Jurnal Inovasi Kesehatan Masyarakat https://ejournal.delihusada.ac.id/index.php/JIKM <div style="text-align: justify;"> <p>Jurnal Inovasi Kesehatan Masyarakat (JIKM) diterbitkan oleh Program Masgister Kesehatan Masyarakat Institut Kesehatan Deli Husada yang bertujuan memberikan ruang bagi akademisi, peneliti dan pengguna hasil penelitian dan pengabdian untuk mendiseminasikan, menginformasikan, mendiskusikan dan menggunakan hasil penelitian dan pengabdian sebagai upaya meningkatkan kualitas kebijakan di bidang kesehatan masyarakat yang berbasis ilmiah dan dapat dipertanggung jawabkan. Jurnal ini menyajikan artikel ilmiah di bidang inovasi teknologi, meteodologi, teori di bidang kesehatan masyarakat. Jurnal Inovasi Kesehatan Masyarakat (JIKM) bersifat independen, ilmiah, memberi kesempatan yang sama kepada akademisi dari berbagai jenjang dan asal pendidikan tinggi.</p> </div> en-US dewisg491@gmail.com (Dewi Safitri Ginting) wahyuhildansyah.tgd@gmail.com (Wahyu Hildansyah, S. Kom) Fri, 15 Nov 2024 10:49:58 SE Asia Standard Time OJS 3.1.1.4 http://blogs.law.harvard.edu/tech/rss 60 ANALISIS FAKTOR YANG MEMPENGARUHI ANEMIA PADA IBU HAMIL TRIMESTER III DI KLINIK PRATAMA MAYEN LIMAU MUNGKUR KABUPATEN DELI SERDANG TAHUN 2024 https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1957 <p><em>Anemia impacts pregnancy, childbirth, the postpartum period, and newborns. It is preval_ent among pregnant women, with 20% affected in the first trimester and 70% in the second and third trimesters. This study aimed to identify the factors influencing anemia in third-trimester pregnant women with hemoglobin levels below 11 g/dL. Using a case-control design and purposive sampling, the study involved 75 participants and 58 respondents (29 cases and 29 controls). Data analysis was conducted using the chi-square test and logistic regression. The results showed that age (OR=5.833, 95% CI: 1.880-18.099, p=0.002), parity (OR=3.148, 95% CI: 1.070-9.264, p=0.035), adherence to taking iron (Fe) tablets (OR=7.283, 95% CI: 2.237-23.715, p=0.001), and frequency of antenatal care (ANC) visits (OR=4.222, 95% CI: 1.409-12.657, p=0.009) significantly influenced anemia in trimester</em><em> III</em><em> pregnant women. The study concluded that the most influential factor was adherence to taking Fe tablets, with an odds ratio of 7.283 (95% CI: 2.237-23.715, p=0.001). This indicates that pregnant women who do not consistently take Fe tablets are 7.283 times more likely to experience anemia compared to those who do. The study recommends enhancing health promotion and creating special monitoring programs to ensure pregnant women adhere to taking Fe tablets.</em></p> <p><em>&nbsp;</em></p> <p>&nbsp;</p> Lawolo Mardian Vita Ester ##submission.copyrightStatement## https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1957 Fri, 15 Nov 2024 10:38:56 SE Asia Standard Time FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN IMUNISASI DASAR LENGKAP PADA BAYI USIA 10-12 BULAN DI PUSKESMAS BINJAI KOTA TAHUN 2024 https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1953 <p><em>Over 1.4 million children worldwide die away from illnesses that may be avoided with vaccinations each year. The extent to which youngsters get their vaccines may potentially have an impact on their health. At 61.03 percent, Binjai is among the cities with the lowest UCI coverage. Thus, the goal of this research was to examine the variables associated with full-course basic vaccination in babies at the Binjai Kota Health Center in 2023 who were between the ages of 10 and 12 months. This kind of study is a cross-sectional, quantitative survey design. The research, which included 59 moms with infants between the ages of 10 and 12 months, was carried out at the Binjai City Health Center. The bulk of the basic immunizations provided to babies at the Binjai City Health Center were found to be 54.2 percent incomplete, according to the study's findings. The results of the Hasul statistics demonstrate that the number of children (p-value=0.004), age (p-value=0.031), education (p- value=0.005), work (p-value=0.008), number of children (p- value=0.004), maternal knowledge (p-value=0.001), attitude (p- value=0.002), distance (p-value=0.038), family support (p-value=0.003), and the role of Posyandu cadres (p-value=0.003) are related to maternal characteristics. It is recommended to the Binjai Kota Health Center to be able to create a special additional program at the posyandu to provide education on basic immunization in infants who also include or invite the next of kin (such as mothers and husbands).</em></p> <p><em>&nbsp;</em></p> Muthiah Fatma Patri seto ##submission.copyrightStatement## https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1953 Fri, 15 Nov 2024 10:39:37 SE Asia Standard Time H Hubungan Gaya Hidup Dengan Penyakit Diabetes Mellitus Pada Lansia Di UPTD Puskesmas Kecamatan Gunungsitoli Kota Gunungsitoli Tahun 2023 https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1931 <p>Diabetes mellitus is a condition that can only be controlled and cannot be cured. Diabetes mellitus sufferers are required to visit the health center regularly for monitoring, which is one way to control their condition. Adopting a healthy lifestyle is one of the things you can do to reduce the risk of developing diabetes mellitus.</p> <p>This research uses an observational design and a cross-sectional design. UPTD Puseksamas Gunungsitoli City District Gunungsitoli City was the location for this research. This research took place from January to April 2024. The population of this study was 235 elderly people who had been diagnosed with diabetes mellitus at the UPTD Community Health Center, Gunungsitoli City District. The sample consisted of 71 respondents, according to the Slovin formula. The chi-square test was used for data analysis, followed by logistic regression. The results of the analysis showed that there was a relationship between eating schedule and the incidence of diabetes mellitus with a value (p-value-.002 &lt; 0.05) RP= 1.761, 95%CI (1.207-2.568), there was a relationship between type of eating and the incidence of diabetes mellitus (P-value - .002&lt;0.05) RP= 1.849, 95%CI (1.182-2.889). there is a relationship between the amount of food eaten and the incidence of diabetes mellitus (P-value - .000&lt;0.05) RP= 3.741, 95%CI (1.701-8.212). there is a relationship between alcohol consumption and the incidence of diabetes mellitus (P-value - .012 &lt;0.05) RP= 1.586, 95%CI (1.112-2.263). there is a relationship between physical activity and the incidence of diabetes mellitus (P-value - .001&lt;0.05) RP= 1.905, 95%CI(1.276-2.843). there is a relationship between stressors and the incidence of diabetes mellitus (P-value - .000&lt;0.05) RP= 2.014, 95%CI (1.351-3005). And there was no relationship between smoking habits and the incidence of diabetes mellitus (P-value - -1.199&gt;0.05) RP= 1.274, 95%CI (317-1.310). Conclusion: With a preval_ence ratio value of 16.446, the results of the multivariate test show that lifestyle, especially diet (the amount of food consumed) has a chance of 16.446 in increasing the incidence of diabetes mellitus in the UPTD Puskesmas Gunungsitoli Regency. Gunungsitoli City. Suggestion: Puskesmas are expected to improve the quantity and quality of services so that the preval_ence of diabetes mellitus and other diseases does not increase.</p> <p>&nbsp;</p> Reka Febri yani Halawa ##submission.copyrightStatement## https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1931 Fri, 15 Nov 2024 10:39:49 SE Asia Standard Time PENGARUH PEMBERIAN KONSELING KB TERHADAP PEMILIHAN ALAT KB DI KLINIK MAIDAWATI, S.KEB., BD KECAMATAN MARELAN TAHUN 2024 https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/2080 <p><em>Counseling for family planning involves a two-way dialogue between a counselor and potential contraceptive users to determine the best contraceptive method tailored to the users' needs. This study arises from the growing number of couples of reproductive age in Indonesia using contraception, which reached 59.54% in 2022. In North Sumatra, 43.8% of couples used contraception in 2023. However, many couples still struggle to select the most appropriate contraceptive method due to a lack of knowledge about the advantages, effectiveness, and potential side effects of different contraceptive options. This research utilizes an analytical survey with a cross- sectional design and analyzes the data using the chi-square test. The study sample consisted of 50 new contraceptive users at Maidawati Clinic, S.Keb., Bd Marelan Sub-district in 2024, who met the inclusion criteria. The results reveal that family planning counseling has a significant impact on the choice of contraceptive methods at the clinic, with findings of (p = 0.000) and (OR = 2.875). Based on these findings, it is recommended that healthcare professionals or midwives at Maidawati Midwife Clinic, S.Keb., Bd Marelan Sub-district consistently offer family planning counseling to potential users before they choose a contraceptive method. This approach helps ensure that users make informed decisions and choose the method that best suits their needs.</em></p> Zuliam Mursida ##submission.copyrightStatement## https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/2080 Fri, 15 Nov 2024 10:41:25 SE Asia Standard Time Analisi Analisis faktor yang berhubungan Dengan kejadian hipertensi pada wanita monopause di puskesmas sihapas barumun tahun 2024 https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1927 <p>The disease that causes death in the world is hypertension. Especially in developing countries, every year it increases. Hypertension cases in menopausal women are higher than men, this is due to a decrease in estrogen levels. This study aims to analyze factors associated with the incidence of hypertension in menopausal women at the Sihapas Barumun Community Health Center in 2023. This research is quantitative and has a case control design. All menopausal mothers who experienced hypertension were 264 people (cases) and 196 people (controls). The sample was 64 people (simple random sampling). bivariate results of maternal age at menopause (0.00), heredity (0.00) and obesity (0.00). The variable most related to the incidence of hypertension is heredity. It is recommended that menopausal mothers pay more attention to the intake of salt, saturated fat and calories in their diet and prioritize regular physical activity as part of efforts to maintain heart health and reduce the risk of hypertension and it is recommended that the Sihapas Barumun Community Health Center can be used as eval_uation material for implementing a periodic screening program. to assess blood pressure, especially in menopausal women, and provide counseling about the importance of weight management and a healthy lifestyle.</p> Elda Naila Rizki, Dr. Elmina Tampubolon SKM, M.kes, Bd. Peny ariani Sst,M.keb ##submission.copyrightStatement## https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1927 Fri, 15 Nov 2024 10:41:38 SE Asia Standard Time PENGARUH KUALITAS PELAYANAN TERHADAP KEPUASAN PASIEN BPJS DI IGD RUMAH SAKIT UMUM HAJI MEDAN TAHUN 2024 https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1920 <p>Kepuasan pasien dalam mendapatkan pelayanan kesehatan di rumah sakit sangat penting untuk diperhatikan. Kepuasan pasien merupakan perasaan senang atau kecewa seseorang yang timbul karena membandingkan kinerja yang diperepsikan produk (atau hasil) terhadap ekpetasi mereka.</p> <p>Jenis penelitian yang digunakan adalah penelitian kuantitatif dengan pendekatan <em>Cross-Sectional</em> atau penelitan yang bertujuan untuk mengetahui pengaruh kualitas pelayanan terhadap kepuasan pasien di IGD (Instalasi Gawat Darurat) Rumah Sakit Umum Haji Medan Tahun 2024. Populasi dalam penelitian ini yaitu seluruh pasien di IGD Rumah Sakit Umum Haji Medan tahun 2024. Pemilihan sampel dalam penelitian ini dilakukan dengan menggunaka rumus slovin sehingga didapatkan 99 orang responden.</p> <p>Berdasarkan hasil uji statistik dengan menggunakan <em>chi-square</em> diperoleh ada pengaruh Bukti Fisik (Tangible) terhadap kepuasan pasien <em>p value</em> = 0,009, kemudian ada pengaruh Kehandalan (Reliability) terhadap kepuasan pasien<em> p value</em> = 0,035, kemudian ada pengaruh Jaminan (Assurance) terhadap kepuasan pasien<em> p value</em> = 0,012, kemudian ada pengaruh Empati (Empathy) terhadap kepuasan pasien<em> p value</em> = 0,000, dan ada pengaruh Daya Tanggap (Responsiveness) terhadap kepuasan pasien<em> p value</em> = 0,004. Pada analisis multivariat didapatkan responsiveness merupakan faktor dominan yang mempengaruhi kepuasan pasien di IGD Rumah Sakir Umum Haji Medan Tahun 2024 diperoleh nilai <em>p value</em> sebesar 0,001 dengan <em>Preval_ensi Ratio</em> sebesar 10,573.</p> <p>Diharapkan kepada kepada Rumah Sakit Haji Medan untuk meningkatkan kualitas pelayanan agar tingkat kepuasan pasien juga meningkat.</p> m hafiz ##submission.copyrightStatement## https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1920 Fri, 15 Nov 2024 10:42:27 SE Asia Standard Time ANALISIS HUBUNGAN ANTARA PENGETAHUAN, SIKAP, DAN PERILAKU KESEHATAN GIGI MULUT DENGAN ANGKA KARIES GIGI PADA MAHASISWA BARU FAKULTAS EKONOMI DAN BISNIS ISLAM UIN SUMATERA UTARA MEDAN https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1896 <p><em>Dental caries is an oral health problem that is of global concern, where dental caries is a dental disease characterized by damage to the tooth surface and if left untreated, the infection extends to the pulp. The impact occurs changes in tooth structure, pain and infection and pulp death. There are 57 students out of 83 new undergraduate students in 2023 at the Faculty of Economics and Islamic Business experiencing dental caries, this case has always been a common dental problem, but must be reduced to a very low case. The purpose of the preparation of this study is to determine the relationship between knowledge, attitudes, and oral health behavior with dental caries rates in new students of the Faculty of Economics and Islamic Business UIN North Sumatra Medan. The method used in this study was observational analytic with a cross sectional approach, a sample of 287 respondents, data collection methods with observation and questionnaires. The results of this study show that there is a relationship between knowledge and dental caries rates (ρ = 0.000), there is a relationship between attitudes and dental caries rates (ρ = 0.000), and there is a relationship between behavior and dental caries rates (ρ = 0.000). The conclusion that behavior is the most dominant factor influencing the number of dental caries ρ = 0.002, OR value 26.903, and C.I 95% (3.250 - 222.684). It is recommended for the Faculty to make a policy with the university clinic in the form of an oral health program. Students are expected to know, be good, and apply oral health behavior.</em></p> Rahmayanti Hasibuan ##submission.copyrightStatement## https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1896 Fri, 15 Nov 2024 10:43:28 SE Asia Standard Time ANALISIS BAURAN PEMASARAN DENGAN MINAT KUNJUNGAN ULANG PASIEN POLIKLINIK SPESIALIS RUMAH SAKIT PERTAMINA RANTAU TAHUN 2023 https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1886 <p><em>This research aims to look at the relationship between the marketing mix based on aspects of service quality, price, promotion and location and to analyze the most dominant factors that have a relationship with interest in repeat visits by patients at the specialist polyclinic at Pertamina Rantau Hospital in 2023. This type of research is quantitative correlation, with cross sectional research design, aims to identify the relationship between independent and dependent variables in quantitative data. This method explores the relationships between variables, using systematic analysis to develop mathematical models, theories and hypotheses related to the phenomenon. The sample that will be used in this research is 97 patients from the specialist polyclinic at Pertamina Rantau Hospital in 2023. The research shows that although the level of marketing mix relationship is based on aspects of service quality, promotion and location with the patient's interest in repeat visits at the Specialist Polyclinic at Pertamina Rantau Hospital in 2023 2023 is low, there is a significant relationship in each of these aspects. The level of relationship based on the price aspect is moderate, with a significant relationship as well. The most dominant factor that has a relationship with patients' intention to revisit is price.</em></p> Juli Fitria Marpaung ##submission.copyrightStatement## https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1886 Fri, 15 Nov 2024 10:43:38 SE Asia Standard Time ANALISIS FAKTOR YANG BERHUBUNGAN DENGAN RENDAHNYA BED OCCUPANCY RATE (BOR) DI RUMAH SAKIT UMUM NATAMA TEBING TINGGI https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1918 <p>&nbsp;</p> <p><em>The Bed Occupancy Rate (BOR) quantifies the amount of time that beds are either fully or partially occupied within a certain time period. When the BOR is low, it means that hospital facilities are underutilized.</em></p> <p><em>This study employs a cross-sectional methodology and is quantitative in nature. Executed between February and May of 2024 in the Natama Tebing Tinggi General Hospital. After averaging 87 patients each month over the course of a year, this study's population consisted entirely of inpatients at Natama Tebing Tinggi Hospital. In this study, the total population is used as the sample.</em></p> <p><em>The study's findings confirm that Natama General Hospital's bed utilization is still subpar and unsatisfactory. The bivariate test found that distance, health workers' attitudes, service facilities' availability, and service quality were all significantly related to the low bed occupancy rate (BOR) at Natama Tebing Tinggi General Hospital in 2023. The multivariate test confirmed this relationship, and the variable Availability was the only one that showed any significant relationship. Among the many factors influencing the 2023 Natama Tebing Tinggi General Hospital's Low Bed Occupancy Rate (BOR), the one most strongly correlated with Service Facilities was the Preval__ence Ratio of 4,013 (1,176-13,687), which indicates that there is a 4.01-fold relationship between the two variables.</em></p> <p><em>In order for the community to receive the best possible services, it is expected that RSU Natama Tebing Tinggi will enhance the quality of service. This can be achieved, for example, by paying closer attention to and improving the maintenance of existing facilities and infrastructure, as well as by providing sufficient facilities and infrastructure. From the comfort of patient care rooms, particularly in third class, to the provision of clean restrooms, parking spots for visitors, and comfortable waiting areas for patients and their families, we aim to enhance the experience of those seeking treatment or visiting.</em></p> <p><em>&nbsp;</em></p> Dini Ariska; Sri Sudewi Pratiwi Sitio, Efrata Sembiring - ##submission.copyrightStatement## https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1918 Fri, 15 Nov 2024 10:43:48 SE Asia Standard Time ANALISIS HUBUNGAN PERSEPSI MASYARAKAT TERHADAP KUALITAS PELAYANAN DENGAN LOYALITAS BEROBAT RAWAT JALAN DI PUSKESMAS SEI APUNG https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1919 <p><em>Patients are more likely to be loyal clients who return to the Puskesmas for future medical care if they are satisfied with the high quality of care they receive there. This study set out to examine the 2020 Sei Apung Public Health Center outpatients' loyalty to the facility in connection to their public impressions of service quality. The location of the facility was chosen to be in Asahan Regency.One hundred individuals lived in the vicinity of the Sei Apung Health Center during the course of this quantitative cross-sectional study. This study used multiple logistic regression for multivariate analysis in addition to univariate and bivariate analyses with a chi-square test and a 95% confidence level.Outpatient loyalty was found to be related to the following factors: responsiveness (RP 1.293, 95% CI 1.02–1.63), assurance (RP 1.299, 95% CI 1.06–1.58), and emphaty (RP 1.381, 95% CI 1.10–1.72) in the community's perceptions. However, no relationship was found between community perceptions of the Tangible and Reliability factors and outpatient loyalty. To determine the Exp value, the most relevant aspect is the assurance factor, which stands as a guarantee. The total amount was 42,635. If the Puskesmas at Sei Apung Puskesmas in Asahan Regency want to see an uptick in patient loyalty and the use of their outpatient services, they should focus on being responsive when serving patients, assuring them of the quality of those services, and showing empathy when dealing with their needs.</em></p> <p><em>&nbsp;</em></p> Surya Hadisyah Putra ##submission.copyrightStatement## https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1919 Fri, 15 Nov 2024 10:44:42 SE Asia Standard Time PENATALAKSANAAN PENGOLAHAN LIMBAH PADAT MEDIS DI RUMAH SAKIT LARAS https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1917 <p><em>It is essential to manage medical waste (B3) since healthcare institutions generate it as a byproduct of providing health care services. This trash can cause pollution, illness transmission, and other health issues. The responsibility for managing solid medical waste lies with Laras Hospital. The purpose of this research was to ascertain whether or not RSUD Langsa's solid medical waste processing meets the health standards set out in Regulation No. 7 of 2019 by the Minister of Health of the Republic of Indonesia, which addresses the environment of hospitals.</em></p> <p><em>The study relied on a descriptive and qualitative approach. The researcher aimed to analyze several aspects linked to the execution of processing solid medical waste at Rumah Sakit Laras, therefore they gathered information from five sources: the hospital management, the ward heads, environmental health, PPI personnel, and sanitarian personnel. The information was acquired using a descriptive technique.</em></p> <p><em>The objectives of the research were to ascertain if the final management procedures for medical solid waste at Rumah Sakit Laras were compliant with the regulations that were in place at the time, to assess the level of knowledge among personnel regarding medical waste, to document the processes for processing, labeling, sorting, collecting, and temporary storage of solid waste at the hospital, and to document the protocols for the use of personal protective equipment by hospital employees.</em></p> <p><em>The research results demonstrated that Rumah Sakit Laras should pay more attention to a) segregating solid medical waste because wasted mix and b) transporting solid medical waste using a particular route. c) The document is comprehensive, which bodes well for its management results; nevertheless, TPS waste storage needs further attention.</em></p> <p><em>Medical waste management at RSUD Langsa was determined to be in compliance with Regulation No. 7 of 2019 of the Minister of Health of the Republic of Indonesia, which pertains to the health requirements for hospital environments and hospital environmental health.</em></p> <p><em>&nbsp;</em></p> Gatot Narta Bahagia ##submission.copyrightStatement## https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1917 Fri, 15 Nov 2024 10:44:52 SE Asia Standard Time ANALISIS PERSIAPAN DAN PEMANFAATAN SIMRS DI RS BALIMBINGAN KABUPATEN SIMALUNGUN https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1916 <p><em>The generation and processing of SIMRS is a responsibility of every hospital. Improvements in operational reporting, decision-making speed, problem-identification accuracy and speed, strategy formulation ease in managerial implementation, work culture, transparency, unit coordination, system understanding, and cost reduction administration are all necessary for the successful processing and development of SIMRS to enhance and support hospital health service processes. There has been no integration between the Balimbingan Hospital's SIMRS processing and the financial and administration department from 2018 to 2021. In light of these issues, it is critical to examine the challenges encountered by Balimbingan Hospital in 2021 while implementing the Hospital Management Information System in Simalungun Regency, North Sumatra Province.</em></p> <p><em>This study employs a descriptive model with a System of Action unit of analysis and is qualitative in nature. It takes the form of a case study. Presented findings from an investigation of the implementation and utilization of SIMRS at Balimbingan Hospital in Simalungun Regency through the use of participant observation and in-depth interviews. People who are familiar with the issues under investigation and can provide insight into the current state of affairs are called "informants" in this study.</em></p> <p><em>The analysis and discussion led to the conclusion that the Balimbingan Hospital SIMRS is an application of a hospital service management system. The implementation of this system has full support from management and all employees. The goal is to help the hospital improve its services by integrating the entire flow of service processes. The only section that needs to be done manually is the Finance and Management section, but other than that, everything else is done using the system. Additionally, in the event of issues with the internet network, particular measures can be taken, such as establishing a secondary network via a more reliable cable or wireless technology, or establishing a modem connection to the server as a backup, and designating specific IT officers to deal with SIMRS issues.</em></p> Muhammad Hanafi Batu Bara ##submission.copyrightStatement## https://ejournal.delihusada.ac.id/index.php/JIKM/article/view/1916 Fri, 15 Nov 2024 10:45:00 SE Asia Standard Time