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Pemberian Asupan Kalori Terestriksi vs. Asupan Kalori Standar yang Berlanjut pada Pasien Penyakit Kritis dengan Refeeding Syndrome: Laporan Kasus Berbasis Bukti Hapsari, Sukma; Pribadi, Rabbinu Rangga
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

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Abstract

Refeeding syndrome is a different clinical symptom and metabolic disorder that occur during the reintroduction of nutrition in chronically malnourished patients. Calorie restriction can increase survival and reduce mortality rates. This evidence-based case report was developed to examine the influence of caloric restriction on mortality, morbidity, and duration of critical illness. A literature search was performed using PubMed, EBSCOHost, ScienceDirect, and Cochrane with the keywords: “critically ill,” “restricted caloric intake,” “standard caloric intake,” “mortality,” “morbidity,” and “duration”. Articles were appraised using the University of Oxford Centre for Evidence-Based Medicine (CEBM) tools. Two studies met the inclusion criteria. The first was a randomized controlled trial, which demonstrated that protocolized caloric restriction significantly improved 60-day survival in ICU patients with refeeding syndrome (91% vs. 78%, p = 0.002), although no significant difference was observed in days alive following ICU discharge (44.8 vs. 39.9 days, p = 0.19). The second was a meta-analysis, which suggested a trend toward reduced hospital mortality with hypocaloric feeding; however, risk ratios varied widely (0.23–5.54), and 30-day mortality differences were not statistically significant (RR: 0.79–3.00). In conclusion, while caloric restriction may not significantly impact overall mortality in chronically ill patients, it appears to improve 60- to 90-day survival in critically ill ICU patients with refeeding syndrome. One study noted a reduced risk of respiratory infection, though evidence on other complications remains inconclusive. A regimen of 20 kcal/hour for at least two days may be suitable for managing refeeding syndrome. Overall, caloric restriction may offer modest clinical benefits in this specific population.
The Influence of Workload, Burnout, Distress on Nurses' Performance Post Covid-19 Pandemic Hapsari, Sukma; Purba, Jenny Marlindawani; Ashar, Taufik
Indonesian Journal of Global Health Research Vol 6 No 6 (2024): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v6i6.3937

Abstract

Workload, burnout and distress are closely related to nurse performance, because increasing workload, burnout and distress can reduce nurse performance. The purpose of this study was to determine the effect of workload, burn out, distress on the performance of nurses after the Covid-19 pandemic. Method: This study is quantitative with a causal associative design. The population in this study were nurses at the Prof. Dr. M. Ildrem, Metal Hospital, totaling 184 people, with a sample of 65 people in the study. Data were collected using questionnaire. Data were analyzed using multiple linear regression. The study shows that workload and distress influence the performance of nurses after the Covid-19 pandemic at the Prof. Dr. M. Ildrem, Mental Hospital, Medan, while burn out has no effect on the performance of nurses after the Covid-19 pandemic at the Prof. Dr. M. Ildrem, Mental Hospotal, Medan. Workload, burn out and distress together influence the performance of nurses after the Covid-19 pandemic at the Prof. Dr. M. Ildrem, Mental Hospital, Medan. Hospitals need to pay attention to workload elements that can affect nurses' performance, as well as exploring the individual abilities of nurses, providing opportunities for nurses to be creative and self-actualizing to reduce burn out as well as screening nurses for psychological problems regularly to support nurses who work in the Mental Hospital.