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All Journal Jurnal Ilmu Kedokteran Keluarga
Kuntadi, Muhammad
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Computer Science & IT Health Professions Physics Public Health Social Sciences

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The Biopsychosocial Spectrum of Osteoarthritis Management in Primary Care : A Case Report Kuntadi, Muhammad; Andarini, Sri; Wuri, Kinanthi
Jurnal Ilmu Kedokteran Keluarga Vol. 4 No. 1 (2025): Juni 2025
Publisher : Family Medicine Department, Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56674/altera.v4i1.46

Abstract

Osteoarthritis (OA), a prevalent degenerative joint disease, poses significant challenges in primary care due to its chronic nature and multifaceted impact on patients' lives. This case report highlights the importance of a comprehensive, patient-centered approach to managing OA, integrating biomedical, psychological, and social considerations within the family medicine framework. A 60-year-old male, a civil servant and single parent, presented with chronic, worsening left knee pain and concurrent left shoulder pain of three months' duration, alongside a history of controlled hypertension. Initial self-management with topical analgesics and knee support provided minimal relief. Clinical assessment, based on ACR and ICPC criteria, led to a diagnosis of left genu osteoarthritis and left shoulder osteoarthritis. The management strategy adopted a holistic perspective, acknowledging the patient's physical symptoms, his concerns as a single parent, and the psychological burden of his condition. Non-pharmacological interventions, including lifestyle modifications, ergonomic advice, and regular light exercise, were emphasized. Pharmacological treatment involved analgesics, while a referral to an orthopedic specialist was initiated due to persistent symptoms. The Family APGAR score indicated good family function, crucial for supporting comprehensive interventions. This case underscores how family dynamics and psychosocial stressors influence chronic disease presentation and management in primary care. This case illustrates that effective OA management extends beyond pharmacological interventions to encompass a thorough understanding of the patient's biopsychosocial context. A robust family medicine approach, integrating patient education, lifestyle modification, and psychosocial support, is crucial for improving outcomes and enhancing the quality of life for individuals with chronic conditions, such as osteoarthritis.
Family-Centered Approach to Chronic Abdominal Pain in a Teacher : A Holistic Perspective Setijowati, Nanik; Kuntadi, Muhammad; Zarithsyafiqah, Siti
Jurnal Ilmu Kedokteran Keluarga Vol. 4 No. 1 (2025): Juni 2025
Publisher : Family Medicine Department, Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56674/altera.v4i1.47

Abstract

Chronic abdominal pain, a prevalent yet often multifactorial complaint in primary care, frequently extends beyond purely biomedical etiologies to encompass significant psychosocial stressors and family dynamics. This case report highlights the importance of a holistic, family-centered approach in diagnosing and managing such conditions, moving beyond a narrow symptomatic focus. We present the case of a 35-year-old female kindergarten teacher experiencing recurrent right lower abdominal bloating and pain for three days, exacerbated by activity and alleviated by rest. Associated symptoms included nausea, irregular bowel movements (once every three days), and feelings of overwhelm due to work and domestic responsibilities. Despite her concerns about a prior hepatomegaly during her second pregnancy, physical examination and initial assessment pointed towards a more generalized abdominal discomfort influenced by lifestyle and stress. This case illustrates how chronic abdominal discomfort, initially perceived by the patient as a singular biomedical issue, can be intricately linked to a confluence of biological, psychological, and social factors. The patient's irregular eating habits, high coffee consumption, lack of exercise, and significant work-life imbalance contributed to her symptoms. While an initial diagnosis of acute gastritis was considered, the persistent nature and association with stress suggest a broader functional gastrointestinal disorder. The family APGAR score of 9 indicated a highly functional family unit, yet the Family SCREEM identified cultural factors (husband's limited domestic involvement) and the patient's poor stress management as potential contributors. Comprehensive intervention involved patient education on lifestyle modification, stress management techniques, and family involvement to alleviate domestic burdens. This case underscores the necessity of a comprehensive, family-oriented approach in managing chronic abdominal pain. By addressing not only the physical symptoms but also the underlying psychosocial stressors and family dynamics, healthcare providers can facilitate more effective and sustainable patient outcomes. This holistic perspective aligns with the principles of family medicine, advocating for interventions that consider the patient within their unique family and community context.
The Hidden Nexus : A Case Report on the Interconnectedness of Metabolic Syndrome, Lifesyle, and Bilateral Nephrolitiasis Kuntadi, Muhammad; Reilinvia, Shanine
Jurnal Ilmu Kedokteran Keluarga Vol. 4 No. 1 (2025): Juni 2025
Publisher : Family Medicine Department, Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56674/altera.v4i1.52

Abstract

Chronic non-communicable diseases (NCDs) often share common root causes, necessitating a holistic approach to care. This report describes the case of a 42-year-old male presenting with bilateral nephrolithiasis. It refines the patient’s initial perception that his back pain was solely caused by hypertension, demonstrating instead that his condition is part of a broader metabolic dysfunction. A 42-year-old male presented with recurring right flank pain, diagnosed as bilateral nephrolithiasis. He had a history of hypertension, obesity (BMI 31.22 kg/m2), and hyperuricemia with gout. His mother also had a history of hypertension and nephrolithiasis. His lifestyle, including irregular eating habits, sedentary work, smoking, and a history of urine retention due to a demanding profession, along with a belief that medication is harmful to the kidneys, were key risk factors. The patient’s bilateral nephrolithiasis, likely uric acid stones given his history of hyperuricemia and gout, and hypertension are manifestations of an underlying metabolic syndrome. This condition, driven by obesity, lifestyle, and genetic predisposition, leads to low urinary pH, directly causing stone formation. This case illustrates the crucial role of a family-oriented approach in identifying and managing complex biopsychosocial barriers to care. This case highlights that managing chronic diseases effectively requires an understanding of their interconnectedness. A holistic family medicine approach, extending beyond symptoms to address lifestyle, psychosocial factors, and genetic risks, is essential for improving patient outcomes and preventing disease recurrence.
Co-Authors Nanik Setijowati Reilinvia, Shanine Sri Andarini Wuri, Kinanthi Zarithsyafiqah, Siti