Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Latar Belakang: Sarkopenia merupakan sindroma geriatri baru tertinggi dengan luaran klinis yang buruk, sehingga perlu dilakukan penapisan. Instrumen penapisan standar memiliki sensitivitas yang rendah. Mini Sarcopenia Risk Assessment (MSRA) merupakan instrumen baru dengan performa penapisan beragam, sehingga perlu diteliti lagi. Penambahan lingkar betis (LB) pada MSRA diharapkan mendapatkan hasil penapisan yang lebih baik. Tujuan: Mengetahui performa penapisan instrumen MSRA dan MSRA-LB terhadap diagnosis sarkopenia pada pasien lansia. Metode: studi potong lintang dengan subjek lansia di Poliklinik Terpadu Geriatri, Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo telah dilakukan bulan Oktober hingga Desember 2022. Data diambil melalui wawancara dan pemeriksaan antropometri, LB, kekuatan genggaman tangan, indeks massa otot apendikular, dan penilaian performa fisik. Hasil: Diperoleh subjek sebesar 118 pasien dengan proporsi sarkopenia sebesar 19 pasien (16,1%) berdasarkan AWGS 2019. Sensitivitas instrumen MSRA-7, MSRA-5, MSRA-7-LB dan MSRA-5-LB secara berurutan adalah 78,95%, 57,89%, 57,89% dan 42,11%. Sedangkan spesifisitas adalah 30,30%, 46,46%, 87,88% and 93,94%. Model MSRA-LB meningkatkan akurasi diagnosis secara bermakna p=0,003 pada MSRA-7-LB dan p= 0,005 pada MSRA-5-LB p=0,00. Simpulan: Performa penapisan intrumen MSRA memiliki sensitivitas tinggi pada versi 7 butir pertanyaan. Penambahan lingkar betis memperbaiki akurasi diagnosis instrumen MSRA namun tidak meningkatkan sensitivitas instrumen. ......Background: Sarcopenia were the highest prevalence in current geriatric syndrome with unfavorable clinical outcomes and standardized tools to screen was unsensitive. Mini Sarcopenia Risk Assessment (MSRA) has been developed to screen sarcopenia. Even, the performance is inconsistent, that is needed to be evaluated. Adding of calf circumference (CC) was conducted to find better screening performance. Objective: To determine the screening performance of the MSRA and MSRA-CC instruments. Methods: A cross-sectional study was conducted in elderly outpatients Cipto Mangunkusumo Central General Hospital, from October to December 2022. Data were collected through interviews and anthropometric examinations, measurements of body weight, hand grip strength, appendicular muscle mass index, and physical performance. Result: Eligible subjects was 118 patients base on inclusion criteria. Sarcopenia were found 19 (16,1%) subjects based on the 2019 AWGS criteria. The sensitivity values of MSRA-7, MSRA-5, MSRA-7-CC, MSRA-5-CC were 78,95%, 57,89%, 57,89% and 42,11%, respectively. The specificities were 30,30%, 46,46%, 87,88% and 93,94%, respectively. Combination MSRA-CC improved diagnostic accuracy with p value of 7 and 5 version 0,003 and 0,005, respectively. Summary: The high sensitivity screening performance of MSRA has been found in 7 item questions version. Combination MSRA-CC improved diagnostic accuracy of sarcopenia without increasing of sensitivity those instruments.

Abstrak :
Indonesia merupakan negara kepulauan dengan berbagai macam suku bangsa yang memiliki keanekaragaman budaya. Berbagai nilai budaya yang dianut sangat berpengaruh terhadap pola prilaku dari masyarakat penganut budaya tersebut salah satunya adalah budaya sunda yang sangat menghormati orang tua. Pengembangan model keperawatan keluarga peka budaya Sunda ini dilatarbelakangi oleh adanya pola prilaku keluarga pada masyarakat sunda yang cenderung mamanjakan orang tua dengan melakukan kebiasaan yang berisiko meningkatkan kadar gula darah demi menyenangkan orang tua. Tujuan penelitian yaitu mengetahui efektifitas model tersebut untuk meningkatkan perilaku dan dukungan keluarga dalam pengendalian gula darah pada lansia DM. Penelitian ini menggunakan desain riset operasional melalui 2 (dua) tahapan penelitian yaitu; Tahap I : pengembangan model keperawatan keluarga peka budaya Sunda hasil integrasi studi literatur, hasil studi pendahuluan dan konsultasi pakar; Tahap II: Uji efektifitas model dengan quasi-eksperiment pre-post test with control group dengan jumlah sampel sebanyak 114. Hasil penelitian diperoleh: Tahap I dihasilkannya model keperawatan keluarga peka budaya Sunda dengan modul, buku kerja dan kurikulum pelatihan; Tahap II : terdapat perbedaan bermakna antara prilaku merawat (pengetahuan, sikap dan keterampilan), dukungan keluarga (dukungan informasional, instrumental, penghargaan dan emosional), kadar gula darah lansia DM antar pengukuran 3 bulan dan 6 bulan setelah penerapan model. Kesimpulan: model keperawatan keluarga peka budaya Sunda efektif meningkatkan prilaku merawat dengan kontribusi besar pada sikap; efektif meningkatkan dukungan keluarga dengan kontribusi besar pada dukungan inforamsional; dan menurunkan kadar gula darah sehingga diharapkan model ini dapat direplikasi dengan menggunakan berbagai bahasa yang disesuaikan dengan kondisi budaya setempat dan dikenalkan kepada peserta didik dengan mengintegrasikan ke dalam kurikulum pendidikan keperawatan. ...... Indonesia is an archipelago with a variety of ethnic groups that have cultural diversity. Various cultural values embraced greatly influence the behavior patterns of adherents of the culture, one of which is Sundanese culture that highly respects of parents. The development of Sundanese culture sensitive family nursing models is based on the background of family behavior patterns in Sundanese people who tend to indulge in habits that risk increasing blood sugar of elderly with DM to please their parents. The aim of the study is to find out the effectiveness of the model to improve family support in controlling blood sugar to elderly with DM. This research uses operational research design through 2 (two) stages of research, namely; Stage I: development of Sundanese culture sensitive family nursing models as a result of the integration of literature study, result of preliminary study and expert consultation; Stage II: Model effectiveness test with quasi-experimental pre- posttest with control group with a total sample of 114. The results of the study are obtained; Stage I: produced Sundanese culture sensitive family nursing model with module, workbook and training curriculum; Stage II: there are significant differences among caring behavior (knowledge, attitude, and skill), family support (informational, instrumental, appreciation and emotional support;), and elderly with DM blood sugar levels between 3 months and 6 months measurement after the application of the model. Conclusion: Sundanese culture sensitive family nursing model effectively improves caring behavior with a large contribution to attitude, effectively improves family support by contributing greatly to information support and effectively reduces blood sugar level so this model is expected to be replicated with various languages which are adjusted to local culture condition and introduced to the students by integrating into the nursing education curriculum.

Abstrak :
Keperawatan Keluarga Santun Lansia sebagai pendekatan pemberdayaan keluarga dalam meningkatkan dukungan dan strategi koping keluarga, serta menurunkan beban keluarga dalam merawat lansia untuk melakukan perawatan secara optimal pada lansia. Tujuan penelitian yaitu memperoleh model keperawatan keluarga santun lansia dalam upaya peningkatan kualitas asuhan keluarga pada lansia.

Penelitian ini menggunakan desain riset operasional melalui 3 (tiga) tahapan penelitian yaitu; Tahap I : Identifikasi masalah dukungan, strategi koping, beban keluarga dalam merawat lansia, status kesehatan lansia dan kejadian salah perlakuan pada lansia. dengan desain kuantitatif (cross-sectional) dengan jumlah sampel sebanyak 135; Tahap II : pengembangan model keperawatan keluarga santun lansia hasil integrasi penelitian tahap 1, studi literature dan konsultasi pakar; Tahap III : Uji coba model dengan quasieksperiment pre-post test with control group dengan jumlah sampel sebanyak 108. Hasil penelitian diperoleh : 1) Tahap I : dukungan informasional dan strategi koping Acquiring Social Support adalah variabel dominan terjadinya salah perlakuan; 2) Tahap II dihasilkan model keperawatan keluarga santun lansia dengan modul, buku kerja dan kurikulum pelatihan; 3) Tahap III : terdapat perbedaan bermakna dukungan keluarga (dukungan informasional dan instrumental), strategi koping keluarga, dan salah perlakuan pada lansia antar pengukuran 3 bulan setelah penerapan model diantara kelompok intervensi dan kontrol. Kesimpulan : model keperawatan keluarga santun lansia efektif meningkatkan dukungan informasional dan instrumental keluarga, meningkatkan penggunaan seluruh strategi koping keluarga, dan meningkatkan kemampuan keluarga untuk tidak melakukan salah perlakuan pada lansia. Rekomendasi : 1) Replikasi model di seluruh Indonesia; 2) Pelatihan berkelanjutan bagi perawat, kader kesehatan dan pelaku rawat dalam merawat lansia di rumah; 3) Penelitian lanjutan yaitu mengidentifikasi lebih objektif mengenai beban pelaku rawat dalam merawat lansia, kualitas hidup lansia yang berkaitan dengan penerapan Model Keperawatan Santun Lansia, difokuskan pada dukungan informasional dan strategi koping Acquiring Social Support yang merupakan variabel yang dominan terhadap. ...... The Cordial Older Family Nursing Model is a family empowerment approach in improving support and coping strategy, as well as reducing family burden in term of providing optimal care for older persons. The objective of this study was to establish The Cordial Older Family Nursing Model in order to improving family care of older persons. This study used operational research design that passed through three steps of research. Step I: Identifying the problems of support, coping strategy, family burden in taking care of older person, the health status of older person, and the incident of elderly abuse through cross-sectional study with 135 samples. Step II: The development of The Cordial Older Family Nursing Model, integrated result of step I of this study, and expert consultation. Step III: Validation of model utilized quasi-experiment pre-post test with control group, 108 samples. The result of this study, were as follows: 1.) Step I: informational of support and coping strategy Acquiring Social Support were predominant variable that provoked the incident of abuse. 2.) Step II: Module, workbook, and training curriculum for The Cordial Older Family Nursing Model were developed 3.) Step III: There were significant differences between family support (informational and instrumental), family coping strategy, and the incident of elderly abuse in 3-months-measurement after the implementation of model between intervention and control group. Conclusion: The Cordial Older Family Nursing Model was able to promote informational and instrumental family support, family coping strategy, and improve family ability not to commit abuse in older persons. Recommendation: 1.) Replication of the model to cities all over Indonesia; 2.) Continuous training for nurses, health cadre, and family caregivers in taking care homebound older adults; 3.) Advanced study that will provide the more objective assessment to identify family burden in taking care of older adults, Quality of Life (QoL) of older adults that is related to the implementation of The Cordial Older Family Nursing Model, the study should be more focused on informational support and coping strategy Acquiring Social Support that was determined as predominant variable towards the incident of abuse and the improvement of self help group for older persons.

Abstrak :
ABSTRAK
Latar Belakang: Alfacalcidol, sebuah vitamin D analog, potensial bermanfaat memperbaiki imunosenesens pada pasien usia lanjut dengan sindrom frailty karena bekerja sebagai anti inflamasi melalui Vitamin D Receptor VDR pada makrofag dan sel TTujuan: Mengkaji efek pemberian alfacalcidol in vitro dan in vivo terhadap perubahan sitokin inflamasi IL-6, IL-10 dan Interferon g serta subset limfosit T rasio CD4/CD8, persentase sel T CD 8 CD28- dari kultur Peripheral Blood Mononuclear Cell PBMC dan Immune Risk Profile IRP pada usila dengan sindrom frailtyMetode: Selama Januari sampai Juli 2017 di RS Cipto Mangunkusumo Jakarta, direkrut masing-masing 8 orang subyek usila fit, pre-frail dan frail dan 10 subyek dewasa sehat sebagai kontrol. Pada 34 subyek ini dinilai perubahan kadar IL-6, IL-10 dan IFN g yang diukur dengan kit ELISA dari supernatan kultur PBMC 24 jam yang distimulus Lipopolisakarida LPS 100 ng/ml dengan dan tanpa pretreatment alfacalcidol in vitro. Selain itu juga dilakukan uji klinis acak tersamar ganda dengan pemberian alfacalcidol 0,5 mcg 90 hari pada 110 subyek berusia lanjut lalu diamati perubahan kadar IL-6, IL-10 dan IFN , g perubahan rasio CD4/CD8 dan persentase sel T CD8 CD28- serta penilaian Immune Risk Profile. Dilakukan uji t tidak berpasangan untuk mengetahui perbedaan rerata kadar sitokin dan persentase populasi sel T dan uji chi square untuk menilai beda proporsi subyek dengan IRP positif.Hasil: Pada penelitian in vitro didapatkan rerata kadar 25 OH D serum yang semakin menurun seiring dengan perburukan status frailty. Alfacalcidol in vitro tidak menurunkan IL-6 dan IFN g, namun meningkatkan IL-10 pada seluruh kelompok. Dari uji klinis didaparkan alfacalcidol 0,5 mcg selama 90 hari tidak menurunkan IL-6 p=0,4 dan IFN gamma p=0,001 , namun mampu meningkatkan IL-10 p=0,005 dan menurunkan rasio IL6/IL10 p=0,008 . Alfacalcidol meningkatkan rasio CD4/CD8 dari 2,68 SB 2,45 menjadi 3,2 SB 2,9 ; p=0,001 dan menurunkan persentase CD8 CD28- dari 5,1 SB 3,96 menjadi 2,5 1,5 ; p

---

ABSTRACT
Introduction Chronic low grade inflammation and dysregulation of cellular immunity are the cardinal signs of immunosenescence in elderly with frailty syndrome. Alphacalcidol, a vitamin D analog shows immunoregulatory potency as it works on the macrophage and T cell, to control inflammation and T cell dysregulation in the elderly.Objective to determine the effect of alphacalcidol on inflammatory cytokines IL 6, IL 10, IFN gamma and T cell subsets CD4 CD8 ratio and CD8 CD28 and Immune Risk Profile of the elderly with frailty syndromeMethods During January to August 2017, in vitro study was conducted involving 10 healthy adults volunteer and 8 elderly each in fit, pre frail and frail category from Outpatient Clinics of Cipto Mangunkusumo Hospital Jakarta Indonesia using 24h Peripheral Blood Mononuclear Cells PBMC culture supernatants to determine the change of IL 6, IL 10 and g IFN level measured by ELISA, following stimulation with Lipopolisaccharide LPS 100 nm, with and without pretreatment with alphacalcidol. A double blind randomized controlled trial RCT with allocation concealment, involving 110 elderly subjects was also conducted to measure the effect of 0,5 mcg alphacalcidol administration for 90 days on inflammatory cytokines IL 6, IL 10, g IFN from 24 h PBMC culture supernatant, as well as CD4 CD8 and CD8 CD28 count and change of Immune Risk Profile. Statistical analysis was performed using t test to measure mean difference of cytokines and T cell count and chi square to measure proportion difference of IRP.Result In vitro study using PBMC showed alphacalcidol administration did not decrease IL 6 level IL p 0,24 and g IFN p 0,36 , but it increased IL 10 p 0,02 . Of 110 subjects involved in the RCT consisting of 27 fit elderly, 27 pre frail elderly and 56 frail elderly, it can be observed that Alphacalcidol 0,5 mcg for 90 did not decrease IL 6 p 0,4 and g IFN p 0,001 , but increased IL 10 p 0,005 and decrease IL6 IL10 ratio p 0,008 . Alphacalcidol increased CD4 CD8 ratio from 2,68 SD 2,45 to 3,2 SD 2,9 p 0,001 and decrease CD8 CD28 percentage from 5,1 SD 3,96 to 2,5 1,5 p

Abstrak :
Lansia dengan demensia dapat menjadi beban bagi keluarga. Mengenal faktor risiko demensia dapat mencegah perburukan Intervensi keperawatan keluarga melalui aplikasi android pada era digital sangatlah penting untuk meningkatkan kemampuan koping keluarga dalam merawat lansia. Tujuan penelitian adalah memperoleh model keperawatan Keluarga Peduli Demensia – Raden Siti Maryam (KEDUSIA-RSM) berbasis android yang efektif untuk meningkatkan kemampuan keluarga, kepuasan keluarga, fungsi kognitif dan pengendalian faktor risiko demensia pada lansia serta menurunkan beban merawat keluarga. Penelitian ini menggunakan desain riset operasional melalui 2 tahapan yaitu Tahap 1 : pengembangan model hasil integrasi antara studi pendahuluan, studi literatur dan konsultasi pakar dan Tahap 2 : uji coba model dengan desain pre dan post tes dengan kelompok kontrol. Strategi pengambilan sampel menggunakan kluster gugus bertahap dengan jumlah sampel sebanyak 156 yaitu 79 keluarga kelompok intervensi dan 77 keluarga kelompok kontrol. Hasil penelitian diperoleh: 1) Tahap I dihasilkan model keperawatan KEDUSIA-RSM berbasis android, buku pegangan untuk keluarga dan aplikasi android KEDUSIA-RSM; 2) Tahap II : terdapat perbedaan bermakna rerata kemampuan merawat keluarga (pengetahuan, sikap, keterampilan) dan kepuasan merawat antar pengukuran (sebelum, 2 bulan dan 4 bulan setelah intervensi model) pada kelompok intervensi (p value < 0,05; repeated measure ANOVA); terdapat perbedaan bermakna rerata fungsi kognitif dan pengendalian faktor risiko demensia antara kedua kelompok pada pengukuran sebelum dan sesudah 4 bulan (p value < 0,05; uji t dua sampel bebas). Kesimpulan: model keperawatan KEDUSIA-RSM efektif meningkatkan kemampuan, kepuasan merawat, fungsi kognitif dan pengendalian faktor risiko demensia lansia serta menurunkan beban merawat keluarga. Rekomendasi: 1) Replikasi model 2) Pelatihan berkelanjutan bagi perawat Puskesmas, kader lansia, dan keluarga 3) Penelitian lanjutan yaitu pengembangan aplikasi berbasis iOS atau web. ......Elderly people with dementia can be a burden to the family. Recognizing risk factors for dementia can prevent progressifity. Family nursing interventions through android applications in the digital era are very important to improve family coping skills in caring for elderly with dementia risk factors. The research objective was to obtain an android-based model of KEDUSIA-RSM which is effective for improving family ability, family satisfaction, cognitive function and controlling for dementia risk factors in the elderly, and decrease caregiver burden. This study uses an operational research design through 2 stages, namely Stage 1: the development of the integration result model between the preliminary study, literature study and expert consultation and Phase 2: the model trial with the pre and post test design with the control group. The sampling strategy used a multistage cluster with a total sample size of 156, namely 79 families in the intervention group and 77 families in the control group. The results of the research were: 1) Phase I produced application based KEDUSIA-RSM nursing model, handbook for family and its application; 2) Phase II: there is a significant difference in the average ability to care for the family (knowledge, attitudes, skills) and care satisfaction between measurements (before, 2 months and 4 months after the model intervention) in the intervention group (p value <0.05; repeated measure ANOVA) There was a significant difference in the mean cognitive function of the elderly and controlling risk factors for dementia between the two groups in the measurement before and after 4 months (p value <0.05; independent t-test). Conclusion: The KEDUSIA-RSM nursing model is effective in increasing the ability to care for and satisfaction in caring as well as improving cognitive function and controlling risk factors for dementia in the elderly. Recommendations: 1) Model replication; 2) Continuous training and assistance for puskesmas nurse, elderly cadres, and family caregiver; 3) Further research, namely web/ iOS-based application development.