Walafiat Hospital Journal is an open-access, scientific and peer-reviewed journal published by Ibnu Sina Hospital YW-UMI twice a year in June and December (E-ISSN: 2722-9017). Walafiat Hospital Journal accepts original research, Literature Reviews, Case Reports, Scientific Lectures, Book Reviews, and Letters of Editor in English, with the term and condition that they have not been published in another journal/website. Wal'afiat Hospital Journal, is a scientific platform dedicated to advancing understanding and knowledge in the field of health and medical care. The journal provides a platform for researchers, medical practitioners, and healthcare professionals to share the latest research results, clinical findings, and insightful views that contribute to the development of medical science. Wal'afiat Hospital Journal is committed to being a pioneer in providing access to relevant and high-quality cutting-edge medical information. In our endeavor to achieve this goal, we welcome scientific articles in a wide range of health disciplines, including, but not limited to, general medicine, surgery, cardiology, oncology, gynecology, and more. We also invite interdisciplinary research covering different aspects of health. Our commitment to quality is high, and every article we publish goes through a rigorous peer review process to ensure its scientific accuracy, reliability and relevance. We believe that by supporting collaboration between healthcare professionals, we can help drive positive change in the ever-changing healthcare sector. This journal has also become a member of CrossRef. Therefore, all articles published by this journal will have a unique DOI number. Informasi Jurnal Journal title : Walafiat Hospital Journal Initials : WHJ Abbreviation : WHJ Frequency : 2 issues per year (June and December) DOI : http://dx.doi.org/10.33096/whj Online ISSN : 2722-9017 Editor-in-chief : dr. Sidrah Darma, Sp.A Publisher : Rumah Sakit Ibnu Sina, Makassar Citation Analysis : Scopus | Sinta | Google Scholar Call for Papers We invite you to submit your manuscript to the Walafiat Hospital Journal. The manuscript is published in the six-monthly journal (April and October). Manuscripts submission deadlines: Vol. 4 No.2, December 2023, submission deadline: 1 November 2023 Vol. 5 No.1, June 2024, submission deadline: 1 May 2024 Vol. 5 No.2, December 2024, submission deadline: 1 November 2024 Vol. 6 No.1, June 2025, submission deadline: 1 May 2025 Walafiat Hospital Journal received articles in a high-impact original research paper, review paper, and case study, from both the result of research and theoretical study of Ethnomathematics that have never been published anywhere.
Tatalaksana Akalasia Esofagus dengan Pneumatic Balloon Dilation: Laporan Kasus
Akalasia esofagus adalah gangguan motilitas esofagus ditandai dengan degenerasi sel ganglion progresif pada pleksus mienterik esofagus, yang mengakibatkan gangguan relaksasi sfingter esofagus bagian bawah (Lower Esophageal Sphincter) saat menelan dan terjadi gagalnya peristaltik esofagus pada area segmen otot polos distal esofagus. Insiden dan prevalensi akalasia di seluruh dunia mengalami peningkatan yaitu dari 0,40 kasus per 100.000 orang-tahun pada periode 1925-1999 menjadi 1,64 kasus pada periode 2018-2021. Dilaporkan seorang pasien perempuan usia 56 tahun dengan keluhan sering muntah tiap makan sejak 4 tahun terakhir, hanya makan konsistensi lunak hampir setiap hari selama 4 tahun. Pada pemeriksaan Oesophageal Maag Duodenum (OMD) ditemukan penyempitan lumen esofagus yang membentuk gambaran "rat tail sign". Dilakukan pemeriksaan endoskopi, didapatkan dua penyempitan setinggi 22cm dan 30cm dari kedalaman scope, sekaligus tatalaksana berupa Pneumatic Balloon Dilation. Hanya penyempitan pertama yang dapat dilebarkan, sementara penyempitan kedua belum dapat dilebarkan akibat diameter lumen esofagus <2cm sehingga alat pneumatic balloon dilation tidak dapat melewati penyempitan tersebut. Pascatindakan masih ditemukan keluhan namun akan dilakukan tindakan yang sama dengan jarak 1-2 bulan.
M. Abrar Naufal Hidayatullah ZA M. Abrar Naufal Hidayatullah ZA
Copyright (c) 2026 Wal'afiat Hospital Journal
Efektivitas Pelaksanaan Senam Hamil Terhadap Kelancaran Proses Persalinan Di Puskesmas Bontonompo II Gowa Tahun 2025
Angka Kematian Ibu (AKI) masih menjadi masalah kesehatan global dan nasional, terutama terkait komplikasi persalinan seperti persalinan lama yang dapat meningkatkan risiko kematian maternal. Salah satu intervensi nonfarmakologis yang banyak digunakan untuk mendukung kelancaran persalinan adalah senam hamil. Penelitian ini bertujuan untuk menganalisis efektivitas pelaksanaan senam hamil terhadap kelancaran proses persalinan di Puskesmas Bontonompo II Kabupaten Gowa tahun 2025. Penelitian ini menggunakan desain kuantitatif quasi-experimental dengan pendekatan non-equivalent control group pre-test and post-test. Sampel penelitian berjumlah 30 ibu bersalin yang dipilih menggunakan teknik accidental sampling dengan kriteria inklusi ibu hamil tanpa komplikasi dan usia kehamilan ≥37 minggu. Data dikumpulkan menggunakan kuesioner dan lembar partograf untuk menilai proses persalinan. Analisis data dilakukan menggunakan uji Chi-Square serta Odds Ratio untuk melihat hubungan antara variabel penelitian. Hasil penelitian menunjukkan bahwa sebagian besar responden berada pada usia reproduksi sehat 20–35 tahun (70%) dengan tingkat pendidikan dominan SMA (66,7%). Terdapat hubungan signifikan antara pelaksanaan senam hamil dan kelancaran persalinan dengan nilai p-value 0,015. Ibu yang rutin melakukan senam hamil memiliki peluang 3,54 kali lebih besar mengalami persalinan lancar dibandingkan yang tidak rutin. Hasil ini menunjukkan bahwa senam hamil berperan dalam meningkatkan kesiapan fisik dan psikologis ibu sehingga mendukung proses persalinan yang lebih efektif. Kesimpulan penelitian ini adalah pelaksanaan senam hamil efektif dalam meningkatkan kelancaran proses persalinan di Puskesmas Bontonompo II Kabupaten Gowa
Perbandingan Antara Pregabalin Dengan Ibuprofen terhadap Kadar Neutrofil Pascabedah Laparotomi Ginekologi
Postoperative pain is an important problem frequently encountered in postoperative patients. Although understanding of the mechanisms of postoperative pain has advanced considerably, postoperative pain management remains suboptimal and is often neglected. Preemptive analgesia refers to the administration of analgesic interventions before nociceptive stimulation occurs, with the aim of preventing pain, suppressing sensory afferent input, reducing central nervous system sensitization, and minimizing postoperative pain effects. This study aimed to compare pregabalin and ibuprofen as preemptive analgesia on neutrophil levels after gynecological laparotomy. This was an experimental clinical trial using a pre-post test control design, in which variables were measured before and after the intervention. The collected data were analyzed using paired t-test and independent t-test. The results showed no significant difference in the increase of neutrophil levels between ibuprofen and pregabalin administration, with a p-value of 0.237. However, the increase in neutrophil levels was higher in the pregabalin group than in the ibuprofen group, namely 683.60 ± 1501.13 compared with 532.82 ± 527.67. Therefore, it can be concluded that there was no significant difference in the increase of neutrophil levels between pregabalin and ibuprofen administration in patients undergoing gynecological laparotomy, although the increase in neutrophil levels was higher in the pregabalin group than in the ibuprofen group.
Hubungan Status Gizi dengan Kejadian Pneumonia Pada Balita di RSUD Syekh Yusuf Tahun 2022
This Acute infection known as pneumonia is one of the leading causes of death in children under five. One of the influential factors that can determine the susceptibility of toddlers to a disease is pneumonia. This study aims to determine the relationship between nutritional status and the incidence of pneumonia in children under five years of age at RSUD Syekh Yusuf Gowa Regency in 2022. This type of research is an observational analytic with a cross-sectional approach . The population of this study were all toddlers diagnosed with pneumonia at RSUD Syekh Yusuf Gowa Regency in 2022, totaling 259 toddlers. The study sample was 108 toddlers using purposive sampling technique . The data used were secondary data in the form of medical records. Statistical calculations used chi-square test analysis . The number of toddlers diagnosed with pneumonia with very poor nutritional status was 15 (17.4%), undernutrition was 28 (32.6%), good nutrition was 37 (43%) and the risk of overweight was 6 (7%). In this study, there was a significant relationship between nutritional status and the incidence of pneumonia in toddlers as evidenced by the chi-square hypothesis test and the p-value = 0.022. The conclusion from the results of the study is that there is a significant relationship between nutritional status and the incidence of pneumonia in toddlers at RSUD Syekh Yusuf Gowa Regency in 2022
Factors Affecting the Stress Level of Students of the Faculty of Medicine, Muslim University of Indonesia in the Cardiovascular Block Practical Exam, Class of 2024
Academic stress is often experienced by medical students due to the high demands of education, including practicum exams that assess psychomotor competence. This study aims to analyze the factors that affect the stress level of students of the Faculty of Medicine, Muslim University of Indonesia class of 2024 in facing the cardiovascular block practicum exam. This observational quantitative analytical research with a cross-sectional design involves all students of the class of 2024 as many as 230 respondents through a total sampling technique. Data collection was conducted using questionnaires of respondent characteristics and DASS 42, analyzed by Chi-Square test (p<0.05). The results showed that the majority of respondents were 19 years old (66.1%) and female (76.5%). Most students experienced moderate stress (40.4%). Bivariate analysis found that length of learning (p=0.001) and hours of sleep (p=0.001) were significantly related to the degree of stress, while age and gender were not related. It was concluded that academic and environmental factors play a role in student stress, so intervention is needed to balance study time and rest.
Penerapan Pursed Lip Breathing Berbasis Evidence-Based Nursing pada Pasien PPOK Eksaserbasi
Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease characterized by airflow limitation and impaired gas exchange, which often leads to dyspnea and decreased quality of life. Pursed Lip Breathing (PLB) is a non-pharmacological intervention based on Evidence-Based Nursing (EBN) that has been shown to improve ventilation and reduce dyspnea in patients with COPD. This case report aims to describe the implementation of Evidence-Based Nursing–based Pursed Lip Breathing in a patient with COPD. The method employed a case report design involving a patient with COPD exacerbation and impaired gas exchange; a comprehensive nursing assessment was conducted, including subjective and objective data, physical examination, and supporting diagnostic tests. The main nursing intervention was Pursed Lip Breathing, provided gradually according to the patient’s tolerance, along with airway management and oxygen therapy, and evaluated based on clinical outcomes. The results showed improvement in respiratory status indicated by reduced dyspnea, more stable respiratory rate, decreased adventitious breath sounds, improved ability to perform effective coughing, improved oxygen saturation, and the patient’s ability to perform PLB independently. In conclusion, Evidence-Based Nursing–based Pursed Lip Breathing is beneficial in improving respiratory status and reducing dyspnea and can be incorporated as part of comprehensive nursing care for patients with COPD.
Penerapan Teknik Relaksasi Genggam Jari terhadap Penurunan Skala Nyeri pada Pasien Post Operasi Appendektomi di Ruang Bedah AN NASR RS Ibnu Sina Makassar
Postoperative patients are individuals who are in the postoperative period and require monitoring as they regain consciousness following anesthesia. Every surgical procedure involves an incision, which causes tissue trauma and may result in pain. Pain is the body’s response to a noxious stimulus. The Finger Grasp Relaxation technique is administered to postoperative patients approximately 6–7 hours after the administration of analgesic medications, whose effects typically last for 2–4 hours. This relaxation technique is performed once daily for 15 minutes and is provided for a minimum of three days. The Five-Finger Grasp Relaxation technique is effective in reducing pain in postoperative patients, except in those who have wounds on the palms of the hands or the soles of the feet, for whom the therapy is contraindicated. The purpose of this scientific paper is to determine the implementation of the Five-Finger Grasp technique in postoperative patients experiencing nursing problems related to pain in the Surgical Ward of Ibnu Sina Hospital in 2025, with the aim of improving patient comfort. This scientific paper employs a case study design. The subject consisted of a postoperative patient with nursing problems related to pain. Data analysis was conducted using descriptive analysis. The results of the implementation showed that after the application of the Five-Finger Grasp Relaxation technique, pain intensity decreased in the subject.
Hubungan Pola Makan, Aktivitas Fisik, dan Tingkat Stres dengan Kadar Glukosa Darah pada Pasien Diabetes di Komunitas Perkotaan Makassar
Introduction: Diabetes mellitus remains a global health problem, including in urban communities, and is influenced by lifestyle factors, particularly family dietary patterns, physical activity, and stress, which play a crucial role in glycemic control. This study aimed to analyze the relationship between family dietary patterns, physical activity, and stress with blood glucose control among patients with diabetes in urban communities of Makassar. Method: A total of 73 respondents were recruited, and data were collected using questionnaires. Results showed that dietary patterns (p = 0.000), adequate physical activity (p = 0.027), and stress levels (p = 0.000) were significantly associated with blood glucose control (p < 0.05) among patients with diabetes in urban Makassar. Discussion: Family support through the provision of healthy meals, home-cooked food habits, and regular physical activity played a protective role in glycemic control, whereas high psychological stress increased the risk of poor glycemic control. Therefore, diabetes management in urban communities should be conducted comprehensively by emphasizing family-based nutritional interventions, increased physical activity, and stress management as key components of blood glucose control. Conclusion: Healthy family dietary patterns, adequate physical activity, and lower stress levels are significantly associated with better glycemic control among patients with diabetes in urban communities of Makassar.
Manajemen Jalan Nafas dengan Kombinasi Chest Physiotherapy dan Terapi Oksienasi pada Pasien Pneumonia
Pneumonia is a lower respiratory tract infection that may cause secretion retention, crackles, tachypnea, and reduced oxygenation, requiring measurable airway clearance and oxygen support in the emergency department. This case report describes clinical improvement in a single case following a combination of Chest Physiotherapy (CPT) and oxygen therapy. The patient presented with dyspnea, productive cough, and fever. Baseline assessment showed crackles, thick sputum difficult to expectorate, RR 27–28 breaths/min, SpO₂ 93%, temperature 38°C, and chest X-ray infiltrates consistent with pneumonia. The primary nursing diagnosis supported ineffective airway clearance with the need for oxygenation support. Interventions included structured CPT (postural drainage, percussion/vibration, deep-breathing, and effective coughing) and oxygen via nasal cannula titrated to target saturation. Outcomes were assessed quantitatively at T0 (baseline), T1 (after one session, ~1–2 h), and T2 (~24 h): RR, SpO₂, lung sounds, sputum characteristics, dyspnea (Borg 0–10), accessory muscle use, and temperature. Gradual clinical improvement was observed (RR 27–28 to 22 breaths/min; SpO₂ 93% to 96%), with reduced crackles, easier sputum expectoration, decreased dyspnea, and lower temperature. Generalization is limited due to the single-case design and concurrent medical therapies.
Copyright (c) 2025 Wal'afiat Hospital Journal
Manajemen Airway Dikombinasi dengan Hand Held Fan dan Deep Breathing Exercise terhadap Penurunan Sesak Nafas pada Pasien Efusi Pleura Bilateral
Pneumonia with bilateral pleural effusion may cause dyspnea due to reduced lung expansion and increased work of breathing. This case report describes clinical changes following an adjunct intervention package consisting of Airway management combined with a hand-held fan (HHF) and Deep breathing exercise (DBE) in the emergency department. A 35-year-old male presented with worsening dyspnea accompanied by chest pain and productive cough; baseline assessment showed a respiratory rate of 28 breaths/min and SpO₂ of 91%, and supplemental oxygen was administered as prescribed. The sequential intervention package (total ~5 minutes) included Airway management (semi-Fowler positioning, breathing-control education, and effective coughing/huff cough), HHF directed to the face at a distance of approximately 15–20 cm for ~2 minutes, and DBE for 5–10 repetitions (inhalation 2–3 s, hold 1–2 s, slow exhalation 4–6 s). Outcomes were assessed by comparing respiratory rate and SpO₂ at baseline and immediately after completing the package (~1 minute after DBE), along with the patient’s subjective dyspnea report. The patient reported reduced dyspnea, with respiratory rate decreasing to 22 breaths/min and SpO₂ increasing to 96%. Conclusion: the Airway-management plus HHF and DBE package was followed by clinical improvement in this case; however, generalizability is limited by the single-case design without control, lack of stage-by-stage measurements, absence of a standardized dyspnea scale, and potential confounding from concurrent medical therapies.
Analisis Interaksi Obat pada Pasien Hipertensi di Posyandu Lansia Lembaga Kartini Surya Khatulistiwa Tanjung Hilir
Polypharmacy of drugs in elderly hypertensive patients cannot be avoided because the elderly have several diseases other than hypertension. Polypharmacy administration of drugs can increase the potential for drug interactions to occur at a major, moderate or minor level, as well as occur in the pharmacodynamic or pharmacokinetic phase. One way that can be done to reduce these risks is by administering the right medication and minimizing the administration of polypharmacy for hypertensive patients. The research to analyze interactions between drugs, classify antihypertensive drugs, describe the percentage of drug interactions, and the severity of drug interactions given to elderly hypertensive posyandu patients at the Kartini Surya Khatulistiwa Tanjung Hilir Society. Observational with a descriptive model of the cross-sectional study. The sample used in this study is 36 hypertensive patients at the Posyandu Lansia Lembaga Kartini Surya Khatulistiwa Tanjung 2019. This research was conducted from March-April 2021. Samples are selected using Consecutive Sampling (nonprobability sampling). 79 cases interaction drug of hypertension patients in Posyandu Lansia Lembaga Kartini Surya Khatulistiwa Tanjung Hilir Drug interactions that occurred moderate level were 47 cases (59%) and pharmacodynamic stage in 71 cases (90%).
Analisis Metrik Sigma Serum Kontrol Komersial Glukosa dan Trigliserida Berdasarkan Variasi Lama Waktu Penyimpanan
Pengendalian mutu laboratorium dilakukan untuk evaluasi suatu proses pengujian untuk meminimalisir serta mencegah kesalahan dan penyimpangan sebelum hasil laboratorium diberikan kepada dokter atau pasien. Kendali mutu membutuhkan bahan kontrol untuk memonitor akurasi suatu metode pemeriksaan yang disebut bahan kontrol. Penyimpanan bahan kontrol haruslah sesuai panduan penyimpanan jika tidak maka akan mempengaruhi stabilitas bahan kontrol. Tujuan penelitian ini yaitu untuk mengetahui kinerja dari bahan kontrol jika dilakukan penyimpanan serum kontrol berdasarkan variasi lama penyimpanan. Metode penelitian yang digunakan yaitu kuantitatif menggunakan desain non randomized group pretest and postest design dengan jumlah kelompok kontrol 30 dan kelompok perlakuan 60 satuan percobaan yang kemudian dianalisis menggunakan rumus persamaan SD, Bias, dan Tea untuk mendapatkan nilai metrik sigma dan DPMO. Hasil metrik sigma pada parameter glukosa kelompok 0, 6, dan 8.5 jam berturut-turut (3,43; 4,64; 2,56) dengan DPMO pemeriksaan (32.263,7; 4.089,6; 201.872) dan parameter trigliserida kelompok 0, 6, dan 8.5 jam berturut-turut (3,06; 3,26; 2,67) dengan DPMO pemeriksaan (9.845,4; 21.963; 228.404).
Hubungan Lama Hemodialisis Dengan Kejadian Pruritus Pada Pasien Yang Mengalami Gagal Ginjal Kronik Di RS. Ibnu Sina Makassar Periode 2024
Chronic Kidney Disease (CKD) has become a global health problem and hemodialysis is one of the most widely used treatment therapies. Pruritus is one of the complications in hemodialysis patients. to determine the relationship between the duration of hemodialysis with the incidence of Pruritus in patients with chronic renal failure at Ibnu Sina Hospital Makassar period 2024. This study used an analytic observational method with cross sectional approach design. The population of all patients undergoing CKD who underwent hemodialysis amounted to 20 people. Data were analyzed by Kruskal-Wallis test. There is a significant relationship between the duration of hemodialysis with the incidence of Pruritus in CKD patients with a p value of 0.033. This value means p less than 0.05, which is then H1 is accepted. There is a significant relationship between duration of hemodialysis with the incidence of Pruritus in CKD patients at Ibnu Sina Hospital Makassar Period 2024.
Faktor yang Berhubungan dengan Lokasi Osteoarthritis Genue pada Pasien Usia Lanjut di RS Ibnu Sina Tahun 2021-2024
Factors Associated with the Location of Osteoarthritis Genue in Elderly Patients at Ibnu Sina Hospital in 2021-2024. Osteoarthritis is a common form of arthritis in geriatric populations that can cause damage to the bones and their surroundings. There are several things that are risk factors for Osteoarthritis. This study aims to make observations related to factors that can affect the occurrence of Osteoarthritis in the elderly, the data used is the patient's medical records recorded in the hospital. This study uses the cross-sectional study method. Univariate or characteristic analysis uses frequency distribution analysis and bivariate analysis or analysis of relationships between variables using the chi-square test. The results of the study showed that there was an effect of disease history on the risk of osteoarthritis in the elderly. Hypertension is one of the risk factors that can increase the incidence of osteoarthritis, especially in men, this is related to the activity of endogenous receptors (AR) in the Renin-angiotensin-aldosterone system.
Penerapan Slow Deep Breathing Terhadap Penurunan Tingkat Nyeri Pada Pasien Hipertensi Di IGD Rs Ibnu Sina YW.UMI Makassar
Hypertension is a chronic condition characterized by increased blood pressure in the arteries, which can disrupt the supply of oxygen and nutrients to body tissues. One nursing intervention for pain management in hypertensive patients is the slow deep breathing (SDB) technique. This technique can reduce pain intensity, stabilize heart rate and blood pressure, alleviate muscle tension, and improve patient well-being. This study aims to evaluate the effectiveness of SDB in reducing pain levels among hypertensive patients in the Emergency Department of RS Ibnu Sina YW.UMI Makassar. The implementation of this nursing intervention showed significant results, with a reduction in patients' pain levels from moderate (NRS 6) to mild (NRS 4), leading to a decrease in headache complaints. These findings indicate that SDB is an effective and efficient method for alleviating pain in hypertensive patients, making it a practical and applicable non-pharmacological intervention in healthcare settings.
Penerapan Terapi Guided Imagery Pada Tn. A Terhadap Penurunan Skala Nyeri Pada Pasien Gastritis Di Rs Ibnu Sina Makassar
Gastritis is one of the most common digestive disorders, often referred to as heartburn. This condition is characterized by inflammation of the gastric mucosa due to irritation or infection, which can lead to stomach damage if it persists. Gastritis is typically diagnosed based on clinical symptoms without histopathological examination. One non-pharmacological approach to alleviating pain caused by gastritis is Guided Imagery, a relaxation technique involving guided imagination to create positive mental images perceived by various senses. This technique aims to provide a calming effect and help reduce pain perception. This study aimed to evaluate the effectiveness of Guided Imagery in reducing pain intensity among patients with gastritis. The implementation of Guided Imagery was carried out as part of nursing interventions for patients with gastritis. The results showed that this technique effectively reduced pain levels, as indicated by a decrease in pain intensity and a reduction in expressions of discomfort, such as the absence of grimacing. Additionally, patients reported feeling more relaxed and comfortable after the therapy. In conclusion, Guided Imagery has proven to be an effective non-pharmacological method for reducing pain in gastritis patients. Given its benefits, this therapy can be recommended as part of a holistic approach to pain management for gastritis patients, particularly for those seeking to avoid or complement pharmacological treatments.
Analisis Biaya Berdasarkan Unit Cost pada Instalasi Rawat Inap
Cost analysis serves as a critical tool for hospital management in evaluating the efficiency of resource utilization. One commonly employed method is unit cost analysis, which supports the assessment of service production processes, determination of break-even points, and formulation of strategic decisions related to service volume and cost control. This study aimed to analyze fixed costs, fixed operational (semi-variable) costs, variable operational costs, total costs, and unit costs in the Inpatient Unit of a Private Hospital in Makassar in 2023. This research adopted an operational research design with a descriptive quantitative approach. The population comprised all financial transactions at the hospital in 2023, with the sample including all transactions associated with inpatient services. The findings showed that the fixed cost amounted to IDR 5,216,229,922, fixed operational cost to IDR 2,811,580,099, and variable operational cost to IDR 3,727,281,560. Total costs, calculated using three different approaches, were IDR 2,915,361,139 (Total Cost I), IDR 1,136,844,781 (Total Cost II), and IDR 650,882,586 (Total Cost III). Unit costs based on the double distribution method were identified as follows: Super VIP – IDR 1,087,677; VIP – IDR 870,775; Class 1 – IDR 654,674; Class 2 – IDR 532,583; and Class 3 – IDR 330,577. The results indicated that unit costs exceeding service tariffs posed a risk of financial loss. Therefore, the study recommends the application of the Activity-Based Costing (ABC) method, the implementation of clinical pathways, and the development of superior service units. Hospitals are encouraged to conduct periodic unit cost analyses and to establish service tariffs rationally, grounded in the outcomes of cost calculations.
Penerapan Head Up terhadap Kesadaran Pasien Cedera Kepala di IGD RSUD Sayang Rakyat
Head injury is a traumatic disturbance of brain function that may or may not be accompanied by interstitial bleeding within the brain substance (2,4,5). Emergency management aims to prevent secondary brain injury, including optimizing ventilation/oxygenation and cerebral perfusion, as well as patient positioning. A common non-invasive measure is 30° head elevation (Head-Up) to facilitate cerebral venous drainage. To describe changes in consciousness level (Glasgow Coma Scale/GCS) following the application of a 30° Head-Up position in a patient with moderate head injury in the emergency department. A single-patient case report in the emergency department of RSUD Sayang Rakyat Makassar. The primary Outcome was serial GCS recorded at baseline before elevation (T0) and during observation until transfer. Head-Up 30° was an independent nursing intervention; oxygen therapy was recorded as collaborative therapy. A 50-year-old male (Mr. R) with moderate head injury and subdural hemorrhage. At T0 (10:15 WITA) GCS was 3-3-5; at 10:45 WITA it remained 3-3-5; it increased to 3-3-6 at 12:50 WITA and remained 3-3-6 until 13:54 WITA when the patient was transferred to the operating room. Available observation lasted approximately 3 hours 39 minutes; the planned 8-hour follow-up was not completed due to definitive transfer. In this case, 30° head elevation (with collaborative oxygen therapy) was followed by an improvement in GCS from 3-3-5 to 3-3-6 during ED observation. As descriptive evidence, this report cannot establish causality but supports the use of 30° Head-Up as part of non-invasive early management for head injury.
Penerapan Balut Tekan sebagai Strategi Penanganan Awal Perdarahan Vulnus Laceratum di IGD Puskesmas Liwuto Kota Baubau
Laceration wounds (vulnus laceratum) may cause pain and external bleeding, requiring prompt initial management to prevent excessive blood loss. One simple early bleeding control strategy is direct pressure maintained with a pressure dressing. This case report describes the use of a sterile pressure dressing in a male patient (Mr. L) with a left plantar foot wound due to glass injury, accompanied by pain and active bleeding, presenting to the emergency unit of Liwuto Primary Health Center, Baubau. Data were obtained through clinical observation, brief interview, and review of available medical records/procedure sheets. Pain was assessed using the Numeric Rating Scale (NRS), while bleeding outcome was operationalized using bleeding status (active/controlled), dressing status (wet/dry), and time to hemostasis. After sterile pressure dressing application and 4-hour monitoring, pain decreased from NRS 8 to 3, and active bleeding was no longer observed at the 4-hour evaluation. These findings indicate clinical improvement in this case, but interpretation is limited by single-case design (n=1) without controls, incomplete quantitative serial bleeding documentation, and potential confounding from concomitant interventions (e.g., analgesics).
Efektivitas Dukungan Ventilasi terhadap Pola Napas pada Pasien Tuberkulosis di IGD RS TK. II Pelamonia Makassar
Pulmonary tuberculosis may impair ventilation and increase the work of breathing, placing patients at risk of an ineffective breathing pattern. This case report describes nursing support for ventilation through nurse-led interventions of pursed-lips breathing (PLB) and the semi-Fowler position in a pulmonary tuberculosis patient with an ineffective breathing pattern diagnosis. A descriptive single case report was prepared following CARE guidelines and the nursing process. Observation was conducted for 24 hours in a 69-year-old male patient in the emergency department of RS TK II Pelamonia Makassar. Outcomes were recorded consistently at baseline (March 17, 2025, 10.00 WITA) and at 24-hour follow-up, including respiratory rate (RR), oxygen saturation (SpO₂), signs of respiratory distress, and dyspnea using the Modified Borg Dyspnea Scale. Nurse-led interventions (semi-Fowler 30–45° and structured PLB) were implemented alongside collaborative therapy (oxygen via nasal cannula at 4 L/min and nebulized combivent/pulmicort) as prescribed. Clinical improvement was observed in this case, indicated by a decrease in RR from 25 to 22 breaths/min, an increase in SpO₂ from 96% to 100%, and a decrease in Borg score from 5/10 to 3/10, accompanied by reduced accessory muscle use. Conclusion: the nursing care package (PLB and semi-Fowler position) together with collaborative therapy was followed by improved breathing outcomes in a single pulmonary TB case; causality and generalization are limited and further studies are needed.
Pendekatan Fitoterapi pada Kejang Demam: Efektivitas Kompres Aloe vera terhadap Penurunan Suhu Tubuh
Kejang demam merupakan kejang yang terjadi pada anak usia 6 bulan - 5 tahun akibat peningkatan suhu tubuh diatas 38°C yang berlangsung lebih dari 15 menit. Kejang demam yang terjadi lebih dari 15 menit tanpa pengobatan awal yang cepat dan tepat dapat terjadi apnea yang menyebabkan hipoksia dan peningkatan kapiler yang menyebabkan kerusakan pada sel-sel otak sehingga berisiko mengalami keterlambatan tumbuh kembang, keterbelakangan mental dan kelumpuhan. Tujuan dari penelitian ini adalah untuk memberikan gambaran penerapan kompres Aloe vera terhadap penurunan suhu tubuh pada pasien kejang demam, Penelitian ini menggunakan metode studi kasus dengan pendekatan deskriptif. Subjek penelitian adalah An.F usia 10 bulan yang mengalami kejang demam. Setiap pasien diberikan kompres Aloe vera yang diterapkan pada dahi, ketiak, dan leher selama 30 menit. Diagnosa keperawatan yang ditegakkan antara lain hipertermia berhubungan dengan proses penyakit, defisit pengetahuan berhubungan dengan kurangnya paparan informasi, dan risiko aspirasi ditandai dengan peningkatan tekanan intragastrik. Asuhan keperawatan dilakukan secara menyeluruh mulai dari pengkajian hingga evaluasi. Hasil menunjukkan adanya penurunan suhu tubuh setelah pemberian kompres Aloe vera. Temuan ini mengindikasikan bahwa kompres Aloe vera berpotensi menjadi terapi tambahan yang efektif dalam penanganan kejang demam pada anak.
Hubungan Sikap Ibu Hamil Terkait Perilaku Hidup Bersih dan Sehat dengan Kejadian Bakteriuria Asimptomatik
Asymptomatic bacteriuria (ASB) during pregnancy may progress to urinary tract infection (UTI) and complications if undetected. Attitudes toward clean and healthy living behavior (PHBS) may be associated with ASB risk through genital hygiene, voiding habits, and hydration. To examine the association between PHBS attitudes and ASB among pregnant women at Jongaya Primary Health Center, Makassar. An analytical cross-sectional study (December 2023–January 2024) involving 56 pregnant women (accidental sampling). The independent variable was PHBS attitude (poor/moderate/good) measured using a PHBS attitude questionnaire. The dependent variable was operational ASB, determined by urine testing (dipstick leukocyte esterase/nitrite and/or urine sediment analysis) among participants without UTI symptoms based on a symptom-screening checklist interview. Chi-Square was used for association testing; due to small cell counts, a sensitivity analysis using category collapsing and exact testing was performed, with effect sizes (PR/OR) and 95% CIs reported. Poor PHBS attitude was found in 27 (48.2%), moderate in 11 (19.6%), and good in 18 (32.1%). Operational ASB was identified in 44 participants (78.6%). Chi-Square indicated a significant association (p=0.01). After collapsing categories (poor vs moderate/good), poor attitude showed higher ASB prevalence (PR=1.55; 95% CI: 1.16–2.08) and higher odds (OR=15.89; 95% CI: 1.88–134.18) with exact p=0.002. PHBS attitude was statistically associated with operational ASB in this setting. Causal inference cannot be made due to the cross-sectional design and potential confounding.
Penerapan Manajemen Asma pada Bersihan Jalan Napas pada Pasien Asma Bronchiale di IGD RS. TK. II Makassar
Bronchial asthma is a chronic inflammatory airway disease that may present with acute exacerbations characterized by bronchospasm, mucus hypersecretion, and increased work of breathing. In emergency settings, nursing care should focus on airway patency and oxygenation. To describe tripod positioning and nebulizer therapy in an acute bronchial asthma patient with ineffective airway clearance in the Emergency Department (ED). A descriptive single-case report in May 2025 at the ED of RS Tk. II Pelamonia Makassar. The intervention included tripod positioning (10 minutes) and nebulizer therapy (15 minutes), with pre- and post-assessment of respiratory rate, oxygen saturation, breath sounds, cough effectiveness, and dyspnea severity, aligned with SDKI–SLKI–SIKI reasoning. Clinical improvement was observed in this case, including reduced respiratory rate (28 to 22 breaths/min), increased oxygen saturation (92% to 97%), resolution of wheezing, more effective cough, and reduced dyspnea severity. Tripod positioning and nebulizer therapy were followed by clinical improvement in this case, while causal inference is limited due to the single-case design and potential concomitant treatments.
Hubungan Paparan Rokok, Riwayat BCG, dan Riwayat Kontak TB dengan Insidens TB Paru pada Wanita Usia Subur
Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (Mtb), affecting people of all ages globally. In Indonesia, the TB incidence in 2021 was 354 per 100,000 population, with an estimated mortality rate of 52 per 100,000. In South Sulawesi, TB cases rose to 68.8% in 2022 from a 48.3% case detection rate in 2021. This study aimed to assess the association between smoking exposure, BCG vaccination history, and TB contact history with pulmonary TB incidence among women of reproductive age at BBKPM Makassar in 2023. Using a cross-sectional quantitative approach, 354 samples were selected from 3,063 TB cases through purposive sampling. Data were collected from medical records of women aged 15–45 years with new pulmonary TB diagnoses and complete documentation. Chi-square analysis showed significant associations for smoking (p = 0.037), BCG history (p = 0.034), and TB contact (p = 0.004). The study concludes that these factors are significantly related to pulmonary TB in reproductive-age women.
Faktor Yang Mempengaruhi Timbulnya Tuberculosis Limfadenitis di Rumah Sakit Umum Pusat Wahidin Sudirohusodo Pada Tahun 2021-2023
Tuberculosis is a contagious disease caused by the bacterium Mycobacterium tuberculosis. This bacterium primarily affects the lungs, but it can also spread to other organs. One of the most commonly found forms of extrapulmonary tuberculosis is Tuberculous Lymphadenitis, which is a TB infection that affects the lymph nodes, especially in the cervical (neck) region. There are many factors that can contribute to the development of this disease. This study aims to identify the factors that influence the occurrence of Tuberculous Lymphadenitis at Wahidin Sudirohusodo Central General Hospital in Makassar during the period of 2021 to 2023. This quantitative research uses a cross-sectional approach to determine the risk factors—age, gender, nutritional status, history of tuberculosis, history of contact, diabetes mellitus, HIV status, immunization status, and hypertension—associated with the occurrence of Tuberculous Lymphadenitis. Data collection began with identifying TB cases, followed by tracing the associated risk factors that may lead to Tuberculous Lymphadenitis. The study population included all patients diagnosed with Tuberculous Lymphadenitis at Wahidin Sudirohusodo Central General Hospital from January to December in the years 2021–2023. The sampling technique used was quota sampling, a non-probability method based on non-random selection of a specific number or proportion of participants. A total of 422 samples that met the inclusion criteria were included in the study.The results showed that age, gender, nutritional status, diabetes mellitus, hypertension, and BCG immunization had a significant relationship with the incidence of Tuberculous Lymphadenitis. In contrast, history of tuberculosis, HIV status, and history of contact did not show a significant association with the disease.
Pengaruh Beban Kerja Dan Stres Kerja Terhadap Burnout Pegawai Di Rumah Sakit Bhayangkara Makassar Tahun 2024
Burnout Syndrome refers to a condition in which the body is completely exhausted, both physically and mentally. According to data from the International Labour Organization (ILO) in 2021, nearly 2 million workers die each year due to work-related accidents caused by fatigue. Of these, 71.43% of workers experienced mild fatigue before starting work. After work, 100% of workers experienced fatigue, with 11.43% reporting mild fatigue, 42.86% moderate fatigue, and 45.71% severe fatigue. It is noted that the number of contract employees at Bhayangkara Hospital Makassar is 448, with 7 employees having resigned, which accounts for 1.52%. The aim of this study is to determine the effect of workload and work stress on employee Burnout at Bhayangkara Hospital Makassar in the year 2024. This study used a quantitative research method with a cross-sectional study design. The total population in this study was 448 individuals, with a sample of 211 respondents. Data collection was conducted using questionnaires, and the analysis techniques included univariate, bivariate, and multivariate analysis. The results showed that workload had a significant effect on Burnout (p = 0.000), work stress had a significant effect on Burnout (p = 0.000), and there was a simultaneous effect of workload and work stress on Burnout, where the calculated F-value (7.363) was greater than the F-table value (3.04), with a significance value of 0.000 < 0.05.Conclusion: There is a simultaneous effect of workload and work stress on employee Burnout at Bhayangkara Hospital Makassar.
Perioperative Nursing Care dengan Tindakan Pyelithotomy pada Nefrolithiasis
Nephrolithiasis, commonly known as kidney stones, is a condition in which stones or crystals form in the kidneys, leading to impaired urination and causing pain. One of the surgical l treatments for staghorn kidney stones is open pyelolithotomy, a procedure to remove large kidney stones. This study aims to analyze Nursing Care for patients undergoing Perioperative pyelolithotomy. The research employs a qualitative case study approach, focusing on the preoperative and postoperative Nursing Care for patients diagnosed with nephrolithiasis and undergoing pyelolithotomy. The findings of the study show that based on Nursing assessment, two main diagnoses were identified: anxiety, related to insufficient information about the procedure, as evidenced by the patient appearing anxious and tense. The intervention provided was anxiety reduction, which effectively alleviated the patient's anxiety. The second diagnosis was acute pain, related to the physical trauma of surgery, as evidenced by the patient grimacing, being restless, and experiencing an increased heart rate. The intervention used was pain management, which included medication and Quranic murottal therapy. In conclusion, the study indicates that interventions such as deep breathing relaxation techniques and education about kidney stones to reduce anxiety, along with the use of murottal therapy and medication for pain relief, significantly improved the effectiveness of Nursing Care during the Perioperative period for nephrolithiasis patients.
Penerapan Manajemen Nyeri pada Pasien Perioperative dengan Hidronefrosis di RSUD Labuang Baji Kota Makassar
Hydronephrosis is a dilation of the renal pelvicalyceal system caused by urinary outflow obstruction, which may increase intrarenal pressure and trigger pain. This case report describes non-pharmacological pain management in a Perioperative hydronephrosis patient using deep breathing relaxation in the pre-operative phase and benson relaxation in the post-operative phase. The report followed the nursing process (assessment–diagnosis–intervention–implementation–evaluation). The primary Outcome was pain intensity using a 0–10 Numeric Rating Scale (NRS), complemented by physiological indicators (blood pressure, pulse, respiratory rate, temperature, oxygen saturation) and behavioral responses. In the pre-operative phase, pain decreased from NRS 4 to NRS 2 after deep breathing relaxation, along with improved vital signs. In the post-operative phase, pain decreased from baseline NRS 5 to NRS 3 after a 15-minute benson relaxation session and further to NRS 2 at the next follow-up (≈30 minutes), with a trend toward stabilized vital signs. Given the Perioperative setting, analgesics/anesthesia and the surgical procedure may confound pain Outcomes; therefore, findings are reported descriptively without attributing the changes solely to relaxation techniques. This case suggests that standardized relaxation techniques can be integrated into Perioperative nursing care to support comfort in hydronephrosis patients.
Penerapan Posisi Lateral Dalam Menjaga Kepatenan Jalan Nafas Pada Pasien Anak Dengan Kejang Demam Di IGD Rs. Ibnu Sina Makassar
Latar Belakang: Keadaan darurat medis yang umum terjadi pada anak-anak dapat menyebabkan kesulitan bernapas dan kehilangan kesadaran, yang merupakan masalah kejang demam. Posisi menyamping dianggap sebagai tindakan pertama yang efektif untuk mengendalikan kejang demam pada anak. Tujuan: Studi kasus ini bertujuan untuk untuk mengetahui kepatenan jalan napas pada posisi lateral dalam mencegah terjadinya aspirasi pada anak serta untuk mengetahui efektifitas penerapan posisi lateral dalam menjaga kepatenan jalan nafas pada pasien anak dengan kejang demam di ruang IGD Rs. Ibnu Sina YW-UMI. Metode: Metode penelitian dengan pendekatan deskriptif, dimana data dikumpulkan melalui observasional terhadap anak yang mengalami kejang demam dan mendapatkan intervensi posisi lateral. Hasil: Hasil studi menunjukkan bahwa penerapan posisi lateral efektif dalam menjaga kepatenan jalan nafas pada pasien anak dengan kejang demam. Kesimpulan: Dari hasil studi yang didapatkan yaitu nampak jalan napas pasien tetap terbuka dan tidak terhalang oleh lidah atau bahan lain yang mungkin masuk ke dalam rongga mulutnya sehingga mencegah terjadinya aspirasi jalan nafas. Temuan ini menekankan pentingnya pendekatan sederhana seperti posisi lateral dalam manajemen kejang demam pada anak di fasilitas kesehatan. Penelitian lebih lanjut diperlukan untuk validasi temuan ini dengan metode yang berbeda serta untuk meningkatkan pemahaman dan kesadaran masyarakat tentang tindakan pertolongan pertama yang tepat dalam situasi kejang demam pada anak.
Tinjauan Literatur Strategis Tentang Isu-Isu Kesehatan Masyarakat di Indonesia
Public health in Indonesia faces a dual burden of disease, persistent Stunting, service inequities, and emerging threats such as climate change, urbanization, and digital health transitions. A transparent literature synthesis is needed to identify critical issues, evidence gaps, and policy priorities. To map strategic public health issues in Indonesia and propose policy and research priorities based on thematic evidence synthesis. This study employed a scoping review of publications from 2019–2025 (with a focus on 2023–2025 while allowing foundational references for conceptual frameworks). Searches were conducted in academic databases and policy sources. Records were screened using predefined inclusion/exclusion criteria. Findings were synthesized thematically using an SDGs and social determinants of health lens. Evidence quality was categorized using a pragmatic appraisal by source type (peer-reviewed vs grey literature). A total of 32 sources were included (as listed in the reference list) and mapped into key themes: social determinants; environment and sanitation; nutrition/Stunting; communicable diseases and NCDs; health policy and systems; health behavior and education; maternal and child health; workforce and community cadres; and cross-cutting challenges (climate change–urbanization–digitalization). Key gaps include limited implementation/evaluation studies and inconsistent cross-region comparative evidence. The literature supports strengthening primary care, adopting evidence-informed policies grounded in social determinants, and prioritizing implementation research to evaluate community-based and system-level interventions.