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All Journal Medula Jurnal Sejarah dan Budaya JURNAL PENELITIAN PERAWAT PROFESIONAL JK Unila (Jurnal Kedokteran Universitas Lampung) Jurnal EduHealth Jurnal Impresi Indonesia Perspektif: Jurnal Pendidikan dan Ilmu Bahasa Majority JPM (Jurnal Pengabdian Masyarakat) Ruwa Jurai Jurnal Agromedicine Unila: Jurnal Kesehatan dan Agromedicine
Tutik Ernawati
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Penatalaksanaan Holistik Pasien Lansia dengan Hipertensi Derajat 1, Diabetes Mellitus Tipe 2, Obese Grade I, dan Hiperkolesterolemia Melalui Pendekatan Kedokteran Keluarga di Puskesmas Rawat Inap Kedaton Dinda Afifa; Tutik Ernawati; Adela Putri Agata
Medula Vol 12 No 2 (2022): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v12i2.411

Abstract

Hypertension is one of the degenerative disease. Degenerative disease is a chronic non-communicable disease due to deterioration in organ function due to the aging process. The prevalence of hypertension in lampung reached 7,95%. Through identifying the risk factors, clinical problems, conduct patient management holistically by applying family doctors according to evidence based medicine through a patient center, family approach, and community oriented. This study is a case report. The primary data obtained through anamnesis, physical examination, and home visits to complete the family data, psychosocial and environmental data. Assessment based upon a holistic diagnosis of early, process, and the final quantitative and qualitative studies. Based on a holistic diagnosis, the patient had a history of hypertension and type 2 diabetes mellitus for more than 10 years, as well as hypercholesterolemia and obesity. Patients routinely seek treatment at the clinic and routinely take medication every day. The patient's diet is still irregular and the patient rarely does physical activity. The diagnosis and managemet of the patient has been done holistically, patient centered, family approach and in accordance with national guidelines and based on evidence based medicine. Changes in patient and family knowledge and behaviour occur after patient center and family approach interventions.
HOLISTIC MANAGEMENT OF A 69 YEAR OLD FEMALE PATIENT WITH LOW BACK PAIN AND GRADE 2 HYPERTENSION IN A PRIMARY HEALTH CARE Adli, Farhan Kamali; Karyus, Aila; Ernawati, Tutik
Medula Vol 13 No 7 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i7.878

Abstract

Based on data from the World Health Organization, it is estimated that around 15-20% of the world's population suffers from hypertension and Hypertension in Indonesia is the third cause of death in all age groups, namely around 6.7% of the total population of deaths in Indonesia. The prevalence of musculoskeletal diseases in Indonesia is 11.9% and based on symptoms, the prevalence of musculoskeletal diseases in Indonesia reaches 24.7%. Meanwhile, the prevalence of musculoskeletal disease in Lampung reached 18.9%. Apply the principles of family medicine services to patients and carry out holistic management based on the patient problem found with patient-centered approach, family focused, and community oriented based on Evidence Based Medicine. This study is a case report with Primary data obtained through history taking, physical examination and home visits to complete family, psychosocial and environmental data. Secondary data was obtained from the patient's medical record. The assessment is based on a holistic diagnosis from the beginning, process, and end of the study. Mrs. L 69 years old, came with complaints of headaches, heavy shoulders and lower back pain. The patient was diagnosed as hypertension and low back pain. In this case, the diagnosis and treatment were carried out according to the theory and related journals. After the intervention, there was a decrease in clinical symptoms and an increase in patient and family knowledge. Holistic management can improve the knowledge, attitudes, and behavior of patients and family in maintaining their health.
PENATALAKSANAAN HOLISTIK PADA AN. TM USIA 18 TAHUN DENGAN BELLS PALSY MELALUI PENDEKATAN KEDOKTERAN KELUARGA DI WILAYAH KERJA UPTD PUSKESMAS NATAR Amalia, Shafira; Ernawati, Tutik
Medula Vol 14 No 6 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i6.1149

Abstract

Bell palsy is an acute paralysis of the peripheral facial nerve (N. Clinical manifestations caused by Bell's palsy can include impairment, disability, handicap, and entertainment, and can cause mental problems for sufferers. Applying the principles of family medicine services and carrying out holistic management based on a framework for solving patient problems with a patient-centered, family-focused, and community-oriented approach based on Evidence-Based Medicine. This study is a case report using primary data obtained through history taking, physical examination, and home visits to complement family data, and psychosocial and environmental data. Secondary data was obtained from patient medical records. Patient An. TM aged 18 years with complaints of stiffness on the right side of the face since two days ago. The patient has a habit of riding a two-wheeler without using head protection. The patient also had a history of varicella two years ago. Holistic management with a family doctor approach has been carried out for An.TM aged 18 years with Bell's palsy which was adjusted based on the initial holistic diagnosis. Before the intervention, the patient and family are given a pretest to measure the patient's level of knowledge regarding the disease they are suffering from. During the intervention, the patient is explained about the disease he is suffering from using media in the form of posters, and the patient is given education regarding the importance of completing treatment, how to prevent the disease, and doing facial exercises. At the last visit, a posttest was given to the patient and family with the results being a significant increase in knowledge about the disease they were suffering from and awareness of the importance of changing patient habits.
Penatalaksanaan Holistik Penyakit Impetigo pada Anak Usia 12 Tahun di Puskesmas Kampung Sawah melalui Pendekatan Kedokteran Keluarga deralitha; Ernawati, Tutik
Medula Vol 14 No 7 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i7.1202

Abstract

Background: Impetigo is a classification of pyoderma, which attacks the epidermal layer of the skin. Impetigo is divided into two types, namely bullous and non-bullous impetigo. One of the clinical forms most often found in pediatric cases is bullous impetigo, this bacteria spreads from one individual to another through direct contact such as through hand contact. Bullous impetigo has lesions in the form of bullae and has thin walls with reddish edges, most often caused by Staphylococcus aureus. Non-bullous impetigo begins with an erythematous papulovesicle that continues to grow with a yellow crust, most often caused by Staphylococcus aureus and Group A Streptococcus. Objective: Implementing the principle of doctor service according to the problems found and carrying out holistic and comprehensive management including patient-centered and family approaches based on Evidence Based Medicine. Method: This study is a case report. The data obtained include primary data were obtained through alloanamnesis and autoanamnesis, physical examination and home visits and secondary data were obtained from the patient's medical record. Results: Patient girl 12 year old complained of brownish yellow scabs on his face and blisters filled with yellow fluid on his neck. The patient is worried that the complaint is getting worse. Clinically the patient was diagnosed with Impetigo. Next, holistic management is carried out, namely intervention using poster media. In the evaluation, results were obtained in the form of a better understanding of the disease and changes in behavior that had an impact on the success of therapy. Conclusion: The diagnosis and management of this patient has been carried out holistically and comprehensively based on several theories and recent research. In the process of changing behavior, the patient has reached the trial stage.
Penatalaksanaan Holistik Penyakit Tonsilitis Akut pada Anak Perempuan Usia Enam Tahun di Puskesmas Pasar Ambon melalui Pendekatan Kedokteran Keluarga Asadha, Syahfa Alzena; Ernawati, Tutik
Medula Vol 14 No 7 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i7.1315

Abstract

Tonsillitis can strike any age but is more common in children. Inflammation of the tonsils can be caused by bacteria or viruses.  Inflammation of the tonsils will result in enlargement which causes difficulty swallowing or feels like there is a lump in the throat. Enlarged tonsils can also cause other symptoms such as hoarseness (muffled voice) or even breathing problems in severe cases. If there is no complete healing of the tonsils, recurrent infections can occur. Applying the principles of family medicine services and carrying out holistic management based on a framework for solving patient problems with a patient-centered, family-focused, and community-oriented approach based on Evidence-Based Medicine. This study is a case report using primary data obtained through history taking, physical examination, and home visits to complement family data, and psychosocial and environmental data. Secondary data was obtained from patient medical records. Patient An. N aged six years old with complaints of swallowing pain since four days ago. Patients have a habit of consuming iced drinks and light snacks which may be unhygienic and can be a risk factor for infection. Holistic management with a family doctor approach has been carried out for An. N aged six years with Acute Tonsillitis  which was adjusted based on the initial holistic diagnosis. Before the intervention, the patient and family are given a pretest to measure the patient's level of knowledge regarding the disease they are suffering from. During the intervention, the family is explained about the disease she is suffering from using media in the form of posters, and the family is given education regarding the importance of treatment and how to prevent the disease. At the last visit a posttest was given to the family with the results being a significant increase in knowledge about the disease they were suffering from and awareness of the importance of changing patient habits.
PENDEKATAN HOLISTIK PADA WANITA USIA 54 TAHUN DENGAN DIABETES MELITUS TIPE II DAN OBESE DERAJAT II MELALUI PENDEKATAN KEDOKTERAN KELUARGA DI PUSKESMAS RAJABASA INDAH Pratiwi, Bella; Ernawati, Tutik
Medula Vol 14 No 7 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i7.1332

Abstract

Diabetes Mellitus is one of the degenerative diseases with high prevalence and is increasing every year in Lampung province by 22,345 cases or 1.37%. Obesity is one of the predisposing factors for diabetes mellitus. The prevalence of obesity in the population aged 18 years and over increased from 14.8% to 21.8%. In Lampung province, it was 17.3%. Diabetes mellitus and Obesity must be managed comprehensively which is expected to prevent complications and improve the quality of life of patients. Objective: Implementation of Evidence Based Medicine-based services in patients by identifying risk factors, clinical problems, and patient management based on a patient problem-solving framework with a patient-centered, family-focused, and community-oriented approach. Method: This study is a case report. Primary data was obtained through anamnesis, physical examination and home visits to assess the physical environment. Assessment based on a holistic diagnosis from the beginning, process, and end of the study qualitatively and quantitatively. Results: After the intervention, there was an increase in patient and family knowledge regarding the importance of health care provider check-ups, regular medication consumption, appropriate diet and physical activity patterns for patients with Diabetes Mellitus and Obesity. Conclusion: Holistic management has been carried out with a family doctor approach for Mrs. A, 54 years old with type II Diabetes Mellitus and grade II Obesity which was adjusted based on the initial holistic diagnosis. The intervention has increased patient and family knowledge regarding the importance of health care provider check-ups, regular medication consumption, diet and physical activity patterns as indicated by improvements in the final holistic diagnosis.
PENATALAKSANAAN HOLISTIK PADA NELAYAN LAKI-LAKI USIA 40 TAHUN DENGAN LOW BACK PAIN MELALUI PENDEKATAN KEDOKTERAN KELUARGA DI WILAYAH KERJA PUSKESMAS RAWAT INAP SUKARAJA Farizy, Diaru Fauzan; Syamhudi, Muhammad Farras Afif; Ernawati, Tutik
Medula Vol 14 No 9 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i9.1189

Abstract

Low Back Pain (LBP) is a musculoskeletal disorder caused by poor body activity. Data for the number of LBP sufferers in Indonesia is estimated at 11.9%. Work-related lower back pain is often reported in workers who perform certain physical actions. Applying the principles of family medicine services and carrying out holistic management based on a framework for solving patient problems with a patient-centered, family focused and community oriented approach based on Evidence Based Medicine. This study is a case report study. Primary data was obtained through auto-anamnesis, physical examination and home visits, filling in the family folder, completing family data, psychosocial and environmental data. The assessment is carried out based on a holistic diagnosis of the beginning, process and end of the study quantitatively and qualitatively. Patient Mr. A, male, 40 years old, works as a fisherman and has a main complaint of lower back pain since approximately one year ago but the pain has worsened in the past one week. The pain improves when resting and gets worse when the patient is active. The patient was diagnosed as Low Back Pain. Pharmacological and non-pharmacological interventions were carried out in the form of education regarding ergonomic body positions and exercise to reduce complaints of lower back pain. The diagnosis and management of Low Back Pain in this patient has been carried out in a holistic, patient-centered, family approach and based on several theories and the latest research.
Penatalaksanaan Holistik pasien Wanita usia 49 Tahun dengan Otitis Eksterna Melalui Pendekatan Kedokteran Keluarga Wilayah Puskesmas Satelit Bandar Lampung. Putra, Mahardika; Ernawati, Tutik
Medula Vol 15 No 1 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i1.1585

Abstract

Otitis externa is an inflammation of the outer ear skin that is commonly caused by excessive ear cleaning, exposure to high humidity, frequent swimming, and prolonged use of earplugs or headsets. The most common pathogens involved in this condition are Pseudomonas aeruginosa and Staphylococcus aureus. Otitis externa is a common condition that can occur in all age groups, although it is rarely found in children under two years of age. Its incidence peaks between the ages of 7 and 14, with approximately 10% of the population experiencing the condition at some point in their lives, and 95% of cases being acute. There is no difference in incidence based on gender. Studies in the Netherlands and the United Kingdom report an annual incidence of approximately 1%, while data from the Centers for Disease Control and Prevention (CDC) indicate approximately 2.4 million visits per year due to acute otitis externa in the United States (8.1 visits per 1,000 population). In developing countries, the prevalence is reported to reach 17.5%. This report is a case study conducted using a family medicine approach, involving the identification of risk factors, clinical issues, and evidence-based medicine management with a family-oriented, patient-centered, and community-based approach. Primary data was obtained through self-reporting, physical examination, and home visits, while secondary data was derived from patient medical records. The evaluation was conducted holistically through qualitative and quantitative approaches from the beginning to the end of the study.
Penatalaksanaan Holistik Pada Pasien Laki-Laki Usia 54 Tahun dengan Gout Artritis dan Hipertensi Melalui Pendekatan Kedokteran Keluarga di Puskesmas Sumur Batu Attara Rafilia Adhata; Ernawati, Tutik
Medula Vol 15 No 2 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i2.1614

Abstract

Gout arthritis is a chronic progressive disease caused by the deposition of monosodium urate (MSU) crystals in the joints, kidneys and other connective tissues due to hyperuricemia. Based on the 2016 Bandar Lampung City health profile, hyperuricemia was included in the 10 most common diseases 141,857 cases. Hypertension is a condition when blood pressure is more than 140/90 mmHg. According to WHO, hypertension is a major problem that attacks 22% of the world's population. The purpose of this case report is to Identify internal risk factors, external risk factors, and clinical problems in patients. Implementing Evidence Based Medicine-based family doctor services for patients and patient management based on a framework for solving patient problems with a patient centered, family focused and community oriented approach. This study is a case report study. Primary data were obtained through history taking (autoanamnesis from the patient and alloanamnesis from the patient's family), physical examination and home visits. Secondary data were obtained from the patient's medical record. Assessment is based on a holistic diagnosis from the beginning, process, and end of the study qualitatively and quantitatively. Patient Mr.MY is 54 years old, has been diagnosed with gout arthritis and hypertension has concerns about his complaint is getting worse and cant be cured. The patient's hope is that the complaints disappear completely and do not recur. The patient's limited knowledge of the illness and an unfavorable lifestyle are factors that cause problems that occur in patients and their families. The diagnosis of gout arthritis and in this case is in accordance with several theories and critical studies from recent research. Management has been given in accordance with the management guidelines. There is good progress in patients starting from decreased clinical symptoms to changes in behavior after an intervention based on evidence-based medicine that is family-approach and patient-centered.
HOLISTIC MANAGEMENT OF A 48 YEAR OLD MAN WITH MATURE CATARACT AND GRADE II OBESE THROUGH A FAMILY MEDICINE APPROACH IN THE WORK AREA OF RAJABASA INDAH COMMUNITY HEALTH CENTER Farida, Lulu; Ernawati, Tutik
Medula Vol 15 No 2 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i2.1617

Abstract

Senile cataracts and obesity are two prevalent health conditions frequently observed among the adult and elderly population. Senile cataracts are characterized by lens clouding, leading to visual impairment, while obesity involves excessive fat accumulation, which can exacerbate ocular health through mechanisms of oxidative stress and systemic inflammation. The aim of this study was to apply a holistic and comprehensive family medicine approach to identify both internal and external risk factors and manage these issues based on Evidence-Based Medicine, incorporating family-approached, patient-centered, and community-oriented care. This research was conducted as a case report, with primary data gathered through anamnesis, physical examination, and home visits, and secondary data collected from the patient’s medical records. The case involved a 48-year-old male, Mr. D, who presented with progressively worsening blurred vision in his right eye over the past five months, originating two years prior. The patient reported overeating habits without regular physical activity. Physical examination revealed stable vital signs and a BMI of 36.3 kg/m² (obesity grade II). Local eye exam findings showed a right eye visual acuity of 1/300 with lens opacity and a negative shadow test. Both the patient and his family expressed concern due to their limited understanding of his condition. The diagnosis and management were carried out holistically—emphasizing patient-centered care, family involvement, and community support—based on current theories and research. Post-intervention, there was a notable improvement in the patient’s and family’s knowledge and behavior, contributing to better quality of life and overall health maintenance.
Co-Authors Adela Putri Agata Adli, Farhan Kamali Alnisrina, Dea Amalia, Shafira Asadha, Syahfa Alzena Asyifa, Takhfa Nur Attara Rafilia Adhata deralitha Dian Isti Angraini Dinda Afifa Dzakwan Cedri Ketierteu Eko Budi Santoso Farida, Lulu Farizy, Diaru Fauzan Harmaina Hasan Hasan Ilmiani, Tasya Khalis Intanri Kurniati Karyus, Aila Muhammad Fitra Wardhana Sayoeti Munthe, Rafif Muhaimin Ikhsan Musyayyadah, Musyayyadah Nararya Budiyono Niken Rahmatia Pratiwi, Bella Putra, Mahardika Putri Octavia Sari Radharani, Radhika Reni Zuraida Retno Mareintika Rini Sekartini Rizqillah, Laili Yumna Sahbani, Muhammad Hasbi Saptawati Bardosono Sari, Merry Indah Sasmita, Anggi Marta Dwi Shafa Inayatullah Sianturi, Efry Theresia Sinum, Muhammad Burdadi Adiwinoto Sofia Tyasni Darma Perbasya Susianti, Susianti Syamhudi, Muhammad Farras Afif Vinezzia, Dillyana