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PEMBERIAN TRIPOD POSITION DAN PURSED-LIP BREATHING PADA PASIEN PPOK DENGAN POLA NAPAS TIDAK EFEKTIF Wulandari, Eka Ananda Agustina Lilis; Ida Zuhroidah; Ayu Dewi Nastiti; Mokh. Sujarwadi; Dimas Hadi Prayoga; Fatimah Zahra; Nadia Rohmatul Laili
Journal of Nursing and Midwifery Sciences Vol. 4 No. 2 (2025): Volume 4 Issue 2
Publisher : Faculty of Nursing and Midwifery, Binawan University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54771/3fnhq480

Penyakit Paru Obstruktif Kronik (PPOK) merupakan masalah kesehatan global dengan angka morbiditas dan mortalitas tinggi, serta menjadi penyebab kematian ketiga menurut WHO pada tahun 2019. Di Indonesia, prevalensi PPOK terus meningkat dengan gejala utama sesak napas akibat pola napas tidak efektif. Penelitian ini bertujuan mendeskripsikan efektivitas tripod position dan pursed-lip breathing pada pasien PPOK di RSUD dr. R. Soedarsono Kota Pasuruan. Desain penelitian kuantitatif deskriptif eksploratif dengan pendekatan observasi. Subjek penelitian adalah seorang pasien PPOK berusia 65 tahun yang dipilih melalui purposive sampling. Intervensi tripod position dan pursed-lip breathing diberikan selama tiga hari, dengan penilaian kondisi respirasi melalui frekuensi napas, penggunaan otot bantu, rasio inspirasi-ekspirasi, saturasi oksigen, dan tingkat sesak berdasarkan skala Borg. Data dikumpulkan melalui observasi, wawancara, dan dokumentasi rekam medis, kemudian dianalisis secara deskriptif. Setelah intervensi, frekuensi napas menurun dari 26 menjadi 20 kali/menit, saturasi oksigen meningkat dari 94% menjadi 99%, dan tingkat sesak berkurang dari skala Borg 6 (berat) menjadi 2 (ringan). Penggunaan otot bantu pernapasan dan flaring cuping hidung tidak ditemukan lagi, serta rasio inspirasi-ekspirasi membaik dari 1:3 menjadi 1:2. Tripod position dan pursed-lip breathing efektif memperbaiki pola napas tidak efektif pada pasien PPOK, sehingga direkomendasikan sebagai intervensi nonfarmakologis dalam praktik keperawatan klinis.

Hubungan Skor Awal GCS dengan Outcome pada Pasien Cedera Kepala Zuhroidah, Ida; Toha, Mukhammad; Sujarwadi, Mokh.; Huda, Nurul
JI-KES (Jurnal Ilmu Kesehatan) Vol. 5 No. 1 (2021): JI-KES (Jurnal Ilmu Kesehatan)
Publisher : LPPM Universitas Hafshawaty Zainul Hasan Probolinggo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33006/ji-kes.v5i1.247

AbstrakCedera kepala adalah gangguan struktur dan fungsi otak yang diakibatkan oleh gaya mekanik dari luar tubuh, ada beberapa faktor prognosis yang berhubungan dengan outcome pasien cedera kepala meliputi jenis kelamin, usia, skor awal GCS, reflek pupil, gambaran CT scan, tanda vital dan hasil laboratorium. Penelitian ini bertujuan untuk menganalisis hubungan antara skor awal GCS dengan outcome pada pasien cedera kepalaÂ di Rumah Sakit X di Pasuruan. Penelitian ini menggunakan metode observasional analitik dengan pendekatan desain cross sectional. Pengukuran variabel independen berupa tingkat kesadaran (GCS) dan variebel dependen berupa nilai Trauma and Injury Severity Score (TRISS) dilakukan secara simultan pada satu saat dan dinilai hanya satu kali saja. Populasi yang digunakan adalah semua pasien cedera kepalaÂ di IGD Rumah Sakit X di Pasuruan. Besar sampel yang digunakan adalah 53 responden dengan teknik concecutive sampling. Data diuji menggunakan correlational Kendall Tau dengan level signifikan < 0.005. Â Hasil uji menunjukkan adanya hubungan antara Skor Awal GCS dengan Outcome pada Pasien Cedera Kepala dengan nilai p =0.00 < 0.05,nilai korelasi 0.402 yang berarti terdapat hubungan sangat erat dan bersifat positif, setiap terjadi penurunan GCS maka nilai TRISS juga akan menurun. Hasil penelitian ini memperkuat indikasi tentang pentingnya penanganan yang tepat dan segera pada penderitaÂ yang mengalami penurunan GCS diawal kejadian trauma.Kata kunci: penderita trauma, GCS, TRISSÂ Â AbstractHead injury is a structure and function brain disorder caused by mechanical forces from outside the body; there are several prognostic factors related to the outcome of head injury, including gender, age, initial GCS score, pupillary reflex, CT scan images, vital signs and laboratory results. This study aims to analyze the relationship between the initial GCS score and the outcome in head injury patients in X Hospital Pasuruan. This study used an analytic observational method with a cross-sectional design approach. Measurement of the independent variable in the form of level of consciousness (GCS) and the dependent variable in the form of the Trauma and Injury Severity Score (TRISS) were carried out simultaneously at one time and were assessed once. The population was all head injury patients at the emergency department of X Hospital Pasuruan. The sample was 53 respondents taking by consecutive sampling technique. The data were tested using Kendall Tau correlational with a significant level of <0.005. The test results showed a relationship between the GCS Initial Score and the Outcome in Head Injury Patients with a value of p = 0.00 <0.05, a correlation value of 0.402 which means that there positive close Â relationship, every time there is a decrease in GCS, the TRISS value will also decrease. This study's results strengthen the indication of the importance of prompt and appropriate treatment in patients who experience a decrease in GCS at the beginning of trauma.Keywords: trauma sufferers, GCS, TRISS

ASUHAN KEPERAWATAN NYERI AKUT PADA PASIEN DENGAN LOW BACK PAIN MELALUI TEKNIK RELAKSASI OTOT PROGRESIF : NURSING CARE FOR ACUTE PAIN IN PATIENTS WITH LOW BACK PAIN THROUGH PROGRESSIVE MUSCLE RELAXATION TECHNIQUES Hakim, Niken; Zuhroidah, Ida; Sujarwadi, Mokh; Wijaya, Darwis
Jurnal Ilmiah Pamenang Vol. 7 No. 2 (2025): Jurnal Imiah Pamenang (JIP)
Publisher : Stikes Pamenang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53599/jip.v7i2.385

Nyeri punggung bawah (low back pain) adalah keluhan muskuloskeletal yang umum dialami oleh pekerja sektor pertanian akibat postur kerja tidak ergonomis. Penanganan nyeri dapat dilakukan secara farmakologis maupun nonfarmakologis, salah satunya melalui latihan relaksasi otot progresif (LROP).Tujuan penelitian ini adalah mendekskripsikan efektivitas asuhan keperawatan latihan relaksasi otot progresif dalam mengurangi nyeri akut pada pasien low back pain di wilayah pertanian. Penelitian ini merupakan studi kasus dengan pendekatan kualitatif naratif pada satu partisipan petani laki-laki berusia 67 tahun yang mengalami nyeri akut low back pain. Intervensi dilakukan selama 3 hari berturut-turut, edukasi nutrisi tinggi protein, dan terapi farmakologis kolaboratif. Pada hari pertama, skala nyeri tercatat 5 dan dinyatakan belum teratasi. Hari kedua, nyeri menurun menjadi skala 3 dan dinyatakan teratasi sebagian. Hari ketiga, nyeri menurun ke skala 2, dan dinyatakan teratasi sepenuhnya dengan kriteria hasil skala nyeri menurun, pasien tidak tampak meringis, tidak bersikap protekif, tidak tampak gelisah, dan frekuensi nadi normal. Pasien menunjukkan peningkatan kenyamanan dan pemahaman terhadap manajemen nyeri secara mandiri. Kesimpulan: Latihan relaksasi otot progresif efektif menurunkan intensitas nyeri akut pada pasien low back pain. Kombinasi dengan edukasi nutrisi dan dukungan farmakologis mempercepat pemulihan. Abstract Low back pain is a common musculoskeletal complaint experienced by agricultural workers due to non-ergonomic work postures. Pain management can be done pharmacologically or non-pharmacologically, one of which is through progressive muscle relaxation exercises (PMRE). The purpose of this study was to describe the effectiveness of progressive muscle relaxation exercises in reducing acute pain in patients with low back pain in agricultural areas. This study is a case study with a qualitative narrative approach on one male farmer participant aged 67 years who experienced acute low back pain. The intervention was carried out for 3 consecutive days, including high-protein nutrition education and collaborative pharmacological therapy. On the first day, the pain scale was recorded at 5 and was declared unresolved. On the second day, the pain decreased to a score of 3 and was considered partially resolved. On the third day, the pain decreased to a score of 2 and was considered resolved based on the following criteria: decreased pain score, no grimacing, no protective posture, no restlessness, normal pulse rate, and no difficulty sleeping. The patient showed increased comfort and understanding of independent pain management. Conclusion: Progressive muscle relaxation exercises are effective in reducing the intensity of acute pain in patients with low back pain. Combining this with nutritional education and pharmacological support accelerates recovery.

Clean and Healthy Living Behavior to Prevent Acute Respiratory Infection among Farmer's Families Enggal Hadi Kurniyawan; Ahmad Hykal Adlan Zein; Selvia Amelinda Novianti; Ivada Dea Nintiarso; Kholid Rosyidi Muhammad Nur; Dicky Endrian Kurniawan; Alfid Tri Afandi; Ida Zuhroidah
Health and Technology Journal (HTechJ) Vol. 2 No. 4 (2024): August 2024
Publisher : KHD Production

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53713/htechj.v2i4.216

Acute Respiratory Infection (ARI) cases in Indonesia and abroad are still a significant health problem. In Indonesia, ARI ranks first as a cause of death in infants and toddlers, with a mortality rate of around 20-30%. ARI can cause severe breathing difficulties, such as pneumonia, and ARI is also one of the leading causes of death in children under the age of five in developing countries. This study aims to analyze how to improve clean and healthy living behavior to prevent ARI in farmer families. The research method used was a literature review conducted through Google Scholar, PubMed, and Science Direct in the 2019-2024 range. The keywords used in the search for articles were "ARI, Respiratory Disorders," "Unhealthy Living Behavior, Reduced Working Period, Well Ventilated House," and "Farmer, Family". Researchers found ten studies that met the inclusion criteria in the review. Prevention of respiratory tract infections (URI) in farming families involves practicing healthy behaviors, such as washing hands with soap, maintaining environmental hygiene, and avoiding exposure to cigarette smoke. The articles highlight the importance of understanding knowledge and adherence to clean and healthy living behaviors (PHBS) in reducing the risk of ARI. However, therapeutic communication is also essential, through providing clear information and emotional support to change unhealthy behaviors. The article still has obstacles, such as the underutilization of sanitation clinics, which calls for a more intensive and focused therapeutic communication approach to overcome these obstacles. Factors that increase the risk of Acute Respiratory Infection (ARI) include cooking with biogas inside the house, high housing density leading to a lack of sanitation around the house, poor ventilation, heavy workload for farmers, which increases exposure to dust, smoke and toxic gases, intense smoking, lack of access or awareness of the benefits of local sanitation clinics, and lack of awareness of the importance of maintaining environmental sanitation. Nurses are expected to conduct community counseling to improve understanding of clean and healthy behavior in ARI prevention practices among farmers.

Determinants of TB Treatment Failure in Pasuruan: A Mixed-Methods Spatial Study Ida Zuhroidah; Isna Qadrijati; Harsini
NurseLine Journal Vol. 11 No. 1 (2026): May 2026
Publisher : Program Studi Ilmu Keperawatan Universitas Jember

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19184/nlj.v11i2.60040

Introduction: Pulmonary tuberculosis (TB) remains one of the leading causes of death from infectious diseases and poses a serious threat to global health. Indonesia ranks second after India in the TB burden. In Pasuruan City, TB cases continue to increase, indicating a persistent public health problem. Objective: This study aimed to analyze the distribution of pulmonary TB cases and identify factors associated with treatment failure. Method: This study employed a mixed-methods design with a descriptive-analytical approach conducted in Pasuruan City from 2020 to 2024. Distribution of pulmonary TB cases were obtained from secondary data from reports of Pasuruan City Health Office, including TB case reports and treatment outcomes. Primary data were collected from 42 patients with treatment failure using structured questionnaires to assess demographic, clinical, and behavioral factors. In-depth interviews were conducted with 15 purposively selected participants to explore contextual factors influencing treatment adherence. Environmental observations were also performed in high-incidence areas to assess housing density, ventilation, and sanitation conditions. Quantitative data were analyzed using descriptive statistics, Chi-square tests, and binary logistic regression, while qualitative data were analyzed using thematic analysis. Results: TB cases increased from 590 in 2020 to 898 in 2023, with a slight decrease in 2024 (893 cases), while drug-resistant TB remained relatively stable. Cases were concentrated in high-burden areas, including Trajeng, Gadingrejo, and Kebonagung. Non-adherence to medication (OR: 3.2), comorbid diabetes mellitus (OR: 2.1), and limited access to health services (OR: 2.5) were identified as significant risk factors for treatment failure. Family support, economic conditions, and transportation influence patient behavior in adherence to TB treatment. Conclusion: Pulmonary TB in Pasuruan City is increasing and spatially clustered in high-risk areas. Behavioral, clinical, and access-related factors influence treatment failure.

Enhancing Wound Repair With Carica Papaya -Based Formulation: A Pretest-Posttest Control Group Trial Mokh. Sujarwadi; Mukhammad Toha; Ida Zuhroidah; Rondhianto Rondhianto; Dimas Hadi Prayoga; Fatimah Zahra; Nadia Rohmatul Laili
An Idea Health Journal Vol 6 No 01 (2026)
Publisher : PT.Mantaya Idea Batara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53690/ihj.v6i01.652

Background: Natural products are increasingly favored in wound care due to concerns about antibiotic resistance and side effects of synthetic drugs. Carica papaya L., a tropical plant native to Central America and widely grown in Indonesia, contains bioactive compounds with properties essential for tissue repair. This study tests whether a topical Carica papaya formulation speeds up wound healing by measuring granulation and epithelialization. Methods: Using a quasi-experimental design. A total of 50 participants were divided into a control (standard wound care) and a treatment group (standard care + C. papaya extract). Analysis used the Paired T test. Result: Paired t-tests indicated no significant changes in the control group (p = 1.00). In contrast, the treatment group demonstrated statistically significant improvements in granulation (pre: 0.44 ± 0.51; post: 1.56 ± 0.51; t = -9.35, p < 0.001) and epithelialization (pre: 0.68 ± 0.47; post: 1.72 ± 0.46; t = -10.25, p < 0.001). Independent-samples t-tests confirmed significant differences between groups after the intervention (granulation: t = -9.35, p < 0.001; epithelialization: t = -10.25, p < 0.001). These results support the incorporation of C. papaya extract into evidence-based complementary wound management protocols. Conclusion: Carica papaya extract significantly enhances wound healing, promoting granulation and epithelialization. Thus, it may serve as an effective adjunctive therapy in clinical wound management.

Asuhan Keperawatan Pola Napas Tidak Efektif (Asma Bronkial) dengan Teknik Diaphragmatic Breathing Exercise di RSUD dr. R. Soedarsono Ghefira Amajida; Ida Zuhroidah; Bagus Dwi Cahyono
Jurnal Vokasi Kesehatan Vol 4 No 2 (2025)
Publisher : Gayaku Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58222/juvokes.v4i2.1445

Pola napas tidak efektif menjadi permasalahan yang erat kaitannya dengan asma bronkial di dunia hingga saat ini. Upaya pengembangan intervensi keperawatan pada pasien asma bronkial terus dilakukan untuk memperbaiki fungsi respirasi. Penelitian ini bertujuan untuk mendeskripsikan asuhan keperawatan pada pasien dengan pola napas tidak efektif akibat asma bronkial. Desain penelitian yang digunakan adalah studi kasus deskriptif eksploratif pada seorang pasien rawat inap dengan diagnosa medis asma bronkial di RSUD dr. R. Soedarsono. Intervensi yang diberikan adalah diaphragmatic breathing exercise (DBE), yaitu latihan pernapasan dengan mengoptimalkan gerakan diafragma guna meningkatkan ventilasi paru. Intervensi dilakukan selama tiga hari berturut-turut dengan durasi 10 menit setiap sesi dan disertai pemantauan frekuensi pernapasan, saturasi oksigen, serta suara napas. Hasil penelitian menunjukkan adanya perbaikan berupa penurunan RR dari 25x/menit menjadi 21x/menit, peningkatan SpO₂ dari 94% menjadi 99%, dan berkurangnya wheezing. Penerapan DBE secara rutin dan terstruktur bermanfaat dalam menangani pola napas tidak efektif pada pasien asma bronkial dan dapat dijadikan intervensi keperawatan untuk mendukung pemulihan fungsi respirasi secara optimal.

Alpha and theta wave activation through pure crystal vibration on reducing anxiety in post-stroke patients with sleep disorders Ida Zuhroidah; Mokh. Sujarwadi; Mukhammad Toha
Nursing and Health Sciences Journal (NHSJ) Vol. 5 No. 2 (2025): June 2025
Publisher : KHD-Production

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53713/nhsj.v5i2.505

Post-stroke patients often experience anxiety and sleep disorders that can hinder the recovery process. Improvement in sleep quality increases with decreasing anxiety; activation of alpha and theta waves can reduce anxiety. This study evaluates the effectiveness of pure crystal vibration waves in activating alpha and theta waves in decreasing anxiety, which has implications for improving sleep quality in post-stroke patients. This study used a quasi-experimental design with a pretest-posttest control group design. The sample consisted of 30 post-stroke patients divided into two groups. Pure crystal vibration wave therapy intervention was given 30 minutes per day for 2 weeks in the treatment group; the control group was not given intervention. Anxiety was measured using the Hamilton Anxiety Rating Scale (HARS), and sleep quality was calculated using the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using paired t-tests and independent t-tests. There was a significant decrease in anxiety scores (p = 0.001) and an increase in sleep quality (p = 0.001) in the intervention group compared to the control group. The frequency of pure crystal vibration waves effectively activates alpha and theta waves to indicate decreased anxiety, which has implications for improving the sleep quality of post-stroke patients.

Effect of a nurse-led four-pillar diabetes management program on HbA1c in adults with type 2 diabetes Ida Zuhroidah; Mokh. Sujarwadi; Mukhammad Toha; Nurfika Asmaningrum; Dimas Hadi Prayoga; Nadia Rohmatul Laili; Fatimah Zahra
Nursing and Health Sciences Journal (NHSJ) Vol. 6 No. 2 (2026): June 2026
Publisher : KHD-Production

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53713/nhsj.v6i2.668

The relative contributions of individual components of multimodal diabetes management to glycemic control remain unclear in real-world primary care settings. This observational pre–post study enrolled 100 adults with type 2 diabetes in a 12-week, nurse-led four-pillar program integrating patient education, physical activity guidance, dietary counseling, and medication adherence monitoring. Multiple linear regression examined the simultaneous associations between behavioral predictors and changes in HbA1c (ΔHbA1c). Mean HbA1c reduction was 2.72 ± 1.25% (95% CI: 2.48–2.96), exceeding the clinically meaningful threshold (>0.5%). The regression model was statistically significant (F(4,95) = 5.16; p = 0.0008; R² = 0.178). Medication adherence independently predicted ΔHbA1c (unstandardized B = 0.327; standardized β = 0.216; p = 0.023), whereas diabetes knowledge, physical activity, and dietary adherence were non-significant (p > 0.05). A structured, nurse-coordinated four-pillar program achieved substantial short-term glycemic improvement among adults with type 2 diabetes, with medication adherence emerging as the strongest behavioral predictor. While comprehensive, multidimensional care remains essential for sustainable self-management, systematic adherence monitoring may optimize metabolic outcomes in routine clinical practice. Causal inference is limited by the observational pre–post design and potential residual confounding; future randomized controlled trials with extended follow-up and objective adherence measures are warranted to clarify component-specific effects and long-term sustainability

Clean and Healthy Living Behavior to Prevent Acute Respiratory Infection among Farmer's Families Enggal Hadi Kurniyawan; Ahmad Hykal Adlan Zein; Selvia Amelinda Novianti; Ivada Dea Nintiarso; Kholid Rosyidi Muhammad Nur; Dicky Endrian Kurniawan; Alfid Tri Afandi; Ida Zuhroidah
Health and Technology Journal (HTechJ) Vol. 2 No. 4 (2024): August 2024
Publisher : KHD Production

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53713/htechj.v2i4.216

Acute Respiratory Infection (ARI) cases in Indonesia and abroad are still a significant health problem. In Indonesia, ARI ranks first as a cause of death in infants and toddlers, with a mortality rate of around 20-30%. ARI can cause severe breathing difficulties, such as pneumonia, and ARI is also one of the leading causes of death in children under the age of five in developing countries. This study aims to analyze how to improve clean and healthy living behavior to prevent ARI in farmer families. The research method used was a literature review conducted through Google Scholar, PubMed, and Science Direct in the 2019-2024 range. The keywords used in the search for articles were "ARI, Respiratory Disorders," "Unhealthy Living Behavior, Reduced Working Period, Well Ventilated House," and "Farmer, Family". Researchers found ten studies that met the inclusion criteria in the review. Prevention of respiratory tract infections (URI) in farming families involves practicing healthy behaviors, such as washing hands with soap, maintaining environmental hygiene, and avoiding exposure to cigarette smoke. The articles highlight the importance of understanding knowledge and adherence to clean and healthy living behaviors (PHBS) in reducing the risk of ARI. However, therapeutic communication is also essential, through providing clear information and emotional support to change unhealthy behaviors. The article still has obstacles, such as the underutilization of sanitation clinics, which calls for a more intensive and focused therapeutic communication approach to overcome these obstacles. Factors that increase the risk of Acute Respiratory Infection (ARI) include cooking with biogas inside the house, high housing density leading to a lack of sanitation around the house, poor ventilation, heavy workload for farmers, which increases exposure to dust, smoke and toxic gases, intense smoking, lack of access or awareness of the benefits of local sanitation clinics, and lack of awareness of the importance of maintaining environmental sanitation. Nurses are expected to conduct community counseling to improve understanding of clean and healthy behavior in ARI prevention practices among farmers.

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