Journal of Midwifery and Nursing

The impact of menstrual education through “rapor kesehatanku” on awareness and preparedness for menarche

Eka Kusumawati, Dede Gantini, Sariestya Rismawati — Fri, 24 Jul 2026 00:00:00 +0000

Menarche is a significant milestone in the maturation of adolescent girls and requires adequate physical and psychological preparedness. However, many eleentary school girls experience menarche without sufficient knowledge and readiness. The Health Report Card, known as Rapor Kesehatanku, is an educational medium developed by the Indonesian Ministry of Health as a reference for adolescent health, including menstrual health information. This study aimed to evaluate the effect of menstruation education using Rapor Kesehatanku on knowledge and preparedness for menarche among 4th, 5th, and 6th-grade elementary school girls in Giriwangi Village, Gunungtanjung District, Tasikmalaya Regency. This study employed a pre-experimental design with a one-group pretest-posttest approach. The sample size was determined using total sampling because the accessible population was relatively small; therefore, all 42 eligible female students from SDN Poponcol and SDN Cikembang were included. The research instruments consisted of a 27-item menstruation knowledge questionnaire and a 22-item menarche preparedness questionnaire. The knowledge questionnaire had been tested for validity, with r-count greater than r-table (0.361), and demonstrated good reliability with a Cronbach’s alpha of 0.854. The preparedness questionnaire had also been tested for validity, with r-count greater than r-table (0.396), and showed excellent reliability with a Cronbach’s alpha of 0.936. The intervention consisted of menstruation education using Rapor Kesehatanku, followed by a post-test seven days after the intervention. Data were analysed using the Wilcoxon Signed Rank Test, and effect sizes were calculated using the formula r = Z/?N. The results showed a significant increase in students’ knowledge of menstruation after the intervention, with p < 0.001 and a large effect size (r = 0.69). The proportion of students with good knowledge increased from 14.3% before the intervention to 40.5% after the intervention. Preparedness for menarche also increased significantly, with p = 0.030 and a moderate effect size (r = 0.34). The proportion of students who were ready to face menarche increased from 81.0% to 95.2%. The use of Rapor Kesehatanku significantly improved knowledge and preparedness for menarche among elementary school girls. These findings indicate that Rapor Kesehatanku can be used as an effective promotive and preventive educational medium to support menstrual health education among adolescent girls.

An ethnomedicine study of the Tengger Tribe in Probolinggo East Java and anti-inflammatory activity

Wed, 30 Sep 2026 00:00:00 +0000

The Tengger Tribe in East Java, Indonesia, has long utilized medicinal plants to treat various diseases, including inflammatory conditions. This study aimed to identify medicinal plants used by the Tengger Tribe and determine their anti-inflammatory activity through in vitro and in vivo assays. An ethnomedicinal survey was conducted using snowball sampling and semi-structured interviews with key informants. Plant importance was assessed using the Use Value and Informant Consensus Factor indices. Selected plants were extracted with ethanol and evaluated for anti-inflammatory activity using the Human Red Blood Cell membrane stabilization assay in vitro and a carrageenan-induced paw edema model in vivo. Four medicinal plant species with high ethnomedicinal significance were selected for biological evaluation. Among the tested extracts, Borreria laevis exhibited the strongest anti-inflammatory activity, with an IC50 value of 133.57 ppm in the HRBC assay. The experimental data met the assumption of ANOVA p > 0.000). In the in vivo model, Tepung Otot (Borrira laevis) showed the highest anti-inflammatory effect, with inhibition percentages of 76.39%, 79.27%, and 81.55% at doses of 105, 210, and 560 mg/kg body weight. These findings support the traditional use of Tengger medicinal plants and highlight Tepung Otot (Borreria laevis) as a promising natural anti-inflammatory agent.

The correlation between family type and attitudes toward early marriage

Yessy Nur Endah Sary, Iit Ermawati, Nova Hikmawati — Wed, 30 Sep 2026 00:00:00 +0000

Both traditional and modern families face challenges in raising children when the family has a son or daughter reaching adolescence. Adolescence is a period of preparation for adulthood during which adolescents go through several important developmental stages in life; during this time, many adolescents engage in promiscuous behavior, experience unwanted teenage pregnancies, and ultimately enter into early marriages. The purpose of this study was to analyze the correlation between family type and adolescents’ attitudes toward early marriage at Al-Irsyad Junior High School in Kraksaan, Probolinggo. This study employed a quantitative approach using a cross-sectional research design. The study population consisted of all 45 eleventh-grade students at Al-Irsyad Junior High School in Kraksaan, Probolinggo. This study employed total sampling, resulting in a sample size of 45 students. Univariate data analysis was conducted using frequency distributions, and bivariate analysis was performed using the chi-square test. Univariate data analysis was conducted using frequency distributions, and bivariate analysis was performed using the chi-square test. Based on the analysis using the chi-square test, the result was p < 0.019, indicating a significant correlation between family type and adolescents’ attitudes toward early marriage at Al-Irsyad Junior High School in Kraksaan, Probolinggo. Health professionals should provide education on the impacts of early marriage.

Scrolling for safety: Digital health literacy and pregnancy danger sign recognition in primary care

Nadila Nefi Nur Alifah, Dedy Purwito — Mon, 07 Sep 2026 00:00:00 +0000

Pregnancy carries the risk of complications such as hemorrhage, hypertension, and infection, key causes of maternal death, making early detection of danger signs essential. Digital media are increasingly used for health information, yet prior research remains largely quantitative and rarely triangulates pregnant women, husbands, and midwives within a single primary care setting, a gap this study addresses. Using a descriptive phenomenological design, in-depth interviews and focus group discussion were conducted wth 27 participants (16 key informants, 5 FGD participants, 2 husbands, 4 midwives) at Community Health Center Sokaraja 1, analyzed using Colaizzi’s method. Four themes emerged: (1) passive, alogirthm-driven access to short-form videos, especially TikTok; (2) a conflict-triggered verification pattern, where online information was cross-checked with midwives mainly when it conflicted with prior belief; (3) adequate danger-sign knowledge anchored in the Maternal and Child Health Handbook and face-to-face education rather than digital media; and (4) formal education constrained by scheduling, quota, and referral barriers, pushing women toward informal digital sources. These findings offer novel, multi-informant qualitative evidence that digital health literacy functions as an adaptive complement to formal education, supporting social media-based education strategies and stronger digital integration in primary care services.

Continuity of midwifery care for a pregnant woman with moderate hyperemesis gravidarum: A case study

Mon, 07 Sep 2026 00:00:00 +0000

Background: Hyperemesis gravidarum (HG) can cause persistent nausea and vomiting, dehydration, reduced nutritional intake, and impaired maternal well-being. Although continuity of midwifery care is increasingly recommended for comprehensive maternal care, published case reports describing its implementation for moderate HG in Indonesian primary healthcare settings, particularly from pregnancy through childbirth, postpartum, neonatal, and family planning care, remain limited. Objective: This study aimed to describe the implementation and clinical outcomes of continuity of midwifery care for a pregnant woman with moderate hyperemesis gravidarum from pregnancy through family planning services. Methods: A descriptive case study was conducted at Elvi Diana Primary Clinic, Medan, Indonesia, involving a 19-year-old primigravida diagnosed with moderate hyperemesis gravidarum. Midwifery care was provided continuously using Helen Varney’s Seven-Step Midwifery Management Model and documented using the Subjective, Objective, Assessment, and Plan (SOAP) format. The intervention included 10T antenatal care, nutritional counseling, hydration management, dietary modification, iron supplementation, psychological support, ginger-therapy education, intrapartum monitoring, postpartum and neonatal care, breastfeeding support, and postpartum family planning counseling. Clinical outcomes were assessed through interviews, observation, physical examinations, supporting examinations, and documentation review. Results: At the initial antenatal assessment, the client experienced nausea and vomiting 6–8 times/day, decreased appetite, dry lips, coated tongue, and generalized weakness. During follow-up, nausea and vomiting decreased to mild and occasional, appetite and general condition improved, hydration status became adequate, and fetal growth remained appropriate for gestational age. Pregnancy progressed without maternal or fetal complications, followed by spontaneous vaginal birth at term. The newborn had an Apgar score of 10, birth weight of 2,800 g, length of 49 cm, temperature of 36.6°C, heart rate of 92 beats/minute, and respiratory rate of 30 breaths/minute. Postpartum recovery was physiological without signs of infection or abnormal bleeding, and exclusive breastfeeding was established. The mother subsequently initiated a three-month injectable contraceptive method. Conclusion: Continuity of midwifery care, including nutritional, hydration, psychological, antenatal, intrapartum, postpartum, neonatal, and family planning interventions, was associated with progressive improvement in HG symptoms and favorable maternal and neonatal clinical outcomes. This case highlights the potential value of continuous, comprehensive midwifery care for women with moderate hyperemesis gravidarum in primary healthcare settings.

Red ginger – date beverage improves labor progress in primigravidas

Fri, 04 Sep 2026 00:00:00 +0000

Background: Maternal fatigue during active labor is associated with ineffective uterine contractions, prolonged labor, and increased obstetric interventions. Although date fruit and red ginger have each demonstrated potential benefits for maternal endurance and labor outcomes, no previous clinical study has evaluated their standardized combination as a functional nutritional beverage during active labor. This evidence gap limits the development of affordable complementary nutritional strategies for intrapartum care. Objective: To evaluate the effectiveness of JAKUMA, a standardized beverage containing red ginger (Zingiber officinale var. rubrum) and dates (Phoenix dactylifera L.), in reducing maternal fatigue and improving first-stage labor progress among primigravida women. Methods: A quasi-experimental, non-randomized, posttest-only control group study was conducted among 60 primigravida women during active labor. Thirty participants received JAKUMA (3 g standardized red ginger powder, 50 g seedless dates, and 250 mL warm water) in addition to standard intrapartum care, while 30 received standard care alone. Maternal fatigue was assessed using the Numerical Fatigue Scale, whereas labor progress was evaluated by active labor duration and cervical dilatation rate. Results: Compared with standard care, JAKUMA significantly reduced maternal fatigue (4.42 ± 1.47 vs. 5.58 ± 1.61; Cohen's d = 0.75; p = 0.005), shortened active labor duration (258.4 ± 41.7 vs. 289.3 ± 46.1 minutes; Cohen's d = 0.70; p = 0.008), and increased cervical dilatation rate (1.42 ± 0.23 vs. 1.25 ± 0.29 cm/hour; Cohen's d = 0.65; p = 0.013), indicating moderate clinically meaningful effects. Conclusion: This study is the first to demonstrate the effectiveness of a standardized red ginger–date beverage administered during active labor. The findings provide preliminary evidence supporting JAKUMA as an affordable, culturally acceptable complementary nutritional intervention to improve maternal endurance and physiological labor progression, while contributing to the evidence base for complementary intrapartum care and informing future clinical research.

Back pain and sleep quality after effleurage massage with lavender aromatherapy in third-trimester pregnant women

Catur Esty Pamungkas, Cahaya Indah Lestari, Ni Wayan Ari Adiputri Pamungkas — Wed, 09 Sep 2026 00:00:00 +0000

The global prevalence of back pain during pregnancy is 40.5%, making appropriate prevention and treatment a priority (Salari et al., 2023). Back pain in pregnant women has the potential to worsen their health and lead to adverse pregnancy outcomes, thereby increasing sleep disturbances. This study aimed to examine changes in back pain intensity and sleep quality before and after a two-day effleurage massage combined with lavender aromatherapy among third-trimester pregnant women. The study employed a quasi-experimental design with a pretest-posttest one-group design, involving 40 pregnant women in their third trimester who received the effleurage massage intervention for 2 days, 20 minutes per day, using massage oil made from a mixture of virgin coconut oil (VCO) and 2% lavender essential oil. This study used the PSQI questionnaire to measure sleep quality and the VAS scale to measure back pain. The results showed a decrease in the average back pain score from 6.3 to 3.35 after the intervention. Additionally, the participants’ sleep quality improved, as evidenced by an increase in the percentage of pregnant women reporting good sleep quality from 5% to 62.5% following the intervention. Statistical analysis revealed a p-value of <0.001, indicating a significant effect of effleurage massage and lavender aromatherapy on reducing back pain and improving sleep quality. The findings of this study indicate that effleurage massage and lavender aromatherapy short-term improvement in reducing back pain and improving sleep quality in third-trimester pregnant women. Thus, this intervention can be used as a simple, safe, and easily implemented nonpharmacological complementary therapy in obstetric care to help alleviate discomfort in third-trimester pregnant women. However, limited evidence is available on the combined use of effleurage massage and lavender aromatherapy as a single integrated intervention to address both back pain and sleep quality in third-trimester pregnant women. The originality of this study lies in its practical combined intervention protocol, using effleurage massage with virgin coconut oil and 2% lavender essential oil, to simultaneously reduce back pain and improve sleep quality.

Association Between Compliance with SBAR Communication During Handover and Patient Safety at Anugerah Regional General Hospital Tomohon, Indonesia

Fri, 24 Jul 2026 00:00:00 +0000

Communication failures during handovers contribute to more than 60% of adverse events in hospitals. The implementation of SBAR (Situation, Background, Assessment, Recommendation) communication is a key strategy for improving patient safety. This study aimed to analyze the relationship between compliance with SBAR communication during handovers and patient safety among nurses at Anugerah Regional General Hospital. A quantitative cross-sectional analytical design was employed. Total sampling was used to recruit 53 nurses from four inpatient wards (Anyelir, Upper Aster, Lower Aster, and Alamanda). Data were collected using the Ministry of Health SBAR Observation Checklist (2022) and the Hospital Survey on Patient Safety Culture (HSOPSC) 2.0. Data were analyzed using the Chi-Square test and Spearman correlation. The results showed that most nurses demonstrated good compliance with SBAR communication (58.5%), experienced a heavy workload (49.1%), and reported a moderate level of patient safety (41.5%). A significant relationship was found between SBAR communication compliance and patient safety (?² = 21.202; p = 0.0003; Cramér’s V = 0.447). Nurses who complied with SBAR communication demonstrated a good patient safety level of 38.7%, compared to 0% among those who were non-compliant. Compliance with SBAR communication during handovers was significantly associated with patient safety. Continuous supervision and regular SBAR training are recommended to improve compliance and enhance patient safety.

Prolonged emergency department length of stay and fall-risk: A hospital-based observational study

Deni Irawan, Fariz Jauhar Muslim, Jumrotun Ni'mah — Wed, 30 Sep 2026 00:00:00 +0000

Emergency Department Length of Stay (EDLOS) is an important indicator of emergency care efficiency and may be associated with patient safety outcomes, including fall risk. This study aimed to determine the association between EDLOS and fall-risk classification among patients in the Emergency Department (ED) of Hospital X, Tegal, Indonesia. This quantitative analytical observational study used a cross-sectional approach with prospective data collection from 29 April to 3 May 2025. A total of 100 patients were recruited using accidental (convenience) sampling. EDLOS was measured from ED arrival until discharge, inpatient admission, or transfer to another hospital unit and summarized using median and interquartile range (IQR). For bivariate analysis, EDLOS was categorized using the hospital's operational 4-hour threshold. Fall risk was assessed using the Morse Fall Scale (MFS). Of the participants, 67.0% had normal EDLOS (<4 hours), with a median of 2 hours 30 minutes (IQR: 1 hour 58 minutes–3 hours 58 minutes), while 33.0% had prolonged EDLOS (?4 hours), with a median of 6 hours 03 minutes (IQR: 4 hours 22 minutes–9 hours 15 minutes). Overall, 66.0% had low fall risk, 19.0% high risk, and 15.0% no risk. EDLOS category was significantly associated with fall-risk classification (Pearson's ?² = 200.000, df = 2, p < 0.001; Cramer's V = 0.787, 95% CI: 0.65–0.86). However, this observational finding does not establish causality or an independent effect of EDLOS. Integrating patient-flow management with systematic fall-risk assessment may support patient safety.

Utilization of cluster 3 primary care integration services among the elderly

Nunung Mahayatun, Dedy Purwito — Mon, 07 Sep 2026 00:00:00 +0000

The growing elderly population demands comprehensive and responsive primary healthcare. In Indonesia, the Cluster 3 Primary Care Integration (ILP) Program was developed to address older adults' health needs; however, prior research mostly used quantitative methods focused on accessibility, leaving older adults’ subjective experiences unexplored. This study fills that gap by qualitatively examining their utilization experiences—including perceptions, benefits, family support, and barriers—offering a multi-stakeholder perspective combining voices of older adults, families, health workers, PPKBD personnel, and staff. A qualitative phenomenological design was employed, collecting data via interviews, FGDs, observations, and documentation from 30 purposively selected participants, analyzed thematically. Five main themes emerged: utilization experiences, perceived quality, family support, multi-level barriers, and improvement expectations. Findings indicate positive experiences were primarily driven by active family and health worker engagement, whereas physical constraints, lack of caregivers, and limited diagnostic facilities were key barriers. Strong support offset individual barriers, but system limitations constrained potential benefits. The study concludes that Cluster 3 ILP utilization is shaped by interacting individual, family, and system factors, implying the need to strengthen elderly education, caregiver support, diagnostic supplies, and formal integration of community roles into primary care policy.

Continuity of midwifery care for a pregnant woman with chronic energy deficiency: A case study

Fri, 04 Sep 2026 00:00:00 +0000

Background: Chronic Energy Deficiency (CED) remains an important nutritional problem among pregnant women and is associated with adverse maternal and neonatal outcomes. However, limited case-based evidence has described the implementation of continuity of midwifery care specifically for pregnant women with CED across the maternal and neonatal continuum. Objective: To implement continuity of midwifery care for a pregnant woman with CED from pregnancy through childbirth, postpartum, neonatal, and family planning care. Methods: A descriptive case study was conducted at an independent midwifery practice in Medan, Indonesia. The participant was a 22-year-old primigravida with a Mid-Upper Arm Circumference (MUAC) of 22 cm, indicating CED. Care was provided using Varney’s Midwifery Management Model and documented using the Subjective, Objective, Assessment, and Plan (SOAP) format. Data were collected through interviews, physical and obstetric examinations, supporting examinations, and documentation review. Results: Continuity of care included nutritional counseling, MUAC monitoring, iron supplementation, antenatal monitoring, intrapartum care, postpartum follow-up, neonatal care, and family planning services. Pregnancy progressed to 38 weeks and 2 days and ended in spontaneous vaginal delivery. At admission, cervical dilatation was 7 cm and fetal heart rate was 140 beats/minute. The first stage of labor lasted approximately 14 hours without complications. Four postpartum follow-up visits showed normal maternal recovery and successful exclusive breastfeeding. The newborn demonstrated normal adaptation without identified complications. Conclusion: Continuity of midwifery care facilitated early identification and management of CED and supported favorable maternal and neonatal outcomes in this case. Practically, integrating nutritional screening, individualized counseling, and continuous maternal-neonatal monitoring may strengthen care for pregnant women with CED in primary midwifery settings.

The culture of betel nut chewing and its relationship to chronic energy deficiency (CED) in pregnant women at the Karang Indah Community Health Center

Erma Retnaningtyas, Mifta Huljanna, Hanriska Awidiya Putri, Erni Agit Ekawati — Fri, 24 Jul 2026 00:00:00 +0000

Betel nut consumption is closely linked to an increased risk of Chronic Energy Deficiency (CED). The active ingredients in it inhibit the absorption of essential nutrients and can reduce appetite, resulting in inadequate macro and micronutrient intake for mothers. This study aims to determine the relationship between the betel nut culture and the incidence of CED in pregnant women at the Karang Indah Community Health Center. The study design was quantitative and analytical with a cross-sectional approach. A purposive sampling technique was used to select 40 pregnant women from Papua who consume betel nut. Data were collected through a questionnaire to determine the consumption behavior of betel nut and pita lila (lila) to determine whether pregnant women had CED and a lila (lila) <23.5 cm. Data were analyzed using univariate and bivariate methods using the Chi-Square test with an ? value of 0.05. The results showed that the majority of respondents had a habit of consuming betel nut (52.5%), those with CED (45.0%), and those without CED (7.5%). Bivariate analysis showed a significant association between the betel nut culture and the incidence of CED in pregnant women (p = 0.010) with strong relationships. These results indicate that CED is more common in pregnant women who consume betel nut compared to those who do not. Therefore, health education for pregnant women is needed to reduce betel nut consumption.