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All Journal Indonesian Journal of Global Health research MAHESA : Malahayati Health Student Journal Kisi Berkelanjutan: Sains Medis dan Kesehatan
Sesilia, Fitri
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Dentistry Education Health Professions Languange, Linguistic, Communication & Media Medicine & Pharmacology Nursing Public Health

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Hubungan antara Dukungan Keluarga dengan Resiliensi Penderita Tuberkulosis Paru Fazriana, Erlina; Matrof, Randika Septembo; Daryaman, Usan; Sesilia, Fitri
Kisi Berkelanjutan: Sains Medis dan Kesehatan Vol 2 No 1 (2025): Januari-Maret
Publisher : PT Karya Inovasi Berkelanjutan

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Abstract

Introduction and Methods Tuberculosis is a directly transmitted infectious disease caused by Mycobacterium tuberculosis. Pulmonary TB patients often exhibit signs and symptoms such as a productive cough lasting 2–3 weeks or more. In addition, they may experience psychological issues such as anxiety about infecting others, passive behavior, low self-esteem, and poor self-acceptance. This study aimed to analyze the relationship between family support and the resilience of pulmonary TB patients in the working area of Garuda Health Center, Bandung. The research used a correlational analytic method with a cross-sectional approach, involving 65 respondents selected through purposive sampling. Data collection instruments included the Multidimensional Scale of Perceived Social Support (MSPSS) questionnaire to assess family support and a resilience questionnaire for pulmonary TB patients. Data were analyzed bivariately using the Chi-Square test. Results The results showed that 46 respondents (70.8%) received good family support. A total of 38 respondents (58.5%) had high resilience levels. A statistically significant relationship was found between family support and the resilience of pulmonary TB patients at Garuda Health Center, Bandung, with a p-value of 0.000. Conclusion and Recommendation The study concluded that the higher the family support, the greater the resilience of TB patients. It is recommended that health professionals encourage families to provide consistent support to pulmonary TB patients. Contribution to the Sustainable Development Goals (SDGs) This study aimed to examine one of the contributing factors to the resilience of pulmonary TB patients, namely family support. The article contributes to the achievement of Sustainable Development Goal (SDG) 3: ensuring healthy lives and promoting well-being for all at all ages. Specifically, it aligns with Target 3.3, which aims to end the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases by 2030, and combat hepatitis, water-borne diseases, and other communicable diseases.
Pengalaman Perawat Dalam Menghadapi Dilema Etik Pada Pasien Paliative Di ICU: A Scoping Review Rizkianti, Intan; Freitas, Lurdes Acorta; Sesilia, Fitri; Kurhayati, Kurhayati; Reis, Silvestre Dos; Nasrullah, Kurnia; Trisyani, Yanny
MAHESA : Malahayati Health Student Journal Vol 5, No 7 (2025): Volume 5 Nomor 7 (2025)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v5i7.18922

Abstract

ABSTRACT Nurses in intensive care units (ICU) often face ethical dilemmas when caring for palliative patients. Decisions made at this late stage of a patient's life have a major impact on the quality of life of the patient and their family, and can trigger conflicts between professional values, patient expectations, and family needs. This study aimed toexplore the experiences of ICU nurses in facing ethical dilemmas in palliative patients and to map the main ethicalissues faced. Methods: This study used a scoping review approach with literature search through several databases, such as Pubmed, Ebsco, and Science Direct. The article searches and analysis was from November to December 2024. Inclusion criteria included studies published from 2014-2024 related to ethical dilemmas in palliative care in the ICU, with experimental, case study, and qualitative descriptive research designs. Relevant articles were screened following PRISMA guidelines and analyzed qualitatively descriptively. Of the 19,765 articles identified, 8 articles metthe inclusion criteria and were analyzed further. Nurses faced ethical dilemmas that included conflicts in carrying outprofessional roles, feeling sandwiched between patient wishes and family expectations, and organizational policylimitations. The two main categories found were conflict within the professional role and conflict between personal autonomy and external demands, including pressure from family and coworkers. The importance of improvingeffective communication, emotional support, multidisciplinary teamwork, clinical ethics training and education, developing adaptive coping strategies, and support policies in an effort to minimize the stress experienced by nurses infacing ethical dilemmas in caring for palliative patients. Keywords: Ethics, Nurse, Palliative Care ABSTRAK Perawat di unit perawatan intensif (ICU) sering menghadapi dilema etik ketika merawat pasien paliatif. Keputusan yang diambil pada tahap akhir kehidupan pasien ini memiliki dampak besar terhadap kualitas hidup pasien dan keluarganya, serta dapat memicu konflik antara nilai profesional, harapan pasien, dan kebutuhan keluarga. Penelitian ini bertujuan untuk menggali pengalaman perawat ICU dalam menghadapi dilema etis pada pasien paliatif dan dalammemetakan isu-isu etika utama yang dihadapi. Studi ini menggunakan metode pendekatan scoping review dengan pencarian literature melalui beberapa database, seperti Pubmed, Ebsco, dan Science Direct. Pencarian serta analisis artikel dilakukan bulan November hingga Desember 2024. Dengan Kriteria inklusi meliputi studi yang dipublikasikansejak 2014-2024 yang berkaitan dengan dilema etika dalam perawatan paliatif di ICU, dengan desain penelitian eksperimental, studi kasus, dan deskriptif kualitatif. Artikel yang relevan diseleksi mengikuti pedoman PRISMA dan dianalisis secara kualitatif deskriptif. Dari 19.765 artikel yang teridentifikasi, 8 artikel memenuhi kriteria inklusi dan dianalisis lebih lanjut. Perawat menghadapi dilema etis yang mencakup konflik dalam melaksanakan peran profesional, perasaan terjepit antara keinginan pasien dan harapan keluarga, serta keterbatasan kebijakan organisasi.Dua kategori utama yang ditemukan adalah konflik dalam peran profesional dan konflik antara otonomi pribadi dengan tuntutan eksternal, termasuk tekanan dari keluarga dan rekan kerja. Pentingnya peningkatan komunikasi efektif, dukungan emosional, kerja sama tim multidisplin, pelatihan dan edukasi etik klinik, pengembangan strategi koping adaptif, dan dukungan organisasi dalam upaya meminimalisir stress yang dialami oleh perawat dalam menghadapi dilema etik merawat pasien paliatif. Kata Kunci: Dilema Etik, Perawat, Perawatan Paliatif
Assessment of Cryptococcal Meningitis Concurrent with Multidrug-Resistant Tuberculous Meningitis: A Case Report Elsadai, Elsadai; Priambodo, Ayu Prawesti; Mirwanti, Ristina; Sesilia, Fitri; Heriyansyah, Heriyansyah
Indonesian Journal of Global Health Research Vol 6 No 5 (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.v6i5.3489

Abstract

Cryptococcal meningitis is an infection that attacks the tissue lining the brain and spinal cord, caused by the fungus Cryptococcus neoformans. This infection mainly occurs in individuals with a weakened immune system, such as people with HIV/AIDS. The spread of this fungus into the central nervous system can result in serious conditions, even fatal if not treated quickly and appropriately. Objective: to present a rare and complex case report of a patient with concurrent cryptococcal meningitis and multiresistant tuberculous meningitis, as well as evaluate the management strategies used in the patient's care. Method: Case study was conducted through a comprehensive approach including health history assessment, physical examinations, psychosocial analysis, customized nursing assessment forms, electronic medical record reviews, laboratory diagnostics, imaging studies, and multidisciplinary consultations to ensure accurate diagnosis and effective interventions Mrs. R, a 33 year old woman with a final diagnosis including Pneumonia with aspiration mechanism, Cryptococcal Meningitis, Grade II MDR TB Meningitis complicated by arteritis, as well as several other conditions including Hyponatremia, hypochloremia, and hypocalcemia due to insufficient intake, Chronic Suppurative Otitis Media (CSOM) and Typhoid Fever. Results: The patient was diagnosed with aspiration pneumonia, cryptococcal meningitis, multiresistant tuberculous meningitis, as well as other conditions such as hypernatremia, hypokalemia, hypocalcemia, chronic suppurative otitis media, and typhoid fever. Despite treatment, the patient's condition worsened, leading to respiratory failure and death from aspiration pneumonia. Conclusions: This case report highlights the diagnostic and therapeutic challenges in managing concurrent cryptococcal meningitis and multiresistant tuberculous meningitis. This emphasizes the importance of a comprehensive approach in diagnosis and management in patients with complex concurrent infections, even without HIV. This case also emphasizes the need for further research and improved strategies for managing rare and complex infections such as this.
Penerapan Bundle Keperawatan untuk Pencegahan Komplikasi pada Pasien Stroke Hemoragik dengan Prolonged Ventilator: A Case Study Sesilia, Fitri; Kosasih, Cecep Eli; Anna, Anastasia
MAHESA : Malahayati Health Student Journal Vol 6, No 5 (2026): Volume 6 Nomor 5 (2026)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v6i5.22965

Abstract

ABSTRACT Hemorrhagic stroke is a neurological emergency with higher mortality and morbidity rates compared to ischemic stroke. Patients with extensive bleeding often require prolonged mechanical ventilation, which increases the risk of complications such as ventilator-associated pneumonia (VAP), pressure ulcers, and respiratory muscle weakness. Although international guidelines recommend bundle-based prevention strategies, their implementation still varies across healthcare facilities. A 67-year-old female patient with a diagnosis of post-craniectomy decompression due to spontaneous intracerebral hemorrhage in the right basal ganglia was admitted to the ICU. The patient underwent treatment with a prolonged ventilator for 38 days. Nursing interventions included a VAP prevention bundle (head-of-bed elevation, aseptic suctioning with pre-oxygenation, chest physiotherapy, nebulization, and oral hygiene), repositioning every two hours using a pressure-relieving mattress, passive mobilization, cuff pressure monitoring every eight hours, and provision of enteral nutrition according to daily calorie and protein targets. During 38 days of ICU care, the patient showed no clinical or radiological signs of pneumonia. Chest X-ray and sputum culture confirmed the absence of pulmonary infection. The patient also did not develop pressure ulcers, maintained oxygen saturation within the range of 95–99%, had reduced sputum production, and remained hemodynamically stable. The patient was deemed fit to be transferred to the neurology ward to continue therapy. This report demonstrates that consistent implementation of a nursing bundle is effective in preventing complications in patients with hemorrhagic stroke requiring prolonged ventilation, and highlights the importance of nurse compliance in maintaining the quality of critical care. Keywords: Complication Prevention, Hemorrhagic Stroke, Nursing Bundle, Nursing Strategy, Prolonged Ventilator.  ABSTRAK Stroke hemoragik merupakan kegawatdaruratan neurologis dengan angka mortalitas dan morbiditas lebih tinggi dibandingkan stroke iskemik. Pasien dengan perdarahan luas sering membutuhkan ventilasi mekanik jangka panjang yang meningkatkan risiko komplikasi, seperti ventilator-associated pneumonia (VAP), luka tekan, dan kelemahan otot pernapasan. Meskipun pedoman internasional merekomendasikan strategi pencegahan berbasis bundle, implementasinya masih bervariasi antar fasilitas kesehatan. Seorang pasien perempuan berusia 67 tahun dengan diagnosis post-craniectomy decompression akibat perdarahan intraserebral spontan pada basal ganglia kanan dirawat di ICU. Pasien menjalani perawatan dengan prolonged ventilator selama 38 hari. Intervensi keperawatan difokuskan pada pencegahan komplikasi, meliputi: (1) bundle pencegahan VAP (elevasi kepala, suction aseptik dengan pre-oksigenasi, fisioterapi dada, nebulisasi, dan oral hygiene); (2) reposisi tiap dua jam dengan pressure-relieving mattress; (3) mobilisasi pasif dan latihan pernapasan sederhana untuk mempertahankan fungsi otot pernapasan; (4) pemantauan cuff pressure setiap delapan jam (20–30 cmH₂O) untuk mencegah aspirasi; serta (5) pemberian nutrisi enteral sesuai target kalori dan protein dengan posisi kepala elevasi. Selama 38 hari perawatan di ICU, pasien tidak menunjukkan tanda klinis maupun radiologis VAP. Foto toraks dan kultur sputum mendukung tidak adanya infeksi paru. Pasien juga tidak mengalami luka tekan, saturasi oksigen stabil pada kisaran 95–99%, produksi sputum berkurang, serta kondisi hemodinamik tetap stabil. Pasien dinilai layak dipindahkan ke ruang perawatan neurologi untuk melanjutkan terapi. Laporan kasus ini menggambarkan bahwa penerapan bundle keperawatan secara konsisten dapat membantu mencegah komplikasi pada pasien stroke hemoragik dengan prolonged ventilator. Laporan kasus ini juga menekankan pentingnya kepatuhan perawat dalam melaksanakan intervensi berbasis bukti untuk mendukung stabilitas klinis pasien kritis. Kata Kunci: Bundle Keperawatan, Pencegahan Komplikasi, Prolonged Ventilator, Strategi Keperawatan, Stroke Hemoragik.
Co-Authors Anastasia Anna Cecep Eli Kosasih Elsadai, Elsadai Fazriana, Erlina Freitas, Lurdes Acorta Heriyansyah, Heriyansyah Kurhayati, Kurhayati Matrof, Randika Septembo Nasrullah, Kurnia Priambodo, Ayu Prawesti Reis, Silvestre Dos Ristina Mirwanti, Ristina Rizkianti, Intan Usan Daryaman Yanny Trisyani