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Pengaruh Edukasi Pra-anestesia terhadap Tingkat Kecemasan Pasien Dewasa yang Menjalani Operasi Jantung Terbuka Marsaban, Arif H. M.; Hidayat, Jefferson; Kusumadewi, Irmia; Nainggolan, Gina Adriana
Majalah Anestesia dan Critical Care Vol 34 No 3 (2016): Oktober
Publisher : Perdatin Pusat

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Abstract

Kecemasan praoperasi mengaktifkan stres respon  yang menyebabkan stimulasi sistem saraf simpatis (menstimulasi sistem kardiovaskular dengan meningkatkan jumlah katekolamin darah yang menyebabkan takikardi, hipertensi, iskemik dan infark miokardial). Respon tersebut merugikan sirkulasi koroner, menyebabkan peningkatan morbiditas dan mortalitas. Salah satu penanganannya adalah dengan pemberian informasi (edukasi), melalui komunikasi efektif, informatif dan empati, diharapkan terjadi penurunan tingkat kecemasan pasien sebelummenjalani pembiusan dan pembedahan. Penelitian ini menginvestigasi pengaruh edukasi pra-anestesia terhadap tingkat kecemasan pasien operasi jantung terbuka di RSUPN Cipto Mangunkusumo. Penelitian ini menggunakan uji kuasi eksperimen pada pasien operasi jantung terbuka dewasa di Instalasi PJT RSUPN Cipto Mangunkusumo pada bulan Maret 2016. Setelah mendapatkan ijin komite medik dan informed consent, pada 36 subyek dilakukan penilaian tingkat kecemasan sebelum dan sesudah edukasi dengan menggunakan instrumen APAIS. Sebelumedukasi dilakukan pengukuran tanda vital, dilanjutkan dengan pemberian edukasi dan diskusi. Terdapat penurunan bermakna rerata tingkat kecemasan sebelum edukasi dibandingkan dengan sesudah edukasi (p<0,001). Edukasi pra-anestesia menurunkan tingkat kecemasan pasien dewasa yang akan menjalani operasi jantung terbuka di Instalasi PJT RSUPN Cipto Mangunkusumo. Kata kunci: Edukasi, komunikasi efektif, tingkat kecemasan, operasi jantung terbuka The Effect of Education on the Anxiety Level of Adults Patient Undergoing Open Heart Surgery Pre-operative anxiety activates the stress response, causing stimulation of the sympathetic nervous system, which timulates cardiovascular system by increasing the blood catecholamines levels, causing tachycardia, hypertension, ischemia and myocardial infarction. The response may have detrimental effects on the coronary circulation, increasing morbidity and mortality. One of the management is by the provision of information (education) through effective and informative communication with empathy, which are expected to decrease patients’ anxiety level before undergoing anesthesia and surgery. This study aimed to determine the effect of preanesthesia education to the anxiety level in open heart surgery patients in Cipto Mangunkusumo Hospital. This was a quasi-experimental trials of adult open heart surgery patients in Integrated Cardiac Center of Cipto Mangunkusumo Hospital in March 2016. After permission from the medical committee and informed consent were obtained, the anxiety level of 36 subjects was assessed before and after the education using APAIS instrument. Before the education was given, vital signs were measured, continued by education and discussion. There was a significant decrease in the average level of anxiety before education compared with after education (p<0.001). Preanesthesia education lowers the anxiety level in adult open heart surgery patients in Cipto Mangunkusumo Hospital. Key words: Education, effective communication, the level of anxiety, opens heart surgery
HUBUNGAN ANTARA GANGGUAN DEPRESI DENGAN KUALITAS HIDUP, STRESOR PSIKOSOSIAL, DAN TINGKAT KONTROL ASMA PADA PASIEN ASMA DI RSUPN DR. CIPTO MANGUNKUSUMO Putro, Agung W; Kusumadewi, Irmia; Rengganis, Iris; Agiananda, Feranindhya
Majalah Kedokteran Indonesia Vol 68 No 8 (2018): Journal of the Indonesian Medical Association Majalah Kedokteran Indonesia Volum
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

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Abstract

Pendahuluan: Tingkat kontrol asma buruk dan gangguan komorbid misalnya depresi dan stres psikososial akan memengaruhi kualitas hidup pasien asma serta meningkatkan beban ekonomi yang ditanggung oleh pasien dan keluarganya. Kami menginvestigasi korelasi antara gangguan depresi, kualitas hidup, stresor psikososial dan tingkat kontrol asma pada pasien asma. Metode: Penelitian ini menggunakan metode cross-sectional deskriptif-analitik pada 37 pasien asma penderita depresi dan 37 pasien asma bukan penderita depresi di Poliklinik Alergi dan Imunologi RSCM Jakarta menggunakan kuesioner SCID-1, WHOQOL-BREF, stresor psikososial Holmes & Rahe, dan ACT. Hasil: Terdapat hubungan antara gangguan depresi dengan skor kualitas hidup yang lebih rendah berdasarkan kesehatan fisik (p<0,001), kesehatan psikologis (p<0,001), relasi sosial (p=0,023), lingkungan (p=0,022), stresor psikososial (OR 3,85; p=0,005), dan tingkat kontrol asma (p=0,001) pada pasien asma. Kesimpulan: Pasien asma yang memiliki gangguan depresi cenderung memiliki skor kualitas hidup yang lebih rendah pada semua domain (kesehatan fisik, kesehatan psikologis, hubungan sosial, dan lingkungan) dan skor tingkat kontrol asma lebih rendah dibandingkan pasien asma yang tidak memiliki gangguan depresi. Pasien asma dengan stresor psikososial berisiko 3,8 kali lebih tinggi memiliki gangguan depresi.
The Association Between Psychopathology Ans Quality Of Life In Burn Patients At Dr. Cipto Mangunkusumo Hospital, Jakarta Winanda, Rizki Aniza; Kusumadewi, Irmia; Wardhana, Aditya; Wiguna, Tjhin; Raharjanti, Natalia Widiasih
Jurnal Plastik Rekonstruksi Vol. 4 No. 2 (2017): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (286.638 KB) | DOI: 10.14228/jpr.v4i2.235

Abstract

Background : Burns result in severe injuries that cause damage or loss of tissue due to contact with sources of heat resulting in injuries to all body systems. Injuries of the skin, which functions as a barrier to protect internal organs, may cause patients to experience damage to one's physical appearance and body image causing negative feelings that may lead to other problems such as psychopathology and symptoms of mental illness. Method : A cross sectional study with consecutive sampling method of burn patients who were treated at the Plastic Surgery Outpatient Clinic and Burn Unit of RSCM was conducted between April-May 2017. Subjects were asked to fill in self-report questionnaires including patient identity form, SRQ-20 (cutoff point ?6) for presence of psychopathology, and WHOQoL-BREF to obtain mean scores of quality of life that include four domains of physical, psychological, social, and environment assessment. Data collected was analyzed using correlation analysis. Result : 56 burn patients were included in the study. 30.4% did not work and 48.2% had very low income per month. 67.9% patients experienced burns due to fire and 44.6% had burns 10-30% of the TBSA with a majority of patients (80.4%) experiencing a combination of second & third degree burns. Based on the analysis, 57.1% of patients had a form of psychopathology and low mean scores of quality life (physical domain 48.1, psychological domain 51.5). Significant negative correlations (p ? 0.05) were obtained between the psychological domain and symptoms of depression, anxiety, low energy; physical domain and low energy; and social domain with anxiety. Conclusion: This study obtained significant results to identify the correlation between psychopathology and various domains of quality of life affected.
Hubungan Antara Gangguan Depresi dengan Kualitas Hidup, Stresor Psikososial, dan Tingkat Kontrol Asma pada Pasien Asma di RSUPN Dr. Cipto Mangunkusumo Putro, Agung W; Kusumadewi, Irmia; Rengganis, Iris; Agiananda, Feranindhya
Majalah Kedokteran Indonesia Vol 68 No 8 (2018): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.68.8-2018-44

Abstract

Introduction : Poor asthma control level and the presence of comorbid disorders such as depression and psychosocial stress will affect the quality of life and increase the economic burden of asthmatic patients and their family. We investigated the correlation between depressive disorders, quality of life, psychosocial stressors, and level of asthma control in asthmatic patients. Methods : The study was cross-sectional descriptive-analytic in 37 asthmatic patients with depressive disorder and 37 asthmatic patients without depressive disorder in the Allergy and Immunology Clinic RSUPN Dr. Cipto Mangunkusumo using SCID-1, WHOQOL-BREF, Holmes and Rahepsychosocial stressors, and ACT questionnaires. Results : There is a relation between the presence of depressive disorders and lower quality of life scores based on physical health (p less-than 0,001), psychological health (p less than 0,001), social relations (p=0.023), environment (p=0.022), psychosocial stressors (OR 3.85; p=0.005), and the level of asthma control (p=0.001) in asthmatic patients. Conclusion: Asthmatic patients with depressive disorders tend to have lower quality of life score in all domains (physical health, psychological health, social relationships, and environment) and lower level of asthma control scores than asthmatic patients without depressive disorders. Asthmatic patients who have psychosocial stressors have 3.8 times higher risk to have depressive disorders.