Semi-Fowler Position Increasing Oxygen Saturation in Non-Hemorrhagic Stroke Patients: A Quasi-experiment Study
DOI:
https://doi.org/10.69606/jps.v3i03.294Keywords:
oxygen saturation, semi fowler, strokeAbstract
Background: Stroke is a disruption of blood and oxygen flow to the brain that represents a major global and national health problem, causing hypoxia and cerebral injury due to obstruction or rupture of cerebral blood vessels, with risk factors including hypertension, lifestyle, and diet. Prompt management is essential, one of which is the 30° semi-Fowler position, which is believed to improve oxygenation. Aims: aimed to analyze the effect of the 30° semi-Fowler position on increasing oxygen saturation in non-hemorrhagic stroke patients at Dr. Rehatta Regional Hospital, Central Java Province. Method: The research design was a quasi-experiment without a control group, conducted in June–July 2025 with a total of 20 respondents using a total sampling technique. Inclusion criteria were patients diagnosed with stroke by a physician, level of consciousness 12–15, and hospitalized, while exclusion criteria were patients with mechanical ventilators. The research instrument was a Nihon Kohden oximeter, type 68042-17 BSM, calibrated in advance. The intervention consisted of the 30° semi-Fowler position for 30 minutes, carried out twice daily for two days (a total of four sessions). Oxygen saturation (SpO₂) was measured at minutes 0, 15, and 30, along with vital signs monitoring. Data analysis using the Wilcoxon Test showed a significant difference in SpO₂ values before and after the intervention (p<0.000; p<0.05). Result: The results demonstrated that the 30° semi-Fowler position effectively increases oxygen saturation in non-hemorrhagic stroke patients. The implication of this study is the need for hospitals to develop standard operating procedures (SOPs) for the application of the 30° semi-Fowler position in non-hemorrhagic stroke patients, especially in Intensive Care Units, as an evidence-based independent nursing intervention to improve the quality of care and patient safety.
References
Fadlilah, S., Hamdani Rahil, N., & Lanni, F. (2020). Analysis of Factors Affecting Blood Pressure and Peripheral Oxygen Saturation (SpO2). Kusuma Husada Health Journal, Sp(2), 21-30. https://doi.org/10.34035/jk.v11il.408.
Faridah, U. (2019). The Effect of the Side-lying Position on Pressure Ulcers in Patients. 10(1), 155-162. https://doi.org/10.26751/jikk.v10i1.632
Hardika, B. D., Yuwono, M., & Zulkarnain, H. M. (2020). Risk Factors Influencing the Occurrence of Non-Hemorrhagic Stroke in Patients at RK Charitas Hospital and Myria Hospital, Palembang. 9(2), 268-274. https://doi.org/10.36565/jab.v9i2.234.
Hutagalung & Puspitasari (2021). Overview of Nursing Care for Non-Hemorrhagic Stroke Patients with Swallowing Disorders in the Sahadewa Ward, Sanjiwani Regional Hospital, Gianyar, in 2018. 1-23.
Ministry of Health & Republic of Indonesia. 2018. What are the Dangers of Stroke?Https://P2ptm.Kemkes.Go.Id/Infographic-P2ptm/Stroke/Apa-Saja-Bahaya-Stroke-Stroke-yuk-Simak-Bag2#:-:Text=Yuk%2c%20simak%20bag.2,-Oleh%20%3a%20p2ptm%20kemenkes%Text=Stroke%20juga%20dapat20mengakibatkan%20rusaknya,Anggota%20tubuh%20lainnya%20bekerja.
Ministry of Health of the Republic of Indonesia. 2023. Prevalence of Non-Hemorrhagic Stroke Patients.https://databoks.katadata.co.id/ekonomi-makro/statistik/669fec0f74a33/10-provinsi-dengan-prevalensi-stroke-tertinggi-nasional-2023
Kusuma, U., & Surakarta, H. (2023). Oxygenation Needs in Stroke Patients. 1-11.
Mahendra, D. (2024). Oxygen Administration and Head Up Position Intervention 30° in Stroke Patients With Ineffective Cerebral Perfusion Problems in the Emergency Department of Budhi Asih Regional Hospital, Jakarta: Case Study. 10(2), 123-131. https://doi.org/10.34005/afiat.v10i2.4349
Mustikarani, A., & Mustofa, A. (2020). Increasing Oxygen Saturation in Stroke Patients by Providing a Head-Up Position. Young Nurses, 1(2), 114.https://doi.org/10.26714/nm.vli2.5750
Nugraheni, F., & Anita, D. C. (2025). Nursing Case Study: Physical Mobility Disorders in Non-Hemorrhagic Stroke Patients. Nursing Case Study: Physical Mobility Disorders in Non-Hemorrhagic Stroke Patients. 3, 532-539.
Pertami, S. B., Munawaroh, S., & Dwi Rosmala, N. W. (2019). The Effect of 30 Degree Head Elevation on Oxygen Saturation and Sleep Quality of Stroke Patients. Health Information : Research Journal, 11(2), 133-144. https://doi.org/10.36990/hijp.v11i2.133
Pratiwi, F. E., Setiyawan, & Sulistyawati, R. A. (2020). Oxygen saturation in critically ill patients in the head-up position: A literature study. Doctoral Dissertation, Kusuma Husada University Surakarta, 47, 1-14.
Riberholt, C. G. (2023). Analysis of Risk Factors for Stroke and Stroke Types. Faletehan Health Journal, 10(01), 48-53. https://doi.org/10.33746/fhj.v10i01.410
Riskesdas 2019: Ministry of Health of the Republic of Indonesia. (2019). Basic Health Research 2019.
Riskesdas. (2023). National report of Riskesdas 2023. Publishing Institute of Balitbangkes, Ministry of Health of the Republic of Indonesia, Health Research and Development Agency. https://books.google.co.id/books?id=xzJtzgEACAAJ
Dr. Rehatta Regional Hospital. (2021). Rehatta Regional Hospital Register. 2021. Hospital Information System. Top 10 inpatient diseases.
Sands, E., Wong, L., Lam, M. Y., Panerai, R. B., Robinson, T. G., & Minhas, J. S. (2020). The Effects of Gradual Change in Head Positioning on the Relationship between Systemic and Cerebral Hemodynamic Parameters in World Health Organization. (2022). Stroke, cerebrovascular accident. Stroke. DOI: http://www.who.int/topics/cerebrovascular_accident/en/index.html.
Setyarini, Elizabeth Ari, Agnes Monica, Friska Sinaga, F.x. Widiantoro, Lidwina Triastuti Listianingsing, and Cindiana Cecilia. 2023. “Illness Perception and Self-Management of Elderly With Hypertension.” Malaysian Journal of Medicine and Health Science 19 (Supplement 9): 97-101. DOI: 10.47836/MJMHS.19.S9.14.
Sholekhah, E. M., & Suyanto, S. (2023). Head-Up Position Can Increase Oxygen Saturation in Stroke Patients: Literature Review. Madago Nursing Journal, 4(2), 161-169. https://doi.org/10.33860/mnj.v4i22470
Syahfitri, D., Perangin-angin, R. E. P., & Oksigen, S. (2024). Application of the Head Up Position 30° to Increase Oxygen Saturation in Hemorrhagic Stroke Patients at Vita Insani Hospital, Pematangsiantar. 1(3), 267-273. https://doi.org/10.31004/science.v1i3.47
Tunik, A. K. A. R. N. (2022). Post-Hospitalization Care: Stroke Patients Undergoing Immobilization. Media Nusa Creative (MNC Publishing). https://books.google.co.id/books?id=-T1W3EAAAQBAJ
Trisila, E., Mukin, F.A., & Dikson, M. (2022). The Effect of 30 Degree Head-Up Position on Oxygen Saturation in Stroke Patients. Ferawati, Rita, I., & Ida, Y. (2021). Stroke: Not the End of Everything (Prevent and Treat Early). GUEPEDIA. https://books.google.co.id/books?id=CQtMEAAAQBAJ
Utami, S., & Risca, F. (2021). Providing a Semi-Fowler Position at 30° on Oxygen Saturation of Covid-19 Patients at K.R.M.T. Wongsonegoro Regional Hospital, Semarang. Proceedings of the National Seminar UNIMUS, 4, 1378-1387. Retrieved from: https://prosiding.unimus.ac.id/index.php/semnas/article/view/910
WHO. Ageing and health (Internet). WHO. 2022 (cited 2024 Sep 26). Available from: https://www.who.int/news-room/fact-sheets/detail/ageing-and-health
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Muhamad Jauhar, Fitri Yuliastuti, Umi Faridah, Thanslechumy Kanan
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
