The chronic renal failure was a problem important, prevalence and evidence based to improve. Patients were chronic renal failure improvement of the quality of patients with undergoing hemodialysis. The purpose of this study was to determine the increase in the quality of life of patients with chronic renal failure undergoing hemodialysis therapy through psychological intervention at the Hemodialysis Unit, Royal Prima Hospital Medan in 2016. This type of research is pre experiment with the design of one group pre-post test design. This research was conducted in June 2016. The samples of this study were 12 patients suffering from chronic renal failure drawn by purposive sampling technique. Based on the results of this study, it is indicated that the quality of life before psychological intervention on (pre-test) the average was 2.58 with a standard deviation of 0.515. While the quality of life is better after the psychological intervention (post-test) the average was 1.50 with a standard deviation of 0.674. Based on statistical test of Wilcoxon, it was obtained that p-value 0.002 (<0.05), meaning there is a significant increase in quality of life between psychological intervention and quality of life of patients with chronic renal failure undergoing hemodialysis. The conclusion of this study states that there is an improvement of the quality of patients with chronic renal failure undergoing hemodialysis to psychological intervention through devotions and spiritual relaxation can be used as an alternative spiritual therapy to improve the quality of life of patients with chronic renal failure undergoing hemodialysis.

The quality of health service at Dr. Pirngadi Hospital Medan is determined by the human resources quality including the nurses. The nurses performance is affected by internal and external factors. The objective of this research is to analyse the effect of individual characteristics upon the nurses performance. The population is 96 nurses who had been working for at least 2 years as Civil Servants in the patient wards. Their qualification is Sekolah Perawat Kesehatan (Nursing School) and D3 Keperawatan (Academy of Nursing). This cross-sectional-study uses chi-square tests and logistic-regression. It is found out that there is a significant proportional difference between the nurses age and quantity of work; between the nurses sex and job quality; between the nurses sex and quantity of work; between the nurses sex and cost effectiveness; between the nurses age, sex and initiatives; between education and quality of work; between education and cost efectiveness; between the length of work and quality of work; between the length of work and quantity of work; between the length of work and cost effectiveness; between the length of work and initiatives; between job placement and quantity of work. The result of logistic regression shows that sex and education has the biggest effect upon the nurses performance. The recruitment of female nurses with Akper qualification may improve the performance. Sex and education is the most influential factors upon the performance. It is worth to increase the nurses performance through education and training which is supported by the hospital policy and management.

Breast cancer is a tumor (cancer) that is originated from the malignant breast cells. The psychological impact inflicted such losses and changes in sense of comfort resulting from the symptoms of the disease or its treatment. This study aims to determine the relationship between psychology and personal hygiene of breast cancer patients at the Hospital of Dr. Pirngadi Medan in 2016. This research used descriptive correlative with a cross-sectional design. The population of this study was 48 people, drawn by purposive sampling technique. The samples obtained were 43 people. The results of the psychological research on breast cancer patients showed that psychological occurred on 35 people (81.40%) and severe psychological were 8 people (18.60%). Results of research on breast cancer patients and personal hygiene were 25 people (58.14%), lack of personal hygiene on 18 people (41.86%). Based on the Spearman Rank correlation test on the relationship between psychology and personal hygiene on breast cancer patients with a significance level (a <0.05) was 0.32 and Sig. (2-tailed) 0.03, meaning there is a relationship between psychology and personal hygiene on breast cancer patients. In conclusion, there is a psychological relationship between personal hygiene on breast cancer patients at the Hospital of Dr. Pirngadi Medan in 2016. It is expected that the hospital can improve the quality of health services, nurses pay more attention to aspects of bio, psycho, socio, and spiritual, assistance and provide motivation in the fulfillment of basic needs and maintain personal hygiene breast cancer patients

Human resource management in organizations is means improving human quality for increased performance and organizational outcomes. Realizing an employee discipline and high performance. In improving performance required analysis factors that influence by paying attention to needs of employees as good organization culture and coordinated. Purpose of study to determine influence of organizational culture performance of employees of PT. PLN. Type of research is an analytical survey that aims to explain the influence of variables through a cross-sectional approach. The population was all employees of PT. PLN, amounting 221 people, sample taken with stratified random sampling method to retrieve each field with a total sample size 69 people. Analyzed using univariate, bivariate, multivariate at 95% significance level. Results showed that reward system (?=0.016) and communication patterns (?=0.032), individual initiative (?=0.703), tolerance for risk measures (?=0.108), directives (?=0.098), integration (?=0.353), management support (?=0.662), control (?=0.948), identity (?=0.532), tolerance for conflict (?=0.336). Suggested to the management of PT PLN (Persero) Regional Office of North Sumatra, Medan to implement the provision of the reward system in accordance with the achievements and more transparency in administration so as to motivate employees to work more productively so as to improve the performance of the company and also implementing the communication patterns of organizations that can provide the necessary information by the employee in performing the task and each section leaders met with the employees so that the employees are motivated to improve their performance.

One of non medical treatment of heart hypertension complication sufferers is by having the heart diet well for reach a normal nutritional status. The main nutrient compositions of this diet are calory, protein, fat, carbohydrate and sodium. This research aims to know the represent of the management of heart diet and nutritional status of hospitalized heart hypertension complication patients in Bandung General Hospital of Medan in 2012. The research was a descriptive study with number of sample 35 hospitalized heart hypertension complication patients in Bandung General Hospital of Medan, which was taken by using consecutive sampling. The results showed that the type of indication heart has been accordance with the standard heart diet type IV. Most of the patients have an obedience action in medium category (94.3%) in having the heart diet which was provided from the hospital. Beside, most of the nutritional status are normal (82.9%). It is recommended to the Bandung General Hospital of Medan especially the installation of nutrition to have a dietary guidelines. Beside it is good to make a hospital policy for hospitalized patients to have the diet well.

Stroke is the first cause of disability and the third cause of death in the world both in developed and developing countries after heart disease and cancer.Based on the result of Basic Health Research in 2013, it was found out that there was the increase of stroke prevalence per 100,000 persons in Indonesia from 830 in 2007 to 1,210 in 2013. The purpose of this analytical observational study with the case-control design was to find out the correlation of the factors of hypertension, diabetes mellitus, smoking, obesity, alcohol and family history of disease on the incident of stroke in the patients at H. Sahudin General Hospital Kutacane Aceh Tenggara District. This research was observational analytic with case control design. The case population is all stroke patients who seek treatment at RSU H. Sahudin Kutacane Aceh Tenggara District. The number of samples were 45 cases and 45 controls, with case and control ratio 1: 1, so the total sample was 90 people performed by matching age and sex. Case samples were taken by purposive sampling and control samples were taken by consecutive sampling. The data obtained were analyzed through univariate and bivariate using chi-square test. The result showed the factors that significantly related to the incident of stroke were hypertension (OR = 4.67; 95% CI: 1.78 – 12.23) and diabetes mellitus (OR = 2.67; 95% CI: 1.01 – 7.04). The factors that did not significantly related to the incident of stroke were smoking, obesity, alcohol consumption and family history of disease. Expected to H. Sahudin General Hospital Kutacane should socialize the risk factors and the prevention of stroke to the patients through direct extension or various other media also adds CT-Scan facility. The community members are expected to be aware to visit the health service facility have their health checked routinely, always control their blood pressure and blood sugar level and to get accustomed to practicing health lifestyle and physical activity to prevent the stroke.

Service quality was assessed based on five dimensions: reliability, tangibles, assurance, and empathy. Decreased performance of nurses who took place at the Hospital Tk. IV Pematang Siantar due to decreased intrinsic motivation such as achievement, recognition, responsibility, opportunity to advance and the work itself that affect the performance of nurse executor. This study aimed to analyze the influence of intrinsic motivation on the performance of nurses in Hospital Tk. IV Pematang Siantar in 2017. This type of research used analytic survey research method. The population was all implementing nurses who number 97 nurses. The number of samples were 61 nurses who were obtained by purposive sampling. Data analysis was done by using linear regression test. The results showed that there was an effect of intrinsic motivation on the performance of nurse executor (p <0,05). The most dominant variable to the performance of the nurse was the work itself which has the greatest coefficient value. The conclusion of this research that there was a significant influence of intrinsic motivation on the performance of nurse executor at Hospital Tk. IV Pematang Siantar. Recommended to Head of Hospital Tk. IV Pematang Siantar in order to motivate their employees, especially the implementing nurses to improve performance for the improvement of the work.

Pin site infections were a common complication of external fixation that places a significant burden on the patient and healthcare system. Such infections increase the number of clinic visits required during a patient’s course of treatment, can result in the need for additional treatment including antibiotics and surgery, and most importantly can compromise patient outcomes should osteomyelitis or instability result from pin loosening or need for pin or complete construct removal. Factors that may influence the development of pin site infections include patient-specific risk factors, surgical technique, pin design characteristics, use of prophylactic antibiotics, and the post-operative pin care protocol including cleansing, dressing changes, and showering. Despite numerous studies that work to derive evidence-based recommendations for prevention of pin site infections, substantial controversy exists in regard to the optimal protocol. This review comprehensively evaluated the current literature to provide an overview of factors that may influence the incidence of pin site infections in patients undergoing treatment with external fixators, and concludes with a description of the preferred surgical and post-operative pin site protocols employed by the senior authors (ATF and SRR)

Early breastfeeding initiation constitutes a process in which a baby begins to suckle on the breast by itself soon after it was born. Within the first hour, a baby must be breastfed by its mother. The aim was not only to give nutrition but also to train the baby to suck the nipple and to prepare the mother to produce colostrum breast milk. In the practice of giving early breastfeeding initiation, the skill of health care providers was very important in giving information through health education about early breastfeeding initiation for mothers. The skill of health care providers was closely related to their knowledge of early breastfeeding initiation. The objective of the research was to find out the correlation of the knowledge of nurses and midwives with the skill in providing health education about early breastfeeding initiation for prenatal mothers at Puskesmas of Kabupaten Batubara. The type of the research was descriptive analytic with cross sectional design. The population was 65 nurses and midwives who worked in KIA (Mother and Child Health), and 55 of them were used as the samples at the level of error 5%, using purposive sampling technique. The data were analyzed by using univatriate analysis with frequency distribution and bivatriate analysis with Spearman Rho test at the significance level of 5%. The result of the research showed that 40 respondents (72.7%), consisted of nurses and midwives, had good knowledge and 41 respondents (74.5%) had good skill which indicated that there was positive correlation between the knowledge of nurses and midwives and the skill in providing health education about early breastfeeding initiation for prenatal mothers at Puskesmas of Kabupaten Batu Bara with the result of coefficient correlation of -0.270 at the significance level p < a (0.047 < 0.05). It was recommended that the agency concerned determine and prepare the location for health counseling or education at the favorable site in order that the message or materials can achieve the target which was in line with the purpose of the expected health education