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"ABSTRAK Latar Belakang : Malnutrisi merupakan faktor independen yang berhubungan dengan morbiditas, mortalitas dan tingginya biaya pengobatan sirosis hati. Kekuatan Genggam Tangan (KGT) merupakan suatu metode yang sering digunakan untuk mendeteksi malnutrisi dan menilai prognosis pasien. Hubungan KGT dengan Skor Child Pugh (CP) dan massa otot masih dalam kontroversi. Indonesia sampai saat ini belum memiliki data tersebutMetode : Studi potong lintang pada pasien sirosis hati di poliklinik hepatobilier RSCM dari Februari-Juni 2015. Status nutrisi dinilai berdasarkan KGT. Massa otot diukur menggunakan bioimpedans. Analisis statistik menggunakan uji korelasi spearmanHasil : Terdapat 115 pasien yang kontrol di poliklinik hepatobilier RSCM, 112 pasien memenuhi kriteria penelitian, terdiri dari 79 laki-laki dan 33 perempuan. Usia pasien rata-rata 54,15±10,55 tahun, median skor CP 6(5-13) dengan median KGT 26(11-50) kgF, rata-rata massa otot 44,43±8,12 kg. Median asupan energi 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalensi malnutrisi berdasarkan KGT ditemukan sebanyak 33%. Kekuatan genggam tangan tidak berkorelasi dengan skor CP (p 0,046, r=-0,19) namun berkorelasi dengan massa otot (p <0,001, r= 0,70) Simpulan Terdapat 33% kasus malnutrisi berdasarkan KGT pada pasien sirosis rawat jalan. KGT tidak berkorelasi dengan skor Child Pugh namun berkorelasi dengan massa otot pasien sirosis hati.ABSTRACT Background : Malnutrition is independent factor related to morbidity, mortality and high cost of treatment in liver cirrhosis. Hand grip strength (HGS) is one of the method use for malnutrition detection and prognosis evaluation. The correlation of HGS with liver function (Child Pugh or CP score) and muscle mass is controversial. These important evaluation is not yet avalaible in Indonesia.Method : This is a cross-sectional study in liver cirrhosis patients at Hepatobiliary clinic of Cipto Mangunkusumo Hospital from February to June 2015. Nutritional status was assessed by HGS. Muscle mass was obtained from bioimpedance. Data were analyzed using Spearman correlation test. Results : There were 115 patients liver cirrhosis at Hepatobiliary clinic of Cipto Mangunkusumo Hospital, 112 patients who fit the inclusion criteria, consisted of 79 men and 33 women with mean age 54,15±10,55 years, median CP score 6(5-13) with median HGS 26 (11-50) kgF, mean muscle mass 44,43±8,12 kg. The median intake of energy 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalence of malnutrition according HGS was 33%. Hand grip strength is not correlated with CP score (p 0,046, r=-0,19) however it is correlated with muscle mass (p<0,001, r= 0,70) Conclusion There are 33% malnutrition cases based on HGS in out patient liver cirrhosis. There is no correlation between hand grip strength with Child Pugh score however HGS is correlated with muscle mass in liver cirrhosis.;Background : Malnutrition is independent factor related to morbidity, mortality and high cost of treatment in liver cirrhosis. Hand grip strength (HGS) is one of the method use for malnutrition detection and prognosis evaluation. The correlation of HGS with liver function (Child Pugh or CP score) and muscle mass is controversial. These important evaluation is not yet avalaible in Indonesia.Method : This is a cross-sectional study in liver cirrhosis patients at Hepatobiliary clinic of Cipto Mangunkusumo Hospital from February to June 2015. Nutritional status was assessed by HGS. Muscle mass was obtained from bioimpedance. Data were analyzed using Spearman correlation test. Results : There were 115 patients liver cirrhosis at Hepatobiliary clinic of Cipto Mangunkusumo Hospital, 112 patients who fit the inclusion criteria, consisted of 79 men and 33 women with mean age 54,15±10,55 years, median CP score 6(5-13) with median HGS 26 (11-50) kgF, mean muscle mass 44,43±8,12 kg. The median intake of energy 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalence of malnutrition according HGS was 33%. Hand grip strength is not correlated with CP score (p 0,046, r=-0,19) however it is correlated with muscle mass (p<0,001, r= 0,70) Conclusion There are 33% malnutrition cases based on HGS in out patient liver cirrhosis. There is no correlation between hand grip strength with Child Pugh score however HGS is correlated with muscle mass in liver cirrhosis.;Background : Malnutrition is independent factor related to morbidity, mortality and high cost of treatment in liver cirrhosis. Hand grip strength (HGS) is one of the method use for malnutrition detection and prognosis evaluation. The correlation of HGS with liver function (Child Pugh or CP score) and muscle mass is controversial. These important evaluation is not yet avalaible in Indonesia.Method : This is a cross-sectional study in liver cirrhosis patients at Hepatobiliary clinic of Cipto Mangunkusumo Hospital from February to June 2015. Nutritional status was assessed by HGS. Muscle mass was obtained from bioimpedance. Data were analyzed using Spearman correlation test. Results : There were 115 patients liver cirrhosis at Hepatobiliary clinic of Cipto Mangunkusumo Hospital, 112 patients who fit the inclusion criteria, consisted of 79 men and 33 women with mean age 54,15±10,55 years, median CP score 6(5-13) with median HGS 26 (11-50) kgF, mean muscle mass 44,43±8,12 kg. The median intake of energy 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalence of malnutrition according HGS was 33%. Hand grip strength is not correlated with CP score (p 0,046, r=-0,19) however it is correlated with muscle mass (p<0,001, r= 0,70) Conclusion There are 33% malnutrition cases based on HGS in out patient liver cirrhosis. There is no correlation between hand grip strength with Child Pugh score however HGS is correlated with muscle mass in liver cirrhosis."

"Latar Belakang: Diabetes melitus masih menyebabkan tingginya angka morbiditas dan mortalitas di seluruh dunia. Capaian kontrol glikemik masih merupakan masalah di Indonesia. Perilaku kesehatan pada DM tipe 2 yang tercermin dalam rutinitas aktivitas perawatan diri memegang peranan penting dalam keberhasilan terapi.Tujuan: 1) Mengetahui rerata aktivitas perawatan diri pasien DM tipe 2 yang menjalani edukasi dan 2) Mengetahui gambaran faktor ancaman, manfaat, hambatan dan efikasi diri pasien DM tipe 2 yang menjalani edukasi dalam melakukan aktivitas fisik dan olahraga serta pemantauan gula darah mandiri (PGDM)Metode: Penelitian ini merupakan studi potong lintang yang menggunakan pendekatan data mixed methods desain sekuensial eksplanatori. Penelitian kualitatif dilakukan dengan design fenomenologi, pengambilan data wawancara semi terstruktur dengan panduan health belief model. Analisis dilakukan dengan menggunakan thematic analysis.Hasil: Olahraga dan PGDM (n=71) memiliki nilai median SDSCA paling rendah yaitu 1 dan 3.5 hari. Sebagian besar memiliki tingkat pengetahuan yang tinggi (73.2%), tingkat distress emosi sedang-tinggi (61%) serta HbA1c > 7% (75%). Wawancara olahraga (n=21) memberikan tema keyakinan tidak melakukan aktivitas fisik dan olahraga dapat memengaruhi kesehatan, aktivitas fisik dan olahraga memberikan manfaat pada kemampuan fisik, psikologis dan penampilan, hambatan dan stimulus dalam melakukan aktivitas fisik dan olahraga serta efikasi diri yang dapat memengaruhi rutinitas olahraga. Sedangkan wawancara PGDM (n=4) memberikan tema tidak melakukan PGDM akan memengaruhi kesehatan, PGDM memberikan manfaat bagi kesehatan dan kemudahan pengobatan, hambatan dan stimulus pasien dalam melakukan PGDM serta efikasi diri memengaruhi rutinitas PGDM.Kesimpulan: Diperoleh gambaran keyakinan ancaman, manfaat, hambatan, stimulus serta efikasi diri dalam melakukan aktifitas fisik dan olahraga serta PGDM yang merupakan komponen aktifitas perawatan diri dengan nilai median hari yang paling rendah.

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Introduction: Diabetes mellitus still cause high morbidity and mortality in the world. Glycemic control is still a challenge in Indonesia. Health behaviour in type 2 DM reflected by self-care activites play an important role in successful therapy.

Aim: 1) Knowing the value of self-care activities in type 2 DM patient undergoing education. 2) Knowing about the perceived threat, benefits, barriers and self-efficacy in type 2 DM patients undergoing education in performing exercise and self monitoring blood glucose.

Method: This is a cross sectional study using mixed methods explanatory sequential design approach. The qualitative phase of this study was a phenomenological study design and used semi-structured interview based on health belief model. Analysis was done by thematic analysis.

Result: The first phase in this study involved 71 respondents. Self monitoring blood glucose (SMBG) and exercise had the lowest median SDSCA scores being 1 and 3.5 days, respectively. Most of them had a high level of knowledge (73.2%) with moderate to high levels of diabetes distress in 61% patients. There were 75% of patients with HbA1c levels > 7%. Qualitative research on exercise involved 21 respondents while SMBG involved 4 respondents. Five themes in exercise, namely not doing exercise can affect health, exercise provide benefits on physical, psychological and appearance, patient barriers and stimulus factors in performing exercise and self-efficacy can affect exercise. While five themes in SMBG include not doing SMBG can affect health, SMBG provides health benefits and ease of treatment, barriers, and stimulus factors for patients in doing SMBG and self-efficacy can affect SMBG.

Conclusion: We obtained a descriptive data on perceived threats, benefits, barriers, cues on action and self-efficacy in doing physical activity and exercise among diabetic patients, alongside SMBG activity which is a component of self-care with the lowest median number of days."