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KESANS : International Journal of Health and Science
Published by Cv.Rifainstitut
ISSN : 28087380     EISSN : 28087178     DOI : https://doi.org/10.54543/kesans.v1i1.2
Core Subject : Health, Science,
Chemistry Health Professions Medicine & Pharmacology Physics Public Health
KESANS : International Journal of Health and Science provides a means for ongoing discussion of the relevant issues that fall within the focus and scope of the journal that can be examined empirically. This journal publishes research articles in the medicine, Nursing, Midwifery, Public Health, Health Technology, Occupational Health and Safety, Pharmacy, and physiotherapy. Articles published are the results of research, studies or scientific studies on important and current issues or scientific book reviews.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 598 Documents
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Risk Factors and Management of Dengue Hemorrhagic Fever (DHF) in Children in 2023–2025: Literature Review) Aullia Auffa Marthadila; Khuliyah Candraning Diyanah
Jurnal KESANS : Kesehatan dan Sains Vol 5 No 8 (2026): KESANS: International Journal of Health and Science
Publisher : Rifa'Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54543/kesans.v5i8.644

Abstract

Introduction: Dengue Hemorrhagic Fever remains a major public health problem in Indonesia, especially among children who are vulnerable to severe complications due to their immature immune systems. Objective: This study aimed to analyze the risk factors and management of Dengue Hemorrhagic Fever in children based on national studies published between 2023 and 2025. Method: This study used a literature review with a descriptive qualitative approach. Articles were collected from Google Scholar, PubMed, and Garuda databases using keywords related to Dengue Hemorrhagic Fever in children. The selection process followed the PRISMA method and resulted in five national journals that met the inclusion criteria. Result and Discussion: The findings showed that the main risk factors included low parental education, poor mosquito nest eradication practices, hanging clothes inside the house, poor nutritional status, and environmental conditions supporting mosquito breeding. Effective management strategies included the implementation of the “3M Plus” program, environmental management, vector control, health education, and early medical treatment through fluid monitoring and shock detection. Conclusions: Collaboration among healthcare workers, families, schools, and communities is important to reduce Dengue Hemorrhagic Fever incidence in children
Determinants of Antihypertensive Medication Adherence among Hemodialysis Patients with Chronic Kidney Disease in Jambi Province, Indonesia Desti Indri Yani; Ummi Kalsum; Willia Novita Eka Rini; Asparian Asparian; Muldiasman Muldiasman; Armaidi Darmawan
Jurnal KESANS : Kesehatan dan Sains Vol 5 No 8 (2026): KESANS: International Journal of Health and Science
Publisher : Rifa'Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54543/kesans.v5i8.645

Abstract

Introduction: Chronic kidney disease patients undergoing hemodialysis commonly experience hypertension requiring long-term antihypertensive therapy. Poor medication adherence may increase complications and mortality. Objective: This study aimed to analyze factors associated with antihypertensive medication adherence among chronic kidney disease patients undergoing hemodialysis in Jambi Province, Indonesia. Method: This analytical observational study used a cross-sectional design. A total of 193 respondents were recruited using consecutive sampling. Data were collected using structured questionnaires, including the Morisky Medication Adherence Scale-8 (MMAS-8), knowledge questionnaire, and family support questionnaire. Data were analyzed using univariate, bivariate, and multivariate logistic regression analyses. Results and Discussion: A total of 53.4% of respondents were non-adherent to antihypertensive medication. Bivariate analysis showed no significant association between independent variables and medication adherence (p>0.05). However, knowledge demonstrated a tendency toward association with adherence behavior. Respondents with good knowledge had 2.44 times higher odds of adherence compared with respondents with poor knowledge (Adjusted OR=2.440; 95% CI: 0.887–6.716; p=0.084). Family support remained in the final model as a contributing variable. Conclusion: No statistically significant determinants of antihypertensive medication adherence were identified. However, knowledge and family support showed a tendency to contribute to medication adherence among hemodialysis patients and may be important targets for future interventions
A Systematic Review of Reimbursement Mechanisms: Effectiveness, Efficiency, and Patient Satisfaction in Insurance-Based Health Financing Systems Neliyana Neliyana; Ummi Kalsum; Asparian Asparian; Dwi Noerjoedianto; Wilia Novita Eka Rini; Muldiasman Muldiasman
Jurnal KESANS : Kesehatan dan Sains Vol 5 No 9 (2026): KESANS: International Journal of Health and Science
Publisher : Rifa'Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54543/kesans.v5i9.646

Abstract

Introduction: The reimbursement mechanism is a fundamental component in an insurance-based financing system that affects service effectiveness, operational efficiency, and patient satisfaction. Objective: This study aims to conduct a systematic review of the literature that discusses reimbursement mechanisms with a focus on these three main dimensions. Method: Using the Systematic Literature Review approach following the PRISMA 2020 guidelines, a comprehensive search was conducted through four electronic databases to identify peer-reviewed articles for the 2021-2025 period. Of the 30 articles initially identified, six studies met the inclusion criteria and were analyzed in depth. Results and Discussion: Results show that the Diagnosis Related Groups system is effective in reducing costs but has the potential to negatively impact the quality of service. Differential reimbursement and cost-sharing mechanisms have been shown to be able to direct healthcare seeking behavior, although their effectiveness is highly contextual dependent on geographic and socio-economic factors. Patient satisfaction shows significant variation by service class with disparities in the dimensions of effectiveness, accessibility, patient-centeredness, and equity. The utilization rate of health services in Indonesia's National Health Insurance system is still relatively low, indicating the need for a comprehensive evaluation of the design of reimbursement mechanisms. Conclusion: This study emphasizes that optimizing the reimbursement system requires a holistic approach that balances cost efficiency, service quality, and patient satisfaction as interrelated outcomes in the health financing ecosystem
Symptomatic Bradycardia Due to Progressive Atrioventricular Block in a Young Woman Without Structural Heart Disease: A Case Report I Gede Putu Ryan Adipathyama Perdana; Febriyanti Angghita Putri Duarsa; I Wayan Prasetya Wisuda
Jurnal KESANS : Kesehatan dan Sains Vol 5 No 9 (2026): KESANS: International Journal of Health and Science
Publisher : Rifa'Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54543/kesans.v5i9.647

Abstract

Introduction: Symptomatic bradycardia in young adults without structural heart disease is uncommon and may delay diagnosis because of its nonspecific presentation. Case Report: A 19-year-old woman presented with generalized weakness, dyspnea, chest discomfort, and recurrent syncope since adolescence. Initial electrocardiography showed second-degree atrioventricular block Mobitz type I with a ventricular rate of 36 beats per minute. Laboratory examination revealed mild hypokalemia and elevated anti-streptolysin O titer, while troponin T was normal. Transthoracic echocardiography showed normal cardiac structure and preserved left ventricular systolic function. Intravenous atropine produced minimal response, and dopamine infusion resulted only in modest heart rate improvement. Serial electrocardiography during hospitalization showed progression to complete atrioventricular block. The patient was referred to a tertiary cardiac center for further electrophysiological evaluation and pacing consideration. Discussion: This case shows that Mobitz type I atrioventricular block in young patients may not always represent a benign condition, particularly when accompanied by recurrent syncope, poor response to atropine, and progressive conduction abnormalities. Conclusion: Progressive atrioventricular block should be considered in young patients with symptomatic bradycardia despite the absence of structural heart disease. Early recognition, close monitoring, and timely pacing consideration are essential to prevent serious complications
Massive Pleural Effusion as the Initial Manifestation of Pulmonary Tuberculosis in an Adolescent: A Case Report Febriyanti Angghita Putri Duarsa; I Gusti Putu Ayu Susilawati Wida Lestari; Putu Siska Suryaningsih
Jurnal KESANS : Kesehatan dan Sains Vol 5 No 9 (2026): KESANS: International Journal of Health and Science
Publisher : Rifa'Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54543/kesans.v5i9.648

Abstract

Introduction: Tuberculosis remains a major global health problem and may present with nonspecific manifestations in adolescents, including pleural effusion, which can complicate diagnosis. Massive pleural effusion as an initial manifestation of pulmonary tuberculosis is uncommon and requires prompt diagnostic evaluation. Case Report: A 15-year-old male adolescent presented with progressive dyspnea, cough, intermittent fever for more than two weeks, decreased appetite, and weight loss. Physical examination revealed decreased breath sounds and stony dullness over the right hemithorax. Chest radiography showed massive right pleural effusion with mediastinal shift. Initial thoracentesis produced approximately 1,600 mL of seroxanthochromic fluid, with a total drainage volume of 2,850 mL following repeated aspiration. Pleural fluid analysis confirmed an exudative effusion with protein 5.1 g/dL and lactate dehydrogenase 1,100 U/L. Molecular testing of pleural fluid detected Mycobacterium tuberculosis at a trace level without rifampicin resistance. The patient received first-line anti-tuberculosis therapy and supportive treatment, resulting in gradual clinical improvement during an 8-day hospitalization. Discussion: This case shows the importance of combining clinical, radiological, pleural fluid, and molecular findings to diagnose pleural tuberculosis. Early molecular testing supported prompt treatment initiation and favorable clinical recovery. Conclusion: Massive pleural effusion in adolescents should raise suspicion for tuberculosis, particularly in endemic areas. Early diagnosis and timely anti-tuberculosis therapy are essential to improve outcomes and prevent complications
Atypical Relapse of Nephrotic Syndrome Without Edema in an Adolescent: A Case Report I Gusti Putu Ayu Susilawati Wida Lestari; Febriyanti Angghita Putri Duarsa; Putu Pradnyanita Mustika
Jurnal KESANS : Kesehatan dan Sains Vol 5 No 9 (2026): KESANS: International Journal of Health and Science
Publisher : Rifa'Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54543/kesans.v5i9.649

Abstract

Introduction: Relapse of nephrotic syndrome in children is typically characterized by the recurrence of edema accompanied by proteinuria. However, some patients may present with atypical clinical manifestations without edema, which can lead to delayed diagnosis and treatment. This case report aims to describe an atypical relapse of nephrotic syndrome without edema in an adolescent and to highlight the diagnostic approach, clinical course, and management during hospitalization. Case Report: A 16-year-8-month-old male adolescent with a previous diagnosis of nephrotic syndrome presented with acute left flank pain, brownish and foamy urine, and no peripheral or periorbital edema. Clinical findings, laboratory investigations, treatment, and follow-up data were collected and analyzed. Laboratory evaluation revealed massive proteinuria, mild hypocalcemia, and vitamin D deficiency, while renal function remained within normal limits. Discussion: The patient was diagnosed with atypical relapse of nephrotic syndrome without edema and was treated with full-dose prednisone, supportive therapy, and serial clinical and laboratory monitoring. Potential precipitating factors included chronic productive cough and temporary nonadherence to prednisone therapy. Significant clinical improvement was observed during five days of hospitalization. At outpatient follow-up, urinalysis showed negative urinary protein and blood findings without the development of edema, indicating complete remission. Conclusion: Relapse of nephrotic syndrome in adolescents can occur without edema and present with atypical manifestations. Careful evaluation of proteinuria, prompt initiation of appropriate therapy, and close clinical monitoring are essential to achieve favorable clinical outcomes
Digital Transformation of Permit to Work Systems for Work at Height in High-Rise Construction Projects: A Narrative Review Widya Ariasti; Muhammad Arrofiq
Jurnal KESANS : Kesehatan dan Sains Vol 5 No 9 (2026): KESANS: International Journal of Health and Science
Publisher : Rifa'Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54543/kesans.v5i9.650

Abstract

Introduction: High-rise construction projects are high-risk activities and effective occupational safety control systems are needed. Traditional paper-based Permit to Work (PTW) systems are often plagued by delayed approvals, poor documentation and limited monitoring capability. Objective: The aim of this study is to analyze the digital transformation of PTW systems in high-rise construction projects for work-at-height activities. Method: he study was a narrative review design with 10 references from SCOPUS, Web of Science, ScienceDirect, SpringerLink, Google Scholar, and PubMed. The analysis was on electronic personal timekeeping systems, construction safety management, and occupational risk control. Result and Discussion: The review showed that website-based PTW systems enhanced approval efficiency, accessibility, integration of risk assessment, documentation management and permit traceability. Previous studies also reported high usability scores (86.9%-93.3%). But major implementation challenges are organizational readiness, workforce competency and cybersecurity issues. Conclusion: Digital PTW systems are highly promising in enhancing the management of occupational safety in work-at-height activities by improving operational efficiency, risk control, and regulatory compliance in high-rise construction projects
Electronic Permit to Work (e-PTW) System as an Effort to Control Hot Work Risks and Fire Protection System Safety at PT. XYZ Didik Mustakim; Nur Rokhman
Jurnal KESANS : Kesehatan dan Sains Vol 5 No 9 (2026): KESANS: International Journal of Health and Science
Publisher : Rifa'Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54543/kesans.v5i9.651

Abstract

Introduction: This study is motivated by the high risk of fire and safety incidents in large-scale commercial buildings, particularly those arising from Hot Work and Fire Protection Impairment activities that are inadequately controlled through conventional paper-based permit systems. Objective: This study aims to describe the development, implementation, and evaluation of the effectiveness of the Electronic Permit to Work (e-PTW) system for controlling risks associated with Hot Work and Fire Protection Impairment activities at PT. XYZ Building Complex, Jakarta. Method: Using a qualitative approach with a case study design, data were collected through in-depth interviews with stakeholders (HSE, Engineering, Security, and Tenant), observations, document analysis, and a questionnaire to contractors. The e-PTW system was developed using the Jotform platform with features such as forced compliance, sequential workflow, photo evidence upload, automatic notifications, audit trail, and HIRADC risk assessment integration. The system was implemented in stages through socialization, training, pilot testing, and full rollout. Result and Discussion: The findings show that e-PTW successfully reduced risk levels of Hot Work and Fire Protection Impairment from Extreme/High to Medium/Low categories. User satisfaction reached an average score of 4.05 (Effective). The system also improved permitting efficiency, transparency, accountability, inter-divisional coordination, and strengthened the safety culture. Conclusion: Although challenges such as contractor resistance and the need for continuous training persist, this study concludes that e-PTW is an effective digital transformation tool that enhances safety management in large-scale commercial buildings
Inpatient Service Quality and Intention to Recommend: The Mediating Roles of Satisfaction and Loyalty at PKU Muhammadiyah Delanggu General Hospital Fery Ardi Kurniawan; Burhannudin Ichsan; Muzakar Isa
Jurnal KESANS : Kesehatan dan Sains Vol 5 No 9 (2026): KESANS: International Journal of Health and Science
Publisher : Rifa'Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54543/kesans.v5i9.652

Abstract

Introduction: Patient-centered service quality influences patient satisfaction, loyalty, and intention to recommend. Objective: This study examined the effect of inpatient service quality on intention to recommend, with patient satisfaction and loyalty as mediators at RSU PKU Muhammadiyah Delanggu. Method: This quantitative study used an explanatory cross-sectional design conducted at RSU PKU Muhammadiyah Delanggu from March to April 2026. A total of 275 adult non-intensive inpatient respondents were selected using consecutive sampling. Data analyzed using Structural Equation Modeling-Partial Least Squares. Result and Discussion: Inpatient service quality significantly affected patient satisfaction (β = 0.798; p < 0.001) and intention to recommend (β = 0.316; p < 0.001), but not patient loyalty (β = 0.059; p = 0.392). Patient satisfaction significantly influenced patient loyalty (β = 0.687; p < 0.001), while patient loyalty significantly influenced intention to recommend (β = 0.588; p < 0.001). Service quality also had significant indirect effects on patient loyalty through satisfaction (β = 0.548; p < 0.001) and on intention to recommend through satisfaction and loyalty (β = 0.357; p < 0.001). Conclusions: Inpatient service quality significantly affects patient satisfaction and intention to recommend, while patient satisfaction and loyalty mediate the relationship between service quality and recommendation intention
Fatigue Risk Management in Fast Moving Coal Mining Units: A Narrative Review of Operational Risks and Control Strategies Yasmu Kurniady; Ardiyanto; Marko Ferdian Salim
Jurnal KESANS : Kesehatan dan Sains Vol 5 No 9 (2026): KESANS: International Journal of Health and Science
Publisher : Rifa'Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54543/kesans.v5i9.653

Abstract

Introduction: Fatigue in coal mining operations has become important operational safety issue because prolonged shift systems, monotonous tasks, environmental exposure, and high-risk heavy equipment activities increase the risk of human error and fatal accidents. Objective: This study aimed to examine fatigue as a systemic operational hazard in fast moving coal mining units and to synthesize evidence-based fatigue risk management strategies. Method: This study employed a narrative review approach by analyzing 13 references from scientific databases, government regulations, and international safety guidelines using thematic synthesis based on Fatigue Risk Management System concepts, the Swiss Cheese Model, and the Context, Input, Process, and Product evaluation framework. Result and Discussion: The review identified physiological, occupational, environmental, and individual factors as the major contributors to fatigue, while also revealing that most previous studies focused mainly on individual determinants without integrating operational risk management approaches. Fatigue Risk Management Systems were identified as the most comprehensive strategy because they combine fatigue monitoring, roster management, worker training, reporting systems, and organizational safety culture. Conclusions: Fatigue should be viewed as a systemic operational hazard rather than solely an individual health issue, therefore, integrated fatigue management strategies are essential to improve safety performance and prevent fatigue-related incidents in coal mining operations

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