Yani Sofiani
Program Studi Spesialis Keperawatan, Universitas Muhammadiyah Jakarta

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Evaluasi efektivitas skrining non-invasif untuk deteksi dini gangguan kaki pada diabetisi Sri Atun; Yani Sofiani; Ninik Yunitri; Wati Jumaiyah; Fitrian Rayasari
Hik Vol. 19 No. 8 (2025): Volume 19 Nomor 8
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i8.1610

Abstract

Background: Diabetic neuropathy is a complication that develops slowly and often goes undiagnosed. Guttormsen explained that neuropathy usually appears after years of diabetes and is often the initial cause of wounds and amputations. Therefore, early detection is crucial to prevent further complications. One recommended approach is non-invasive screening, which allows for early identification before severe symptoms appear. Purpose: To evaluate the effectiveness of non-invasive screening for early detection of foot disorders in people with diabetes. Method: The implementation of evidence-based nursing practice (EBNP) at Al Ihsan Regional Hospital, West Java Province, from June to July 2025, involved a non-invasive screening intervention for each patient for early detection of foot disorders in diabetic patients. This study was preceded by a systematic review and meta-analysis that compiled data from various previous studies. Results: Participants with the ROC curve test showed screening results on BDRFS with a sensitivity value of 1.000; on monofilament screening the sensitivity value was 0.545; vibration screening test sensitivity value was 0.818; temperature screening test sensitivity value was 0.864. In the QST screening test of touch sensation, it showed that the temperature screening test sensitivity value was 0.909. The QST screening test of vibration sensation showed that the temperature screening test sensitivity value was 0.909. The QST screening test of temperature sensation showed that the temperature screening test sensitivity value was 0.773. Conclusion: The implementation of EBNP “Evaluation of the Effectiveness of Non-Invasive Screening for Early Detection of Foot Disorders in Diabetics” has been proven to significantly increase early detection of diabetic neuropathy through a method that is safe, inexpensive, and can be performed by nurses.   Keywords: Diabetes; Early Detection of Foot Disorders; Non-Invasive Screening.   Pendahuluan: Neuropati diabetik merupakan komplikasi yang berkembang secara perlahan dan sering kali tidak terdiagnosis secara dini. Guttormsen menjelaskan bahwa neuropati biasanya muncul setelah bertahun-tahun menderita DM dan sering kali menjadi penyebab awal terjadinya luka hingga amputasi. Untuk itu, deteksi dini sangat penting guna mencegah komplikasi lebih lanjut. Salah satu pendekatan yang direkomendasikan adalah skrining non-invasif, yang memungkinkan identifikasi dini sebelum muncul gejala berat. Tujuan: Untuk mengevaluasi efektivitas skrining non-​​invasif untuk deteksi dini gangguan kaki pada diabetisi. Metode: Penerapan praktik keperawatan berbasis bukti (Evidence Based Nursing Practice/EBNP) yang dilaksanakan di RSUD Al Ihsan Provinsi Jawa Barat pada bulan Juni-Juli 2025. Setiap pasien dilakukan intervensi berupa pemeriksaan skrining non-invasif untuk deteksi dini gangguan kaki pada pasien diabetes. Hasil: Partisipan dengan uji ROC curve menunjukkan hasil skrining pada BDRFS dengan nilai sensitivity 1.000; pada skrining monofilamin nilai sensitivit 0.545; skrining vibrasi test nilai sensitivity 0.818; skrining temperatur test nilai sensitivit 0.864. Pada uji skrining QST sensasi sentuhan menunjukkan bahwa skrining temperatur test nilai sensitivit 0.909. Uji skrining QST sensasi getaran menunjukkan bahwa skrining temperatur test nilai sensitivit 0.909. Uji skrining QST sensasi suhu menunjukkan bahwa skrining temperatur test nilai sensitivit 0.773. Simpulan: Penerapan EBNP “evaluasi efektivitas skrining non-invasif untuk deteksi dini gangguan kaki pada diabetisi” terbukti dapat meningkatkan deteksi dini neuropati diabetik secara signifikan melalui metode yang aman, murah, dan dapat dilakukan oleh perawat.   Kata Kunci: Diabetisi; Deteksi Dini Gangguan Kaki; Skrining Non-​​Invasif.
Penerapan evidence-based practice nursing program intradialytic flexsibility exercise range of mation terhadap fatigue pada pasien chronic kidney disease yang menjalani hemodialisa Sada Ukur Barus; Rizki Nugraha Agung; Rani Septiawantari; Iyar Siswandi; Yani Sofiani
Hik Vol. 19 No. 8 (2025): Volume 19 Nomor 8
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i8.1671

Abstract

Background: Chronic Kidney Disease (CKD) is one of the leading causes of global morbidity and mortality. Patients undergoing hemodialysis often experience fatigue, which significantly affects their quality of life, productivity, and psychological well-being. One of the non-pharmacological interventions that can be applied is intradialytic flexibility exercise in the form of range of motion (ROM). Purpose: To determine the effect of intradialytic flexibility exercise range of motion on fatigue levels among CKD patients undergoing hemodialysis. Method: A quasi-experimental study using a one-group pre-post test design was conducted from May to July 2025 at Al Ihsan Regional General Hospital, West Bandung. Purposive sampling was used to select 18 participants. The independent variable in this study was the Intradialytic Flexibility Exercise Range of Motion Program, while the dependent variable was the level of fatigue. Data analysis was performed using univariate analysis in the form of frequency distribution and bivariate analysis using the Cochran test. Translated with DeepL.com (free version) Results: Before the intervention, 77.8% of participants experienced severe fatigue. After 8 weeks of intervention, all participants (100%) showed a decrease in fatigue to a mild category. Statistical analysis indicated a significant difference in fatigue levels before and after the intervention (p < 0.05). Conclusion: Intradialytic flexibility exercise range of motion is effective in reducing fatigue levels among CKD patients undergoing hemodialysis. This intervention can be considered a non-pharmacological nursing strategy to improve patients’ quality of life.   Keywords: Chronic Kidney Disease; Fatigue; Hemodialysis; Intradialytic Exercise; Range of Motion.   Pendahuluan: Penyakit ginjal kronis (CKD) merupakan salah satu penyebab utama morbiditas dan mortalitas global. Pasien CKD yang menjalani hemodialisis sering mengalami kelelahan (fatigue) yang berdampak pada kualitas hidup, produktivitas, dan kesehatan mental. Salah satu intervensi non-farmakologis yang dapat diterapkan adalah intradialytic flexibility exercise berupa range of motion (ROM). Tujuan: Untuk mengetahui pengaruh penerapan intradialytic flexibility exercise range of motion terhadap tingkat kelelahan pada pasien CKD yang menjalani hemodialisa. Metode: Penelitian quasi experimental dengan metode one group pre-posttest design, dilaksanakan pada Mei-Juli 2025 di RSUD Al Ihsan, Bandung Barat. Teknik pengambilan sampel menggunakan purposivel sampling dengan jumlah sampel yang digunakan sebanyak 18 partisipan. Variabel independen dalam penelitian ini adalah Program Intradialytic Flexibility Exercise Range of Motion, sedangkan variabel dependen ialah tingkat kelelahan. Analisis data yang digunakan univariate dalam bentuk distribusi frekuensi dan bivariate menggunakan uji Cochran. Hasil: Sebelum intervensi, 77.8% partisipan mengalami fatigue berat. Setelah 8 minggu intervensi, seluruh partisipan (100%) mengalami penurunan tingkat fatigue menjadi kategori ringan. Hasil uji statistik menunjukkan adanya perbedaan signifikan tingkat fatigue sebelum dan sesudah intervensi (p < 0.05). Simpulan: Penerapan intradialytic flexibility exercise range of motion efektif menurunkan tingkat kelelahan pada pasien CKD yang menjalani hemodialisa.   Kata Kunci: Chronic Kidney Disease; Fatigue; Hemodialisa; Intradialytic Exercise; Range of Motion.
Evaluasi efektivitas penerapan chlorhexidine kumur pada diabetisi tipe II dengan periodontitis Ristonilassius Ristonilassius; Yani Sofiani; Ninik Yunitri; Fitrian Rayasari; Wati Jumaiyah
Hik Vol. 20 No. 3 (2026): Volume 20 Nomor 3
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v20i3.2726

Abstract

Background: Diabetes mellitus is a chronic metabolic disease with increasing prevalence globally. Chronic hyperglycemia in patients with type II diabetes mellitus can impair the immune response, increase inflammatory activity, and contribute to an increased risk and severity of periodontitis. Periodontitis is an inflammatory condition that causes damage to the supporting tissues of the teeth and can worsen oral health in diabetic patients. Chlorhexidine mouthwash has strong antimicrobial properties and is often used as an adjunct therapy to reduce dental plaque, gingivitis, and oral pain. Purpose: To evaluate the effectiveness of chlorhexidine mouthwash as an adjunct intervention in patients with type II diabetes mellitus with periodontitis. Method: This study used a quasi-experimental design with a single-group pretest-posttest approach. The study was conducted at Al Ihsan Regional Hospital, West Java Province, in July 2025 as part of the implementation of evidence-based nursing practice. The sampling technique used total sampling with six participants. Gum condition and pain levels were assessed using the Modified Gingival Index and Visual Analog Scale. Data were analyzed using descriptive statistics and the Wilcoxon Signed Rank Test. Results: Most participants were male (66.7%) and adult (83.3%), with a mean age of 52.7 years. After the intervention, there was a significant reduction in pain (p = 0.024) and gingival inflammation based on the Modified Gingival Index (p = 0.034). Conclusion: Chlorhexidine mouthwash is effective in reducing pain and improving gingival condition in patients with type II diabetes mellitus and periodontitis. Recommendation: Future studies should use a larger sample size and longer follow-up period to confirm these findings and evaluate the long-term effects of chlorhexidine mouthwash use.   Keywords: Chlorhexidine; Gingivitis; Periodontitis; Type II Diabetes Mellitus.   Pendahuluan: Diabetes melitus merupakan penyakit metabolik kronis dengan prevalensi yang terus meningkat secara global. Hiperglikemia kronis pada pasien diabetes melitus tipe II dapat mengganggu respons imun, meningkatkan aktivitas inflamasi, serta berkontribusi terhadap peningkatan risiko dan keparahan periodontitis. Periodontitis merupakan kondisi inflamasi yang menyebabkan kerusakan jaringan penyangga gigi dan dapat memperburuk status kesehatan rongga mulut pada pasien diabetes. Chlorhexidine kumur memiliki sifat antimikroba yang kuat dan sering digunakan sebagai terapi tambahan untuk mengurangi plak gigi, inflamasi gingiva, serta keluhan nyeri pada rongga mulut. Tujuan: Untuk mengevaluasi efektivitas penerapan chlorhexidine kumur sebagai intervensi tambahan pada pasien diabetes melitus tipe II dengan periodontitis. Metode: Penelitian ini menggunakan desain quasi-experimental dengan pendekatan one-group pretest–posttest. Penelitian dilakukan di RSUD Al Ihsan Provinsi Jawa Barat, pada bulan-Juli 2025 sebagai bagian dari implementasi evidence-based nursing practice. Teknik pengambilan sampel menggunakan total sampling dengan jumlah 6 partisipan. Kondisi gingiva dan tingkat nyeri dinilai menggunakan Modified Gingival Index dan Visual Analog Scale. Data dianalisis menggunakan statistik deskriptif dan Wilcoxon Signed-Rank Test. Hasil: Sebagian besar partisipan berjenis kelamin laki-laki (66.7%) dan berada pada kategori dewasa (83.3%), dengan rata-rata usia 52.7 tahun. Setelah intervensi, terdapat penurunan nyeri yang signifikan dengan p = 0.024 dan penurunan inflamasi gingiva berdasarkan Modified Gingival Index dengan p = 0.034. Simpulan: Chlorhexidine kumur efektif dalam menurunkan nyeri dan memperbaiki kondisi gingiva pada pasien diabetes melitus tipe II dengan periodontitis. Saran: Penelitian selanjutnya dapat menggunakan jumlah sampel yang lebih besar dan periode pemantauan yang lebih panjang untuk mengonfirmasi temuan ini serta mengevaluasi efek jangka panjang penggunaan chlorhexidine kumur.   Kata Kunci: Chlorhexidine; Diabetes Melitus Tipe II; Inflamasi Gingiva; Periodontitis.