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All Journal Jurnal Kedokteran Brawijaya Journal of Community Health and Preventive Medicine (JOCHAPM)
Rahmawati Aminingrum
Brawijaya University
Environmental Science Health Professions Medicine & Pharmacology Nursing Public Health

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Hambatan Implementasi Surviving Sepsis Campaign Guidelines 2012 pada Pasien Anak di Rumah Sakit Rujukan Tersier Yuliarto, Saptadi; Kadafi, Kurniawan Taufiq; Nugrahani, Iin Tri Listiyanti; Aminingrum, Rahmawati; Asariati, Husnul
Jurnal Kedokteran Brawijaya Vol 28, No 1 (2014)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (523.824 KB) | DOI: 10.21776/ub.jkb.2014.028.01.11

Abstract

Tata laksana adekuat sepsis dapat memperbaiki luaran pasien. Surviving sepsis campaign (SSC) guidelines 2012 merupakan panduan internasional tata laksana sepsis berat dan syok septik, namun implementasinya dipengaruhi oleh sumberdaya dan fasilitas kesehatan. Penelitian ini mengevaluasi implementasi SSC di rumah sakit. Studi prospektif dilakukan antara Februari-Juni 2013 pada seluruh pasien usia 1 bulan–18 tahun yang memenuhi kriteria sepsis, dengan menilai penggunaan cairan resusitasi dan obat vasoaktif, waktu pemberian antibiotika, waktu pengambilan kultur, pemberian nutrisi, penggunaan ventilator, dan angka kematian. Di antara 40 pasien, 34 merupakan kasus syok septik. Seluruh pasien syok septik mendapatkan resusitasi cairan dan obat vasoaktif. Obat vasoaktif diberikan kurang dari 6 jam pada 21 pasien. Hanya 14 pasien mendapatkan antibiotika pada jam pertama, dan hanya 6 pasien dilakukan pemeriksaan kultur darah sebelum pemberian antibiotika awal. Sebanyak 28 pasien membutuhkan ventilator, namun 13 pasien tidak bisa mendapatkannya.Hal ini meningkatkan risiko mortalitas 2,1 kali (95% IK 1,2; 3,7). Saat perawatan di unit intensif, 27 pasien mendapatkan nutrisi pada 6-24 jam pertama, namun sebagian besar (32 pasien) mendapatkan kalori kurang dari 80% dalam 48 jam pertama yang meningkatkan risiko mortalitas 3 kali (95% IK 1,1; 8,2). Mortalitas terjadi pada 24 pasien. Hal ini menunjukkan adanya hambatan pelaksanaan SSC guidelines 2012 dalam hal pemberian antibiotika, pemeriksaan kultur darah, penggunaan ventilator, dan pemberian nutrisi adekuat. Ketidaktersediaan ventilator dan terapi nutrisi inadekuat meningkatkan risiko mortalitas.Kata Kunci: Antibiotika, kultur darah, mortalita, nutrisi, sepsis, ventilator
Penurunan Luaran Neurodevelopmental pada Sepsis Neonatal terjadi melalui Peningkatan IL- 6 dan bukan TNF-α Aminingrum, Rahmawati; Ariani, Ariani; ES, M Istiadjid
Jurnal Kedokteran Brawijaya Vol 28, No 4 (2015)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2015.028.04.10

Abstract

Bayi yang mengalami gangguan pada masa prenatal, natal dan paska natal mempunyai risiko tinggi untuk mendapatkan hambatan tumbuh kembang secara optimal dibandingkan bayi lainnya. IL-6 dan TNF-α merupakan salah satu sitokin yang diproduksi saat terjadi sepsis dan mempunyai peranan pada perkembangan otak sebagai sinyal proinflamasi. Tujuan penelitian ini adalah untuk mengetahui pengaruh sepsis terhadap luaran neurodevelopmental, melalui peningkatan kadar IL-6 dan TNF α. Dua puluh neonatus yang memenuhi kriteria sepsis pada ruang perinatologi RSSA dimasukkan dalam subjek penelitian, diukur kadar IL-6 dan TNF-α saat sepsis neonatal dengan menggunakan metode ELISA, dan dinilai perkembangannya pada usia 9 bulan dengan menggunakan Bayley 3. Analisis data diolah dengan menggunakan PLS untuk menentukan pengaruh sepsis neonatal terhadap luaran neurodevelopmental. Hasil penelitian menunjukkan peningkatan IL-6 dan TNF-α pada sepsi dan penurunan luaran neurodevelopmental usia 9 bulan terutama pada aspek kognitif diikuti motorik, dan bahasa, namun tidak didapatkan pengaruh bermakna pada peningkatan TNF-α dengan luaran neurodevelopmental. Dapat disimpulkan bahwa sepsis neonatal dapat berpengaruh pada luaran neurodevelopmental usia 9 bulan melalui peningkatan IL-6 dan bukan TNF-α. Kata Kunci: IL-6, neonatal sepsis, neurodevelopmental outcome, TNF-α
FACTORS INFLUENCING NON-BPJS PATIENTS CHOICE OF HOSPITALS FOR OUTPATIENT SERVICES Rini, Kartika; Setijowati, Nanik; Aminingrum, Rahmawati
Journal of Community Health and Preventive Medicine Vol. 5 No. Issue Supplement 1 (2025): JOCHAPM Vol. 5, Issue Supplement 1, March 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Non-BPJS patients have greater autonomy in selecting healthcare providers, making them a vital segment in ensuring the sustainability and growth of hospital businesses. These patients tend to consider various factors when choosing healthcare services, including accessibility, service quality, hospital reputation, medical technology, and overall patient experience. This study aims to identify the key factors influencing the decision of non-BPJS patients to return to a private hospital for further treatment. By highlighting the importance of this patient segment, the study emphasizes how hospitals can better understand and respond to patient preferences in order to enhance competitiveness. A qualitative research design was employed, with data collected through in-depth interviews involving 10 outpatients from specialist clinics at a private hospital in Malang City. The data were analyzed using thematic analysis, whereby the interview findings were categorized according to emerging themes aligned with the research objectives. The study reveals that, based on patient experiences, several key factors influence the decision of non-BPJS patients to return for services at private hospitals. Among the primary considerations for revisiting outpatient specialist clinics in Malang City are the friendliness of specialist doctors, the availability of medication delivery services, the hospital’s proximity, and affordable medical fees. Conversely, several issues were identified that could negatively impact patient satisfaction if not addressed. These include the lack of clear registration instructions, particularly for new patients; unfriendly behavior from some staff members; cramped facilities; limited patient waiting areas; and prolonged waiting times.
MATERNAL PATIENT EXPERIENCE AND INTENTION TO REVISIT: A STUDY IN A PRIVATE HOSPITAL IN MALANG CITY Oktaviana, Ratih; Setijowati, Nanik; Aminingrum, Rahmawati
Journal of Community Health and Preventive Medicine Vol. 5 No. Issue Supplement 1 (2025): JOCHAPM Vol. 5, Issue Supplement 1, March 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Maternal health care is an important component of the national health system since it directly affects maternal and child health. The quality of maternal care is evaluated not only based on clinical outcomes, but also on the patient's experience with the preceding treatment. This experience encompasses emotional factors, interactions with health care providers, hospital facilities, and service accessibility. Patients who have pleasant pregnancy, delivery, and postpartum experiences are more likely to revisit and use the same health services in the future. This study employs a qualitative methodology with a phenomenological approach. Data was collected through in-depth interviews with seven outpatients chosen based on particular criteria at the gynecological clinic at X Hospital in Malang City. The data were evaluated using thematic analysis, which involved categorizing interview results based on themes that arose in line with the research objectives. The findings of this study indicate that pregnant patients desire to revisit to Hospital X for a variety of reasons, including the availability of qualified specialist doctors, comprehensive facilities and infrastructure, good and courteous staff service, and the hospital's Islamic brand image. The majority of the informants expressed great happiness and satisfaction with their interactions at this facility. However, there were also less pleasant encounters, such as long and inconvenient lines and doctors who arrived late. Exploring the experiences of these maternal patients is one of the initiatives to find measures to boost patients' intent to visit this hospital again.
Co-Authors Ariani Ariani Husnul Asariati Iin Tri Listiyanti Nugrahani Kartika Rini Kurniawan Taufiq Kadafi M Istiadjid ES Nanik Setijowati Oktaviana, Ratih Saptadi Yuliarto