Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery <p align="justify"><strong>The Science Midwifery</strong> is a peer-reviewed open access <strong>bi-monthly</strong> Intitute of Computer Science (IOCS). This journal is <strong>published bi-monthly (August, October, December, February, April, June)</strong> since August 2022. This professional journal provides a venue for the publication of research relevant to midwifery and reproductive health practice by specialists and researchers in various disciplines including midwifery, reproductive health, maternal and child health, obstetrics and gynecology, sexual health promotion, women's health and nursing. It publishes quantitative and qualitative original articles, review articles, short communications, case reports and letters to the editor in a broad range of clinical and interdisciplinary topics. <em>(<a href="http://midwifery.iocspublisher.org/index.php/midwifery/EP#focusAndScope">Look at the scope</a>)</em></p> <p>&nbsp;</p> <p>&nbsp;</p> en-US jmidwifery@iocspublisher.org (Patrisia) jmidwifery@iocspublisher.org (Tigor Methodeus) Sat, 22 Mar 2025 23:06:53 +0000 OJS 3.1.2.4 http://blogs.law.harvard.edu/tech/rss 60 Literature review: Personal hygiene genitalia and adolescent reproductive health https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1863 <p>Genital hygiene is an essential aspect of maintaining adolescent reproductive health. Poor hygiene practices can increase the risk of infections and other health problems. This study aims to review the relationship between genital personal hygiene and adolescent reproductive health based on various previous studies. The method used was a literature review of eleven scientific articles that discussed genital hygiene, reproductive health education, and factors that affect adolescent behavior in maintaining personal hygiene. The sources studied include quantitative and qualitative research from various countries. The results showed that teenage knowledge about genital hygiene was closely related to hygiene behavior. Health education, the role of parents, and effective methods of conveying information have been proven to contribute to increasing adolescents' awareness of the importance of genitalia hygiene. However, the research still has limitations, such as the lack of longitudinal studies and the lack of focus on adolescent boys. The conclusions of this review confirm that proper education about genital hygiene is essential to prevent reproductive health problems. Further research is needed with a wider population coverage, a more varied approach to methods, and the use of technology in genital hygiene education for adolescents.</p> Sukmawati Sukmawati, Jacoba Nugrahaningtyas Wahjuni Utami, Tutik Astuti Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1863 Thu, 20 Mar 2025 07:11:49 +0000 Determinants of patient satisfaction in health center services in Indonesia https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1855 <p>Patient satisfaction is a crucial indicator in assessing the quality of health services in Community Health Centers (Puskesmas). As the primary healthcare providers at the community level in Indonesia, Puskesmas play a vital role in ensuring accessible, affordable, and comprehensive health services. High patient satisfaction not only reflects the effectiveness of healthcare delivery but also influences patient adherence to medical recommendations, trust in the healthcare system, and overall public health outcomes. Therefore, understanding the factors that determine patient satisfaction is essential for improving service quality and formulating effective healthcare policies. Quality health services in Community Health Centers are one of the main indicators in increasing patient satisfaction. This study aims to analyze the determinants of patient satisfaction with Community Health Center services in Indonesia using secondary data from the 2017 Health Manpower Research (Risnakes). The research design uses a quantitative approach with Spearman Rank correlation analysis to see the relationship between independent variables, such as speed of service, friendly attitude of officers, communication, patient rights, and quality of health service facilities, to the dependent variable, namely patient satisfaction. The results showed that speed of service had the most dominant influence on patient satisfaction (r = 0.792; p &lt; 0.05), followed by quality of service facilities (r = 0.473; p &lt; 0.05) and the right to choose health services (r = 0.283; p &lt; 0.05). Other factors, such as friendliness of officers, communication, and confidentiality of patient information, showed a weak but significant relationship. Overall, the independent variables contributed 99% to the dependent variable. This study emphasizes the importance of improving the efficiency of services and physical facilities in Community Health Centers to improve patient satisfaction. These findings are expected to be a reference in formulating better health service policies in Indonesia.</p> Preti Sinta Harahap, Putra Apriadi Siregar, Fitriani Pramita Gurning Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1855 Thu, 20 Mar 2025 09:58:25 +0000 SUS- The relationship between motivation, anxiety, stress and hockey athletes' confidence before competing https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1876 <p>Confidence is a key aspect of an athlete's performance, affecting motivation, performance, and stress management while competing. This study aims to analyze the relationship between motivation, anxiety, and stress with the confidence of East Java hockey athletes before competing. A quantitative descriptive research method was conducted with the DASS-42 questionnaire to measure anxiety and stress levels, as well as a questionnaire adopted for motivation and confidence. Of the 60 respondents, 73.3% of the athletes showed excellent motivation, while anxiety and stress ranged from normal to severe. Analysis using Spearman rank showed a significant relationship between motivation (p=0.001), anxiety (p=0.006), and stress (p=0.005) and self-confidence. These results emphasize the importance of athletes' mental readiness in facing competition and the need for support and education regarding the management of psychological factors. Advice is given for coaches to strengthen mental support programs to increase athletes' confidence.</p> Nafiatus Sa'adah, Wiwik Widiyawati Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1876 Sat, 22 Mar 2025 06:13:44 +0000 Characteristics of chronic rhinosinusitis patients at the ENT head and neck polyclinic https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1794 <p>Background: Chronic rhinosinusitis (CRS) is a long-lasting inflammatory disorder affecting the nasal passages, paranasal sinuses, and upper respiratory tract, marked by symptoms persisting for a minimum of 12 weeks. The purpose of this study is to identify the characteristics of chronic rhinosinusitis patients at the ENT Head and Neck Polyclinic at ROYAL PRIMA Hospital, Medan. Methods: A descriptive research design with a retrospective data collection method was used through secondary data. The population comprised medical records of patients diagnosed with chronic rhinosinusitis at the outpatient polyclinic during the 2021-2022 period, totaling 80 records. Data were collected using purposive sampling, selecting the most complete medical records. Results: The distribution of chronic rhinosinusitis patients showed that the largest age group was 20-29 years (28.4%). Females were more affected (59.7%) than males (40.3%). The most common primary complaint was nasal congestion (28.4%), with the maxillary sinus being the most infected (47.8%). Medical treatment was predominant (55.2%) compared to surgical intervention (turbinectomy) at (44.8%), emphasizing the need for patient evaluation to ensure appropriate treatment. Conclusions: This study provides an overview of chronic rhinosinusitis (CRS) patients, highlighting that those aged 20-29 years are most affected, with a notable prevalence among females (59.7%). The primary complaints include nasal obstruction, facial pain, and headaches, often linked to inflammation and blockage in the sinus pathways. Treatment typically involves pharmacological therapy, while surgery is reserved for those with more severe cases, emphasizing the need for tailored management strategies.</p> <p>&nbsp;</p> Yemima Kristina, Yuliani Mardiati Lubis, Andika Zayani Tambunan, Naomi Grace Rezeki Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1794 Tue, 25 Mar 2025 04:10:43 +0000 The immunomodulatory activity of dioscorea alata on spleen histology of rats induced with 50% alcohol https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1865 <p>Dioscorea alata is frequently consumed and has several health advantages. The immune system-protecting spleen may be protected by bioactive substances in Dioscorea alata tubers. This study examined the influence of immunomodulatory ethanol extract of Dioscorea alata (EEDA) on the diameter of the white pulp of the spleen in 50% alcohol-induced rats (Rattus norvegicus). This research is quasi-experimental using post-test only controlled group design. Twenty-five Rattus norvegicus were separated into five groups. The normal control group (C) received Carboxymextyl Cellulose (CMC), the negative control group (NC) received CMC and 50% alcohol, and three groups received EEDA at doses of 50, 250, and 500 mg/kg for 14 days and 50% alcohol. The diameter of the white pulp of the spleen data analyzed with Kruskal-Wallis and Mann-Whitney tests. The study found a significantly increase in the diameter of the white pulp of the spleen (p&lt;0.05) in the negative control group, EEDA doses of 50 and 250 mg/kg. The control group and EEDA doses 500 mg/kg groups had smaller the diameter of the white pulp of the spleen. The conclusions of this research proved that EEDA has an immunomodulatory activity, EEDA was immunostimulant at doses 50 and 250 mg/kg and immunosuppressant at doses 500 mg/kg.</p> Sri Nabawiyati Nurul Makiyah, Adelia Nabilah Zahra Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1865 Tue, 25 Mar 2025 04:40:54 +0000 Analysis of the performance of access and quality of the public safety center (PSC) 119 on patient satisfaction at the North Tapanuli District Health Office https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1866 <p>Public Safety Center (PSC) 119 is an integrated emergency service based on a call center. Patient satisfaction in health services is very important to note because it can describe the quality of service at a health service location. The purpose of this study was to analyze the Influence, Performance, service quality, and access to patient satisfaction of the Public Safety Center (PSC) 119 of the North Tapanuli Health Office in 2024. This research method is descriptive analytic with a correlational design. A total of 150 patients who had used the PSC 119 service at 5 Health Centers in the North Tapanuli Health Office became respondents in this study and were selected using a simple random sampling technique. The research instrument used a questionnaire sheet. Data analysis included univariate analysis, bivariate analysis and multivariate analysis using multiple logistic regression tests. The results of this study indicate that using the Pearson Correlation test and found a significance value (2-tailed) of 0.000 (p &lt;2 0.05) which means H1 is accepted so that there is a significant influence between the influence of Officer Performance and Satisfaction of PSC 119 ambulance patients, there is an Influence between Service and Satisfaction of PSC 119 Ambulance Patients in North Tapanuli Regency with the results that (2-tailed) is 0.000 (p &lt;0.05), the Influence of Access to Patient Satisfaction by PSC 119 Ambulance Nurses in North Tapanuli Regency with the results that all variables are strongly and positively correlated with patient satisfaction (Coeff. correlation&gt; 0.6) The most dominant variable that influences Service to satisfaction is empathy with a value of p = 0.006. It is expected that the health service can improve facilities and training regularly to all officers in order to provide better services.</p> Pebri Angki Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1866 Tue, 25 Mar 2025 05:16:52 +0000 Analysis of axial T2 TSE images using deep learning reconstruction in MRI of brain tumors https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1867 <p>Magnetic Resonance Imaging (MRI) Brain examinations often encounter uncooperative patients, necessitating rapid scanning techniques that yield optimal results. To address this challenge, advanced technologies such as deep learning can be leveraged to accelerate scan time, reduce noise, and enhance image precision. This study aims to evaluate the disparity in MRI Brain image quality with and without deep learning in tumor cases to achieve superior diagnostic imaging. Employing a quantitative experimental approach, this research analyzed a sample of 30 patients collected from January to February 2025. Three Radiologist Specialists assessed the images using a questionnaire based on the Visual Grading Analysis (VGA) method. The obtained responses were statistically examined through Cohen’s Kappa consistency test and Wilcoxon Signed-Rank Test. Findings revealed a statistically significant difference in image information between deep learning-assisted and conventional MRI scans. In T2 TSE sequences, deep learning reconstruction demonstrated superior anatomical visualization of the Gray Matter, White Matter, Lateral Ventricles, Basal Ganglia, and Parafalx Cerebri. However, in brain tumor pathology visualization, conventional MRI exhibited sharper and more distinct tumor delineation. Although deep learning-enhanced T2 TSE sequences reduced scan duration and improved overall image quality, they provided suboptimal diagnostic information in tumor cases.</p> Nadifah Pratiwi Muzdalifah, Hernastiti Sedya Utami, Fathur Rachman Hidayat, Kusnanto Mukti Wibowo, Muhammad Riefki Jadmika, Alan Samudra Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1867 Tue, 25 Mar 2025 06:25:04 +0000 Nostalgic card games as a dementia prevention therapy in the elderly https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1874 <p>PAKARNOS is a cognitive training effort to prevent dementia in the elderly by enhancing their memory through storytelling based on images. This nostalgia card game utilizes reminiscence therapy, encouraging elderly individuals to recall past events, relax their minds, and alter their response to dementia. Dementia is a clinical syndrome characterized by a decline in intellectual function, memory impairment, and cognitive deterioration, which can disrupt daily life and affect the elderly's bio-psycho-social-spiritual well-being. PAKARNOS involves showing old pictures to elderly participants, with a facilitator providing keywords to stimulate memory recall and storytelling. This method helps sharpen cognitive function and prevent dementia. This study used a case study method with nine elderly respondents at the Jolotundho guest house, Tresna Werdha Yogyakarta Social Service Center. The elderly actively engaged in the game, expressed happiness, and enthusiastically shared memories associated with the objects in the images. They recalled past experiences and demonstrated an improved ability to remember and describe objects, indicating enhanced cognitive function. The results suggest that PAKARNOS is an effective educational and recreational tool to improve memory, reduce dementia risk, and provide meaningful activities for the elderly.</p> Ganesa Gita Ayu Cahyani, Kartinah Kartinah, Muhammad Fathoni Rohman Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1874 Tue, 25 Mar 2025 07:09:56 +0000 The effectiveness of moringa leaves extract to prevent stunting at toddlers aged 23-59 months https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1872 <p>Background: Stunting remains a critical public health challenge, particularly in low- and middle-income countries, where inadequate nutrition affects child growth and development. One of the main factors causing stunting is chronic malnutrition in early life. Moringa (Moringa oleifera) leaves are rich in essential nutrients, including proteins, vitamins, and minerals, which are vital for growth. This study investigates the effectiveness of Moringa leaves extract in preventing stunting among toddlers aged 23–59 months. Method’s: This study involved 40 participants who were in kebomas sub-district, gresik district. A randomized controlled trial was conducted with an intervention group receiving Moringa leaves extract supplementation and a control group receiving standard nutrition. Anthropometric measurements, including height-for-age Z-scores (HAZ), were recorded at baseline and after a 6-month intervention period. The results indicate a significant improvement in HAZ scores in the intervention group compared to the control group (p &lt; 0.05). Additionally, children who received Moringa supplementation showed better appetite, improved hemoglobin levels, and enhanced overall nutritional status. Conclusion: These findings suggest that Moringa leaves extract can be an effective, affordable, and sustainable strategy for preventing stunting in vulnerable populations. However, further research is needed to determine the optimal dosage and long-term effects. Integrating Moringa supplementation into nutrition programs could be a promising approach to combating childhood stunting and improving global child health outcomes.</p> Nugrahadi Dwi Pasca Budiono, Dwi Faqihatus Syarifah Has Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1872 Wed, 26 Mar 2025 05:18:10 +0000 Comparison of visual acuity before and after senile cataract surgery (in patients with diabetes mellitus less than 5 years and more than 5 years) in Yogyakarta https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1875 <p>Cataract is a condition in which the lens fiber on the lens capsule crumbles. One of the complications of diabetes mellitus is diabetic retinopathy. The study aimed to compare the visual acuity before and after phacoemulsification surgery in senile cataract patients with diabetes mellitus less than and more than 5 years in Yogyakarta. It was analytical observational research with cross-sectional design. The study was conducted at the Eye Clinic of a private hospital in Yogyakarta by using samples of 53 patients. The dependent t test method was used as the research test. The results of the study were significant with a value of 0.000 (P &lt; 0,05), indicating there was a significant correlation between the visual acuity before and after phacoemulsification.</p> Yunani Setyandriana, Putri Virda Salsabillah Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1875 Wed, 26 Mar 2025 05:44:42 +0000 Differences in knowledge and attitudes between adolescents about HIV/AIDS, and their implications for targeted interventions https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1829 <p>This study analyzed the differences in levels of knowledge and attitudes towards HIV/AIDS between adolescent boys and girls and encouraged them towards more targeted interventions. Using a quantitative approach, data was collected through a survey of 300 respondents aged 15–19 years in urban and rural areas. The results show that adolescent girls tend to have a higher level of knowledge about HIV/AIDS transmission and prevention compared to adolescent boys. However, positive attitudes towards people with HIV/AIDS are higher in adolescent boys. Factors such as access to information, parental education, and peer influence play a significant role in shaping knowledge and attitudes. Based on these findings, the intended intervention needs to consider gender differences to improve the effectiveness of HIV/AIDS prevention programs. Programs for adolescent boys can be focused on improving basic knowledge, while programs for adolescent girls require the stress of the importance of empathy and stigma reduction.</p> Edi Purwanto, Lingga Arta Gumilang Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1829 Wed, 02 Apr 2025 04:44:10 +0000 Dietary almonds and peanuts improve metabolic health and reduce oxidative stress in wistar rats https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1856 <p>Metabolic syndrome characterized by insulin resistance, atherogenic dyslipidemia, and hypertension, is a significant health concern often associated with obesity and Diabetes Mellitus. Regular consumption of nuts has been suggested to mitigate some of these conditions. This study investigates the effects of almond and peanut consumption on oxidative stress, plasma lipids, body weight, glucose, and blood pressure in Wistar rats. Wistar rats were divided into four dietary groups: standard diet (ST), high-fat diet (HF), high-fat diet with almonds (HFA), and high-fat diet with peanuts (HFP). The treatment lasted for 8 weeks, during which body weight was monitored weekly. Blood pressure measurements and retro-orbital blood samples were collected before and after the treatment. Superoxide dismutase (SOD) and malondialdehyde (MDA) levels were measured using ELISA and TBARS methods. Blood lipid profiles and glucose levels were analyzed using enzymatic methods. Statistical tests used the oAnova followed by Posthoc LSD. The HF group exhibited significant increases in body weight, blood glucose, cholesterol, triglycerides, MDA, and blood pressure, with reduced SOD levels. Conversely, the HFA and HFP groups showed moderated increases in these parameters compared to the HF group. Both nut-supplemented groups had significantly lower MDA levels and higher SOD activity, indicating reduced oxidative stress and enhanced antioxidative defenses. Almonds and peanuts can reduce body fat, improve lipid profiles, and stabilize blood glucose levels, suggesting their potential role in promoting metabolic health and reducing cardiovascular risk. Further research should explore the long-term benefits and the specific bioactive compounds responsible for these effects.</p> Diniwati Mukhtar, Nunung Ainur Rahmah, Aan Royhan, Amirah Yusnidar Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1856 Wed, 02 Apr 2025 06:52:18 +0000 Top management support and electronic medical records effectiveness: A case study at Amanda Hospital https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1859 <p>The adoption of Electronic Medical Records (EMRs) has significantly enhanced healthcare efficiency, accuracy, and data accessibility. However, successful EMR implementation is highly dependent on top management support. This study examined the role of leadership in facilitating EMR effectiveness at Amanda Hospital, Indonesia. A quantitative descriptive approach was employed with a cross-sectional design, involving 55 respondents comprising administrative staff, IT personnel, and healthcare professionals. Data were collected through structured surveys, interviews, and observations. The results indicated a strong positive correlation between top management support and EMR effectiveness. Leadership commitment played a crucial role in resource allocation, policy enforcement, and staff training, all of which contributed to successful EMR adoption. System usability and training availability were identified as key moderating factors, influencing user adaptation. Despite improvements in data accuracy, infrastructure limitations and system downtimes emerged as critical challenges. The findings emphasize the need for continuous managerial involvement, structured training programs, and robust IT infrastructure to sustain EMR effectiveness. This study provides valuable insights for healthcare institutions aiming to optimize EMR implementation by integrating technical, managerial, and policy-driven strategies.</p> Mutiara Nurtika Widyasasmita, Agustinus Very Ricki Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1859 Thu, 03 Apr 2025 04:30:13 +0000 Evaluation of electronic medical record user satisfaction in baros public health center using the end user computing satisfaction model https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1860 <p>The implementation of Electronic Medical Records (EMRs) has transformed healthcare services by improving accessibility, efficiency, and patient data management. However, user satisfaction remains a significant challenge, affecting the successful adoption and utilization of EMR systems. This study evaluated EMR user satisfaction at UPTD Puskesmas Baros, Kota Sukabumi using the End User Computing Satisfaction (EUCS) model, which assesses five key factors: content, accuracy, format, ease of use, and timeliness. A cross-sectional survey was conducted among 120 healthcare professionals, and the collected data were analyzed using descriptive statistics and multiple linear regression. The results indicated that format had a significant negative impact on satisfaction, suggesting usability issues related to system interface design. While content and accuracy were positively correlated with satisfaction, their effects were not statistically significant. Ease of use and timeliness showed weak correlations, indicating that system efficiency remains a concern. The findings highlight the need for user-centered design improvements and workflow integration strategies to enhance EMR usability. Future research should explore additional factors influencing satisfaction and investigate the long-term effects of system modifications.</p> Dwi Anantama Putra, Wahyu Wijaya Widiyanto Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1860 Thu, 03 Apr 2025 05:03:34 +0000 Analysis of risk factors for incomplete inpatient medical records using the fishbone method https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1861 <p>Incomplete inpatient medical summaries remain a persistent issue that affects administrative processes and the quality of patient data. This study aimed to analyze the completeness and contributing factors of incomplete inpatient medical summaries using the Fishbone Method (Ishikawa Diagram). A qualitative descriptive approach was employed, with data collected through observations, interviews, and document reviews of 99 inpatient medical summaries, selected using Slovin’s formula with a 10% margin of error. The study involved medical record officers and healthcare professionals, selected through purposive sampling. Data analysis followed the qualitative descriptive method, including data reduction, data presentation, conclusion drawing, and triangulation. The findings identified five primary factors contributing to incomplete medical summaries: Man (low compliance among healthcare professionals), Method (suboptimal Standard Operating Procedures), Machine (ineffective hospital information systems), Money (insufficient investment in training), and Material (medical records not yet fully electronic). The study recommends medical staff training, SOP optimization, and the implementation of an electronic medical record system with a required lock feature to ensure complete documentation of inpatient medical summaries.</p> Ernawati Ernawati, Sinta Novratilova Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1861 Thu, 03 Apr 2025 05:22:11 +0000 Optimizing outpatient claim management: The role of sep and document completeness – a qualitative https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1862 <p>Efficient outpatient claim management is essential for hospital financial sustainability, particularly under Indonesia’s National Health Insurance (Jaminan Kesehatan Nasional, JKN) system. This study aimed to explore the challenges and optimization strategies in outpatient claim management at UOBK RSUD R Syamsudin SH, focusing on the role of Participant Eligibility Letter (Surat Eligibilitas Peserta, SEP) and document completeness. A qualitative descriptive approach was applied, using thematic analysis to identify key themes from observations, in-depth interviews, and document analysis. Findings revealed that incomplete claim documents, errors in SEP completion, manual verification bottlenecks, and lack of administrative training significantly contributed to claim delays and rejections. The study suggests that standardized document verification, digital integration with BPJS Kesehatan, and regular staff training are critical for optimizing claim processing. These strategies can improve hospital cash flow, reduce claim rejection rates, and enhance service efficiency. This research provides practical recommendations for hospital administrators and policymakers to refine BPJS claim management, ensuring timely reimbursement and sustainable healthcare financing.</p> Budi Ramdhani, Musta'inul Habibi Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1862 Thu, 03 Apr 2025 05:41:30 +0000 Correlation between clinical severity and chest X-ray grade using the Brixia score in pneumonia patients confirmed with the Delta variant of Covid-19 https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1886 <p>Background: COVID-19 is a disease that attacks the respiratory organs. This disease can be transmitted directly or indirectly through droplets released by an infected individual. The clinical manifestations that appear vary depending on the degree of severity. Chest X-ray is one of the supporting examinations to establish a diagnosis of COVID-19. There are several chest X-ray assessments used to determine the severity of pneumonia in individuals infected with COVID-19, one of them is Brixia Score. The aim of this study is to determine the correlation between the degree of clinical severity and the degree of chest X-ray using Brixia Score in pneumonia patients confirmed with delta variant of COVID-19. Method: This study is an observational study using a correlative analysis method with a cross-sectional research design. Sampling in this study was carried out by non-random consecutive sampling from medical record data at the RSUD Merah Putih Magelang, totaling 38 samples. The statistical analysis used is the Spearman's test. Result: In this study, the correlation coefficient value was 0.851 and p &lt; 0.05, which states that there is a strong correlation between the degree of clinical severity and the degree of chest X-ray using Brixia Score. Conclusion: There is a strong correlation between the degree of clinical severity and the degree of chest X-ray using the Brixia Score in pneumonia patients confirmed with delta variant of COVID-19.</p> Anggita Putri Kantilaras, Rifqy Hendrian Pamungkas Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1886 Thu, 03 Apr 2025 06:07:09 +0000 Analysis of hypertension health services in the working area of the Padangsidimpuan City Health Office https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1850 <p>The low achievement of hypertension services in the work area of the Padangsidimpuan City Health Office needs to be analyzed on the level of knowledge and attitude of patients, the availability of facilities and infrastructure, and the support of health workers. System components are also analyzed to find out how input, process and output elements are in hypertension services. The research method combines quantitative and qualitative methods sequentially. A sample of 107 respondents was taken proportionally random sampling in the hypertensive population aged ≥ 15 years. The results of the study revealed that 42.1% of patients had low knowledge, 62.6% of patients had a negative attitude, and 57% of the support of health workers was negative. In the system analysis, (input elements) are known to be inadequate in the availability of human resources and the availability of funds. It was concluded that public attitudes, support of health workers, human resources and inadequate budgets have a relationship with low hypertension service achievement. The author's recommendations include the importance of improving public attitudes through more optimal education. The role of the government must be more decisive on the availability of human resources and consistently provide support for the hypertension program budget.</p> Sahran Azhari Sitompul, Hardisman Hardisman, Kamal Kasra Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1850 Fri, 04 Apr 2025 04:26:02 +0000 Investigating crucial elements of formula milk and the inadequacy of exclusive breastfeeding in Indonesia: A litarature review https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1879 <p>Breast milk provides optimal nutrition for newborns, supporting their growth and development while meeting essential nutritional needs. Exclusive breastfeeding is crucial; however, many mothers face challenges that hinder their ability to breastfeed exclusively. Additionally, some parents believe that breast milk alone is insufficient, leading them to supplement with formula milk. Methods: This literature review analyzed studies from Google Scholar, Semantic Scholar, and Garuda, published between 2014 and 2024 in English or Indonesian. Only full-text quantitative or qualitative studies were included, assessed using the CASP tool, and data extraction followed a structured approach. The synthesis identified six predominant factors contributing to the failure of exclusive breastfeeding and the use of formula milk, which were further analyzed for interconnections. Results: The investigation produced 20 studies that highlighted the factors influencing formula milk use and the failure of exclusive breastfeeding in Indonesia. Key elements identified include understanding, spousal/family support, promotion of formula milk, maternal disposition, profession, and education. These factors were found to interact and exacerbate the challenges of exclusive breastfeeding. Conclusion: The review found that inadequate breastfeeding practices in Indonesia are primarily due to factors such as lack of knowledge, insufficient family support, the aggressive promotion of formula milk, maternal attitudes, work demands, and educational background. Addressing these issues through targeted interventions can improve breastfeeding rates and reduce the reliance on formula milk.</p> Anis Novitasari, Monica Ria Pramesti, Qorinah Estiningtyas Sakilah Adnani, Hadi Susiarno Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1879 Fri, 04 Apr 2025 10:08:01 +0000 The influence of nutritional literacy and adolescent eating habits: A literature review https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1869 <p>Adolescents are prone to nutrition problems due to low nutrition literacy and unhealthy eating patterns. In Indonesia, the prevalence of chronic energy deficiency (CED), central obesity, and anemia in adolescents is still high, potentially increasing infectious diseases in adulthood. The literature review method was used in this study through a systematic search through BioMed, Googe Scholar, Pubmed, Science Direct, and SAGE databases. Articles that met the inclusion criteria and were published between 2020-2024 and were relevant to nutrition literacy, eating habits, and nutritional status of adolescents were further analyzed. Analysis of the 7 selected articles showed that good nutrition literacy was positively associated with healthier food choices. However, good nutrition literacy is not sufficient without a supportive environment and behavioral skills. Nutritional literacy and adolescent diets are influenced by factors such as socioeconomic status, maternal education, and access to health services. A comprehensive approach through school education, family roles, and policies that contribute to improving nutrition literacy in adolescents is needed. Preventing obesity and non-communicable diseases in the future is important by strengthening nutrition literacy. Prioritizing applicable skills such as healthy cooking, and reading food labels in support of sustainable behavior change is recommended for future interventions.</p> Yadya'ul Fikroh, Nurjanah Nurjanah, Eti Rimawati, MG Catur Yuantari, Adian Khoironi Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1869 Fri, 04 Apr 2025 10:35:15 +0000 Improving reproductive health counseling for women with chronic kidney disease in nephrology settings https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1883 <p>Chronic kidney disease (CKD) presents significant challenges for women of reproductive age, particularly regarding pregnancy planning and maternal-fetal health risks. This study explores the perspectives of women with CKD on pregnancy and family planning, focusing on communication gaps between patients and nephrologists at Murni Teguh Hospital Pematang Siantar. Using a qualitative research design, semi-structured interviews were conducted with 30 women aged 18–45 years diagnosed with CKD at varying stages. Thematic analysis identified three key issues: (1) limited discussions with nephrologists regarding pregnancy and contraception, (2) patient concerns about pregnancy risks, and (3) the need for a multidisciplinary approach in reproductive healthcare. The findings revealed that 73.3% of participants had never received preconception counseling, despite expressing significant concerns about CKD-related pregnancy complications. Many participants perceived pregnancy as a high-risk endeavor due to fears of worsening renal function, hypertensive disorders, and adverse fetal outcomes. The study further highlights the critical role of nephrologists in reproductive health counseling, emphasizing the need for integrated care involving obstetricians and reproductive specialists. Enhancing nephrology training programs, implementing standardized reproductive health counseling protocols, and fostering patient-centered communication are essential for improving pregnancy outcomes among women with CKD. Future research should explore interdisciplinary interventions aimed at addressing the systemic barriers to reproductive health discussions in nephrology care.</p> Esti Pratiwi Yosin Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1883 Fri, 04 Apr 2025 12:09:24 +0000 Formulation and characterization of bay leaf extract nanophytosomes (Syzgium polyanthum) and affinity study of interaction with alpha glucosidase enzyme as antidiabetic https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1888 <p>Introduction: Diabetes Mellitus is a metabolic syndrome disease in which around 90-95% of all cases of adults aged 20-79 years suffer from type 2 Diabetes Mellitus, with long-term conventional treatment causing side effects of hypoglycemia. Bay leaves which contain quercetin and kaempferol compounds are able to lower blood glucose levels, but have challenges in drug delivery due to easy oxidation and low bioavailability. Therefore, an innovative drug delivery system is needed, such as nanophytosomes, to increase its bioavailability. Objective: This study aims to develop a thin film formula of bay leaf extract nanophytosomes that have antidiabetic affinity with in silico studies and evaluate the physical characteristics of nanophytosomes. Method: in silico using the molecular docking method to evaluate the interaction of active compounds of bay leaves with the alpha glucosidase enzyme. Bay leaf nanophytosomes are formulated using heat homogenization and probe sonicator techniques. Characterization is carried out by measuring particle size, polydispersity index, zeta potential, and particle morphology. Results: The nanophytosome formula of bay leaf extract showed a particle size of &lt;1000 nm, a polydispersity index of &lt;0.5, and a zeta potential of ±25 mV. In silico studies showed that quercetin and kaempferol have a strong affinity for the α-glucosidase enzyme, which plays an important role in inhibiting glucose absorption. Conclusion: Bay leaf extract can be formulated into a phytosome-based nanoparticle delivery system that shows stable physical characteristics, high adsorption efficiency, and potential antidiabetic activity through the interaction of inhibiting the α-glucosidase enzyme.</p> Regina Dwi Septianti, Garnadi Jafar, Westi Nur Dinayanti, Deden Indra Dinata Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1888 Fri, 11 Apr 2025 05:44:33 +0000 Formulation and characterization of tretinoin nanosuspension and in silico testing as an anti-inflammatory https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1892 <p>Introduction: Tretinoin is an effective retinoid derivative for acne therapy, but has formulation challenges due to its lipophilic nature and high crystallinity. An appropriate formulation strategy is needed to improve its stability and bioavailability. Objective: This study aims to evaluate the compatibility of tretinoin with excipients in nanosuspension formulations and their physicochemical characterization. Methods: Preliminary tests were carried out using Fourier Transform Infrared Spectroscopy (FTIR), crystallinity was analyzed by X-ray Diffraction (XRD), and thermal analysis by Differential Scanning Calorimetry (DSC). Nanosuspension characterization includes particle size, polydispersity index, zeta potential and entrapment efficiency. In silico test of the potential of tretinoin as a COX-2 inhibitor related to anti-inflammatory effects. Results: FTIR results showed no chemical interaction between tretinoin and excipients. XRD showed a decrease in tretinoin crystallinity after mixing with HPMC and PVP. DSC showed a shift in the melting point of tretinoin, indicating a physical interaction with excipients. Characterization of nanosuspension showed particle size &lt;1000 nm, polydispersity index &lt;0.5, zeta potential ±-20 mV, and entrapment efficiency &gt;80%. In silico tests show that tretinoin has a binding energy of -9.57 kcal/mol against the Cyclooxygenase-2 (COX-2) enzyme with an inhibition constant of 96.03 nM. Conclusion: Tretinoin shows good compatibility and physicochemical characteristics in nanosuspension formulation, as well as potential as an anti-inflammatory agent through COX-2 inhibition<em>.</em></p> M Ayodia Ramadhoni, Garnadi Jafar, Arin Nur Halizah, Fenti Fatmawati Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1892 Fri, 11 Apr 2025 06:32:08 +0000 Analysis of electronic medical record acceptance among inpatient registration staff using the technology acceptance model at RS PKU Muhammadiyah Gombong https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1895 <p>The adoption of Electronic Medical Records (EMR) has become an essential transformation in healthcare to enhance service efficiency and data accuracy. However, the successful implementation of EMR significantly depends on user acceptance, particularly among hospital administrative staff. This study aimed to evaluate EMR adoption at RS PKU Muhammadiyah Gombong using the Technology Acceptance Model (TAM), focusing on perceived usefulness (PU), perceived ease of use (PEOU), and behavioral intention (BI). A qualitative descriptive approach was employed through structured interviews, direct observations, and document analysis. The results showed that 75% of staff acknowledged improved efficiency and accuracy, yet 30% experienced workflow disruptions due to technical issues. Additionally, 60% found the system easy to use after training, but 25% struggled with document uploads. Major challenges included system downtime, connectivity issues, and storage limitations, with 50% of staff reporting these barriers. Training deficiencies were noted by 20% of respondents, highlighting the need for continuous learning initiatives. Management support played a vital role in implementation success, yet ongoing assistance remained necessary. Addressing technical constraints, refining training programs, and strengthening managerial engagement are crucial for optimizing EMR adoption.</p> Eli Purwati, Edy Susena Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1895 Fri, 11 Apr 2025 06:56:57 +0000 Formulation and characterization of nanoemulgel of ethanol extract of bay leaves (Syzygium polyanthum) as an anti-burn agent using the hot plate method using white wistar rats https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1890 <p>Introduction: Wounds are tissue damage that can cause functional disorders and risk of infection. Effective wound management is essential to accelerate tissue regeneration and prevent complications. Bay leaf extract (Syzygium polyanthum) contains bioactive compounds such as flavonoids, tannins, and saponins that have anti-inflammatory, antibacterial, and wound healing activities. However, the limited bioavailability and skin penetration of these active compounds are challenges in topical therapy. Objective: This study aims to develop and evaluate a topical drug delivery system based on bay leaf extract nanoemulsion as an alternative therapy to accelerate wound healing. Method: Extraction was carried out using ethanol solvent, then formulated into a nanoemulsion with oil, surfactant, and co-surfactant components. Formulation characterization was carried out by measuring particle size, polydispersity index, zeta potential, and physical stability tests. Evaluation of effectiveness was carried out using a wound model in Wistar rats with the hot plate induction method. Wound healing observations were carried out clinically and histologically for a period of 14 days. Results: The formulation results showed that the nanoemulsion had a particle size of &lt;200 nm, PDI &lt;0.5, and zeta potential of ±25 mV, indicating good physical stability. Burn activity tests showed that topical administration of bay leaf extract nanoemulsion accelerated wound contraction, increased epithelialization, and improved tissue structure compared to the control group. Conclusion: Bay leaf extract can be formulated in a nanoemulsion-based nanoparticle delivery system that shows stable physical characteristics and is effective in accelerating wound healing.</p> Windi Pratama Ningrum, Garnadi Jafar, Ananda Rota Pramudiahwardani, Herni Kusriani Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1890 Fri, 11 Apr 2025 07:21:05 +0000 Bloodless, painless, suture less circumcision: A combination of diode laser with cyanoacrylate skin glue in patient with second grade of phimosis https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1901 <p>Circumcision is a common surgical operation that entails excising the foreskin from the penis, primarily to improve hygiene and prevent the accumulation of smegma. This practice is widely observed worldwide, especially within Muslim and Jewish populations. However, despite its advantages, circumcision may lead to several complications, such as excessive bleeding and infections. A healthy 13-year-old male presented for circumcision due to grade 2 phimosis, seeking to improve his personal hygiene. The procedure was executed using a combination of diode laser technology and cyanoacrylate skin glue, which minimized tissue trauma and provided effective wound closure. When circumcision is performed utilizing advanced methods such as diode laser and cyanoacrylate glue, it is regarded as a safe and effective intervention. This approach offers considerable benefits in terms of recovery duration, cosmetic results, and overall patient comfort, while also maintaining low rates of complications.</p> Fadli Robby Amsriza, Rizka Fakhriani Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1901 Fri, 11 Apr 2025 08:56:09 +0000 Evaluation of supporting document completeness in outpatient claims to prevent BPJS claim returns at charitas Hospital Palembang https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1900 <p>This study examined the completeness of outpatient claim documents and how it affected the return of claims by the national health insurance agency at Charitas Hospital Palembang. Incomplete documents often delay claim verification and lead to financial loss for healthcare providers. The research used a quantitative approach and analyzed 206 outpatient claim files submitted between February and June 2025. Data were collected through observation checklists and structured questionnaires distributed to administrative staff. The findings revealed that most returned claims were caused by missing laboratory or radiology results, incomplete referral documents, and inconsistent medical records. Statistical analysis showed a strong correlation between document completeness and the frequency of returned claims. Factors such as coordination between hospital units, staff competence, and the effectiveness of hospital information systems were found to significantly influence the completeness of claim files. The study concluded that improving internal communication, enhancing staff training, and optimizing electronic record systems can reduce the risk of claim rejection and improve financial sustainability.</p> Elta Miliana, Canggih Ajika Pamungkas Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1900 Thu, 17 Apr 2025 05:13:20 +0000 Evaluating electronic medical record implementation using the HOT-FIT model at UPTD Puskesmas Ungaran https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1896 <p>This study evaluated the implementation of Electronic Medical Records (EMR) at UPTD Puskesmas Ungaran using the Human-Organization-Technology Fit (HOT-FIT) model. The research employed a descriptive qualitative approach to explore how human readiness, organizational support, and technological infrastructure influenced EMR adoption. Data were collected through in-depth interviews, observations, and document analysis involving twelve healthcare professionals. Thematic analysis revealed that most users had limited training and lacked confidence in using the system, often leading to partial documentation. Organizationally, there was minimal supervision, unclear standard operating procedures, and no internal technical support. Technologically, the system frequently experienced downtime and integration failures with national platforms such as Pcare BPJS. These findings indicate that the EMR implementation remains fragmented and procedural, rather than transformative. The study concluded that the success of EMR adoption requires not only system availability but also holistic readiness across all HOT-FIT dimensions. Practical recommendations include ongoing capacity-building, improved policy enforcement, and user-centered system development. This study provides insight for policymakers and healthcare managers to enhance EMR sustainability in primary care settings.</p> Novi Ika Kurniawati, Wahyu Wijaya Widiyanto Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1896 Thu, 17 Apr 2025 06:43:01 +0000 Readiness analysis of electronic medical record implementation in inpatient services using the DOQ-IT Method at Pusri Hospital Palembang https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1899 <p>This study explored how ready Pusri Hospital Palembang was to implement electronic medical records in its inpatient services, using the Doctor’s Office Quality – Information Technology (DOQ-IT) framework. Using a quantitative, cross-sectional approach, data were gathered from 43 health workers and administrative staff through validated questionnaires. The assessment focused on four key areas: readiness of human resources, organizational work culture, governance and leadership, and the hospital’s technology infrastructure. Results showed that while infrastructure and governance were relatively ready, the readiness of staff and the work culture still needed improvement. Statistical analysis confirmed that all four factors significantly influenced the hospital’s overall readiness to adopt electronic medical records. Although the hospital demonstrated moderate readiness, the findings highlight the need for enhanced training and better infrastructure planning to ensure a smoother digital transition. This study offers practical insights for hospital leaders and health policymakers aiming to advance digital transformation in healthcare settings.</p> Budiantono Budiantono, Wahyu Wijaya Widiyanto Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1899 Thu, 17 Apr 2025 07:08:29 +0000 Evaluating electronic medical records in inpatient psychiatric services using the PIECES framework https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1898 <p>This study evaluated the implementation of Electronic Medical Records (EMR) in inpatient psychiatric services at RSJ Mutiara Sukma using the PIECES framework. Employing a qualitative approach, data were collected through in-depth interviews and observations involving twelve informants from various healthcare professions. Thematic analysis identified systemic challenges across six domains: performance, information, economy, control, efficiency, and service. Key issues included slow system response times, fragmented data presentation, dual documentation, limited audit trails, inefficient workflows, and gaps in user training. Despite having an EMR infrastructure, its utilization remained suboptimal due to usability and integration barriers. The study underscores the need for user-centered design, continuous training, and institutional support to optimize EMR systems in psychiatric settings. These insights are essential for enhancing digital health strategies in mental health care.</p> Nur Aini Mayasqa, Canggih Ajika Pamungkas Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1898 Thu, 17 Apr 2025 07:35:05 +0000 Evaluating registration staff understanding of electronic medical record use https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1897 <p>This study aimed to evaluate the understanding of registration staff regarding the use of Electronic Medical Records (EMR) at Puskesmas Bringin, a primary healthcare center in Semarang Regency. Despite the growing emphasis on digital transformation in health services, the success of EMR implementation largely depends on how well frontline staff comprehend and engage with the system. Using a qualitative descriptive method, data were collected through in-depth interviews and direct observations with selected registration officers. The findings revealed varying levels of understanding among staff, influenced by differences in digital literacy, training exposure, and system accessibility. Some staff demonstrated strong conceptual and operational knowledge of EMR, while others relied on peer support or manual records due to uncertainty in system navigation. Technical barriers and limited organizational support further impacted their ability to fully utilize EMR functions. The study concluded that improving staff understanding requires targeted training, user-friendly system design, and continuous mentoring. These efforts are essential to ensure the successful integration of EMR in primary healthcare services and to support better health data management at the grassroots level.</p> Iis Nurnanik, Wahyu Wijaya Widiyanto Copyright (c) 2025 Science Midwifery https://midwifery.iocspublisher.org/index.php/midwifery/article/view/1897 Thu, 17 Apr 2025 07:52:45 +0000