Jurnal Ilmiah Keperawatan IMELDA

EFEKTIVITAS KOMPRES DINGIN (ICE BAG) MENURUNKAN INTENSITAS NYERI INSERSI AV-FISTULA PADA PASIEN GAGAL GINJAL KRONIK YANG MENJALANI HEMODIALISA

2026-09-21T08:47:58+00:00

Background: Patients with chronic kidney disease (CKD) who have an arteriovenous fistula (AVF) undergo about 300 cannulations a year, which causes repeated acute pain. Cold compresses (ice bags) have been reported to reduce cannulation pain; however, the protocols used vary and evidence on brief (3-minute) application repeated across consecutive hemodialysis sessions remains limited. Objective: To determine the effectiveness of cold compresses (ice bags) in reducing the intensity of AV-fistula insertion pain in CKD patients receiving haemodialysis. Methods: A quasi-experimental one-group pretest-posttest approach was used in this quantitative investigation. Twenty respondents were selected by purposive sampling with the following inclusion criteria: routine haemodialysis patients with AVF access, mild to moderate cannulation pain (NRS score 1–6), fully conscious, and willing to participate. Cold compresses were administered for three minutes before needle insertion in four consecutive haemodialysis sessions. The Numeric Rating Scale (NRS) was used to gauge pain. JASP 0.95.4 software was used for analysis, utilizing the Wilcoxon Signed-Rank test because the data were not normally distributed (Shapiro-Wilk p<0.001). Results: The average pain score dropped by 2.40 points, from 4.65 (SD=0.875; moderate) to 2.25 (SD=0.444; mild); Z=3.920; p<0.001. Conclusion: Cold compresses (ice bags) effectively reduce the intensity of AV-fistula insertion pain and may be considered for inclusion in the Standard Operating Procedure (SOP) for non-pharmacological pain management in haemodialysis units.

PENGARUH TERAPI MUSIK TERHADAP TINGKAT KECEMASAN PASIEN GAGAL GINJAL KRONIK YANG MENJALANI HEMODIALISA

2026-04-10T03:41:23+00:00

Chronic Kidney Disease (CKD) is a progressive loss of kidney function that often necessitates renal replacement therapy, such as dialysis or transplantation. Globally, in 2012, CKD accounted for 2,968,600 (1%) disability-adjusted life-years and 2,546,700 (1–3%) years of life lost. In the United States, CKD affected approximately 26 million people in 2016. Hemodialysis is a form of renal replacement therapy used to sustain the lives of patients with kidney failure; however, these patients frequently experience anxiety, which can stem from various stressors. This study aimed to analyze the effect of music therapy on anxiety levels in patients with chronic kidney disease undergoing hemodialysis. This quantitative study employed a quasi-experimental design with a one-group pretest-posttest approach. A non-probability purposive sampling technique was used, resulting in a sample size of 78 participants. The study was conducted between June and December 2025 at Imelda Pekerja Indonesia General Hospital in Medan. The Hamilton Anxiety Rating Scale (HARS) served as the research instrument, and data were analyzed using the Wilcoxon test. The results showed that the majority of the 78 respondents were male (n=49; 63%). The median anxiety score was 24.00 prior to the intervention and 16.00 following the intervention. Statistical analysis yielded a p-value of <0.001, indicating that the intervention had a positive effect by reducing anxiety in patients undergoing hemodialysis. The study concludes that music therapy effectively reduces anxiety in hemodialysis patients. It is hoped that respondents will listen to music while undergoing hemodialysis, and that hospitals will adopt music therapy as a means to reduce patient anxiety.

PENENTUAN POSISI TOP, BOTTOM, DAN VERSATILE PADA HOMOSEKSUAL DENGAN HIV/AIDS: STUDI KUALITATIF

2026-09-03T02:43:08+00:00

Homosexuality is the highest risk factor for HIV transmission in Indonesia. Being the "bottom" increases HIV transmission because the anus is easily torn due to decreased elasticity, is more permeable to the HIV virus, has only one layer of epithelium that can cause abrasions (caused by mechanical friction during anal sex), and is more likely to damage the protective integrity of skin cells. This study aims to determine how to build identity and negotiate the determination of the "top," "bottom," or "versatile" position during sexual intercourse among homosexuals with HIV/AIDS. A qualitative research design was employed using in-depth interviews conducted from June to July 2025, with data analyzed through thematic analysis. The participants in this study were six participants using purposive sampling techniques, consisting of two participants in the "top" position, two participants in the "bottom" position, and two participants in the "versatile" position. This study revealed five main themes, namely (1) past history of sexual abuse, attraction to the same sex as a child, or not having a father figure in their lives; (2) masculine and feminine traits that are not related to gender, but rather to the determination of these positions; (3) satisfaction in determining position is not only based on physical characteristics such as penis size, muscularity, and facial features, but also on emotional and psychological factors; (4) benefits, they gain benefits for each other's positions; and (5) social factors, such as the influence of peers, norms, and pressure within social groups that support or force their involvement in determining their position as "top," "bottom," or "versatile.”

MISINFORMASI VAKSINASI DI MEDIA SOSIA DAN KEPUTUSAN IMUNISASI BALITA: PERAN MEDIASI KESADARAN RISIKO ORANG TUA

2026-09-22T08:10:57+00:00

PERAN PROBIOTIK DAN VITAMIN E DALAM PENANGANAN PENYAKIT LIVER: DAMPAK TERHADAP FUNGSI LIVER

2026-09-21T08:45:16+00:00

Liver disease remains a significant global health problem characterized by hepatocellular injury mediated by oxidative stress, inflammation, and toxic exposure such as formaldehyde. Probiotics and vitamin E have been proposed as complementary interventions due to their antioxidant and immunomodulatory effects. This study aimed to evaluate the effectiveness of probiotics and vitamin E in reducing SGOT and SGPT levels in formaldehyde-induced liver injury in Wistar rats. An experimental posttest-only control group design was used. Twenty-five Wistar rats were randomly allocated into five groups: negative control, positive control, probiotic, vitamin E, and combination (probiotic + vitamin E), with five rats per group. Liver injury was induced via formaldehyde inhalation. Serum SGOT and SGPT levels were measured after intervention. Data were analyzed using One-Way ANOVA for normally distributed data and Kruskal–Wallis test for non-normally distributed data, followed by post hoc analysis using SPSS. Significant differences in SGOT levels were observed among groups (0.000 < 0.05). SGPT levels also showed significant differences among groups (p = 0.008). Overall, formaldehyde exposure increased SGOT and SGPT levels, while probiotics and vitamin E significantly reduced both markers. Probiotics and vitamin E, particularly in combination, demonstrated hepatoprotective effects in formaldehyde-induced liver injury. These findings support their potential role as complementary interventions in evidence-based nursing care for patients with liver dysfunction.

EKSPLORASI HAMBATAN KOMUNIKASI EDUKATIF PERAWAT DALAM MEMBERIKAN ASUHAN KEPERAWATAN KEPADA PASIEN: STUDI KUALITATIF

2026-09-21T08:47:46+00:00

Background: Communication is essential for humans as social beings. Communication is beneficial for interactions Communication and education are important competencies for nurses in providing patient-centered nursing care. However, there are still obstacles in nurses' ability to explain health conditions, disease progression, and nursing actions to patients and their families. Previous research has focused more on the effectiveness of therapeutic communication, while studies on barriers to educational communication related to nursing knowledge mastery are still limited. Therefore, further exploration of communication and education issues faced by nurses in nursing practice is needed. Purpose: This study aims to explore the barriers to nurses' educational communication in providing health information to patients and families, as well as to identify aspects of competence that still need to be strengthened in the implementation of nursing care. Methods: This study uses a descriptive qualitative approach with purposive sampling technique. Participants were selected based on their involvement and experience in the nursing education communication process, consisting of 18 informants: 5 patients undergoing treatment, 5 family members of the patients, 5 active nurses in the care unit, and 3 nursing lecturers. The criteria for participants include patients and families receiving nursing services, nurses actively providing nursing care, and lecturers with experience in nursing education. Data were collected through semi-structured interviews and analysed using qualitative content analysis with the help of Atlas.ti. Result: The research findings indicate several barriers to nurses' educational communication in providing explanations to patients and families. Five main themes identified include: (1) limitations in understanding human anatomy; (2) limitations in understanding human physiology; (3) difficulties in explaining the course of the disease; (4) difficulties in explaining changes or deviations caused by the disease; and (5) limitations in explaining the nursing actions provided. Conclusion: This study shows that issues with nurse education communication are still related to the limited understanding of basic health science concepts and nursing processes. Strengthening communication competencies needs to be carried out by enhancing nurses' abilities to understand and explain patients' health conditions systematically, understandably, and based on patients' needs.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN DIABETES MELITUS DI DESA LADANG BARO KECAMATAN MEUKEK KABUPATEN ACEH SELATAN

2026-09-21T08:47:02+00:00

EFEKTIVITAS INFANT CALMING MASSAGE TERHADAP KUALITAS TIDUR, REGULASI STRES DAN SELF-SOOTHING BEHAVIOR BAYI PASCA BENCANA

2026-09-22T08:20:54+00:00

Infants represent a vulnerable group in post-disaster situations because environmental changes, noise, disrupted caregiving routines, and family stress can interfere with emotional regulation and sleep patterns. Infant Calming Massage (ICM) has potential as a non-pharmacological intervention that can be performed by mothers. This study aims to evaluate changes in sleep indicators following the implementation of ICM, describe stress regulation and self-soothing behavior conditions, and design an ICM intervention model recommended for post-disaster child healthcare services. This quasi-experimental one-group pretest-posttest study involved 32 infants aged 0–12 months in Muara Batang Angkola Village. ICM was administered for 15 minutes, 3–5 times per week over 4 weeks. Data were analyzed descriptively, along with reliability testing, Shapiro-Wilk, Wilcoxon Signed-Rank, and paired t-tests. The results indicated that following ICM implementation, nighttime sleep duration increased from 8.33 hours to 9.89 hours, with waking frequency decreasing from 2.96 times to 0.57 times. Furthermore, sleep latency decreased from 24.71 minutes to 8.37 minutes. All changes were statistically significant (p<0.001) with large effect sizes. ICM shows potential to improve sleep quality and continuity in post-disaster infants. The designed ICM model encompasses screening, education, routine massage, and monitoring and evaluation as a supportive intervention at integrated health posts (Posyandu) and community health centers (Puskesmas).

HUBUNGAN KEPATUHAN PROLANIS DENGAN OUTCOME KLINIS KRONIS DI KLINIK X

2026-09-03T02:44:49+00:00

Non-communicable diseases, particularly diabetes mellitus and hypertension, require long-term management and continuous monitoring. The Chronic Disease Management Program (PROLANIS) is implemented in Indonesian primary care to improve adherence and clinical control. This study aimed to analyze the relationship between participant characteristics and PROLANIS visit adherence with clinical outcomes among BPJS participants in 2023-2025. This retrospective cohort study used secondary medical record data from PROLANIS participants at Clinic X. Participant characteristics included age, sex and duration of illness. Visit adherence was calculated from the proportion of attended visits to scheduled visits. Clinical outcomes consisted of fasting bloimtod glucose and blood pressure. Data were analyzed using descriptive statistics, normality testing, Spearman correlation, Friedman test, and Wilcoxon test. The dataset was dominated by hypertension observations (62.4%), female participants (81.3%), age >60 years (70.9%), duration of illness >5 years (94.5%), adherent visits (54.1%), and controlled clinical outcomes (87.5%). Adherence was significantly correlated with fasting blood glucose (r=0.136; p<0,001), systolic blood pressure (r=-0.171; p<0,001), and diastolic blood pressure (r=0.188; p<0,001). Longitudinal tests showed no significant changes in fasting blood glucose or blood pressure from 2023 to 2025. PROLANIS adherence was associated with clinical outcomes, although the correlation strength was very weak. Strengthening adherence monitoring remains important in primary care chronic disease management.

HUBUNGAN DERAJAT STROKE DENGAN STATUS DEPRESI PADA PASIEN PASCA STROKE DI RUMAH SAKIT UMUM IMELDA PEKERJA INDONESIA

2026-09-22T08:00:08+00:00

Stroke is an acute neurological disorder that can cause long- term disability. One complication that often occurs in post- stroke patients is depression, which can worsen prognosis and hinder the recovery process. The severity of stroke is thought to be closely related to the severity of depression. This study aims to determine the relationship between the severity of stroke and the status of depression in post- stroke patients at the Imelda Indonesian Workers General Hospital in 2025. This study used a quantitative analytical design with a cross- sectional approach. A sample of 32 respondents was selected using purposive sampling. The severity of stroke was measured using the National Institutes of Health Stroke Scale (NIHSS), and depression status was assessed using the Beck Depression Inventory- II (BDI- II). Informasi analysis was performed using univariate and bivariate analysis with the Chi- square test. The majority of respondents had mild stroke severity (50%) and moderate depression status (68. 8%). Statistical test results showed a significant relationship between stroke severity and depression status p<0,001. In conclusion, there is a significant relationship between stroke severity and depression status in post- stroke patients; more severe stroke severity is associated with higher levels of depression.

EVALUASI BERBASIS SIMULASI SKRINING KEKERASAN PSIKOLOGIS DAN TRAUMA KETIDAKSETIAAN PASANGAN PADA IBU HAMIL

2026-09-22T07:17:46+00:00

Trauma and psychological violence related to partner infidelity often remain undisclosed during routine antenatal care, particularly when face-to-face interviews are perceived as unsafe or uncomfortable. This study aims to evaluate the initial measurement performance of an adaptive digital screening model and its detection rates. This study combines a descriptive analysis of an initial 80-case screening dataset with fully simulation-based item-level and paired pre-post datasets. The model assesses psychological violence, trauma from partner infidelity, anxiety, depression, social support, disaster-related vulnerability, and safety red flags. Simulated changes in detection performance were analyzed using the t-test, Wilcoxon signed-rank test, McNemar test, and Cohen’s dz. Findings revealed moderate-to-high psychological violence in 55% of cases and moderate-to-severe trauma in 60% of cases. All 25 simulated items met validity and reliability criteria. Detection performance scores significantly increased from 54.62 to 70.96 (p < 0.001; dz = 2.648). Detected cases increased from 38 to 65 cases (a 71.05% increase), accompanied by significant shifts in paired pre-post detection status. The adaptive model demonstrates methodological feasibility for privacy-preserving and risk-stratified antenatal screening. Nevertheless, field validation against direct clinical assessments remains necessary prior to routine implementation in clinical practice.

KEPARAHAN STROKE, KEMANDIRIAN FUNGSIONAL, DAN KEPARAHAN GEJALA DEPRESI PADA PASIEN PASCASTROKE

2026-09-16T08:30:53+00:00

PENGARUH SARAPAN TELUR AYAM REBUS TERHADAP KADAR GULA DARAH SEWAKTU PADA PASIEN DIABETES MELITUS TIPE 2

2026-09-28T08:19:43+00:00

Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder characterized by impaired insulin action, insufficient insulin production, or a combination of both, resulting in elevated blood glucose levels. The increasing prevalence of this disease has become a significant public health concern worldwide. In addition to pharmacological treatment, effective diabetes management requires appropriate dietary modifications. A high-protein breakfast has been reported to improve glycemic control by slowing glucose absorption and enhancing satiety. Boiled chicken eggs are a readily available, affordable, and low-carbohydrate source of high-quality protein, making them a potential dietary option for individuals with diabetes. This study aimed to analyze the effect of consuming boiled chicken eggs as a breakfast meal on random blood glucose levels among patients with Type 2 Diabetes Mellitus. A quantitative approach with a one-group pretest-posttest pre-experimental design was employed. The study involved 40 participants selected through purposive sampling based on predetermined inclusion criteria. The intervention consisted of consuming boiled chicken eggs as breakfast for seven consecutive days. Random blood glucose levels were measured using a glucometer before and after the intervention. Data were analyzed using the Wilcoxon Signed Rank Test. The findings revealed that prior to the intervention, most participants were classified in the diabetes category, accounting for 21 individuals (52.5%). Following the intervention, the majority of participants shifted to the prediabetes category, with 24 individuals (60.0%). Statistical analysis demonstrated a p-value of 0.008 (p < 0.05) and a Z-score of -2.653, indicating a significant difference between pre-intervention and post-intervention random blood glucose levels. These results suggest that consuming boiled chicken eggs as part of breakfast may contribute to reducing random blood glucose levels among patients with Type 2 Diabetes Mellitus.

PENERAPAN MODEL ADAPTASI ROY PADA ASUHAN KEPERAWATAN PASIEN ACUTE DECOMPENSATED HEART FAILURE: STUDI KASUS

2026-09-03T02:41:47+00:00

Acute Decompensated Heart Failure (ADHF) is a heart failure with clinical manifestations of symptoms and signs of congestion and poor organ perfusion and requires immediate management. The care process in patients with ADHF is a process with an adaptive system that continues to interact with a changing environment and uses a coping process or defense mechanism that can maintain patient adaptation to four modes, namely physiological, self-concept, role function, and interdependence function in the Roy Adaptation Model nursing theory. The purpose of writing this case study is to determine the application of the Roy Adaptation Model theory in nursing care for patients with ADHF. This study employed a case study method and was conducted at Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita Jakarta from September 19, 2024, to September 27, 2024. The results of the assessment obtained maladaptive behavior with the priority of nursing problems of decreased cardiac output. Focal stimuli in the form of changes in preload and afterload with contextual stimuli of a history of hypertension and non-compliance, and residual stimuli of genetic risk factors. Nursing interventions are given based on the control mechanisms of regulators and cognators. After nursing actions were carried out, the patient was able to adapt compensatory to the circulatory status by regularly taking medication and restricting fluids. It can be concluded that the Roy Adaptation Model theory is appropriate and effective in nursing care for patients with ADHF.

FAKTOR-FAKTOR YANG MEMPENGARUHI STIGMA MASYARAKAT TERHADAP PENDERITA GANGGUAN JIWA

2026-09-03T02:45:57+00:00

The number of people with mental disorders in Indonesia continues to increase from year to year. This is exacerbated by the negative stigma against people with mental disorders in society. The negative stigma attached to people with mental disorders can be influenced by various factors such as education, knowledge, attitudes, and culture. This study aims to determine the factors that influence the public stigma towards people with mental disorders. The type of research used is descriptive correlation. The population in this study was the community of Sumedang Regency. The sampling technique used simple random sampling with a total of 385 people. Data collection tools used were the Mental Health Knowledge Schedule (MHKS) questionnaire to measure knowledge, Community Attitudes Toward Mental Illness (CAMI) to measure attitudes, Multicultural Mental Health Awareness Scale (MMHAS) to measure culture and Perception Discrimination Devaluation Scale (PDDS) to measure stigma. The study found that 59.74% had low education levels, 51.43% had poor knowledge, 52.97% had negative attitudes, 53.51% had unsupportive cultural practices, and 62.86% had high stigma. There was a correlation between education level and societal stigma toward people with mental disorders (P-Value <0.05). There was a correlation between knowledge level and societal stigma toward people with mental disorders (P-Value 0.02). There was a correlation between attitudes and societal stigma toward people with mental disorders (P-Value 0.03). There was a correlation between culture and societal stigma toward people with mental disorders (P-Value 0.02). This study recommends that healthcare professionals improve public education to reduce stigma toward people with mental disorders.