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Spectra Clinical Case Reports Journal
Published by Universitas Sriwijaya
ISSN : 31637272     EISSN : 31634877     DOI : https://doi.org/10.32539/sccrj
Core Subject :
Spectra Clinical Case Reports Journal is dedicated to publishing research findings, particularly case reports in the fields of Health Sciences, with a focus on Nursing, Midwifery, and Medical Science. Manuscript submissions are accepted throughout the year, and all papers undergo a blind peer-review process followed by editorial evaluation prior to acceptance for publication. The journal utilizes the Open Journal System (OJS), requiring authors to register online before submitting their manuscripts. Through this platform, editors, reviewers, and authors can conveniently track the progress of their submissions. Spectra Clinical Case Reports Journal is published biannually, in June and December.
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Articles 11 Documents
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STRETCHING EXERCISE THERAPY AS A NON-PHARMACOLOGICAL NURSING INTERVENTION FOR ACTIVITY INTOLERANCE IN HYPERTENSIVE PATIENTS: A CASE STUDY FROM A RURAL AGRICULTURAL COMMUNITY IN INDONESIA Fatmala Fathul Huda; Bagus Dwi Cahyono; Evy Aristawati; Nurul Huda; Apriana Rahmawati; Ronal Surya Aditya
Spectra Clinical Case Reports Journal Vol. 1 No. 1 (2025): December 2025
Publisher : Department of Nursing, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/sccrj.v1i1.2

Abstract

Activity intolerance, characterized by fatigue, dyspnea, and reduced exercise capacity, is a common nursing diagnosis among patients with hypertension, particularly in rural farmers whose livelihoods require sustained physical labor. In resource limited settings such as Indonesia’s agricultural communities, non pharmacological nursing interventions play a critical role in managing functional impairment associated with uncontrolled hypertension. This case study describes the successful implementation of Stretching Exercise Therapy as a nurse led, home based intervention for Mr. S, a 67 year old farmer with hypertension from Pasuruan, East Java, who presented with activity intolerance manifested by dizziness, leg cramps, and exertional dyspnea. During a three day intervention period, the patient received supervised static stretching sessions lasting 5 to 10 minutes, administered twice daily and targeting major muscle groups. Vital signs and subjective symptoms were monitored before and after each intervention session. Following the intervention, Mr. S demonstrated marked clinical improvement. Blood pressure decreased from 160 over 103 mmHg to 137 over 84 mmHg, heart rate declined from 115 to 84 beats per minute, and all reported subjective symptoms resolved. The patient reported restored energy, improved mobility, and increased confidence in performing daily activities, including light farming tasks. The intervention was safe, cost free, and easily adopted by both the patient and his family. Although this evidence is derived from a single case, the findings suggest that Stretching Exercise Therapy may represent a feasible and low intensity strategy for nurses to address activity intolerance in rural populations with hypertension. Further studies with larger samples and longer follow up periods are needed to confirm efficacy and sustainability.
ALLEVIATING ACUTE PAIN TO RESTORE FUNCTION: A NURSING-LED GINGER OIL INTERVENTION FOR A FARMER WITH RHEUMATOID ARTHRITIS Fitriah Effendy; Bagus Dwi Cahyono; Evy Aristawati; Nurul Huda; Apriana Rahmawati; Ronal Surya Aditya
Spectra Clinical Case Reports Journal Vol. 1 No. 1 (2025): December 2025
Publisher : Department of Nursing, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/sccrj.v1i1.3

Abstract

Rheumatoid arthritis is a chronic autoimmune disease causing persistent joint inflammation, pain, stiffness, and progressive functional decline, particularly exacerbated among farmers by repetitive non-ergonomic labor. This case involved a 74-year-old male farmer from Pasuruan Regency, Indonesia, who presented with severe functional limitations. Assessment revealed throbbing joint pain rated 7 out of 10 on the Numeric Rating Scale, prolonged morning stiffness, fatigue with minimal exertion, slow and assisted gait, and dependence on family for ambulation and self-care. The priority of nursing diagnosis was Acute Pain related to inflammatory joint process and mechanical stress, per the Standar Diagnosis Keperawatan Indonesia, as uncontrolled pain was the primary barrier to physical function; activity intolerance was identified as a secondary diagnosis. The purpose of this case report was to evaluate the effectiveness of a nursing-led, non-pharmacological intervention topical ginger (Zingiber officinale) extract oil combined with massage in reducing acute pain and thereby improving functional capacity in a rural rheumatoid arthritis patient with limited access to pharmacotherapy. The intervention plan consisted of twice-daily application of ginger oil to knees and ankles with 10-minute gentle massage over three consecutive days, integrated with health education on activity pacing and light stretching. Following the intervention, pain intensity decreased to 3/10, ambulation improved from assisted to independent, and the patient resumed light farming and self-care tasks without frequent rest. No adverse effects occurred. These outcomes suggest that targeted pain management using locally available ginger oil may rapidly enhance activity tolerance in resource-limited settings. Further research is warranted to confirm efficacy and safety in larger cohorts.
APPLICATION OF LAVENDER AROMATHERAPY WITH INHALATION METHOD TO OVERCOME SLEEP PATTERN DISTURBANCES IN CHILDREN WITH CHRONIC KIDNEY DISEASE Marshella Tri Pradilaga; Zesi Aprillia
Spectra Clinical Case Reports Journal Vol. 1 No. 1 (2025): December 2025
Publisher : Department of Nursing, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/sccrj.v1i1.4

Abstract

Chronic Kidney Disease (CKD) is a major global health problem due to the high number of sufferers and deaths from CKD. In children with end-stage CKD, permanent kidney damage requires partial renal excretory replacement therapy, such as hemodialysis. Children undergoing hemodialysis often experience sleep cycle disturbances. One form of non-pharmacological therapy that can be applied is aromatherapy with inhalation methods. This article describes the results of pediatric nursing practice that focuses on nursing care for children with CKD and is in accordance with evidence-based practice reviews. The method used is a descriptive case study approach in three pediatric clients with CKD who have sleep pattern disturbances. In this case study, seven nursing problems were found in the three clients: sleep pattern disturbances, hypervolemia, acute pain, decreased cardiac output, risk of ineffective renal perfusion, risk of infection, and risk of nutritional deficits, with the main nursing problem being sleep pattern disturbances. The results of the evaluation of sleep pattern disturbances in the three patients after being given aromatherapy with inhalation methods for three consecutive days showed an improvement in sleep quality as measured by a sleep quality questionnaire. The application of lavender aromatherapy as a non-pharmacological therapy has an effect on improving sleep quality in children with sleep pattern disorders, so it can be concluded that the application of lavender aromatherapy with the inhalation method is effective in overcoming sleep pattern disorders in children.
IMPLEMENTATIONS OF SPIRITUAL EMOTIONAL FREEDOM TECHNIQUE THERAPY FOR TREATING SLEEP DISORDERS IN CHRONIC KIDNEY DISEASE (CKD) PATIENTS AT MOHAMMAD HOESIN GENERAL HOSPITAL Walensya Laura Agatha Hutabarat; Lisa Rizky Amalia
Spectra Clinical Case Reports Journal Vol. 1 No. 1 (2025): December 2025
Publisher : Department of Nursing, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/sccrj.v1i1.5

Abstract

Sleep pattern disturbance is a common nursing problem in Chronic Kidney Disease (CKD) patients undergoing hemodialysis. Spiritual Emotional Freedom Technique (SEFT) is a non-pharmacological intervention that may improve sleep quality through physical stimulation and spiritual relaxation. This case study aimed to describe the implementation of nursing care in CKD patients with sleep disturbances and to evaluate the effectiveness of SEFT therapy. The study involved three inpatients with CKD undergoing hemodialysis. Assessment results showed similar complaints among patients, including difficulty initiating sleep, frequent awakenings, dissatisfaction with sleep, altered sleep patterns, and inadequate rest. Based on these findings, the nursing diagnoses established were sleep pattern disturbance, ineffective peripheral perfusion, fatigue, acute pain, nausea, and ineffective breathing pattern. Nursing care planning prioritized sleep support, circulation care, energy conservation, pain and nausea management, and respiratory monitoring. SEFT therapy was provided as a complementary intervention for 10–20 minutes daily over three consecutive days. After therapy, all three patients demonstrated improved sleep quality marked by reduced sleep onset latency, fewer nighttime awakenings, and increased feelings of restfulness. The mechanism of SEFT therapy involves tapping on body meridian points, which stimulates the parasympathetic nervous system, promotes relaxation, and enhances sleep-regulating hormones such as melatonin, serotonin, and oxytocin. These physiological effects help reduce stress responses and increase comfort levels. In this case study, the use of SEFT therapy was associated with observed improvements in sleep pattern disturbances among CKD patients; however, these findings are limited to the reported cases and cannot be generalized to other populations with similar conditions.
ANALYSIS OF NURSING CARE PLAN FOR PULMONARY TUBERCULOSIS PATIENTS WITH PURSED LIPS BREATHING INTERVENTION AT HOSPITAL WEST JAVA PROVINCE Riesma Pratiwi Nuril Azmi; Vivop Marti Lengga
Spectra Clinical Case Reports Journal Vol. 1 No. 1 (2025): December 2025
Publisher : Department of Nursing, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/sccrj.v1i1.7

Abstract

Pulmonary tuberculosis remains a global health problem, with Indonesia ranking second in the world in terms of TB cases, with West Java recording high cases. Although pharmacological therapy is the mainstay of pulmonary tuberculosis management, non-pharmacological interventions such as pursed lips breathing (PLB) have been shown to improve ventilation, reduce CO₂ retention, and increase oxygen saturation, however, its application in nursing practice is still very limited. This study aims to analyze the application of pursed lips breathing in pulmonary TB patients at Hospital in West Java Province. This study uses a case study approach with the nursing problem of ineffective breathing patterns and the administration of pursed lips breathing in the Umar bin Khattab 3 room. Based on the results of a physical examination obtained by the patient, the respiratory rate was 27 breaths/minute, oxygen saturation was 93%, accessory muscles were used for breathing, there was rales in the left lung, and thick sputum was difficult to expel. Based on the assessment results, three nursing diagnoses were established: ineffective airway clearance related to airway hypersecretion, ineffective breathing pattern related to breathing effort obstruction, and sleep pattern disturbance related to lack of sleep control. Interventions included airway management, effective coughing exercises, sleep support, nebulization, oxygen therapy, and pursed-lip breathing exercises during the three days of treatment. The evaluation results showed significant improvement with oxygen saturation increasing to 97%, respiratory rate decreasing to 20 breaths/minute, reduced sputum, and improved sleep quality. These findings confirm that pursed-lips breathing is an effective non-pharmacological intervention that supports pharmacological therapy in improving respiratory function and quality of life in pulmonary TB patients. Therefore, a holistic nursing approach is recommended for optimal TB care.
THE SYMPTOM AND MEDICATION MONITORING WITH LUPIE DIARY IN PEDIATRIC SYSTEMIC LUPUS ERYTHEMATOSUS Arie Kusumaningrum; Nadia Zahra Amelia
Spectra Clinical Case Reports Journal Vol. 2 No. 1 (2026): June 2026
Publisher : Department of Nursing, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/sccrj.v2i1.14

Abstract

Pediatric systemic lupus erythematosus (pSLE) in low-and-middle-income countries often leads to rapid organ damage due to complex treatment regimens and limited specialized care. Effective home-based symptom monitoring is critical to detect early flares, yet conventional tracking is often suboptimal, necessitating tailored digital health solutions like the "Lupie Diary" application to capture real-time clinical fluctuations. This case report describes the nurse-facilitated implementation of "Lupie Diary" to enhance self-management in three adolescent female patients in a resource-limited Indonesian hospital. Based on Indonesian nursing standards, primary diagnoses included Hyperthermia, Nutritional Deficit, Impaired Skin Integrity, Nausea, and Readiness for Enhanced Health Management. The intervention spanned 4 weeks, comprising a 3-day hospital-based training phase on daily symptom logging and medication reminders, followed by weekly remote nursing tele-monitoring at home. As a direct result of utilizing the application, the patients demonstrated significant improvements in treatment adherence, systematic symptom tracking, and active engagement, heavily facilitated by the nurse's role as a clinical educator and technology facilitator. This approach highlights the critical role of nurses in bridging hospital-to-home care through technology-integrated, family-centered interventions. Embedding simple digital tools into standard nursing care plans is a viable, effective strategy to empower pediatric patients with complex chronic diseases despite resource constraints.
GARDENING-BASED OCCUPATIONAL THERAPY AS AN INTERVENTION TO REDUCE AUDITORY HALLUCINATIONS IN PATIENTS WITH SCHIZOPHRENIA: A CASE REPORT Fatimah Al-Zahra; Dhia Diana Fitriani; Herliawati; Zulian Effendi
Spectra Clinical Case Reports Journal Vol. 2 No. 1 (2026): June 2026
Publisher : Department of Nursing, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/sccrj.v2i1.15

Abstract

Mental health disorders, particularly schizophrenia, represent a global health challenge that significantly affects quality of life, productivity, and social functioning. One of the most common symptoms of schizophrenia is auditory hallucinations, which impair daily functioning and increase the risk of harmful behavior. Therefore, nonpharmacological interventions are needed to support symptom management. This case report aimed to implement gardening occupational therapy as an intervention to reduce the level of auditory hallucinations among patients with schizophrenia in the Cendrawasih Ward of Hospital. Three patients with schizophrenia who experienced auditory hallucinations were observed over a seven-day period. Baseline assessment was conducted using interviews, observation, and the Auditory Hallucination Rating Scale (AHRS). Patients received four days of nursing interventions focused on hallucination management, followed by three consecutive days of gardening-based occupational therapy. The therapy was conducted once daily in the hospital’s therapeutic garden, with each session lasting 30–40 minutes. Outcome assessment was performed using the AHRS immediately after completion of the intervention period. The results showed a reduction in hallucination severity in all patients. Two patients who were initially categorized as having severe auditory hallucinations and one patient with moderate auditory hallucinations showed a reduction in AHRS scores, resulting in all patients being classified in the mild category after the intervention. In addition, patients appeared calmer, more focused, and better able to manage hallucinations and interact with their environment. These findings suggest that gardening-based occupational therapy may be an effective complementary intervention for reducing auditory hallucination severity and promoting psychosocial functioning among patients with schizophrenia
TALKING THERAPY TO REDUCE AUDITORY HALLUCINATIONS IN SCHIZOPHRENIA PATIENTS: A CASE STUDY AT SOCIAL REHABILITATION Nuril Hikmah; Bagus Dwi Cahyono; Nurul Huda; Ronal Surya A; Apriana Rahmawati; Evy Aristawati
Spectra Clinical Case Reports Journal Vol. 2 No. 1 (2026): June 2026
Publisher : Department of Nursing, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/sccrj.v2i1.16

Abstract

Schizophrenia is a serious mental disorder characterized by perceptual changes, including auditory hallucinations. Non-pharmacological interventions are needed to help patients manage these symptoms. This case report describes nursing care for two schizophrenia patients with auditory hallucinations using talking therapy. Assessment was conducted on two patients at the Social Rehabilitation Unit through interviews and observations. The nursing diagnosis established was sensory perception disturbance: auditory hallucinations. Planning involved implementing talking therapy interventions based on Indonesian Nursing Intervention Standards. The intervention was conducted once daily for three consecutive days, with each session lasting approximately 30 minutes. Results showed a decrease in hallucination frequency in both patients after three days of intervention. Patient one showed significant improvement in using conversation as a distraction, while patient two showed reduced response to commanding hallucinations. Talking therapy showed improvement in reducing auditory hallucinations by shifting focus from internal stimuli to external reality through social interaction.
THE EFFECT OF REBUKING AND EAR-CLOSING TECHNIQUE ON THE ABILITY TO CONTROL AUDITORY HALLUCINATIONS: A CASE STUDY AT THE BINA LARAS SOCIAL REHABILITATION CENTER Khusnun Nazwa Arifin; Bagus Dwi Cahyono; Nurul Huda; Ronal Surya A; Apriana Rahmawati; Evy Aristawati
Spectra Clinical Case Reports Journal Vol. 2 No. 1 (2026): June 2026
Publisher : Department of Nursing, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/sccrj.v2i1.17

Abstract

Schizophrenia is characterized by disturbances in thought processes, emotions, and perceptions. Among its symptoms, auditory hallucinations are the most frequently experienced by individuals with schizophrenia. If not managed appropriately, this condition can impair social functioning and increase the risk of destructive behavior. In addition to pharmacological therapy, non-pharmacological interventions such as rebuking and ear-closing techniques can be applied to help control emerging symptoms. This study aims to describe the implementation of nursing care for patients with schizophrenia experiencing sensory perception disorders, specifically auditory hallucinations, through the application of rebuking and ear-closing techniques. Methods: This study used a case study design involving two patients at UPT Rehabilitasi Sosial Pasuruan. Data were collected through interviews, observations, physical examinations, and documentation. The intervention consisted of rebuking and ear-closing techniques implemented once daily for three consecutive days, with each session lasting approximately 30 minutes. Outcomes were evaluated using indicators based on the Indonesian Nursing Diagnosis Standards (SDKI) and Indonesian Nursing Outcome Standards (SLKI), focusing on hallucination frequency, patients’ responses, and independence in controlling auditory hallucinations. After implementing SP1 (Implementation Strategy 1), the results showed that the intervention reduced the frequency of hallucinations. Quantitatively, the first patient demonstrated a 65% improvement in self-control ability, while the second patient showed a 75% improvement. The application of rebuking and ear-closing techniques showed potential benefits in helping patients control auditory hallucinations.
NON-NUTRITIVE SUCKING FOR PROCEDURAL PAIN RELIEF IN A PRETERM NEONATE: A NURSING CASE REPORT Hiwala Lisdayanti; Janatia Anggraini; Meta Puspita Sari; Nurul Dwi Khairani; Masrianah Masrianah; Selvia Zulviani; Adelia Pradita
Spectra Clinical Case Reports Journal Vol. 2 No. 1 (2026): June 2026
Publisher : Department of Nursing, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/sccrj.v2i1.18

Abstract

Premature infants admitted to the neonatal intensive care unit are frequently subjected to repeated invasive procedures, placing them at high risk for procedural pain that can adversely affect neurological development if not properly managed. This case report describes the nursing care provided to a premature infant born at 27 weeks’ gestation with a birth weight of 1,100 grams. The assessment revealed that the infant exhibited acute pain responses during invasive procedures, including peripheral intravenous catheter placement and venous blood sampling, characterized by grimacing, high-pitched crying, increased limb movements, and irregular breathing patterns, with a Neonatal Infant Pain Scale score of 7 indicating severe pain. The established nursing diagnoses included acute pain related to stimulation from invasive procedures, evidenced by physiological and behavioral pain indicators; impaired spontaneous ventilation; risk of infection; and impaired gas exchange related to underlying medical conditions such as respiratory failure, metabolic acidosis, grade 1 hyaline membrane disease, hyperbilirubinemia, and anemia. The nursing care plan was developed by applying the Non-Nutritive Sucking technique as the primary non-pharmacological pain intervention, administered consistently before, during, and after each invasive procedure, supplemented by environmental modifications and the use of the nesting position to optimize the neonate’s comfort. Following the intervention, the Neonatal Infant Pain Scale score decreased significantly from 7 to 1, accompanied by a reduction in crying duration, calmer behavior, and stable physiological parameters. This case demonstrates that the Non-Nutritive Sucking technique is a simple, safe, cost-effective, and scientifically supported nursing intervention for reducing procedural pain in preterm infants in an intensive care setting; therefore, its integration into standard neonatal pain management protocols should be considered.

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