Background: Chronic kidney disease (CKD) is a global health issue that significantly impacts the quality of life of patients undergoing hemodialysis. Anxiety is one of the common psychological challenges faced by these patients. While various studies have addressed psychological and social interventions, most have focused on only one aspect, such as family support or psychological therapy, without considering the biological, social, and spiritual needs simultaneously. No research has integrated all these dimensions into a holistic approach.Purpose: This study aims to develop and evaluate a holistic nursing management model that combines all of these aspects to reduce anxiety levels for hemodialysis patients.Methods: This study used a mixed-method approach with an action research design. It was conducted at the Klaten Islamic Hospital. The population in the study was patients undergoing hemodialysis; as many as 15 patients participated in this study. The holistic nursing module was tested in five sessions, each lasting 15-30 minutes. Anxiety levels were measured using the Hamilton Rating Scale for Anxiety (HRS-A) before and after the intervention.Results: The study's results showed that the average level of anxiety in patients before the intervention was 35.13±3.22; after the intervention, it decreased to 24.87±1.68 (p<0.001).Conclusion: The application of the holistic nursing management model effectively reduced anxiety levels in hemodialysis patients.

Background: Adolescence is a period of emotional, mental, and physical change. To improve health-seeking behavior, reduce risky sexual behaviors, and increase knowledge about sexual and reproductive health, adolescents need support and access to services. The increasing availability of mobile apps requires a thorough evaluation of the quality and classification of these mobile apps so that accurate and evidence-based information can reach their users. Because smartphones are a private (intimate) technology, they are a promising means of closing this gap. However, research focusing on sexual health promotion programs delivered through smartphones is still rare.Purposes: Developing and testing a smartphone and internet-based comprehensive sex education app.Methods: This study employed Research and Development consisting of 4 stages, namely Literature Study, Development Stage, Validity Expert, and Trial.Result: The SEMAR app has seven features, ranging from mental health education to human relationships. The convenience score is 70%. The results of the trial show that this application effectively improves health education. 50-83% agree to use it. The sex stigma variable has the most extensive r (r=0.955), which means it has a solid and positive relationship.Conclusion: This application benefits adolescents in improving health education and adolescent reproductive health.

Background: Bullying behavior among students has become a severe problem that affects their mental and physical well-being. The factors that cause bullying behavior are very complex and involve various aspects. One factor that is receiving increasing attention is alexithymia.Purpose: This study explores the relationship between alexithymia and student bullying behavior.Methods: The research used a quantitative design with a cross-sectional study approach. The research sample consisted of 120 class X students at Senior High School X in Bandung, selected using a total sampling technique. Data was collected by distributing online questionnaires, including the Toronto Alexithymia Scale-20 (TAS-20) to measure alexithymia and the Olweus Bully/Victim Questionnaire for bullying behavior. Data were analyzed using descriptive statistics and the Spearman correlation test.Results: The data obtained show that less than half of the respondents (36.7%) experienced high levels of alexithymia, 38.3% likely experienced possible alexithymia, and 25% did not experience alexithymia, while the majority of respondents exhibited high bullying behavior (43.5%). This study shows a positive relationship between alexithymia and student bullying behavior (p <0.0001; r: 0.309).Conclusion: Alexithymia can increase bullying behavior in school children. The higher the level of alexithymia, the greater the tendency to engage in bullying behavior.

Background: Treating diabetic foot ulcers (DFU) sometimes takes a long time. During treatment, the patient's feet are usually given a cushion (such as a sleeping pillow or bolster) to make the wound seen. This way, some patients reported that their feet tingled because they were not positioned rightly for an extended period. So far, no unique pillow is available for this function. This pillow would help in treating DFU and should be comfortable for patients. Thus, it is essential to research designing such a product.Purpose: To develop and test a special pillow for treating DFU.Methods: This research adopts Research and Development (R&D). This research is divided into two stages: designing and developing and product testing.Results: This pillow is made of multiplex and foam, covered with Polyester fabric. It is 75mm in length and 45mm in width. It is equipped with a foot care area and waste storage tank. The test results showed that the score for comfort for the patients was 92%, while the score from the nurse was 88%.Conclusion:The pillow product helps the nurse conduct the DFU treatment and is comfortable for the patients.

Background: Human papillomavirus is an infection that causes malignancy because of persistency and modulation of apoptotic pathways, especially caspase-3. Factors that can increase persistency, recurrency, and malignancy of HPV infection include HIV infection with low CD4 levels. There is disagreement or deep molecular understanding of the induction and modulation of apoptosis in HIV-mediated CD4+ T cell depletion, especially in CA. However, it is necessary to see how CD4+ levels can influence caspase-3, so it may open up new avenues for supporting investigation to consider the presence of malignancy or therapeutic strategies regarding CD4+ can induce apoptosis.Purpose: This study aimed to determine whether there is a correlation between CD4+ levels and caspase-3 expression in condyloma acuminata with HIV reactive patients.Methods: This is an analytic observational study with a cross-sectional design. The research was conducted at Dr. Moewardi General Hospital from August to December 2023. Nineteen patients with condyloma acuminata and HIV reactive were included in this study with a consecutive sampling technique. The expression of caspase-3 was assessed using immunohistochemical staining, looking at the percentage of stained cell nuclei and cytoplasm and CD4+ levels with flow cytometry examination—data analysis using Pearson correlation.Results: Respondents in this study were primarily men, self-employed with heterosexual orientation and genito-genital-oral sexual intercourse. The statistical analysis showed no significant relationship (p: 0.300, r: -0.251) between CD4+ levels and caspase-3 expression.Conclusions: While not statistically significant, CD4+ level is reduced in correlation with increased caspase-3 expressions.

Background: The incidence of striae gravidarum in Indonesia is 95%, and 79.7% are primigravida. Striae gravidarum is not a direct physical health risk but is associated with body image and decreased self-confidence. Curcuma domestica contains curcumin and vitamin C, which can stimulate the synthesis of type IV collagen. In contrast, the Centella asiatica plant contains triterpenoids and saponins, which can stimulate the synthesis of type I collagen, which helps regenerate skin cells and improve skin elasticity. However, it is necessary to see the effectiveness of the two herbs, Centella asiatica and Curcuma domestica, in fading striae gravidarum. Purpose: To prove the effectiveness of topical gel formulation extract Centella asiatica and Curcuma domestica for fading of striae gravidarum.Methods: This is a quasi-experimental study with a pretest-posttest control group design. The sample consisted of 32 primigravida pregnant women divided into two groups: the intervention group was given a combination of Curcuma domestica and Centella asiatica gel at a dose of 5 mg twice a day for 14 days, and the control group was given a mineral oil gel at a quantity of 5 mg twice a day for 14 days—measurement of striae gravidarum using Davey score. The statistical test used the Friedman and Wilcoxon test.Results: The average fading of striae gravidarum in the intervention group was more significant than in the control group, 11.44±4.131 to 4±3.033 vs.12.19±5.788 to 8.56±4.320 treatment on the 14th day. The analysis results showed that the topical gel formulation of Centella asiatica and Curcuma domestica was more effective in fading striae gravidarum than the placebo gel (p<0.001).Conclusion: Administering topical gel containing 12% Centella asiatica extract and a 10% Curcuma domestica dose of 5 mg twice a day for 14 days affected the fading of striae gravidarum.

Background: A perineal tear affects around 85% of women who give birth vaginally. Previous animal research has demonstrated the beneficial effects of turmeric extract gel on wound healing, which speeds up the process of repairing wounded tissue. However, since this research is only in vivo, more studies and clinical trials are required to evaluate the efficacy of using turmeric extract gel to treat perineal lacerations.Purpose: To analyze the potential of turmeric extract gel (Curcuma Longa Linn.) in reducing REEDA score and IL-6 levels in postpartum women.Method: This is a quasi-experiment study with pretest–posttest with control group design. The study respondents comprised 20 people in the intervention group who were given turmeric extract gel and amoxicillin and 20 in the control group who were given amoxicillin for seven days. Measurement of wound healing using the REEDA score while IL-6 levels using ELISA. Data analysis of used Friedman and Wilcoxon tests.Results: There was a significant decrease in the intervention group's REEDA score and IL-6 levels (p<0.05). There was a significant difference in the average decrease in REEDA score and IL-6 levels between the two groups (p<0.05). The administration of turmeric extract gel led to faster wound healing for two days compared to the control group, which was only given standard treatment.Conclusion: Turmeric extract gel can reduce REEDA score and IL-6 levels.

Background: Self-care behavior and diabetic management in patients with diabetes mellitus (DM) tends to be low, especially during the COVID-19 pandemic. Various studies have found the influence of knowledge with self-care behavior diabetic management, as well as attitudes, motivation, family support and self-efficacy, but research analyzing the most dominant factors that play a role in influencing diabetic patients in self-care behavior and diabetic management is still limited.Purposes: Analyzing the factors that influence self-care behavior and diabetic management in diabetic patients. This study also analyzes the factor that play the most dominant role to influence self-care behavior and diabetic management in diabetic patients.Methods: This type of research is observational analytic with cross-sectional design. Patients of type 2 diabetes were the population in this study, with a sample size of 312 selected by convenience sampling. Factors of knowledge, attitude, motivation, family support and self-efficacy were observed in the study which were thought to be factors affecting self-care behavior diabetic management. The data were analyzed by chi square test and logistic regression.Results: The factors of knowledge, family support, and motivation significantly influence self-care behavior and diabetic management (p<0.05). The motivation factor is the most dominant factor affecting it (AOR 2.760; p<0.001).Conclusion: Good knowledge about diabetes management plus optimal family support and high motivation will improve self-care behavior and diabetic management in diabetic patients.

Background: The prevalence of primary dysmenorrhea in Indonesia is 54.89%. Progressive Muscle Relaxation (PMR) exercises have proven to decrease the symptoms of dysmenorrhea. Nowadays, the android application can be widely accessed anywhere and anytime, thus saving time and costs. There has never been a study that applies PMR, especially android-based dysmenorrhoea.Objective: The current study aimed to develop the PURE App, a PMR exercise android-based application, and to test the effectiveness of reducing the menstrual pain score of adolescents with primary dysmenorrhea.Method: This study conducted Research and Development (R&D), which consists of 4 stages, namely information collection, application design, expert validation and revision, and trial.Result: The PURE App has five features, ranging from pain screening to exercise. The trial results showed that the PURE App application effectively reduced menstrual pain in adolescents with dysmenorrhea. The treatment decreased pain score from 4.48±0.71 to 1.98±1.49 in the treatment group (p<0.001). The treatment group's post-measurement pain score was also significantly different compared to the control group, 1.98±1.49 and 4.90±1.10, respectively.Conclusion: The PURE App benefits teenagers, especially those with primary dysmenorrhea. This application will make it easier for teenagers to overcome pain because the exercises on the application can be accessed anytime and anywhere.

Since the first vaccine was developed (1796; smallpox vaccine), the world has seen its impact on health and well-being. Vaccines are one of the most influential scientific innovations of all time, helping to protect generations of people from infectious diseases throughout their lives. Parents need not worry too much about their children suffering from a deadly disease that has plagued previous generations because of vaccines. However, a top-down approach is needed so that vaccination becomes necessary for every people worldwide.