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"Latar BelakangGangguan kepribadian ambang (GKA) berhubungan dengan masalah interpersonal, ketidakstabilan emosi, masalah citra diri, dan impulsif dengan risiko tinggi perilaku bunuh diri. Saat ini, masih kekurangan data prevalensi GKA di Indonesia. Oleh karena itu, penelitian ini akan memberikan data pasien GKA di RSCM dan mengevaluasi kepatuhan penatalaksanaan GKA terhadap Panduan Praktik Klinis (PPK).MetodePenelitian ini akan berbentuk studi deskriptif retrospektif potong-lintang dan dilakukan menggunakan data sekunder berupa rekam medis yang didapat dari klinik psikiatri pasien dewasa RSCM. Evaluasi akan ditinjau dengan menggunakan formulir kepatuhan PPK yang dikembangkan oleh RSCM dan dianalisis secara kuantitatif dan kualitatif.HasilSebagian besar pasien GKA yang dirawat di rumah sakit berada dalam kelompok usia 18 hingga 29 tahun, yaitu 88,9% dari total sampel. Sebagian besar pasien GKA yang dirawat di RSCM adalah perempuan sebanyak 91,7% (33 dari 36) pasien. Sebagian besar pasien memiliki gangguan bipolar (69,4%) sebagai diagnosis Axis 1, atau gangguan depresi (27,8%). Sebanyak 94,5% pasien mendapatkan antipsikotik atipikal. Semua pasien (100%) dalam penelitian ini menunjukkan ketaatan yang lengkap terhadap parameter struktural dan proses, yaitu mengikuti lebih dari 80% aspek yang diuraikan dalam PPK. Namun, hanya 24 pasien (66,7%) yang memenuhi kriteria respons yang baik, termasuk skor risiko bunuh diri rendah dan tidak terjadi insiden.KesimpulanSebagian besar pasien GKA yang dirawat di RSCM adalah perempuan dewasa muda. Terdapat tingkat kepatuhan tinggi terhadap PPK pada pasien GKA rawat inap RSCM.

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Introduction

Borderline personality disorder (BPD) is associated with interpersonal problems, emotional instability, self-image issues, and impulsivity with a high risk of suicidal behavior. There are no BPD prevalence data in Indonesia. Therefore, this research will provide data of BPD patients in RSCM and evaluate the adherence of the managements according to Clinical Practice Guideline (CPG).

Method

This will be a cross-sectional retrospective descriptive study and conducted using secondary data from database of department of psychiatry in RSCM. The evaluation will utilize the CPG’s adherence form and analyzed in quantitative and qualitative methods. Result

The majority of hospitalized BPD patients were in the age group of 18 to 29 years around 88.9% of the total sample. The population of hospitalized BPD patients mostly are females that accounts for 91.7% (33 of 36) of the patients. There are patients diagnosed with bipolar disorder (69.4%) and depressive disorder (27.8%). Most of BPD patients (94.5%) were administered atypical antipsychotics. All 36 patients (100%) in the study shows complete adherence to the structural and process parameters by following more than 80% of the aspects in the CPG. Despite the high level of adherence to the CPG, only 24 patients (66.7%) fulfilled good outcome criteria, including low suicide risk score and no incident.

Conclusion

Most of hospitalized BPD patients were young females. High level of adherence to the CPG was observed among hospitalized BPD patients in RSCM. Further study should identify the risk factors associated with poor treatment response."

"Musik memiliki banyak memiliki kegunaan, mulai dari mengekspresikan diri, terapi dan medium pembelajaran, dan memperbaiki emosi. Salah satunya adalah sarana latihan bagi para lansia untuk memperbaiki kemampuan kognitifnya yang berkurang karena usia. Dengan bertambahnya usia, kemampuan untuk mengingat, mempelajari, bersosialisasi, dan mengikuti gerakan akan semakin berkurang. Laporan ini akan membahas beberapa penelitian yang telah berhasil menggunakan musik dan olahraga sebagai alat untuk memperbaiki lansia yang telah mengalami penurunan kognitif.

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Music has many benefits, starting from self-expression, therapy and learning medium, and altering mood. One of them is a medium for older adults to exercise in order to improve their cognitive abilities which decrease with age. With increasing age, the ability to remember, learn, socialize, and follow movement diminishes. This report will discuss several studies that have successfully used music and exercise as tools to improve older people who have experienced cognitive decline."

"[ABSTRAKLatar Belakang. Obat Anti Epilepsi (OAE) generasi lama banyak digunakan di Rumah Sakit sebagai terapi epilepsi. Beberapa studi terdahulu telah mengonfirmasi bahwa terapi OAE generasi lama terasosiasi dengan penurunan rerata kadar serum asam folat. Penurunan kadar serum asam folat ini berhubungan dengan anemia, defisit kognitif, penyakit vaskular, kanker, gangguan psikiatri, aborsi spontan dan malformasi kongenital. Oleh karena itu, maka dilakukan penelitian mengenai kadar serum folat pada ODE yang menggunakan OAE generasi lama di Indonesia. Metode. Desain penelitian adalah potong lintang untuk mengetahui gambaran kadar serum asam folat ODE pengguna OAE generasi lama (fenitoin, fenobarbital, karbamazepin dan asam valproat) jika dibandingkan dengan populasi normal serta kaitan dengan asupan. Subyek penelitian sejumlah 75 orang didapatkan di poli rawat jalan RSUPN Cipto Mangunkusumo dan Yayasan Epilepsi Indonesia yang dibandingkan dengan 76 orang populasi normal. Dilakukan wawancara pola makan melalui metode food recall, pemeriksaan laboratorium kadar folat. Hasil. Didapatkan kadar rerata serum asam folat sebesar 9.95 + 3.61 ng/mL pada ODE pengguna OAE generasi lama. Populasi normal didapatkan kadar rerata 4.59 + 2.4 ng/mL (p=<0.001). Rerata asupan diet setara folat kelompok studi 119.7 (28.4-340) microgram, kelompok kontrol 104.65 (38-510) microgram (p=0.095). Simpulan. Rerata kadar serum asam folat ODE yang menggunakan OAE generasi lama lebih tinggi dari rerata kadar serum asam folat populasi normal secara bermakna. Hanya terdapat 2,7% ODE dengan kadar asam folat rendah secara bermakna. Tidak ada perbedaan bermakna antara jumlah asupan diet folat dengan klasifikasi kadar serum asam folat pada ODE.

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ABSTRACTBackground. Antiepileptic drugs (AEDs) are frequently used in the treatment of epilepsy, psychiatric diseases, and pain syndromes. Studies have established that chronic anticonvulsant therapy can lead to folate deficiency. Anti-convulsant-induced folate deficiency has been associated with megaloblastic anemia, cognitive decline, vascular diseases, cancer, psychiatric comorbidity, spontaneous abortion and teratogenesis. Thus, patients with epilepsy are a suitable population to investigate the association of AED treatment with folate serum levels in comparison with normal population. Method. This is comparative cross-sectional study focusing on the level and intake of folate in relation with AED (phenytoin, phenobarbital, carbamazepine, valproic acid) in epileptic patients in outpatient clinic of Neurology Cipto Mangunkusumo General Hospital and Indonesia Epilepsy Foundation, with comparison to normal population. Seventy five epileptic patients and seventy six healthy people were recruited with food recall interview and their serum folate were measured. Results. The mean folate serum of study group were 9.95 + 3.61 ng/mL and the mean folate serum of control group were 4.59 + 2.4 ng/mL (p=<0.001). The mean dietary folate of study group were 119.7 (28.4-340) microgram and the mean dietary folate of control group 104.65 (38-510) microgram (p=0.095). Conclusion. The mean folate serum in study group were significant much more higher compare with the control group. As many as 2.7% of study group with significantly low folate serum level. There were no any significant association of dietary folate with folate serum classification of study group. ;Background.. Antiepileptic drugs (AEDs) are frequently used in the treatment of epilepsy, psychiatric diseases, and pain syndromes. Studies have established that chronic anticonvulsant therapy can lead to folate deficiency. Anti-convulsant-induced folate deficiency has been associated with megaloblastic anemia, cognitive decline, vascular diseases, cancer, psychiatric comorbidity, spontaneous abortion and teratogenesis. Thus, patients with epilepsy are a suitable population to investigate the association of AED treatment with folate serum levels in comparison with normal population. Method. This is comparative cross-sectional study focusing on the level and intake of folate in relation with AED (phenytoin, phenobarbital, carbamazepine, valproic acid) in epileptic patients in outpatient clinic of Neurology Cipto Mangunkusumo General Hospital and Indonesia Epilepsy Foundation, with comparison to normal population. Seventy five epileptic patients and seventy six healthy people were recruited with food recall interview and their serum folate were measured. Results. The mean folate serum of study group were 9.95 + 3.61 ng/mL and the mean folate serum of control group were 4.59 + 2.4 ng/mL (p=<0.001). The mean dietary folate of study group were 119.7 (28.4 ? 340) microgram and the mean dietary folate of control group 104.65 (38-510) microgram (p=0.095). Conclusion. The mean folate serum in study group were significant much more higher compare with the control group. As many as 2.7% of study group with significantly low folate serum level. There were no any significant association of dietary folate with folate serum classification of study group. , Background.. Antiepileptic drugs (AEDs) are frequently used in the treatment of epilepsy, psychiatric diseases, and pain syndromes. Studies have established that chronic anticonvulsant therapy can lead to folate deficiency. Anti-convulsant-induced folate deficiency has been associated with megaloblastic anemia, cognitive decline, vascular diseases, cancer, psychiatric comorbidity, spontaneous abortion and teratogenesis. Thus, patients with epilepsy are a suitable population to investigate the association of AED treatment with folate serum levels in comparison with normal population. Method. This is comparative cross-sectional study focusing on the level and intake of folate in relation with AED (phenytoin, phenobarbital, carbamazepine, valproic acid) in epileptic patients in outpatient clinic of Neurology Cipto Mangunkusumo General Hospital and Indonesia Epilepsy Foundation, with comparison to normal population. Seventy five epileptic patients and seventy six healthy people were recruited with food recall interview and their serum folate were measured. Results. The mean folate serum of study group were 9.95 + 3.61 ng/mL and the mean folate serum of control group were 4.59 + 2.4 ng/mL (p=<0.001). The mean dietary folate of study group were 119.7 (28.4 – 340) microgram and the mean dietary folate of control group 104.65 (38-510) microgram (p=0.095). Conclusion. The mean folate serum in study group were significant much more higher compare with the control group. As many as 2.7% of study group with significantly low folate serum level. There were no any significant association of dietary folate with folate serum classification of study group. ]"

"Latar belakang : Tidur berguna untuk kesehatan mental, emosi, fisik, dan sistemimunitas tubuh. Gangguan tidur pada anak semakin menjadi masalah karena akanberdampak pada mood, perilaku dan intelektual anak. Dilaporkan, insidensigangguan tidur pada anak lebih tinggi pada kasus epilepsi.Tujuan : Mengetahui prevalensi gangguan tidur pada anak dengan epilepsi, sertamenilai hubungan antara faktor-faktor risiko yang memengaruhinya kejadiangangguan tidur pada anak dengan epilepsi.Metode : Studi potong lintang yang dilakukan di Poliklinik Anak Kiara RS CiptoMangunkusumo Jakarta dengan populasi anak epilepsi usia 4-18 tahun. Penilainvariabel gangguan tidur menggunakan kuesioner sleep disturbance scale forchildren (SDSC) terdiri dari 26 pertanyaan yang telah tervalidasi sebelumnya.Kuesioner akan diisi oleh orang tua mengenai pola tidur anak dalam 6 bulanterakhir. Pasien yang sebelumnya memiliki gangguan tidur primer sepertiobstructive sleep apnea (OSA), sindrom epilepsi, disabilitas intelektual, attentiondeficit hyperactivity disorder (ADHD) akan dieksklusi.Hasil : Didapatkan 99 subyek dengan karakteristik 22,2% menderita epilepsiintraktabel, 28,2% serebral palsi dan 64,6% tipe kejang umum. Dari hasilkuisioner SDSC didapatkan 71,7% anak dengan epilepsi mengalami gangguantidur, jenis terbanyak 62% gangguan memulai dan mempertahankan tidur. Faktorrisiko yang terbukti memengaruhi secara independen kejadian gangguan tidurpada pasien epilepsi adalah tipe kejang umum, serebral palsi, epilepsi intraktabel,elektroensefalografi (EEG) abnormal, dan obat antiepilepsi (OAE) jenis nonbenzodiazepin.Kesimpulan : Tipe kejang umum, serebral palsi, epilepsi intraktabel,abnormalitas EEG, dan OAE jenis non-benzodiazepin bermakna secara statistikindependen memengaruhi kejadian gangguan tidur pada epilepsi.

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Background : Sleep is affecting mental health, emotional, physical, and immunesystem. Sleep disorder in children was increased and became a burden because itwill affect the mood, behaviour and intellectual. Reportedly, the incidence ofsleep disorder is higher in children with epilepsy.Objective : Knowing the prevalence of sleep disorder in children with epilepsy,and to assess the risk factors which affecting it.Methods : A cross-sectional study was conducted at children polyclinic CiptoMangunkusumo Hospital in Jakarta with populations of epilepsy children aged 4-18 years old. The assessment of sleep disorder using the sleep disturbance scalefor children (SDSC), which consist of 26 questions that had been previouslyvalidated. The questionnaire will be filled out by parents regarding the childssleep pattern in the past 6 months. Patients who had primary sleep disorders suchas obstructive sleep apnea (OSA), epilepsy syndrome, intellectual disabilities,attention deficit hyperactivity disorder (ADHD) will be excluded.Results : There were 99 subjects, with characteristics are 22.2% had intractableepilepsy, 28.2% had cerebral palsy and 64.6% generalized seizures. Theprevalence of sleep disorder in child with epilepsy in this study was 71.7%, themost frequent type was disorder of starting and maintaining sleep. Risk factorsthat have been shown to independently affecting the incidence of sleep disorder inepilepsy patients are generalized seizures, cerebral palsy, intractable epilepsy,electroencephalography (EEG) abnormality, and non-benzodiazepine typeantiepileptic drugs (AED).Conclusion : Generalized seizure, cerebral palsy, intractable epilepsy, EEGabnormality, and non-benzodiazepine type of AED are statistically significantaffecting the incidence of sleep disturbance in epilepsy independently."

"Pemerintah sebagai penyelenggara pelayanan memiliki kewajiban untuk menjamin segala bentuk pelayanan publik yang berkualitas termasuk dalam bidang kesehatan. Kesehatan yang dimaksud tidak hanya selalu mengenai kesehatan fisik, melainkan juga kesehatan jiwa yang akan menjadi fokus pembahasan dalam penelitian ini. Secara umum kesehatan jiwa dikaitkan dengan kondisi seorang yang mengalami masalah gangguan jiwa. Gangguan jiwa sendiri merupakan masalah kesehatan yang cukup serius sampai saat ini. Namun sayangnya, kesehatan jiwa belum menjadi fokus perhatian, baik dari pemerintah maupun masyarakat khususnya dalam hal pemenuhan layanan kesehatan dan rehabilitasi bagi para penderitanya. Salah satu daerah di Indonesia yang pernah menjadi daerah dengan jumlah penderita Orang Dengan Gangguan Jiwa berat se-Indonesia adalah Provinsi Bali. Skripsi ini membahas mengenai pelaksanaan pelayanan publik terkait pelayanan kesehatan dan pelayanan kesehatan jiwa khususnya bagi Orang Dengan Gangguan Jiwa berat di Provinsi Bali. Metode penelitian yang digunakan dalam penulisan ini adalah yuridis-normatif yang menekankan pada norma hukum dengan disajikan secara deskriptif dan analisis. Penelitian ini juga turut membahas peraturan- peraturan baik secara nasional maupun daerah terkait penanganan terhadap Orang Dengan Gangguan Jiwa. Hasil penelitian ini menyimpulkan para penyelenggara pelayanan kesehatan jiwa baik pihak fasilitas kesehatan, Dinas Kesehatan, Dinas Sosial termasuk Pemerintah Daerah sudah menjalankan kewajibannya dengan cukup baik walaupun belum sempurna. Perihal pelaksanaan layanan kesehatan dan rehabilitasi di fasilitas kesehatan jiwa yang tersedia juga sudah dilaksanakan dengan cukup baik dan sesuai dengan standar pelayanan serta ketentuan yang diatur dalam UU Kesehatan, UU Kesehatan Jiwa, UU Pelayanan Publik dan PERMENPAN Nomor 15 Tahun 2014. Namun dalam pelaksanaannya masih terdapat kendala yang menjadi penghambat dalam pemberian layanan seperti masalah transportasi yang kurang memadai, kurangnya pengetahuan masyarakat serta keterbatasan sarana fasilitas kesehatan. Atas kendala tersebut terdapat beberapa upaya optimalisasi yang dapat dilakukan khususnya bagi Pemerintah Daerah sebagai penyelenggara utama pelayanan publik.

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The government as a service provider has an obligation to ensure all forms of quality public services, including in the health sector. Health in question is not only about physical health, but also mental health which will be the focus of discussion in this study. In general, mental health is associated with the condition of a person experiencing mental disorders. Mental disorder itself is a health problem that is quite serious to date. But unfortunately, mental health has not become the focus of attention, both from the government and society, especially in terms of fulfilling health services and rehabilitation for sufferers. One of the areas in Indonesia that was once the area with the most sufferers of people with severe mental disorders in Indonesia is the Province of Bali. This thesis discusses the implementation of public services related to health services and mental health services, especially for people with severe mental disorders in the Province of Bali. The research method used in this paper is juridical-normative which emphasizes legal norms presented descriptively and analytically. This research also discusses regulations both nationally and regionally related to the treatment of people with mental disorders. The results of this study concluded that mental health service providers, including facilities, office, the Social Service, including the Regional Government, had carried out their obligations quite well, although not yet perfect. Regarding the implementation of health and rehabilitation services in available mental health facilities, they have also been carried out quite well and in accordance with service standards and provisions stipulated in the Health Law, Mental Health Law, Public Service Law and PERMENPAN Number 15 of 2014. However, in practice there are still obstacles in providing services such as inadequate transportation problems, lack of public knowledge and limited health facilities. Due to these constraints, there are several optimization efforts that can be made, especially for the Regional Government as the main provider of public services."

"Pemasungan merupakan tindak pembatasan, pengekangan pada fisik maupun kehidupan sosial pada orang yang mengalami gangguan jiwa ODGJ . Seseorang dengan gangguan jiwa pada dasarnya memiliki keinginan untuk sembuh, namun untuk mencapai hal tersebut diperlukan lingkungan yang kondusif. Kenyataannya perlakuan keluarga justru menurunkan keinginan atau dorongan dari dalam diri ODGJ untuk mencapai sembuh. Keinginan ODGJ untuk dapat kembali sembuh sangat memerlukan motivasi atau dorongan yang kuat dari dalam diri sendiri. Penelitian ini adalah penelitian kualitatif dengan desain fenomenologi deskriptif. Pengumpulan data dilakukan dengan teknik wawancara mendalam kepada 12 partisipan. Terdapat lima yang dihasilkan dalam penelitian ini : Keinginan untuk menjalani hidup yang lebih baik, Pengendalian pikiran sebagai mekanisme koping dalam upaya pencapaian penyembuhan diri, Dampak pengalaman yang tidak menyenangkan sebagai motivasi untuk sembuh, Kontribusi kondisi pulih terhadap peningkatan konsep diri dan Perlawanan terhadap stigma agar tetap pulih. Tema-tema ini didukung oleh 19 kategori. Keinginan untuk dapat menjalani hidup yang lebih baik merupakan hal yang mendorong untuk ODGJ untuk memotivasi dirinya untuk dapat kembali pulih. Bentuk mekanisme koping yang berfokus pada pengendalian pikiran dan emosi ditambah dengan konsep diri yang positif, serta kondisi untuk melawan stigma dengan harapan dapat diterima di lingkungan sosial dapat membantu ODGJ paska pasung dalam membangkitkan motivasi ODGJ untuk dapat kembali sembuh.

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Confinement is an act of limiting and restraining an individual with mental health issues both physically and socially. A mental health patient fundamentally possess the aspiration to recover, but in order to achieve that, it takes a supportive environment. Ironically, family treatment towards the mental health patient decreases their hope to recover. The mental health patient wish to recover needs strong motivation and support from within themselves. This research was a qualitative research with descriptive phenomenology research design. Data collection conducted by in depth interview to 12 participants. There were 5 five themes produced on this research such as the aspire to have a better life, thought control as a coping mechanism on the effort to self recover, The impact of unpleasing experience as the motivating factor to recover, the recover state contribution to the increasing self concept, and against the stigma to maintain health. This themes supported by 19 categories. The aspire to have a better life was prompting mental health patient to motivate themselves to recover. Focused on thought and emotion controlling coping mechanism added by positive self concept and the against the stigma condition with the hope for the society acceptance helped post confinement mental health patient to increase the motivation on recovering."