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The Effect of Organizational Culture and Internal Supervision on the Performance of Health Workers Harefa, Karnirius
JURNAL KEPERAWATAN DAN FISIOTERAPI (JKF) Vol. 7 No. 2 (2025): Jurnal Keperawatan dan Fisioterapi (JKF)
Publisher : Fakultas Keperawatan dan Fisioterapi Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/arxdpw94

Abstract

Background: Health worker performance is a key element in the success of primary healthcare services at Puskesmas. A strong organizational culture and effective internal supervision are believed to enhance motivation, productivity, and service quality among health workers. Objective: This study aims to analyze the effect of organizational culture and internal supervision on the performance of health workers at Bandar Khalifah Health Center, Percut Sei Tuan District. Methods: This research employed an analytical quantitative approach with a cross-sectional design. The population consisted of all active health workers (n=58), selected through total sampling. Data were collected via structured questionnaires and analyzed using Spearman correlation and multiple logistic regression. Results: Findings indicated that organizational culture and internal supervision simultaneously had a significant influence on health worker performance (p<0.05), explaining 63.7% of performance variation. Organizational culture showed a greater effect (Exp(B)=5.66) compared to internal supervision (Exp(B)=3.64). Conclusion: Positive organizational culture and structured internal supervision significantly improve health worker performance. It is recommended that management enhance teamwork values, provide leadership training, and ensure consistent, participative supervision practices.
The Effect of Transformational Leadership Style and Interpersonal Competence on Work Motivation of Health Workers Harefa, Karnirius
JURNAL KESMAS DAN GIZI (JKG) Vol. 7 No. 2 (2025): Jurnal Kesmas dan Gizi (JKG)
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/sm58k627

Abstract

Background: Community Health Centers (Puskesmas) play a crucial role in providing basic health services. However, the work motivation of health workers is often affected by high workloads, limited infrastructure, and the complexity of cases handled. Objective: This study aimed to analyze the influence of transformational leadership style and interpersonal competence on the work motivation of health workers at Bandar Khalifah Health Center, Percut Sei Tuan District. Research Methods: A quantitative approach with a correlational design was used. A total of 40 health workers were selected using a total sampling technique. Data were collected through a Likert-scale questionnaire and analyzed using Pearson correlation and multiple linear regression with SPSS software. Results:The results showed a significant positive influence between transformational leadership style and work motivation (r = 0.650; p < 0.05) as well as between interpersonal competence and work motivation (r = 0.680; p < 0.05). Regression analysis indicated that transformational leadership (? = 0.480; p = 0.000) and interpersonal competence (? = 0.420; p = 0.004) significantly contributed to improving health workers' work motivation.Conclusion:Transformational leadership style and interpersonal competence significantly influence the improvement of health workers' work motivation. Strengthening these factors is recommended to enhance performance and the quality of health services.
Butterfly Pea and Roselle Combination Extracts Reduce V-CAM, ICAM, and IL-6 Levels in High Fat Atherogenic Diet Rats Harefa, Karnirius; Ritonga, Ahmad Hafizullah; Safitri, Riri; Aritonang, Barita; Gurusinga, Rahmad; Irmayani, Irmayani; Wulan, Sri
The Indonesian Biomedical Journal Vol 16, No 6 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i6.3361

Abstract

BACKGROUND: Atherosclerosis, driven by inflammation and oxidative stress, increases the risk of coronary heart disease (CHD). Flavonoids in butterfly pea and roselle are known for their potent antioxidant and anti-inflammatory properties. While their individual effects on cardiovascular health have been studied, no studies have explored the combined impact on atherosclerosis biomarkers, including vascular cell adhesion molecules (VCAM)-1, intercellular adhesion molecule (ICAM)-1, and interleukin (IL)-6. Therefore, this study was performed to evaluate the synergistic effects of butterfly pea and roselle combination extracts (BPRCE) on these biomarkers.METHODS: A study with a post-test control group design using 36 male white rats was performed. The rats were randomly assigned to 6 groups; 1 group was fed with standard feed, while 5 groups were fed with a high-fat atherogenic diet (HFAD) to create atherosclerosis rat models. The HFAD rats were given either no treatment, sodium carboxymethylcellulose (Na-CMC), 300, 400, or 500 mg/kgBW BPRCE. Serum levels of VCAM-1, ICAM-1, and IL-6 of rats were measured using enzyme-linked immunosorbent assay (ELISA) methods.RESULTS: Increasing doses of BPRCE resulted in a significant reduction in VCAM-1, ICAM-1, and IL-6 compared to the other groups. The group with the highest dose, 500 mg/kgBW BPRCE, showed the greatest reduction of VCAM-1 level (32.73±3.57 pg/mL), ICAM-1 level (5.68±1.17 ng/mL), and IL-6 levels (21.49±4.62 pg/mL).CONCLUSION: Administration of BPRCE in atherosclerosis rats model reduces VCAM-1, ICAM-1, and IL-6 in a dose-dependent manner. This study showed that using BPRCE as a traditional remedy for preventing and treating CHD at an optimal dose of 500 mg/kgBW might be a potential future application in reducing atherosclerosis biomarkers.KEYWORDS: VCAM-1, ICAM-1, IL-6, butterfly pea, rosella, atherosclerosis
Differences In The Results Of Examination Of Blood Glucose Levels By The Point Of Care Test (Poct) Method Using Vein And Capillary Blood Samples In Type II Diabetes Mellitus Patients Simamora, Artha; Harefa, Karnirius
Medistra Medical Journal (MMJ) Vol 1 No 1 (2023): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/mmj.v1i1.1948

Abstract

Glucose is an aldohexose monosaccharide found in the human body and other living things. It is the end product of carbohydrate metabolism that is released into the blood and becomes the main energy source of living things. Because of its role as the main energy, glucose is then transported into cells for generate energy. This energy formation process occurs in the mitochondria by requiring oxygen as fuel to produce ATP as energy for every cell activity. Blood glucose is influenced by factors of nutritional status, genetics and age, and disease. This study determine to differences in blood glucose levels measured using venous blood and capillary blood samples. This study used an analytical observational research design with a cross sectional approach. Observational research, which is to find differences between independent variables and dependent variables whose analysis is to determine whether there are differences between variables, so it is necessary to develop a hypothesis. Based on the results of the analysis of this study, it was found that from 25 respondents, the average value of capillary blood was 192.76, with a standard deviation of 56,302, with a min value of 111 and a max value of 288, with a p value of 0.007. The mean difference in venous blood is 186.44, with a standard deviation of 55.586, with a min value of 114 and a max of 280, with a p value = 0.007 with a significance level of p<? (0.05) which is 0.007<0.05. Based on the results of the study, it can be concluded that there are differences in the results of blood glucose levels using the POCT (Point Of Care Test) method using venous blood and capillary blood samples at Grandmed Lubuk Pakam Hospital
Effect Of Emotional Freedom Technique On Pre Percutaneous Coronary Intervention Patients' Anxiety In Hospital Syara, Arfah May; Gandaria Purba, Anita Sri; Harefa, Karnirius
JURNAL KEPERAWATAN DAN FISIOTERAPI (JKF) Vol. 5 No. 2 (2023): Jurnal Keperawatan dan Fisioterapi (JKF)
Publisher : Fakultas Keperawatan dan Fisioterapi Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/jkf.v5i2.1259

Abstract

Coronary heart disease is a degenerative disease. One of the techniques that can open blood vessels and return blood through the coronary arteries is Percutaneous Coronary Intervention (PCI). Hemodynamic conditions are one of the patient's preparations for PCI, but anxiety can respond to the cardiovascular system, one of which is a disturbance in a person's hemodynamics. Problems that often arise in pre PCI patients are anxiety.Percutaneous Coronary Intervention is one of the techniques that have been invented to open the blood vessels and return blood through the coronary arteries (PCI). PCI, also known as cardiac catheterization, is a procedure that involves inserting one or more catheters into the heart and blood arteries. The catheter is inserted through a peripheral vessel, usually femoral, then non-operatively invasive so that complications can be kept as low as possible. Percutaneous Coronary Intervention (PCI) can cause complications in the form of myocardial infarction, stroke, arrhythmia and death. This causes a person to feel himself threatened, someone feels himself threatened can cause the effect of Anxiety (anxiety). The problem that often arises in pre PCI patients is anxiety. One of the efforts to overcome anxiety is the Emotional Freedom Technique (EFT). This type of research is a quantitative study using a quasi-experimental design with a pretest-posttest with a control group, namely by conducting a pretest in both groups and followed by an intervention in the experimental group and then conducting a posttest in both groups, with a sample of 34 respondents. The results showed that the effect of EFT on the anxiety of pre PCI patients in the intervention group with p-value = 0.000, while in the control group with p-value = 0.650. Furthermore, it is hoped that clients who will undergo PCI will not be hindered from doing PCI because the client has been given Emotional Freedom Technique (EFT) therapy.
The Effect of Motor Relearning Program on Daily Living Activity and Dynamic Balance in Non-Hemorrhagic Post Stroke Hemiparese Patients at Grandmed Lubuk Pakam Hospital Jehaman, Isidorus; Br Siagian, Khairunnisa; Bintang, Siti Sarah; Ginting, Raynald Ignasius; Ginting, Rosita; Harefa, Karnirius
JURNAL KEPERAWATAN DAN FISIOTERAPI (JKF) Vol. 6 No. 1 (2023): Jurnal Keperawatan dan Fisioterapi (JKF)
Publisher : Fakultas Keperawatan dan Fisioterapi Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/jkf.v6i1.1887

Abstract

Stroke is a functional disorder of the brain that can occur suddenly or abruptly with focal or global neurological signs that can last 24 hours or more (if no surgery or death occurs) without any signs of non-vascular causes, which include signs of subarachnoid hemorrhage, intracerebral hemorrhage, ischemia or cerebral infarction. This can cause disturbances in vital brain functions such as coordination disorders, balance disorders, posture control disorders, sensation disorders and movement reflex disorders, thereby reducing the ability to carry out daily living activities and balance disorders. The motor relearning program method is a program for retraining specific motor controls by avoiding unnecessary or wrong movements that involve cognitive processes, the application of motor and psychological science, training, understanding of nervous anatomy and physiology and is not based on the theory of normal development (neuro development). The research aims to determine the effect of the motor relearning program on daily living activities and dynamic balance disorders in post-stroke patients. The method used in this research is a quasi experiment with one group pretest and post test design. The research sample consisted of 9 people. The samples will be observed and adjusted to the specified criteria so that they do not cause problems. Each respondent was measured 2 (two) times, namely before and after the intervention. Test the hypothesis using the Wilcoxon test. The research results obtained a value of p = 0.000 (p=<0.05), which means there is a significant influence of the motor relearning program intervention on daily living activities and dynamic balance disorders in post-stroke patients. The results of this research can be concluded that the motorbike relearning program can improve daily living activities and dynamic balance disorders in patients after non-hemorrhagic stroke. It is hoped that the results of this research can contribute to health services for the community in overcoming the problems of daily living activities and dynamic balance disorders in post-stroke patients.
Analysis of the Elderly Class Program in Siumbut Baru Village, Kisaran Timur District Sagala, Erlina Bernadet; Karnirius Harefa; Desideria Yosepha Ginting
JURNAL KESMAS DAN GIZI (JKG) Vol. 8 No. 1 (2025): Jurnal Kesmas dan Gizi (JKG)
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/bgr46e03

Abstract

The Elderly Class Program is a form of non-formal education that aims to improve the quality of life of the elderly through health, social, and empowerment education. This study aims to analyze the implementation of the Elderly Class Program in Siumbut Baru Village, Kisaran Timur District, with a focus on implementation, assistance, obstacles, and its benefits for elderly participants. The method used is descriptive qualitative with data collection techniques through in-depth interviews, observation, and documentation of the head of the health center, cadres, health workers, community leaders, and elderly participants. The results of the study indicate that the program has run according to its objectives, received support from various parties, and its benefits are felt by the elderly, especially in increasing understanding of healthy lifestyles, chronic disease management, and strengthening social functions. However, there are several obstacles such as the limited number of assistants and the inaccuracy of implementation time due to late participants. Routine evaluation and monitoring are carried out by officers and cadres to ensure that the quality of the program is maintained and obstacles can be overcome immediately. In conclusion, the Elderly Class Program in Siumbut Baru Village is an effective community education model, but requires strengthening in terms of human resources and cross-sector support to be more optimal
Analysis of the Relationship between Health Center Management and Service Quality at Pon Village Health Center, Serdang Bedagai Regency in 2024 Manurung, Tetty Grace Manurung; Karnirius Harefa; Novita Br. Ginting Munthe
JURNAL KESMAS DAN GIZI (JKG) Vol. 8 No. 1 (2025): Jurnal Kesmas dan Gizi (JKG)
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/s8hsyn43

Abstract

Background: Health Center Management is a series of planning, organizing, implementing and controlling processes to achieve targets/objectives effectively and efficiently. Objective: This study aims to analyze the relationship between Health Center management and service quality at Pon Village Health Center, Serdang Bedagai Regency. Research Method: This type of research is quantitative research in the form of an analytical survey with a cross-sectional design. Results: The results of the study showed that bivariately all variables, namely planning (P1), implementation (P2) and supervision (P3) had a significant value <0.05. Multivariately based on candidate selection, it was obtained that the three variables were eligible to be included in the multivariate model because the significant value was P <0.25. The final result of the logistic regression obtained that only 2 variables were included in the final regression model, namely implementation (p 0.003) and supervision (p 0.003). And the most related variable is supervision with Exp (B) 55.594. Conclusion: there is a relationship between health center management consisting of planning, implementation and supervision of the quality of service at the Health Center. It is expected that the Head of the Health Center must really carry out a series of management processes, starting from planning, because from the results of the study there were still respondents who answered that the planning was not good, as well as the implementation, even from the results of the study it was found that supervision was not running well at the Pon Village Health Center. For this reason, the Head of the Health Center must increase supervision routinely. So that the management process is really implemented, to achieve maximum service.
Analysis of Factors Influencing the Choice of Non-Hormonal Long-Acting Contraceptive Methods Emi Juniarita Br. Barus; Karnirius Harefa; Ika Nursaputri
JURNAL KESMAS DAN GIZI (JKG) Vol. 8 No. 1 (2025): Jurnal Kesmas dan Gizi (JKG)
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/4ygfp560

Abstract

Background: The Maternal Mortality Ratio (MMR) in Indonesia is still relatively high, with one of the causes being unintended pregnancies. One way to reduce MMR is by increasing the use of long-acting non-hormonal contraceptives (LA/NGCs), such as IUDs and MOWs. Factors influencing the selection of non-hormonal LA/NGCs include attitude, trust, location/distance, spousal support, and healthcare facilities. Objective: This study aims to analyze the factors influencing the selection of non-hormonal long-acting contraceptives (LA/NGCs) in Tanjung Balai District, Asahan Regency, focusing on attitude, trust, location/distance, and the role of healthcare workers. Methods: This study used a quantitative design with a cross-sectional approach. Data were collected through questionnaires distributed to 92 respondents, who were couples of reproductive age (PUS). The variables analyzed include attitude, trust, location/distance, spousal support, and healthcare facility services. The statistical test used was chi-square to examine the relationship between independent and dependent variables (the selection of non-hormonal LA/NGCs). Results: The results showed a significant relationship between attitude, trust, location/distance, and the role of healthcare workers with the selection of non-hormonal LA/NGCs (p < 0.05). Respondents with a positive attitude, trust in healthcare providers, easy access to healthcare facilities, and quality services were more likely to choose non-hormonal LA/NGCs. Conclusion: This study concludes that factors such as attitude, trust, location/distance, and the role of healthcare workers significantly influence the selection of non-hormonal long-acting contraceptives. Therefore, increasing knowledge and improving access to healthcare services is crucial to encourage the selection of these contraceptive methods
The analysis of the factors influencing the awareness of post-operative neurosurgery patients in the ICU of a hospital N.C Sitanggang, Margaretha; Karnirius Harefa; Tati Murni Karo Karo
JURNAL KESMAS DAN GIZI (JKG) Vol. 8 No. 1 (2025): Jurnal Kesmas dan Gizi (JKG)
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/xmqpxm81

Abstract

Background: The Intensive Care Unit (ICU) plays a crucial role in the care of post-surgical neurosurgery patients, as patients with critical conditions require close monitoring. The changes in the consciousness level of post-neurosurgery patients are influenced by various factors, including age, gender, Glasgow Coma Scale (GCS), family support, and teamwork among medical staff. Objective: This study aims to analyze the factors influencing the changes in the consciousness level of post-neurosurgery patients in the ICU of Grandmed Lubuk Pakam Hospital in 2024. Research Method: This study uses a cross-sectional design with primary data collection through observation and direct measurement. The sample consists of 40 post-surgical neurosurgery patients treated in the ICU of Grandmed Lubuk Pakam Hospital. Data were analyzed using univariate, bivariate, and multivariate analysis, employing chi-square tests and logistic regression. Results: The results show that factors such as age, gender, GCS, family support, and teamwork significantly influence the consciousness level of patients. The GCS factor (?8) has the most dominant effect, with an Odds Ratio (Exp(B)) = 5.523, indicating that patients with a low GCS have 5 times the risk of experiencing a decrease in consciousness compared to patients with a higher GCS. Conclusion: Factors such as age, gender, GCS, family support, and teamwork influence the changes in the consciousness level of post-neurosurgery patients. Monitoring GCS and strengthening teamwork, along with family support, can accelerate the recovery of patients' consciousness.
Co-Authors A.Dachi, Rahmat Abdi Lestari Sitepu Agnes Silvina Marbun Ahmad Hafizullah Ritonga Andriani Harianja, Bulan Annisa Nabila Ardianto Saputra Aritonang, Barita Bahdin Nur Tanjung Bancin, Dewi R. Berampu, Sabirin Bintang, Siti Sarah Bintang, Siti Sarah Bintang Sarah Br Siagian, Khairunnisa Brahmana, Netti Etalia Br. Cahayani Zebua, Kristian Chatarina Umbul Wahyuni CHRESNANDO GINTING, JOE Christiani N Daely, Ruth Cut Nurjulianti Dani Hafiz Utomo Daniel Ginting Debi Meilani Desideria Yosepha Ginting Dian Christy Rahayu Dicky Yuswardi Wiratma Dwi Handayani Elisabeth Purba, Ivan Elvida Rahmi Elvida Rahmi Zein Emi Juniarita Br. Barus Evawani Martalena Silitonga Evi Martina, Siska Fikrih Utama, Rezza Frida Lina Tarigan Gandaria Purba, Anita Sri Ginting, Raynald Ignasius Ginting, Rosita Gultom, Rumondang Handayani, Diah Tri Harahap, Fitri Ramadani Harahap, Hasni Yaturramadhan Hariyati Wahyuni Hasibuan, Eva Kartika Helvi Herlina Herlina . Herlina H Herlina Herlina Hestina Hutajulu, Johansen Ihsan Ihsan Ika Nursaputri Irmayani Irmayani Jehaman, Isidorus Junita Karokaro, Tati Murni Kesaktian Manurung Ketaren, Otniel Khairil Akbar Lukman Hakim Manik, Tumpak Rudi Aman Manurung, Tetty Grace Manurung Marbun, Agnes Silvina Marlindawani, Jenny Mestika Lumbantoruan MHD Yoppy Monika Helen Sinaga Myrnawati N.C Sitanggang, Margaretha Nababan, Donal Novita Br. Ginting Munthe Purba, Novandi Rahmad Gurusinga Rahmat Alyakin Dakhi Ramadani Sitepu Rinco Siregar Riri Safitri Ritonga, Tintin Insani Hartuti Rizka Mutiara Rohana, Taruli Romi Syahputra Tarigan Roslianizar, Syarifah Rotua Sumihar Sitorus Rumapea, Fina Sabirin Berampu Sagala, Erlina Bernadet Sari, Yuli Permata Siagian, Mindo Tua Siahaan, Marlinewati Sianturi, Theodora R. Silitonga, Evani Martalena SILITONGA, EVAWANI Simamora, Artha Simarmata, Pratiwi Simson Sinuhaji Sinabutar, Theresia Yuni Florensia Sinaga, Arman Bemby Siregar, Hesti Despita Siti Sarah Bintang Sitorus, Binsar Sitorus, Mido Ester Sri Wulan, Sri Suharyanisa Syamsudin Syara, Arfah May Teja Kesuma Theresia Yuni Florensia Sinabutar Titin Novayanti Dey Togatorop, Lamtiar Betty Ulina Purba, Sri Vierto Winda Alfiana Yosepha Ginting, Desideria Yulia Mehatte