Ahmar Metastasis Health Journal

Complete Recovery Following Intestine Perforation Caused by Tuberculosis: A Case Report

Ikhsan Budi — 2026-02-24

Intestinal tuberculosis (ITB) can mimic common gastrointestinal disorders and is frequently diagnosed late, particularly in resource-limited settings where microbiological confirmation is unavailable. This case report aims to describe an unusual presentation of ITB as ileocaecal perforation and to highlight diagnostic and therapeutic considerations. The method used was a descriptive case report of a 25-year-old woman who presented with watery diarrhoea, vomiting, diffuse abdominal pain, fever, weight loss, and cough, and subsequently developed generalized peritonitis requiring emergency exploratory laparotomy. Intraoperative findings revealed an ileocaecal perforation requiring segmental resection with primary anastomosis. Histopathological examination of the resected bowel and regional lymph nodes demonstrated necrotising granulomatous inflammation with caseation and Langhans-type giant cells, supporting the diagnosis of ITB. Microbiological tests such as GeneXpert and culture were not performed due to resource limitations. Postoperatively, the patient received supportive care, antibiotics, and standard anti-tuberculosis therapy. The results showed a favorable clinical outcome, with no early postoperative complications, discharge on postoperative day seven, and complete symptom resolution with weight gain and radiological improvement at follow-up. This case illustrates that when microbiological confirmation is not feasible, histopathology combined with timely surgical intervention and anti-tuberculosis therapy can support diagnosis and lead to successful management of complicated ITB.

Knowledge and Acceptance of HPV Vaccination among Early Adolescents in Secondary Schools

Alfiyana Yuliasari — 2026-01-29

Human Papillomavirus (HPV) infection remains the leading cause of cervical cancer and continues to pose a public health problem in Indonesia. While previous studies have widely examined HPV-related knowledge and vaccines acceptance, evidence focusing on early adolescents within school-based vaccination settings remain limited. This study aims to analyze the relationship between the level of knowledge and acceptance of the HPV vaccine among third-grade junior high school students, a key target group for national immunization programs. A cross-sectional quantitative design was conducted among 48 students selected through total sampling. Data were collected using a structured questionnaire that measured respondent characteristics, knowledge levels about HPV, and acceptance of the HPV vaccine. Data analysis was performed univariately and bivariately using Fisher's Exact test with a significance level of 0.05. Most respondents were aged 14 years (60.4%), had high knowledge about HPV (72.9%), and showed positive acceptance of the HPV vaccine (64.6%). Bivariate analysis showed that students with high knowledge were 1.14 times more likely to accept the HPV vaccine positively than students with poor to moderate knowledge. However, this relationship was not statistically significant (p = 0.731; PR = 1.14; 95% CI: 0.67–1.94). There was no significant relationship between students' level of knowledge about HPV and their acceptance of the HPV vaccine. The study highlights the need for multidimensional intervention strategies involving parental engagement, school support, and health worker communication.

The Effectiveness of Tornado Disaster Mitigation Education in Improving the Knowledge of Junior High School Students

Meutia Nanda — 2026-02-05

Schools in Indonesia face the challenge of low student knowledge and preparedness for tornado mitigation, a common hydrometeorological disaster that can threaten safety due to a lack of systematic disaster education. This study aims to determine the effectiveness of natural disaster mitigation education on tornadoes for ninth-grade students at SMPN 2 Pancur Batu. This study used a quantitative method with a one-group pretest-posttest pre-experimental design. The population in this study was all ninth-grade students at SMPN 2 Pancur Batu. The intervention involved 57 students in December 2025, with interactive counseling using visual media, discussions, and a three-point Likert scale pretest and posttest questionnaire to measure students' knowledge improvement. The results showed a significant increase in knowledge, with an average pretest score of 31.60 (SD=4.088) increasing to a posttest score of 32.65 (SD=4.104). Statistical test results showed a significant difference between the pretest and posttest scores (t=-3.711, df=56, p= 0.001), indicating that the education provided had a real effect on increasing students' knowledge. The effect size (Cohen's d = 0.492) indicates that the effect of the education was moderate, meaning that this intervention was quite effective in increasing students' knowledge in building awareness of natural disasters for reducing more dangerous risks after a disaster.

Intrinsic Motivation in The Development of Motivational Interviewing Method for Compliance Programs in Hypertension Patients

Efitra Efitra — 2026-03-31

Hypertension is a non-communicable disease and a major contributor to global mortality, including in Indonesia. Uncontrolled hypertension over a prolonged period can lead to arterial damage and adversely affect organs supplied by these blood vessels. Increased blood pressure places excessive workload on the heart, impairing its ability to pump blood effectively. Furthermore, hypertension increases the risk of stroke, kidney failure, hypertensive retinopathy, and even blindness. Efforts to control blood pressure require not only medical management but also strong internal motivation from patients. This study aimed to explore the internal motivation of hypertensive patients in controlling blood pressure through “OBEY” behavior. This study employed a qualitative research design using Focus Group Discussion (FGD). The participants were patients diagnosed with hypertension. The analysis identified key themes related to the implementation of “OBEY” behavior among hypertensive patients. The findings of this study are expected to serve as a basis for developing a Motivational Interviewing module tailored for hypertension patients to improve adherence and blood pressure control.

The Mediating Role of Midwifery Support in the Association Between Tokophobia and Elective Caesarean Requests Among Primigravida: A Cross-Sectional Study

Neneng Siti Lathifah — 2026-03-31

Fear of childbirth remains a significant psychological factor influencing delivery mode preferences among first-time pregnant women. This study aimed to examine the direct effect of tokophobia on non-medically indicated caesarean section (CS) requests among primigravidae and to assess the mediating role of midwifery support in this relationship. A cross-sectional design was employed involving 150 third-trimester primigravid women in Bandar Lampung City, selected through multi-stage cluster sampling across eight sub-districts. Tokophobia was measured using a culturally adapted version of the Wijma Delivery Expectancy Questionnaire Version A, while midwifery support was assessed using a researcher-developed instrument. Preferences for CS were collected through a nominal questionnaire. Data were analyzed using structural equation modeling with bootstrapping. The results showed that tokophobia significantly predicted both CS requests and the level of midwifery support. Furthermore, midwifery support significantly mediated the relationship between tokophobia and CS requests. Interestingly, the mediating effect was positive, indicating that supportive approaches lacking structured cognitive components may unintentionally reinforce CS preference among women experiencing fear of childbirth. These findings highlight tokophobia as a key psychological determinant of non-medically indicated CS demand in urban settings. In practice, integrating structured psychoeducational counseling and cognitive reframing techniques into routine antenatal care is crucial. Additionally, midwifery training programs should be strengthened to include evidence-based psychological intervention skills. Early screening for tokophobia, starting from the first trimester, is strongly recommended to help reduce unnecessary caesarean sections and improve maternal health outcomes.

The Relationship Between Coffee Consumption and Students’ Stress Levels

Intan Nurul Hayati — 2026-03-31

Final-year students often face high academic pressure, particularly during the completion of their thesis or final project. This condition has the potential to cause stress, which may negatively affect physical and mental health if not properly managed. Coffee consumption is a common habit among students to support their academic activities. The caffeine content in coffee is known to stimulate the central nervous system, thereby increasing alertness and reducing fatigue. However, studies specifically examining the relationship between the frequency of coffee consumption and stress levels among students remain limited. This study aims to analyze the relationship between the frequency of coffee consumption and stress levels among final-year students. This research employed a quantitative approach with a cross-sectional design. The sample consisted of 52 respondents selected using a total sampling technique based on inclusion criteria. Data were collected using a Food Frequency Questionnaire (FFQ) to assess coffee consumption and the Depression Anxiety Stress Scale (DASS-21) to measure stress levels. Data analysis was performed using the Spearman test. The results showed that most respondents consumed coffee more than three times per day and were categorized as having moderate stress levels. Statistical analysis indicated a significant negative correlation between the frequency of coffee consumption and stress levels (ρ = -0.389; p = 0.004), meaning that the higher the frequency of coffee consumption, the lower the perceived stress level. In conclusion, there is a moderate negative relationship between the frequency of coffee consumption and stress levels among final-year students at STIKes RS Husada.

The Relationship Between The Level of Knowledge and Family Support, and Measures to Prevent Pulmonary Tuberculosis Transmission

Tessalonika Marcelin Pangaribuan — 2026-03-31

Pulmonary tuberculosis remains a global health problem with a significant burden, particularly in densely populated areas such as Jakarta. The occurrence of this disease is influenced not only by medical factors but also by the level of individual knowledge and family support in preventing its transmission. This study aims to analyze the relationship between knowledge level and family support with efforts to prevent the transmission of pulmonary tuberculosis in the working area of the Kemayoran Public Health Center, Central Jakarta. This study employed a quantitative approach with a cross-sectional design involving 75 respondents selected through a survey technique using a structured questionnaire. Data analysis was conducted using univariate analysis to describe variable distributions and bivariate analysis using Spearman’s rho correlation test. The results showed a significant relationship between knowledge level and efforts to prevent the transmission of pulmonary tuberculosis, with a strong correlation. In addition, family support also demonstrated a very strong and significant relationship with prevention efforts. The majority of respondents had a moderate level of knowledge, tended to have low family support, and their prevention efforts were generally in the moderate to good category. In conclusion, this study highlights that improving knowledge and strengthening family support play an important role in enhancing preventive behaviors against pulmonary tuberculosis transmission. Therefore, continuous health education interventions and family empowerment are needed to reduce the transmission rate of pulmonary tuberculosis, particularly in urban areas.

The Lived Experience of Patients with Diabetes Mellitus Participating in Rubber Ball Foot Exercise Intervention: A Qualitative Study Using Interpretative Phenomenological Analysis

Abdurrasyid Abdurrasyid — 2026-03-31

Diabetes mellitus is a chronic condition that requires comprehensive and long-term management, including non-pharmacological interventions that support patients’ quality of life. Rubber ball foot exercise represents a simple, low-cost physical activity designed to enhance peripheral circulation and strengthen lower extremity function. This study aims to explore the lived experiences of individuals with type 2 diabetes mellitus who participated in a structured rubber ball foot exercise intervention. Employing a qualitative approach through Interpretative Phenomenological Analysis (IPA), the study provides an in-depth understanding of participants’ perceptions, emotions, and reflections throughout the intervention process. Findings reveal that the exercise not only offers physiological benefits but also fosters self-confidence, hope, and social connectedness, serving as a meaningful space for psychosocial recovery. Despite practical challenges in home implementation such as limited space, family dynamics, and lack of structured reminders participants demonstrated notable adaptive strategies, including visual cues, family involvement, and spatial modifications. These responses highlight the importance of context-sensitive and participatory design in enhancing program adherence and sustainability. From an economic perspective, the intervention’s affordability, accessibility, and potential for independent practice underscore its relevance for resource-limited settings. Its integration into national programs such as Prolanis and Posbindu PTM may strengthen primary healthcare systems and promote community engagement in chronic disease prevention. Given its clinical efficacy, social relevance, and cost-efficiency, rubber ball foot exercise holds strategic potential as a sustainable, community-based intervention for non-communicable disease control.

Modeling Dysmenorrhea Using PLS-SEM: The Role of Pain Frequency, Severity, and Self-Management among Female Health Students

Karwati Karwati — 2026-03-31

Dysmenorrhea remains a common health issue among young women, yet limited studies have examined the behavioral structure underlying its burden, particularly among female health students. This study aimed to develop and test a structural behavioral model linking menstrual bleeding duration, pain frequency, pain severity, and primary self-management methods. A cross-sectional design was employed involving 215 female health students, with data collected through a structured questionnaire. The analysis was conducted using Partial Least Squares Structural Equation Modeling (PLS-SEM) to evaluate the relationships among variables. The findings indicate that menstrual pain frequency significantly predicts pain severity (p < 0.001) and the choice of primary self-management methods (p = 0.034). In contrast, menstrual bleeding duration showed no significant effect on either pain severity or self-management strategies. These results highlight that pain frequency is the key determinant in shaping dysmenorrhea burden and behavioral responses, providing a novel contribution to understanding self-management patterns among health students. The study suggests that interventions should prioritize managing pain frequency to reduce dysmenorrhea impact.

Forecast of Dengue Hemorrhagic Fever Cases Based on Climate and Population Density Data Using Autoregressive Integrated Moving Average

Muhammad Farid Dimjati Lusno — 2026-03-31

Dengue fever remains a major public health problem in Bali, with Denpasar consistently reporting high incidence rates in recent years. However, limited studies have quantitatively examined the influence of climate variability on dengue fever incidence and its temporal trends in this area. This study aimed to predict the trend of dengue fever incidence and to assess the impact of climate factors on dengue occurrence in Denpasar. This observational study used secondary data and was analyzed using cross-correlation, Pearson correlation, and Autoregressive Integrated Moving Average (ARIMA) time series modeling. The results of cross-correlation analysis showed that temperature had a significant negative correlation with dengue incidence, while rainfall showed a significant positive correlation. Humidity was not significantly associated with dengue incidence. The ARIMA model demonstrated good predictive performance with an R-squared value of 0.698, indicating that approximately 69.8% of the variation in dengue incidence could be explained by the model. The model also identified a consistent increase in dengue cases at the beginning of the year. These findings indicate that climate factors, particularly temperature and rainfall, play a significant role in influencing dengue incidence in Denpasar. The ARIMA model provides a reliable tool for early prediction of dengue outbreaks. Therefore, vector control and preventive interventions should be intensified at least one month prior to the expected increase in cases, particularly during periods of high rainfall.

Family Support and Exclusive Breastfeeding: The Mediating Role of Breastfeeding Self-Efficacy

Rochmawati Rochmawati — 2026-03-31

Family support is widely acknowledged as a key determinant of breastfeeding; however, the psychological mechanism linking it to exclusive breastfeeding remains inadequately examined in Indonesia, as no published study has formally tested breastfeeding self-efficacy as a mediator using path analysis frameworks. This study aimed to analyze the mediating role of breastfeeding self-efficacy in the relationship between family support and exclusive breastfeeding among postpartum mothers. A cross-sectional analytical study was conducted with 250 postpartum mothers in Tangerang City and Regency, recruited through purposive sampling across multiple healthcare settings. Data were collected using two validated instruments and analyzed via Partial Least Squares Structural Equation Modeling (PLS-SEM), with indirect effects examined through indirect effect analysis. Family support had no significant direct effect on exclusive breastfeeding (β = 0.097; p = 0.422), yet strongly predicted breastfeeding self-efficacy (β = 0.887; p < 0.001). Breastfeeding self-efficacy significantly predicted exclusive breastfeeding (β = 0.761; p < 0.001), and the indirect effect was confirmed (β = 0.675; p < 0.001), indicating full mediation. The model explained 45.1% of variance in exclusive breastfeeding and 78.6% in breastfeeding self-efficacy, though causal inference remains constrained by the cross-sectional design. These findings demonstrate that family support promotes exclusive breastfeeding only insofar as it simultaneously strengthens maternal psychological confidence. Exclusive breastfeeding promotion programs should integrate self-efficacy-building components as a core intervention element rather than targeting family support in isolation.