Garuda - Garba Rujukan Digital

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

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

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

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.

A 19-year-old woman with Irritable Bowel Syndrome with Constipation (IBS-C), Chronic Gastritis, Psychological Stress with Risk Factors of Unhealthy Diet, Vulnerable Economic Status, and Unhealthy Work Environment Kuntadi, Muhammad; Trsinawati, Heksa
Jurnal Ilmu Kedokteran Keluarga Vol. 4 No. 2 (2025): December 2025
Publisher : Family Medicine Department, Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56674/altera.v4i2.78

Background: Irritable Bowel Syndrome with Constipation (IBS-C), chronic gastritis, and insomnia are functional disorders frequentlyinfluenced by psychosocial stressors and unhealthy lifestyle. Case Presentation: A 19-year-old woman presented with left abdominal painpersisting since March 2025, worsening in the last four days, associated with constipation, nausea, and reduced oral intake. She alsoreported insomnia for the past four months, triggered by work-related stress and financial difficulties. Physical examination revealednormal findings except for tachycardia. Supporting examinations included IBS Symptom Severity Score 240 (moderate IBS), SRQ-20score 9/20 (suggestive of psychological distress), and Insomnia Severity Index 19 (moderate insomnia). Discussion: The patient wasdiagnosed with IBS-C, chronic gastritis, and psychological stress with insomnia. The interplay between gastrointestinal symptoms andpsychological stress highlights the biopsychosocial approach in family medicine. Non-pharmacological interventions such as dietmodification, sleep hygiene, and stress management were prioritized, complemented with pharmacological agents (hyoscine butylbromide,antacids, lactulose, PPI). Conclusion: Holistic management addressing biomedical, psychological, and social aspects is crucial inimproving outcomes in young patients with IBS-C, chronic gastritis, and insomnia

A 69-Year-Old Woman with Diabetes Mellitus, Hypertension, Knee Osteoarthritis, Dyslipidemia, and Obesity with Genetic and Lifestyle Factors: A Family Medicine Case Report Kuntadi, Muhammad
Jurnal Ilmu Kedokteran Keluarga Vol. 5 No. 1 (2026): July 2026
Publisher : Family Medicine Department, Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56674/4v9yq814

Background: Multimorbidity in older adults is commonly driven by overlapping biological, behavioral, familial, and social determinants. Type 2 diabetes mellitus, hypertension, dyslipidemia, obesity, and knee osteoarthritis frequently coexist through shared mechanisms involving insulin resistance, chronic low-grade inflammation, endothelial dysfunction, oxidative stress, and mechanical joint loading. Case: A 69-year-old woman presented for routine primary care follow-up with bilateral plantar tingling, intermittent occipital headache, and chronic bilateral knee pain. She had been diagnosed with type 2 diabetes mellitus and hypertension since 2016 and later developed dyslipidemia, grade I obesity, symptoms suggestive of diabetic peripheral neuropathy, and bilateral knee osteoarthritis. Her body weight was 69 kg, height 150 cm, and body mass index 30.7 kg/m². Initial blood pressure was 159/80 mmHg and fasting blood glucose was 215 mg/dL. Previous laboratory examination showed HbA1c 9.3%, total cholesterol 201 mg/dL, triglycerides 293 mg/dL, HDL cholesterol 30.5 mg/dL, and LDL cholesterol 106 mg/dL. Family history revealed diabetes mellitus and hypertension in both parents, stroke in paternal relatives, hypertension in her husband and second child, and hypercholesterolemia in two siblings. Intervention and follow-up: Three home visits were conducted on 10 February, 16 February, and 17 April 2025. Interventions included medication adherence education, dietary counseling, family conference, reduction of sweetened beverages, fried foods, organ meats, and fatty foods, activity modification for knee osteoarthritis, and family involvement in symptom, blood pressure, and glucose monitoring. Blood pressure improved from 160/94 mmHg during the first home visit to 135/80 mmHg during the second visit and 138/72 mmHg during the third visit. Random blood glucose decreased from 153 mg/dL to 122 mg/dL and then 110 mg/dL. Tingling improved but persisted, while knee pain during prayer remained functionally relevant. Conclusion: This case illustrates that multimorbidity in older adults cannot be addressed by biomedical treatment alone. A family medicine approach, including family assessment, home visits, behavioral negotiation, and community-oriented follow-up, is essential for improving metabolic control and supporting sustainable lifestyle change.

Title

Found 5 Documents
Search

Abstract

Abstract

Abstract

Abstract

Abstract

Title Search

Found 5 Documents Search

Abstract

Abstract

Abstract

Abstract

Abstract

Title

Found 5 Documents
Search