MEDICA (International Medical Scientific Journal)

Anxiety Levels and Associated Factors Among Elderly Patients with Cardiovascular Diseases: A Mixed-Methods Study

Lola Felnanda Amri — 2026-02-28

The increasing prevalence of cardiovascular diseases among the elderly is often accompanied by psychological problems, particularly anxiety, which may worsen health outcomes and quality of life. However, limited studies have comprehensively explored anxiety levels and their associated factors among elderly patients in primary healthcare settings. This study aimed to assess anxiety levels and identify associated factors among elderly individuals with cardiovascular disorders in the working area of Puskesmas Anak Air, Padang City. A mixed-methods approach with an explanatory sequential design was employed, combining quantitative and qualitative data. The study involved 139 participants in the quantitative phase and eight participants in the qualitative phase. Most participants were aged 60–74 years (87.1%) and female (69.1%). A small proportion had both hypertension and cardiovascular disease (7.2%), while 30.9% experienced moderate anxiety. Qualitative findings revealed that anxiety was mainly triggered by exposure to distressing information, such as news about death, disasters, and conflicts. Participants commonly managed anxiety through distraction techniques, including light physical activity, watching television, and avoidance coping. In conclusion, moderate anxiety is prevalent among elderly individuals with cardiovascular disorders and is influenced by psychosocial factors. These findings highlight the need for appropriate coping strategies and supportive interventions to reduce anxiety and improve the well-being of the elderly.

Path Analysis of Food Literacy and eHealth Literacy on Diet Quality through Nutritional Self-Efficacy among Pregnant Women in Urban Indonesia: A Cross-Sectional Study

Lina Fitriani — 2026-02-28

Maternal diet quality during pregnancy remains critically suboptimal in Indonesia, contributing to the high prevalence of anemia and adverse pregnancy outcomes. This study aimed to analyze the direct and indirect effects of food literacy and eHealth literacy on diet quality through nutritional self-efficacy among pregnant women in urban Indonesia. A cross-sectional analytical study was conducted on 238 pregnant women in the second and third trimesters at Puskesmas Wara Selatan, Palopo City, South Sulawesi. Data were collected using four validated instruments: the Self-Perceived Food Literacy Scale, the eHealth Literacy Scale (comprising the core eHEALS items and a digital information access sub-dimension), the Nutrition Self-Efficacy Scale, and the Minimum Dietary Diversity for Women indicator via 24-hour dietary recall. Partial Least Squares Structural Equation Modeling with 5,000 bootstrap resamples was employed. Results showed that food literacy had the strongest direct effect on diet quality (β=0.689; p<0.001) and significantly predicted nutritional self-efficacy (β=0.453; p<0.001). eHealth literacy significantly influenced nutritional self-efficacy (β=0.484; p<0.001) but did not directly affect diet quality (β=0.162; p=0.254). Nutritional self-efficacy significantly predicted diet quality (β=0.140; p=0.036) and served as a partial mediator in the food literacy–diet quality pathway and a full mediator in the eHealth literacy–diet quality pathway. The model explained 48.5% of diet quality variance and 77.8% of nutritional self-efficacy variance. These findings confirm that nutritional self-efficacy constitutes a critical intervention point for optimizing maternal diet quality in urban primary healthcare settings.

The Effectiveness of Application (Adolescent Thalassemia Self) on the Quality of Life of Children with Thalassemia

Ria Andriani — 2026-02-28

Thalassemia is a chronic hereditary blood disorder that requires lifelong blood transfusions and iron chelation therapy, significantly affecting the physical, emotional, social, and academic functioning of adolescents. These challenges highlight the need for innovative, technology-based interventions to support sustainable self-care. This study aimed to determine the effectiveness of the SETARA (Self-Care Thalassemia Adolescents) application in improving the quality of life among adolescents with thalassemia compared to standard education. A quasi-experimental pre–post design with a control group was conducted involving 34 adolescents aged 12–18 years with transfusion-dependent thalassemia. Participants were equally divided into intervention and control groups (n = 17 each). The intervention group used the SETARA application for 4–8 weeks, while the control group received standard education. Quality of life was measured using the PedsQL Thalassemia Module and analyzed using a paired samples t-test. The results showed a statistically significant improvement in the quality of life in the intervention group (p < 0.001), indicating the effectiveness of the SETARA application. In contrast, the control group did not show a significant change (p = 0.205). In conclusion, the SETARA application is effective in improving the quality of life of adolescents with thalassemia and has the potential to complement standard education and clinical care. It is recommended that adolescents use the application regularly, and healthcare professionals integrate it into patient education and family support programs.

The Effect of an Android-Based HIV/AIDS Monitoring Application on Adolescents’ Knowledge and HIV/AIDS Screening

Maulidiyah Salim — 2026-02-28

Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) remain major global public health challenges, including in Indonesia, where adolescents are particularly vulnerable due to high-risk behaviors. This study aimed to evaluate the effectiveness of an Android-based HIV/AIDS monitoring application (PAHIVA) in improving adolescents’ knowledge and facilitating early HIV/AIDS risk screening. A pre-experimental study with a one-group pretest–posttest design was conducted among 90 high school students in Singkawang City. Data on HIV/AIDS knowledge were collected using structured questionnaires before and after the intervention and analyzed using the Wilcoxon signed-rank test. The results showed a statistically significant increase in knowledge scores, with the median rising from 67 at baseline to 87 after the intervention (p < 0.001). A total of 76 participants demonstrated improved knowledge, while 14 showed no change. Additionally, the application-based screening identified 9 participants (10%) as being at high risk for HIV/AIDS, who were subsequently referred to the nearest Voluntary Counseling and Testing (VCT) clinic for further evaluation. In conclusion, the PAHIVA application was associated with improved knowledge and demonstrated potential as a preliminary HIV/AIDS risk screening tool among adolescents. This mobile health innovation may contribute to strengthening adolescent-focused HIV/AIDS prevention strategies, although further studies with more robust designs are recommended to confirm its effectiveness.

The Impact of Nursing Management Information Systems on Workload and Effectiveness of Inpatient Nursing Services

Novi Triwanto — 2026-02-28

The implementation of the Nursing Management Information System (NMIS) represents a strategic effort by hospitals to enhance the quality of nursing services through the digitalization of care documentation. However, during the early stages of implementation, the system may exert varying effects on nurses’ workload and the effectiveness of nursing services. This study aimed to analyze the influence of NMIS implementation on nurses’ workload and the effectiveness of nursing services, with user behavior as a mediating variable, in the inpatient wards of Khidmat Sehat Afiat Regional General Hospital, Depok City, in 2025. This study employed a quantitative analytical observational design with a cross-sectional approach. A total of 94 inpatient nurses were recruited using a total sampling technique. Data collection was carried out using a questionnaire, then analyzed using the Partial Least Square-based Structural Equation Modeling (SEM-PLS) method using SmartPLS 4.0. The results indicated that NMIS implementation had a positive and significant effect on user behavior and the effectiveness of nursing services, while demonstrating a negative and significant effect on nurses’ workload. User behavior was found to negatively and significantly influence nurses’ workload and positively and significantly affect the effectiveness of nursing services. Furthermore, nurses’ workload had a negative and significant impact on service effectiveness. Mediation analysis revealed that user behavior and nurses’ workload functioned as significant sequential mediators in the relationship between NMIS implementation and the effectiveness of nursing services. In conclusion, the optimal implementation of NMIS can contribute to reducing nurses’ workload and improving the effectiveness of nursing services.