Health Access Journal

Dietary Modification in an Outpatient With Type 2 Diabetes Mellitus and Hypertension

Dita Noviasari — 2026-10-28

Type 2 Diabetes Mellitus (T2DM) accompanied by hypertension is a chronic metabolic disorder requiring individualized nutrition therapy to improve metabolic control and prevent complications. This study aimed to evaluate dietary modification through the Nutrition Care Process in an outpatient with T2DM and hypertension at RSUD Bangil, Pasuruan Regency. A descriptive case study was conducted on a 55-year-old female outpatient diagnosed with T2DM and hypertension. Nutritional care included assessment, diagnosis, intervention, monitoring, and evaluation. The intervention consisted of individualized meal planning, a diabetic diet with sodium and saturated fat restriction, nutrition education, counseling, and modified pumpkin pudding as a healthy snack. Nutritional status, biochemical parameters, dietary intake, knowledge, adherence, and food acceptability were monitored before and after the intervention. Average energy intake reached approximately 100% of estimated requirements. Blood pressure decreased from 138/85 mmHg to 120/79 mmHg. Fasting blood glucose decreased from 172 to 115 mg/dL, while two-hour postprandial blood glucose decreased from 199 to 112 mg/dL. Nutrition knowledge, dietary adherence, and acceptance of the modified diet also improved. Individualized dietary modification combined with continuous nutrition education improved dietary intake, glycemic control, blood pressure, and adherence in this patient.

The Effectiveness of Early Mobilization Education Using Video Media on Post-Laparotomy Patient Recovery

Mita Amalia Karunia Akbar — 2026-10-28

Post-laparotomy patients generally experience pain, decreased mobility, impaired intestinal peristalsis, and an increased risk of complications. Therefore, early mobilization is an important step to accelerate recovery. However, its implementation is often suboptimal due to limited patient education. Video media can provide clear and easy-to-understand explanations. This study aimed to determine the effectiveness of early mobilization education using video media on the recovery of post-laparotomy patients. The study used a quasi-experimental approach with a posttest-only control group design. The population consisted of 79 patients, with 40 respondents selected through simple random sampling. The sample included 20 respondents in the control group and 20 in the intervention group. Bivariate analysis was performed using the Mann-Whitney test. The results showed that recovery in the control group was slower than in the intervention group. The intervention group demonstrated better mobilization ability (p = 0.000) and faster reduction in pain intensity, particularly at 12 hours (p = 0.009) and 24 hours postoperatively (p = 0.021). However, intestinal peristalsis recovery was not significantly different between groups (p = 0.127). Thus, early mobilization education using video media was effective in accelerating recovery among post-laparotomy patients. Further research with longer observation periods and more comprehensive implementation is recommended.

Support Systems and Maternal Motivation for Exclusive Breastfeeding in Kediri

Edzwina Hayyu Saffira — 2026-10-28

Exclusive breastfeeding is defined as natural breast milk without any other additives for the first six months of a baby's life. Despite its significant benefits, exclusive breastfeeding in Indonesia remains suboptimal. Support systems, or social support, are among the factors that support exclusive breastfeeding. This study aims to examine the impact of the support system on maternal motivation for exclusive breastfeeding at the Balowerti Community Health Center in Kediri City. This research is quantitative, with a cross-sectional, analytical-correlational design. The study population comprised 112 breastfeeding mothers aged 0–6 months, of whom 86 were selected by simple random sampling. The collective instrument was a structured questionnaire. Data analysis was performed using Fisher's Exact test. The results showed a significant relationship between the Support System and maternal motivation regarding exclusive breastfeeding (p=0.000; p<0.05). Increased support from family, health workers, and the surrounding environment is needed to strengthen mothers' motivation to breastfeed exclusively.

Treatment Adherence Among Hypertensive Patients: A Qualitative Case Study

Eko Sari Wahyuni — 2026-10-28

Hypertension, known as the silent killer, is a chronic disease requiring long-term management. Patient adherence to a treatment program is a key determinant of therapeutic success; however, non-adherence remains widespread. This study aimed to determine the level of adherence among hypertensive patients in following the treatment program at Lavalette Hospital, Malang City. A descriptive qualitative method with a case study design was employed, involving five outpatient hypertensive patients, conducted from February 19 to March 26, 2025. Data were collected through in-depth interviews, direct observation, and blood pressure measurements across three visits per subject. Based on clinical assessment and participant self-report, all subjects appeared to demonstrate low adherence to antihypertensive medication. However, adherence was not measured using a validated standardized instrument. Factors contributing to non-adherence included limited knowledge about hypertension, low family support, fear of medication side effects, daily busyness, and restricted access to healthcare facilities. Blood pressure in all subjects remained above normal values. The findings suggest that continuous patient education and active family involvement may represent important strategies for improving hypertension treatment adherence, though further research with larger samples is warranted.

Knowledge and Drug Abuse Among Prison Inmates

Awan Hariyanto — 2026-10-28

Drug abuse remains a significant public health problem worldwide and is associated with increased morbidity, criminal behavior, and social burden. Knowledge regarding narcotics and psychotropic substances is considered an important determinant in preventing substance abuse; however, evidence among prison inmates remains limited. This study aimed to determine the relationship between knowledge regarding drugs and drug abuse among inmates at Trenggalek Detention Center. A quantitative correlational study with a cross-sectional approach was conducted among 15 inmates selected through purposive sampling. Data were collected using structured questionnaires assessing respondents’ knowledge regarding drugs and history of drug abuse. Descriptive statistics were used to summarize respondent characteristics. The relationship between knowledge and drug abuse was analyzed using Lambda and Goodman–Kruskal Tau statistics with a significance level of 0.05. Most respondents were male (100%), had completed senior high school (53.3%), worked as self-employed individuals before imprisonment (60%), and had been incarcerated for more than two years (80%). Most respondents had good knowledge of narcotics (73.3%). Lambda analysis showed no significant relationship between knowledge and drug abuse (p = 0.301). Knowledge regarding narcotics was not significantly associated with drug abuse among inmates

Design of Traditional Nebulizer for Patients with Coughs

Muty Dewi Hasanah — 2026-10-28

Cough is a common respiratory disorder that may become chronic in the elderly and reduce quality of life. Limited access to conventional nebulizers necessitates the development of more affordable inhalation therapy alternatives. This study aimed to design a herbal-based traditional nebulizer as an alternative inhalation therapy for patients with productive cough. This study used a Research and Development (R&D) approach with the ADDIE model. It was conducted at Griya Sakinah Nursing Home, Blitar, Indonesia, from January to April 2025. Data were collected using expert validation and field-testing checklists rated on a 1–5 scale, which underwent expert judgment to ensure content validity. Validation involved three experts, followed by a limited trial on two elderly participants. Expert validation yielded a feasibility score of 77.25% (feasible), while participant trials showed 81.17% (very feasible). The device consists of a clay pot heater, plastic tubing, an aluminum sheath, and Piper betle leaves with mucolytic and expectorant properties. No significant adverse effects were observed. This device is potentially beneficial, practical, and cost-effective for use in resource-limited settings. However, the very small sample size limits generalizability.

Midwifery Care For Pregnant Women Obesity And Hypertension : A Case Study

Ririn Indriani — 2026-10-28

Obesity during pregnancy is defined as excessive weight gain exceeding 12–16 kg above the normal range. This condition can trigger metabolic and cardiovascular complications, including hyperglycemia, hypercholesterolemia, and hypertension. Gestational hypertension is characterized by an increase in blood pressure to 140/90 mmHg or higher after 20 weeks of gestation. Such conditions elevate the risk of complications and may potentially lead to mortality for both the mother and the infant. Objective: This study aims to examine the influence of obesity on hypertension in pregnant women and to identify preventive measures to reduce the risk of both conditions during pregnancy. Methods: A case study design was employed, focusing on a 36 year old pregnant woman (G2P1001) at 33–34 weeks of gestation with a single, viable intrauterine pregnancy, complicated by obesity and hypertension. Data were collected through interviews, physical examinations, observations, and documentation. The diagnosis was based on body mass index (BMI) assessment and blood pressure measurements. Interventions included pregnancy monitoring, nutritional counseling for a balanced diet, weight gain management, and health education. Results: The findings indicate a strong association between obesity and hypertension in pregnant women. Conclusion: Obesity influences the occurrence of hypertension in pregnant women

Hallucination Levels in Schizophrenia After Perceptual Stimulation Group Activity Therapy

Leni Eka Sefia — 2026-10-28

Schizophrenia is frequently accompanied by hallucinations that disrupt functioning and quality of life. Perceptual stimulation group activity therapy is a structured nursing intervention intended to strengthen patients’ ability to recognize and manage hallucinatory experiences. This study aimed to describe post-therapy hallucination levels and analyze their relationships with selected therapy-related factors. A quantitative descriptive-analytical cross-sectional study was conducted among 30 patients with schizophrenia and hallucinations at Radjiman Wediodiningrat Lawang Hospital. Participants were selected using purposive sampling. Data were obtained through structured interviews, observations, and questionnaires assessing hallucination levels, social support, interaction quality, therapy environment, knowledge, and participation. Descriptive statistics and Spearman’s rank correlation were used for analysis. After therapy, 17 participants (56.7%) had mild hallucinations and 13 (43.3%) had moderate hallucinations. Social support was inversely associated with hallucination level, whereas patient knowledge showed a positive association. Interaction quality, therapy environment, and participation were not significantly associated with hallucination level. Perceptual stimulation group activity therapy was followed predominantly by mild hallucination levels, with social support and patient knowledge emerging as relevant correlates of hallucination management.