Hasil Pencarian  ::  Simpan CSV :: Kembali

"Penyakit refluks gastroesofagus (GERD) merupakan kondisi kronik yang terjadi akibat asam lambung naik ke esofagus. COVID-19 dapat memperburuk gejala GERD dan berdampak pada fungsi pernapasan. Latihan diafragma mampu memperbaiki gejala GERD, namun efektivitasnya pada orang dewasa dengan GERD pasca COVID-19 belum pernah diteliti. Penelitian ini bertujuan untuk menguji efektivitas latihan diafragma modifikasi terhadap gejala GERD, tekanan inspirasi maksimal (TIM), ekskursi diafragma, dan fungsi paru. Penelitian ini merupakan uji klinis acak tersamar tunggal pada bulan September 2022 sampai April 2023 di Rumah Sakit Persahabatan. Dari data rekam medis terdapat 364 pasien yang mengalami gejala gastrointestinal persisten. Dari data pasien tersebut, 302 pasien mengalami gejala sebelum COVID-19 dan 62 pasien setelah COVID19. Sebanyak 55 pasien memenuhi kriteria inklusi dan lolos kriteria eksklusi. Selanjutnya dialokasikan secara random pada kelompok uji (n = 25) dan kontrol (n = 25), dan 5 pasien menjalani penelitian pendahuluan. Latihan diafragma selama empat minggu terdiri atas latihan diafragma modifikasi atau latihan diafragma standar. Evaluasi dilakukan 30 hari setelah latihan pertama. Dibandingkan dengan kelompok kontrol, kelompok uji menunjukkan peningkatan bermakna pada tekanan inspirasi maksimal (TIM; 42,68 cmH2O ± 16,46 vs. 55,40 cmH2O ± 20,33 dan 74,80 cmH2O ± 20,33 vs. 68,68 cmH2O ± 21,25), ekskursi diafragma kanan (4,75 cm ± 0,98 vs. 4,97 cm ± 0,93 dan 6,84 cm ± 0,92 vs. 5,57 cm ± 0,95), dan ekskursi diafragma kiri (4,42 cm ± 0,86 vs. 4,70 cm ± 0,85 dan 6,48 cm ± 0,78 vs. 5,33 cm ± 0,90). Selain itu, baik kelompok uji sebelum-dan-sesudah maupun kelompok kontrol mengalami penurunan bermakna pada skor GERDQ (10,44 ± 2,00 vs. 1,84 ± 2,17 dan 8,64 ± 0,57 vs. 3,32 ± 1,49), dengan nilai p < 0,001. Latihan diafragma meningkatkan nilai kapasitas vital paksa (KVP), tidak meningkatkan nilai volume ekspirasi paksa detik pertama (VEP1) maupun rasio antara volume ekspirasi paksa detik pertama dan kapasitas vital paksa (VEP1/KVP), tidak bermakna secara statistik (p > 0,05). Latihan diafragma modifikasi pada orang dewasa setelah COVID-19 dengan GERD meningkatkan TIM dan ekskursi diafragma, serta mengurangi gejala refluks gastroesofageal yang terlihat dari perbaikan skor GERDQ.

---

Gastroesophageal reflux disease (GERD) is a common chronic condition characterized by stomach acid reflux into the esophagus. COVID-19 may worsen GERD symptoms and impact respiratory function. Diaphragmatic training has demonstrated potential effectiveness in managing GERD symptoms, but its effectiveness in adults with GERD after COVID-19 is unknown. This study aimed to examine the effectiveness of modified diaphragmatic training (MDT) on GERD symptoms, maximum inspiratory pressure (MIP), diaphragmatic excursion, and lung function in this population. This single-blinded randomized control trial was conducted from September 2022 to April 2023 at Persahabatan Hospital. The research team evaluated the medical records of 364 patients presenting persistent gastrointestinal symptoms; among these potential participants, 302 reported symptoms before COVID-19 infection, while 62 developed symptoms after being infected with COVID-19. After applying the study's inclusion and exclusion criteria, a total of 55 patients were selected and randomly assigned to either the intervention group (n = 25) or the control group (n = 25), and 5 patients were enrolled in the preliminary research. The intervention phase consisted of four weeks of diaphragmatic training, wherein participants received either modified diaphragmatic training (MDT) or standard diaphragmatic training. Following the training period, a follow-up assessment was conducted 30 days from the initiation of the intervention. In comparison to the control group, the intervention group demonstrated significant improvements in maximum inspiratory pressure (MIP; 42,68 cmH2O ± 16,46 vs. 55,40 cmH2O ± 20,33 and 74,80 cmH2O ± 20,33 vs. 68,68 cmH2O ± 21,25), right diaphragmatic excursion (RDE; 4,75 cm ± 0,98 vs. 4,97 cm ± 0,93 and 6,84 cm ± 0,92 vs. 5,57 cm ± 0,95), and left diaphragmatic excursion (LDE; 4,42 cm ± 0,86 vs. 4,70 cm ± 0,85 and 6,48 cm ± 0,78 vs. 5,33 cm ± 0,90). Additionally, both the pre–post-intervention group and the control group exhibited significant reductions in GERDQ scores (10.44 ± 2.00 vs. 1.84 ± 2.17 and 8.64 ± 0.57 vs. 3.32 ± 1.49, respectively), with a p-value < 0.001. Diaphragmatic training resulted in increased forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and the ratio of forced expiratory volume in the first second to forced vital capacity (FEV1/FVC), these differences were not statistically significant in both groups (p > 0,05). MDT in adults post-COVID-19 with GERD enhanced MIP and diaphragmatic excursion, along with a reduction in symptoms of GERD as evidenced by improvements in GERDQ scores."

"Inkontinensia urin (IU) pasca stroke merupakan salah satu gejala sisa stroke yang mempengaruhi seluruh kehidupan pasien baik fisik, psikologis, sosial, dan spiritual pasien. Penelitian ini bertujuan mengembangkan model asuhan keperawatan berbasis teori human becoming dan self-care deficit theory of nursing dan teridentifikasi pengaruhnya terhadap penurunan insomnia dan peningkatan kualitas hidup pasien IU pasca stroke. Penelitian ini terbagi atas dua tahap yaitu penelitian kualitatif (studi kasus) yang melibatkan 18 informan, kemudian dilanjutkan dengan penyusunan model dan penelitian kuantitatif (non-equivalent control group pretest-posttest design) yang melibatkan 56 responden secara consecutive sampling, yang dibagi dalam kelompok intervensi dan kelompok kontrol dengan lama intervensi 8 minggu. Penelitian tahap ini dilakukan di empat rumah sakit di Kota Kendari kemudian dilanjutkan di rumah pasien. Hasil penelitian tahap satu didapatkan lima tema dari hasil wawancara mendalam sehingga dihasilkan model pengelolaan IU pasca stroke beserta buku panduan intervensi model, modul untuk pasien dan perawat. Hasil penelitian tahap dua membuktikan bahwa model ini berpengaruh dalam menurunkan insomnia dan meningkatkan kualitas hidup dengan p value < 0,05. Kesimpulan hasil penelitian yaitu model asuhan keperawatan berbasis teori human becoming dan self-care deficit theory of nursing berpengaruh dalam menurunkan insomnia dan meningkatkan kualitas hidup pasien

---

Post-stroke urinary incontinence (UI) is one of the sequelae of stroke that affects the patient's entire life (physically, psychologically, socially, and spiritually). This study aims to develop a nursing care model based on the theory of human becoming and self-care deficit theory of nursing and identify its effect on decreasing insomnia and improving quality of life. This research was divided into two stages, namely qualitative research (case study) involving 18 informants, then continued with model development and quantitative research (non-equivalent control group pretest-posttest design) involving 56 respondents by consecutive sampling. Respondents were divided into the intervention group and the control group with an intervention duration of 8 weeks. This research was conducted in four hospitals in Kota Kendari and then continued at the patient's home. The results of the first phase of the study obtained five themes from the results of in-depth interviews so that a post-stroke UI management model was produced along with a model intervention guide, modules for patients and nurses. The results of the second stage of the study proved that the post-stroke UI management model had an effect on reducing insomnia and improving quality of life with p value <0.05. The conclusion of the research is that nursing care model based on the theory of human becoming and self-care deficit theory of nursing has an effect on reducing insomnia and improving the patient's quality of life"

"Infeksi COVID-19 (Corona Virus Disease 2019) dapat meninggalkan gejala sisa multisistemik (long COVID). Gejala long COVID meliputi kelelahan, sesak napas, batuk, sakit kepala, nyeri otot, dan gangguan kesehatan kognitif atau mental seperti kecemasan atau depresi. Salah satu tata laksana long COVID adalah intervensi rehabilitasi dan telerehabilitasi disarankan sebagai salah satu strategi inovatif. Namun, belum dikembangkan model telerehabilitasi untuk pasien long COVID di Indonesia. Oleh karena itu, perlu dilakukan penelitian yang bertujuan untuk mengembangkan model telerehabilitasi dan menilai efektivitasnya terhadap perbaikan kapasitas fungsional, kualitas hidup, tingkat stres oksidatif dan disfungsi endotel pada pasien long COVID di Indonesia. Penelitian dilakukan di Jakarta pada Juni 2022 hingga Juli 2024. Tahap pertama adalah studi kualitatif pengembangan model telerehabilitasi CoFit Rehab untuk pasien long COVID menggunakan metode Delphi yang melibatkan 24 panelis. Tahap kedua adalah uji randomisasi terkontrol pada 41 pasien long COVID (21 subjek perlakuan dan 20 subjek kontrol) untuk menguji efektivitas model telerehabilitasi yang dikembangkan. Selama 12 minggu, subjek perlakuan menjalani intervensi telerehabilitasi dan subjek kontrol menjalani intervensi rehabilitasi standar. Dilakukan pengukuran parameter kapasitas fungsional (uji jalan enam menit, uji sit-to-stand 30 detik dan uji kekuatan genggam tangan), kualitas hidup (kuesioner EQ-5D-5L versi Indonesia), tingkat stres oksidatif (kadar GSH dan rasio GSH/GSSG) dan disfungsi endotel (kadar mikropartikel endotel CD31+CD42b–). Studi kualitatif mendapatkan model telerehabilitasi. Uji randomisasi terkontrol memperlihatkan peningkatan bermakna jarak tempuh uji jalan enam menit baik kelompok kontrol dan kelompok perlakuan. Peningkatan jarak tempuh uji jalan enam menit lebih besar pada kelompok perlakuan. Ditemukan peningkatan bermakna jumlah repetisi uji sit-to-stand 30 detik, kekuatan genggam tangan, skor VAS EQ-5D-5L yang bermakna pada kelompok perlakuan. Ditemukan penurunan bermakna kadar mikropartikel endotel CD31+CD42b– plasma pada kelompok perlakuan. Tidak terdapat perbaikan bermakna pada parameter lain. Model telerehabilitasi CoFit Rehab terbukti lebih unggul dalam memperbaiki kapasitas fungsional dan fungsi endotel pada pasien long COVID dibandingkan rehabilitasi standar.

---

COVID-19 (Corona Virus Disease 2019) infection can result in multisystemic sequelae (long COVID). Commonly reported symptoms include fatigue, shortness of breath, cough, headache, muscle pain, and cognitive or mental health disorders such as anxiety or depression. One of the management for long COVID is rehabilitation intervention and telerehabilitation is suggested as one of the innovative strategies. However, a telerehabilitation model (CoFit Rehab) for long COVID patients has not been developed in Indonesia. This study aims to develop a telerehabilitation model for long COVID patients and assess its effectiveness in improving functional capacity, quality of life, oxidative stress levels and endothelial dysfunction in long COVID patients in Indonesia. This study was done in Jakarta from June 2022 until July 2024. The first stage was a qualitative study to obtain a telerehabilitation model for long COVID patients using the Delphi method that involved 24 panelists. The second stage was a randomized controlled trial on 41 long COVID patients (21 treatment subjects and 20 control subjects) to test the effectiveness of the telerehabilitation model that has been developed. For 12 weeks, treatment subjects received telerehabilitation intervention and control subjects received standard rehabilitation intervention. Functional capacity parameters (six-minute walk test, 30-second sit-to-stand test, and handgrip strength test), quality of life (Indonesian version of the EQ-5D-5L questionnaire), oxidative stress levels (GSH levels and GSH/GSSG ratio) and endothelial dysfunction (concentration of CD31+CD42b– endothelial microparticles) were measured. The qualitative study obtained a telerehabilitation model. Randomized controlled trial showed a significant increase in the six-minute walk test distance in both groups. Compare to the control group, the distance increase in the six-minute walk test was greater in the treatment group. There was a significant increase in the total repetitions of the 30-second sit-to-stand test, handgrip strength, and EQ-5D-5L VAS scores in the treatment group. There was a significant decrease of the endothelial microparticle plasma level (CD31+CD42b) in the treatment group. There was no significant improvement in other parameters. The telerehabilitation model (CoFit Rehab) was shown to be superior in improving functional capacity and endothelial function in long COVID patients compared to standard rehabilitation."