The success of information technology-based services is largely determined by the acceptance and willingness of the community to use them. One such digital service provided by the government through BPJS Kesehatan is the Mobile JKN application. designed to facilitate access to health services for JKN participants online. Community participation. especially in DKI Jakarta with its urban characteristics. plays a key role in the effectiveness of this service. This study aims to measure the level of acceptance of the Mobile JKN application in DKI Jakarta using the Unified Theory of Acceptance and Use of Technology 3 (UTAUT 3) model. The research uses purposive and proportional stratified sampling methods. involving 250 respondents who are users of the Mobile JKN application. Data were collected through online questionnaires and analyzed using the Structural Equation Modeling-Partial Least Square (SEM-PLS) method. Results show that performance expectancy (p = 0.014). social influence (p = 0.020). facilitating conditions (p = 0.010). habit (p = 0.025). and price value (p = 0.000) significantly influence behavioral intention. Moreover. facilitating conditions (p = 0.044). habit (p = 0.000). personal innovativeness (p = 0.003). and behavioral intention (p = 0.001) significantly influence use behavior. Meanwhile. effort expectancy (p = 0.262). hedonic motivation (p = 0.632). and personal innovativeness (p = 0.080) do not significantly affect behavioral intention. The study recommends enhancing features. fostering innovation. and increasing outreach to improve application acceptance.
to experience increased stress related to the childbirth process, which may lead to fear of childbirth (FOC). High levels of FOC negatively affect the childbirth process and overall birth experience. Fear of childbirth is known to be negatively correlated with childbirth self-efficacy, where better selfefficacy is associated with higher childbirth satisfaction. Expressive writing is a simple psychological intervention focused on emotional processing through writing and has been proven effective in reducing stress and anxiety among pregnant women. However, research examining the effects of expressive writing on FOC and childbirth self-efficacy among third-trimester pregnant women in Indonesia remains limited. Objectives: To examine the effect of expressive writing on fear of childbirth and childbirth self-efficacy among third-trimester pregnant women. Methods: This study employed a preexperimental design using a one-group pretest–posttest approach. A total of 26 third-trimester pregnant women were selected using accidental sampling. The expressive writing intervention was conducted for four consecutive days. FOC was measured using the W-DEQ version A, while childbirth self-efficacy was assessed using the CBSEI C-32. Data were analyzed using the paired ttest. Results: The results showed a significant reduction in fear of childbirth after the expressive writing intervention (p = 0.043). However, the increase in childbirth self-efficacy scores after the intervention was not statistically significant (p = 0.063). Conclusion: Expressive writing was effective in reducing fear of childbirth but did not demonstrate a significant effect on improving childbirth self-efficacy among third-trimester pregnant women.
Hemodialysis is a renal replacement therapy highly dependent on the availability of medical-grade water, stable electricity, and supporting technological systems. This dependency makes hemodialysis services vulnerable to disruption during disasters, particularly in earthquake- and flood-prone areas. Treatment interruption may increase the risk of serious complications and threaten patient safety. In this context, families play an essential role in maintaining therapy continuity; however, their perspectives in disaster mitigation remain underexplored. This study aimed to explore family expectations regarding the resilience of hemodialysis services in disaster situations. A qualitative exploratory approach with thematic analysis was employed. Primary informants consisted of two family members of hemodialysis patients, supported by source triangulation through interviews with one manager, one nurse, and two patients. Data were collected through in-depth interviews and analyzed using thematic analysis. The findings identified four main themes: (1) expectations for clear and structured hospital preparedness systems, (2) the need for technical education and risk communication, (3) clarity of emergency referral systems and alternative service networks, and (4) comprehensive protection of patient safety. The results indicate that families expect a structured mitigation system that is well-communicated and actively involves them in pre-disaster simulations and education. This study highlights that the resilience of hemodialysis services in disaster situations depends not only on infrastructure and hospital management but also on empowering families as integral components of the healthcare resilience system. Integrating families into preparedness planning may strengthen therapy continuity and enhance patients’ sense of security during crises.
Hospitals provide services. Good quality of hospital services will produce a final product that makes patients dependent on the hospital's services. In this study, researchers will analyze the service quality of Dokter Rubini Regional General Hospital, Mempawah Regency, using the Importance Performance Analysis and Potential Gain in Customer Values methods. This study uses the Importance Performance Analysis (IPA) method. The population in this study were inpatients treated during November 2022. Data were collected using a validated questionnaire. Importance Performance Analysis and Potential Gain in Customer Values tests were conducted to calculate the level of conformity between the level of importance and the level of patient satisfaction. The results of the study show that the results of the IPA Method analysis obtained items in quadrant A: adequate hospital facilities. Meanwhile, from the PGCV index, the work and time allocated for inpatient nurses has the highest index of 6.69, while the lowest PGCV value is in item 21, namely hospital staff continue to monitor the development of the disease. The priority that must be improved is related to the work and time allocated for inpatient nurses, because it is related to their effectiveness in meeting patient needs. The attribute that must be maintained in service is the monitoring of hospital staff on the development of the disease.
Abstract The rapid expansion of social media has transformed how university students construct identity and evaluate self-worth, with Instagram emerging as a prominent platform for social validation. This study aimed to examine the relationship between Instagram follower count and self-confidence among university students, positioning follower count as a psychosocial indicator of digital social approval. Using a quantitative cross-sectional design, data were collected through an online survey administered to 76 undergraduate students who actively used Instagram. Self-confidence was measured using a Likert-scale questionnaire adapted from social self-efficacy theory, while follower count was assessed through self-reported data. Instrument validity and reliability were confirmed prior to analysis.Normality testing indicated non-normality, leading to the use of Spearman’s rank-order correlation to examine the association between variables. The results revealed a strong, statistically significant positive relationship between Instagram follower count and self-confidence, indicating that students with higher follower counts reported greater confidence in social interactions. These findings suggest that follower count serves as a meaningful form of social validation, influencing students’ self-perceptions in both digital and offline contexts.The study highlights the psychological implications of digital popularity metrics and underscores the need for higher education institutions to promote digital literacy and mental health awareness. By fostering critical engagement with social media, universities can help students develop healthier relationships with online validation and support more resilient forms of self-confidence.
Adolescence is a transitional period characterized by rapid physical and psychological development, making it highly vulnerable to reproductive health issues. This study aims to analyze adolescents' perceptions regarding the need for information, radiological examinations, and reproductive health services based on Government Regulation No. 28 of 2024 in Genuksari Village, Genuk District, Semarang City. The research method used was descriptive qualitative, with data collected through in-depth interviews with adolescents aged 15–19 years and the use of supporting questionnaires. The study results show that the majority of adolescents (65%) require additional reproductive health information, particularly through social media platforms like YouTube and Instagram. Perception of radiology examinations remains low, as they are considered solely for detecting diseases in adults. Regarding services, adolescents prefer a combination of online and offline services for convenience and privacy. The study concludes that policy implementation needs to be strengthened through proactive information technology-based education strategies to improve the accessibility and confidentiality of adolescent reproductive health services. Adolescence is a transitional period characterized by rapid physical and psychological development, making it highly vulnerable to reproductive health issues. This study aims to analyze adolescents' perceptions regarding the need for information, radiological examinations, and reproductive health services based on Government Regulation No. 28 of 2024 in Genuksari Village, Genuk District, Semarang City. The research method used was descriptive qualitative, with data collected through in-depth interviews with adolescents aged 15–19 years and the use of supporting questionnaires. The study results show that the majority of adolescents (65%) require additional reproductive health information, particularly through social media platforms like YouTube and Instagram. Perception of radiology examinations remains low, as they are considered solely for detecting diseases in adults. Regarding services, adolescents prefer a combination of online and offline services for convenience and privacy. The study concludes that policy implementation needs to be strengthened through proactive information technology-based education strategies to improve the accessibility and confidentiality of adolescent reproductive health services.
Pemeriksaan radiografi shoulder joint dengan posisi pasien Antero Posterior supine nyatanya tidak memperlihatkan kondisi True Antero Posterior untuk shoulder joint, karena tidak dapat memvisualisasi optimal terhadap struktur glenohumeral. Penggunaan proyeksi Grashey view dengan memposisikan pasien oblik sebesar 30-45 derajad menawarkan visualisasi artikulasi sendi bahu secara lebih jelas karena dapat memperlihatkan anatomi glenoid cavity dan caput humerus tanpa tumpang tindih. Tantangan muncul saat memeriksa pasien yang tidak kooperatif dalam menghasilkan citra shoulder joint yang optimal. Dengan memodifikasi arah sinar / central ray dengan posisi pasien supine true AP dapat menjadi opsi ketika pasien tidak kooperatif. Tujuan dari penelitian ini adalah memberikan alternatif bagi pasien tidak kooperatif: Menciptakan opsi prosedur pemeriksaan bagi pasien trauma (seperti dislokasi atau fraktur) yang mengalami nyeri hebat sehingga tidak mampu memutar tubuhnya sebesar 30-45 derajat sesuai standar proyeksi Grashey. Jenis penelitian ini merupakan penelitian deskriptif kualitatif, dengan pendekatan studi kasus. Instrument penelitian ini adalah observasi dan wawancara kepada radiografer dan dokter spesialis radiologi. Posisi pasien supine diatas meja pemeriksaan atau di atas bed pasien,dengan arah sinar 30° kearah lateral. Central point berada dipertengahan shoulder joint dan FFD 100cm. Hasil citra grashey yang normal dengan proyeksi Grashey modifikasi arah sinar tidak terdapat perbedaan yang berarti. Proyeksi grashey dapat menampakkan acromioclavicular joint space dan glenohumeral joint space dengan lebih baik karena tidak adanya superposisi, serta dengan proyeksi penyudutan ini dapat memperlihatkan adanya dislokasi maupun luksasi yang mungkin terjadi.
Early detection of Alzheimer's disease using brain MRI image data can substantially improve clinical intervention and patient management. Our study evaluates the performance of an Alzheimer's classification system based on Fuzzy Inference Systems (FIS), specifically for the Mamdani and Sugeno models, in identifying four patient categories: (1) Non-Dementia, (2) Very Mild Dementia, (3) Mild Dementia, and (4) Moderate Dementia. In addition, this study compares the classification performance and computational efficiency of several deep learning architectures, including a traditional CNN (VGG16), a modern model (EfficientNet-B0), and a hybrid Fuzzy Convolutional Inference Engine (FCIE) that integrates CNN-based feature extraction with fuzzy logic reasoning. The dataset used consists of normalized and augmented Alzheimer's MRI images, and each model was trained and validated using a 70%:15%:15% split for training, validation, and testing. Experimental results show that the Mamdani and Sugeno FIS models achieve validation accuracies of about 32% and 35%, respectively, which highlights the limitations of pure texture-based features in capturing complex classification patterns. In contrast, VGG16 and EfficientNet-B0 produced validation accuracies of 82.81% and 85.22%, respectively, with AUC values of 0.95 and 0.96, respectively. However, when both schemes were combined into a hybrid model FCIE achieved the highest validation accuracy of 98.03% and AUC of 0.99. Comparative analysis of metrics, including precision, recall, F1-score, AUC, and training duration, shows a clear trade-off between accuracy and computational efficiency. This study recommends the FCIE model for clinical applications requiring high diagnostic accuracy, while EfficientNet-B0 is suggested for medical environments with moderate GPU resource constraints.
Labor pain remains a distressing experience that can negatively affect both mothers and babies. According to the Indonesian Ministry of Health (2019), around 15% of mothers in Indonesia experience labor complications accompanied by pain, while 22% report severe pain during childbirth. Excessive labor pain may lead to frustration, anxiety, and emotional distress. One non-pharmacological method considered safe, simple, and comfortable for pain management is the use of a birthing ball. This study aimed to determine the effectiveness of the birthing ball method in reducing labor pain intensity. The study used a quantitative approach with a quasi-experimental one-group pretest–posttest design without a control group. A total of 45 maternity mothers who met the inclusion criteria at the Kemayoran Health Center participated in the study and received a 30-minute birthing ball intervention. Labor pain intensity was measured using the Numerical Rating Scale (NRS). The statistical analysis showed a significant reduction in labor pain intensity after the intervention, with a p-value of <0.001 and a Z-score of -5.798b. These findings indicate that the birthing ball method is effective in reducing labor pain intensity. Therefore, healthcare workers are encouraged to optimize the use of birthing balls as a non-pharmacological pain management method during labor. Proper technique, along with responsive and empathetic support during childbirth, is important to maximize the benefits of this intervention.
Background: Short-term memory disorders can have an impact on a child's future. Purpose: This study aims to determine the effect of a combination of Dual Task Training and Aerobic Exercise on improving short-term memory in 12-year-old children. Method: This research used a quasi-experimental research design with a pre-test and post-test two group design. Carried out for 4 weeks with a frequency of 3 times a week. The research subjects consisted of 28 people, 14 people in the Intervention I group, a combination of Dual Task Training and Aerobic Exercise, and 14 people in the Intervention II Aerobic Exercise group. And measurements were carried out using the Digit Span Test and Harvard Test. Results: Test showed a p < 0.001 in the Combination Intervention of Dual Task Training and Aerobic Exercise, and a p < 0.001 in the Intervention II Aerobic Exercise group. The test of difference of 2 mean is p = 0.01, which means there is a significant difference between the two interventions with the average difference between intervention group I being 2.79 and intervention II being 1.71. Conclusion: This research can be concluded that the combination of Dual Task Training and Aerobic Exercise intervention is more influential in improving the short-term memory of children aged 12 years.
Sexual violence is the most common form of child abuse in Indonesia. Sexual violence against children has a negative impact that can damage the development process and future of children, so it is necessary to provide health education about sexual violence in the right way. One way that can be used is by utilizing digital media through e-comics. The purpose of this study was to determine the effect of health education using e-comics media on children's knowledge about efforts to prevent sexual violence. This study is a quantitative research model using a pre experimental research design with a one group pretest-posttest design. This study used primary data with a sample of 42 students in grade 6 of Sekolah Dasar Negeri (SDN)/Public Elementary School Joglo 08 Pagi with a sampling technique using simple random sampling. And data analysis using a parametric test (paired t-test). The results of this study stated that there was a significant difference in the level of children's knowledge before is mean value 46.88, and std deviation 9.541. after is mean value 84.43, std deviation 9.034 and after being given intervention through e-comic media about efforts to prevent sexual violence against children with a p value of 0.001 <0.05.
Pharmacist counseling is intervention that can increase patient satisfaction and compliance with treatment. This study aims to analyze the effect of pharmacist counseling on the level of patient satisfaction and adherence to taking medication in patients with type 2 diabetes mellitus complicated by hypertension. This research uses a one group pretest-posttest design. The research subjects were 95 patients who met the inclusion criteria and were taken using the MMAS-8 method and the satisfaction method. Satisfaction and compliance measurements were carried out before and after pharmacist counseling. Data analysis was carried out descriptively, Wilcoxon signed-rank test with a significance level of 5%. The results of the analysis showed that the average patient satisfaction score increased from 0.40 before counseling to 0.76 after counseling, with a difference of 0.36. The Wilcoxon test showed p = 0.00 (p < 0.05), which indicates there is a significant difference in the level of patient satisfaction. In the medication adherence variable, the average score increased from 27.94 to 51.27 with a difference of 23.34. The Wilcoxon test results obtained p = 0.00 (p < 0.005), which shows that there is a significant difference in the level of adherence to taking medication before and after counseling. Analysis based on the compliance category after counseling experienced an increase marked by the dominance of the high compliance category with an average of 51.27. Analysis based on satisfaction categories after counseling experienced an increase marked by the dominance of the high satisfaction category with an average of 6.07.
To enhance public awareness in adopting a healthier lifestyle, it is essential to provide support and information through nutritional counseling. This approach allows for the development and application of knowledge in daily life. The objective of this study is to evaluate the effectiveness of nutrition counseling using booklets and videos on knowledge, nutrient intake, purine intake, and uric acid levels in gout patients. The research method employed is an experimental design with a pre-experimental two-group pre-test post test design. The study sample consists of gout patients residing in the Social Health Center (Puskesmas Sosial) Palembang area, with purposive sampling used to select a total of 40 gout patients divided into 2 groups. Each group, whether receiving booklets or videos, was given 2 counseling sessions per week for 4 weeks. An analysis was conducted to compare changes in knowledge, nutrient intake, purine intake, and uric acid levels before and after the intervention. For data with normal distribution, a paired samples t test was applied, whereas non-normally distributed data were assessed using the Wilcoxon signed-rank test. The findings demonstrated that nutrition counseling delivered through booklet and video media significantly improved participants’ knowledge, purine intake, and uric acid levels (p < 0.05). In contrast, no statistically significant change was observed in overall nutrient intake (p > 0.05).
Fetal movement is a critical indicator of fetal well-being, yet practical devices integrated with digital interventions for direct, objective monitoring remain limited. This study aimed to develop and evaluate the functionality and safety compliance of the Smart Mom–Integrated Prototype for real-time fetal movement monitoring. Employing a Research and Development (R&D) approach, the prototype was developed using an accelerometer sensor, an ATmega328P microcontroller, an OLED display, and Bluetooth connectivity integrated with an Android application. The device underwent a rigorous four-stage evaluation: (1) simulated testing for initial movement detection accuracy; (2) laboratory functional testing for overall system performance; (3) safety testing based on the SNI IEC 60601-1 standard; and (4) limited clinical/user testing involving five third-trimester pregnant women (32–38 weeks gestation) monitored for 15–30 minutes.In simulated testing, the device achieved an initial fetal movement detection accuracy rate of 85%. Laboratory functional testing demonstrated a 93% system operation success rate with clear data visualization and stable Bluetooth transmission. Safety testing indicated that the device's surface temperature reached 35.2°C after eight hours of continuous use, with 0.0 mA leakage current and no reported skin irritation. In limited clinical testing, the device successfully recorded a mean of 20.6 movements per 30 minutes. Concurrently, maternal stress scores (PSS-10) decreased significantly post-intervention ($22.40 \pm 3.13$ to $15.80 \pm 2.28$; $p = 0.005$). Data sensitivity in the field was moderately influenced by maternal Body Mass Index (BMI) and biological motion artifacts. The Smart Mom–Integrated Prototype demonstrates functional feasibility and safety compliance for home-based screening. Future development should focus on refining signal processing algorithms to mitigate maternal biological artifacts alongside validation trials against clinical gold standards.
Ischemic stroke causes partial or complete blockage of blood flow to the brain. Signs of ischemic stroke can be observed on CT scans of the head, namely Hyperdense Artery Sign (HAS) and parenchymal hypoattenuation. A CT scan can make the diagnosis by providing the desired anatomical information. The slice thickness of the CT scan examination of the head is 2-5 mm from the base of the cranium to the pars petroleum and 5-10 from the pars petroleum to the vertex, while in RSI Siti Rahmah Padang CT scan of the head in the case of ischemic stroke uses a slice thickness of 5 mm. Slice thickness is one of the significant parameters in providing anatomical information and good image quality. This research was conducted at RSI. Siti Rahamah from February to April 2023. Slice thickness variations start from 2 mm, 3 mm, 4 mm, and 5 mm. Descriptive qualitative research type. The research informants consisted of 5 radiology specialists. Data collection methods consisted of literature study, observation, interviews, and documentation. Data is processed using comparative, namely comparing the results of observations with existing theories in reference books through data reduction, data presentation, and conclusions. The results showed that the periventricular anatomy was visible at each slice thickness. The basal ganglia area is clearer at a 2 mm slice thickness, the sulci cerebrum is better at a 2 mm slice thickness, hippo lesion area is clear at a 2 mm slice thickness. The boundary between white matter and gray matter is clearer at 2 mm slice thickness, the pons and thalamus look the same at each slice thickness, and the head CT scan examination of ischemic stroke cases is better at 2 mm slice thickness.
Paparan sinar ultraviolet (UV) dapat menimbulkan berbagai kerusakan kulit, seperti penuaan dini, hiperpigmentasi, dan peningkatan risiko kanker kulit. Upaya pencegahan semakin berkembang melalui pemanfaatan bahan alam yang memiliki kemampuan menyerap sinar UV. Penelitian ini bertujuan untuk membandingkan nilai Sun Protection Factor (SPF) dari ekstrak etanol kunyit (Curcuma longa L.), jahe (Zingiber officinale Roscoe), dan sereh (Cymbopogon citratus DC.) sebagai kandidat bahan aktif tabir surya alami. Ekstraksi dilakukan secara maserasi menggunakan etanol, kemudian larutan diuji menggunakan spektrofotometer UV-Vis pada konsentrasi 100–300 ppm. Nilai SPF dihitung menggunakan persamaan Mansur dan dianalisis secara deskriptif serta uji Kruskal–Wallis untuk mengetahui perbedaan antar kelompok. Hasil menunjukkan bahwa nilai SPF meningkat seiring kenaikan konsentrasi, dengan ekstrak kunyit memiliki nilai tertinggi (7,649–22,554), diikuti sereh (3,934–11,833) dan jahe (2,369–6,512). Variasi nilai SPF dipengaruhi oleh perbedaan kandungan senyawa aktif, seperti kurkumin pada kunyit, citral pada sereh, dan gingerol pada jahe. Secara keseluruhan, ketiga ekstrak berpotensi menjadi agen tabir surya alami, dengan kunyit sebagai kandidat utama karena memberikan perlindungan UV paling efektif.
Nyeri punggung bawah non-spesifik (NSLBP) merupakan masalah muskuloskeletal yang umum terjadi dan menyebabkan nyeri serta keterbatasan fungsional. Terapi latihan secara luas direkomendasikan, namun bukti yang membandingkan Core Stabilization Exercises (CSE) dan McKenzie Exercises (ME) masih bervariasi. Meta-analisis ini bertujuan untuk membandingkan efektivitas CSE dan ME dalam mengurangi intensitas nyeri pada orang dewasa dengan NSLBP. Tinjauan sistematis dan meta-analisis dilakukan mengikuti pedoman PRISMA 2020. Pencarian dilakukan pada Scopus, ProQuest, dan Google Scholar dari tahun 2020 hingga Oktober 2025. Randomized controlled trials (RCT) yang melibatkan peserta berusia 18–65 tahun dengan NSLBP disertakan. Hasil nyeri dianalisis menggunakan Standardized Mean Difference (SMD) with a 95% confidence interval (CI) menggunakan random-effects model. Tujuh Studi RCT dengan 330 peserta memenuhi kriteria inklusi. Analisis gabungan menunjukkan bahwa CSE secara signifikan menurunkan intensitas nyeri dibandingkan ME (SMD = –0.65; 95% CI = –1.21 hingga –0.08; p = 0.02). Heterogenitas yang cukup besar diamati (I² = 83%), kemungkinan disebabkan oleh variasi durasi intervensi, intensitas, dan karakteristik peserta. CSE lebih efektif dibandingkan ME dalam mengurangi nyeri pada dewasa dengan NSLBP. Meskipun heterogenitas tinggi, temuan ini mendukung integrasi CSE dalam program rehabilitasi untuk manajemen nyeri optimal. Diperlukan RCT yang lebih terstandarisasi dan berkualitas tinggi untuk memastikan efek jangka panjang dan perbedaan subkelompok.
This study aims to examine the application of the physiotherapy code of ethics within the management of health services delivered by Physiotherapy students at Universitas Widya Husada Semarang (UWHS) during their clinical practice. A qualitative approach with an empirical juridical design was employed. Data were gathered through literature review, direct observation, interviews, and questionnaires. The study involved diploma-level physiotherapy students from UWHS undertaking clinical placements across various healthcare institutions. The findings indicate that students implemented health service management in accordance with the Indonesian Ministry of Health Regulation No. 65 of 2015 concerning Physiotherapy Service Standards. The adherence to the physiotherapy code of ethics was found to be a fundamental element in maintaining service quality, ensuring patient safety, and fostering student professionalism in clinical settings.
