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DUKUNGAN KELUARGA DAN READMISI PASIEN PASCAOPERASI KATUP JANTUNG Adam, Muhamad; Artati, Artati; Herawati, Tuti; Nova, Prima Agustia; Mirharina, Irza
Jurnal Persatuan Perawat Nasional Indonesia (JPPNI) Vol 7, No 1 (2022)
Publisher : Persatuan Perawat Nasional Indonesia (JPPNI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32419/jppni.v7i1.348

ABSTRAKOperasi katup jantung sering dilakukan, seiring dengan prevalensi penyakit jantung katup yang masih tinggi. Namun, setelah menjalani operasi, pasien mengalami readmisi dalam 1 bulan yang kemungkinan berkaitan dengan dukungan keluarga. Tujuan penelitian: Penelitian ini bertujuan mengidentifikasi hubungan dukungan keluarga dengan readmisi setelah pasien menjalani operasi katup jantung. Metode: Penelitian cross-sectional ini melibatkan 105 responden pascaoperasi katup jantung yang mengalami readmisi di Rumah Sakit Pusat Jantung Nasional Harapan Kita, Jakarta dengan menggunakan teknik consecutive sampling. Penelitian ini menggunakan kuesioner karakteristik responden, readmisi, dan dukungan keluarga. Analisis univariat dilakukan untuk mengetahui distribusi frekuensi dan analisis bivariat chi square untuk mengetahui kemaknaan hubungan dukungan keluarga dan readmisi. Hasil: Sebagian besar responden (46,7%) berada pada rentang usia pertengahan (45–59 tahun), jenis kelamin perempuan (52%) lebih banyak daripada laki-laki (47%), katup mitral (37,1%) dan aorta (31,4%) yang paling banyak dilakukan operasi. Sebagian besar responden (75%) mengalami dukungan keluarga yang nonsuportif dan sebagian besar responden (61%) setidaknya mengalami satu kali readmisi dalam 1 bulan. Terdapat hubungan yang bermakna antara dukungan keluarga dengan readmisi pasien pascaoperasi katup jantung (p = 0,019; α < 0,05). Diskusi: Dukungan keluarga dapat meningkatkan perilaku sehat dan proses pemulihan sehingga dapat mencegah terjadinya readmisi. Kesimpulan: Perawat dianjurkan mengkaji dukungan keluarga terhadap pasien yang direncanakan menjalani operasi katup jantung dan memberikan intervensi keperawatan yang diperlukan untuk meningkatkan dukungan keluarga dan mencegah readmisi. Penelitian lebih lanjut diperlukan untuk mengidentifikasi penyebab sebagian besar pasien pascaoperasi katup jantung mengalami dukungan keluarga yang nonsuportif.Kata Kunci: dukungan keluarga, katup jantung, pascaoperasi, readmisi pasien Family Support and Readmission After Heart Valve Surgery ABSTRACTHeart valve surgery is often performed, along with the high prevalence of valvular heart disease. However, after surgery, the patient is readmitted within 1 month, probably related to family support. Objective: This research aims to identify the correlation between family support and readmission after the patient undergoes heart valve surgery. Methods: This cross-sectional research involved 105 respondents after heart valve surgery who were readmitted at Harapan Kita National Heart Center Hospital, Jakarta. The respondents were taken using a consecutive sampling technique. This research employed a questionnaire on the characteristics of the respondents, readmission, and family support. Univariate analysis was used to identify the frequency distribution, and bivariate chi-square analysis was used to identify the significance of the correlation between family support and readmission. Results: Most of the respondents (46.7%) were in the middle age range (45-59 years), more female (52%) than male (47%), mitral valve (37.1%), and aorta (31.4%) was the most frequently operated on. Most respondents (75%) had non-supportive families, and most respondents (61%) experienced at least 1 readmission in 1 month. There was a significant correlation between family support and patient readmission after the heart valve surgery (p=0.019; <0.05). Discussion: Family support can improve healthy behaviour and the recovery process so that it can prevent readmissions. Conclusion: Nurses are recommended to assess family support in patients planning for heart valve surgery and provide necessary nursing interventions to increase family support and prevent readmission. Further research is needed to identify the cause of most post-heart valve surgery patients having non-supportive families.Keywords: Family support, heart valve, post-surgery, patient readmission

Inspiratory Muscle Training to Improve Activity Tolerance in Heart Failure Patients Amanah, Dinny Atin; Nurachmah, Elly; Nova, Prima Agustia
Media Keperawatan Indonesia Vol 6, No 3 (2023)
Publisher : Universitas Muhammadiyah Semarang

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Characteristic of heart failure patients is decreased activity tolerance which is defined as a decreased capacity to carry out activities accompanied by symptoms of dyspnea and/or significant fatigue. This study aimed to determine whether Inspiratory Muscle Training (IMT) can improve activity tolerance in heart failure patients. A systematic review design with the PICO (Population, Intervention, Comparation, and Outcome) approach has been arranged based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline. Articles were collected through the online database ClinicalKey Nursing, EBSCOhost, Oxford Journals, ProQuest, Sage Journals, ScienceDirect, Scopus, and SpringerLink. Articles with Randomized Controlled Trial (RCT) and quasi experimental design in English were included. Quality of the article was assessed using JBI Critical Appraisal Checklist. There were seven research articles that met the criteria in this study. Those studies show that IMT can increase activity tolerance in heart failure patients. IMT can be applied as a single intervention or in combination with other interventions. Interventions that can be combined with IMT include Cardiac Rehabilitation (CR), Peripheral Muscle Training (PMT), or Functional Electrical Stimulation (FES) programs.

Walking Exercise and Its Effect on Functional Capacity and Productivity in Post-Coronary Artery Bypass Graft (CABG) Patients: A Randomized Controlled Trial Pamungkas, Indra Gilang; Herawati, Tuti; Nova, Prima Agustia
Nurse Media Journal of Nursing Vol 14, No 3 (2024): (December 2024)
Publisher : Department of Nursing, Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/nmjn.v14i3.57436

Background: Post-CABG patients may experience several problems following surgery. Their functional capacity and productivity often decline after the procedure. Walking exercise is considered beneficial for improving functional capacity and productivity, as it can increase cardiac output. However, previous studies have shown mixed results, highlighting the need for further research that takes into account variables such as the type, intensity, frequency, and duration of exercise to better understand its impact.Purpose: This study aimed to assess the effect of walking exercise on functional capacity and productivity in patients after CABG.Methods: This study used a Randomized Controlled Trial (RCT) design with a single-blind outcome assessor. The sample size was 42 respondents, who were divided into the intervention and control groups. The intervention group received walking exercise and leg straightening, while the control group received only leg straightening. The 6-Minute Walking Test (MWT) was used to measure functional capacity, while the WPAI measured productivity. Data analysis used independent and dependent t-tests for normally distributed variables such as functional capacity, impairment while working, and activity impairment, and Mann-Whitney and Wilcoxon tests for variables that were not normally distributed, such as work time missed and overall work impairment.Results: This study showed a significant effect of walking exercise on functional capacity (6.262±0.597 vs. 5.762±0.559, p=0.008), impairment while working (27.14±10.556 vs. 36.67±12.383, p=0.011), and activity impairment (23.81±6.690 vs. 19.52±6.690, p=0.044). Moreover, the study’s results showed no significant difference in work time missed (4.086±7.003 vs. 3.900±6.288, p=0.967) and overall work impairment (3.795±4.756 vs. 3.757±4.628, p=0.696) between the groups.Conclusion: Walking exercise improves cardiac function and metabolism, which increases adenosine triphosphate (ATP) production, thereby enhancing functional capacity and productivity in patients. Nurses should play active roles in encouraging and educating post-CABG patients to incorporate regular walking exercises into their recovery routines.

Penerapan Therapeutic Positions terhadap Parameter Vital Signs Pasien Stroke di Rumah Sakit Pusat Otak Nasional Prof. Dr. Dr. Mahar Mardjono Jakarta Irman, Irman; Kariasa, I Made; Nova, Prima Agustia; Mulyatsih, MG Enny
MAHESA : Malahayati Health Student Journal Vol 4, No 5 (2024): Volume 4 Nomor 5 (2024)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v4i5.14389

ABSTRACT This study aims to determine the application of therapeutic positions to the vital signs parameters of stroke patients at the Prof. Dr. National Brain Center Hospital. Dr. Mahar Mardjono Jakarta. This research is an application of Evidence-Based Nursing which was applied to 12 respondents. Each patient in the study group was positioned in various therapeutic positions every 2 hours following a semi-fowler's rotating schedule, lying on their side to the healthy side (Unaffected Side Position), lying on their back (Supine Position), and lying on their side to the side with hemiparesis or hemiplegia (Affected Side Position). Based on the results, the average systolic blood pressure decreased on the second post-intervention day (day 2) with a mean of 124.08 and a standard deviation of 3,147, while the diastolic mean was not much different from the first day, namely 83.17 and a standard deviation of 2,657. The average heart rate on the second-day post-intervention decreased with a mean of 84.92 and a standard deviation of 0.900. In the respiration rate variable, the decrease in the mean value post-intervention on the second day was 15.33 (standard deviation 0.888). The mean value for oxygen saturation levels (SPO2) with the mean post-test value on the second day was 99.75 (standard deviation 0.452). So it can be concluded that providing therapeutic positions intervention can reduce blood pressure, heart rate, and respiration rate and increase oxygen saturation. Keywords: Therapeutic Positions, Vital Signs ABSTRAK Penelitian ini bertujuan untuk mengetahui Penerapan Therapeutic Positions Terhadap Parameter Vital Signs Pasien Stroke Di Rumah Sakit Pusat Otak Nasional Prof Dr. dr. Mahar Mardjono Jakarta. Penelitian ini merupakan Penerapan Evidence-Based Nursing yang diterapkan pada 12 responden. Setiap pasien dalam kelompok studi diposisikan pada berbagai posisi terapeutik setiap 2 jam dengan mengikuti jadwal berputar seperti semi fowler's, berbaring miring ke sisi yang sehat (Unaffected Side Position), berbaring terlentang (Supine Position) dan berbaring miring ke sisi yang hemiparesis atau hemiplegia (Affected Side Position). Berdasarkan hasil bahwa rata-rata tekanan darah sistole terjadi penurunan pada post intervensi hari kedua (day 2) dengan mean 124.08 dan standar deviasi 3.147, sedangkan diastole diperoleh mean yang tidak berbeda jauh dengan hari pertama yaitu 83.17 dan standar deviasi 2.657. Rata-rata heart rate post intervensi hari kedua terjadi penurunan dengan mean 84.92 dan standar deviasi 0.900. Pada variabel respiration rate diperoleh penurunan untuk nilai mean post intervensi hari kedua adalah 15.33 (standar deviasi 0.888). Nilai mean pada kadar saturasi oksigen (SPO2) dengan nilai mean post-test hari kedua 99.75 (standar deviasi 0.452). Pemberian intervensi therapeutic positions dapat menurunkan tekanan darah, heart rate, respiration rate dan meningkatkan saturasi oksigen. Kata Kunci: Posisi Terapeutik, Tanda-Tanda Vital

Penerapan Panduan Nurse-Led Early Mobilization Pada Pasien yang Menjalani Pembedahan Elektif Tulang Belakang Irman, Irman; Pitaloka, Rika Diah; Rakhman, Isnawan Risqi; Kariasa, I Made; Nova, Prima Agustia; Mulyatsih, MG Enny
MAHESA : Malahayati Health Student Journal Vol 4, No 9 (2024): Volume 4 Nomor 9 (2024)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v4i9.14889

ABSTRACT This study aims to determine the implementation of the Nurse-LED Early Mobilization Guide in patients undergoing elective spinal surgery. This research is an implementation of an Innovation Project which was applied to 10 respondents. Each patient in the study group was mobilized in a sequence starting from right lateral/supine/left, sitting 45o, sitting upright 90o, and dangling sitting mobilization according to the specified time. Post intervention results were evaluated where pain started from the first 24 hours (POD-1) to the third day (POD-3) while functional status after 72 hours post surgery (POD-3). Based on the results, the average Barthel Index in the post-intervention group evaluated on the third day (POD-3) was 15.30 with a standard deviation of 3.40. Meanwhile, the average pain score in the first day post-intervention group (POD-1) was 4.50 with a standard deviation of 0.97. The mean pain score on the second day (POD-2) was 3.60 with a standard deviation of 0.69. Meanwhile, the average pain score on the third day was 2.50 with a standard deviation of 0.70. Conclusion: Nurse-LED early mobilization intervention can be carried out in degenerative disc disease patients undergoing elective spine surgery to improve the patient's clinical outcomes, especially functional status and decreased pain. Keywords: Decreased Pain, Functional Status, Nurse-LED Early Mobilization ABSTRAK Penelitian ini bertujuan untuk mengetahui Penerapan Panduan Nurse-LED Early Mobilization pada pasien yang Menjalani pembedahan elektif tulang belakang. Penelitian ini merupakan Penerapan Proyek Inovasi yang diterapkan pada 10 responden. Setiap pasien dalam kelompok studi dimobilisasikan dengan urutan mulai dari lateral kanan/supine/kiri, duduk 45o, duduk tegak 90o, dan mobiliasi duduk berjuntai sesuai dengan waktu yang telah ditentukan. Hasil post intervensi dievaluasi dimana nyeri mulai dari 24 jam pertama (POD-1) sampai dengan hari ketiga (POD-3) sedangkan status fungsional setelah 72 jam post operasi (POD-3). Berdasarkan hasil bahwa rata-rata Barthel Index pada kelompok post intervensi yang dievaluasi pada hari ketiga (POD-3) adalah 15,30 dengan standar deviasi 3,40. Sedangkan rata-rata skor nyeri pada kelompok post intervensi hari pertama (POD-1) adalah 4.50 dengan standar deviasi 0.97. Mean skor nyeri pada hari kedua (POD-2) adalah 3,60 dengan standar deviasi 0,69. Sedangkan rerata skor nyeri pada hari ketiga adalah 2,50 dengan standar deviasi 0,70. Kesimpulan : intervensi Nurse-LED Early mobilization dapat dilakukan pada pasien-pasien degenerative disc disease yang menjalani pembadahan elektif tulang belakang untuk meningkatkan outcome klinis pasien khususnya adalah status fungsional dan penurunan nyeri. Kata Kunci: Penurunan Nyeri, Status Fungsional, Nurse-LED Early Mobilization

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