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All Journal COPING (Community of Publishing in Nursing) Jurnal Ners Indonesia Jurnal Keperawatan Jiwa (JKJ): Persatuan Perawat Nasional Indonesia Jurnal Keperawatan Soedirman (The Soedirman Journal of Nursing) Jurnal Online Mahasiswa (JOM) Bidang Ilmu Keperawatan Jurnal Keperawatan Sriwijaya Jurnal Ilmiah Universitas Batanghari Jambi JNKI (Jurnal Ners dan Kebidanan Indonesia) (Indonesian Journal of Nursing and Midwifery) JURNAL PHOTON Jurnal Kreativitas PKM Indonesian Journal of Nursing Research (IJNR) Jurnal Ilmiah Keperawatan JURNAL KESEHATAN MERCUSUAR Jurnal Ners BIMIKI (Berkala Ilmiah Mahasiswa Ilmu Keperawatan Indonesia) Community Development Journal: Jurnal Pengabdian Masyarakat Health Care : Jurnal Kesehatan Jurnal Kesehatan Tambusai Journal of English Language and Education SEHATI: Jurnal Kesehatan Jurnal Teknologi Kesehatan COMSERVA: Jurnal Penelitian dan Pengabdian Masyarakat Journal of Midwifery Science and Women's Health (JMSWH) Florona : Jurnal Ilmiah Kesehatan Journal of Nursing Science Update Jurnal Lentera Journal Of Health & Cardiovascular Nursing Cerdika: Jurnal Ilmiah Indonesia Innovative: Journal Of Social Science Research JURNAL ILMIAH KESEHATAN MASYARAKAT DAN SOSIAL Jurnal Pendidikan Kesehatan (e-Journal) Indo Green Journal JUKEJ: Jurnal Kesehatan Jompa Oshada Jurnal Vokasi Keperawatan (JVK) Jurnal Keperawatan Profesional Jurnal Smart Keperawatan Malahayati International Journal of Nursing and Health Science Holistik Jurnal Kesehatan Jurnal SMART Kebidanan Indo Green Journal Jurnal SMART Kebidanan Borneo Nursing Journal
Amir, Yufitriana
Fakultas Keperawatan, Universitas Riau
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EFEKTIVITAS MEDIA AUDIO VISUAL TERHADAP PENINGKATAN PENGETAHUAN MAHASISWA TENTANG KONSEP TERMOREGULASI Jamariah, Siti; Amir, Yufitriana; Utami, Sri
Jurnal Pendidikan Kesehatan (e-Journal) Vol. 11 No. 2 (2022): Jurnal Pendidikan Kesehatan (E-Journal)
Publisher : Poltekkes Kemenkes Malang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31290/jpk.v11i2.3382

Abstract

The Covid 19 pandemic has caused major changes in all aspects of life, one of which is education. Audio visual media are learning media needed during the Covid 19 pandemic. The human senses have different percentage levels in receiving information. The sense of sight and the sense of hearing have a percentage of 50 Percent in receiving information. This study aims to determine the effectiveness of audio visual media to increase students knowledge about the concept of thermoregulation. The research method used is quasy experiment with pretest posttest design with control group. The research sample amounted to 34 people who were divided into 17 experimental groups who were given audio visual and powerpoint and 17 control groups who were given powerpoints taken based on inclusion criteria with random sampling technique. This research instrument uses a questionnaire that has been tested for validity and reliability. The analysis used is univariate and bivariate analysis using the Dependent T Test and Mann Whitney. The results of this study indicate that the average level of knowledge in the experimental group was 82.06 and in the control group was 68.53 with P Value of 0.004 Less than a 0.05. Statistically there is an effect of effective audio visual media on increasing student knowledge about the concept of thermoregulation.
GAMBARAN HEALTH SEEKING BEHAVIOR PENDERITA HIPERTENSI DI MASA PANDEMI COVID-19 Salasi, Arisa; Deli, Hellena; Amir, Yufitriana
BIMIKI (Berkala Ilmiah Mahasiswa Ilmu Keperawatan Indonesia) Vol. 9 No. 2 (2021): Edisi Juli - Desember 2021
Publisher : Ikatan Lembaga Mahasiswa Ilmu Keperawatan Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53345/bimiki.v9i2.217

Abstract

Pendahuluan: Health seeking behavior merupakan perilaku yang dilakukan oleh orang yang menderita suatu penyakit untuk memperoleh kesembuhan. Penelitian ini bertujuan untuk mengetahui gambaran health seeking behavior penderita hipertensi di masa pandemi COVID-19. Metode: Penelitian ini menggunakan desain penelitian deskriptif dengan jumlah sampel sebanyak 70 responden. Alat ukur yang digunakan adalah kuesioner. Penelitian ini dilakukan pada tanggal 17-27 Juli 2021 di Puskesmas Rejosari. Analisa yang digunakan dalam penelitian ini adalah analisis statistik deskriptif. Hasil: Perilaku pencarian pengobatan penderita hipertensi di masa pandemi COVID-19 berdasarkan usia lebih banyak memilih melakukan pengobatan ke public medicine. Responden dengan pendidikan SMA memilih public medicine (60,9%), responden dengan penghasilan < Rp 2.998.000 memilih public medicine (48,9%), dan responden yang telah menderita hipertensi selama ≤ 5 tahun memilih public medicine (45,2%). Kesimpulan: Perilaku pencarian pengobatan penderita hipertensi di masa pandemi COVID-19 dari segala kategori mayoritas responden memilih melakukan pengobatan ke public medicine. Kata Kunci : COVID-19; Health Seeking Behavior; Hipertensi Introduction: Health seeking behavior is behavior carried out by people who suffer from a disease to obtain healing. This study aims to describe the health seeking behavior of hypertension sufferers during the COVID-19 pandemic. Methods : This study used a research design descriptive with a sample of 70 respondents with hypertension who met the inclusion criteria. The measuring instrument used is a questionnaire. This research was conducted on 17-27 July 2021 at the Puskesmas Rejosari. This study uses descriptive statistical analysis. Results:The behavior of seeking treatment for hypertension sufferers during the COVID-19 pandemic based on age is more likely to choose treatment public medicine for. Respondents with high school education chose public medicine (60.9%), respondents with income <Rp 2,998,000 chose public medicine (48.9%), and respondents who had suffered from hypertension for 5 years chose public medicine (45.2% ). Conclusion: The behavior of seeking treatment for hypertension sufferers during the COVID-19 pandemic from all categories, the majority of respondents chose to go to treatment public medicine for. Keywords : COVID-19; Health Seeking Behavior; Hypertension
THE EFFECTIVENESS OF HEALTH EDUCATION ON PARENT’S KNOWLEDGE LEVEL ABOUT CHILDREN WITH CONGENITAL TALIPES EQUINOVARUS IC ROOMS Ingga; Amir, Yufitriana; Novayelinda, Riri
Jurnal Smart Kebidanan Vol. 12 No. 1 (2025): JUNE 2025
Publisher : Universitas Karya Husada Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34310/jskb.v12i1.153

Abstract

CTEV (Congenital et al.) is defined as a condition in which there is adductor in the front of the foot and supination in the back, varus in the toes in the subtalar complex, equinus in the hindfoot, and medial deviation of the entire foot towards the floor surface. The CTEV therapy process requires routine and periodic evaluations until the child ages 4-5. This, of course, impacts the level of knowledge and compliance of parents in accompanying their children during the therapy program. Examining how health education utilizing leaflet media affects parents' understanding of children with CTEV is the primary goal of this study. One group was given a pretest-posttest as part of this quantitative study's quasi-experimental methodology. The parents of children who are patients make up the population. Thirty participants were selected using a purposive sampling method. Using a questionnaire as its measuring instrument, this study examines two parts: part A, which focuses on respondent characteristics, and part B, which delves into questions on CTEV and the knowledge element associated with it. The analysis used is a bivariate analysis using the Wilcoxon test. There is a significant difference in the mean level of parental knowledge on the pre-test and post-test in the experimental group, with a p-value of 0f 0.019. Health education regarding CTEV for parents who have children suffering from CTEV using leaflets influences the level of knowledge of respondents. Hopefully,  these results can be an alternative intervention to increase parents' knowledge about CTEV.
PENGARUH BRAIN GYM TERHADAP TINGKAT KETAKUTAN ANAK PRASEKOLAH YANG MENJALANI HARI PERTAMA HOSPITALISASI Eliyana, Nur; Amir, Yufitriana; Zukhra , Ririn Muthia
Jurnal Keperawatan Sriwijaya Vol. 12 No. 2 (2025): Vol 12, No 2 (2025)
Publisher : Bagian Keperawatan Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/jks.v10i1.299

Abstract

Tujuan: Penelitian ini bertujuan untuk mengevaluasi pengaruh Brain Gym terhadap tingkat ketakutan anak prasekolah pada hari pertama hospitalisasi di RSUD Arifin Achmad Pekanbaru. Metode: Penelitian ini menggunakan desain kuantitatif dengan pendekatan quasi-eksperimental pre-post test tanpa kelompok kontrol. Sampel berjumlah 34 anak prasekolah yang dipilih melalui teknik purposive sampling. Instrumen yang digunakan untuk mengukur tingkat ketakutan adalah kuesioner skala ketakutan anak prasekolah. Analisis data dilakukan menggunakan uji Wilcoxon untuk mengetahui perbedaan tingkat ketakutan sebelum dan sesudah intervensi Brain Gym pada hari pertama dan kedua hospitalisasi. Hasil: Hasil penelitian menunjukkan bahwa terdapat penurunan signifikan tingkat ketakutan anak setelah intervensi Brain Gym baik pada hari pertama maupun hari kedua hospitalisasi (p < 0,05). Simpulan: Brain Gym efektif dalam menurunkan tingkat ketakutan anak prasekolah selama hospitalisasi. Penelitian ini direkomendasikan sebagai dasar penerapan Brain Gym sebagai intervensi non-farmakologis dalam perawatan anak di rumah sakit.
PENGARUH RANGE OF MOTION (ROM) TERHADAP PERUBAHAN SKALA NYERI PADA PASIEN POST OPERASI OPEN REDUCTION INTERNAL FIXATION (ORIF) FRAKTUR EKSTREMITAS BAWAH Lubis, Jimmi Eka Putra; Amir, Yufitriana; Indriati, Ganis
Jurnal Keperawatan Sriwijaya Vol. 12 No. 2 (2025): Vol 12, No 2 (2025)
Publisher : Bagian Keperawatan Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/jks.v10i1.300

Abstract

Tujuan: Tujun penelitian ini untuk melihat pengaruh Range of Motion (ROM) terhadap perubahan skala nyeri pada pasien post operasi Open Reduction Internal Fixation (ORIF) fraktur ekstremitas bawah. Metode: Penelitian ini merupakan penelitian kuantitatif dengan desain penelitian quasi eksperimental dengan rancangan one grup pretest posttest design. Teknik pengambilan sampel pada penelitian ini yaitu dengan purposive sampling, yang berjumlah 34 responden. Hasil: Hasil penelitian dengan menggunakan uji wilcoxon dengan nilai p value (0,000) < α (0,05) sehingga dapat disimpulkan bahwa H0 ditolak dan H1 diterima, yang berarti terdapat Terdapat pengaruh ROM Terhadap Perubahan Skala Nyeri Pada Pasien Post ORIF ekstremitas bawah Simpulan: Latihan ROM efektif dalam menurunkan nyeri pada pasien pasca operasi ORIF Ekstremitas di Rumah Sakit Umum Daerah Provinsi Riau
Description of Home Conditions Based on Healthy Home Standards for Toddlers with Acuate Respiratory Tract Infections (ARI) Natasya, Saruli; Tampubolon, Nurhannifah Rizky; Amir, Yufitriana; Novayelinda, Riri; Fitri, Aminatul
Jurnal Keperawatan Profesional Vol 13, No 2 (2025): Infectious Diseases
Publisher : Nurul Jadid University, Probolinggo, East Java, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33650/jkp.v13i2.11217

Abstract

Healthy home conditions based on healthy home standards for toddlers with ARI. This study used a descriptive observational design. The study sample consisted of 67 respondents selected based on inclusion criteria, namely parents of toddlers diagnosed with ARI using the accidental sampling technique. The questionnaire used was a healthy home assessment. The analysis used was univariate data analysis. There were 62.7% of respondents in early adulthood (26-35 years old), 47.8% of toddlers (12-59 months old), and 50.7% of male children. Of the 67 respondents, 59.7% of respondents' homes met the healthy home criteria and 40.3% of respondents' homes did not meet the healthy home criteria. In terms of housing components, 88.1% had permanent ventilation <10% of the floor area of the house, 56.7% of respondents' homes did not have a kitchen smoke vent, In terms of sanitation facilities, 100% of waste was discharged into open gutters, and in terms of resident behavior, 92.5% sometimes opened their bedroom windows and 91% sometimes opened their living room windows, while 95.5% sometimes cleaned their yards. In conclusion, some of the houses met the requirements for healthy housing, while others did not. The majority of the houses, sanitation facilities, and residents' behavior were found to be good.
Parental empowerment strategies on stress levels in pediatric intensive care settings: A Literature Review Aulia Gawara; Yufitriana Amir; Agrina Agrina
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 3 (2025): Volume 8 Number 3
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i3.703

Abstract

Background: Having a child admitted to the intensive care unit (ICU) is an extremely distressing experience for parents. This heightened stress can negatively affect their mental health and their capacity to support their child's recovery process. To address this, a range of interventions aimed at empowering parents has been developed. Nonetheless, a comprehensive evaluation of the effectiveness of these interventions in alleviating parental stress is still lacking. Purpose: To evaluate different parent empowerment strategies used in pediatric critical care settings and examine their effects on reducing stress among parents. Method: A systematic review was carried out, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for selecting relevant studies. The review began with formulating clinical questions and defining PICOS criteria—P (Population): parents of children in the pediatric intensive care unit (PICU); I (Intervention): empowerment strategies for parents; C (Comparison): routine care without empowerment or parent groups not receiving targeted interventions; O (Outcome): parental stress levels during ICU hospitalization; S (Study design): randomized controlled trials. The literature search used specific keywords, including: “Parent Empowerment,” “Family Centered Care,” “Pediatric Intensive Care,” “PICU,” “NICU,” and “Parental Stress.” Results: Interventions involving educational support, parental empowerment, and family engagement contribute to better mental health outcomes for parents, particularly enhancing their ability to care for critically ill or premature infants in the NICU. Conclusion: Empowerment strategies in pediatric intensive care settings are effective in lowering stress among parents. This review underscores the importance of educational initiatives, family involvement, supportive empowerment techniques, and digital tools such as telenursing in promoting parents' psychological resilience and participation in infant care.
Gambaran aktivitas fisik dengan Indeks Massa Tubuh (IMT) pada anak usia sekolah Yugan, Enggia; Amir, Yufitriana; Fitri, Aminatul
FLORONA : Jurnal Ilmiah Kesehatan Vol. 2 No. 2 (2023): Florona: Jurnal Ilmiah Kesehatan
Publisher : ARKA INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55904/florona.v2i2.905

Abstract

Anak Usia Sekolah adalah anak yang berada pada periode usia pertengahan yaitu usia 6-12 tahun dimana biasanya disebutkan dengan masa intelektual. Indeks massa tubuh (IMT) dan aktivitas fisik adalah dua variabel yang berkorelasi, karena semakin tinggi intensitas aktivitas fisik, semakin baik IMT. Di sisi lain, semakin sedikit aktivitas fisik, semakin buruk BMI. Aktivitas fisik yang rendah menyebabkan tubuh menumpuk energi dalam bentuk lemak. Tujuan penelitian ini untuk mengetahui hubungan aktivitas fisik dengan indeks massa tubuh (IMT) pada anak usia sekolah. Metode: Desain penelitian kuantitatif. Penelitian ini dilakukan di Sekolah Dasar Negeri 39 Pekanbaru dengan jumlah sampel sebanyak 110 anak kelas 4 dan 5 dengan teknik proportional stratified random sampling. Alat ukur yang digunakan adalah lembar kuesioner dan timbangan serta meteran. Analisis pada uji statistik menggunakan analisis univariat menggunakan data demografi, tinggi badan dan berat badan. Hasil: Hasil penelitian didapatkan sebagian besar anak Sekolah Dasar Negeri 39 Pekanbaru memiliki indeks massa tubuh (IMT) obesitas sebanyak 54 orang (49,1%) dengan aktivitas fisik responden pada kategori sedang sebanyak 85 orang (77,3%). Kesimpulan: semakin tinggi aktivitas seseorang maka semakin tingi pula indeks massa tubuh seseorang dan sebaliknya jika aktivitas fisik seseorang rendah maka rendah pula indeks massa tubuh.  
Perbedaan Pendidikan Kesehatan Melalui Media Video Dan Booklet Terhadap Kemampuan Keluarga Dalam Melakukan Mobilisasi Dan Rom Pada Pasien Stroke Nadila, Nadila; Amir, Yufitriana; Putri, Syeptri Agiani
Innovative: Journal Of Social Science Research Vol. 4 No. 6 (2024): Innovative: Journal Of Social Science Research
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/innovative.v4i6.12249

Abstract

Stroke patients need family help in mobilizing and ROM to prevent complications. Video media and booklets are media in providing health education that can increase the ability of families to mobilize and ROM in stroke patients. This study used an experimental quasy design with the Two group pre test-post test method. The research sample was 30 respondents with a purposive sampling technique. The bivariate analysis used was by the mc. nemar and ficsher's exact tests. The results of the fischer's exact test with a p value of 0.009 showed that there was a difference between health education, video media and booklets. As a medium in health education, video media and booklets both have an influence in improving the ability of families to mobilize and ROM in stroke patients. However, after being given the intervention video media is more effective compared to booklet media.
Gambaran Upaya Masyarakat Terhadap Pengendalian Demam Berdarah Dengue Al Bayhaqqi, Hayyum; Erwin, Erwin; Amir, Yufitriana
Cerdika: Jurnal Ilmiah Indonesia Vol. 2 No. 8 (2022): Cerdika: Jurnal Ilmiah Indonesia
Publisher : Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/cerdika.v2i8.532

Abstract

Pendahuluan: Demam Berdarah Dengue (DBD) merupakan infeksi yang disebabkan oleh virus dengue yang ditularkan melalui gigitan nyamuk Aedes aegypti. Pengendalian DBD terdiri atas pemberantasan sarang nyamuk, pengendalian vektor, pengendalian gigitan nyamuk dan pengendalian lingkungan. Penelitian ini bertujuan untuk mengetahui gambaran upaya masyarakat terhadap pengendalian DBD di Kelurahan Duri Timur, Kecamatan Mandau. Metode: Penelitian ini adalah penelitian deskriptif kuantitatif dengan desain penelitian survei. Teknik sampling dalam penelitian ini menggunakan purposive sampling dengan total sampel 91 responden. Teknik pengumpulan data menggunakan kuesioner yang berisi 25 pertanyaan yang telah valid dan reliabel. Analisis data menggunakan analisis univariat. Hasil: Penelitian menunjukkan bahwa karakteristik umur responden mayoritas adalah umur 15-25 tahun, karakteristik jenis kelamin responden mayoritas adalah perempuan, karakteristik pendidikan responden mayoritas adalah SMA dan karakteristik pekerjaan responden mayoritas adalah pedagang. Kemudian terdapat 56 responden (61,5%) sering melakukan kegiatan pemberantasan sarang nyamuk, 42 responden (46,2%) jarang melakukan pengendalian vektor, 64 responden (70,3%) sering melakukan pengendalian gigitan nyamuk dan 55 responden (60,4%) sering melakukan pengendalian lingkungan. Kesimpulan: Upaya masyarakat dalam pengendalian DBD sudah sering dilakukan oleh masyarakat Kelurahan Duri Timur, Kecamatan Mandau dan penelitian ini disarankan agar dapat meningkatkan upaya masyarakat dalam pengendalian DBD sehingga dapat lebih optimal dalam pelaksanaan pengendalian DBD di Kelurahan Duri Timur, Kecamatan Mandau.
Co-Authors ", Bayhakki " ", Erwin " ", Norsusanti " Adlina, Refah Rezkiana Putri Afni Ramadhani Agnes Putri S Marbun Agrina Al Bayhaqqi, Hayyum Ali Ali Amanda Gabriella Aminatul Fitri Andrikasmi, Sukamarriko Annisa, Afifah Ari Pristiana Dewi Arifany, Hanifa Arneliwati Aulia Gawara Bayhakki , Bayhakki Bayhakki Bayhakki Bayhakki Bayhakki Camilla Devania Danu Mangippu Pasaribu Darwin - Karim Deby Octaviani Deby Rayendra Dedi Kristian Gulo Delfitri, Meri Deovia, Wieke Serly Devi Afriza Devi Amelia Dewi Liesnoor Setyowati Diah Safitri Dini Sisware Yulia Dismawati Ditha Paulina Sembiring Dona Armelia Putri Dwi Mardiah Safitri Dwi Ningtias Eliyana, Nur Eliyanti Aroza Enggia Yugan Erika Erika Erika Ersya, Rhea Asfiranda Erwin Erwin Erwin Esra Mai Winda Manalu Fahrur Rozi Fathra Annis Nauli Febriana - Sabrian Fitriana Fitriana Gustika Wulandari Gustira, Erika Habiburrahman Habiburrahman Harahap, Litha Atikah Hayyum Al Bayhaqqi Helapsindah Ramadhani Hellena Deli Herlina Hernita, Rifa Indah Chairunnisa Indriati, Ganis Ingga Ingga Intan Dwi Febriyana Irwan Ardianto Iskandar Muda Jamariah, Siti Junaidi Junaidi Juniar Ernawati Juniar Ernawaty Juniar Ernawaty Khansa Rizki Syukrina Lita Lubis, Jimmi Eka Putra Mala Sasmita Masniari Juliana Siregar Masniari Juliana Siregar Mebi " Rania Mexsasai Indra Misrawati Munte, Mei Indah Nadila, Nadila Natasya, Saruli Nikmah Rokhmani Nisa Destiana Nopriadi Nopriadi Nopriadi Novia Candry Nur Fitriani Nurhannifah Rizky Tampubolon Nurhayati Nurul " Amalliya Nurwahyuni Oswati - Hasanah Ozafina Martaviani Paramita, Riza Patri Cia Yeremia Puja Permata Nur Putri, Novrita Riawan Rafiq Hidayah Rahayu, Venessa Rahmayanti " " Ramadhani, Dina Amanda Rasyidah " " Reni Zulfitri Reza Dwi Ananda Richa Pramaneta Riri Novayelinda Risfinda, Risfinda Riska Dwi Candrawati Rismadefi - Woferst Rosa Prestika Sari Roslaini " " Rustam, Musfardi Ruth Pratiwi Nathasya Manurung Salasi, Arisa Salma Mahiroh Siska Rani Ramadhani Siswahyudianto Siti Nurhaliza Siti Rahmalia Hairani Damanik Sofiana Nurchayati Sonia Meili Kamalin Sri " Utami Sri Utami Sri Utami Sri Wahyuni Sukma Handayani Syafni Syafni Syarifah Ayni Harahap Syeptri Agiani Putri Tanisa Mega Silvia Tiara Asyifa Putri Ulfa Amalia Wahyudi Diagama Wahyunengsih, Sry " Wasisto Utomo Widia Lestari Wieke Serly Deovia Windy Oktaviana Wulan Suci Ramadhani Yesi " Hasneli Yesi Hasneli Yesi Hasneli Yugan, Enggia Yulia Irvani Dewi Yulianti, Tarisha Rizqy Zukhra, Ririn Muthia