Client Level Research Articles

Corporate marketing in modern hospitals and satisfaction level of corporate clients in Bangladesh

The study's abstract emphasizes the Marketing Department's dual responsibility in creating external awareness and disseminating internal information in modern hospitals. To improve service quality and management decision-making, the department keeps an eye on patient happiness and oversees communication, advertising, corporate agreements and feedback methods. Key research findings show that while corporate patients generally value the department's cutting-edge technology and the expertise of its staff, they do have reservations about the department's responsiveness and punctuality, particularly with regard to inpatient care. Patients in the Outpatient Department (OPD) expressed greater levels of satisfaction than those in the Inpatient Department (IPD), where patients expressed greater dissatisfaction with personalized care and error correction. To increase general patient happiness, recommendations include enhancing service speed, providing personnel training, and attending to particular patient requirements.

Implementation of Measurement-Based Care in Mental Health Service Settings for Youth: A Systematic Review.

Measurement-Based Care (MBC) is the systematic use of patient-reported data to inform care decisions and monitor treatment progress. MBC has been shown to improve patient outcomes across medical and mental health treatment settings for adults and youth. While many studies have examined the use of MBC in specific care settings, few have focused on the implementation of MBC among youth populations or across care settings. While a review has shown that use of MBC benefits youth, no published reviews exist that summarize the successful strategies and barriers to implementation models across studies in youth service settings. To address these gaps, the present systematic review (N = 25 studies) focuses on the implementation of MBC across four youth service settings, including outpatient mental health centers, medical centers/pediatric clinics, schools, and clinical psychology training clinics. Results suggest that few studies employ consistent implementation models or strategies to guide efforts. Further, there is significant overlap in the successful strategies employed as well as the barriers to implementation of MBC across youth service settings, at the client, clinician, and organizational levels. Broadly, the authors recommend on the basis of findings that future implementation work in youth service settings: incorporate comprehensive training in the use of MBC for clinicians; incorporate stakeholder feedback into the implementation process for initial and sustained use; employ digital measurement feedback systems to deliver MBC that allow for real-time feedback and continuous technical support; and employ a health equity lens in implementation efforts to help address disparities in access to and use of MBC so that all youth and families may benefit from this evidence-based practice.

THE APPLICATION OF SPIRITUAL COUNSELING TO OVERCOME GENERALIZED ANXIETY DISORDER (GAD): A CASE STUDY ON CLIENT “I” FROM GOMBAK, SELANGOR, MALAYSIA

Generalized Anxiety Disorder (GAD) is a mental disorder involving excessive and uncontrollable fear, anxiety, and worry. Referring to this research, the focus of the study is related to the description of client “I”’s GAD, such as factors, symptoms, and level of GAD anxiety disorders. This research also explains how the spiritual counseling approach can overcome client “I” ‘s GAD problem based on Surah Al-Ma'arij from verses 19 to 32. Client “I” is the main source for this research. Therefore, this research was carried out in three meetings from 03 September 2023 to 10 January 2024 according to the type of research using field research with qualitative methods. The data from this research were obtained from interviews and observations and used data analysis for case studies that had been developed by Robert K. Yin, namely pattern matching, explanation, and time series analysis. The results of the study showed that there was a significant impact on the symptoms of anxiety disorder in a client “I”. Apart from that, the GAD level of client “I” also showed a positive change from a score of 14 to a score of 11 using the GAD-7 Rating Scale. In conclusion, a systematic spiritual counseling approach guided by the verses of the Qur'an has been proven to bring positive changes and overcome Generalized Anxiety Disorder (GAD).

Exploring the socioeconomic factors affecting green cities development

PurposeThis paper explored the socioeconomic factors affecting green cities development. Extant literature have highlighted green cities as a major path towards sustainability in the construction industry but very little is known on the socioeconomic aspect of green cities and its bid in promoting sustainability in the construction industry; hence, the premise of this study which highlights the socioeconomic factors affecting green cities development in Ghana.Design/methodology/approachA comprehensive literature review was conducted to identify the socioeconomic factors affecting green cities. A quantitative research strategy was adopted to collect primary data from respondents who have the requisite understanding and knowledge in green cities using questionnaires. The data gathered was then analysed using descriptive statistics and exploratory factor analysis viz principal component analysis.FindingsThe socioeconomic factors affecting green city development comprised: Green support mechanisms (i.e. innovation and technology, green city planning (urban planning), stakeholder engagement, awareness, city planning (transportation) and environmental regulations); green inhibitors (i.e. population, culture, housing and policy implementation); green market and finance (i.e. digital finance, green market mechanism, green investment finance, risks and uncertainties, income levels of clients). It was evident that socioeconomic factors are significant to the development of green cities in Ghana and hence policy makers and various stakeholders should prioritize socioeconomic factors in the bid to achieve sustainability through green cities in the construction industry.Originality/valueThis paper presents a foremost and comprehensive study on the socioeconomic factors affecting green cities in Ghana. The study results showed that even though the path to sustainability in green cities has pivoted mainly on environmental factors, socioeconomic factors are also significant to green city development, hence, policy makers and the construction industry should keenly consider the socioeconomic factors affecting green city development in the bid towards sustainability for cities.

Remote Work in Audit Firms: A Systematic Literature Review and Theoretical Framework

The mass adoption of remote working technologies, facilitated by the COVID-19 pandemic, has permitted a transformation in the work of professional auditors. Where auditors previously worked long hours at the office or on the road near colleagues, remote work has created new work routines that are conducted alone at home. While home-based remote work may be a relatively new phenomenon for auditors, it is not a new phenomenon for knowledge workers in general. In this paper, we perform a systematic literature review across fields such as sociology, psychology, and management information systems to develop an organizing framework for the literature on remote work according to four primary dimensions: organizational factors, employee factors, job-level outcomes and the work-family boundary. From this organizing framework, we propose a theoretical model for how remote work can impact auditors in audit firms bringing in insights from the literature on the audit profession. Our theoretical model proposes that remote work will lead to changes in audit practices that will have implications at the client, employee and firm level. This theoretical model allows us to propose future avenues for research in this rapidly evolving area.

Fairness-Aware Federated Learning with Real-Time Bias Detection and Correction

Federated Learning (FL) enables collaborative model training across decentralized devices while preserving user data privacy. However, disparities in data distributions among clients can lead to biased models that perform unfairly across different demographic groups. This paper proposes a fairness-aware Federated Learning framework equipped with real-time bias detection and correction mechanisms. Our approach adjusts model updates to address biases detected at local client levels before aggregating them at the central server. We demonstrate the effectiveness of our method through empirical evaluations on multiple datasets, showcasing significant improvements in fairness and model accuracy. Our proposed framework involves a multi-tiered approach to ensure fairness in the model training process. Firstly, it employs local bias detection techniques at the client level to identify disparities in model performance across different groups. Clients then utilize bias correction mechanisms to adjust their model updates, addressing any detected biases before sending updates to the central server. The central server aggregates these bias-corrected updates, ensuring that the global model benefits from equitable learning while maintaining overall performance.

Multimodal analysis of temporal affective variability within treatment for depression.

Affective flexibility, the capacity to respond to life's varying environmental changes in a dynamic and adaptive manner, is considered a central aspect of psychological health in many psychotherapeutic approaches. The present study examined whether affective two-dimensional (i.e., arousal and valence) temporal variability extracted from voice and facial expressions would be associated with positive changes over the course of psychotherapy, at the session, client, and treatment levels. A total of 22,741 mean vocal arousal and facial expression valence observations were extracted from 137 therapy sessions in a sample of 30 clients treated for major depressive disorder by nine therapists. Before and after each session, the clients self-reported their level of well-being on the outcome rating scale. Session-level affective temporal variability was assessed as the mean square of successive differences between consecutive two-dimensional affective measures. Session outcome was positively associated with temporal variability at the session level (i.e., within clients, between sessions) and at the client level (i.e., between clients). Importantly, these associations held when controlling for average session- and client-level valence scores. In addition, the expansion of temporal variability throughout treatment was associated with steeper positive session outcome trajectories over the course of treatment. The continuous assessment of both vocal and facial affective expressions and the ability to extract measures of affective temporal variability from within-session data may enable therapists to better respond and modulate clients' affective flexibility; however, further research is necessary to determine whether there is a causal link between affective temporal variability and psychotherapy outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Do major public emergencies affect audit quality? —Evidence from China

ABSTRACT Taking Chinese listed firms from 2019 to 2021 as research samples, we examine the impact of major public emergencies on audit quality using COVID-19 as exogenous shock. Distinguishing the location of audit clients and that of auditors, we find that if major public emergency occurs in the city of audit clients during the period of annual report audit, audit quality will be significantly reduced. If emergency occurs in auditor’s city, audit quality has improved instead of declining. Through the heterogeneity test, we find that the information level of audit clients has a double effect. When public emergencies in audit clients’ locality have a negative impact on audit quality, the information level of clients can alleviate the negative impact. However, when emergencies occur in auditor’s locality, the higher information level of the client may lower audit quality. However, whether public emergence occurs in the city of clients or auditors, auditing firms’ information technology level and more information technology personnel in auditors’ team are conducive to improve audit quality. The research has enriched the relevant research on audit quality in the context of public emergencies, and provided a theoretical basis for the urgency of digital transformation of accounting and auditing industry.

Floating meta-bubbles: aerial gateway and routing on the sky

Reflecting intelligent surface technology (RIS) is regarded as a key enabler of the sixth-generation (6G) communication system. It provides the ability to reshape radio channels through passively reflecting beams in a reconstructive manner. Furthermore, aerial RIS (ARIS) introduces more flexibility in providing line-of-sight (LOS) links. Unfortunately, most of the related research efforts supposed the system as a planar RIS mounted on a satellite, unmanned aerial vehicle (UAV), or balloon despite reported limitations of planar RISs. The essential problem in designing any planar RIS network resides in mutual orientation and alignment difficulty, especially under random fluctuation of position/orientation due to wind conditions or UAV wobbling in the hover state. So, this paper highlights spherical RIS (bubble) as the optimal choice for aerial beam routing where the orientation/rotation can be completely relaxed. It outperforms planar RIS in terms of RIS networking flexibility, dead zone relaxation, and coverage extension. Consequently, due to the added degrees of freedom, many new deployment scenarios/use cases are recommended such as introducing meta-bubbles as intermediate gateways between satellite and ground nodes and extending network infrastructure installation down to the client level to enhance its visibility and throughput. Simulations demonstrate the superiority of meta-bubbles in minimizing channel loss over successive multi-hop routing.

Trends in Mental Disorders in Children and Adolescents Receiving Treatment in the State Mental Health System

To examine recent trends in clinical diagnoses of children and adolescents receiving treatment in publicly funded mental health treatment services in the United States. Data on children and adolescents (≤17 years) receiving treatment from publicly funded mental health treatment services recorded in Mental Health Client-Level Data 2013-2021 (total number of records= 13,684,154) were used to examine temporal trends in the proportion of different child and adolescent psychiatric disorders. Trends were examined overall and in age, sex, racial/ethnic, and service strata focusing on community-based programs. The analyses revealed increases in the proportion of anxiety disorders from 9.6% in 2013 to 19.2% in 2021 (adjusted odds ratio [AOR] 2.17, 95% CI 1.85-2.55, p< .001), trauma- and stressor-related disorders from 22.7% to 27.4% (AOR 1.31, 95% CI 1.09-1.57, p= .004), and depressive disorders from 13.4% to 17.0% (AOR 1.20, 95% CI 1.03-1.41, p= .04). During this same period, the proportion of bipolar disorders declined almost 8-fold from 10.0% to 1.3% (AOR 0.07, 95% CI 0.06-0.09, p< .001). The proportion of conduct disorder and oppositional defiant disorder also declined from 9.7% to 4.4% (AOR 0.42, 95% CI 0.32-0.55, p< .001) and from 11.1% to 7.8% (AOR 0.79, 95% CI 0.65-0.98, p= .03), respectively. Trends varied across sex, age, and racial/ethnic strata. The composition of childhood psychiatric diagnoses in patients within publicly funded mental health treatment settings changed over the past decade. While some of the trends may reflect changes in diagnostic practices of clinicians, increases in anxiety and depressive disorders parallel trends in the prevalence of these conditions in the general population and highlight a growing need for identifying and treating these conditions in this age group.

Perbandingan Motivasi Kerja Ruang Rawat Inap Dan Ruang Operasi Dalam Pelaksanaan Pendokumentasian Di RS MTSJ

As providers of health services, hospitals are required to provide quality health services. Quality service is reflected in documentation in the form of client nursing notes. Nursing documentation is a very important tool that can be used as an indicator of the implementation of nursing care in hospitals (Fitri, 2019). Nursing care documentation is documentation that contains complete, real and recorded data, not only about the client's level of pain, but also the type, quality and quantity.

Conducting a successful diet trial for the diagnosis of food allergy in dogs and cats.

A limited antigen diet trial and subsequent food provocation is currently the optimal method of confirming a diagnosis of food allergy in dogs and cats. However, performing an effective diet trial can be challenging as it requires a high level of client and pet compliance, appropriate diet selection and correct interpretation of the provocative challenge. This narrative guides the clinician through the process, highlights potential pitfalls and specifies how these can be avoided to achieve a successful outcome.

Особенности управления профессиональными рисками при взаимодействии с подрядными организациями

The need to involve contractors for a client is caused by special knowledge, skills, methods, and means possessed by contractors and required by the client in order to achieve certain results. Contractors, however, do not always support the client’s policies and attitudes to the occupational safety values; whereas the safety culture of contractors is, to a certain extent, conditioned by a subjective judgment and personal definition of safety criteria by the contractors’ management. Therefore, the client is exposed to additional professional risks associated with the admission of contractors to work on the client’s territory. One of the main sources of professional risks is the human factor, i.e., hazardous and mistaken actions of the contractors’ personnel. The cost of such actions in the conditions of highly hazardous work on the territories of active productions is specifically high. International and Russian studies have indicated the dependence between employee competence and the number of mistakes causing injuries. The level of competencies of both workers and managers is crucial. The impact of the human factor of contractors on the professional risk level of clients has been considered; and the relevant risk management methods have been proposed. One of the methods is the evaluation of employees’ cognitive abilities before admission to highly hazardous work as human cognitive abilities such as the perception of information, memory, and attention affect their actions when performing the jobs. The next step is the improvement of the competencies of contractors’ employees based on the evaluation of knowledge and skills and further theoretical and practical training based on the results obtained. In addition, a model of contractor HR management structure with specifications of the manageability norm has been proposed.

Measuring the communication field of a successful organization

The article examines the practical aspects of measuring communication in modern organizations. The author reveals approaches to assessment, measurement and monitoring based on her professional experience in the area. The author reveals the new possibilities for generating reports on existing communications based on the Model of the Government of the Russian Federation in the field of quality. The purpose of the study is to construct criteria and indicators, both external and internal, to measure the effectiveness of providing information about the organization activities. The study was conducted using methods of document analysis and expert surveys of employees of organizations preparing the organization for the competition and assessing experts, and provides possibilities for measuring the quantitative characteristics of building the organizational communicative field. It is expected that the organization conducting the measurements will subsequently take corrective actions and review the approach being implemented. The article provides links to current official documents, international standards adopted on the territory of the Russian Federation, recommending indicators for assessing the communication field of a modern organization, as well as requirements for the competence of persons performing the assessment. Besides, the paper considers the forms of constructing the organizational communicative and information fields in relation to its own personnel, various levels of management, consumers, partners, suppliers, clients, state and municipal authorities.

Implementation of gender-based violence screening guidelines in public HIV treatment programs: A mixed methods evaluation in Uganda.

HIV and gender-based violence (GBV) intersect to threaten population health. The Uganda Ministry of Health recommends routine GBV screening alongside HIV care but evidence detailing its implementation in HIV care settings is limited. We evaluated screening practices in public HIV clinics to generate evidence supporting GBV screening optimization. To evaluate GBV screening implementation in antiretroviral therapy (ART) clinics, we extracted client data from GBV registers at 12 public ART clinics in Uganda (January 2019-December 2021). We concurrently evaluated perceptions of GBV screening/referral practices by conducting in-depth qualitative interviews with providers (N = 30) and referral partners (N = 10). We contextualized quantitative findings with interview data which were analyzed using a thematic analysis approach. During the evaluation period, >90% of providers in participating health facilities implemented GBV screening. Among 107,767 clients served in public ART clinics, providers identified 9,290 (8.6%) clients who experienced past-year physical, sexual and/or emotional GBV of whom 86% received counseling and 19% were referred to support services-most commonly to legal services. Key factors influencing GBV screening implementation included awareness of screening guidelines; client volume; and client's level of engagement in HIV care. Providers and referral partners identified important benefits to clients (e.g., pursuit of justice and removal from violent environments) when referrals were successful. Key factors influencing referrals included financial constraints that limited referral partners' ability to provide services at no cost to clients and socio-cultural norms that inhibited client willingness to pursue support services. GBV screening implementation in ART clinics supports identification and referral of clients exposed to violence. The effectiveness of GBV screening may be limited by socio-cultural factors that inhibit client capacity to pursue referrals and fragmented and resource-constrained referral networks. Providers and referral partners identified allocating funds to support referrals and collaborative networking meetings as important opportunities for strengthening GBV referrals.

Where Should Senior Welfare Centers Stand in Older Adult Care in South Korea?

Senior Welfare Centers, the vital community facilities known mostly as leisure venues for older adults in South Korea, are expanding their roles as older adult care providers to respond to the aging population. However, their roles remain unclear, which makes it difficult to utilize their potential and establish a position in older adult care. This study conducted qualitative research to clarify and seek the role of Senior Welfare Centers by exploring their experiences in two major older adult care services, Community Care and Customized Care, through a focus group interview conducted with 13 Senior Welfare Center professionals. Using qualitative thematic analysis, the findings resulted in two main themes: (1) experiences of Community Care and Customized Care and (2) redefining the role of Senior Welfare Centers in older adult care. Nine subthemes presented limitations in the care system and possible strategies to ameliorate the care roles of Senior Welfare Centers. The findings indicate recommendations at the facility, client, and governmental levels for Senior Welfare Centers to reestablish their position in older adult care. The study recommends future research to study policies and care services maximizing strengths and potentials of Senior Welfare Centers to redesign optimized older adult care in South Korea.

Media Guidelines, Rules and Regulations and Perceived Customer Worth in Vision Group Media in Uganda

This research focused on the media guidelines, rules and importance of customers in Vision Group Media in Uganda. The study design was a case study technique. It used both qualitative and quantitative methods to gain in-depth understanding of performance of the media sector. The population of the study consisted of 176 respondents drowned from Vision Group mangers, supervisors and key stake holders like distributors, readers and listeners. This category was selected because they are believed to be knowledgeable about the subject matter and the company.The results of the research show how there was a favorable correlation between media rules and importance of customers. The results indicate how the company complied with media regulation practices as shown by (74.51%) response. The results on the level of clients’ commitment on different product platforms offered by VG indicates that (74.48%) of the respondents are committed. The key indicators are high on Vision Group rates aligning with the industry standards (50.8%); effective management of client’s feedback (51.6%) and Vision Group print products meeting for audience needs across all categories (50%). The findings from indicate a significant positive correlation between media regulations and customer perceived value (r =0.24). The study recommends that; Vision should continue developing flexible media mix aimed at reaching consumers across the country as each market niche has varying needs, therefore niche marketing tactics should be developed to access these markets. Vision Group and other media houses in general should focus attention on telling brand stories in snippets, with different narrative styles and a balance of information and entertainment, thus allowing consumers to find different pieces in different places. Keywords: Media, Vision group, Customer worth, Media regulations

Perceived barriers and facilitators to infection prevention and control in Dutch residential care facilities for people with intellectual and developmental disabilities: a cross-sectional study

BackgroundAdequate implementation of infection prevention and control (IPC) in residential care facilities (RCFs) for people with intellectual and developmental disabilities (IDDs) is crucial to safeguarding this vulnerable population. Studies in this field are scarce. This study aimed to identify perceived barriers to and facilitators of IPC among professionals working in these settings, along with recommendations to improve IPC, to inform the development of targeted interventions.MethodsWe administered an online questionnaire to 319 professionals from 16 Dutch RCFs for people with IDDs (March 2021-March 2022). Perceived multilevel barriers and facilitators (guideline, client, interpersonal, organisational, care sector, and policy level) were measured on a 5-point Likert scale (totally disagree-totally agree). Recommendations were assessed using a 5-point Likert scale (not at all helpful-extremely helpful), supplemented by an open-ended question. Barriers, facilitators, and recommendations were analysed by descriptive statistics. Open answers to recommendations were analysed through thematic coding.ResultsBarriers to IPC implementation included the client group (e.g., lack of hygiene awareness) (63%), competing values between IPC and the home-like environment (42%), high work pressure (39%), and the overwhelming quantity of IPC guidelines/protocols (33%). Facilitators included perceived social support on IPC between professionals and from supervisors (90% and 80%, respectively), procedural clarity of IPC guidelines/protocols (83%), and the sense of urgency for IPC in the organisation (74%). Main recommendations included the implementation of clear IPC policies and regulations (86%), the development of a practical IPC guideline (84%), and the introduction of structural IPC education and training programmes (for new staff members) (85%). Professionals also emphasised the need for IPC improvement efforts to be tailored to the local care context, and to involve clients and their relatives.ConclusionsTo improve IPC in disability care settings, multifaceted strategies should be adopted. Initial efforts should involve clients (and relatives), develop a practical and context-specific IPC guideline, encourage social support among colleagues through interprofessional coaching, reduce workload, and foster an IPC culture including shared responsibility within the organisation.

Facilitators and barriers to community pharmacy PrEP delivery: a scoping review.

Pre-exposure prophylaxis (PrEP) is an effective medication to reduce the risk of acquiring HIV. PrEP is available free of charge in the UK from sexual health clinics. Expanding PrEP delivery to community pharmacies holds promise and aligns with UK government goals to eliminate new cases of HIV by 2030. The aim of this scoping review was to describe the existing evidence about the barriers to and facilitators of community pharmacy oral PrEP delivery, for pharmacists and pharmacy clients, as aligned with the Capacity Opportunity, Motivation Behaviour (COM-B) Model. Five bibliographic and five review databases were searched from inception to August 2023. Literature of any study design was included if it discussed barriers and facilitators of community pharmacy PrEP delivery. Trial registrations, protocols and news articles were excluded. A total of 649 records were identified, 73 full texts were reviewed and 56 met the inclusion criteria, predominantly from high-income/westernized settings. Most of the included literature was original research (55%), from the United States (77%) conducted during or after the year 2020 (63%). Barriers to PrEP delivery for pharmacists included lack of knowledge, training and skills (capability), not having the necessary facilities (opportunity), concern about the costs of PrEP and believing that PrEP use could lead to risk behaviours and sexually transmitted infections (motivation). Facilitators included staff training (capability), time, the right facilities (opportunity), believing PrEP could be a source of profit and could reduce new HIV acquisitions (motivation). For clients, barriers included a lack of PrEP awareness (capability), pharmacy facilities (opportunity) and not considering pharmacists as healthcare providers (motivation). Facilitators included awareness of PrEP and pharmacist's training to deliver it (capability), the accessibility of pharmacies (opportunity) and having an interest in PrEP (motivation). To effectively enhance oral PrEP delivery in UK community pharmacies, the identified barriers and facilitators should be explored for UK relevance, addressed and leveraged at the pharmacy team, client and care pathway level. By comprehensively considering all aspects of the COM-B framework, community pharmacies could become crucial providers in expanding PrEP accessibility, contributing significantly to HIV prevention efforts.

Effect of stress management intervention I and II: relaxation and combination techniques (relaxation and lemon turmeric and honey) on the stress level of comorbid respondents during the COVID-19 pandemic in west Bogor district

Background: This study aimed to determine the effect of stress management I: progressive relaxation &amp; 5 fingers, and stress management II: relaxation (progressive and 5 fingers) with lemon turmeric honey (lemonyit honey) on the stress level of cormobid respondents in the COVID-19 pandemic era. Methods: The research design was a quasi-experimental pre-test and post-test control group. The location was in the area with the highest Covid-19 cases and Rukun Warga (RW) with the largest population, namely West Bogor Subdistrict in Curug and Cilendek RW. The study population was all residents aged adults to pre elderly. Samples were taken randomly, by first screening for hypertension, diabetes and respiratory disorders in adults-pre elderly. Samples that fit the inclusion and exclusion criteria were obtained 100 respondents, consisting of 3 groups; namely group 1 = 34 people received progressive relaxation techniques and five fingers for 60-90 minutes, group 2 = 30 people received a combination of relaxation techniques and lemonyit honey, and group 3 (control) = 36 people. Stress levels were measured using the Kurzen stress questionnaire. Data analysis included descriptive analysis and hypothesis testing. Results: Stress management I and II, effectively controlling stress levels in the Covid-19 pandemic era in comorbid respondents. Conclusions: Stress management I and II can reduce stress levels during the Covid-19 pandemic in respondents with cormobid. Stress management I and II, can be applied in health care facilities both in hospitals and communities during the Covid-19 pandemic, to reduce the stress levels of clients who have cormobid.