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The Effect of the TEMAN SETIA Program Intervention on Immunosuppressant Medication Adherence in Post-Kidney Transplant Patients at RSCM Jakarta Suhartini, Euis; Nursanti, Irna; Natashia, Dhea; Irawati, Diana; Jumaiyah, Wati; Uly, Nilawati
Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal) Vol. 11 No. 1 (2025): JURNAL KEPERAWATAN KOMPREHENSIF (COMPREHENSIVE NURSING JOURNAL)
Publisher : STIKep PPNI Jawa Barat

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Abstract

Aims: Chronic Kidney Disease (CKD) poses a significant global health challenge, with an increasing number of kidney transplantations in Indonesia. The success of kidney transplants hinges on adherence to immunosuppressant medications to prevent organ rejection. Non-adherence among post-transplant patients can lead to infections, graft loss, or a return to dialysis. This study evaluated the impact of the TEMAN SETIA program on adherence to immunosuppressant medications among post-kidney transplant patients at Dr. Cipto Mangunkusumo National Referral Hospital (RSCM) in Jakarta. Methods: A pre-post-test design with a control group was utilized. The sample included 28 post-transplant patients meeting inclusion criteria. The TEMAN SETIA program provided patient mentoring to improve adherence. Adherence was assessed before the intervention, one month after, and two weeks post-intervention using a validated questionnaire. Data were analysed using t-tests and repeated measures ANOVA. Results: The control and intervention groups were comparable in demographic and clinical characteristics, though the intervention group had more non-working participants. The program significantly improved adherence (Cohen’s d = 1.97) and knowledge (Cohen’s d = 1.99). While family support increased in both groups, differences were not significant (Cohen’s d = 1.02). A significant group-by-time interaction (F (1.246, 26) = 7.394, p = 0.007, η² = 0.221) demonstrated greater adherence improvements over time in the intervention group. Discussion: The findings demonstrate that the TEMAN SETIA program is an effective intervention for enhancing medication adherence and knowledge among post-transplant patients. The structured mentoring approach provided patients with the necessary support and education to improve their adherence behaviors. Although family support increased in both groups, the changes were not statistically significant, highlighting the need for further exploration of the role of familial involvement in adherence programs Conclusion: The TEMAN SETIA program effectively enhanced medication adherence and knowledge in post-transplant patients. This structured intervention offers a promising strategy to improve outcomes and reduce risks of organ rejection.
Penerapan Evidence Based Practice Chin Tuck Againts Resistance (CTAR) dalam Penanganan Disfagia pada Pasien Stroke Rinawati, Rinawati; Jumaiyah, Wati; Yunitri, Ninik; Agung, Rizki Nugraha; Nurhayati, Elis
MAHESA : Malahayati Health Student Journal Vol 4, No 4 (2024): Volume 4 Nomor 4 (2024)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v4i3.14130

Abstract

ABSTRACT The Chin Tuck Against Resistance (CTAR) intervention is rarely utilized by nurses in treating dysphagia among stroke patients. Symptoms arising from a stroke can differ based on the affected brain area, encompassing speech disorders, chewing and swallowing difficulties (dysphagia), limb paralysis or weakness, personality alterations, emotional disturbances, diminished cognitive abilities, impaired urinary function, and others. The use of Evidence-Based Nursing Practice (EBNP) is conducted to comprehend the impact of implementing chin tuck against resistance (CTAR) on improving swallowing muscle strength in stroke patients with dysphagia. In this study, the data were analyzed using univariate data analysis to evaluate the demographic characteristics and swallowing ability profiles of each respondent. Furthermore, the statistical test of influence was conducted using a paired t-test to assess changes in swallowing ability after undergoing CTAR rehabilitation exercises. Sampling in this study utilized the total sample method, involving 8 respondents. The CTAR intervention has been shown to significantly improve swallowing ability in stroke patients. The results indicate a meaningful increase from an average of 84.3 to 91.7 post-intervention, with an effect size of 4.59 and a p-value of 0.022, demonstrating the statistical effectiveness of this therapy. Furthermore, CTAR exercises are convenient to implement, time-efficient, and can be performed by patients without disrupting their daily routines. To enhance its effectiveness, it is recommended to involve patients and their families in the education process, enabling them to continue the exercises independently. The simplicity of these exercises facilitates nurses in providing interventions during nursing care for stroke patients experiencing dysphagia. Keywords: Evidence Based Practice Chin Tuck Against Resistance (CTAR), Dysphagia, Stroke Patients  ABSTRAK Intervensi Chin Tuck Exercise (CTAR) jarang digunakan oleh perawat untuk mengatasi disfagia pada pasien stroke. Gejala yang muncul akibat stroke dapat bervariasi tergantung pada area otak yang terkena, termasuk gangguan berbicara, kesulitan mengunyah dan menelan (disfagia), kelumpuhan atau kelemahan anggota gerak, perubahan kepribadian, gangguan emosi, penurunan fungsi kognitif, gangguan fungsi berkemih, dan lainnya. Penggunaan Praktik Keperawatan Berbasis Bukti (EBNP) dilakukan untuk memahami dampak dari penerapan chin tuck against resistance (CTAR) terhadap peningkatan kekuatan otot menelan pada pasien stroke dengan disfagia. Pada penelitian ini, data dianalisis menggunakan analisis data univariat untuk mengevaluasi karakteristik demografi dan gambaran kemampuan menelan pada setiap responden. Selanjutnya, uji statistik pengaruh dilakukan dengan uji paired t-test untuk menilai perubahan kemampuan menelan setelah menjalani latihan rehabilitasi CTAR. Pengambilan sampel dalam penelitian ini menggunakan metode total sampel dengan melibatkan 8 responden. Intervensi CTAR terbukti secara signifikan meningkatkan kemampuan menelan pada pasien stroke. Hasil menunjukkan peningkatan yang berarti dari rata-rata 84.3 menjadi 91.7 setelah intervensi, dengan besaran efek sebesar 4.59 dan nilai p-value sebesar 0.022, menunjukkan keefektifan terapi ini secara statistik. Lebih lanjut, latihan CTAR memberikan kemudahan dalam pelaksanaan, tidak memakan waktu lama, dan dapat dilakukan oleh pasien tanpa mengganggu rutinitas harian. Untuk meningkatkan efektivitasnya, disarankan untuk melibatkan pasien dan keluarganya dalam proses edukasi, sehingga mereka dapat melanjutkan latihan secara mandiri. Kesederhanaan latihan ini memudahkan perawat dalam memberikan intervensi selama asuhan keperawatan pada pasien stroke yang mengalami disfagia. Kata Kunci: Praktek Berbasis Bukti Chin Tuck Melawan Resistensi (CTAR), Disfagia, Pasien Stroke 
Cognitive Behavioral Therapy (CBT-I) Terhadap Kualitas Tidur Pasien Gagal Ginjal Yang Menjalani Hemodialisis Lakoro, Danny Des Kartyko; Natashia, Dhea; Gayatri, Dewi; Irawati, Diana; Jumaiyah, Wati; Nuraini, Tuti
MAHESA : Malahayati Health Student Journal Vol 4, No 8 (2024): Volume 4 Nomor 8 (2024)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v4i8.15079

Abstract

ABSTRACT Hemodialysis can cause multi-component impacts such as fatigue, pain, restless legs syndrome, anxiety and depression which can cause sleep disturbances resulting in decreased sleep quality. CBT-I is a multi-component therapy that can overcome sleep problems caused by many factors. The purpose of this study was to determine the effect of CBT-I on sleep quality. The research method used a quasi-experiment with a one group pretest-posttest design without control group approach. The population was 90 respondents with a sample size of 30 respondents using purposive sampling technique. Measurement sleep quality using pittsburgh sleep quality index (PSQI). Data analysis was performed using paired t-test and Repeated Measures ANOVA. The results showed that the average value of sleep quality before the intervention on the 1st measurement was 15.00 (±2.262), on the 2nd measurement after the intervention was 13.23 (±2.674) and the 3rd measurement was 10.23 (2.991). These findings explain cognitive behavioral insomnia (CBT-i) has a significant impact on improving sleep quality (P = 0.00). Multivariate analysis results showed the effect of time on sleep quality improvement scores (F(2, 58) = 349.493, p-value 0.000, partial eta squared = 0.959). It was also found that fatigue, pain, restless legs syndrome, anxiety and depression scores decreased. The results of this study can be used as a non-pharmacological treatment to improve sleep quality independently. Keywords: Cognitive Behavioral Therapy Insomnia, Fatigue, Sleep Quality, Hemodialysis.  ABSTRAK Hemodialisis dapat menimbulkan dampak multi komponen seperti kelelahan, nyeri, sindrom kaki gelisah, kecemasan dan depresi yang dapat menyebabkan gangguan tidur sehingga mengakibatkan penurunan kualitas tidur. CBT-I merupakan terapi multikomponen yang dapat mengatasi gangguan tidur yang disebabkan oleh banyak faktor. Tujuan penelitian ini adalah untuk mengetahui pengaruh CBT-I terhadap kualitas tidur. Metode penelitian yang digunakan adalah quasi eksperimen dengan pendekatan one group pretest-posttest tanpa pendekatan kelompok kontrol. Populasi sebanyak 90 responden dengan jumlah sampel sebanyak 30 responden dengan menggunakan teknik purposive sampling. Pengukuran kualitas tidur menggunakan pittsburgh sleep quality index (PSQI). Analisis data dilakukan dengan menggunakan uji t berpasangan dan Repeated Measures ANOVA. Hasil penelitian menunjukkan nilai rata-rata kualitas tidur sebelum intervensi pada pengukuran ke-1 sebesar 15,00 (±2,262), pada pengukuran ke-2 setelah intervensi sebesar 13,23 (±2,674) dan pada pengukuran ke-3 sebesar 10,23 (2,991). Temuan ini menjelaskan insomnia perilaku kognitif (CBT-i) mempunyai dampak signifikan terhadap peningkatan kualitas tidur (P = 0,00). Hasil analisis multivariat menunjukkan adanya pengaruh waktu terhadap skor peningkatan kualitas tidur (F(2,58) = 349,493, p-value 0,000, parsial eta squared = 0,959). Ditemukan juga bahwa skor kelelahan, nyeri, sindrom kaki gelisah, kecemasan dan depresi menurun. Hasil penelitian ini dapat digunakan sebagai pengobatan non farmakologi untuk meningkatkan kualitas tidur secara mandiri. Kata Kunci: Terapi Perilaku Kognitif Insomnia, Kelelahan, Kualitas Tidur, Hemodialisis.
Penyuluhan Peran Kader dan Remaja dalam Pencegahan Penyakit Katastropik di Ragajaya Bogor Jumaiyah, Wati; Agung, Rizki Nugraha; Siswandi, Iyar; Hanifah, Siti; Purnawati, Dewi; Kamil, Abdu Rahim; Rinawati, Rinawati; Firdaus, Nuzula; al Hasbi, Sulthan Dzahir; Triantono, Bayu; Fawwaz, Achmad Daffa
Jurnal Kreativitas Pengabdian Kepada Masyarakat (PKM) Vol 7, No 2 (2024): Volume 7 No 2 2024
Publisher : Universitas Malahayati Lampung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jkpm.v7i2.13189

Abstract

ABSTRAK Penyakit tidak menular (PTM) merupakan penyakit katastropik yang dapat menimbulkan terjadinya peningkatan beban sosial ekonomi bagi penderita, keluarga maupun pemerintah, karena penanganannya membutuhkan waktu yang tidak sebentar, beberapa penyakit yang pada tingkat rumah tangga tergolong katastropik adalah Hipertensi, Diabetes Melitus (DM) dan Stroke. Kegiatan pengabdian kepada masyarakat ini bertujuan untuk memberi pemahaman hingga pencegahan terhadap penyakit Katastropik pada Kader dan Remaja Ragajaya Bojong Gede, Bogor. Kegiatan pengabdian kepada masyarakat ini dilakukan melalui beberapa tahapan yaitu dimulai dengan penyuluhan, pemeriksaan deteksi dini faktor risiko PTM, konseling serta pelatihan Tekanan Darah dan Pengukuran Tinggi Badan. Pasca kegiatan ini diketahui telah terjadi peningkatan pengetahuan peserta terkait Penyakit Katastropik pada kader dan remaja RW 007 Ragajaya Bogor. Kegiatan Pelatihan penting dijalankan untuk dapat meningkatkan kesadaran masyarakat terhadap penyakit tidak menular melalui deteksi dini, early treatment serta mengendalikan faktor risiko sehingga dapat menurunkan tingkat kesakitan dan kematian. Kata Kunci: Pencegahan, Katastropik, Hipertensi, Diabetes, Stroke  ABSTRACT Non-communicable diseases (NCDs) are catastrophic diseases that can cause an increase in the socio-economic burden for sufferers, families and the government, because treatment requires a long time, some diseases that are classified as catastrophic at the household level are hypertension, diabetes mellitus (DM ) and Strokes. This community service activity aims to provide understanding and prevention of catastrophic diseases in Ragajaya Bojong Gede Cadres and Youth, Bogor. This community service activity is carried out through several stages, starting with counseling, early detection of NCD risk factors, counseling and training on Blood Pressure and Height Measurement. After this activity, it was discovered that there had been an increase in participants' knowledge regarding Catastrophic Diseases among cadres and teenagers of RW 007 Ragajaya Bogor. Training activities are important to carry out to increase public awareness of non-communicable diseases through early detection, early treatment and controlling risk factors so as to reduce morbidity and mortality rates. Keywords: Prevention, Catastrophe, Hypertension, Diabetes, Stroke
Application of Evidence-Based Nursing Practice: Shaker Exercise for Swallowing Ability in Stroke Patients with Dysphagia Saputra, M. Khalid Fredy; Agung, Rizki Nugraha; Yunitri, Ninik; Jumaiyah, Wati; Mulyatsih, MG Enny
Jurnal Ilmiah Ilmu Keperawatan Indonesia Vol 14 No 04 (2024): Jurnal Ilmiah Ilmu Keperawatan Indonesia (JIIKI) Volume 14 Number 04 December 2
Publisher : UIMA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33221/jiiki.v14i04.3664

Abstract

Background: Stroke is one of the leading causes of disability and mortality worldwide, with more than 13 million new cases recorded annually. Stroke can lead to various complications, including dysphagia, which disrupts the patient's swallowing ability. One therapy that can assist stroke patients with dysphagia is the Shaker Exercise. Objectives: This study aims to provide an overview of the impact of implementing Shaker Exercise on swallowing ability in stroke patients experiencing dysphagia through Evidence-Based Nursing Practice (EBNP). Methods: The study used a systematic approach by reviewing various articles and literature from seven prominent health databases, including ProQuest, PubMed, and ScienceDirect. Selected articles focused on Shaker Exercise interventions for stroke patients with dysphagia. Results: The review identified one article in the form of a Systematic Review Meta-Analysis, which examined 37 studies involving a total of 2,656 participants. The analysis results demonstrated that the Shaker Exercise is effective in strengthening suprahyoid muscles, reducing aspiration frequency, and improving swallowing ability in stroke patients with dysphagia. Conclusion: The implementation of Shaker Exercise therapy for stroke patients with dysphagia shows significant results in enhancing swallowing ability and reducing aspiration complications. This therapy aligns with evidence-based nursing principles, supporting the improvement of patients' quality of life through scientifically proven interventions.
Co-Authors Abriyanti, Rika Mustika Agung Waluyo Agung, Rizki Nugraha Agung, Rizky Nugraha Agustina, Elis Nurhayati Aji, Prima Trisna al Hasbi, Sulthan Dzahir Anggaraini, Dewi Anggareni, Dewi Ardiani, Kristi Aresta, Annisa Septiani Arsianti, Lyana Arsyi, Dila Nurul Ashar Prima Asmara, Amelia Atlantic, Mia Budi Susanto Budi, Arif Wahyu Setyo Burmanajaya, Bram Desy anggraini Dewi ANGGRAENI Dewi Anggraini Dewi Gayatri Dewi Purnamawati Dian Hudiyawati Ernawati, Dedeh Erni Kurniasih Erwin Erwin Fajarini, Melati Fawwaz, Achmad Daffa Febryandy, Valentino Feriadianto, Feriadianto Firdaus, Nuzula Firmansyah, Doddy Hamdah, Hamdah Handayani, Martuti Dwi Harison, Nunu Hartati, Yeni Hentu, Ardin Saleh Hernani, Eny Ibrahim, Mufti Indraswati, Ita Irawan, Aprianto Guntur Irawati, Diana Ismail, Ii Jaemi, Jaemi Jum’atina, Jum’atina Junaidin, Junaidin Kamil, Abdu Rahim Komalawati, Dedeh Lakoro, Danny Des Kartyko Maesaroh Maesaroh Maria Yulianti, Maria Masykur Khair Moh. Heri Kurniawan Mulyadi, Egi Mulyatsih, MG Enny Munaya Fauziah Munaya, Munaya Mustafida, Ika Natashia, Dhea Noviana Noviana Nurhayati, Elis Nurrahman, Aris Nursanti, Irna Nusanti, Irna Octoba, Fatwa Achmad Oktavina, Risa Pinamiranti, Firza Pramono, Cahyo Prima, Ashar Purnawati, Dewi Ratna Dewi Rayasari, Fitrian Rinawati Rinawati Rohani Rohani Safruddin Saputra, M. Khalid Fredy Setiawati, Desy Silalahi, Lenny Erida Sismanto, Bayu Aji Siswandi, Iyar Siti Hanifah Sofiani, Yani Suhartini, Euis Sulistiyowati, Heppy Sumedi Sumedi Suryanti, Asih Dwi Suwandi, Wawan Suwito, Kafi Pangki Syafriati, Ani Tallulembang, Abdi Toha Muhaimin Triantono, Bayu Tuti Nuraini Tyawarman, Ady Uly, Nilawati Uswatun Hasanah Wahidi, Kemala Desy Yuli Widyastuti Yuliarti Yuliarti Yuliastutik, Fitri Yulistriani, Anisa Yuniarsih, Winda Yunitri, Ninik Yunus, Muhammad Iqbal Zuliani, Peri