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"Stroke menjadi penyebab utama kecacatan dan penyebab kematian kedua di dunia. Sebanyak 87% kasus stroke yang terjadi merupakan stroke iskemik. Stroke merupakan penyakit neurologis yang dapat menyebabkan hilangnya kemampuan fungsi motorik pada sebagian atau seluruh bagian ekstremitas sebagai akibat kelemahan pada salah satu anggota tubuh yang disebut dengan hemiparese. Hemiparese yang tidak tertangani dapat menurunkan kualitas hidup klien paska perawatan stroke. Terapi yang dilakukan pada pasien stroke adalah latihan motoric yang bertujuan untuk mengembangkan, memelihara, dan memulihkan pergerakan. Salah satu latihan yang dapat diberikan terhadap klien stroke iskemik dengan hemiparese yaitu latihan RPS (Rentang Pergerakan Sendi) aktif asistif dengan menggunakan bola karet yang bertujuan untuk meningkatkan rentang pergerakan sendi, meningkatkan fungsi dan kekuatan otot, serta mencegah kontraktur. Karya ilmiah ini bertujuan memberikan gambaran analisis asuhan keperawatan pada klien stroke iskemik dan latihan rentang pergerakan sendi menggunakan bola karet. Intervensi latihan rentang pergerakan sendi (RPS) dilakukan selama 4 hari, 7 kali latihan dengan durasi 15 menit. Hasil evaluasi menunjukkan adanya peningkatan kekuatan otot. Oleh karena itu, intervensi RPS menggunakan bola karet sangat penting dan direkomendasikan untuk diterapkan oleh perawat kepada klien stroke iskemik dengan hemiparese.

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Stroke is the leading cause of disability and the second leading cause of the death in the world. As many as 87% of case are ischemic stroke. Stroke is a neurological disease that can cause loss of motoric function ability to some or all part of extremities. Loss of motoric function ability caused by weakness in a part of exstremities call as hemiparese. Untreated hemiparese can reduce the quality of life after stroke treatment.

Therapy performed on stroke iskemik clientt is intended to develop, maintain and restore moton by motor exercise. One of exercise can be done for stroke ischemic clients with hemiparesis is by providing active assistif ROM (Range Of Motion) exercise using rubber aimed to increase the range of joint movement, improve muscle function and strength, and prevent contracture.

This paper aimed to provide on analyzed nursing care on an ischemic stroke client with hemiparese with Range of Motion using rubber ball. ROM intervention was done for 4 days, 7 times with duration as much as 15 minutes. The result showed an increased of muscle strength. Therefore, ROM exercise is very important and recommended to be applied by nurse to stroke ischemic clients with hemiparesis."

"This book investigates the ways in which the evidence base is influencing complementary and alternative medicine in general and Ayurveda and allied health practices in particular. The latter have traditionally been prevalent in Asia and are now increasingly attracting interest worldwide. The book is divided into four sections, the first of which examines issues related to acquisition and evaluation of the evidence base. Evidence-based approaches to Ayurvedic diagnosis and therapy are then examined, with a special focus on management of cardiovascular and rheumatological diseases, dental care, and rejuvenating treatments. The final section explores further the challenges of applying evidence-based practice in contemporary and alternative medicine and Ayurveda with a focus upon the issues requiring urgent attention in ongoing decade. The same involves encompassing areas such as Ayurvedic pharmaceutics, practice, education and research within an evidence-based perspective."

"Apoteker adalah profesi yang memberikan pelayanan farmasi klinik dengan berorientasi pada pasien, bertujuan untuk meningkatkan hasil terapi obat dan mengurangi risiko efek samping. Dalam praktiknya, apoteker sebagai decision maker pada konsep 10-star pharmacist, diharapkan untuk mengambil keputusan yang baik, dimana hal tersebut dapat dicapai dengan pendekatan pengobatan berbasis bukti atau evidence-based medicine (EBM). Penggunaan bukti yang dapat diandalkan sangat penting dalam membuat keputusan terhadap terapi untuk pasien. Contohnya adalah pasien dengan penyakit kardiovaskular di Indonesia yang semakin berkembang, sedangkan tiap pasien memiliki kondisi unik yang mungkin memerlukan penanganan yang berbeda-beda. Keputusan penggunaan obat selalu mempertimbangkan kemanan dan khasiat, sehingga dapat meningkatkan kualitas hidup pasien dengan risiko yang minimal. Dalam laporan ini, jurnal tentang efek obat kardiovaskular oleh Ma et al., (2021) ditelaah secara kritis berdasarkan EBM, dan jurnal oleh Adesuyan et al., (2022) dirangkum. Telaah kritis jurnal tentang efek obat kardiovaskular yang mengacu pada appraisal tools oleh Critical Appraisal Skills Programme (CASP). Hasil dari telaah kritis jurnal oleh Ma et al., (2021) menegaskan keandalan data studi, namun diperlukan penelusuran lebih lanjut untuk memastikan keamanan penggunaan 4-5 obat kombinasi untuk mengatasi stroke iskemik dan serangan iskemik transien pada populasi Indonesia. Ringkasan tinjauan sistematis dari Adesuyan et al., (2022) menunjukkan bahwa obat antihipertensi golongan angiotensin receptor blocker (ARB) dapat secara signifikan mengurangi risiko Alzheimer's disease, dengan analisis sensitivitas dan heterogenitas yang tinggi sebagai penegasnya.

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A pharmacist is a profession who provides patient-oriented clinical pharmacy services, aiming to improve the results of drug therapy and reduce the risk of side effects. In practice, pharmacists as decision-makers in the 10-star pharmacist concept, are expected to make good decisions, which can be achieved through an evidence-based medicine (EBM) approach. The use of reliable evidence is essential in making therapeutic decisions for patients. For example, with the increasing prevalence of cardiovascular disease in Indonesia, each patient may have unique conditions that require individualized treatment. Decisions regarding drug use always consider safety and efficacy to enhance the patient's quality of life with minimal risk. In this report, a journal about the effects of cardiovascular drugs by Ma et al., (2021) is critically appraised based on EBM, and a journal by Adesuyan et al., (2022) is summarized. Critical appraisal of journal on the effects of cardiovascular drugs referring to appraisal tools by the Critical Appraisal Skills Program (CASP). The results of a critical appraisal of the journal by Ma et al., (2021) confirm the reliability of the study data, but further investigation is needed to ensure the safety of using 4-5 combination drugs to treat ischemic stroke and transient ischemic attacks in Indonesian population. The systematic review journal summary from Adesuyan et al., (2022) shows that angiotensin receptor blocker (ARB) antihypertensive drugs can significantly reduce the risk of Alzheimer's disease, with high sensitivity and heterogeneity analysis as confirmation."

"This book investigates the ways in which the evidence base is influencing complementary and alternative medicine in general and Ayurveda and allied health practices in particular. The latter have traditionally been prevalent in Asia and are now increasingly attracting interest worldwide. The book is divided into four sections, the first of which examines issues related to acquisition and evaluation of the evidence base. Evidence-based approaches to ayurvedic diagnosis and therapy are then examined, with a special focus on management of cardiovascular and rheumatological diseases, dental care, and rejuvenating treatments. The final section explores further the challenges of applying evidence-based practice in contemporary and alternative medicine and Ayurveda with a focus upon the issues requiring urgent attention in ongoing decade. The same involves encompassing areas such as Ayurvedic pharmaceutics, practice, education and research within an evidence-based perspective."

"[ABSTRAKTujuan penelitian ini yaitu mengembangkan intervensi model adaptasi paska stroke serta mengidentifikasi efektifitasnya terhadap perilaku adaptasi dan kualitas hidup pasien paska stroke. Penelitian ini secara keseluruhan dilakukan dalam dua tahap. Tahap satu yaitu pengembangan model intervensi yang diawali dengan penelitian kualitatif menggunakan pendekatan fenomenologi deskriptif tentang pengalaman pasien beradaptasi paska stroke. Model intervensi kemudian dikembangkan dengan cara mengintegrasikan tema hasil penelitian kualitatif, studi literatur, dan konsultasi pakar. Tahap kedua yaitu uji coba intervensi model untuk menentukan efektifitasnya terhadap respon adaptasi dan kualitas hidup pasien paska stroke. Penelitian tahap dua merupakan penelitian kuasi eksperimen menggunakan desain post test control group. Metode sampling yang digunakan dalam penelitian tahap dua yaitu consecutive sampling dengan jumlah sampel 65 orang (32 orang kelompok intervensi dan 33 orang kelompok kontrol). Pembagian sampel ke dalam kelompok intervensi dan kontrol dilakukan dengan matching rumah sakit. Hasil penelitian tahap satu teridentifikasi 9 tema yang dinyatakan partisipan dan dihasilkan intervensi model adaptasi paska stroke (IMAPS) beserta perangkatnya meliputi buku panduan intervensi model, modul untuk perawat pelaksana, dan booklet untuk pasien dan keluarga. Hasil penelitian tahap dua membuktikan adanya perbedaan respon adaptasi fisiologis, adaptasi psikososial, dan kualitas hidup yang bermakna antara pengukuran 3 bulan dengan 4 bulan sesudah intervensi diantara kelompok intervensi dan kontrol. Kesimpulan hasil penelitian yaitu intervensi model adaptasi paska stroke efektif meningkatkan respon adaptasi fisiologis, adaptasi psikososial dan kualitas hidup paska stroke.;

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ABSTRACTThe purpose of this research was to develop intervention adaptation model for post-stroke (IMAPS) and identify its effectiveness on adaptation response and quality of life after stroke. This study conducted in two stages. The first stage was the development of intervention model that begins with a qualitative research using a descriptive phenomenological approach. Intervention model was then developed by integrating the results of qualitative research, literature review, and expert review. The second stage was examination the intervention model to identified its effectiveness on adaptation response and quality of life after stroke. This study was quasi-experimental research using post test control group design. The sampling method used in this study was consecutive sampling with a sample of 65 stroke patient (32 samples in intervention group and 33 samples in control group). Samples were allocated to intervention and control group by matching the hospital. The qualitative study identified nine theme stated by the participants. Qualitative themes serve as guidelines for developing intervention model. The first stage resulted in intervention model and its devices include intervention manual, module for nurses, and booklet for patients and their families. The second stage of research proves the significant difference in physiological and psychosocial adaptation response, and quality of life between measurements 3 months to 4 months after the intervention between groups. We conclude that IMAPS effectively improve the response of physiological and psychosocial adaptation, and quality of life after stroke;The purpose of this research was to develop intervention adaptation model for post-stroke (IMAPS) and identify its effectiveness on adaptation response and quality of life after stroke. This study conducted in two stages. The first stage was the development of intervention model that begins with a qualitative research using a descriptive phenomenological approach. Intervention model was then developed by integrating the results of qualitative research, literature review, and expert review. The second stage was examination the intervention model to identified its effectiveness on adaptation response and quality of life after stroke. This study was quasi-experimental research using post test control group design. The sampling method used in this study was consecutive sampling with a sample of 65 stroke patient (32 samples in intervention group and 33 samples in control group). Samples were allocated to intervention and control group by matching the hospital. The qualitative study identified nine theme stated by the participants. Qualitative themes serve as guidelines for developing intervention model. The first stage resulted in intervention model and its devices include intervention manual, module for nurses, and booklet for patients and their families. The second stage of research proves the significant difference in physiological and psychosocial adaptation response, and quality of life between measurements 3 months to 4 months after the intervention between groups. We conclude that IMAPS effectively improve the response of physiological and psychosocial adaptation, and quality of life after stroke, The purpose of this research was to develop intervention adaptation model for post-stroke (IMAPS) and identify its effectiveness on adaptation response and quality of life after stroke. This study conducted in two stages. The first stage was the development of intervention model that begins with a qualitative research using a descriptive phenomenological approach. Intervention model was then developed by integrating the results of qualitative research, literature review, and expert review. The second stage was examination the intervention model to identified its effectiveness on adaptation response and quality of life after stroke. This study was quasi-experimental research using post test control group design. The sampling method used in this study was consecutive sampling with a sample of 65 stroke patient (32 samples in intervention group and 33 samples in control group). Samples were allocated to intervention and control group by matching the hospital. The qualitative study identified nine theme stated by the participants. Qualitative themes serve as guidelines for developing intervention model. The first stage resulted in intervention model and its devices include intervention manual, module for nurses, and booklet for patients and their families. The second stage of research proves the significant difference in physiological and psychosocial adaptation response, and quality of life between measurements 3 months to 4 months after the intervention between groups. We conclude that IMAPS effectively improve the response of physiological and psychosocial adaptation, and quality of life after stroke]"

"Persepsi keluarga terhadap kualitas hidup pasien stroke menjadi penting karena cara keluarga merawat dan memperlakukan pasien stroke akan sangat bergantung pada persepsinya terhadap kemampuan pasien, Perilaku pasien tergantung pada persepsi tentang kualitas hidupnya sendiri dan bagaimana pasien berespons terhadap stimulus dari lingkungannya.Tujuan penelitian ini adalah membandingkan persepsi pasien, pasangan dan analmya tentang kualitas hidup pasien pasca stroke yang dirawat dirumah dan bagaimana koping pasien bila menghadapi persepsi tersebut. Aspek yang digunakan untuk menilai kualitas hidup yang berkaitan dengan kesehatan pasien pasca stroke adalah status dan fungsi fisik, status psikologis, fungsi sosial serta gejala yang berkaitan dengan penyakit dan terapi. Koping pasien diukur dengan menilai strategi koping yang digunakan pasien terhadap penilaian kualitas hidupnya; baik oleh diri sendiri, pasangan maupun anakya.Disain penelitian yang digunakan adalah multi metode (mixed methode); yang merupakan gabungan metode kuantitatif dan kualitatif. Responden penelitian kuantitatif adalah pasien pasca stroke, pasangan dan anaknya yang berjumlah 93 orang sedangkan informan/subyek penelitian kualitatif adalah 12 orang diantaranya Data kuantitatif dianalisis menggunakan metode univariate analysis dan data kualitatif menggunakan manifest content analysis.Hasil penelitian menunjukkan secara kualitatif pasien dan pasangannya mempersepsikan kualitas hidup pasien adalah tinggi yang berarti pasien mampu beradaptasi dengan dampak penyakitnya atau rnengarah pada kesembuhan sedangkan anak pasien menganggap kualitas hidup pasien pada level sedang; artinya pasien belum sepenuhnya mampu beradaplasi dengan penyakitnya atau belum rnengarah pada kesembuhan.Hasil penelitian secara kualitatif temyata tidak sesuai dengan hasil kuantitatif karena hasil wawancara menyatakan pasien masih mempunyai mengalami banyak keterbatasan fisik, masalah psikososial dan gejala penyakit yang jelas. Strategi koping yang digunakan pasien terhadap kondisi stroke maupun persepsi diri tentang kualitas hidupnya adalah emotion atau problem focused coping dan campuran dari emotion dan problem focused coping."

"Latar belakang : Stroke masih merupakan penyebab kematian ketiga setelah penyakit jantung koroner dan kanker. Kematian karena perdarahan intraserebral dalam 7 hari pertama masih tinggi. Banyak faktor yang berpengaruh dan dapat dilakukan intervensi pada perawatan khusus.Tujuan : Mengetahui faktor faktor prognostik kematian dini di RSUD R Syamsudin SH Sukabumi.Bahan dan Cara : Pasien yang ikut penelitian ini adalah pasien stroke dengan perdarahan intraserebral yang dirawat di RSUD R Syamsudin SH yang memenuhi kriteria inklusi sejak 1 Januari 2005 sampai 30 Juni 2006.Metode : Penelitian kohort prospektif dan dianalisis dengan analisis survival.Hasil : Dari 117 pasien perdarahan intra serebral didapatkan kematian dini sebanyak 26,5%. Variabel yang sangat berpengaruh sebagai faktor prognosis kematian dini perdarahan intraserebral adalah gangguan kesadaran HR= 4,31 Interval Kepercayaan (2,0-9,19) p{1,000 sedangkan volume perdarahan HR=5,3 Interval Kepercayaan (2,34-11,9) p=0,000 serta kadar gula darah HR= 2,15 Interval Kepercayaan (0,99-4,65) p=0,051.Kesimpulan : Kematian karena perdarahan intra serebral masih cukup tinggi yaitu 26,5%. Perlu penanganan segera faktor yang sangat berpengaruh terhadap terjadinya kematian dini yaitu gangguan kesadaran, gula darah, dan volume perdarahan sehingga dapat menurunkan angka kematian.

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Background: Stroke is still known as the third leading cause of death after coronary heart disease and cancer. Death due to intra-cerebral hemorrhage in the first 7 days is having high rote. Many factors are able to influence the incidence, although it can he inter vent through special care.

Objectives: To find out prognostic factors on early death due to infra-cerebral hemorrhage at the District General Hospital of R. Syanisudin SH (DGH-RS) at Kota Sukabumi.

Objects and Technique: Respondents involved in the study are stroke patients that suffer with infra-cerebral hemorrhage. The patients are being treatment at the DGH-RS and have fulfilled the inclusion criteria of the study, from 1st `January 2005 until 30rd June 2006.

Method: The study is a prospective cohort study and is analyzed by using survival analysis.

Results: Of 117 patients with intro-cerebral hemorrhage, an early death has occurred at 26.5%. The most influence variables, as prognostic factor to early death of infra-cerebral hemorrhage, are: consciousness disorders HR= 4.31 Confidence interval (2.0 - 9.19) p= 0.000, blood depletion volume HR= 5.3 Confidence interval (2.34 - 11.9) p= 0.000, and blood sugar level l-IR= 2.15 Confidence Interval (0.9[9 - 4.65) p= 0.051.

Conclusion: The rate of death as a result of infra-cerebral is still high, i.e. 26.5%, There is an urgent need on controlling those factors affected the incidence of early death, namely consciousness disorders, blood sugar, and blood depiction volume, in order to decrease the death rate."

"Tujuan: Penelitian ini bertujuan untuk mengetahui besarnya risiko stroke berulang pada pasien paska stroke pertama di RS Pusat Otak Nasional dan faktor risikonya. Metode: Desain penelitian ini adalah cohort retrospektif. Sampel dalam penelitian ini adalah semua pasien stroke serangan pertama yang menjalani pelayanan rawat inap pada tahun 2014 dan memiliki catatan rekam medik yang lengkap. Analisis data mengunakan regresi cox multivariat. Hasil: Hasil penelitian menunjukkan bahwa pada bulan ≤ 15,umur ≥ 60 tahun memiliki risiko lebih besar untuk terjadinya stroke berulang ; pada bulan < 15, overweight memiliki risiko lebih tinggi untuk terjadinya stroke berulang; pada bulan ≤ 15, obesitas memiliki risiko lebih tinggi untuk terjadinya stroke berulang; pada bulan ≤ 30, pre hipertensi memiliki risiko lebih tinggi untuk terjadinya stroke berulang ; pada bulan ≤ 15, hipertensi grade 1 dan 2 memiliki risiko yang lebih tinggi untuk terjadinya stroke berulang, ; kontrol yang tidak teratur memiliki risiko 8,71 kali lebih tinggi untuk terjadinya stroke berulang.

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Objective: This study aims to determine the risk of recurrent strokein patients with post-stroke first in the brain center of the national hospitaland the risk factors that influence.

Methods: This study was a retrospective cohort. The sample in this study is the first to attack all stroke patients who underwent inpatient services in 2014 and had a complete medical record. Analysis of data using multivariate cox regression.

Results: The results showed that in ≤ 15, ≥ 60 years of age have a greater risk for recurrent stroke; in <15 overweight have a higher risk for recurrent stroke; in ≤ 15, obesity have a higher risk for recurrent stroke; in ≤ 30, pre-hypertension are at higher risk forrecurrent stroke; in ≤ 15, hypertension grade 1 and 2 have a higher risk for the recurrent stroke; control irregular had 8.71 times higher risk for recurrent stroke."