Hasil Pencarian  ::  Simpan CSV :: Kembali

"[ABSTRAKLatar Belakang: Masalah relasi orangtua-anak dapat berdampak fatal, tapi seringdisepelekan. Penanganannya mencakup psikofarmaka dan psikoterapi, khususnya analisistransaksional (AT). Penelitian ini bertujuan untuk mendapatkan data kebutuhan pelatihanaplikasi AT, sebagai dasar pembuatan modul aplikasi AT tingkat dasar (AATD) yangvalid dan reliabel. Penelitian juga bertujuan mendapatkan model pelatihan efektifmeningkatkan pengetahuan dan keterampilan AATD untuk penyelesaian masalah relasiorangtua-anak, menggunakan pendekatan pendidikan berbasis kompetensi agar dapatmenghasilkan luaran psikiater yang kompeten.Metode: Disain studi adalah mixed methods, terdiri atas: (a) penelitian potong-lintanganalisis kebutuhan pelatihan aplikasi AT melalui survai kepada 54 psikiater dan 53 calonpsikiater di Indonesia yang terpilih secara acak; (b) pembuatan modul AATD; (c) ujivaliditas dan reliabilitas modul AATD; (d) penelitian kuasi eksperimental keefektifanmodel pelatihan untuk pencapaian kompetensi AATD pada dua kelompok residenpsikiatri; (e) studi kasus implementasi AATD untuk penyelesaian masalah relasiorangtua-anak, yang dilakukan masing-masing 2 orang dari kedua kelompok tersebut.Hasil: Seluruh subjek (total 107) menyatakan membutuhkan modul pelatihan AT.Penilaian modul AATD adalah valid dengan rerata nilai di atas 90 (kategori baik sekali).Penilaian reliabilitas menggunakan Bland-Altman Plot menunjukkan semua penilaianberada dalam rentang batas judgment agreement (SB ±1,96). Pada kelompok latihdidapatkan perbedaan bermakna peningkatan pengetahuan AATD (RR=2,54; IK 95 %1,12-5,75; p <0,001), dan peningkatan keterampilan AATD (RR 4,37; IK 95 % 1,81-10,54; p<0,001) dibandingkan dengan kelompok baca. Implementasi AATD padapenyelesaian masalah relasi orangtua-anak menunjukkan cukup efektif dengan rentanghasil perbaikan dari social control sampai pada tahap transference cure.Simpulan dan Saran: Modul AT dan pelatihannya dibutuhkan oleh psikiater dan calonpsikiater. Modul AATD valid, reliabel, dan efektif untuk penyelesaian masalah relasiorangtua-anak. Model perlakuan latih lebih efektif secara bermakna meningkatkankompetensi pengetahuan dan ketrampilan AATD. Pengembangan modul aplikasi ATtingkat lanjut diperlukan untuk penanganan kasus yang lebih kompleks;

---

ABSTRACTBackground: The parent-child relationship problems can cause fatal effects if theywere not managed properly. Managements of parent-child relationship problems requirepharmacotherapy and psychotherapy, also transactional analysis (TA). The aims of thisstudy are to obtain data on the training needs of TA applications, which are used as thebasis for the application of basic transactional analysis (ABTA) which is valid andreliable, also capturing the effective training model to improve the knowledge and skillsof ABTA, as well as evaluating its effectiveness in managing the parent-childrelationship problems. The module approach is competency-based on education in orderto produce psychiatrists who are competent in providing optimal health care.Method: The design of this study was a mixed methods, comprising: (a) cross-sectionalstudy of needs training analysis for the TA application by survey on 54 psychiatrists and53 psychiatrist candidates in Indonesia which were chosen randomly; (b) ABTA modulemaking along with the tools; (c) validity and reliability test of ABTA module; (d) quasiexperimentalstudy about the effectivity of training module in order to achieve theABTA competency in two groups of psychiatrict candidates; (e) case studies of ABTAimplementation in managing the parent-child relationship problems.Result: The whole subjects (total 107) declared the needs of ABTA training modules;demonstrated the validity of the ABTA module was valid, with a mean value of all is theabove 90 (excellent value category) and reliability assessment judgment using the Bland-Altman Plot indicates that all within the range limits of agreement (± 1.96 SD). In thetraining group, a significant difference about the improvement of TA knowledge wasfound (RR=2.54; 95 % CI: 1.12-5.75; p<0.001), and the improvement of ABTA skill(RR=4.37; 95 % CI: 1.81-10.54; p<0.001) compared with the reading group. Theimplementation of ABTA indicated that the use of ABTA module was effective enough,with the results of improvements ranging from the social control to the transference curestage.Conclusion and Recommendation: The TA module and its training is needed by bothpsychiatrists and psychiatrist candidates. The ABTA module is valid, reliable, andeffective in managing the parents-child relationship problems. ABTA training module ismore effective and significant to improve the knowledge and skills competency ofABTA. Development of advanced application module TA is necessary in managingmore complex cases.;Background: The parent-child relationship problems can cause fatal effects if theywere not managed properly. Managements of parent-child relationship problems requirepharmacotherapy and psychotherapy, also transactional analysis (TA). The aims of thisstudy are to obtain data on the training needs of TA applications, which are used as thebasis for the application of basic transactional analysis (ABTA) which is valid andreliable, also capturing the effective training model to improve the knowledge and skillsof ABTA, as well as evaluating its effectiveness in managing the parent-childrelationship problems. The module approach is competency-based on education in orderto produce psychiatrists who are competent in providing optimal health care.Method: The design of this study was a mixed methods, comprising: (a) cross-sectionalstudy of needs training analysis for the TA application by survey on 54 psychiatrists and53 psychiatrist candidates in Indonesia which were chosen randomly; (b) ABTA modulemaking along with the tools; (c) validity and reliability test of ABTA module; (d) quasiexperimentalstudy about the effectivity of training module in order to achieve theABTA competency in two groups of psychiatrict candidates; (e) case studies of ABTAimplementation in managing the parent-child relationship problems.Result: The whole subjects (total 107) declared the needs of ABTA training modules;demonstrated the validity of the ABTA module was valid, with a mean value of all is theabove 90 (excellent value category) and reliability assessment judgment using the Bland-Altman Plot indicates that all within the range limits of agreement (± 1.96 SD). In thetraining group, a significant difference about the improvement of TA knowledge wasfound (RR=2.54; 95 % CI: 1.12-5.75; p<0.001), and the improvement of ABTA skill(RR=4.37; 95 % CI: 1.81-10.54; p<0.001) compared with the reading group. Theimplementation of ABTA indicated that the use of ABTA module was effective enough,with the results of improvements ranging from the social control to the transference curestage.Conclusion and Recommendation: The TA module and its training is needed by bothpsychiatrists and psychiatrist candidates. The ABTA module is valid, reliable, andeffective in managing the parents-child relationship problems. ABTA training module ismore effective and significant to improve the knowledge and skills competency ofABTA. Development of advanced application module TA is necessary in managingmore complex cases., Background: The parent-child relationship problems can cause fatal effects if theywere not managed properly. Managements of parent-child relationship problems requirepharmacotherapy and psychotherapy, also transactional analysis (TA). The aims of thisstudy are to obtain data on the training needs of TA applications, which are used as thebasis for the application of basic transactional analysis (ABTA) which is valid andreliable, also capturing the effective training model to improve the knowledge and skillsof ABTA, as well as evaluating its effectiveness in managing the parent-childrelationship problems. The module approach is competency-based on education in orderto produce psychiatrists who are competent in providing optimal health care.Method: The design of this study was a mixed methods, comprising: (a) cross-sectionalstudy of needs training analysis for the TA application by survey on 54 psychiatrists and53 psychiatrist candidates in Indonesia which were chosen randomly; (b) ABTA modulemaking along with the tools; (c) validity and reliability test of ABTA module; (d) quasiexperimentalstudy about the effectivity of training module in order to achieve theABTA competency in two groups of psychiatrict candidates; (e) case studies of ABTAimplementation in managing the parent-child relationship problems.Result: The whole subjects (total 107) declared the needs of ABTA training modules;demonstrated the validity of the ABTA module was valid, with a mean value of all is theabove 90 (excellent value category) and reliability assessment judgment using the Bland-Altman Plot indicates that all within the range limits of agreement (± 1.96 SD). In thetraining group, a significant difference about the improvement of TA knowledge wasfound (RR=2.54; 95 % CI: 1.12-5.75; p<0.001), and the improvement of ABTA skill(RR=4.37; 95 % CI: 1.81-10.54; p<0.001) compared with the reading group. Theimplementation of ABTA indicated that the use of ABTA module was effective enough,with the results of improvements ranging from the social control to the transference curestage.Conclusion and Recommendation: The TA module and its training is needed by bothpsychiatrists and psychiatrist candidates. The ABTA module is valid, reliable, andeffective in managing the parents-child relationship problems. ABTA training module ismore effective and significant to improve the knowledge and skills competency ofABTA. Development of advanced application module TA is necessary in managingmore complex cases.]"

"Remaja usia transisi rentan mengalami masalah kesehatan jiwa dan sekitar 50–75% masalah kesehatan jiwa muncul pada usia 14–24 tahun. Pada usia tersebut terjadi perubahan biologis, psikologis dan lingkungan yang dapat menimbulkan stres sehingga remaja perlu beradaptasi. Mahasiswa merupakan remaja usia transisi yang rentan terhadap stres sehingga perlu dilatih untuk meningkatkan ketahanan mental (resiliensi). Namun, belum ada modul penguatan kesehatan jiwa bagi mahasiswa usia transisi sehingga diperlukan modul yang efektif memperkuat kesehatan jiwa berdasarkan aspek biospikososial. Desain penelitian ini adalah mixed method research, yaitu exploratory sequencial method dengan penelitian kualitatif untuk pengembangan modul yang diikuti penelitian kuantitatif untuk menilai efektivitas modul. Penelitian dilakukan di Fakultas Kedokteran Universitas Indonesia (FKUI) pada bulan September 2020 sampai Januari 2022. Subjek penelitian kualitatif adalah 20 mahasiswa FKUI serta 12 ahli yang terdiri atas psikiater, psikolog dan dosen. Mahasiswa dipilih secara random sedangkan para ahli dipilih dengan consecutive sampling. Data dari mahasiswa diambil dengan wawancara mendalam dan dari para ahli dilakukan metode delphi. Uji efektivitas terhadap resiliensi mahasiswa dilakukan secara kuasi eksperimental dengan pengukuran berulang pada minggu ke-4, ke-8, ke-12. Tema modul adalah “Transisi dan Adaptasi Menuju Resiliensi: Modul Kenali Stres dan Penguatan Kesehatan Jiwa dalam Proses Adaptasi Mahasiswa Baru di Fakultas Kedokteran”. Kepuasan mahasiswa terhadap modul diukur dengan instrumen CSQ-I dan diperoleh skor 37,4 (SB 3,81) dari skor maksimal 40. Uji validitas dan reliabilitas pada kuesioner pengetahuan, sikap terhadap kesehatan jiwa, dan perilaku mencari bantuan diperoleh rentang I-CVI 0,7–1,0, serta nilai S-CVI untuk masing-masing kuesioner 0,87; 0,90 dan 0,99. Reliabilitas kuesioner diuji dengan cronbach’s alpha dan diperoleh nilai 0,521; 0,780; dan 0,852. Pengukuran biomarker kortisol menurun bermakna pada kelompok perlakuan (uji Wilcoxon, p < 0,001), sedangkan kadar enzim alfa-amilase saliva tidak berbeda bermakna. Nilai resiliensi yang diukur dengan kuesioner CD-RISC meningkat bermakna pada kelompok perlakuan dibandingkan kontrol pada minggu ke-4, ke-8 dan ke-12 (Uji ANOVA two way, p < 0,001). Terdapat juga peningkatan bermakna pada pengetahuan (uji ANOVA two way, p < 0,001), sikap dan perilaku terhadap kesehatan jiwa (uji ANOVA two way, p < 0,001). Terdapat penurunan bermakna (uji ANOVA two way, p < 0,001) skor persepsi terhadap stres yang diukur dengan kuesioner PSS. Skor depresi pada kelompok perlakuan yang diukur dengan kuesioner DASS pada minggu ke-12 menunjukkan penurunan bermakna (uji Wilcoxon, p < 0,001), demikian juga dengan ansietas (uji Wilcoxon, p < 0,001) dan stres (uji Wilcoxon, p < 0,001). Disimpulkan modul penguatan kesehatan jiwa dapat diterima dan diterapkan pada mahasiswa tingkat pertama di FKUI karena efektif meningkatkan kekuatan menghadapi stres dari aspek biopsikososial......Adolescents of transitional age are vulnerable to mental health problems, and about 50–75% of mental health problems arise at the age of 14–24 years. At that age, biological, psychological and environmental changes can cause stress, so adolescents need to adapt. Students are teenagers of transition-age prone to stress, so they need to be trained to increase mental resilience. However, there is no module for strengthening mental health for transitional-aged students, so an effective module is needed based on biopsychosocial aspects. This research design is mixed-method research, namely exploratory sequential method with qualitative research for module development followed by quantitative research to assess the module’s effectiveness. The research was conducted at the Faculty of Medicine, University of Indonesia (FKUI) from September 2020–January 2022. The subjects of the qualitative research were 20 FKUI students and 12 experts consisting of psychiatrists, psychologists and lecturers. Students were selected randomly, while the experts were selected by consecutive sampling. Data from students were taken through in-depth interviews, and from the experts, the Delphi method was used. The effectiveness test on student resilience was conducted in a quasi-experimental manner with repeated measurements at the 4th, 8th, and 12th weeks. The module’s theme is “Transition and Adaptation Towards Resilience: Recognizing Stress and Strengthening Mental Health in the Adaptation Process of New Students at the Faculty of Medicine”. Student’s satisfaction with the module was measured using the CSQ-I instrument and a score of 37.4 (SB 3.81) out of a maximum score of 40. The validity and reliability test of the knowledge, attitudes toward mental health and help-seeking behaviour questionnaires obtained the I-CVI range of 0.7–1.0, while the S-CVI value for each questionnaire was 0.87; 0.90 and 0.99. The reliability of the questionnaire was tested with Cronbach’s alpha and obtained a value of 0.521; 0.780; and 0.852. Cortisol measurement decreased significantly in the treatment group (Wilcoxon test, p < 0.001), while salivary alpha-amylase enzyme levels were not significantly different. The value of resilience as measured by the CD-RISC questionnaire increased significantly in the treatment group compared to the control group at week 4, 8, 12 (ANOVA two way test, p < 0.001). There were significant improvement in knowledge (ANOVA two way test, p < 0.001) and in attitudes and behaviour toward mental health (ANOVA two way, p < 0.001). The PSS questionnaire measured a significant decrease (ANOVA two way, p < 0.001) in perceived stress scores. Depression scores as measured by the DASS questionnaire at week 12 showed significant differences (Wilcoxon test, p < 0.001), as did anxiety (Wilcoxon test, p < 0.001) and stress (Wilcoxon test, p < 0.001). It is concluded that the mental health strengthening module can be accepted and applied to first-year students at FKUI because it effectively increases the strength to deal with stress from a biopsychosocial aspect."

"Latar belakang. Gangguan Pemusatan Perhatian dan Hiperaktif (GPPH) merupakan gangguan psikiatri anak yang paling sering dan 30-40% dari kasus kesehatan mental anak yang dirujuk. GPPH ditandai sulit memusatkan perhatian, hiperaktif, impulsif serta berdampak terhadap emosi, perilaku, psikososial, akademik dan fungsi keluarga. GPPH merupakan gangguan berat karena melibatkan multi aspek yaitu hambatan, kronisitas, morbiditas dan komorbiditas. Puncak usia onset pada usia 3-5 tahun. Penelitian ini untuk memperoleh proporsi GPPH pada anak prasekolah dengan alat ukur SPGPI, membuktikan alat ukur SPGPI, SPRDAP dan SPMP andal dan sahih serta membuktikan riwayat GPPH dalam keluarga dan regulasi diri berhubungan dengan GPPH.Metode. Uji diagnostik untuk alat ukur skala penilaian GPPH prasekolah Indonesia (SPGPI), skala penilaian regulasi diri prasekolah (SPRDAP) dan skala penilaian model pengasuhan (SPMP). Metode pengambilan sampel dengan cara simple random sampling. Subjek adalah anak berusia 3 - < 7 tahun pada 34 kelompok bermain dan taman kanak-kanak di DKI Jakarta, bulan Maret-Juni 2009. Seribu subjek untuk penelitian uji diagnostik dan 750 subjek untuk potong lintang. Alat ukur yang dibuat pada penelitian pertama diterapkan pada penelitian kedua.Hasil. Uji diagnostik SPGPI mempunyai Cronbach coefficient alpha 0,996, sensitivitas 96%, spesifisitas 99%, titik potong 30 dan area di bawah kurva ROC 0,9774. SPRDAP mempunyai Cronbach coefficient alpha 0,937, sensitivitas 92%, spesifisitas 96%, titik potong 20 dan area di bawah kurva ROC 0,9383. SPMP mempunyai Cronbach coefficient alpha 0,8125, sensitivitas 72%, spesifisitas 95%, titik potong 70, dan area di bawah kurva ROC 0,8233. Faktor risiko ayah perokok RP 3,48(1,79 sampai 6,78), regulasi diri RP 21,01(6,98 sampai 63,28), riwayat GPPH dalam keluarga RP 11,89 (2,44 sampai 44,65).Simpulan. SPGPI, SPRDAP dan SPMP adalah andal dan sahih untuk digunakan sebagai alat ukur. Faktor-faktor yang berhubungan bermakna dengan GPPH anak prasekolah adalah ayah perokok, regulasi diri dan riwayat GPPH dalam keluarga.

---

Background. Attention deficit hyperactivity disorder (ADHD) is the most common child psychiatric disorder, comprising 30-40% child mental health cases referred. ADHD is typically characterized by inattention, hyperactivity and impulsivity and affects the emotion, behavior, psychosocial, academic and family functioning. ADHD is a severe disorder includes the impairment, chronicity, morbidity and comorbity. The peak of onset is 3-5 years. This study aims to obtaining the proportion of ADHD in preschool children with SPGPI instrument, to demonstrate SPRDAP and SPMP instrument are reliable and valid, and to demonstrate ADHD related to family history and self regulation.

Methods. Diagnostic test for SPGPI, SPRDAP and SPMP Instruments. This study using questionnaire and interview. Sampling method was simple random sampling. Participant from 34 playgroup and kindergarten were selected from DKI Jakarta. The study was conducted from March-June 2009. The samples were 1000 for diagnostic test and 750 for cross sectional study and the children age from 3 - < 7 years were selected. Parents and teachers of these children were asked to complete SPGPI, SPRDAP, SPMP and personal form. The instruments from first study were applied for the second study.

Result. The result on diagnostic test showed that the Cronbach coefficient alpha 0.996, sensitivity 96%, specificity 99% for SPGPI, cut off point 30 and area under ROC curve 0.9774. For SPRDAP instrument, the Cronbach coefficient alpha 0.937, sensitivity 92%, specificity 96%, cut off point 20 and area under ROC curve 0.9383. For SPMP instrument, the Cronbach coefficient alpha 0.8125, sensitivity 72%, specificity 95%, titik potong 70 dan area under ROC curve 0.8233. The related factors were patemal smoking PR 3.48 (1.79 to 6.78), self regulation PR 21.01 (6.98 to 63.28) and family history PR 11.89 (2.44 to 44.65).

Conclusion SPGPI, SPRDAP and SPMP is reliable and valid and used as an instrument. Patemal smoking, self regulation, family history of ADHD were related to ADHD."

"Risiko kegagalan dapat terjadi pada rekonstruksi dengan flap bebas karena mengandalkan vaskularisasi kecil. Pemeriksaan klinis yang merupakan baku emas dalam evaluasi sirkulasi flap masih bersifat subjektif dan sulit untuk mendeteksi gangguan vaskularisasi secara dini. Indocyanine green (ICG) merupakan instrumen pemeriksaan objektif yang dapat digunakan untuk evaluasi sirkulasi flap, tetapi belum ada konsensus mengenai dosis ICG dan kekuatan fluoresensi bersifat dose-dependent. Pada penelitian awal model in vitro dan hewan coba didapatkan konsentrasi 0,5 mg/mL menghasilkan fluoresensi yang setara dengan konsentrasi standar (5 mg/mL). Analisis dosis titrasi ICG dilakukan pada penelitian ini untuk mengevaluasi (sirkulasi) flap bebas menggunakan kamera near-infrared radiation standar serta korelasinya terhadap pemeriksaan suhu flap, TcPCO2, TcPO2, kadar HIF-1α, dan gambaran histopatologi flap untuk menunjang bedah mikro rekonstruksi. Penelitian menggunakan desain eksperimental uji klinis acak tersamar ganda di Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo (RSCM) dan Rumah Sakit Persahabatan (RSP) pada bulan September 2022 hingga Januari 2024. Sebanyak 63 pasien yang sesuai dengan kriteria inklusi dari kuesioner skrining dilakukan randomisasi menjadi 3 kelompok konsentrasi ICG, yaitu 5 mg/mL, 2,5 mg/mL, dan 0,5 mg/mL yang diberikan ICG secara intravena, dengan jumlah masing-masing 21 flap. Data diambil segera pasca-operasi, 24 jam, 72 jam, serta 120 jam pasca-operasi. Ketiga kelompok menunjukkan peningkatan fluoresensi ICG dari waktu ke waktu, dengan intensitas fluoresensi pada konsentrasi 2,5 mg/mL serupa dengan konsentrasi standar (p = 0,792), tetapi intensitas konsentrasi 0,5 mg/mL lebih lemah (p = 0,006 dan p = 0,041). Intensitas fluoresensi tidak berkorelasi dengan pemeriksaan objektif lainnya. Disimpulkan besar dosis ICG memengaruhi intensitas fluoresensi karena fenomena quenching effect dan keseimbangan ikatan ICG dengan protein plasma. Analisis konsentrasi 5 mg/mL dan 2,5 mg/mL menghasilkan intensitas serupa sehingga penggunaan dosis 2,5 mg/mL dapat menggantikan dosis standar pada praktik klinis. Pemeriksaan objektif lainnya belum dapat menggantikan pemeriksaan ICG untuk evaluasi sirkulasi flap bebas.

---

The risk of failure in free flap reconstruction may occur due to small vascularization. Clinical examination, which is the gold standard for free flap evaluation, is subjective and difficult to detect early vascularization problems. Indocyanine green (ICG) is an objective instrument to evaluate flap circulation, but there is no ICG consensus and the fluorescence emitted is dose-dependent. In the preliminary studies conducted in vitro followed by in vivo with animal models, we found that 0.5 mg/mL concentration produced equivalent fluorescence to the standard concentration (5 mg/mL). This study aimed to analyze the titration dose of ICG to evaluate free flaps using a standard near-infrared radiation camera and its correlation with the examination of flap temperature, TcPCO2, TcPO2, HIF-1α levels, and histopathological to support reconstructive microsurgery procedure. This was a randomized, double-blind clinical trial at Dr. Cipto Mangunkusumo National Central General Hospital and Persahabatan Hospital from September 2022 to January 2024. A total of 63 patients that met the inclusion criteria through screening questionnaire were randomized into 3 ICG concentration groups: 5 mg/mL, 2.5 mg/mL, and 0.5 mg/mL. The ICG was given intravenously to each group which consist of 21 subjects. The data were obtained immediately postoperative, 24 hours, 72 hours, and 120 hours post-operative. There were 63 flaps divided into three groups with 21 flaps each. All three groups showed an increase in ICG fluorescence over time, with fluorescence intensity emitted by 2.5 mg/mL concentration is equivalent to the standard concentration (p = 0.792), but the fluorescence from 0.5 mg/mL concentration emitted weaker intensity (p = 0.006 and p = 0.041). Fluorescence intensity did not correlate with other objective examinations. It was concluded that the titration dose of ICG influenced the fluorescence intensity due to quenching effect and ICG and plasma protein bond equilibrium. Analysis of 5 mg/mL and 2.5 mg/mL concentration groups produced similar intensities, leading to the feasibility of 2.5 mg/mL concentration to replace the standard dose in clinical practice. Other objective examinations can not replace ICG examination for free flap perfusion evaluation."