Journal of Comprehensive Medical-Surgical Nursing

Prevalence and Characteristics of Kinesiophobia Among Postoperative Extremity Fracture Patients: A Descriptive Study at a Referral Hospital

Mulia Hakam, Cintya Dyah Pramesthi — Tue, 02 Jun 2026 00:00:00 +0000

Introduction: Patient complaints after extremity fracture surgical procedures can lead to pain and an irrational fear of movement (Kinesiophobia) is a highly prevalent yet frequently unrecognized psychological complication in orthopedic nursing practice. Aim: This study aimed to describe the profile of kinesiophobia in postoperative extremity fracture patients according to demographic and clinical characteristics. Method: A quantitative descriptive design with a cross-sectional approach was applied to 51 respondents recruited via total sampling in the surgical inpatient ward hospital in Jember. Kinesiophobia was measured using the Tampa Scale of Kinesiophobia (TSK-17), with a score ≥ 37 classified as high kinesiophobia. Data were analyzed using univariate analysis and presented through descriptive cross-tabulation. Result: Results demonstrated that 72.5% of respondents experienced high kinesiophobia. The highest proportions were observed in female respondents (100%), oldest-old patients (100%), homemakers (100%), primary school graduates (100%), radius fractures (100%), and femur fractures (84.6%). Groups with dominant low kinesiophobia included males (43.7%), unemployed respondents (58.3%), and ulna fractures (80.0%). Conclusion: These findings underscore the necessity of routine TSK-17 screening and prioritized non-pharmacological interventions targeting female, elderly, and lower extremity fracture patients in postoperative orthopedic nursing care.

Assessment of Knowledge Level about Amblyopia among Adolescents with Refractive Errors in Jember

Andrian Dwi Yuliorofi, Siswoyo, Rismawan — Sat, 20 Jun 2026 00:00:00 +0000

Introduction: Adolescent eye health is often overlooked, despite the long-term impact of conditions such as amblyopia if left undetected. Amblyopia is a visual disorder that occurs when one eye fails to achieve normal visual acuity, despite the absence of structural abnormalities. This condition is commonly associated with uncorrected refractive errors and may progress without noticeable symptoms. Adolescents with amblyopia may remain unaware of the problem due to gradual visual adaptation. Aim: This study aimed to assess the level of knowledge about amblyopia among adolescents with refractive errors. Method: A descriptive quantitative method with a cross-sectional design was used. A total of 53 adolescents aged 10–17 years were selected using purposive sampling at the Eye Polyclinic of Dr. Soebandi Regional Hospital, Jember. Data were collected through a structured, validated questionnaire. Result: Results showed that the majority of respondents (62.3%) had low knowledge levels, while only a small proportion (11.3%) demonstrated high understanding. Limited awareness of risk factors and consequences of amblyopia emerged as a key finding. Conclusion: Adolescents with refractive disorders exhibited insufficient knowledge of amblyopia, particularly regarding its general concepts, causes, and complications, underscoring the need for targeted eye health education to enhance awareness, facilitate early detection, and prevent long-term visual impairment.

Implementation of Slow Deep Breathing After Implant Removal Surgery: A Case Study

Novia Narulia Sari, Mulia Hakam, Kushariyadi, Sujarwanto — Fri, 19 Jun 2026 00:00:00 +0000

Introduction: Postoperative pain is a common problem following implant removal surgery and may interfere with recovery. Uncontrolled pain can increase blood pressure, pulse rate, and decrease patient comfort. Slow deep breathing is a non-pharmacological intervention that promotes relaxation and helps reduce pain perception. Method: A descriptive case study was conducted on one day-0 postoperative implant removal patient experiencing moderate pain. Slow deep breathing was administered twice daily for three days, with each session lasting 15 minutes. Pain intensity was measured using the Numeric Rating Scale (NRS). Result: Pain intensity decreased from NRS 6 (moderate pain) on the first day to NRS 2 (mild pain) on the third day Conclusion: Slow deep breathing helped reduce postoperative pain intensity, as evidenced by a decrease in pain score from NRS 6 (moderate pain) to NRS 2 (mild pain) after three days of intervention. This technique may be used as a simple, safe, and complementary nursing intervention for postoperative pain management.

The Effect of Active External Warming Using Electric Blankets on Post-Anesthetic Shivering and Hypothermia in Spinal Anesthesia Patients: A Quasi-Experimental Study

Fitria Wahyu Ariyanti, Ika Suhartanti — Fri, 19 Jun 2026 00:00:00 +0000

Introduction: Post-anesthetic shivering after spinal anesthesia may increase oxygen consumption, discomfort, pain, and difficulties in patient monitoring. Active external warming is a practical nursing intervention to reduce hypothermia-related shivering. Objective: This study aimed to determine the effect of electric warming blankets on the incidence and severity of post-anesthetic shivering and hypothermia among patients undergoing spinal anesthesia. Methods: This study analyzed the effect of an electric warming blanket on shivering among patients after spinal anesthesia. A quasi-experimental posttest-only control-group study was conducted in the operating room of Lavalette Hospital Malang. Thirty postoperative spinal-anesthesia patients were recruited by consecutive sampling and allocated to an intervention group (n=15) that received an electric warming blanket and a control group (n=15) that did not. Shivering was observed 60 minutes after spinal anesthesia, as assessed using the Alfonsi shivering scale. Data were analyzed using the Mann-Whitney test. Result: No shivering was observed in 8 intervention patients (53.3%) compared with 3 control patients (20.0%). The most frequent control-group outcome was grade 2 shivering, observed in 5 patients (33.3%). The Mann-Whitney test showed a significant difference between groups (U=53.500; Z=-2.592; p=0.010). Conclusion: Electric warming blankets significantly reduced shivering severity after spinal anesthesia and may support postoperative comfort and safety.

Relationship Between Ventilator Use Duration, Open Suction, and Ventilator-Associated Pneumonia in ICU Patients: A Cross Sectional Study

Rhohis Algiyansyah, Ruris Haristiani, Baskoro Setioputro — Fri, 19 Jun 2026 00:00:00 +0000

Introduction: Ventilator-associated pneumonia (VAP) is a lung infection that occurs after 48 hours or > 2 days of using mechanical ventilation. Patients who use a ventilator will experience airway obstruction due to the accumulation of secretions in the Endotracheal Tube; therefore, suction of secretions is carried out by inserting a suction catheter through the nose/mouth/Endotracheal Tube (ETT). The method in this research is cross-sectional with prospective data collection

Aim: to analyze the relationship between the duration of mechanical ventilator use and the implementation of open suction with the incidence of ventilator-associated pneumonia (VAP) among patients receiving mechanical ventilation in the ICU

Method: This research uses a purposive sampling technique. The sample in this study comprised 37 patients receiving ventilatory support in the ICU. Data were analyzed using the Spearman rank test. The test results show that the duration of ventilator use has a p value (p=0.040) and the suction action has a p value (p=0.003), which means the results show a p value <0.05.

Result: Among 37 mechanically ventilated ICU patients, 4 (10.8%) developed VAP. Ventilator use duration was significantly associated with VAP incidence (r = 0.339; p = 0.040). Open suction implementation was also significantly associated with VAP incidence (r = -0.479; p = 0.003), with non-compliance to SOP associated with a higher risk of VAP.

Conclusion: This study concludes that the length of use of a mechanical ventilator and suction procedures in patients is related to the incidence of VAP in patients in the ICU

The Effect of First Aid Education via Audio-Visual Media on Adolescents' Knowledge Levels

Sufendi Hariyanto, Khotimah, Sri Wahyuni; Kurniawati — Thu, 28 May 2026 00:00:00 +0000

Introduction: Adolescents, as active participants in social and academic life, need adequate first-aid knowledge. One effective educational method is through audio-visual media, which can enhance learners' understanding and retention. Objective: This study aims to analyze the effect of providing first aid education through audiovisual media on adolescents' knowledge levels. Methods: This study employed a quasi-experimental, pretest-posttest, nonequivalent control group design. The sample consisted of 37 adolescents selected via simple random sampling. Data collection was conducted through questionnaires administered before and after the educational intervention to measure the adolescents' knowledge levels. Result: The analysis showed a significant increase in adolescents' knowledge levels after receiving education through audiovisual media. The mean knowledge level before the intervention was 11.97 ± 1.818, which increased to 29.05 ± 2.981 after the intervention. The Wilcoxon test showed a Z value of -5.308 (p < 0.001), indicating a significant difference between the pre- and post-educational session scores. This increase indicates that audiovisual media are effective in delivering first-aid information to adolescents. Factors such as learning interest and prior experience also contributed to improved understanding. Conclusion: The results of this study indicate that first-aid education using audiovisual media significantly increases adolescents' knowledge levels. Therefore, this method can be used as an alternative in health education programs, particularly to enhance adolescents' preparedness to face emergencies.