inadequate training, technological limitations, inconsistent implementation, and limited public awareness. Conclusion: CTAS is a reliable and effective triage system in Saudi Arabian emergency departments. National standardization, continuous professional education, digital infrastructure, stronger primary healthcare integration, and public education are recommended to improve emergency care efficiency in alignment with Saudi Vision 2030.
Family Experience in Caring for Sick Family Members Using Sundanese Local Wisdom
Traditional medicine remains embedded in family health practices and cultural traditions. Among Sundanese families, traditional healing may influence how illness is interpreted, managed, and communicated before or alongside professional health care. However, limited qualitative evidence has explored how Sundanese families experience traditional treatment as part of everyday caregiving. This study aimed to explore the lived experiences of Sundanese family members in caring for sick family members through traditional treatment and local wisdom, with particular attention to the meanings, beliefs, practices, and decision-making processes underlying traditional healing. A qualitative phenomenological design was employed. Six Sundanese family members with experience caring for sick relatives using traditional treatment participated in the study through purposive sampling. Data were collected through in-depth interviews and analyzed using Colaizzi’s descriptive phenomenological approach. The analysis focused on participants’ experiences, perceptions, cultural beliefs, and practices related to traditional healing. Six interconnected themes emerged: traditional treatment as first aid; affordability and accessibility; integration of natural ingredients and beliefs; communicating with plants; obedience to cultural customs; and use of mystical power. The findings indicate that traditional treatment was perceived not merely as an alternative therapeutic practice but as a culturally embedded component of family caregiving. Its use was influenced by practical considerations, family knowledge, intergenerational transmission, spirituality, and relationships with the natural environment. Traditional healing remains influential in Sundanese family caregiving and reflects the interaction between cultural values, family knowledge, spirituality, and health-seeking behavior. The findings highlight the importance of culturally responsive family nursing that recognizes traditional practices while maintaining patient safety and evidence-based care. Nurses should assess traditional health practices as part of cultural and family assessment, communicate respectfully about cultural beliefs, and provide evidence-based guidance concerning the safety and appropriate use of traditional remedies. Culturally sensitive approaches may strengthen therapeutic relationships and support family-centered care.
Effect of Mirror Therapy on Upper Extremity Motor Function in Stroke Patients
Stroke is one of the leading causes of disability and often results in impaired upper extremity motor function, which affects daily activities and quality of life. This study aimed to determine the effectiveness of mirror therapy in improving upper extremity motor function in stroke patients. This study used a quantitative method with a quasi-experimental non-equivalent control group pretest-posttest design. A total of 50 respondents were selected using consecutive sampling and divided into intervention and control groups, each consisting of 25 respondents. The intervention group received mirror therapy, while the control group received routine hospital therapy. Motor function was measured using the Fugl-Meyer Assessment for Upper Extremity (FMA-UE). The results showed improvement in both groups. The intervention group’s mean score increased from 52.32 to 55.88, while the control group’s score increased from 48.40 to 49.32. Statistical analysis showed significant improvements before and after intervention in both groups; however, no significant difference was found between groups after intervention (p=0.110). Mirror therapy may contribute to improvements in upper extremity motor function when used alongside routine rehabilitation. However, its superiority over routine rehabilitation alone was not demonstrated in this study.