Inovasi Lokal

Comfort Theory in Practice: Lavender Aromatherapy for Sleep Pattern Disturbance in Hypertensive Older Adults at a Community Health Center

2026-06-22T14:47:38+00:00

Introduction: Hypertension commonly impairs sleep quality among older adults because persistent sympathetic nervous system activation interferes with the physiological relaxation required for sleep initiation and maintenance. Although antihypertensive therapy controls blood pressure, sleep disturbances often persist, highlighting the need for effective non-pharmacological nursing interventions in primary care. This case report aimed to describe the implementation of lavender aromatherapy, guided by Kolcaba's Comfort Theory, in managing sleep pattern disturbances among hypertensive older adults.

Methods: A descriptive case report was conducted involving two hypertensive older adults receiving nursing care at the Gadingrejo Health Center, Pasuruan City, Indonesia. Nursing assessment and care were based on the Indonesian Nursing Diagnosis, Intervention, and Outcome Standards (SDKI, SIKI, and SLKI). Lavender aromatherapy was administered using a diffuser containing 50 mL of water and 4–5 drops of lavender essential oil for approximately 60 minutes before bedtime over seven consecutive days, accompanied by sleep hygiene education. Data were collected through interviews, direct observation, physical examination, and nursing documentation.

Results: Both participants experienced fewer nocturnal awakenings and reported improved subjective sleep quality after the intervention. One participant also demonstrated resolution of neck pain and dizziness, accompanied by normalization of blood pressure. In the second participant, nocturia remained a persistent factor limiting optimal sleep despite overall improvement.

Conclusion: Lavender aromatherapy, integrated within Kolcaba's Comfort Theory, showed potential as a feasible, theory-based nursing intervention for improving sleep comfort in hypertensive older adults in primary care settings. Further studies with larger samples are warranted to confirm its effectiveness.

Empowering Lay Rescuers in Out-of-Hospital Cardiac Arrest: A Pretest-Posttest Study Guided by Orem’s Self-Care Deficit and Neuman’s Systems Models

2026-07-01T07:14:41+00:00

Introduction: Out-of-hospital cardiac arrest (OHCA) has a low survival rate, making bystander Basic Life Support (BLS) crucial. However, in Indonesia, bystander intervention is frequently hindered by knowledge deficits, cultural norms regarding cross-gender touch, and fear of legal liability. This community service aimed to enhance the BLS competence of PIA Ardhya Garini members as first responders, theoretically grounded in Orem’s Self-Care Deficit and Neuman’s Systems Models.

Methods: A quasi-experimental one-group pretest-posttest design was employed involving 60 PIA members. The intervention was a contextualized BLS training integrating legal empowerment (Indonesian Good Samaritan Law), cultural adaptation, and demographic adjustments (Hands-Only CPR for middle-aged women). Effectiveness was evaluated using a validated 10-item cognitive test, and data were analyzed using the Wilcoxon signed-rank test and Normalized Gain (N-Gain).

Results: The intervention significantly improved participants' cognitive knowledge. The mean score increased from 6.87 ± 0.96 (pretest) to 9.03 ± 0.74 (posttest) with a p-value < 0.001. The Normalized Gain (N-Gain) was 0.67, indicating moderate effectiveness. The training successfully corrected clinical misconceptions and mitigated specific socio-cultural and legal barriers to bystander intervention.

Conclusion: Integrating nursing theories with socio-cultural-legal-clinical modifications effectively empowers laywomen as "dependent care agents" and strengthens community primary prevention against OHCA. To sustain cognitive and psychomotor retention, periodic refresher training every 6–12 months is strongly recommended. This model provides a replicable blueprint for community nursing practice in collectivist societies.

Community Integrative Ethnomedicine for Diabetes Prevention: A Holistic Community Empowerment Approach

2026-07-10T09:24:01+00:00

Introduction: Diabetes mellitus (DM) remains a major global public health challenge, particularly in low- and middle-income countries where delayed diagnosis and inadequate preventive behaviors contribute to increasing disease burden. This study evaluated the effectiveness of a holistic community empowerment program combining diabetes education, self-acupressure training, preventive herbal medicine education, and opportunistic blood glucose screening, while introducing an integrated conceptual direction for community-based diabetes prevention.

Methods: A one-group pretest–posttest pre-experimental study, reported according to the TREND Statement, was conducted among 30 women aged 40–60 years participating in the Family Welfare Movement (PKK) Indonesia. Diabetes knowledge was assessed using the 24-item Diabetes Knowledge Questionnaire before and immediately after the intervention.

Results: Twenty participants completed both knowledge assessments, while 16 underwent blood glucose screening. Participants demonstrating poor diabetes knowledge decreased from 70.0% at baseline to 0% after the intervention, whereas good knowledge increased from 0% to 100%. Blood glucose screening identified 14 participants (87.5%) within the normal range and two participants (12.5%) with random blood glucose levels exceeding 200 mg/dL, prompting immediate referral for further clinical evaluation.

Conclusion: Integrating health education, self-acupressure, preventive herbal medicine, and opportunistic screening within existing community organizations is a feasible and culturally responsive strategy for strengthening diabetes prevention. These findings provide preliminary support for the proposed Community Integrative Ethnomedicine Prevention (CIEP) Model, which conceptually integrates health literacy, evidence-informed traditional medicine, community empowerment, and early metabolic surveillance as an emerging framework for sustainable diabetes prevention.

Transformative Praxis Beyond Methodology: A Multi-Theoretical Integration of Classroom Action Research for Novice Educators' Critical Reflection and Epistemic Awakening

2026-05-12T03:40:31+00:00

Introduction: Critical reflection constitutes a foundational competency for novice educators, yet remains suboptimally developed due to limited experiential scaffolding and insufficient systematic guidance. While Classroom Action Research (CAR) has been widely employed as a methodological tool, its transformative potential as a multi-theoretical praxis remains underexplored. This study addresses this gap by integrating four complementary theoretical frameworks—Dewey's reflective thinking, Korthagen's ALACT model, Mezirow's transformative learning, and Freirean critical pedagogy—to reconceptualize CAR not merely as research methodology but as transformative praxis capable of catalyzing epistemic awakening among novice educators.

Method: Employing a participatory action research design, this study conducted an intensive one-day workshop with novice educators (pre-certification teachers) in the coastal communities of Sidoarjo Regency, Indonesia. The intervention comprised four sequential phases: (1) conceptual grounding through theoretical orientation, (2) problem identification and critical analysis using classroom data as evidentiary foundations, (3) CAR proposal development with peer review and mentor feedback, and (4) evaluation and reflective synthesis. Data were collected through pre-post evaluation forms,

Result: Evaluation data revealed significant paradigmatic shifts in participants' understanding of critical reflection and CAR. Participants transcended viewing reflection as administrative ritual, instead embracing it as transformative strategy for cultivating sustained critical consciousness.

Conclusion: This study contributes theoretical novelty by demonstrating the integrative power of synthesizing Deweyan, Korthagenian, Mezirowian, and Freirean perspectives within a unified framework for novice educator development. The findings validate CAR's function not merely as methodological instrument but as transformative praxis that catalyzes epistemic awakening and perspective transformation.

Celery Juice as a Gate Control Theory-Based Nursing Intervention for Chronic Pain in Hypertensive Older Adults: A Quasi-Experimental Community Health Study

2026-06-23T14:29:23+00:00

Chronic pain is a common yet under-recognized complication of hypertension, resulting from sustained vascular stress, sympathetic overactivity, and impaired tissue perfusion. Celery juice (Apium graveolens) has been proposed as a nonpharmacological adjunct to interrupt this pain–pressure cycle, but community-based nursing evidence remains limited. This study evaluated the effect of home-administered celery juice on chronic pain and blood pressure among hypertensive older adults in the Gadingrejo Community Health Center, Pasuruan City, using the Gate Control Theory of pain as the theoretical framework. A quasi-experimental, non-equivalent two-group pretest–posttest design compared one adherent and one non-adherent patient over seven days. Both met identical inclusion criteria and received the same education and intervention offers. The intervention consisted of 200 mL of celery juice administered 1–2 times daily alongside standard nursing care. Pain was assessed using the Numeric Rating Scale (NRS), and blood pressure was measured with a calibrated sphygmomanometer before and after the intervention. Both patients had baseline pain scores of 6 and blood pressure of 160/100 mmHg. The adherent patient improved to a pain score of 3 with reduced blood pressure and better functional comfort, whereas the non-adherent patient improved only to a pain score of 5 with minimal blood pressure change. Regular celery juice consumption was associated with greater reductions in chronic pain and blood pressure, supporting its use as a safe, low-cost nursing adjunct when combined with sustained patient adherence.

Slow Deep Breathing for Acute Post-Appendectomy Pain: A Gate Control Theory-Based Nursing Care Study

2026-07-08T03:11:41+00:00

Acute pain is one of the most consistent complications after appendectomy and, when left poorly controlled, delays mobilization, disrupts rest, and slows recovery. Slow deep breathing (SDB) is listed among the independent, non-pharmacological interventions in the Indonesian Nursing Intervention Standards, yet detailed, session-by-session accounts of how the technique is delivered at the bedside and how patients respond across successive post-operative days remain scarce in the nursing literature. This study described the nursing care process for a post-appendectomy patient with acute pain and evaluated within-subject changes in pain intensity and physiological indicators before and after three days of SDB therapy at Bangil Regional General Hospital (RSUD Bangil), Indonesia. A quasi-experimental, one-group pre-test post-test case design, embedded in the nursing process and reported in line with single-case reporting conventions, was used. SDB was delivered once daily for three consecutive days: inhalation through the nose for four seconds, breath-holding for two seconds, and exhalation through pursed lips for eight seconds, repeated across three cycles per session. Pain was scored with the Numeric Rating Scale (NRS) before and after each session. Pain intensity declined from severe (NRS 7) at baseline to mild (NRS 3) after the third session, accompanied by a drop in pulse rate from 104 to 87 beats per minute and the resolution of grimacing, restlessness, and protective behavior. SDB is a feasible, low-cost, nurse-initiated intervention that surgical wards can integrate into routine post-appendectomy pain management protocols alongside pharmacological treatment.

Toward Holistic Workplace Health: Integrating Ergonomics, Nutrition, Herbal Medicine, and Self-Acupressure for Shoulder Pain Prevention Among Manufacturing Workers

2026-07-10T10:29:13+00:00

Background: Work-related shoulder pain remains one of the leading musculoskeletal disorders among manufacturing workers, resulting in impaired productivity, reduced functional capacity, and increased occupational health burden. Existing workplace education primarily emphasizes ergonomics, while integrated self-management approaches incorporating nutrition, complementary medicine, and self-care techniques remain underexplored. This study evaluated the effectiveness of a holistic educational intervention for improving workers' knowledge of shoulder pain prevention and self-management.

Methods: A community-based one-group pre-test–post-test study was conducted among 20 workers from a plywood manufacturing industry in East Java, Indonesia. Participants attended a 90-minute educational program integrating occupational health education, ergonomic practices, nutritional counseling, herbal education using turmeric (Curcuma longa) and tamarind (Tamarindus indica), and guided self-acupressure.

Results: All participants completed the intervention (response rate: 100%). The mean knowledge score increased from 4.5 at baseline to 9.4 after the intervention, representing an average improvement of 4.9 points. Every participant demonstrated higher post-test scores, with individual improvements ranging from 1 to 8 points. Before the intervention, 60% of participants had poor knowledge, 25% had fair knowledge, and 15% had good knowledge.

Conclusions: The holistic educational intervention effectively enhanced workers' knowledge regarding shoulder pain prevention and self-management. The principal novelty of this study is the introduction of a Holistic Occupational Self-Management Framework, integrating occupational health education, ergonomics, nutrition, herbal medicine, and self-acupressure into a unified worker-centered model. This framework provides a foundation for future technology-enabled occupational health programs aimed at promoting sustainable prevention of work-related musculoskeletal disorders.

Family-Centered Care as A Cadre Empowerment Strategy For Early Detection Of High-Risk Pregnancies in The Community

2026-06-05T08:08:21+00:00

High-risk pregnancies remain a significant contributor to maternal complications and elevated maternal mortality rates, necessitating early detection efforts that involve communities and families. This community service program aimed to enhance the knowledge and skills of community health cadres in early detection of high-risk pregnancies using a Family-Centered Care (FCC) approach in the working area of Wagir Primary Health Center, Malang Regency. Methods used included health education, training on the use of screening forms, simulation exercises, family education sessions, and on-site mentoring of cadres at integrated health posts (posyandu). Evaluation was conducted using a pretest-posttest design among 64 health cadres. Results showed an increase in the average knowledge score from 54.90 at pretest to 88.75 at posttest. In addition, cadres demonstrated the ability to identify pregnancy risk factors, detect pregnant women in the high-risk category, and coordinate with village midwives for case follow-up. Family involvement in pregnancy monitoring also increased through improved awareness of danger signs and greater support for antenatal care visits. Statistical analysis showed that Family-Centered Care-based training and mentoring are effective in enhancing cadre capacity and family participation in the early detection of high-risk pregnancies. This program can serve as a community empowerment strategy that supports the prevention of pregnancy complications and the sustainable improvement of maternal health.

Virgin Coconut Oil Therapy for Coastal Dermatitis: A Community Nursing Application of Orem's Self-Care Deficit Theory

2026-06-29T15:09:06+00:00

Dermatitis is one of the most common integumentary disorders encountered in community nursing practice, and its burden is amplified among populations continuously exposed to environmental irritants such as seawater, wind, dust, and extreme humidity. Coastal communities sit at the upper end of this exposure gradient, yet affordable, theory-guided non-pharmacological interventions for this population remain sparsely evaluated. This study evaluated the effectiveness of standardized topical Virgin Coconut Oil (VCO) therapy, delivered through a structured nursing process guided by Orem's Self-Care Deficit Theory, on impaired skin integrity among coastal residents with contact dermatitis. A quasi-experimental, one-group pretest-posttest design, reported in accordance with the TREND Statement, was conducted over three consecutive days (12–14 May 2026) with two purposively selected participants, aged 35 and 60 years, in the coastal working area of the Gadingrejo Community Health Center, Pasuruan City, Indonesia. VCO was applied topically per a standard operating procedure while nursing support progressed from a wholly compensatory to a partially compensatory and finally a supportive-educative system. Skin integrity was assessed daily using SDKI/SLKI-aligned indicators covering pruritus, erythema, skin texture, lesion status, and local skin temperature. Both participants showed a consistent decline in pruritus and erythema, smoother skin texture, and reduced local skin temperature (37.4°C to 36.5°C in the older participant), with near-complete symptom resolution by the third day. Structured VCO therapy delivered through a theory-guided nursing process meaningfully restored skin integrity within 72 hours and moved participants toward independent self-care, supporting its viability as a low-cost, evidence-based community nursing intervention for coastal dermatitis.

Guided Autogenic Relaxation for Hypertensive Acute Pain: An Orem-Based Community Nursing Program

2026-07-08T10:14:27+00:00

Hypertension rarely presents in isolation; a substantial proportion of affected adults also live with acute pain, most often occipital headache and neck tension, that erodes daily functioning and pushes patients toward unsupervised analgesic use. Community-based, non-pharmacological interventions capable of addressing this dual burden inside patients' own homes remain underdocumented, particularly when explicitly grounded in a nursing theoretical framework. This community nursing program examined the effect of guided autogenic relaxation therapy, structured around Orem's Self-Care Deficit Theory, on acute pain intensity, blood pressure, and self-care behavior among hypertension patients in a primary care catchment area. A quasi-experimental, one-group pretest-posttest design, reported following TREND and TIDieR guidance, was applied to three male patients aged 49-56 years with moderate acute pain (Numeric Rating Scale 4-5). Each participant received a standardized 15-minute guided autogenic relaxation session daily for three consecutive days at home, with pain, blood pressure, vital signs, and pain-related behavior recorded before and after every session. Mean pain intensity fell from 4.67 to 1.33, a 71.5% reduction; systolic pressure declined by 21 mmHg and diastolic pressure by 13 mmHg; and observable pain behaviors resolved by the third day. Two of the three participants began practicing the technique independently before the scheduled session on day two, consistent with Orem's transition from a partially compensatory to a supportive-educative nursing system. These findings support incorporating guided autogenic relaxation into home-based community nursing as an accessible, theory-consistent strategy for strengthening self-care agency in hypertension management.