scholarly journals COMPARISON OF THE EFFECTIVENESS OF TWO LEVELS OF SUCTION PRESSURE ON OXYGEN SATURATION IN PATIENTS WITH ENDOTRACHEAL TUBE

2017 ◽  
Vol 3 (6) ◽  
pp. 693-696
Author(s):  
Muhaji Muhaji ◽  
Bedjo Santoso ◽  
Putrono Putrono
Keyword(s):  
Oxygen Saturation ◽  
T Test ◽  
Mean Difference ◽  
P Value ◽  
Pressure Group ◽  
Endotracheal Suctioning ◽  
Consecutive Sampling ◽  
The Common ◽  
The Mean ◽  
Paired T Test

Background: Endotracheal suctioning is one of the common supportive measures in intensive care units (ICU), which may be related to complications such as hypoxia. However, a questionable efficacy is still identified to choose suctioning pressure between 130 mmHg and 140 mmHg that is effective for patients with endotracheal tube.Objective: To compare the effectiveness of 130 mmHg and 140 mmHg suctioning pressure on oxygen saturation in patients with endotracheal tube.Methods: This research used a quasy experimental design with pretest and posttest group. The study was conducted from 31 January to 1 March 2017 in the Hospital of Panti Wilasa Citarum and Hospital of Roemani Muhammadiyah Semarang. There were 30 samples recruited using consecutive sampling, with 15 assigned in the 130 mmHg and 140 mmHg suctioning pressure group. Pulse oximetry was used to measure oxygen saturation. Paired t-test and Independent t-test were used for data analysis.Results: Findings showed that there was a statistically significant effect of 130 and 140 mmHg suctioning pressure on oxygen saturation in patients with ETT with p-value <0.05. There was a significant mean difference of oxygen saturation between 130 mmHg and 140 mmHg suctioning pressure group with p-value 0.004 (<0.05). The mean difference of oxygen saturation between both groups was 13.157.Conclusion: The 140 mmHg suctioning pressure is more effective compared with 130 mmHg suctioning pressure in increasing oxygen saturation in patients with ETT.

scholarly journals Pengaruh Jus Apel Terhadap Penurunan Tekanan Darah pada Lansia Hipertensi di Puskesmas Muara Kaman

2018 ◽  
Vol 5 (2) ◽  
pp. 121-129
Author(s):  
Siti Khoiroh
Keyword(s):  
Blood Pressure ◽  
Community Health ◽  
Apple Juice ◽  
Antihypertensive Drugs ◽  
Intervention Group ◽  
T Test ◽  
Mean Difference ◽  
Control Group ◽  
P Value ◽  
The Mean

Background : Hypertension is a condition of high blood pressure in the arteries that lasted continuously for the long term. Hypertension can be overcome in two ways: pharmacology and non-pharmacology. Pharmacology treatment usually use medicine while one of the ways for non-pharmacology treatment is to consumes apple juice.Research Objective : The aim of this research is to know the effect of apple juice on blood pressure decrease in elderly people with hypertension at Muara Kaman Community Health Center.Methods : The design of this research used quasi experimental design (quasi experiment) with pretest posttest control group design. The sample of the research was hypertensive respondents at Muara Kaman Community Health Center as many as 30 respondents were divided into 2 groups, 15 intervention groups and 15 control groups. The sampling technique used purposive sampling. The research instruments were stethoscope and sphygmomanometer, data analysis using t test dependent and t test independent.Results : There were a significant influence between pretest and posttest of apple juice in the intervention group (P value = 0,000; P <0.005). The mean difference in systolic blood pressure in the intervention group and the control group also had significant differences (P value = 0.002; P <0.05), where as the mean difference in diastolic blood pressure in the intervention group and the control group also had significant differences (P value = 0,039; P <0,05).The Conclusions : The results of this research showed that consumes apple juice gives an effect on the blood pressure of hypertensive patients by consumes regularly.The Suggestions : Nurses and the public can use apple juice as one of the ways to handling to hypertension sufferers besides antihypertensive drugs.

scholarly journals Persepsi Petani terhadap Pilihan Menjual Padi Kepada Penebas atau Perpadi (Kasus Subak Benel, Desa Kaliakah, Kecamatan Negara, Kabupaten Jembrana)

2017 ◽  
pp. 563
Author(s):  
I MADE PRASADA ARY WIRAWAN ◽  
I DEWA PUTU OKA SUARDI ◽  
I MADE SARJANA
Keyword(s):  
T Test ◽  
Mean Difference ◽  
P Value ◽  
Food Crops ◽  
Test Program ◽  
Qualitative Descriptive ◽  
The Mean ◽  
The Difference ◽  
The Government ◽  
Better Than

Farmers Perception Of Options To Sell Rice Penebas Or Perpadi(especially in Subak Benel, Kaliakah Village, Negara districts,Jembrana Regency) Various efforts have been implemented by the Provincial Food Crops Agency of Balito stabilize the price of grain, this is done by giving Funds of Rural EconomicEmpowerment Capital to the government for the purchase of rice. Although it hasbeen done from 2003, farmers are still selling it to Penebas with a bondage system.The purpose of this study to determine the perception of farmers to the choice ofselling rice to Perpadi or Penebas seen and differences in farmers' perceptions of thechoice of selling rice to Penebas or Perpadi. The research location is located in SubakBenel, Kaliakah Village, State District, Jembrana District. The analytical methodused is qualitative descriptive that aided with score, to answer the purpose ofresearch by using questionnaire. The results of this study indicate that the perceptionof farmers to the choice of selling rice to Perpadi better than to Penebas. This is seenin the achievement of the farmers' choice of selling paddy to Perpadi is very goodand to Penebas is good. The difference of Perpadi with Penebas is measured throughDifferent Test with SPSS Independent Sample T test program which the result of Sigvalue. Or p value of 0.004 where <0.05 then there is a statistically significantdifference in probability 0.05, the mean difference or mean of both groups is shownin Mean Difference ie .29559.

Memperbaiki Saturasi Oksigen, Frekuensi Denyut Jantung, dan Pernafasan Neonatus yang Menggunakan Ventilasi Mekanik Dengan Terapi Musik

2013 ◽  
Vol 16 (3) ◽  
pp. 154-160 ◽  
Author(s):  
Rahmadevita S.A.M ◽  
Yeni Rustina ◽  
Elfi Syahreni
Keyword(s):  
Heart Rate ◽  
Mechanical Ventilation ◽  
Music Therapy ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
T Test ◽  
P Value ◽  
Respiratory Disorder ◽  
Significant Difference ◽  
Paired T Test

AbstrakNeonatus yang menggunakan ventilasi mekanik akibat gangguan pernapasan mengalami masalah oksigenisasi dan frekuensi denyut jantung. Berbagai upaya perlu dilakukan agar neonates tenang sehingga kebutuhan oksigen dapat diminimalkan, salah satu upaya tersebut adalah terapi musik. Penelitian ini bertujuan untuk menguji pengaruh terapi musik terhadap saturasi oksigen, frekuensi denyut jantung dan frekuensi pernafasan neonatus yang menggunakan ventilasi mekanik. Penelitian kuasi eksperimen dengan rancangan pretest-posttest without control meibatkan 13 neonatus yang dipilih secara konsekutif. Intervensi yang diberikan adalah terapi musik dengan Brahm’s Lullaby selama 30 menit dengan headphone. Pengumpulan data menggunakan observasi dan dianalisis dengan Paired t test. Hasil penelitian menunjukkan adanya perbedaan bermakna antara rerata saturasi oksigen, frekuensi denyut jantung dan frekuensi pernafasan sebelum dan setelah pemberian terapi musik. Pada saturasi oksigen terjadi peningkatan, sedangkan pada frekuensi denyut jantung dan pernapasan mengalami penurunan. Terapi musik dapat digunakan sebagai pendamping terapi medis untuk memperbaiki oksigenisasi pada neonatus yang menggunakan ventilasi mekanik.Kata kunci: denyut jantung neonatus, pernapasan, saturasi oksigen, terapi musik, ventilasi mekanikAbstractImproving Oxygen Saturation, Heart Rate, and Respiratory Rate of Neonates Using Mechanical Ventilation with Music Therapy. Neonates using mechanical ventilation cause of respiratory disorder experience oxygenation and heart rate problems. Interventions should be made in order to calm neonates so that the need of oxygen can be minimized, one of these interventions is music therapy. This study aimed to identify the effect of music therapy on oxygen saturation, heart rate and respiratory rate of neonates using mechanical ventilation. This quasi experiment study with a pretest-posttest design without control involved 13 neonates selected by consecutive sampling. Data collected through observation and analyzed by paired t test. There was a significant difference on the average of oxygen saturation, heart rate and respiratory rate of infants using mechanical ventilation before and after music therapy (p value <0,05). Music therapy can be used as a complementary medical therapies to improve oxygenation in neonates using mechanical ventilation.Key words: heart rate, mechanical ventilation, music therapy, neonate, oxygen saturation, respiratory rate

scholarly journals Pengaruh Zumba Gold Dan Rendam Kaki Dengan Air Hangat Terhadap Kualitas Tidur Lansia Di Dukuh Pandes Desa Pandes Kecamatan Wedi Kabupaten Klaten

2019 ◽  
Vol 6 (1) ◽  
pp. 503
Author(s):  
Setianingsih Setianingsih ◽  
Afiya Nurrahma Deanti ◽  
Nur Wulan Agustina
Keyword(s):  
T Test ◽  
P Value ◽  
Consecutive Sampling ◽  
Paired T Test

Proses degeneratif pada lansia menyebabkan terjadinya penurunan kondisi, salah satu dampaknya yaitu perubahan kualitas tidur lansia. Dampak lebih lanjut menyebabkan menurunnya kemandirian lansia yang akan berujung pada penurunan kualitas hidup lansia, untuk itu perlu adanya upaya yang efektif untuk mempertahankan kualitas tidur pada lansia. Upaya tersebut diantaranya zumba gold dan rendam kaki dengan air hangat. Tujuan penelitian ini untuk mengetahui pengaruh zumba gold dan rendam kaki dengan air hangat terhadap kualitas tidur lansia. Penelitian ini menggunakan desain penelitian Quasi Eksperimen. Populasi penelitian ini adalah lansia yang tinggal di dukuh Pandes. Responden penelitian sebanyak 40 responden yang diperoleh dengan teknik Consecutive Sampling yang sesuai dengan kriteria inklusi dalam penelitian. Instrumen pengumpulan data menggunakan kuesioner PSQI. Analisa data bivariat menggunakan uji Paired t-test dan Independent T-test. Hasil uji Paired T-test diperoleh p value = 0,000 < 0,05 untuk kedua intervensi dan hasil uji Independent T-test diperoleh p value = 0,0678 untuk kedua intervensi yang berarti tidak terdapat perbedaan pengaruh yang signifikan antara kedua intervensi. Kesimpulannya zumba gold dan rendam kaki dengan air hangat mampu meningkatkan kualitas tidur pada lansia, serta tidak ada perbedaan pengaruh yang signifikan antara kedua intervensi tersebut di dukuh Pandes, desa Pandes, kecamatan Wedi, kabupaten Klaten.

scholarly journals The Effect of the Emotional Demonstration Method of Mealing Schedule on the Knowledge of Mothers to Children in Posyandu V Mulyorejo Surabaya

2021 ◽  
Vol 2 (1) ◽  
pp. 17-21
Author(s):  
Nidya Comdeca Nurvitriana ◽  
Setiana Andarwulan
Keyword(s):  
Health Workers ◽  
Sampling Technique ◽  
Mean Value ◽  
T Test ◽  
P Value ◽  
Children Under Five ◽  
Under Five ◽  
Post Test ◽  
The Mean ◽  
Paired T Test

Background of research on mother's knowledge of toddlers in providing feeding schedules, especially snacks. Giving snacks that are not right on schedule will have an influence on the growth and development of infants. Through the Emotional Demontration method, eating schedule for snacking can be controlled. Emotional Demonstration is the provision of education not only through lectures but also through games so that the key messages conveyed can be remembered by mothers of toddlers in Posyandu V Mulyorejo Surabaya. The Emo Demo method is one solution to reduce the stunting rate. In 2017 the stunting rate in Indonesia reached 22.2%. Based on the results of the survey conducted through interviews with nutritionists, it was explained that there were 16 stunting toddlers in Posyandu V Surabaya. Quantitative Research Methodology, a quasi-experimental research design method with one group pretest posttest approach. The population in this study were all mothers of children under five in Posyandu V Mulyorejo Surabaya as many as 36 people, samples as many as 36 mothers of toddlers. With a total sampling technique. Analyze data with Paired T-test. The results showed the mean value of the pre test was 6.06, the mean value after the post test reached 8.16. While the significance value of p value = 0,000 with α = 0.05 through the Paired T-test. The conclusion is that there are differences in the knowledge of pre and post test among mothers of children under five in Posyandu V Mulyorejo Surabaya, p value = 0,000 with α = 0.05. Suggestions for health workers to continue to make improvements in practicing emotional demonstration to participants because it is very useful in increasing knowledge to prevent increased stunting rates.

scholarly journals Terapi pada Pasien Kanker Payudara Stadium Lanjut Menurunkan Kadar C- Reaktif Protein dan Meningkatkan Kadar Albumin

2019 ◽  
Vol 11 (2) ◽  
pp. 116
Author(s):  
Arya Wawolumaja ◽  
Victor Pontoh ◽  
Marselus Merung
Keyword(s):  
Breast Cancer ◽  
Serum Albumin ◽  
Late Stage ◽  
T Test ◽  
Nutrition Status ◽  
P Value ◽  
Female Patients ◽  
The Mean ◽  
Serum Crp ◽  
Paired T Test

Abstract: Breast cancer is one of the malignancies that has a high prevalence and can occur in both sexes. Albeit, more than 70% of these patients were detected at late stage. Inflammation could accelerate the tumor growth, invasion, angiogenesis, and metastasis. Increased serum CRP indicates uncontrolled infection or pathological process. Meanwhile, serum albumin is used to evaluate the nutrition status, the severity of disease, and prognosis. This study was aimed to evaluate the influence of serum CRP and albumin levels in female patients with breast cancer after treatment. This was an interventional analytical study with a cross sectional design. This study was conducted at Prof. Dr. R. D. Kandou Hosppital Manado. Subjects were all female patients with breast cancer from May to August 2018. The results showed that there were 43 patients of late stage breast cancer, mean age of 52.16 years. After treatment there was a decrease in the mean serum CRP level from 17.05 mg/dL to 6.40 mg/dL and the paired t test obtained a t value of 3.269 and a P value of 0.001. Moreover, there was an increase in the mean serum albumin level from 3.59 mg/L to 3.76 mg/L and the paired t test obtained a t value of -2,896 and a P value of =0.003. Conclusion: Chemotherapy and or surgery performed on female patients with breast cancer could decrease the serum CRP level and increase the serum albumin level.Keywords: breast cancer, serum CRP, serum albuminAbstrak: Kanker payudara merupakan salah satu jenis keganasan yang memiliki prevalensi cukup tinggi dan dapat terjadi baik pada laki-laki maupun perempuan. Lebih dari 70% penderita kanker payudara ditemukan pada stadium lanjut. Keadaan inflamasi dapat mempercepat pertumbuhan tumor, invasi, angiogenesis, dan metastasis. Hadirnya CRP serum yang meningkat mengindikasikan adanya infeksi atau proses patologik yang tidak teratasi. Albumin serum secara umum digunakan untuk menilai status nutrisi, derajat keparahan penyakit, perkembangan penyakit, dan prognosisnya. Penelitian ini bertujuan untuk menilai pengaruh kadar CRP dan albumin serum pada pasien perempuan dengan kanker payudara stadium lanjut setelah terapi. Jenis penelitian ialah intervensional analitik dengan desain potong lintang Penelitian dilakukan di RSUP Prof. Dr. R. D. Kandou Manado. Subjek penelitian ini ialah semua penderita kanker payudara berjenis kelamin perempuan pada periode Mei 2018 s/d Agustus 2018. Hasil penelitian mendapatkan 43 pasien dengan kanker payudara stadium lanjut dengan usia rerata 52,16 tahun. Setelah terapi terjadi penurunan rerata kadar CRP serum dari 17,05 mg/dL menjadi 6,40 mg/dL dan uji t berpasangan menunjukkan nilai t=3,269 dengan P=0,001. Selain itu, terjadi peningkatan rerata kadar albumin serum dari 3,59 mg/L menjadi 3,76 mg/L dan uji t berpasangan menunjukkan nilai t=-2,896 dengan P=0,003. Simpulan: Modalitas kemoterapi dan/atau operasi pada pasien kanker payudara stadium lanjut secara bermankna menurunkan kadar CRP serum tetapi meningkatkan kadar albumin serum.Kata kunci: kanker payudara, CRP serum, albumin serum

scholarly journals PENGARUH TERAPI HUMOR DENGAN VIDEO KOMEDI TERHADAP PENURUNAN TEKANAN DARAH PADA PASIEN HIPERTENSI PRIMER

2022 ◽  
Vol 4 (1) ◽  
pp. 168-178
Author(s):  
Tri Wijayanto ◽  
Apri Budianto ◽  
Irmaya Meilinda Sari
Keyword(s):  
T Test ◽  
P Value ◽  
Consecutive Sampling ◽  
Paired T Test

Terapi humor merupakan tindakan untuk menstimulasi seseorang untuk tertawa, tindakan ini mampu merangsang pelepasan opiat endogenous atau yang sering disebut dengan endorfin. Manfaat endorfin yaitu membuat relaksasi yang berdampak pada pelebaran pembuluh darah sehingga menurunkan tekanan darah, dengan kondisi relaks juga akan membuat denyut jantung menjadi normal. Tujuan dari penelitian ini mengetahui pengaruh terapi humor dengan video komedi terhadap penurunan tekanan darah pada pasien hipertensi primer di Panti Tresna Werdha Natar Lampung Selatan. Desain penelitian ini adalah jenis quasy experiment semu dengan rancangan pretest–posttest design. Populasi dalam penelitian ini adalah pasien yang menderita hipertensi primer di panti tresna werdha. Populasi dalam penelitian ini berjumlah  86 orang  Teknik sampel consecutive sampling. Analisis data yang peneliti gunakan adalah uji Paired T Test. Berdasarkan analisis data diketahui nilai p-value 0,000 atau p-value < 0,05, yang artinya ada pengaruh terapi humor terhadap penurunan tekanan darah pada pasien hipertensi primer di Wilayah Kerja Panti Tresna Werdha Natar Lampung. Hasil penelitian diharapkan agar pihak Puskesmas dapat bekerjasama dengan instansi lain untuk menjalankan program penurunan angka kejadian hipertensi memberikan sosialisasi, terapi humor secara rutin serta pencatatan tekanan darah kepada para lansia.

scholarly journals EFFECT OF SPIRITUAL NURSING CARE ON THE LEVEL OF ANXIETY IN PATIENTS WITH STROKE

2018 ◽  
Vol 4 (1) ◽  
pp. 98-103
Author(s):  
Bernadeta Trihandini ◽  
Diyah Fatmasari ◽  
Lucia Endang Hartati YK ◽  
Sudirman Sudirman
Keyword(s):  
Nursing Care ◽  
Rating Scale ◽  
T Test ◽  
Control Group ◽  
P Value ◽  
Life Changes ◽  
Stroke Patients ◽  
The Mean ◽  
And Control ◽  
Paired T Test

Background: Anxiety in stroke patients occurs as a normal reaction to stress with life changes; however, when it becomes excessive, It becomes disabling. Effort to deal with anxiety is needed and spiritual approach nursing care is considered useful in caring patients with stroke.Objective: To examine the effect of spiritual nursing care on anxiety in stroke patients in the inpatient ward.Methods: This study used a quasy experimental design with pretest-postest control group. Thirty respondents were selected using consecutive sampling, which 15 respondents assigned in the experiment and control group. The Hamilton Anxiety Rating Scale was used to measure anxiety. Data were analyzed using paired t-test and independent t-test.Results: The results showed that the mean level of anxiety in the experiment group before intervention was 29.33 and decreased to 9 after intervention, while in the control group the mean level of anxiety before intervention was 29.47 and decreased to 17.73 after intervention. Paired t-test obtained p-value 0.000 (<0.05), which indicated that there was a significant effect of spiritual nursing care on anxiety levels in patients with stroke.Conclusion: Spiritual nursing care could reduce anxiety in patients with stroke. 

scholarly journals COMBINATION OF HYPNOSIS THERAPY AND RANGE OF MOTION EXERCISE ON UPPER-EXTREMITY MUSCLE STRENGTH IN PATIENTS WITH NON-HEMORRAGHIC STROKE

2018 ◽  
Vol 4 (1) ◽  
pp. 104-111
Author(s):  
Chandra Irawan ◽  
Mardiyono Mardiyono ◽  
Suharto Suharto ◽  
Aris Santjaka
Keyword(s):  
Muscle Strength ◽  
Upper Extremity ◽  
Mean Value ◽  
T Test ◽  
Control Group ◽  
P Value ◽  
Significant Difference ◽  
The Mean ◽  
And Control ◽  
Paired T Test

Background: Range of Motion (ROM) exercise has been identified in the literature that it has an effect in improving muscle strength, especially in patients with stroke. However, little is known about the effect of ROM exercise combined with hypnosis therapy.Objective: To determine the effect of combination of hypnosis therapy and ROM exercise on upper extremity muscle strength in patients with non-hemorrhagic.Methods: This study employed a quasy experiment with pretest-posttest control group design. Thirty-two samples were selected using simple random sampling, which 16 randomly assigned in the experiment and control group. Muscle strength was measured using Muscle Strength Scale. Hypnosis Deepening test was used to measure the level of hypnosis depth. Paired t-test and Independent t-test were used for data analysis.Results: The mean value of muscle strength in the experiment group was 3.50 and  the mean value in the control group  was 2.62. Independent sample t-test obtained p-value = 0.012, indicated that there was a statistically significant difference in the mean of muscle strength of upper extremity in the experiment and control group. Paired t-test obtained p-value = 0.000, which indicated that there was significant difference between the average of muscle strength value before and after treatmentConclusion: The combination of hypnosis therapy and ROM exercise has a significant effect in increasing muscle strength of upper extremity in patients with stroke non-haemorrhagic.

scholarly journals Perbandingan Diabetes Self Management Education Metode Ceramah Menggunakan Booklet dengan Metode Group Whatsapp terhadap Self Care BehaviorPasien Diabetes Mellitus

2019 ◽  
Vol 4 (3) ◽  
pp. 126-131
Author(s):  
Dwi Elka Fitri ◽  
Siska Mayang Sari ◽  
Tri Krianto
Keyword(s):  
Diabetes Mellitus ◽  
Management Education ◽  
Self Care ◽  
T Test ◽  
Mean Difference ◽  
Self Management ◽  
P Value ◽  
Paired Sample ◽  
Consecutive Sampling ◽  
Care Behavior

ABSTRAK Diabetes Mellitus (DM) merupakan penyakit metabolik kronis yang membutuhkan pendidikan pengelolaan mandiri untuk mencegah  komplikasi akut dan menurunkan resiko komplikasi jangka panjang. Diabetes Self Management Education (DSME) dapat digunakan sebagai metode yang efektif dalam meningkatkan perawatan mandiri pasien dengan Diabetis Mellitus saat keluar dari RS. Dalam pelaksanaan edukasi pada pasien banyak metode yang bisa dilakukan. Metode ceramah adalah metode yang paling sering  digunakan, salah satunya adalah dengan menggunakan booklet. Metode lain yang dapat dilakukan adalah dengan menggunakan aplikasi group WhatsApp. Tujuan dari penelitian ini adalah mengetahui perbandingan  DSME metode ceramah menggunakan booklet dengan metode group WhatsApp terhadap  self  care behavior pasien DM. Jenis penelitian ini adalah kuantitatif dengan pendekatan Quasy eksperiment dengan desain two group pretest-posttest.  Sampel dalam penelitian ini adalah pasien DM yang diarawat jalan di RS PMC dengan jumlah 30 orang, menggunakan tekhnik consecutive sampling yang dibagi 2 kelompok. Analisa yang digunakan adalah analisa univariat dan bivariat dengan menggunakan  uji paired sample t-test dan independent sample t test.  Hasil uji t independent didapatkan p value = 0.001 lebih kecil dari nilai alpha (p < 0.05) dengan mean difference, yaitu -15,33. Dapat disimpulkan bahwa diabetes self management education dengan metode whatsApp group)  lebih berpengaruh dalam meningkatkan self care behavior dibandingkan diabetes self management education dengan metode ceramah menggunakan booklet. Dari hasil penelitian ini diharapkan agar RS dapat melakukan edukasi pada pasien DM dengan mengikuti prinsip DSME dengan metode group WhatsApp. Kata Kunci        : Ceramah, Diabetes mellitus, DSME, Media sosial (grup WhatsApp), Self Care Behavior

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