JURNAL VNUS (Vocational Nursing Sciences)

Occupational Therapy Drawing in Patients with Auditory Hallucinations: Descriptive Case Study Approach

Noviyanti Parapaga — 2025-11-11

Mental disorders are someone who shows changes in behavior and symptoms in thoughts and feelings that cause suffering and prevent them from carrying out activities as they should. Hallucinations are one of the most common mental disorders suffered by hallucination patients, there are various kinds such as auditory, visual, tactile, gustatory, and olfactory hallucinations. The implementation strategy is occupational drawing therapy given to auditory hallucination patients which aims to control hallucinations. The purpose of this case study is Occupational Drawing Therapy in Patients with Auditory Hallucination Problems at Prof. Dr. V. L. Ratumbuysang Mental Hospital, North Sulawesi Province to get an overview of occupational drawing therapy in auditory hallucination patients. The method used is descriptive using a case study approach. Obtained from the application of occupational drawing therapy on 2 subjects, namely verbalization of hearing whispers, sensory distortion, hallucinatory behavior, and decreased daydreaming. Occupational drawing therapy as a complementary therapy in patients with auditory hallucinations is useful for self-control. This case study expected nurses areo apply occupational drawing therapy as part of nursing interventions in patients with sensory perception disorders, especially auditory hallucinations.

Implementation of Exclusive Breastfeeding Education for Postpartum Mothers at Maccini Sawah Community Health Centre, Makassar City

Fani Wulandari — 2025-11-11

Exclusive breastfeeding is breast milk given to babies under 6 months Mother's knowledge about exclusive breastfeeding is an understanding of the benefits, techniques of giving, and the importance of exclusive breastfeeding for the health of the mother and baby Mothers' knowledge about exclusive breastfeeding is an understanding of the benefits, techniques for giving, and the importance of exclusive breastfeeding for the health of mothers and babies. This case study was conducted with the aim of evaluating how education related to exclusive breastfeeding is implemented and to what extent it has an impact on increasing the knowledge of postpartum mothers in the working area of the Macini Sawah Community Health Centre, Makassar City. This case study design uses a descriptive approach with a case study method. The case study in this research focuses on exploring the implementation of education on exclusive breastfeeding and its impact on the level of knowledge of postpartum mothers in the working area of the Maccini Sawah Community Health Centre, Makassar City. In this case study, data was collected using an observation form aimed at assessing the level of knowledge among postpartum mothers. The observation form was filled out directly by the respondents using paper and pen. The results of observations for 3 days showed the effectiveness of providing exclusive breastfeeding education to postpartum mothers, the level of maternal knowledge increased. After conducting a case study, it was concluded that the implementation of exclusive breastfeeding on postpartum mothers' knowledge increased after the action was given.

Implementation of Effective Cough Training to Improve Airway Clearance in Asthma Patients: A Nursing Care Process Case Study in the Emergency Department

Linda Oktavianingsih — 2025-11-11

Asthma is a chronic respiratory disorder that remains a major public health concern, particularly in areas with high pollution levels. One of the most frequent nursing problems among asthma patients is ineffective airway clearance caused by mucus retention. Effective cough training is a non-pharmacological nursing intervention aimed at facilitating secretion removal and improving respiratory function. This case study evaluated the effectiveness of cough training in improving airway clearance in an asthma patient treated in the emergency department. A descriptive case study design using the nursing care process assessment, diagnosis, intervention, implementation, and evaluation was applied. Data were collected through interviews, physical examinations, observations, and documentation for two days. The intervention consisted of deep nasal inhalation for four seconds, breath-holding for two seconds, exhalation through pursed lips for eight seconds, followed by a controlled cough. After two days, improvements were observed in respiratory rate (from 26 to 22 breaths per minute), oxygen saturation (from 90% to 95%), and mucus expectoration. The patient was able to perform the technique independently after education and guided practice. These findings indicate that effective cough training is a simple, evidence-based nursing intervention that enhances airway clearance and oxygenation and should be integrated into emergency asthma care to prevent complications.

Implementation of Sauropus Androgynus (Katuk Leaves) as a Non-Pharmacological Intervention to Increase Breast Milk Production in Postpartum Mothers at Pelamonia Hospital Makassar

Landi Sangalia — 2025-11-11

Breast milk or mother’s milk is the best source of nutrition recommended for babies from birth to 6 months of age. However, low breast milk production remains a barrier to exclusive breastfeeding, including at RS TK II Pelamonia Makassar. Sauropus androgynus (katuk leaves) is known as a natural ingredient believed to increase breast milk production deu to its active compounds. Identifying how the non-pharmacological implementation of Sauropus Androgynus (katuk leaves) can increase breast milk production in postpartum mothers. This case study used a descriptive method with an observational approach on normal post partum mothers from day 2 to day 7. The intervention involved administering 300 grams of katuk leaf clear soup daily for three consecutive days. The study subjects included two postpartum mothers who met the inclusion criteria: normal postpartum mothers 2–7 days postpartum, primiparous postpartum mothers, postpartum mothers with insufficient breast milk, infants who refuse to breastfeed, and mothers aged 20–35 years. This case study showed a significant increase in breast milk production: Subject I from 9 ml to 78 ml, and Subject II from 13 ml to 86 ml, in addition, there was an improvement in milk output indicators, such as milk leaking, calmer infants, and increased urination frequency. The non-pharmacological use of Sauropus androgynus (katuk leaves) increased breast milk volume in both postpartum subjects. This result suggests that katuk leaves may serve as an effective natural galactagogue. Further research with a larger sample and control group is recommended.

Family Nursing Care for Gout Arthritis Patients Using Soursop Juice as a Non-Pharmacological Therapy to Reduce Uric Acid Levels

Asep Gunawan — 2025-11-11

Gout arthritis is a form of joint inflammation caused by the accumulation of urate crystals, resulting in pain, swelling, and limited mobility. Non-pharmacological therapy such as soursop (Annona muricata) juice, which contains antioxidants and xanthine oxidase inhibitors, may help reduce uric acid levels. This case study was conducted on Mr. A, a patient with gout arthritis living in Palasari Hamlet, Sukahurip Village, Ciamis. The intervention consisted of daily soursop juice administration for five consecutive days, with monitoring of uric acid levels and pain symptoms. After treatment, uric acid decreased slightly from 8.7 mg/dL to 8.6 mg/dL, accompanied by reduced pain and swelling. Although the reduction was minimal, soursop juice showed potential as a safe, low-cost complementary therapy for gout arthritis management in family settings.

Application of Lamaze Breathing Technique to Reduce Labour Pain in The First Stage Of Active Labour at Pelamonia Hospital Makassar

Erna Kasim — 2025-11-11

Labor pain is a common physiological response but often causes physical and emotional discomfort, especially in the first stage of active labor. One non-pharmacological method than can be used to reduce pain is the Lamaze breathing technique. This case study was conducted to determine the application of Lamaze breathing techniques on the reduction of pain during the active phase of the first stage of labour. a descriptive case study research methodology that focuses on one of the main issues in the selected case. Inclusion criteria: Mothers in active phase 1 labour with moderate to severe pain, mothers who are responsive or in good general condition with vital signs within normal limits, mothers under 35 years of age, primiparas/multiparas, mothers with cephalic presentation. Exclusion criteria: Mothers in active phase I labour with multiple pregnancies, malpresentation, haemorrhage, high-risk pregnancies accompanied by conditions such as pre-eclampsia, heart disease, asthma, premature rupture of membranes, pelvic abnormalities. The results show that both respondents experienced a decrease in pain intensity after applying the Lamaze breathing. The mothers appeared calmer, able to control their breathing, and reduced tension during contractions. The Lamaze breathing technique is effective in helping to reduce labor pain and is worth recommending as a non-pharmacological intervention.

Association of Physical Activity and Coffee Consumption with Hypertension Incidence Among Productive-Age Adults in Godong I Community Health Center, Grobogan Regency

Anita Lufianti — 2025-11-13

Hypertension is a major non-communicable disease that increasingly affects individuals of productive age and contributes to cardiovascular complications such as stroke and heart failure. This study aimed to examine the association between physical activity, coffee consumption, and hypertension incidence among productive-age adults at the Godong I Community Health Center, Grobogan Regency. Objective is to find the relationship between physical activity and coffee consumption with the incidence of hypertension. A quantitative cross-sectional study was conducted among 99 respondents. Data were collected through questionnaires and blood pressure measurements. Statistical analysis was performed using Spearman’s rank correlation test with a significance level of p<0.05. Physical activity (p=0.001) and coffee consumption (p=0.008) showed significant associations with hypertension incidence. Both physical activity and coffee consumption are significantly associated with hypertension among the productive-age population.

Local Government Roles in School-Based Hypertension Prevention Among Adolescents in Tasikmalaya City

Betty Suprapti — 2025-11-22

Adolescent hypertension has become a global public health concern due to its potential to increase the risk of cardiovascular diseases in adulthood. Early prevention efforts through school-based initiatives are essential; however, policy implementation at the local level continues to face significant challenges. This study aims to analyze the role of the Tasikmalaya City local government in school-based hypertension prevention among adolescents. A qualitative case study design was employed, with data collected through in-depth interviews, focus group discussions, observations, and document reviews. Participants consisted of officials from the Health and Education Departments, school principals, teachers, healthcare workers from community health centers, and student representatives. Data were analyzed thematically using NVivo software for coding. The findings show that the local government has implemented several programs, including non-communicable disease screening, Posyandu Remaja (Youth Integrated Health Post), Usaha Kesehatan Sekolah (School Health Unit/UKS), and Promosi Kesehatan Reproduksi Remaja (Adolescent Reproductive Health Promotion). Key barriers identified include a limited number of healthcare workers, inadequate facilities, budget constraints, and uneven program outreach. Nevertheless, opportunities for improvement were observed through the planned development of a Mayor’s Regulation, strengthened intersectoral coordination, and the empowerment of school health cadres. This study concludes that while the local government has taken steps toward adolescent hypertension prevention, efforts remain suboptimal and require enhanced local policies, resource allocation, and multisector collaboration to improve program effectiveness. Overall, the study contributes to strengthening evidence on the role of local governments in implementing adolescent health policies at the school level in Indonesia.

Influence of Menarche Experiences on Reproductive Health Knowledge, Emotional Well-Being, and Social Support among Adolescent Girls at SMPN 1 Paiton

Ica Maulina Rifkiyatul Islami — 2025-11-26

Menstruation is a major developmental milestone for adolescent girls and is often associated with various emotional and physical reactions. Limited knowledge prior to menarche frequently contributes to feelings of anxiety, confusion, and discomfort. This study aims to explore the experiences of adolescent girls during their first menarche and identify the factors that shape their responses. A qualitative phenomenological design was employed, and data were collected through in-depth interviews with purposively selected seventh-grade students at SMPN 1 Paiton who had experienced menarche within the past two years. Thematic analysis was used to identify patterns related to emotional reactions, sources of information, and perceived support. The findings indicate that anxiety, confusion, and surprise were common initial responses. Most participants relied on informal sources such as mothers, peers, and social media while school-based education was perceived as insufficient. Family and peer support played an important role in increasing awareness, reducing fear, and improving menstrual readiness. These results highlight the need for comprehensive and evidence-based menstrual education programs in schools, along with stronger engagement from families and the community. Enhancing these support systems may improve adolescents’ understanding of menstruation and promote more positive physical and emotional experiences during menarche

Kidney Transplantation and Its Impact on Quality Of Life: An Integrative Review.

Felipe Kohl Hemsing — 2025-11-25

Chronic kidney disease (CKD) is highly prevalent worldwide and carries significant morbidity and mortality rates. Kidney transplantation is the last-line therapy for patients with end-stage renal disease. The quality of life after kidney transplantation is a widely studied topic, given its importance in assessing not only the clinical aspects but also the overall impact on the patient's life. This study aims to analyze the key impacts of kidney transplantation on the quality of life of transplant recipients. An integrative literature review was conducted using the Virtual Health Library (VHL) and PubMed databases. Articles were selected between April and June 2025 using the descriptors "kidney transplantation," "quality of life," and "transplant recipient," combined with the Boolean operator AND. Inclusion criteria were primary studies published in national and international journals within the last five years. Exclusion criteria were review articles, experience reports, editorials, articles requiring a subscription for open access, and studies that did not address the research question. The guiding question of this study was: What are the main impacts of kidney transplantation on the quality of life of patients after the procedure? Kidney transplantation significantly improves the quality of life and physical well-being, such as the ability to resume daily activities, enhanced self-esteem, reduced depressive symptoms, and increased autonomy. However, these benefits are accompanied by challenges, including side effects of immunosuppressive medications, sleep disorders, and physical limitations. Continuous care is essential, emphasizing the need for a multidisciplinary approach. The results highlight the positive influence of transplantation on work capacity and social reintegration, though factors like age, education level, and access to rehabilitation can affect this process. Psychologically, patients show significant improvements in mental well-being post-transplant compared to those on dialysis, with reduced levels of depression, anxiety, and stress. However, the side effects of immunosuppressants may lead to mood swings, insomnia, and fear of graft rejection. While kidney transplantation leads to significant improvements in the patients' quality of life particularly in physical, psychological, and social domains these benefits are not without challenges. Recipients face ongoing issues such as immunosuppressive side effects, sleep disturbances, functional and mental limitations, and the need for continuous multidisciplinary care

The Impact of Psychosocial and Culturally Informed Care Approaches on Patient Adaptation in Degenerative Diseases: A Systematic Review

Wijayanti Wijayanti — 2025-11-26

Degenerative diseases pose complex challenges that extend beyond physical impairment to encompass emotional, social, and cultural dimensions. Standard medical care alone often falls short in meeting patients’ holistic adaptation needs. This systematic review aimed to evaluate the effectiveness of psychosocial and culturally informed approaches in enhancing adaptation among individuals with degenerative diseases. Following PRISMA 2020 guidelines, a Systematic Literature Review (SLR) was conducted using Scopus as the primary database, including peer-reviewed English-language primary research published between 2010 and 2025. Study selection and data extraction were performed independently by two reviewers using Rayyan. Twenty-three eligible studies were synthesized narratively based on the PICO framework, and methodological quality was assessed using the JBI Critical Appraisal Tools. Psychosocial and cultural interventions including family counseling, caregiver training, mindfulness, nurse-led programs, continuity-of-care initiatives, and community-based support consistently improved quality of life, reduced anxiety and depression, strengthened social support, and enhanced self-management capacity. The greatest benefits were observed among patients with Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, and traumatic brain injury, particularly in early to mid-stage illness. Moderating factors such as intervention intensity, family involvement, and cultural sensitivity significantly shaped effectiveness. Overall, psychosocial and culturally responsive approaches were more effective than standard care in supporting patient adaptation to degenerative conditions. Comprehensive integration of these interventions into care pathways is strongly recommended, and future research should.

Current Clinical Approaches in the Management of Pharyngitis: A Narrative Review

Ayu Hirdayanti — 2025-11-27

Pharyngitis is one of the most common acute respiratory infections worldwide. It affects both kids and adults anda significant global health issue. Bacterial infections, such group A streptococcus (GAS), may lead to serious problems if they aren't treated, even though they are usually viral and go away on their own. This underscores the importance of accurate etiological differentiation and judicious antibiotic use. Methods: A methodical literature search was performed in PubMed and Google Scholar for papers published from 2020 to 2025. Twelve publications were selected and summarized to analyze contemporary diagnostic procedures, treatment methodologies, and antibiotic management treatments. Result: The st udy found that there are still problems, such as too many antibiotics being prescribed, not always following clinical recommendations, and not using fast diagnostic testing enough. Combining clinical scoring systems like Centor and McIsaac with rapid antigen detection tests (RADT), polymerase chain reaction (PCR), and nucleic acid amplification testing (NAAT) makes diagnoses much more accurate, which means fewer people will be given antibiotics when they don't need them. Short-course antibiotic regimens have shown efficacy comparable to traditional long-term therapies, providing advantages such as reduced risk of antimicrobial resistance, less side effects, and decreased costs. Conclusions: Integrating evidence-based diagnostics with consistent guideline implementation and continuing education for healthcare professionals and patients is essential for optimizing antibiotic prescription and enhancing antibiotic stewardship in the management of pharyngitis

Clinical Presentation, Diagnostic Challenges, and Management of Bezold’s Abscess: A Narrative Review

Ainun Nimah Syawaliyah — 2025-11-28

Bezold’s abscess is a rare yet severe complication of otitis media that poses significant diagnostic challenges due to its non-specific and often misleading symptoms, which can mimic less serious conditions. This review aims to summarize recent literature (2015–2025) on the clinical presentation, diagnostic approaches, and management of Bezold’s abscess. A narrative review was conducted through a systematic search of electronic databases, including PubMed, ScienceDirect, SpringerLink, Wiley Online Library, and Frontiers. Twenty relevant case reports and case series published between 2015 and 2025 met the inclusion criteria. The findings show that Bezold’s abscess frequently presents with atypical manifestations that deviate from classical features, leading to delays in recognition. Consequently, diagnosis relies heavily on a high index of clinical suspicion, supported by definitive imaging modalities such as contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI). Early detection requires heightened clinical vigilance, especially in patients with persistent otitis media symptoms and new-onset neck swelling. Management typically involves a combination of broad-spectrum intravenous antibiotics and surgical procedures, such as abscess drainage and mastoidectomy. Early diagnosis and timely intervention are essential to prevent complications and improve patient outcomes.

Clinical Features, Diagnosis, and Management of Herpes Zoster Oticus: A Narrative Review

Labid Al Mutawakkil — 2025-11-28

Herpes Zoster Oticus (HZO) is a neurological disorder caused by reactivation of the varicella-zoster virus in the geniculate ganglion, resulting in facial paralysis and, in severe cases, auditory or vestibular impairment. This narrative review summarizes current evidence regarding the clinical features, diagnostic approaches, and management of HZO. A literature search was conducted in PubMed for articles published between 2015 and 2025 using the keywords “herpes zoster oticus,” “Ramsay Hunt syndrome,” “facial palsy,” and “varicella-zoster virus.” Only English-language, full-text case reports discussing the clinical presentation of HZO were included. Of the 38 articles initially identified, 18 met the inclusion criteria after screening titles, abstracts, and full manuscripts. The synthesized findings highlight recent advancements in understanding VZV pathogenesis, improved diagnostic accuracy, and refinement of treatment strategies. Evidence consistently indicates that early initiation of antiviral therapy, combined with corticosteroids, is associated with better facial nerve recovery and reduced long-term complications. Furthermore, the variability of clinical manifestations including atypical presentations such as zoster sine herpete underscores the importance of maintaining a high index of suspicion and adopting a multidisciplinary approach to care. Early diagnosis and timely treatment remain key determinants of patient outcomes. Future research should aim to identify reliable prognostic biomarkers, develop rapid diagnostic tools for atypical cases, and conduct randomized controlled trials to optimize therapeutic regimens, particularly regarding the role of corticosteroids and emerging antiviral agents

Exploring the Influence of Toxic Leadership Behavior in Nursing Organizations within Hospital Settings: An Integrative Review

Windri Dewi Ayu — 2025-11-28

Toxic leadership in nursing organizations has emerged as a significant concern due to its negative impact on nurses’ well-being, job satisfaction, patient safety, and overall quality of care. While many scholars highlight its harmful consequences, some argue that the term “toxic leadership” may oversimplify complex organizational and interpersonal dynamics, potentially overlooking contextual factors that influence leadership behaviors. This integrative review aims to examine the influence of toxic leadership behavior in nursing organizations and synthesize current evidence regarding its impact on nurses, organizational culture, and patient outcomes. An integrative review approach was employed using literature from PubMed, Scopus, Google Scholar, and ResearchGate. Studies focusing on toxic leadership among nurse leaders and its organizational consequences were screened and analyzed thematically. Research conducted in various countries including the United States, Canada, Australia, the United Kingdom, China, Korea, and the Philippines consistently shows that toxic leadership contributes to decreased job satisfaction, heightened burnout, increased turnover intention, compromised patient safety, and a deteriorating organizational climate. These effects extend beyond individual nurses and can negatively influence team performance and care quality. Toxic leadership behavior in nursing organizations poses substantial risks to both staff and patient outcomes. Addressing this issue requires organizational strategies that promote healthy leadership styles, psychological safety, and supportive work environments. Future studies should focus on designing and evaluating interventions that reduce toxic leadership behaviors and strengthen positive, evidence-based leadership practices in nursing.