Non-pharmacological Therapies Research Articles

Effectiveness of Red Ginger (Zingiber officinale var. Rubrum) Foot Hydrotherapy in Lowering Blood Pressure among Pregnant Women with Hypertension

Pregnancy hypertension is one of the complications of pregnancy. One nonpharmacological treatment to reduce hypertension is the foot hydrotherapy method with red ginger (Zingiber officinale var. rubrum). The essential oil content of red ginger provides a warm effect and spicy aroma so that blood vessels widen and blood flow becomes smooth. The research aims to determine the effectiveness of red ginger foot hydrotherapy in lowering blood pressure among pregnant women with hypertension. This one-group pretest-posttest pre-experimental study design was conducted at the Talaga Community Health Centre, West Java, from May 2023 to July 2023. The sample was 32 pregnant women with hypertension. Bivariate analysis test using paired t-test. The average systolic blood pressure measurement results for pregnant women before the intervention were 154.09 mmHg, and after the intervention was given 140.22 mmHg, there was a decrease of 13.87 mmHg. The average diastole for pregnant women before the intervention was 100.22; after the intervention, it was 91.62, resulting in a reduction of around 8.6 mmHg. The paired t-test with a p-value <0.001 shows the effectiveness of foot hydrotherapy with red ginger in reducing blood pressure in pregnant women with hypertension. Red ginger using the foot hydrotherapy method has been proven effective in lowering blood pressure in pregnant women. To reduce the risk factors for pregnancy with hypertension, pharmacological and nonpharmacological therapy is a solution that needs to be considered. This research can become a reference for evidence-based midwifery practice in providing midwifery care.

Impact of Group Reality Therapy on Treatment Adherence and Health Indicators in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial

Background: The use of non-pharmacological therapies is important in reducing the complications and consequences of diabetes. Objectives: This study aimed to determine the effect of group reality therapy on adherence to treatment regimens and health indicators in patients with type 2 diabetes. Methods: This randomized controlled trial was performed on 60 patients with diabetes who were referred to Amir Al-Momenin Hospital in Ahvaz. Patients were randomly assigned to either the intervention group (N = 30) or the control group (N = 30). Both groups completed health indicator tests, questionnaires on demographic and clinical information, perceived adherence to the treatment regimen, and the Perceived Stress Scale. The intervention group received reality therapy training, which consisted of 10 sessions of 45 minutes each (one session per week) over 2 months, delivered through lectures and face-to-face training sessions. The control group received only routine hospital interventions. The collected data were then analyzed using a one-way t-test and one-way analysis of variance (ANOVA). Results: Twenty-seven patients in the intervention group and 27 in the control group completed the study. After analyzing the data, it was revealed that the mean age of the patients in the control group was 55.30 ± 7.95, while it was 51.96 ± 10.55 in the intervention group. Findings showed that scores for the dimensions of adherence to the treatment regimen in the intervention group significantly increased compared to the control group (P < 0.001). Additionally, the mean health indicators in the intervention group showed a significant decrease compared to the control group (P < 0.001). Moreover, the mean blood sugar level of patients in the intervention group decreased from 229.63 ± 98.76 to 123.59 ± 42.03. Likewise, the level of glycosylated hemoglobin and blood cholesterol significantly decreased from 8.19 ± 2.09 to 6.11 ± 1.86 and from 176.52 ± 51.53 to 146.22 ± 34.68, respectively. Conclusions: A reality therapy training program can be effectively used to increase treatment adherence and improve health indicators in patients with type 2 diabetes.

Application of Progressive Muscle Relaxation Technique to Reduce Blood Glucose Levels in Elderly with Diabetes Mellitus

Diabetes mellitus is a metabolic disease which is often found in the elderly caused by a degenerative process. Progressive muscle relaxation technique is one of the non-pharmacological therapy to decrease blood glucose levels in diabetes mellitus. This case study aimed to analyzed the effect of progressive muscle relaxation technique on problem of instability of blood glucose levels in elderly. This research design is case study. The sample of this research is one elderly who had diabetes mellitus type 2. The data collection by measuring blood glucose levels during pre-intervention in the morning and post-intervention in the afternoon. The elderly had intervention twice a day for 20 minutes and forward until 5 days. Data collected and processed by using statistical T-test dependent. The elderly with diabetes mellitus type 2 given progressive muscle relaxation technique experienced a decrease in blood glucose levels from pre to post intervention with p-value 0.005 which means it is significant. The application of progressive muscle relaxation technique given to the elderly affect to decrease blood glucose levels in the outcome of pre and post intervention.

Review of pharmacogenetics of antiseizure medications: focusing on genetic variants of mechanistic targets.

Antiseizure medications (ASMs) play a central role in seizure management, however, unpredictability in the response to treatment persists, even among patients with similar seizure manifestations and clinical backgrounds. An objective biomarker capable of reliably predicting the response to ASMs would profoundly impact epilepsy treatment. Presently, clinicians rely on a trial-and-error approach when selecting ASMs, a time-consuming process that can result in delays in receiving alternative non-pharmacological therapies such as a ketogenetic diet, epilepsy surgery, and neuromodulation therapies. Pharmacogenetic studies investigating the correlation between ASMs and genetic variants regarding their mechanistic targets offer promise in predicting the response to treatment. Sodium channel subunit genes have been extensively studied along with other ion channels and receptors as targets, however, the results have been conflicting, possibly due to methodological disparities including inconsistent definitions of drug response, variations in ASM combinations, and diversity of genetic variants/genes studied. Nonetheless, these studies underscore the potential effect of genetic variants on the mechanism of ASMs and consequently the prediction of treatment response. Recent advances in sequencing technology have led to the generation of large genetic datasets, which may be able to enhance the predictive accuracy of the response to ASMs.

Efficacy and safety of TOMAC for treatment of medication-naïve and medication-refractory restless legs syndrome: A randomized clinical trial and meta-analysis

Objective/backgroundThere is a significant unmet need for safe and effective nonpharmacological therapies for restless legs syndrome (RLS). The objective was to evaluate the efficacy and safety of tonic motor activation (TOMAC) in patients with RLS. Patients/methodsA multicenter, randomized, participant-blinded, sham-controlled trial enrolled 45 adults with primary moderate-to-severe RLS who were either medication-naïve (n = 20) or medication-refractory (n = 25). Participants were 1:1 randomized to TOMAC (n = 22) or sham (n = 23) for two weeks and instructed to self-administer 30-min TOMAC sessions when they experienced RLS symptoms. The primary outcome was mean change in International RLS Study Group Rating Scale (IRLS) total score. A subsequent meta-analysis included the present trial and a previous randomized clinical trial that enrolled medication-naïve RLS patients. ResultsIRLS reduction was significantly greater for TOMAC than sham (TOMAC -6.59 vs. sham −2.17; mean difference (MD) = −4.42; 95 % confidence interval [CI] −1.57 to −7.26; p = 0.0040). Subgroup analysis showed similar IRLS mean difference for medication-refractory (MD = −4.50; p = 0.02) and medication-naïve (MD = −4.40; p = 0.08) cohorts, which was significantly different from sham only for the medication-refractory cohort. Meta-analysis of combined data from 33 medication-naïve RLS patients showed a significant reduction in mean IRLS score after two weeks for TOMAC compared to sham (MD = −4.30; 95 % CI -1.36 to −7.24; p = 0.004). ConclusionsThe present trial confirmed previous reports documenting efficacy and safety of TOMAC in refractory RLS and indicated similar effect sizes in refractory versus naïve subgroups. The meta-analysis demonstrated that TOMAC significantly improves RLS symptoms in naïve participants.

Patient satisfaction in the use of non-pharmacological therapies in the management of postoperative pain: a study in a tertiary hospital, Ghana

ABSTRACT Background: Non-pharmacological therapies are complementary to pharmacological therapies for managing disease symptoms, including pain, and can be integrated into a self-management program, enhancing patient independence and autonomy. It has been discovered that therapies that are non-pharmacological for pain relief are effective with minimal side effects. This study, therefore, seeks to determine how frequently non-pharmacological methods (NPMs) are used in the management of postoperative pain (POP) and the influence of these NPMs on patient satisfaction. Methods: This study had a descriptive cross-sectional design. A quantitative approach was used with a structured questionnaire based on the International Pain Outcome Questionnaire (IPO-Q) to obtain responses from patients from October 2019 to December 2019. Results: The majority of the patients, 52.2%, responded using some form of (NPM) for pain relief. The most widely used non-pharmacological method of pain relief was mobilization, representing 79.2%. The male participants were observed to use more NPMs for pain relief. Most patients (51.4%) who used NPMs for pain relief reported that their pain was not relieved. A majority (90.6%) of the participants desired more pain treatment. The type of surgery the patients underwent had a statistically significant negative correlation with using NPMs for pain relief. A higher percentage (71%) of participants were highly satisfied with their overall pain treatment. Conclusion: Pain is subjective, and it would be appropriate if patients were allowed to describe the location and intensity of their pain and choose their preferred NPMs which would be of help.

A Systematic Review and Meta-Analysis of Randomized Trials to Evaluate the Impact of Exercise on Heart Rate Variability Post-Bariatric Surgery.

Bariatric surgery is an approach used to treat patients with obesity in a small minority of eligible patients. Non-pharmacological therapies are important to maintain decent health status post-bariatric surgery. We performed a systematic review with meta-analysis to evaluate the effects of exercise on heart rate variability (HRV) in patients submitted to bariatric surgery. The searches were made via MEDLINE/PubMed (via the National Library of Medicine), EMBASE, Web of Science, and Scopus databases. We included non-blind, single-, or double-blind randomized control trials in patients older than 18 years of age submitted to bariatric surgery. The intervention group should be submitted to an exercise training protocol, including aerobic, strength, and other exercise modality after bariatric surgery. We documented 245 studies, and after screening and eligibility phases, only 4 were included. We observed no significant change for the SDNN: subtotal = 19.74 (CI: -4.98, 44.45), p = 0.12, I2 = 85% (very low quality of evidence); pNN50: subtotal = 13.09 (CI: -9.17, 35.35), p = 0.25, I2 = 93% (very low quality of evidence); RMSSD: subtotal = 8.44 (CI: -3.61, 25.50), p = 0.17, I2 = 95% (very low quality of evidence); SD1: subtotal = 9.36 (CI: -4.48, 23.21), p = 0.19, I2 = 96% (very low quality of evidence). We could not detect significant effects of exercise on resting HRV after bariatric surgery. The low certainty of the results via the evidence level analysis suggest further studies might be beneficial.

The Effect of Brisk Walking Exercise on Blood Pressure in Hypertension Patients at Muhammadiyah Gresik Hospital

One of the non-communicable diseases that is very serious and experienced by many people is hypertension, pharmacological therapy often fails in practice because hypertensive patients are lazy to take medication, forget to take medication/difficulty accessing medication. One type of non-pharmacological therapy to assist in controlling blood pressure is to carry out brisk walking exercise routinely. Objective: To analyze the effect of brisk walking exercise on changes in blood pressure in hypertensive patients at Muhammidyah Gresik Hospital. The design of this study used a quasy experiment with a one-group pre-posttest design approach. The population was all high blood pressure sufferers at Muhammadiyah Gresik Hospital, a sample of 36 patients with a sampling technique using simple random sampling. Data collection using questionnaires and SOP and data analysis using paired t test From the results of the study, the average blood pressure measurement results for the majority of patients who did the brisk walking exercise at the Muhammadiyah Gresik MAP Hospital (pretest) in the study patients was 124.7mmHg. From these results it was found that there was an average decrease in MAP (posttest) blood pressure in patients by 120mmHg. From the results of the paired t test, the PValue was 0.001 <α (0.05). There is an effect of the brisk walking exercise on changes in blood pressure in hypertensive patients at the Muhammadiyah Gresik Hospital.

Pengaruh Abdominal Stretching Exercise terhadap Penurunan Nyeri Dismenore pada Remaja Putri

During menstruation one of the most common complaints experienced by adolescents during menstruation caused by severe contractions of the uterine muscles is called dysmenorrhea. Almost all teenage daughters experience menstrual pain with levels of pain ranging from mild to severe. The absence of teenagers at school is one of the consequences of dysmenorrhea. Abdominal Stretching Exercise is an alternative non-pharmacological therapy option that can reduce dysmenorrhea. During exercise, there will be an increase in the levels of endorphins produced in the brain and also in the spinal cord nerve structure. To find out the impact of abdominal stretching exercises on decreased dysmenorrhea in teenage girls. This type of research is pre-experimental with the design of one group pretest posttest with a sample of 26 respondents. The research tools used in this data collection are the numeric rating scale questionnaire sheet and the observation sheet. The abdominal stretching exercise is performed on the first day of menstruation twice with a duration of 15 minutes. Data analysis using the Wilcoxon test. Before performing abdominal stretching exercises some respondents experienced severe to moderate pain. The Wilcoxon test results showed an Asymp. Sig. (2-tailed) value of <0.05 which means there is an effect of Abdominal Stretching Exercise on Dismenorean Pain Reduction in Teenage Girls. The abdominal stretching exercises have an effect on dismenoreal pain reduction in teenage girls.

A pharmacist's guide to mitigating sleep dysfunction and promoting good sleep in the intensive care unit.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. To review causes, risk factors, and consequences of sleep disruption in critically ill patients; evaluate the role of nonpharmacological and pharmacological therapies for management of sleep in the intensive care unit (ICU); and discuss the role of pharmacists in implementation of sleep bundles. Critically ill patients often have disrupted sleep and circadian rhythm alterations that cause anxiety, stress, and traumatic memories. This can be caused by factors such as critical illness, environmental factors, mechanical ventilation, and medications. Methods to evaluate sleep, including polysomnography and questionnaires, have limitations that should be considered. Multicomponent sleep bundles with a focus on nonpharmacological therapy aiming to reduce nocturnal noise, light, and unnecessary patient care may improve sleep disorders in critically ill patients. While pharmacological agents are often used to facilitate sleep in critically ill patients, evidence supporting their use is often of low quality, which limits use to patients who have sleep disruption refractory to nonpharmacological therapy. Dedicated interprofessional teams are needed for implementation of sleep bundles in the ICU. Extensive pharmacotherapeutic training and participation in daily patient care rounds make pharmacists vital members of the team who can help with all components of the bundle. This narrative review discusses evidence for elements of the multicomponent sleep bundle and provides guidance on how pharmacists can help with implementation of nonpharmacological therapies and management of neuroactive medications to facilitate sleep. Sleep bundles are necessary for patients in the ICU, and dedicated interprofessional teams that include pharmacists are vital for their successful creation and implementation.

Suboptimal reporting of randomized controlled trials on non-pharmacological therapies in Chinese medicine.

With the successive release of the CONSORT extensions for acupuncture, moxibustion, cupping, and Tuina/massage, this review aims to assess the reporting characteristics and quality of randomized controlled trials (RCTs) based on these specific guidelines. A comprehensive review was conducted by searching multiple databases, including Embase, Ovid MEDLINE(R), All EBM Reviews, AMED, CNKI, VIP Chinese Medical Journal Database, and Wanfang Data, for publications from January 1 to December 31, 2022. Two reviewers independently evaluated the eligibility of the records, extracted predetermined information, and assessed the reporting based on the STRICTA, STRICTOM, STRICTOC, and STRICTOTM checklists. Among the included 387 studies (acupuncture, 213; Tuina/massage, 85; moxibustion, 73; cupping, 16), the overall reporting compliance averaged 56.0%, with acupuncture leading at 62.6%, followed by cupping (60.2%), moxibustion (53.1%), and Tuina/massage (47.9%). About half of the evaluated items showed poor reporting (compliance rate < 65%). Notably, international journals demonstrated significantly higher reporting quality than Chinese journals (P < 0.05). Although acupuncture trials had relatively higher compliance rates, deficiencies persist in reporting non-pharmacological therapies of Chinese medicine, particularly in areas like treatment environment details and provider background information.

2197 Effectiveness of horticultural therapy on the psychosocial and physical function of older adults with normal cognitive function.

Abstract Introduction Horticultural therapy (HT) is not uncommonly used as non-pharmacological therapy for patients with dementia. However, less is known about its effects on older adults with normal cognition. This systematic review and meta-analysis syntheses available evidence to evaluate the effects of HT on psychosocial and physical function in cognitively intact older adults. Method A systematic search in 9 electronic databases for experimental and quasi-experimental studies was performed between January 1, 2001, and July 19, 2021. Studies involving participants above 60 years old with normal cognition, analysing psychosocial and physical effects of HT, were included. Cochrane Risk of Bias 2 (RoB2) tool and Risk of Bias in Non-randomised Studies- of Interventions (ROBINS-I) were used to assess risk of bias. Meta-analysis was conducted using Stata software. Cochran’s Q test and I2 were used to explore statistical heterogeneity. Narrative synthesis was conducted for trials unsuitable for quantitative pooling. Results Nineteen articles (2191 participants) were included. Meta-analyses found that HT showed moderate-large effects on psychosocial outcomes, with improved self- efficacy (Hedges’ g = 0.49, 95%Confidence Interval: 0.07,0.91, 3 trials, I2:0.00%) and self-esteem (g = 1.01, 95%CI:0.33,1.68, 2 trials, I2:0.00%), and decreased depressive symptoms (g = −3.33, 95%CI:-6.29,-0.37, 4 trials, I2:98.51%). Narrative synthesis suggested benefits in Health-related Quality of Life. Regarding physical effects, HT improved exercise duration and intensity (g = 1.37, 95%CI:0.92,1.82, 2 trials, I2:0.00%). Effects on anxiety, social engagement and fitness did not achieve statistically significance. Conclusion The findings support the potential role of HT in promoting psychosocial and physical function among older adults with intact cognition. Given high statistical heterogeneity, more work is needed to explore the effect of possible moderators on treatment effects.

Exploring the biological basis of acupuncture treatment for traumatic brain injury: a review of evidence from animal models.

Traumatic brain injury (TBI) occurs when external physical forces impact the brain, potentially causing long-term issues such as post-traumatic stress disorders and cognitive and physical dysfunctions. The diverse nature of TBI pathology and treatment has led to a rapid acceleration in research on its biological mechanisms over the past decade. This surge presents challenges in assessing, managing, and predicting outcomes for TBI cases. Despite the development and testing of various therapeutic strategies aimed at mitigating neurological decline after TBI, a definitive cure for these conditions remains elusive. Recently, a growing focus has been on preclinical research investigating acupuncture as a potential treatment method for TBI sequelae. Acupuncture, being a cost-effective non-pharmacological therapy, has demonstrated promise in improving functional outcomes after brain injury. However, the precise mechanisms underlying the anticipated improvements induced by acupuncture remain poorly understood. In this study, we examined current evidence from animal studies regarding acupuncture's efficacy in improving functional outcomes post-TBI. We also proposed potential biological mechanisms, such as glial cells (microglia astrocytes), autophagy, and apoptosis. This information will deepen our understanding of the underlying mechanisms through which acupuncture exerts its most beneficial effects post-TBI, assisting in forming new clinical strategies to maximize benefits for these patients.

Pengaruh Effleurage Massage dan Teknik Relaksasi Nafas dalam terhadap Nyeri Punggung Bawah Ibu Hamil Trimester III

Lower back pain is a common complaint among pregnant women in the third trimester. It is estimated that approximately 70% of pregnant women experience some form of back pain during pregnancy, childbirth, or postpartum. Non-pharmacological therapies such as deep breathing relaxation techniques and effleurage massage therapy can effectively reduce pain levels in these women. This study employs a quantitative approach using a quasi-experimental research method and employs purposive sampling with a sample size of 37 participants. Data analysis includes both univariate and bivariate analyses. Most respondents (64.9%) were aged between 20 and 35 years old. Additionally, the majority (64.9%) were experiencing their first pregnancy. All respondents (100%) were confirmed to have no comorbidities. Furthermore, 73% of the participants had tertiary education (Diploma, Bachelor's, Master's, or Doctorate degrees), and 62.2% continued working during pregnancy. The results of the Wilcoxon test indicated a significant effect (p = 0.000 &lt; 0.05), confirming that effleurage massage and deep breathing relaxation techniques effectively reduce lower back pain in pregnant women. This reduction is attributed to the stimulation of tactile fibers in the skin by effleurage massage, which inhibits pain signals. In conclusion, the findings suggest that implementing effleurage massage and deep breathing relaxation techniques is beneficial for alleviating lower back pain in pregnant women. Public health advice advocates for the application of these techniques to manage such pain effectively.

Effectiveness of Psychodrama Model Group Activity Therapy on Anxiety Levels in The Elderly

Background: Psychodrama Model Group Activity Therapy is a therapeutic approach that involves the use of dramatic roles in a group so that individuals can feel some relief. Elderly people often feel anxious because they experience changes due to the aging process. This research was conducted to determine the effectiveness of psychodrama model group activity therapy on anxiety levels in the elderly at UPT PSTW Tulungagung.Method: This research uses a pre-experimental design with one group pretest-posttest type. With purposive sampling technique, a sample of 30 respondents was obtained. Using the Geriatric Anxiety Scale questionnaire instrument. Data analysis used the Wilcoxon statistical test.Results: The results of the research from 30 respondents after carrying out psychodrama model activity therapy showed that there were 2 (6.7%) respondents with severe anxiety, 16 (53.3%) respondents with moderate anxiety, 10 (33.3%) respondents with mild anxiety, and the elderly who did not experience anxiety were 2 (6.7%) respondents. Analysis of the Wilcoxon statistical test showed that the "output" test statistics" results were known to be asymp.sig (2-talled) or the p value was 0.000. Because the value of 0.000 is smaller than &lt;0.05, it can be concluded that the "hypothesis is accepted" which means the provision of therapy Psychodrama model group activities have an influence in reducing anxiety levels in the elderly at UPT PSTW Tulungagung.Conclusion: Anxiety can not only be treated with pharmacological therapy but can also be treated using non-pharmacological therapy. One effective intervention in alleviating anxiety is psychodrama model group activity therapy.

Application of Positive Affirmation Therapy in Increasing Self-Esteem in a Patient with Low Self-Esteem: Case Study

Low self-esteem will experience negative feelings which cause loss of self-confidence, feelings of worthlessness and pessimism about oneself. Positive affirmation therapy is giving positive sentences which are usually about ideals and hopes expressed in thoughts or writing which are done repeatedly. This research aims to analyze how positive affirmation therapy is applied in providing mental nursing care for people with low self-esteem. The method used in this scientific work is a case study of a client in the Wijaya Kusuma room at Radjiman Wediodiningrat Lawang Hospital with a nursing problem of Chronic Low Self-Esteem adjusted to the Low Self-Esteem SP and then receiving additional non-pharmacological therapy in the form of positive affirmation therapy for 10 minutes at every 5-day meeting. Interventions for clients with chronic low self-esteem are adapted to SP chronic low self-esteem and self-esteem promotion interventions and substance abuse education. After that, Positive Affirmation therapy is given for 10 minutes at each meeting. This positive affirmation therapy can free oneself from negative thoughts and can increase an individual's ability to have positive thoughts. There is a need for non-pharmacological therapy that is easy, effective and economical, namely positive affirmation therapy to increase client self-esteem for clients in nursing care for clients with low self-esteem.

Improving the Nutritional Status of Pregnant Women Who Experience Chronic Energy Deficiency with Spirulina Platensis

The highest prevalence of chronic energy deficiency (CED) in pregnancy occurs in the third trimester of pregnancy. The impacts that occur are abortion, premature birth, premature rupture of membranes, histitis, postpartum hemorrhage, and low birth weight (LBW). To prevent negative impacts, giving Spirulina Platensis is believed to improve nutritional status. This study aimed to analyze the effect of spirulina platensis extract on improving nutritional status in pregnant women. Using a Quasi-Experiment with a pretest and posttest control group design with a sample of 60 participants consisting of an intervention group of n=30 participants and a control group of n=30 participants. The intervention group received treatment, namely being given Spirulina Platensis extract, 1 capsule containing 300 mg, taken once for 30 days and standard care, while the control group received standard care only. The sampling technique used was simple side random. Chi-Square test results in the intervention group mean pretest nutritional status (m=22.04, SD=1.170) and posttest (m=23.33, SD=0.922) p-value=0.000, while the control group showed pretest nutritional status (m=22.16, SD=1.104) and posttest (m=22.39, SD=1.016) p-value=0.150. The difference between the mean posttest nutritional status in the experimental and control groups shows (m=23.33, SD=0.922) vs (m=22.39, SD=1.016) p-value=0.000. There is an increase in the administration of Spirulina Platensis extract on the nutritional status of pregnant women. As input for health workers, especially midwives, to provide non-pharmacological therapy to pregnant women who experience chronic energy deficiency (CED) by administering Spirulina Platensis.

Penerapan Pengaruh Terapi Murottal Surat Ar Rahman terhadap Status Hemodinamik pada Pasien Rawat Inap di Ruang ICU (Intensive Care Unit) RSUD Dr. Soehadi Prijonegoro Sragen

Intensive Care Unit (ICU) is a special room for patients who are critically ill to receive special medical and nursing services in a hospital. This is associated with several conditions and situations, for example heart disease and other conditions that affect the heart can cause hemodynamic instability. An unstable hemodynamic condition carries a high risk of potential complications that can cause death. Non-pharmacological therapy to reduce hemodynamic status is by using Murottal Surah Ar-Rahman therapy. To find out the results of applying the effect of Murottal Surah Ar Rahman therapy on hemodynamic status in inpatients in the ICU (Intensive Care Unit) RSUD dr. Soehadi Prijonegoro Sragen. The design used was qualitative with descriptive methods using pre-test and post-test case studies, the application of therapy was carried out 3 days for 16 minutes on 2 respondents. Based on the results of the implementation, there was a decrease in hemodynamic status after Murottal Surat Ar Rahman Therapy was carried out. Murottal Surat Ar Rahman therapy can be used as a non-pharmacological technique or independent intervention in patients with inpatient hemodynamic status

Pengaruh Kombinasi Aromaterapi Lemon dan Air Jahe pada Emesis Gravidarum

Emesis gravidarum is common problem experienced by 50-90% of pregnant women, and 2% of these cases into hyperemesis gravidarum. One of the safe solutions to nausea and vomiting of pregnant women with non-pharmacological therapy of lemon aromatherapy and ginger drink. This study aims to test the effectiveness of a combination of lemon aromatherapy and ginger drink to reduce nausea and vomiting in pregnant women. This research method used quasy experiment, pre-post test control group design. Population was pregnant women at TPMB in Songgon District who experienced nausea and vomiting. This study used consecutive sampling inclusion criteria, 20 people for the treatment group and 20 people in the control group. Data analysis used the Wilcoxon Sign Rank Test. Before the intervention, the frequency of nausea and vomiting in the study subjects was high. However, after treatment, there was decrease in the frequency of nausea and vomiting. The results of data analysis show a value of P = 0.000, which states that P &lt; 0.05, meaning that there is an effect of giving a combination of lemon aromatherapy and ginger drink on reducing emesis gravidarum in TPMB in the Songgon Banyuwangi sub-district area in 2021. Health workers can use non-pharmacological alternative therapy in the form of combination of lemon aromatherapy and ginger drink as a step to reduce and overcome symptoms of nausea and vomiting. In addition, there is an opportunity to conduct research as one of the safe solutions to overcome nausea and vomiting of pregnant women with other complementary therapies.

Projected Impact of Nonpharmacologic Management of Stage 1 Hypertension Among Lower-Risk US Adults.

The 2017 American College of Cardiology/American Heart Association blood pressure guideline classified 31 million US adults as having stage 1 hypertension and recommended clinicians provide counseling on behavioral change to the low-risk portion of this group. However, nationwide reductions in cardiovascular disease (CVD) and associated health care expenditures achievable by nonpharmacologic therapy remain unquantified. We simulated interventions on a target population of US adults aged 35 to 64 years, identified from the 2015-2018 National Health and Nutrition Examination Survey, with low-risk stage 1 systolic hypertension: that is, untreated systolic blood pressure 130 to 139 mm Hg with diastolic BP <90 mm Hg; no history of CVD, diabetes, or chronic kidney disease; and a low 10-year risk of CVD. We used meta-analyses and trials to estimate the effects of population-level behavior modification on systolic blood pressure. We assessed the extent to which restricting intervention to those in regular contact with clinicians might prevent the delivery of nonpharmacologic therapy. Controlling systolic blood pressure to <130 mm Hg among the 8.8 million low-risk US adults with stage 1 hypertension could prevent 26 100 CVD events, avoid 2900 deaths, and save $1.7 billion in total direct health care costs over 10 years. Adoption of the Dietary Approaches to Stop Hypertension diet could prevent 28 000 CVD events. Other nonpharmacologic interventions could avert between 3800 and 19 500 CVD events. However, only 51% of men and 75% of women regularly interacted with clinicians for counseling opportunities. Among low-risk adults with stage 1 hypertension, substantial benefits to cardiovascular health could be achieved through public policy that promotes the adoption of nonpharmacologic therapy.