Ahmar Metastasis Health Journal

Community-Based Health Education to Improve Knowledge, Attitudes, and Participation in Visual Inspection of Acetic Acid Testing

2026-04-16T03:45:18+00:00

Cervical cancer remains a major reproductive health problem with low Visual Inspection with Acetic Acid (VIA) screening coverage in Indonesia. This study aimed to evaluate the effects of community-based health education through the “Bincang Asik” program on knowledge, attitudes, and participation in visual inspection with acetic acid (VIA) screening among women of reproductive age. A pre-experimental one-group pretest–posttest design was conducted among 59 women selected via simple random sampling at Primary Health Center, West Lombok. The "Bincang Asik" intervention employed a participatory peer-group discussion approach, meeting weekly for one month to discuss cervical cancer prevention. Knowledge (25 items) and attitudes (10 items) questionnaires were administered, alongside tracking VIA attendance. Because the data violated normality assumptions, pre- and post-intervention scores were analyzed using the Wilcoxon signed-rank test. The results of the study show that knowledge scores significantly increased from a baseline mean of 45.20 ± 8.13 to 79.77 ± 6.45 (mean difference: 34.57; p<0.001), with 94.9% achieving good knowledge post-test. Similarly, positive attitudes improved from a baseline mean of 52.30 ± 5.42 to 72.40 ± 4.11 (mean difference: 20.10; p<0.001; 94.9% positive attitudes). However, actual VIA screening participation only reached 25%. In conclusion, while the participatory approach of the "Bincang Asik" program positively influences cognitive and affective outcomes, it does not fully translate into behavior.However, actual VIA screening participation only reached 25%. In conclusion, while the participatory approach of the "Bincang Asik" program positively influences cognitive and affective outcomes, it does not fully translate into behavior.

The Impact of Psychoeducation and Spiritual Emotional Freedom Technique on Self-Efficacy Among Chemotherapy Patients with Cancer

2026-02-07T06:11:58+00:00

Cancer and chemotherapy often cause psychological distress, including anxiety, depression, and reduced self-efficacy, which can negatively affect treatment adherence and quality of life. Strengthening self-efficacy is essential to support emotional resilience and adaptive coping during treatment. This study aimed to evaluate the effectiveness of a psychoeducation program integrated with the Spiritual Emotional Freedom Technique in improving self-efficacy among cancer patients. A quasi-experimental study with a one-group pre-test and post-test design was conducted at Dr. M. Yunus Hospital, Bengkulu Province, from March to May 2024. A total of 40 patients undergoing chemotherapy were recruited using purposive sampling. The intervention consisted of five structured psychoeducation sessions combined with the Spiritual Emotional Freedom Technique, delivered using a standardized protocol. Self-efficacy was measured using the General Self-Efficacy Scale developed by Schwarzer and Jerusalem (1995), with higher scores indicating greater perceived self-efficacy. Data were analysed using the Wilcoxon signed-rank test due to non-normality. Self-efficacy significantly improved after the intervention (Z = −5.44, p < 0.001). The mean score increased from 198.90 to 220.30, indicating a moderate-to-high improvement in patients’ confidence in managing treatment-related challenges. This finding suggests a clinically meaningful enhancement in patients’ ability to cope with the psychological demands of chemotherapy. Psychoeducation integrated with the Spiritual Emotional Freedom Technique significantly improves self-efficacy and may serve as a complementary approach to support psychological well-being among patients undergoing chemotherapy.

Determinants of Chronic Energy Deficiency Among Pregnant Women in Keruak East Lombok: A Case-Control Study

2026-06-08T08:19:28+00:00

Chronic Energy Deficiency (CED) among pregnant women remains an important public health problem because it is associated with adverse maternal and neonatal outcomes, including anemia, low birth weight, and pregnancy complications. Keruak Primary Health Center reported one of the highest CED rates in East Lombok, with a prevalence of 13.67% in 2024. This study aimed to identify factors associated with CED among pregnant women in the working area of Keruak Primary Health Center, East Lombok. This quantitative analytical study used an unmatched case-control design based on secondary data from maternal health records from January to December 2024. The study population consisted of 1,117 pregnant women, and the sample included 338 respondents, comprising 169 pregnant women with CED and 169 pregnant women without CED selected using a 1:1 case-control ratio. Data were analyzed using chi-square tests and multivariate logistic regression. Bivariate analysis showed significant associations between CED and maternal education, parity, body mass index (BMI), frequency of antenatal care (ANC) visits, hemoglobin level, and iron tablet consumption. BMI in this study referred to the BMI recorded during pregnancy in the maternal health records. In the final multivariate model, BMI showed the strongest association with CED (OR=23.209; 95% CI: 8.463–63.651), followed by parity (OR=2.754; 95% CI: 1.554–4.880), hemoglobin level (OR=2.527; 95% CI: 1.385–4.612), and ANC attendance (OR=1.925; 95% CI: 1.027–3.609). These findings indicate that maternal nutritional status, parity, ANC utilization, and anemia are important factors associated with CED among pregnant women. Strengthening nutritional screening, preconception care, ANC follow-up, hemoglobin monitoring, iron-folic acid supplementation counseling, and targeted nutritional support may help improve early identification and management of pregnant women at risk of CED.

Analysis of Self-Care Behavior Factors Among Patients with Hypertension at the Rasau Jaya Community Health Center in 2025

2026-06-22T07:56:47+00:00

Hypertension, known as “The Silent Killer,” is a global health challenge with an ever-increasing prevalence. In the service area of the Rasau Jaya Community Health Center, 5,662 cases were recorded from January through October 2025. Management of this chronic disease relies heavily on self-care behavior. This study aims to analyze factors associated with self-care behavior among patients with hypertension at the Rasau Jaya Community Health Center in 2025. A quantitative analytical study with a cross-sectional design was conducted from June to October 2025. A sample of 252 respondents was selected using purposive sampling from the population of patients with hypertension. Data were analyzed univariately and bivariately using the Chi-Square test (α=0.05; CI=95%). The results showed that the majority of respondents with good self-care behaviors were in the 31–44 age group (94.7%), male (78.3%), highly educated (93.7%), had a family history (82.9%), and had been living with the condition for >5 years (89.1%). However, the majority of respondents had knowledge and self-efficacy levels in the “poor” category (83.3%). Bivariate analysis showed a significant association between family history (p=0.009; PR=1.20) and duration of hypertension (p=0.026; PR=2.41) with self-care behavior. The variables of age, gender, educational level, knowledge level, and self-efficacy did not show statistically significant associations. In conclusion, family history and duration of hypertension are factors associated with self-care behavior in patients with hypertension. Patients are recommended to improve self-management through family support for home care and by regularly participating in the Prolanis program at community health centers to maintain long-term treatment motivation.

Evaluation of Creatinine Levels, Ureum Levels, Urine Protein in Diabetes Mellitus Patient as a Predictor of Kidney Failure

2026-04-16T03:23:40+00:00

Chronic kidney failure is a common microvascular complication of diabetes mellitus, and kidney function is routinely evaluated using creatinine, urea, and urinary protein tests. However, because creatinine and urea testing requires automated laboratory equipment that is often unavailable in primary healthcare facilities, urinary protein testing remains the most accessible screening method for the early detection of kidney function impairment. The purpose of this study is to evaluate creatinine levels, urea levels, and urine protein in patients with Diabetes Mellitus as predictors of kidney failure. This study is a quantitative descriptive study with a cross-sectional approach. The independent variables are creatinine levels, urea levels, and urine protein, while the dependent variable is blood glucose levels. The study sample consisted of 30 individuals using accidental sampling technique. Data collection was conducted using secondary data. The data were analyzed descriptively and with the Pearson chi-square test. The research results showed that 47% of respondents had high creatinine levels, 83% had high urea levels, and 80% had positive urine protein results, including positive levels 1, 2, and 3. The Pearson chi-square test results indicated that all three variables creatinine, urea, and urine protein had a significant relationship with p-values less than 0.05, specifically creatinine at 0.045, urea at 0.037, and urine protein at 0.032. The conclusion that can be drawn from these results is that the examination of creatinine levels, urea levels, and urine protein can serve as predictors of kidney failure in patients with diabetes mellitus. In particular, urine protein levels can be a simple test used to detect kidney conditions in diabetes mellitus patients and can be performed at community health centers.

Factors Associated with Pre-Hospital Clinical Improvement in Non-Trauma Emergencies: A Cross-Sectional Analysis

2026-02-05T08:20:28+00:00

Ambulance response time is a key performance indicator of Emergency Medical Services (EMS) and is essential for early patient stabilization. However, evidence on factors associated with pre-hospital clinical improvement, particularly changes in the Australasian Triage Scale (ATS), remains limited in developing countries. This study aimed to identify factors associated with pre-hospital clinical improvement among non-trauma emergency patients. A cross-sectional analytical study was conducted involving 113 non-trauma emergency patients transported by ambulance to a tertiary referral hospital in Samarinda, East Kalimantan, Indonesia. ATS improvement was defined as a positive shift to a lower-acuity category between the initial assessment at the emergency scene and reassessment at the emergency department. Data were analyzed using multivariate logistic regression controlling for age, transport distance, diagnosis, and pre-hospital interventions. Ambulance response time of ≤15 minutes was the strongest factor associated with ATS improvement (p < 0.001; adjusted OR = 0.019; 95% CI = 0.003–0.122). Circulation management during pre-hospital care also significantly improved clinical status (p = 0.039), whereas age (p = 0.298) and transport distance (p = 0.114) showed no significant association. These findings indicate that rapid ambulance response and appropriate pre-hospital interventions are strongly associated with improved clinical outcomes in non-trauma emergencies. Although the cross-sectional, single-center design limits causal inference and generalizability, strengthening EMS dispatch systems and timely pre-hospital care remains essential for optimizing patient outcomes.

The Effectiveness of Role-Play Basic Life Support Training in Improving Knowledge and Attitudes Toward Cardiac Arrest Among the Laypersons

2026-02-05T08:26:43+00:00

Out-of-hospital cardiac arrest (OHCA) remains a leading cause of death worldwide, and early Basic Life Support (BLS) provided by laypeople is critical for improving survival before emergency medical services arrive. However, public knowledge and attitudes toward BLS remain inadequate because many individuals have never received formal training. This study aimed to evaluate the effectiveness of role play-based BLS training in improving laypeople’s knowledge and attitudes toward cardiac arrest first aid. A quasi-experimental one-group pretest–posttest design was conducted among 68 lay participants recruited through consecutive sampling. Participants received role play-based BLS training, and knowledge and attitudes were assessed using structured questionnaires before and after the intervention. Data were analyzed using the Wilcoxon Signed Rank Test, with additional analyses examining associations between demographic characteristics and study outcomes. Following the intervention, participants demonstrated significant improvements in both knowledge and attitudes. The proportion with good knowledge increased from predominantly moderate (63.6%) to 97.0%, while positive attitudes increased from 72.7% to 93.9%. Significant differences were observed in knowledge and attitude scores (both p < 0.001), with a large intervention effect (r = 0.62). No significant associations were found between demographic factors and outcomes. Role play-based BLS training effectively improves laypeople’s knowledge and attitudes regardless of demographic characteristics, supporting its implementation as an inclusive, practical strategy to strengthen community preparedness for cardiac arrest emergencies.

Community-Based Health Education and Personal Hygiene Knowledge Among Hypertensive Older Adults: A Gerontologic Nursing Perspective

2026-02-05T00:23:51+00:00

Hypertension is a major global health problem with increasing prevalence among older adults and requires comprehensive management beyond pharmacological treatment. From a gerontic nursing perspective, strengthening self-care, including personal hygiene, is essential to prevent complications and improve health outcomes. However, age-related cognitive and sensory changes often reduce the effectiveness of conventional health education. This study aimed to evaluate the effectiveness of a community-based educational video in improving personal hygiene knowledge among older adults with hypertension. A quantitative pre-experimental study using a one-group pretest–posttest design was conducted among 38 adults aged ≥60 years recruited through purposive sampling at a public health center in Samarinda, East Kalimantan, Indonesia. Knowledge was assessed using a validated and reliable structured questionnaire before and after participants viewed a seven-minute educational video developed according to gerontic nursing principles. Data were analyzed using descriptive statistics and the Wilcoxon Signed Rank Test. Personal hygiene knowledge improved significantly following the intervention. Before the intervention, most participants had good or moderate knowledge, whereas after the intervention all participants achieved a good level of knowledge, with a statistically significant improvement (p < 0.001). These findings demonstrate that community-based educational videos are an effective, practical, and age-appropriate strategy for improving personal hygiene knowledge among older adults with hypertension and support their integration into promotive and preventive gerontic nursing services in primary health care and community settings.

Key Factors Associated with Nursing Care Intensity for Nursing Service Management in a Psychiatric Hospital: A Cross-Sectional Study Approach

2026-02-08T23:56:51+00:00

Nursing care intensity is an important indicator of nursing service quality and patient safety. However, in many clinical settings, nursing workload and care demand assessments are still largely based on medical diagnoses rather than psychosocial and cognitive conditions that may better reflect patients’ actual nursing needs. This study examined the association between patient-related factors across four domains (health history and genetic factors, emotional and cognitive functioning, self-concept, and social–interpersonal relationships) and nursing care intensity levels. A cross-sectional study was conducted at RSJD Atma Husada Mahakam Samarinda, Indonesia, using data from 491 patients collected through a standardized nursing care intensity assessment instrument based on the NANDA–NIC–NOC framework. Nursing care intensity was categorized into low, moderate, and high levels, with most patients classified in the moderate category. Associations between variables and nursing care intensity were analyzed using Chi-square tests, and the strength of associations was evaluated using Cramer’s V and Phi coefficient to identify key associated factors. The result showed that most psychosocial, emotional, cognitive, and social variables showed significant associations with nursing care intensity. The strongest associationships were observed for self-esteem (V = 0.487), socialization in the community (V = 0.408), emotion (V = 0.405), perception (V = 0.290), and intelligence (V = 0.280). In contrast, genetic factors and medical diagnosis showed no significant association with nursing care intensity. Nursing care intensity is more strongly associated with psychosocial and cognitive factors than by traditional medical indicators. These findings highlight key associated factors identified through bivariate analysis and suggest that integrating these domains into routine nursing assessments may support evidence-based staffing allocation, reduce missed nursing care, and improve nursing service quality.

Correlation between Family Support and Quality of Life Among Post-Stroke Patients

2026-02-11T08:20:41+00:00

Stroke is one of the leading causes of disability that can reduce patients’ quality of life. Post-stroke patients often experience physical, psychological, and social limitations, thereby requiring family support to manage their daily lives. Family support plays a crucial role in assisting the care process, rehabilitation, and patients’ adaptation to post-stroke conditions. This study aimed to determine the relationship between family support and quality of life among post-stroke patients. This research design uses a quantitative research approach. The approach method taken is a cross-sectional approach with analysis using Spearman’s rank. The study results, with a p-value of 0.001 < 0.05, showed that there was a relationship between family support and quality of life among post-stroke patients. The correlation coefficient (r = 0.712) indicated a strong positive relationship, suggesting that greater family support is associated with improved quality of life. In conclusion, according to the findings of this study, there is a correlation between family support and quality of life among post-stroke patients. A recommendation of the research is that family support can be used to help post-stroke patients with medication.

The Effectiveness of Audiovisual Education on the Level of Pre-Elderly's Knowledge about Healthy Lifestyle and Hypertension Prevention

2026-02-20T03:39:09+00:00

As humans age, there are physiological changes that reduce the elasticity of blood vessel walls, which can cause increased blood pressure. In addition, unhealthy lifestyles can also cause high blood pressure. For example, lack of physical activity, stress, and poor eating habits are factors that increase the incidence of high blood pressure. Individuals aged 45-59 years (pre-elderly) need to prepare themselves to carry out self-care in order to face the emergence of hypertension. This study aims to analyze the effectiveness of audiovisual education on the level of knowledge of pre-elderly about healthy lifestyle to prevent hypertension. The research design One-group Pretest-posttest was conducted on 30 pre-elderly respondents in Samarinda City. Data collection on respondent characteristics and level of knowledge about lifestyle used a structured questionnaire. The results showed that the characteristics of pre-elderly respondents based on an average age of 52 years, while the average systolic blood pressure was 131.07 mmHg and diastolic was 84.07 mmHg. The results of statistical analysis showed that there was significant difference in the average knowledge score of respondents between before being given education (6.27) and after being given audiovisual education (7.60). The statistical test results using the Wilcoxon Signed Rank Test obtained a p-value of 0.001 (<0.05). This indicates that audiovisual education can effectively increase pre-elderly knowledge about healthy lifestyle to prevent hypertension.

Husband Support and Maternal Mental Health Among Pregnant Women in Independent Midwifery Practices

2026-02-25T00:26:37+00:00

Evidence on the role of husband support in maternal mental health remains limited in community-based midwifery services in Indonesia. This study aimed to examine the relationship between husband support and maternal mental health among pregnant women attending independent midwifery practices in Cimahi City and to explore the psychosocial mechanisms underlying this relationship. A convergent mixed-methods design was employed, involving 72 pregnant women for the quantitative component and 20 participants for in-depth qualitative interviews. Husband support, antenatal anxiety, and emotional wellbeing were assessed using validated questionnaires. Quantitative data were analyzed using Pearson correlation and multiple linear regression, while qualitative data were examined through thematic analysis. Husband support was significantly associated with lower antenatal anxiety and higher emotional wellbeing and remained an independent predictor of maternal mental health after controlling for maternal age, education, parity, and economic status. Descriptive findings indicated that a considerable proportion of participants experienced moderate to severe antenatal anxiety. Qualitative analysis identified emotional presence, shared responsibility, and affirmation of maternal identity as key mechanisms through which husband support strengthened maternal coping capacity. These findings demonstrate that husband support serves as an important protective psychosocial factor for maternal mental health. Integrating family empowerment strategies into routine antenatal care may improve psychological wellbeing and strengthen community-based maternal health services.

The Role of School Mental Health Resources and the Implementation of Anti-Bullying Policies in Adolescents

2026-02-15T05:33:50+00:00

Adolescent mental health is an important aspect of individual development but is vulnerable to challenges such as academic pressure, social problems, and bullying. Schools have a strategic role in supporting adolescent mental health through the availability of mental health services and the implementation of anti-bullying policies. However, evidence regarding the relationship between these factors and students’ mental health at the local vocational school level remains limited. This study aimed to analyze the relationship between school mental health service resources and the implementation of anti-bullying policies with students’ mental health at SMK Muhammadiyah 1 Samarinda City. This quantitative study used a cross-sectional design involving 125 students. Data were collected using questionnaires assessing mental health service resources, anti-bullying policy implementation, and students’ mental health measured by the General Health Questionnaire-12 (GHQ-12). Data were analyzed using multiple linear regression. The results showed that school mental health service resources (p=0.01) and anti-bullying policy implementation (p=0.0001) were significantly associated with students’ mental health. The regression model explained 21.6% of the variation in students’ mental health (R²=0.216), while the remaining variation was associated with other factors. This study provides local evidence on the role of school-based mental health resources and anti-bullying policies in supporting adolescent psychological well-being, particularly in a vocational school setting. Strengthening mental health services and consistently implementing anti-bullying policies may support the development of safer and more supportive learning environments.

The Impact of First Aid Training on Knowledge and Practical Skills Among Sports Vocational Students

2026-02-13T05:48:57+00:00

Musculoskeletal injuries represent a significant challenge in youth athletics, necessitating effective immediate management to prevent complications. This study aimed to evaluate the effectiveness of a targeted musculoskeletal injury first aid training program on the knowledge and practical skills of Grade 10 student-athletes at the Indonesian Special Sports School (SKOI), East Kalimantan. Utilizing a pre-experimental, one-group pretest-posttest design, 30 student-athletes participated in a structured intervention covering dislocations, sprains and strains, fractures, bleeding, and muscle cramps. The findings revealed statistically significant improvements across all injury categories (p<0.001), with substantially large effect sizes indicating the program's strong efficacy. Notably, the sprain and strain category showed the most pronounced advancement, with practical skills rising from a low baseline to high proficiency (Cohen's d=7.06). Furthermore, robust practical skill acquisitions were consistently documented for fractures (d=3.66), bleeding (d=3.09), muscle cramps (d=2.63), and dislocations (d=2.49). These results demonstrate that the training successfully bridged the gap between theoretical comprehension and on-field application. In conclusion, structured first aid education significantly enhances student-athlete competence, supporting its integration as a sustainable core component of sports school curricula to mitigate injury-related risks.

The Relationship between Stress Level and Self-Harm Behavior among Nursing and Midwifery Students

2026-02-24T03:31:11+00:00

Self-harm is an emerging public mental health concern among university students, particularly those enrolled in health science programs who are exposed to academic and clinical stressors. Although several international studies have examined the stress–self-harm relationship, empirical evidence from Indonesian health polytechnic students remains limited, especially regarding gender-imbalanced cohorts and early clinical-placement semesters. This study aimed to analyze the relationship between stress levels and self-harm behavior among Nursing and Midwifery students at the Polytechnic of the Ministry of Health, East Kalimantan. A quantitative cross-sectional design with a correlational approach was employed. Respondents were selected through proportionate stratified random sampling from 1,148 active students; 186 respondents met the inclusion criteria and completed the questionnaire. Stress levels were measured using the Indonesian-adapted 14-item stress subscale of the Depression Anxiety Stress Scales (DASS-42; Cronbach's α = 0.87 in the study sample), and self-harm behavior was measured using the Self-Harm Inventory (SHI; 22 items; Cronbach's α = 0.82). Data were analyzed using univariate frequency distribution and bivariate Chi-Square test (α = 0.05), supplemented by the prevalence ratio (PR) to quantify the strength of association. The results showed that 24.2% of respondents experienced severe stress, and 38.2% reported self-harm behavior. Among students with severe stress, 66.7% engaged in self-harm, compared with 24.1% among those with normal stress (PR = 2.77; 95% CI = 1.82–4.21). The Chi-Square test revealed a significant association between stress level and self-harm behavior (p = 0.001). These findings underscore the urgent need for institutionally embedded mental health screening, structured clinical-placement orientation, and cognitive-behavioral coping training to mitigate maladaptive coping among future health professionals.

Determinants of Cesarean Section Decision-Making Beyond Clinical Indications: A Qualitative Study

2026-02-15T05:27:46+00:00

Cesarean section (CS) rates have increased substantially worldwide, with a growing proportion performed without clear medical indications, raising concerns about avoidable maternal and neonatal risks, healthcare costs, and health system inefficiencies. In Mataram City, Indonesia, hospital-based CS rates exceed 60%, substantially higher than national levels and international recommendations, yet evidence regarding the decision-making processes underlying this pattern remains limited. This study aimed to explore how clinical, sociocultural, and health system factors interact to shape CS decision-making in Mataram City. A qualitative case study was conducted from June to August 2025 using in-depth interviews with women who voluntarily chose CS without emergency indications, obstetricians, and nursing staff, as well as focus group discussions with midwives recruited purposively from public and private healthcare settings. Data were analyzed thematically using the Health Belief Model as an analytical framework. Five interrelated domains shaped CS decision-making: medical considerations, maternal and family perceptions, social interactions, healthcare provider authority, and childbirth financing mechanisms. Relative medical indications emerged as critical triggers that legitimized maternal preferences for CS by amplifying perceived risks within asymmetrical patient provider relationships. Overall, CS decision-making was shaped by the interaction of clinical assessments, sociocultural norms, provider authority, and health system financing. Strengthening shared decision-making, standardizing antenatal counseling, improving maternal health literacy, and addressing financial incentives may help reduce unnecessary CS while preserving maternal autonomy and ensuring maternal and neonatal safety.