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"ABSTRAKPasien stroke akut sering mengalami hemiparese dan hemiplegi khususnya pada ekstremitas atas. Menimbulkan kelemahan motorik dan penurunan rentang gerak bahu, yang beresiko menyebabkan nyeri bahu dan kontraktur. Pencegahan dapat dilakukan dengan pemberian posisi yang tepat. Tujuan penelitian adalah untuk mengetahui efektifitas pemberian posisi bahu selama 30 menit dan 45 menit terhadap rentang gerak bahu. Penelitian ini merupakan penelitian quasi eksperiment yang melibatkan 32 responden. Hasil penelitian menunjukan tidak ada perbedaan rerata rentang gerak bahu pada pemberian posisi 30 menit dan 45 menit p=0,334 . Peningkatan lama pemberian posisi pada bahu selama 45 menit, dapat mempertahankan rentang gerak bahu.

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ABSTRACTAcute stroke patients frequently experienced hemiparese and hemiplegi especially in the upper limbs, that cause motor weakness and decreases in ROM of the shoulders, risk of shoulders pain and contractures. Prevention can be performed by assigning the right position. The research objective was to determine the effectiveness of the position of the shoulders for 30 minutes and 45 minutes to the ROM of the shoulders. This research is a quasi experiment with pre post test design involving 32 respondents. The results showed that there were no differences between the mean ROM of the shoulders in the delivery position 30 minutes and 45 minutes p 0.334 . This study suggested that increased in the duration of the position of the shoulders for 45 minutes, can to maintain the ROM of the shoulders."

"[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]"

"Latar Belakang: Stroke merupakan penyakit yang memiliki perbedaan karakteristik antara pria dan wanita. Tujuan: Penelitian bertujuan untuk mengetahui hubungan jenis kelamin dengan fungsi kognitif yang dinilai menggunakan uji Montreal Cognitive Assesment versi Indonesia MoCA-Ina pada pasien stroke fase subakut dan kronik di Departemen Rehabilitasi Medik RSCM, dengan melakukan kontrol terhadap variabel perancu berupa tingkat pendidikan dan usia. Metode: Penelitian merupakan studi observasional analitik dengan desain potong lintang. Sampel penelitian sebanyak 34 subjek, diperoleh melalui teknik consecutive sampling. Analisis bivariat uji Mann-Whitney dan uji korelasi Pearson dilakukan untuk melihat hubungan antarvariabel, dan dilanjutkan dengan analisis multivariat regresi linier. Hasil: Berdasarkan uji Mann-Whitney diperoleh nilai p hubungan jenis kelamin dan tingkat pendidikan dengan skor MoCA-Ina sebesar 0,103 dan 0,076. Nilai korelasi hubungan usia dengan skor MoCA-Ina berdasarkan uji korelasi Pearson sebesar r=0,135 p=0,447 . Persamaan regresi skor MoCA-Ina=21,268-3,620 Wanita 3,762 Pendidikan Tinggi R2=8,6 . Perbedaan rerata skor MoCA-Ina antara pria dan wanita setelah dilakukan kontrol variabel tingkat pendidikan adalah sebesar -3,620 IK95 =-8,928-1,058 , namun secara statistik tidak bermakna p=0,125. Diskusi: Tidak ada perbedaan signifikan pada fungsi kognitif yang dinilai menggunakan MoCA-Ina antara pasien stroke sub-akut dan kronik pria dan wanita.

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Background: Stroke is a disease with different characteristics between men and women.

Objective: This study aims to determine the age and level of education adjusted relationship between gender and cognitive function which is assessed by Montreal Cognitive Assessment in sub acute and chronic stroke patients in the Department of Rehabilitation Medicine RSCM.

Methods: This study is an analytic observational study with a cross sectional design. 34 subjects were selected as samples with consecutive sampling method. Mann Whitney test and Pearson's correlation test were used in to determine the bivariate relationships between the variables, proceeded by a multivariate linear regression analysis.

Results: Based on the Mann Whitney test, the p value of the relationship between gender and the level of education and MoCA Ina score were p 0,103 and p 0,076 respectively. Correlation value between age and MoCA Ina score was r 0,135 p 0,447. The regression equation generated was MoCA Ina score 21,268 3,620 Women 3,762 Higher Education R2 8,6. The mean difference of MoCA Ina score between men and women stroke patients after adjusting for age and level of education was 3,620 CI 95 8,928 1,058, but it was statistically insignificant p 0,125.

Discussion: There was no significant difference in the cognitive function which is assessed by MoCA Ina between the male and female sub acute and chronic stroke patients."

"LATAR EELAKANGKejadian stroke menimbulkan kerusakan sel otak. Berbagai faktor risiko telah dikenal meliputi faktor risiko mayor dan minor. Kadar magnesium endogen sebagai salah satu faktor risiko kerusakan set otak masih belum banyak dianalisa dengan berbagai hasil penelitian yang masih kontroversial.METODEPenelitian ini merupakan penelitian prospektif longitudinal (retreated measurement design) dengan data printer diperoleh dari penderita stroke iskemik yang berobat ke RSCM yang memenuhi kriteria inklusi dan eksklusi. Diagnosis stroke iskemik dilakukan melalui pemeriksaan klinis dan CT Scan atau MRI kepala. Dilakukan pemeriksaan laboratorium darah, analisa urin, EKG, dan foto thoraks pada saat masuk. Dilakukan pemeriksaan magnesium serum, plasma, eritrosit pada hari ke-2, ke-4 dan ke-7 dan skor NIHSS pada hari dan saat yang sama.HASILJumlah objek penelitian 53 orang. Sebagian besar rerata magnesium serum dan plasma dalam batas normal (1,4-2,0 mmEq/l) pada tiap hari pengambilan (Mg serum 67,9% - 90,6%, Mg plasma 75-5% - 88,7%) sedangkan ditemukan hipoMg eritrosit pada hari ke-4 dan ke-7 onset stroke (81,1 % dan 73,6%). Ditemukan hubungan sangat bermakna antara Mg serum dengan Mg plasma pada tiap hari pengambilan (p=0,000) dan hubungan bermakna antara Mg serum dengan Mg eritrosit (p=0,02) dan Mg plasma dan Mg eritrosit (p=0,033) pada hari ke-4. Ditemukan hubungan bermakna independen antara Mg plasma hari ke-4 dengan NIHSS hari ke-4 (p=0,005) di samping faktor risiko riwayat stroke /TIA, aritmia jantung dan hiperkoleslerolemia dengan NIHSS.KESIMPULANPenderita iskemik serebral menunjukkan perubahan kadar Mg serum, plasma, eritrosit yang dipengaruhi berbagai faktor risiko lain dan hubungan bermakna antara kadar Mg plasma dan skor NIHSS hari ke-4.KATA KUNCI: Stroke iskemik, hipertensi, magnesium serum, plasma, eritrosit, NIHSS.

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PREFACE

Stroke causes damage to brain cells. Many risk factors of stroke are known like mayor and minor risk factors. Endogen magnesium level as one of risk factor of brain cell damage is analyzed rarely with the controversially results of its studies.

METHOD

The design of this study was repeated measurement with its primary data were collected from ischemic stroke patients in Cipto Mangunkusumo hospital who fulfilled inclusion and exclusion criteria. Diagnosis of stroke was made by physical exam, CT scan or head MRI and completed by blood and urine analysis, echocardiography and chest photo. Serum, plasma and erythrocyte Mg were collected on the 2nd, 4th, aid 7th days after onset and compared with NIHSS scores at the same times.

RESULT

There are 53 persons of subjects studied. Almost all means of the serum Mg and plasma Mg were in normal limits (1,4-2,0 mEq/l) on every days of data collection (serum Mg : 67,6%-90,6%, plasma Mg : 75,5%-88,7%), but there were erythrocyte hipoMg on the 4th and 7th days of stroke onset (81,1% and 73,6%). There were very significant relationship between serum Mg with plasma Mg (p=0,000) on every days of data collection and significant relationship between serum Mg with erythrocyte Mg (p=0,02) and plasma Mg with erythrocyte Mg (p 1,033) on the 4th day onset. There were significant independent relationship between plasma Mg on the 4th day onset with NIHSS in the same day (p=0,005), besides between the history of stroke/TIA, aritmia and hypercholesterolemia with NIHSS.

CONCLUSION

Cerebral ischemic patients showed changes of serum, plasma and erythrocyte Mg levels which were influenced by other risk factors and there was significant relationship between plasma Mg and NIHSS score in the 4th day."

"Stroke merupakan kondisi emergency yang terjadi karena iskemi serebral, dengan penurunanaliran darah dan oksigen ke jaringan serebral yang dapat menyebabkan kerusakan otak yangpermanen bahkan sampai dengan kematian. Latar belakang dalam pengambilan kasusStroke dikarenakan terdapat 15 juta orang yang mengalami stroke setiap tahun danmerupakan penyebab kematian kedua diatas usia 60 tahun dan penyebab kematian kelimapada usia 15-59 tahun. Tujuan penelitian ini untuk mengetahui hubungan antara karakteristik,tingkat kecemasan dan ketergantungan dengan penerimaan diri pasien keterbatasan gerakakibat stroke. Hasil penelitian didapatkan terdapat hubungan karakteristik usia dan tingkatkecemasan dengan penerimaan diri pasien keterbatasan gerak akibat stroke. Hasil penelitian merekomendasikan Rumah Sakit umum sebagai pemberi layanan kesehatanyang berfokus pada pelayanan kesehatan fisik hendaknya juga meningkatkan layanankesehatan jiwa dalam memberika asuhan keperawatan yang komperhensif.

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Stroke is an emergency condition that occured as the cerebral ischemic, with decreased inblood flow and oxygen to the cerebral tissues that can caused permanent brain damaged andeven up to death, basic in decision Stroke cased because there are 15 million people whosuffered stroke each year and the second leading caused of death above the age of 60 yearsand the fifth leading caused of death at the age of 15 59 years.

The purpose of this study todetermine the relationship between the characteristics, the level of anxiety and selfacceptancedependence with reduced mobility as stroke patients.

The results showed there arerelation characteristics of the age and level of anxiety with self acceptance limitation ofmotion in stroke patient.

The results of the study recommended to general hospital as thehealth care provider that focuses on physical health services should be also improving mentalhealth services in providing a comprehensive nursing care. "

"Ansietas merupakan masalah psikososial yang banyak terjadi pada klien stroke. Ansietas yang tidak ditangani dapat menjadi penyulit bagi klien untuk mengikuti program pengobatan secara efektif dan memperlambat proses pemulihan. Salah satu psikoterapi yang dapat diberikan untuk mengatasi ansietas adalah Acceptance and Commitment Therapy (ACT). Penelitian ini bertujuan untuk mengetahui pengaruh ACT terhadap ansietas klien stroke yang dirawat di Rumah Sakit Stroke Nasional (RSSN) Bukittinggi. Desain penelitian yang digunakan adalah quasi experimental pre-post test with control group. Sampel penelitian berjumlah 60 orang dengan teknik pengambilan sampel consecutive sampling.Hasil penelitian menunjukkan ada perbedaan yang signifikan skor rata-rata ansietas antara kelompok yang mendapatkan ACT (intervensi) dengan kelompok yang tidak mendapatkan ACT (kontrol) p value=0,002 (P<0,05). ACT direkomendasikan untuk diterapkan sebagai terapi keperawatan untuk mengatasi ansietas pada klien stroke yang dirawat di rumah sakit umum.

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Anxiety is a psychological problem that experienced by patients with stroke. Untreated anxiety can be a serious barrier for the patient to follow an effective treatment program and also slowing down the recovery process. One of psychotherapy that can be provided to treat anxiety is Acceptance and Commitment Therapy (ACT).

The purpose of this study was to determine the effect of ACT towards stroke patient's anxiety who are hospitalized at the National Stroke Hospital Bukittinggi. This study used a quasi-experimental prepost test with control group design. The research sample consisted of 60 people with consecutive sampling technique.

The results of the study revealed that the significant difference of anxiety scores between the groups who received ACT (intervention) with the group without receiving ACT (control), p value=0.002 (P <0.05). ACT was recommended to be applied as a nursing therapy to overcome anxiety to the patient who are hospitalized in the general hospital."

"Unit Stroke (US) telah terbukti sangat baik dalam peawatan pasien stroke.Penelitian US pada tahitn 1990 menunjukkan hasil dengan peningkatan rata-rata kehidupan dan perbaikan status fungsionai pendetita dun menurunkan hari perawatan pasien, Di Indonesia US masih bum sehingga penelitian tentang tatalaksana perawatan dl US sangat diperlukan.Penelitian ini dilakukan untuk evaluasi manfaat US sebagai perawatan pasien stroke khususnya perbaikan status fungsional pasien dibandingkan perawatan pasien di Sudut Stroke Bangsal Umum Neurologi. Hasil penelitian menunjukan perbaikan status fungsionai stroke (Skor NIHSS) baik di US maupiin di Sudut Stroke Bangsal Neurologi Umum.Data memperlihatkan penumnan nilai NIHSS yaitu 17,35 tnenjadi 5,31 sedangkan di Sudut stroke 13,83 menjadi 8,87. Dengan menggunakan Independent t-test,penurunan NIHSS di US signifikan dibandingkan sudut stroke di bangsal neurologi umum. (MedJ Indones 2006; 15:30-3).

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Stroke unit has been believed us the best institutional care for stroke patients. Recent researches in 1990s indicated thai stroke units can produce increasing survival rate and improving the functional state of the patients which can reduce the need for institutional care after stroke. In Indonesia, stroke unit is still new. Because stroke unit has educational role beside its clinical importance, the research about stroke unit especially in its value in managing stroke patients in Indonesia is needed.

This study was evaluated the effectiveness of stroke unit care in managing stroke patients especially in improving the functional state of the patients in compared with conventional care of stroke corner in general neurology ward. This study indicated that both stroke unit (SU) and stroke corner in general neurology ward (SC) shows reduction in NIHSS score. In Stoke Unit, the reduction of NIHSS was 17.35 to 5.31 while in Neurology ward from 13.83 to 8.87. Using independent t-test, the reduction of NIHSS in stroke unit is more significance compared with stroke corner in general neurology ward (p=0,000). (Med J Indones 2006; 15:30-3)."