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Journal of Epidemiology and Public Health
Published by Universitas Sebelas Maret
ISSN : 25490273     EISSN : 25490273     DOI : -
Core Subject : Health,
Public Health
Background: Increased blood pressure for a long time can increase the risk of kidney failure, co­ronary heart disease, brain damage, and other di­seases. In 2019, it is estimated that hyper­tens­ion is experienced by 1.13 billion people in the world with most (two thirds) living in low and mid­­dle income countries. Other study also shows that the police and military are at risk of develop­ing hypertension due to a number of factors such as low know­led­ge about healthy and nutritious food, co-workers who are smokers, and consum­ing alco­hol. This study aimed to analyze the risk factors for hypertension in the police and military in the world using meta analysis. Subjects and Method: This was a meta-ana­lysis and systematic review. The articles used we­re obtained from Google Scholar, Springer Link, Pro­­Quest, and Science Direct databases. Selected arti­cles published from 2000 to 2020. Keywords to search for articles are as follows: hypertension po­lice personnel and military, or hypertension po­lice personnel and military. The articles studi­ed are 3 full text articles with cross sectional stu­dy designs and 1 full text articles with case cont­rol study design. Articles are col­lect­ed using PRI­S­­­MA diagrams, and analy­zed us­ing the Re­vi­ew Ma­nager application 5.3. Results: Overweight (aOR= 1.42; 95% CI = 1.01 to 2.00; p= 0.04), alcohol consumption (aOR­=­ 1.­55; 95% CI= 1.12 to 2.12; p= 0.007), ciga­rette con­­­­sumption (aOR= 1.45 ; 95% CI= 1.06 to 1.97; p= 0.020) is a risk factor for hyper­­­tension in the po­­­lice and military. Conclusion: Overweight, alcohol consump­tion, and cigarette consump­tion, are risk fac­tors for hypertension in po­lice and military personnel.
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Articles 24 Documents
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Search results for , issue "Vol. 8 No. 4 (2023)" : 24 Documents clear
Trend and Epidemiology of Tetanus in Nasarawa State, Nigeria: A Five Years Review Ibrahim, Hassan Ikrama; Oyeleke, Bello Surajudeen; Eselema, Odonye Caleb; Abdulmumuni, Lawal; Solomon, Audu Esther; Chidi, Anazodo Michael
Journal of Epidemiology and Public Health Vol. 8 No. 4 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2023.08.04.09

Abstract

Background: Tetanus is a vaccine preventable, non-communicable disease known as lockjaw and characterized by muscle spasm. It is a forgotten disease in the developed world but remained an infection of public health importance in the developing countries. This study aimed to determine the trend in its epidemiology and outcome in Nasarawa state. Subjects and Method: A retrospective study using secondary data from the medical records of three selected health facilities, one each across the three senatorial zones of the state. All those who had tetanus were included while those with incomplete records, 5 were excluded. Data analysis was done using a statistical package for social sciences version 23. The dependent variable was the outcome of tetanus while the independent variables were incubation period, onset period, type of tetanus, risk factors, vaccination history, and manifestations of tetanus. Results: The subject consists of 53.8% males and single with age (Mean=15; SD=6.90). Four and 17 days were the shortest and longest incubation periods while one and six days were the shortest and longest onset periods respectively. A total of 24 (93.3%) patients had generalized tetanus. Nail puncture, road traffic accidents, and umbilical infection were the commonest sources of post-neonatal and neonatal tetanus in this study. Spasm is the commonest manifestation, present in 19 (73.1%) of the study population. This is closely followed by trismus in 57.7% of the cases. About half have a positive vaccination history. This study found case fatality of 7.7%. Conclusion: Generalized tetanus was the commonest type seen in this study, while nail puncture, road traffic accident and umbilical infection were the most common sources of infection. Although, more than half of the study subjects received immunization to prevent tetanus, the case fatality in this study was in one in twelve sufferers. Keywords: Epidemiology, review, tetanus, trend. Correspondence:Bello Surajudeen Oyeleke. Department of Paediatrics Dalhatu Araf Specialist Hospital. Shendam Road, PMB 07, Lafia, Nasarawa State. Email: surajudeenbello4@gmail.com. Mobile: +2347064641540.
Vaccination in the Time Of COVID-19: Survey Study at the University of Tlemcen in the Spring of 2022 Zatla, Ilyes; Boublenza, Lamia; Zair, Soumia; Diab, Nesrine
Journal of Epidemiology and Public Health Vol. 8 No. 4 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2023.08.04.02

Abstract

Background: The novel human coronavirus SARS-CoV-2 causing COVID-19 with symptoms ranging from the common cold to pneumonia, has been responsible for the current health crisis, it has spread rapidly at record speed leaving many deaths of different ages and different ethnicities, and in order to stop this propagation, scientists rushed to create several efficient vaccines against this virus, and despite being marketed in all countries of the world, opinions diverged between supporters and opponents. This prompted us to carry out this survey study on vaccination against COVID-19 at the University of Tlemcen, with the aim of exploring the perceptions and opinions of participants on vaccination and vaccines in general. Subjects dan Method: A cross-sectional study was conducted over a two months period, using a questionnaire to collect data from Teachers and Students of the University of Tlemcen with a 382 calculated sample size, the survey was shared via email and social media networks. Variables of interest included exposure to the pathogen, the laboratory testing results, effectiveness and adherence to the preventive measures, while also monitoring the vaccine acceptance and hesitancy. Descriptive and statistical analysis were run on SPSS Statistics with a p-value <0.050. Results: The majority of respondents for this study belonged to young people of the female gender (37.4%), despite the latter, men were the most vaccinated (53.4%), fortunately, most of them also acknowledge the association between prevention and vaccination (94.6%). Conclusion: Vaccine reluctance is a huge problem in the face of a pandemic that is not yet over. Even with the availability of vaccines and vaccination campaigns, unexplained fear due to rumors and conspiracy theories on social media still wins over the public about the safety of these vaccines. Keywords: COVID-19, SARS-CoV-2, investigation, vaccination, University of Tlemcen. Correspondence:Ilyes Zatla. Laboratory of Microbiology applied to the Food industry, Biomedical and the Environment, Faculty of Natural and Life Sciences, Earth and Universe Sciences. Department of Biology. University of Tlemcen, Algeria. E-mail: ilyes.zatla@univ-tlemcen.com. Mobile: +213540315422.
Meta Analysis – Effect of Occupational Noise on the Risk of Hypertension and Noise Induced Hearing Loss in Industrial Workers Salamah, Ila Izzatus; Sumardiyono, Sumardiyono; Murti, Bhisma
Journal of Epidemiology and Public Health Vol. 8 No. 4 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2023.08.04.01

Abstract

Background: Noise is defined as sound intensity that is unwanted and can pose risks to health and safety at work, such as the risk of hypertension and noise-induced hearing loss. This study aims to analyze the effect of occupational noise on the risk of hypertension and noise induced hearing loss in industrial workers.Subjects and Method: A systematic review and meta-analysis was carried out using the PRISMA guidelines and the PICO model. Population: industrial workers. Intervention: occupational noise exposure ≥85 dB. Comparison: occupational noise exposure <85 dB. Outcome: hypertension and noise induced hearing loss. Articles are collected from PubMed, Science Direct, and Google Schoolar. The keywords used “occupational noise and hypertension” OR “occupational noise and hearing loss” AND “occupational noise” OR “hypertension” AND “hearing loss” AND “cross sectional study”. A total of 13 articles met the inclusion criteria, namely primary full text paper, cross-sectional study design, with a relationship size adjusted Odds Ratio (aOR), labor research subjects, interventions in the form of exposure to noise ≥85 dB and outcomes in the form of hypertension and noise induced hearing loss for meta-analyses were then assessed using RevMan 5.3.Results: Meta-analysis included 13 cross sectional studies from China, Brazil, Ethiopia, Jordan, South Africa, Thailand, Kuwait, and Pakistan. Occupational noise ≥85 dB significantly increased the risk of hypertension (aOR= 2.07; 95% CI= 1.31 to 3.26; p= 0.002) and hearing loss (aOR= 1.97; 95% CI= 1.36 to 2.85; p= 0.003) than occupational noise <85 dB.Conclusion: Occupational noise ≥85 dB increases the risk of hypertension and hearing loss in industrial workers. Keywords: occupational noise, hypertension, hearing loss, workers Correspondence:Ila Izzatus Salamah. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: ilaizzatus31@gmail.com. Mobile: +62858868132490.
Meta-Analysis: Effects of Lession and Exposed to Risk Factor on Leptospirosis Infection Wicaksono, Satriyo Fajar; Rahardjo, Setyo Sri; Murti, Bhisma
Journal of Epidemiology and Public Health Vol. 8 No. 4 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2023.08.04.03

Abstract

Background: Leptospirosis is a zoonotic disease that occurs due to interactions between agents, hosts, and the environment. Leptospira bacteria can infect humans through wounds on the skin and mucosa of the body. This study aims to examine the effect of injury history and contact risk factors on the incidence of leptospirosis by using meta-analysis. Subjects and Method: This was a systematic review and meta-analysis study carried out using the PICO model. P: Adults. Intervention: injury and contact. Comparison= no injuries and no contact with risk factors. Outcome: Leptospirosis. The meta-analysis was conducted by systematically reviewing articles from Google Scholar, PubMed, Springer Link, and Science Direct. Search keywords “Wound OR Lession AND Leptospira”, “Risk Factor Exposure AND Leptospira”, “Risk Factor AND Leptospira AND adjusted odds ratio”. The inclusion criteria used were full paper articles from 2002-2022 using Indonesian and English. The study design used was observational and the analysis used multivariate adjusted odds ratio results. Articles were collected using the PRISMA diagram and analyzed using the Review Manager 5.3 application. Results: Meta-analysis included 22 cross-sectional and case-control studies from Indonesia, India, Iran, Sri Lanka, Malaysia, Thailand, Laos, France, Germany, Kenya, Tanzania, Australia, Fiji, British Virgin Islands, Mexico, Jamaica, Peru, and Argentina. Leptospirosis increased with history of injury (aOR= 3.51; 95% CI= 2.94 to 4.19; p<0.001) and contact with risk factors (aOR=1.82; 95% CI=1.25 to 2.65; p=0.002). Conclusion: History of injury and contact with risk factors increases the risk of developing Leptospirosis. Keywords: history of injury, contact risk factors, leptospirosis, meta-analysis Correspondence:Satriyo Fajar Wicaksono. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: dr.satriyofw@student.uns.ac.id. Mobile: +6285641711987.
Meta-Analysis: Effects of Exposure to Tobacco Smoke and Malnutrition on the Risk of Pneumonia in Children Minawati, Atika Dwi; Murti, Bhisma; Prasetya, Hanung
Journal of Epidemiology and Public Health Vol. 8 No. 4 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2023.08.04.04

Abstract

Background: Exposure to tobacco smoke (ETS) and poor nutritional status affect the risk of pneumonia in children. The purpose of this study was to analyze and estimate the effect of exposure to tobacco smoke and nutritional status in children on the risk of pneumonia. Subjects and Method: The meta-analysis was carried out using the PRISMA flowchart and the PICO model. Population: children under five. Intervention: exposure to tobacco smoke and poor nutritional status. Comparison: no exposure to tobacco smoke and no malnutrition status. Outcome: Pneumonia. The online databases used are Google Scholar, PubMed, and Scient Direct with the keywords “Pneumonia” AND “Exposure to tobacco smoke” AND “Poor nutritional status” AND “Children under five years” AND “Multivariate” AND “Cross-sectional”. The inclusion criteria were full-text, cross-sectional study, and published in English. The data were analyzed by RevMan 5.3. Results: A meta-analysis included 14 cross-sectional studies from Hong Kong, Nepal, Mongolia, Morocco, Uganda, Cameroon, Ethiopia, Nigeria, Egypt, and China. The total sample was 52,863 children under five. The results of the meta-analysis showed that exposure to tobacco smoke was 2.08 times more at risk of developing pneumonia than children under five who were not exposed (aOR=2.08; Cl 95%=1.30 to 3.32; p= 0.002). The presence of poor nutritional status is 2.00 times more at risk of experiencing pneumonia than children under five with no malnutrition status. (aOR=2.00; 95% Cl=1.31 to 3.06; p= 0.001). Conclusion: Exposure to tobacco smoke and poor nutritional status in toddlers can increase the risk of pneumonia. Keywords: exposure to tobacco smoke, poor nutritional status, children under five years pneumonia. Correspondence:Atika Dwi Minawati. Master’s Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Jawa Tengah, Indonesia. Email: dwiminawatiatika@gmail.com. Mobile: +625212613303.
Meta-Analysis of the Effect of Prolonged Use of High Heels on Low Back Pain in Female Sales Employees Firmanurulita, Fadhila; Kristiyanto, Agus; Prasetya, Hanung
Journal of Epidemiology and Public Health Vol. 8 No. 4 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2023.08.04.06

Abstract

Background: Low Back Pain is the pain that is felt from the lower back area to the lower buttocks crease area (Gluteal inferior fold). One of the causes of Low Back Pain is a prolonged and excessive use of high heels. This study aims to analyze and estimate the effect of the use of high heels on Low Back Pain in sales promotion girls. Subjects and Method: Meta-analyses were carried out according to the PICO model. Population: female sales promotion employee. Intervention: Wearing High Heels. Comparison: Not using High Heels. Outcome: Low Back Pain. The article search in this study was conducted through databases that included PubMed, Google Schoolar, ScienceDirect. The keywords included: "Low Back Pain" AND "Low Back Pain" AND "High Heels" AND "Low Back Pain" "Employee sales" AND "High Heels" "Sales Low Back Pain" (aOR) "Employee sales" And "Employe sales" "Low Back Pain" AND "High Heels" AND "Employe sales", "High Heels AND High Heels" "Low Back pain Employee Sales" AND "High Heels". Full-paper articles with cross-sectional study design. The subjects of the study were users of high heels toward low back pain, the measure of association used was the adjusted odd ratio. The article selection used was PRISMA flow diagram. The analysis was performed using Revman 5.3 Results: A meta-analyss included 10 cross-sectional studies from Africa and Asia. Prolonged use of high heels increased the risk of low back pain in female sales promotion employee (aOR= 1.41; 95% CI= 1.16 to 1.171 p=0.001). Conclusion: Female sales promotion employee who wear high heels have a higher risk of experiencing low back pain. Keywords: sales promotion girl, high heels, low back pain. Correspondence:Fadhila Firmanurulita. Master’s Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: missdhila18@gmail.com. Mobile. +6285740045026.  
Meta-Analysis of the Effect of Exposure to Indoor Cigarette Smoke in Pregnant Women on the Risk of Infants Low Birth Weight Ramadhani, Dinda Nur Asri Mutiara; Budhiastuti, Uki Retno; Murti, Bhisma
Journal of Epidemiology and Public Health Vol. 8 No. 4 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2023.08.04.05

Abstract

Background: Problems related to low birth weight are often found in developing countries. Expo-sure to cigarette smoke is one of the factors causing low birth weight, in this case caused by the chemicals in cigarettes which affect the health of pregnant women and babies. This study aims to determine the effect of exposure to secondhand smoke in the home on pregnant women on the risk of giving birth to babies with low birth weight. Subjects and Method: This study is a systematic review and meta-analysis using the PRISMA flow chart and the PICO model. Population: pregnant women. Intervention: exposure to household ciga-rette smoke is high. Comparison: household exposure to secondhand smoke is low. Outcome: low birth weight. The databases used are PubMed, Google Scholar, and Science Direct with keywords (“Pregnancy Women” OR “Passive Smoking” OR “Low Birth Weight”) AND “Case Control Study”. A total of 9 articles met the inclusion criteria, namely primary full text paper, case-control design, adjus-ted Odds Ratio (aOR), research subjects of pregnant women, interventions in the form of high cigarette smoke exposure, and outcomes in the form of low birth weight for analysis carried out with RevMan 5.3. Results: A meta-analysis has been carried out on 9 articles with a case-control study design from the Asian Continent and the African Continent in pregnant women with a sample size of 4,244. The results of the meta-analysis showed that pregnant women who were exposed to secondhand smoke from the environment had a risk of giving birth to babies with low birth weight 1.82 times compared to those not exposed to secondhand smoke and the effect of exposure was statistically significant (aOR= 1.82; 95% CI= 1.54 to 2.16; p <0.001). Conclusion: The effects of exposure to cigarette smoke in pregnant women can increase the risk of low birth weight babies. Keywords: passive smokers, low birth weight, pregnant women, babies, Correspondence:Dinda Nur Asri Mutiara Ramadhani. Master’s Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: mutiaradinda42@gmail.com Mobile: +6282323346406
Mortality Risk Factors of COVID-19 Inpatients at Panembahan Senopati Hospital, Bantul, Yogyakarta Wahyuningsih, Christiana Sri; Asih, Esthi Budhi; Vinantika, Ledy; Sulistiani, Ria
Journal of Epidemiology and Public Health Vol. 8 No. 4 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2023.08.04.07

Abstract

Background: COVID-19 Case Fatality Rate (CFR) in Bantul district is 2.64%. This figure is higher than the world CFR reported by WHO of 2.07%. Panembahan Senopati Regional General Hospital is a hospital owned by the Regional Government of Bantul Regency and is one of the COVID-19 referral hospitals. This study aims to determine the characteristics and risk factors for the death of inpatient COVID-19 patients at Panembahan Senopati Hospital. Subjects and Method: This type of study is observational analytic with a retrospective cross-sectional design. This research was carried out from July to September 2021 at Panembahan Senopati Hospital. A total of 289 research subjects were selected in total sampling. The dependent variable is the mortality of COVID-19 patients. The independent variables were age, sex, diabetes mellitus, hypertension, chronic renal failure, heart disease, immunological disorders, and chronic liver failure. The data were analyzed by multiple logistic regression. Results: Risk factors for death in hospitalized COVID-19 patients were age, diabetes mellitus, hypertension, and chronic renal failure. Age ≥60 years was 2.13 times more likely to cause death (OR = 2.13; CI 95% = 1.24 to 3.66; p=0.006). Hospitalized COVID-19 patients with comorbid diabetes Mellitus were 2.31 times more likely to cause death (OR= 2.31; CI 95% =1.30 to 4.12; p=0.004). Hospitalized Covid-19 patients with comorbid hypertension 2.18 times chance of causing death (OR= 2.18; CI95% =1.12 to 4.25; p= 0.021). Hospitalized COVID-19 patients with comorbid chronic renal failure were likely to cause 3.25 times the death rate (OR= 3.25; CI 95%= 1.11 to 9.51; p=0.031). Conclusion: Risk factors for death in hospitalized COVID-19 patients are age, diabetes mellitus, hypertension, and chronic renal failure. Keywords: Hospitalization, death, COVID-19 patients Correspondence:Christiana Sri Wahyuningsih. Nursing and Quality Assurance, Panembahan Senopati Hospital. Jl. Dr. Wahidin Sudiro Husodo, Trirenggo, Bantul, Yogyakarta. Email: anachristi19@gmail.com. Mobile: +6281287783924.
Effects of Chest Physiotherapy and Effective Cough Exercise on Sputum Clearance and Respiratory Frequency in Tuberculosis Patients Windiastoni, Yoga Handita; Basuki, Nur; Haritsah, Nurul Fithriati
Journal of Epidemiology and Public Health Vol. 8 No. 4 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2023.08.04.11

Abstract

Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Chest physiotherapy and cough exercises are one of the commonly used methods as part of TB treatment. This study aimed to determine the effects of chest physiotherapy and cough exercises on sputum clearance and respiratory frequency in TB patients. Subjects and Method: This was a quasy experiment study with no control group. The study was conducted at Dungus Respiratory Hospital, Madiun, East Java. A sample of 26 TB patients was selected purposively. The independent variables in the study were effective cough and chest physiotherapy. The dependent variable in this study was sputum discharge. Chest and cough physiotherapy interventions are effective in patients 3 times. This study used a measuring instrument in the form of a sputum glass. The data collected were analyzed quantitatively using the Mann-Whitney test to determine the effect of chest physiotherapy and effective cough exercises on pulmonary tuberculosis conditions. Results: After combination interventions of chest physiotherapy and effective cough exercises, sputum released (Mean= 29.35; SD= 0.85) was higher than before (Mean= 23.65; SD= 0.68). Respiratory frequency after intervention (Mean= 25.88; SD= 0.73) was higher than before (Mean= 27.12; SD= 0.98). Conclusion: Sputum secretion and respiratory frequency are higher than before chest physiotherapy and cough exercises in TB patients. Keywords: chest physiotherapy, cough exercise, physiotherapy, tuberculosis. Correspondence:Nurul Fithriati Haristah. Study Program of Physiotherapy, Health Polytechnics, Ministry of Health Surakarta. Email: nurulfithriati_haritsa@yahoo.com. Mobile: +6285157577816.  
Associations between Parenting Style and Nutritional Knowledge on Stunting in Children Aged 24-60 Months in Ketang Health Center, East Nusa Tenggara, Indonesia Erick, Heribertus Handi
Journal of Epidemiology and Public Health Vol. 8 No. 4 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2023.08.04.12

Abstract

Background: Stunting is a condition of children under five with a z-score of less than -2 standard deviation (stunted) and less than -3 standard deviation (severely stunted). Interventions to accelerate stunting prevention require intervention and coaching, such as knowledge and parenting of toddlers in the community. This study aimed to determine the relationships between knowledge, and stunting in children aged 24-60 months.Subjects and Method: This was a retrospective cross-sectional study conducted in the Ketang Health Center, East Nusa Tenggara, Indonesia. A total of 60 children aged 24-60 months and their mothers was selected using purposive sampling. The independent variables were parenting and nutritional knowledge. The dependent variable was stunting. The instruments of this study were height measurement tools, knowledge, and parenting questionnaires. The data were analyzed using multiple logistic regression.Results: Children who have mothers with poor parenting are 0.15 times more stunted than mothers with good parenting. Nutrition knowledge is 0.04 times less likely to be stunted than mothers with good nutrition knowledge.Conclusion: Mothers with poor parenting and nutritional knowledge increase the risk of stunting. Keywords: Nutritional knowledge, parenting, stunting. Correspondence:Heribertus Handi. Nursing Study Program, Universitas Katolik Indonesia Santu Paulus Ruteng. Jl. Jenderal A. Yani No. 10, Langke Rembong, East Nusa Tenggara. Email: herihandi84@gmail.com. Mobile: 085236119205.

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