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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.
Evidence based nursing in practice penerapan breating relaxation exercise untuk mengurangi nyeri selama pemasangan chest tube dan thoracotomy Tampubolon, Briefman; Rayasari, Fitrian; Yunitri, Ninik; Agung, Rizki Nugraha; Anggraini, Dewi
Holistik Jurnal Kesehatan 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.v19i8.1670

Abstract

Background: Chest tube placement in post-thoracostomy patients often causes pain, which impacts the healing process. Pharmacological therapies such as analgesics are commonly used but have limitations. Therefore, non-pharmacological interventions such as Breathing Relaxation Exercise (BRE) are needed to help reduce pain. Purpose: To determine the effect of breathing relaxation exercises on pain reduction during chest tube placement and thoracotomy. Method: A pre-experimental one-group pretest-posttest design with a sample size of 13 participants determined using the G*Power calculation. The pain measurement instrument used was the Visual Analogue Scale (VAS). Data analysis was performed using the Shapiro-Wilk normality test and a paired sample t-test. Results: Before BRE, most patients experienced severe pain (69.2%). After the intervention, the pain scale decreased to moderate (38.5%) and mild (46.2%) pain categories. The paired sample t-test results showed a significant difference (p<0.05), with an average pain reduction of 1.615. Conclusion: There was a significant decrease in the pain scale before BRE was implemented.   Keywords: Breathing Relaxation Exercise; Chest Tube; Evidence Based Nursing In Practice; Painful; Thoracotomy.   Pendahuluan: Pemasangan chest tube pada pasien pasca torakostomi sering menimbulkan nyeri yang berdampak pada proses penyembuhan. Terapi farmakologis seperti analgetik umum digunakan, namun memiliki keterbatasan. Oleh karena itu, diperlukan intervensi nonfarmakologis seperti Breathing Relaxation Exercise (BRE) untuk membantu menurunkan nyeri. Tujuan: Mengetahui pengaruh penerapan breating relaxation exercise untuk mengurangi nyeri selama pemasangan chest tube dan thoracotomy. Metode: Desain pre-eksperimental one group pretest-posttest dengan jumlah sampel 13 partisipan yang ditentukan melalui perhitungan G*Power. Instrumen pengukuran nyeri menggunakan Visual Analogue Scale (VAS). Analisis data dilakukan dengan uji normalitas Shapiro-Wilk dan uji Paired Sample t-Test. Hasil: Sebelum diberikan BRE, sebagian besar pasien mengalami nyeri berat (69.2%). Setelah intervensi, skala nyeri menurun menjadi kategori nyeri sedang (38.5%) dan ringan (46.2%). Hasil uji Paired Sample t-Test menunjukkan terdapat perbedaan bermakna (p<0.05), dengan rata-rata penurunan nyeri sebesar 1.615. Simpulan: Adanya penurunan signifikan skala nyeri sebelum dilakukan dilakukan penerapan BRE.   Kata Kunci: Breating Relaxation Exercise; Evidence Based Nursing In Practice; Chest Tube; Nyeri; Thoracotomy.
Penerapan evidence-based practice nursing program intradialytic flexsibility exercise range of mation terhadap fatigue pada pasien chronic kidney disease yang menjalani hemodialisa Barus, Sada Ukur; Agung, Rizki Nugraha; Septiawantari, Rani; Siswandi, Iyar; Sofiani, Yani
Holistik Jurnal Kesehatan 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.
Pengaruh nostril breathing terhadap depresiasi tekanan darah pada orang dengan hipertensi usia produktif Zaki, Muhamad; Sofiani, Yani; Agung, Rizki Nugraha; Rayasari, Fitrian; Kurniasih, Dian Noviati
Holistik Jurnal Kesehatan Vol. 19 No. 10 (2025): Volume 19 Nomor 10
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i10.2043

Abstract

Background: Uncontrolled hypertension over a long period of time can lead to heart attacks, strokes, chronic heart failure (CHF), and chronic renal failure (CRF). The prevalence of hypertension in Indonesia's productive-age population is 13.2%, 20.1%, 31.6%, 45.3%, and 55.2%, among those aged 25-34. One non-pharmacological treatment that can be used to lower blood pressure in hypertensive patients is Nostril Breathing. Purpose: To determine the effect of nostril breathing on blood pressure depression in people with hypertension of productive age. Method: This quantitative quasi-experimental study, with pre- and post-tests without a control group, used a cross-sectional approach. This study was conducted at Astra Insurance Jakarta in August 2025 for 5 days, measuring blood pressure before and after the intervention in 40 participants with hypertension. Data analysis used repeated measures ANOVA at a p-value of 0.002 (<0.05). Results: The average systolic blood pressure before the intervention on day 1 was 151.18 ± 7.26, while the average diastolic blood pressure on day 1 before the intervention on the first day was 85.28 ± 6.91. In the next measurement, the average systolic blood pressure after the intervention on day 5 was lower than the previous days, at 133.63 ± 6.13. Meanwhile, the average diastolic blood pressure after the intervention on day 5 was lower than the previous days, at 82.63 ± 4.08. Conclusion: There is an effect of nostril breathing on blood pressure in people with hypertension, marked by a decrease in blood pressure with a p-value = 0.000 (<0.05). Suggestion: For future researchers, to further examine risk factors that influence the degree of hypertension, such as age and obesity, develop nursing interventions through experimental research, for example, the effect of health education on sleep quality on reducing blood pressure, employee behavior such as lack of physical activity, obesity, smoking, coffee consumption, and personality type.   Keywords: Blood Pressure; Hypertension; Nostril Breathing.   Pendahuluan: Hipertensi yang tidak terkontrol dalam waktu yang lama akan menyebabkan serangan jantung, stroke, chronic heart failure (CHF), dan chronic renal failure (CRF). Prevalensi hipertensi penduduk usia produktif di Indonesia pada umur 18-24 tahun sebesar 13.2%, umur 25-34 tahun sebesar 20.1%, umur 35-44 tahun sebesar 31.6%, umur 45-54 tahun sebesar 45.3%, dan umur 55-64 tahun sebesar 55.2%. Salah satu penatalaksanaan non farmakologis yang dapat dilakukan untuk menurunkan tekanan darah pada pasien hipertensi adalah Nostril Breathing. Tujuan: Untuk mengetahui pengaruh nostril breathing terhadap depresiasi tekanan darah pada orang dengan hipertensi usia produktif. Metode: Penelitian kuantitatif quasy experiment dengan pre and post without control group menggunakan pendekatan cross-sectional. Penelitian ini dilakukan di Asuransi Astra Jakarta pada bulan Agustus 2025 selama 5 hari dengan mengukur tekanan darah sebelum dan sesudah intervensi kepada 40 partisipan dengan hipertensi. Analisis data yang digunakan adalah menggunakan repeated measure ANOVA pada ketetapan p-value 0.002 (< 0.05). Hasil: Rata-rata tekanan darah sistole sebelum intervensi pada hari ke-1 adalah 151.18 ± 7.26, sedangkan rata-rata tekanan darah diastole hari ke-1 sebelum intervensi pada hari pertama adalah sebesar 85.28 ± 6.91. Pada pengukuran berikutnya didapatkan hasil rata-rata tekanan darah sistole sesudah intervensi pada hari ke-5 lebih rendah dari hari-hari sebelumnya, sebesar 133.63 ± 6.13. Sementara itu, rata-rata tekanan darah diastole sesudah intervensi pada hari ke-5 lebih rendah dari hari-hari sebelumnya, sebesar 82.63 ± 4.08. Simpulan: Terdapat pengaruh nostril breating terhadap tekanan darah pada orang dengan hipertensi, ditandai adanya penurunan tekanan darah dengan p-value = 0.000 (<0.05). Saran: Bagi peneliti selanjutnya untuk meneteliti lebih lanjut faktor risiko yang memengaruhi derajat hipertensi, seperti usia dan obesitas kembangkan intervensi keperawatan melalui penelitian eksperimen, misalnya pengaruh penyuluhan kesehatan tentang kualitas tidur terhadap penurunan tekanan darah. perilaku pegawai seperti kurangnya aktivitas fisik, obesitas, merokok, konsumsi kopi, dan tipe kepribadian.   Kata Kunci: Hipertensi; Nostril breathing; Tekanan darah.
Effect of rubber ball gripping range-of-motion exercise on hand muscle strength in patients with non-hemorrhagic stroke Zainab, Zainab; Yunitri, Ninik; Agung, Rizki Nugraha; Saharuddin, Saharuddin
Lentera Perawat Vol. 7 No. 1 (2026): January - March
Publisher : School of Health Sciences Al-Ma'arif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52235/lp.v7i1.694

Abstract

Background: Stroke remains a major cause of disability worldwide, often resulting in impaired upper limb function and decreased hand muscle strength that limit independence in daily activities. Simple, structured rehabilitation strategies such as range-of-motion (ROM) exercises using a rubber ball may provide practical and cost-effective support for motor recovery, yet evidence regarding their specific impact on hand muscle strength in non-hemorrhagic stroke patients remains limited. Objective: This study aimed to examine the effect of rubber ball gripping range-of-motion exercise on hand muscle strength in patients with non-hemorrhagic stroke. Methods: This study employed a pre-experimental one-group pretest–posttest design conducted in the Stroke Center inpatient ward of RSUD Labuang Baji Makassar. A total of 21 patients with non-hemorrhagic stroke who experienced upper extremity weakness were recruited using consecutive sampling based on predefined inclusion criteria. Hand muscle strength was measured using the manual muscle testing scale before intervention and daily after implementation. The intervention consisted of rubber ball gripping ROM exercise performed twice daily for six consecutive days as part of evidence-based nursing practice. Data were analyzed using descriptive statistics and paired statistical testing with a significance level of α = 0.05. Results: The mean hand muscle strength score increased from 3.10 ± 0.301 before intervention to 4.10 ± 0.301 after six days of exercise. Progressive improvement was observed beginning on the third day of intervention, with statistically significant differences between pre- and post-intervention measurements (p < 0.05). These findings indicate that repetitive ROM rubber ball gripping exercise contributed to clinically meaningful improvement in upper limb muscle strength among non-hemorrhagic stroke patients. Conclusion: Rubber ball gripping range-of-motion exercise demonstrated significant effectiveness in improving hand muscle strength in patients with non-hemorrhagic stroke.
Terapi musik efektif menurunkan kecemasan pada pasien penyakit ginjal kronis yang menjalani pemasangan akses vena Budianto, Apri; Agung, Rizki Nugraha; Siswandi, Iyar; Sofiani, Yani; Andini, Sandra
Holistik Jurnal Kesehatan Vol. 19 No. 12 (2026): Volume 19 Nomor 12
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i12.2417

Abstract

Background: Anxiety in patients with chronic kidney disease (CKD) is not only a psychological problem but also a serious clinical threat because it triggers hemodynamic instability. When patients experience intense anxiety before an invasive procedure such as double-lumen catheter (DLU) placement, the sympathetic nervous system is activated, increasing blood catecholamine levels, leading to spikes in blood pressure and tachycardia. This condition is particularly risky for CKD patients who already have cardiovascular complications. Several factors can trigger anxiety and depression in hemodialysis patients, including frequent comorbidities, frequent hospitalizations, new experiences with invasive procedures, chronic pain, sleep disturbances, chronic inflammation, increased fatigue, decreased sexual function, uremia, and lack of family support in daily life. Purpose: To determine the effectiveness of music therapy in reducing anxiety in patients with chronic kidney disease undergoing venous access placement. Method: This study used an evidence-based nursing practice (EBNP) approach with a quasi-experimental pre-post-test design, conducted on 14 participants selected through purposive sampling based on inclusion criteria. Music therapy was administered during the venous access/CDL surgical procedure for 30 minutes. Anxiety was measured using the HARS and VAS questionnaires. Data were analyzed using univariate and bivariate tests, including paired t-tests and Wilcoxon tests. Results: The prevalence of anxiety decreased from 60% to 40%, with HARS and VAS measurements decreasing from 48% to 43% after the intervention. The paired t-test and Wilcoxon test showed p-values ​​of 0.01 and 0.00, respectively. Conclusion: Music therapy can reduce anxiety in hemodialysis participants. Applied systematically and supported by scientific evidence, music therapy has a positive effect on anxiety in patients with chronic kidney disease (CKD) undergoing venous access. Suggestion: Further exploration of the physiological and psychological mechanisms of music therapy is needed, as well as consideration of other factors, such as pain, sleep quality, depression levels, and medication adherence, which may influence anxiety levels in hemodialysis patients undergoing first-time venous access.   Keywords: Anxiety; Chronic Kidney Disease Patients; Music Therapy; Venous Access Insertion.   Pendahuluan: Kecemasan pada pasien Penyakit Ginjal Kronis (PGK) bukan sekadar masalah psikologis, melainkan ancaman klinis yang serius karena memicu instabilitas hemodinamik. Saat pasien mengalami kecemasan hebat menjelang tindakan invasif seperti pemasangan catheter dual lumen (CDL), sistem saraf simpatis akan teraktivasi, meningkatkan kadar katekolamin dalam darah yang berujung pada lonjakan tekanan darah dan takikardia. Kondisi ini sangat berisiko bagi pasien PGK yang sudah memiliki komplikasi kardiovaskular. Beberapa faktor yang bisa memicu kecemasan dan depresi pada pasien hemodialisis, antara lain penyakit penyerta yang sering timbul, seringnya dirawat di rumah sakit, pengalaman baru terhadap tindakan invasif, nyeri kronik, gangguan tidur, peradangan kronik, peningkatan kelelahan, penurunan fungsi seksual, uremia, dan kegagalan dukungan keluarga dalam kehidupan sehari-hari. Tujuan: Untuk menerapkan terapi musik efektif menurunkan kecemasan pada pasien penyakit ginjal kronis yang menjalani pemasangan akses vena. Metode: Penelitian ini menggunakan pendekatan evidence-based nursing practice (EBNP) dengan desain quasi-experiment pre-posttest, dilakukan pada 14 partisipan terpilih berdasarkan purposive sampling sesuai kriteria inklusi. Terapi musik diberikan selama proses operasi pemasangan akses vena/CDL selama 30 menit, kecemasan diukur menggunakan kuesioner HARS dan VAS. Data dianalisis menggunakan uji univariat dan bivariat dengan uji paired t-test dan uji Wilcoxon. Hasil: Prevelansi tingkat kecemasan 60% menurun menjadi 40% dengan pengukuran HARS dan VAS 48% menurun menjadi 43% setelah intervensi. Uji paired t-test dan Uji wilcoxon menunjukkan nilai p=0.01 dan p=0.00. Simpulan: Terapi musik dapat menurunkan kecemasan pada partisapan hemodialisis, diaplikasikan secara sistematis dan didukung oleh bukti ilmiah untuk menurunkan kecemasan terapi musik memiliki efek positif terhadap kecemasan pasien penyakit ginjal kronis yang menjalani pemasangan akses vena. Saran: Perlu mengeksplorasi lebih jauh mekanisme fisiologis maupun psikologis dari penerapan terapi musik, serta mempertimbangkan faktor-faktor lain, seperti nyeri, kualitas tidur, tingkat depresi, dan kepatuhan terhadap pengobatan yang mungkin berpengaruh terhadap tingkat kecemasan pada pasien hemodialis yang akan menjalani pemasangan akses vena pertama kali.   Kata Kunci: Kecemasan; Pasien Penyakit Ginjal Kronis; Pemasangan Akses Vena; Terapi Musik.