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Rayasari, Fitrian
Universitas Muhammadiyah Jakarta
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Evaluasi efektivitas skrining non-invasif untuk deteksi dini gangguan kaki pada diabetisi Atun, Sri; Sofiani, Yani; Yuniarti, Niknik; Jumaiyah, Wati; Rayasari, Fitrian
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.v19i8.1610

Abstract

Background: Diabetic neuropathy is a complication that develops slowly and often goes undiagnosed. Guttormsen explained that neuropathy usually appears after years of diabetes and is often the initial cause of wounds and amputations. Therefore, early detection is crucial to prevent further complications. One recommended approach is non-invasive screening, which allows for early identification before severe symptoms appear. Purpose: To evaluate the effectiveness of non-invasive screening for early detection of foot disorders in people with diabetes. Method: The implementation of evidence-based nursing practice (EBNP) at Al Ihsan Regional Hospital, West Java Province, from June to July 2025, involved a non-invasive screening intervention for each patient for early detection of foot disorders in diabetic patients. This study was preceded by a systematic review and meta-analysis that compiled data from various previous studies. Results: Participants with the ROC curve test showed screening results on BDRFS with a sensitivity value of 1.000; on monofilament screening the sensitivity value was 0.545; vibration screening test sensitivity value was 0.818; temperature screening test sensitivity value was 0.864. In the QST screening test of touch sensation, it showed that the temperature screening test sensitivity value was 0.909. The QST screening test of vibration sensation showed that the temperature screening test sensitivity value was 0.909. The QST screening test of temperature sensation showed that the temperature screening test sensitivity value was 0.773. Conclusion: The implementation of EBNP “Evaluation of the Effectiveness of Non-Invasive Screening for Early Detection of Foot Disorders in Diabetics” has been proven to significantly increase early detection of diabetic neuropathy through a method that is safe, inexpensive, and can be performed by nurses.   Keywords: Diabetes; Early Detection of Foot Disorders; Non-Invasive Screening.   Pendahuluan: Neuropati diabetik merupakan komplikasi yang berkembang secara perlahan dan sering kali tidak terdiagnosis secara dini. Guttormsen menjelaskan bahwa neuropati biasanya muncul setelah bertahun-tahun menderita DM dan sering kali menjadi penyebab awal terjadinya luka hingga amputasi. Untuk itu, deteksi dini sangat penting guna mencegah komplikasi lebih lanjut. Salah satu pendekatan yang direkomendasikan adalah skrining non-invasif, yang memungkinkan identifikasi dini sebelum muncul gejala berat. Tujuan: Untuk mengevaluasi efektivitas skrining non-​​invasif untuk deteksi dini gangguan kaki pada diabetisi. Metode: Penerapan praktik keperawatan berbasis bukti (Evidence Based Nursing Practice/EBNP) yang dilaksanakan di RSUD Al Ihsan Provinsi Jawa Barat pada bulan Juni-Juli 2025. Setiap pasien dilakukan intervensi berupa pemeriksaan skrining non-invasif untuk deteksi dini gangguan kaki pada pasien diabetes. Hasil: Partisipan dengan uji ROC curve menunjukkan hasil skrining pada BDRFS dengan nilai sensitivity 1.000; pada skrining monofilamin nilai sensitivit 0.545; skrining vibrasi test nilai sensitivity 0.818; skrining temperatur test nilai sensitivit 0.864. Pada uji skrining QST sensasi sentuhan menunjukkan bahwa skrining temperatur test nilai sensitivit 0.909. Uji skrining QST sensasi getaran menunjukkan bahwa skrining temperatur test nilai sensitivit 0.909. Uji skrining QST sensasi suhu menunjukkan bahwa skrining temperatur test nilai sensitivit 0.773. Simpulan: Penerapan EBNP “evaluasi efektivitas skrining non-invasif untuk deteksi dini gangguan kaki pada diabetisi” terbukti dapat meningkatkan deteksi dini neuropati diabetik secara signifikan melalui metode yang aman, murah, dan dapat dilakukan oleh perawat.   Kata Kunci: Diabetisi; Deteksi Dini Gangguan Kaki; Skrining Non-​​Invasif.
Evidence based nursing in practice penerapan breating relaxation exercise untuk mengurangi nyeri selama pemasangan chest tube dan thoracotomy Tampubolon, Briefman; Rayasari, Fitrian; Yuniarti, Niknik; Nugraha, Rizki; 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.
Pemberdayaan Komunitas Lansia melalui Edukasi Kesehatan dan Pemeriksaan Dini Faktor Risiko Penyakit Kronis Latipah, Siti; Sofiani, Yani; Rayasari, Fitrian; Siswandi, Iyar; Nugraha, Rizky; Jumaiyah, Wati; Aisyah, Aisyah; Nathasia, Dhea
Kolaborasi: Jurnal Pengabdian Masyarakat Vol 5 No 6 (2025): Kolaborasi: Jurnal Pengabdian Masyarakat
Publisher : Yayasan Inspirasi El Burhani

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56359/kolaborasi.v5i6.700

Abstract

Introduction: Diabetes mellitus (DM) is one of the major non-communicable diseases with a steadily increasing prevalence in Indonesia, including in island regions with limited access to healthcare services. This community service program was conducted on Lancang Island, Kepulauan Seribu. Objective: The purpose of this service was of improving elderly participants’ knowledge of diabetes management, conducting early detection through health screening, and providing education on healthy lifestyle practices. Method: The methods included interactive health education sessions and physical examinations covering random blood glucose, blood pressure, and cholesterol levels. Result: The results showed that the majority of the 101 elderly respondents exhibited significant chronic health risk factors. The average blood pressure was 152/88 mmHg, indicating a tendency toward hypertension. The mean random blood glucose level of 140 mg/dL suggested a predisposition to prediabetes and diabetes mellitus, while the mean cholesterol level reached 253 mg/dL, categorized as high. Conclusion These findings indicate that most elderly participants have not yet implemented optimal dietary management and physical activity, further exacerbated by limited health facilities and access in island areas. The educational intervention effectively increased participants awareness of disease risks and complications, as well as the importance of early detection. Overall, the promotive and preventive activities had a positive impact on improving knowledge, awareness, and motivation among elderly participants to adopt healthy lifestyles. This program is expected to serve as a foundation for sustainable community health development efforts in island regions.
Penerapan metode teach-back terhadap self-care pasien gagal jantung Aminah, Siti; Jumaiyah, Wati; Latipah, Siti; Rayasari, Fitrian; Anggraini, Dewi
Holistik Jurnal Kesehatan Vol. 19 No. 9 (2025): Volume 19 Nomor 9
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i9.1702

Abstract

Background: Heart failure is a chronic disease that requires long-term management and active patient involvement in self-care. Non-adherence to medication, diet, and symptom monitoring increases the risk of recurrent hospitalization. The teach-back method is an effective educational approach to ensure patients’ understanding of medical instructions and improve self-care behaviors. Purpose: To analyze the effectiveness of implementing teach-back method-based education on self-care of heart failure patients. Method: This study implemented an Evidence-Based Nursing Practice (EBNP) approach using a one-group pretest–posttest design. The sample consisted of 13 heart failure patients who met the inclusion criteria. The intervention was delivered in three sessions during hospitalization, followed by two educational follow-ups via telephone after discharge. The instrument used to measure self-care was the European Heart Failure Self-care Behavior Scale (EHFScB-9). Data were analyzed using a paired t-test. Results: There was a significant improvement in patients’ self-care scores after the intervention (mean before = 48.49; after = 80.97; p = 0.000). This indicates that the teach-back method effectively enhanced the self-care abilities of patients with heart failure. Conclusion: The teach-back intervention effectively improved self-care among heart failure patients, demonstrating high validity, an applicable educational SOP, and positive patient responses.   Keyword: Heart Failure; Self-Care; Teach-Back Method.   Pendahuluan: Gagal jantung merupakan penyakit kronis yang membutuhkan manajemen jangka panjang dan keterlibatan aktif pasien dalam melakukan perawatan mandiri (self-care). Ketidakpatuhan pasien terhadap pengobatan, diet, dan pemantauan gejala dapat meningkatkan risiko rawat inap berulang. Metode teach-back merupakan salah satu pendekatan edukasi yang efektif untuk memastikan pemahaman pasien terhadap instruksi medis dan meningkatkan self-care. Tujuan: Untuk menganalisis efektivitas penerapan pendidikan berbasis metode teach-back terhadap self-care pasien gagal jantung. Metode: Implementasi Evidence-Based Nursing Practice (EBNP) dengan desain one group pretest post-test. Sampel terdiri dari 13 pasien gagal jantung sesuai kriteria inklusi. Intervensi diberikan dalam tiga sesi selama perawatan dan dilanjutkan dengan dua kali edukasi melalui telepon setelah pasien pulang. Instrumen pengukuran self-care menggunakan European Heart Failure Self Care Behavior Scale (EHFScB-9). Analisis data dilakukan dengan uji paired t-test. Hasil: Terdapat peningkatan signifikan skor self-care pasien setelah intervensi (mean sebelum 48.49; sesudah 80.97; p = 0.000). Hal ini menunjukkan bahwa metode teach-back mampu meningkatkan kemampuan perawatan mandiri pasien gagal jantung secara bermakna. Simpulan: Intervensi teach-back efektif meningkatkan self-care pasien gagal jantung dengan validitas tinggi, SPO edukasi aplikatif, dan respon positif pasien.   Kata Kunci: Gagal Jantung; Metode Teach-Back; Self-Care.
Efektivitas kombinasi buerger allen and resistance exercise terhadap gula darah puasa dan adekuasi hemodialisis pasien diabetic kidney disease Afriza, Wicke; Astika, Tria; Rayasari, Fitrian; Natashia, Dea
Holistik Jurnal Kesehatan Vol. 19 No. 9 (2025): Volume 19 Nomor 9
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i9.1841

Abstract

Background: Diabetic nephropathy is another term for diabetic kidney disease. patients with diabetes and diabetic kidney disease constitute a distinct population group diagnosed with increased urinary albumin excretion or decreased glomerular filtration rate (GFR). This impacts kidney function and alters the way waste and excess fluid are removed from the body. Purpose: To determine the effectiveness of a combination of buerger allen and resistance training on fasting blood sugar and hemodialysis adequacy in patients with diabetic kidney disease. Method: This study used a quasi-experimental design with a pre- and post-test and control group. The study was conducted at Pondok Kopi Islamic Hospital in Jakarta, with 59 participants divided into two groups: 32 in the intervention group and 27 in the control group. Both groups underwent fasting blood sugar and hemodialysis adequacy (Kt/V) measurements before and after the combination of Buerger Allen and resistance training. The intervention group performed a combination of Buerger Allen and resistance training for 8 weeks (16 sessions), while the control group received only standard intervention during hemodialysis. Results: The combination of buerger allen exercises and weight training proved effective in lowering fasting blood sugar levels and improving hemodialysis adequacy in patients with diabetic kidney disease. In the intervention group, fasting blood sugar decreased with a mean score difference of 1.75, while the control group experienced an increase of 2.06. Furthermore, there was a significant change in the hemodialysis adequacy score (Kt/V) in the intervention group with a p-value of 0.02. Paired sample results also supported these findings, with the fasting blood sugar (t = 2.11) and Kt/V (t = 2.81) scores showing significant improvements, while the control group showed no significant changes. Overall, the combination of buerger allen exercises and weight training was effective in improving blood sugar control and improving hemodialysis quality in patients with diabetic kidney disease. Conclusion: The combination of buerger allen exercises and weight training was effective in improving blood sugar control and improving hemodialysis quality in patients with diabetic kidney disease.   Keywords: Buerger Allen; Diabetic Kidney Disease Patients; Fasting Blood Sugar; Hemodialysis Adequacy; Weight Training.   Pendahuluan: Nefropati diabetik adalah istilah lain dari Diabetic Kidney Disease (DKD). Pasien dengan diabetes dan DKD adalah kelompok yang berbeda dari populasi yang didiagnosis dengan salah satu dari dua karakteristik peningkatan ekskresi albumin urin atau penurunan laju filtrasi glomerulus (GFR). Hal ini berdampak pada fungsi ginjal dan mengubah cara pembuangan limbah dan kelebihan cairan dari tubuh. Tujuan: Untuk mengetahui efektivitas kombinasi buerger allen and resistance exercise terhadap gula darah puasa dan adekuasi hemodialisis pasien diabetic kidney disease. Metode: Penelitian ini menggunakan quasi eksperimen dengan rancangan pre and post test group design with control group. Penelitian ini dilakukan di Rumah Sakit Islam Jakarta Pondok Kopi dengan jumlah sampel sebanyak 59 partisipan yang dibagi menjadi 2 kelompok, yakni 32 partisipan pada kelompok intervensi dan 27 partisipan pada kelompok kontrol. Kedua kelompok sampel dilakukan pemeriksaan gula darah puasa dan adekuasi hemodialisis (Kt/V) sebelum dan sesudah kombinasi buerger allen dan resistance exercise. Kelompok intervensi melakukan kombinasi Buerger Allen dan latihan resistensi selama 8 minggu (16 kali pertemuan), sedangkan kelompok kontrol hanya menerima intervensi standar selama hemodialisis. Hasil: Kombinasi buerger allen dan resistance exercise terbukti efektif dalam menurunkan kadar gula darah puasa serta meningkatkan adekuasi hemodialisis pada pasien dengan DKD. Pada kelompok intervensi, terjadi penurunan gula darah puasa dengan selisih mean rank 1.75, sedangkan kelompok kontrol justru mengalami peningkatan sebesar 2.06. Selain itu, terdapat perubahan signifikan pada nilai adekuasi hemodialisis (Kt/V) kelompok intervensi dengan p-value 0.02. Hasil paired sample juga memperkuat temuan ini, nilai t gula darah puasa (t = 2.11) dan Kt/V (t = 2.81), menunjukkan perbaikan bermakna, sementara kelompok kontrol tidak menunjukkan perubahan signifikan. Secara keseluruhan, kombinasi buerger allen dan resistance exercise efektif dalam memperbaiki kontrol gula darah dan meningkatkan kualitas hemodialisis pada pasien DKD. Simpulan: Kombinasi buerger allen dan resistance exercise efektif dalam memperbaiki kontrol gula darah dan meningkatkan kualitas hemodialisis pada pasien DKD.   Kata Kunci: Adekuasi Hemodialisis; Buerger Allen; Gula Darah Puasa; Pasien Diabetic Kidney Disease; Resistance Exercise.  
Co-Authors Abdu Rahim Kamil Abdu Rahim Kamil Abdul Khamid, Abdul Abriyanti, Rika Mustika Adria Rusli, Adria Afriza, Wicke Agung, Rizki Nugraha Agus Purnama Ahmad Zubairi Aisyah Aisyah Alfin, Riandi Ali Asman Harahap Amelia Andini Anggareni, Dewi Anwar, Tasbihul Apriani, Nuni Arisanty, Irma Puspita Arta Marisi Dame Asmara, Amelia Astika, Tria Astuti, Medya Aprilia Astuty, Yeni Az Zahra, Fajar Putri Azzam, Rohman Badriah, Siti Besral . Briefman Tampubolon Busjra M Nur Chairunnisa, Dea Desy anggraini Desy Anggraini Dewi ANGGRAENI Dewi Anggraini Dewi Gayatri Dian Noviati Dian Noviati Kuriasih Dian Novita Dian Novita Kurniasih Dian Novita Kurniasih Dwi Riniasih E.P, Tria Astika Erna Rochmawati, Erna Eva Desvita Eva Desvita Fadilah, Riska Fakhrudin Nasrul Sani Firmansyah Firmansyah Ganjar Kundi Prasetya Handayani, Martuti Dwi Hartati, Yeni Haryanti, Noviana Henny Dwi Susanti Hernani, Eni Hernani, Eny Ii Ismail Ilham Suryana Indraswati, Ita Irawati, Diana Irawati, Diana Jumaiyah, Wati Jumaiyah, Wati Komalawati, Dedeh Kurniasih, Dian Noviati Latipah, Siti Lofa, Priyo Hadi Prasetiyo Maemun, S.KM, M.Epid, Siti Maemun, Siti Maryani, Fenny Muhammad Irfan Nugraha Mulya, Devi Sri Mulyatsih, MG Enny Munaya Fauziah Munaya, Munaya Mustafida, Ika Nana Supriyatna Natashia, Dea Natashia, Dhea Nathasia, Dhea Noviana Haryanti Novianti, Dian Nugraha, Rizki Nugraha, Rizky Nur Aini Nuraenah, Nuraenah Nurapandi, Adi Nurhayati Nurhayati Nyimas Heny Purwati Nyimas Heny Purwati Prasetya, Ganjar Kundi Purnamawati, Dewi Putri, Handayani Rahayu, Esti Kusuma Ria Mariatul Isnaani Rina Yuliaty, Rina Risdayati Risdayati Rita Erlina Rohani Rohani Rohman Rohman Azzam Rostini, Heny S, Baharudin Lutfi Saadulloh, Dadang Salsabila, Sephia Sari, Irma Permata Satriani Gultom Satriani Satriani Selvi Monika Septiawantari, Rani Setiawati, Desy Shahroh, Yuni Siswandi, Iyar Siti Aminah Siti Badriah Siti Nurlaelah Siti Rahayu Slametiningsih, Slametiningsih Sofian, Yani SRI ATUN Sri Mulati Nendah Agreta Sufiana Larombia Sukmawati, Lina Sulistyorini, Cahyo Ismawati Surani, Sri Suryati Suryati Susanti, Ricka Ardila Susanto, Tandang Tampubolon, Briefman Teti Hayati Ulina, Barita Uswatul Khasanah Uswatun Hasanah Wahyuni, Yuni Wahyuningsih, Retno Dyah Warongan, Anwar Warongan, Anwar Wardi Wasis Widodo Widia Astuti Widia Astuti AW widya astuti Yani Sofiani Yanti Susanti Yari, Yarwin Yeni Yarnita Yohanes Andy Rias Yuli Widyastuti Yuliastutik, Fitri Yulistriani, Anisa Yundari, Yundari Yuniarti, Niknik Yunitri, Ninik Yuntiri, Ninik