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"LATAR EELAKANGKejadian stroke menimbulkan kerusakan sel otak. Berbagai faktor risiko telah dikenal meliputi faktor risiko mayor dan minor. Kadar magnesium endogen sebagai salah satu faktor risiko kerusakan set otak masih belum banyak dianalisa dengan berbagai hasil penelitian yang masih kontroversial.METODEPenelitian ini merupakan penelitian prospektif longitudinal (retreated measurement design) dengan data printer diperoleh dari penderita stroke iskemik yang berobat ke RSCM yang memenuhi kriteria inklusi dan eksklusi. Diagnosis stroke iskemik dilakukan melalui pemeriksaan klinis dan CT Scan atau MRI kepala. Dilakukan pemeriksaan laboratorium darah, analisa urin, EKG, dan foto thoraks pada saat masuk. Dilakukan pemeriksaan magnesium serum, plasma, eritrosit pada hari ke-2, ke-4 dan ke-7 dan skor NIHSS pada hari dan saat yang sama.HASILJumlah objek penelitian 53 orang. Sebagian besar rerata magnesium serum dan plasma dalam batas normal (1,4-2,0 mmEq/l) pada tiap hari pengambilan (Mg serum 67,9% - 90,6%, Mg plasma 75-5% - 88,7%) sedangkan ditemukan hipoMg eritrosit pada hari ke-4 dan ke-7 onset stroke (81,1 % dan 73,6%). Ditemukan hubungan sangat bermakna antara Mg serum dengan Mg plasma pada tiap hari pengambilan (p=0,000) dan hubungan bermakna antara Mg serum dengan Mg eritrosit (p=0,02) dan Mg plasma dan Mg eritrosit (p=0,033) pada hari ke-4. Ditemukan hubungan bermakna independen antara Mg plasma hari ke-4 dengan NIHSS hari ke-4 (p=0,005) di samping faktor risiko riwayat stroke /TIA, aritmia jantung dan hiperkoleslerolemia dengan NIHSS.KESIMPULANPenderita iskemik serebral menunjukkan perubahan kadar Mg serum, plasma, eritrosit yang dipengaruhi berbagai faktor risiko lain dan hubungan bermakna antara kadar Mg plasma dan skor NIHSS hari ke-4.KATA KUNCI: Stroke iskemik, hipertensi, magnesium serum, plasma, eritrosit, NIHSS.

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PREFACE

Stroke causes damage to brain cells. Many risk factors of stroke are known like mayor and minor risk factors. Endogen magnesium level as one of risk factor of brain cell damage is analyzed rarely with the controversially results of its studies.

METHOD

The design of this study was repeated measurement with its primary data were collected from ischemic stroke patients in Cipto Mangunkusumo hospital who fulfilled inclusion and exclusion criteria. Diagnosis of stroke was made by physical exam, CT scan or head MRI and completed by blood and urine analysis, echocardiography and chest photo. Serum, plasma and erythrocyte Mg were collected on the 2nd, 4th, aid 7th days after onset and compared with NIHSS scores at the same times.

RESULT

There are 53 persons of subjects studied. Almost all means of the serum Mg and plasma Mg were in normal limits (1,4-2,0 mEq/l) on every days of data collection (serum Mg : 67,6%-90,6%, plasma Mg : 75,5%-88,7%), but there were erythrocyte hipoMg on the 4th and 7th days of stroke onset (81,1% and 73,6%). There were very significant relationship between serum Mg with plasma Mg (p=0,000) on every days of data collection and significant relationship between serum Mg with erythrocyte Mg (p=0,02) and plasma Mg with erythrocyte Mg (p 1,033) on the 4th day onset. There were significant independent relationship between plasma Mg on the 4th day onset with NIHSS in the same day (p=0,005), besides between the history of stroke/TIA, aritmia and hypercholesterolemia with NIHSS.

CONCLUSION

Cerebral ischemic patients showed changes of serum, plasma and erythrocyte Mg levels which were influenced by other risk factors and there was significant relationship between plasma Mg and NIHSS score in the 4th day."

"Latar Belakang: Ankle Brachial Index (ABI) merupakan pemeriksaan noninvasif sederhana dan akurat untuk penyaring dan diagnostik Penyakit Arteri Perifer (PAP). Nilai ABI abnormal merupakan prediktor penting terjadi aterosklerosis sistemik yang menjadi penyebab stroke dan penyakit kardiovaskuler. Nilai ABI rendah berhubungan dengan telah tezjadi aterosklerosis sistemik atau PAP. Setelah lima tahun kemudian 25-35% penderita PAP akan mendenita stroke atau infark miokard. Faktor risiko stroke iskemik yang berhubungan dengan proses aterosklerosis adalah hipertensi, dislipidemia, homosisteinemia, merokok, infeksi dan hiperglikemia. Tujuan: Mengetahui gambaran nilai ankle brachial index pada penderita stroke iskemik di RSUPN Cipto Mangunkusumo Jakarta. Metode: Penelitian ini dilakukan menggunakan disain potong lintang deskriptif analitik pada 73 penderita stroke iskemik. Kemudian dilakukan anamnesis, pemeriksaan fisik umum, pemeriksaan neurologi rutin, pemeriksaan kadar total kolesterol darah, trigliserida, LDL, HDL, GDS, dan dilakukan pemeriksaan ABI. Pasien yang tidak memiliki CT scan / MRI kepala tidak masuk dalam penelitian. Hasil: Dari 73 subyek penelitian didapatkan sebaran umur terbanyak pada kelompok umur 55-64 tahun (42,5%) dan sebagian besar subyek (78.1%) memiliki hipertensi. Proporsi nilai ABI abnormal pada penderita stroke iskemik adalah 26,0 %. Faktor risiko yang bermakna Secara Statistik dengan analisis bivariat adalah kadar total kolesterol darah p=0,039 dan umur p=0,034. Seclangkan hasil analisis multivariate menunjukkan bahwa kelompok umur merupakan faktor risiko independen yang bermakna terhadap nilai ABI abnormal dengan p-value 0,023 (OR 2,556; IK 95% 1,136-5,752). Kesimpulan: Penderita stroke iskemik berumur lebih dari 55 tahun merupakan faktor risiko yang berhubungan terhadap kejadian nilai ABI abnormal. Sedangkan hiperkolesterolemia merupakan faktor risiko yang mempunyai hubungan yang bermakna dengan nilai ABI abnormal."

"Latar Belakang: Stroke merupakan penyakit yang memiliki perbedaan karakteristik antara pria dan wanita. Tujuan: Penelitian bertujuan untuk mengetahui hubungan jenis kelamin dengan fungsi kognitif yang dinilai menggunakan uji Montreal Cognitive Assesment versi Indonesia MoCA-Ina pada pasien stroke fase subakut dan kronik di Departemen Rehabilitasi Medik RSCM, dengan melakukan kontrol terhadap variabel perancu berupa tingkat pendidikan dan usia. Metode: Penelitian merupakan studi observasional analitik dengan desain potong lintang. Sampel penelitian sebanyak 34 subjek, diperoleh melalui teknik consecutive sampling. Analisis bivariat uji Mann-Whitney dan uji korelasi Pearson dilakukan untuk melihat hubungan antarvariabel, dan dilanjutkan dengan analisis multivariat regresi linier. Hasil: Berdasarkan uji Mann-Whitney diperoleh nilai p hubungan jenis kelamin dan tingkat pendidikan dengan skor MoCA-Ina sebesar 0,103 dan 0,076. Nilai korelasi hubungan usia dengan skor MoCA-Ina berdasarkan uji korelasi Pearson sebesar r=0,135 p=0,447 . Persamaan regresi skor MoCA-Ina=21,268-3,620 Wanita 3,762 Pendidikan Tinggi R2=8,6 . Perbedaan rerata skor MoCA-Ina antara pria dan wanita setelah dilakukan kontrol variabel tingkat pendidikan adalah sebesar -3,620 IK95 =-8,928-1,058 , namun secara statistik tidak bermakna p=0,125. Diskusi: Tidak ada perbedaan signifikan pada fungsi kognitif yang dinilai menggunakan MoCA-Ina antara pasien stroke sub-akut dan kronik pria dan wanita.

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Background: Stroke is a disease with different characteristics between men and women.

Objective: This study aims to determine the age and level of education adjusted relationship between gender and cognitive function which is assessed by Montreal Cognitive Assessment in sub acute and chronic stroke patients in the Department of Rehabilitation Medicine RSCM.

Methods: This study is an analytic observational study with a cross sectional design. 34 subjects were selected as samples with consecutive sampling method. Mann Whitney test and Pearson's correlation test were used in to determine the bivariate relationships between the variables, proceeded by a multivariate linear regression analysis.

Results: Based on the Mann Whitney test, the p value of the relationship between gender and the level of education and MoCA Ina score were p 0,103 and p 0,076 respectively. Correlation value between age and MoCA Ina score was r 0,135 p 0,447. The regression equation generated was MoCA Ina score 21,268 3,620 Women 3,762 Higher Education R2 8,6. The mean difference of MoCA Ina score between men and women stroke patients after adjusting for age and level of education was 3,620 CI 95 8,928 1,058, but it was statistically insignificant p 0,125.

Discussion: There was no significant difference in the cognitive function which is assessed by MoCA Ina between the male and female sub acute and chronic stroke patients."

"[ABSTRAKTujuan penelitian ini yaitu mengembangkan intervensi model adaptasi paska stroke serta mengidentifikasi efektifitasnya terhadap perilaku adaptasi dan kualitas hidup pasien paska stroke. Penelitian ini secara keseluruhan dilakukan dalam dua tahap. Tahap satu yaitu pengembangan model intervensi yang diawali dengan penelitian kualitatif menggunakan pendekatan fenomenologi deskriptif tentang pengalaman pasien beradaptasi paska stroke. Model intervensi kemudian dikembangkan dengan cara mengintegrasikan tema hasil penelitian kualitatif, studi literatur, dan konsultasi pakar. Tahap kedua yaitu uji coba intervensi model untuk menentukan efektifitasnya terhadap respon adaptasi dan kualitas hidup pasien paska stroke. Penelitian tahap dua merupakan penelitian kuasi eksperimen menggunakan desain post test control group. Metode sampling yang digunakan dalam penelitian tahap dua yaitu consecutive sampling dengan jumlah sampel 65 orang (32 orang kelompok intervensi dan 33 orang kelompok kontrol). Pembagian sampel ke dalam kelompok intervensi dan kontrol dilakukan dengan matching rumah sakit. Hasil penelitian tahap satu teridentifikasi 9 tema yang dinyatakan partisipan dan dihasilkan intervensi model adaptasi paska stroke (IMAPS) beserta perangkatnya meliputi buku panduan intervensi model, modul untuk perawat pelaksana, dan booklet untuk pasien dan keluarga. Hasil penelitian tahap dua membuktikan adanya perbedaan respon adaptasi fisiologis, adaptasi psikososial, dan kualitas hidup yang bermakna antara pengukuran 3 bulan dengan 4 bulan sesudah intervensi diantara kelompok intervensi dan kontrol. Kesimpulan hasil penelitian yaitu intervensi model adaptasi paska stroke efektif meningkatkan respon adaptasi fisiologis, adaptasi psikososial dan kualitas hidup paska stroke.;

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ABSTRACTThe purpose of this research was to develop intervention adaptation model for post-stroke (IMAPS) and identify its effectiveness on adaptation response and quality of life after stroke. This study conducted in two stages. The first stage was the development of intervention model that begins with a qualitative research using a descriptive phenomenological approach. Intervention model was then developed by integrating the results of qualitative research, literature review, and expert review. The second stage was examination the intervention model to identified its effectiveness on adaptation response and quality of life after stroke. This study was quasi-experimental research using post test control group design. The sampling method used in this study was consecutive sampling with a sample of 65 stroke patient (32 samples in intervention group and 33 samples in control group). Samples were allocated to intervention and control group by matching the hospital. The qualitative study identified nine theme stated by the participants. Qualitative themes serve as guidelines for developing intervention model. The first stage resulted in intervention model and its devices include intervention manual, module for nurses, and booklet for patients and their families. The second stage of research proves the significant difference in physiological and psychosocial adaptation response, and quality of life between measurements 3 months to 4 months after the intervention between groups. We conclude that IMAPS effectively improve the response of physiological and psychosocial adaptation, and quality of life after stroke;The purpose of this research was to develop intervention adaptation model for post-stroke (IMAPS) and identify its effectiveness on adaptation response and quality of life after stroke. This study conducted in two stages. The first stage was the development of intervention model that begins with a qualitative research using a descriptive phenomenological approach. Intervention model was then developed by integrating the results of qualitative research, literature review, and expert review. The second stage was examination the intervention model to identified its effectiveness on adaptation response and quality of life after stroke. This study was quasi-experimental research using post test control group design. The sampling method used in this study was consecutive sampling with a sample of 65 stroke patient (32 samples in intervention group and 33 samples in control group). Samples were allocated to intervention and control group by matching the hospital. The qualitative study identified nine theme stated by the participants. Qualitative themes serve as guidelines for developing intervention model. The first stage resulted in intervention model and its devices include intervention manual, module for nurses, and booklet for patients and their families. The second stage of research proves the significant difference in physiological and psychosocial adaptation response, and quality of life between measurements 3 months to 4 months after the intervention between groups. We conclude that IMAPS effectively improve the response of physiological and psychosocial adaptation, and quality of life after stroke, The purpose of this research was to develop intervention adaptation model for post-stroke (IMAPS) and identify its effectiveness on adaptation response and quality of life after stroke. This study conducted in two stages. The first stage was the development of intervention model that begins with a qualitative research using a descriptive phenomenological approach. Intervention model was then developed by integrating the results of qualitative research, literature review, and expert review. The second stage was examination the intervention model to identified its effectiveness on adaptation response and quality of life after stroke. This study was quasi-experimental research using post test control group design. The sampling method used in this study was consecutive sampling with a sample of 65 stroke patient (32 samples in intervention group and 33 samples in control group). Samples were allocated to intervention and control group by matching the hospital. The qualitative study identified nine theme stated by the participants. Qualitative themes serve as guidelines for developing intervention model. The first stage resulted in intervention model and its devices include intervention manual, module for nurses, and booklet for patients and their families. The second stage of research proves the significant difference in physiological and psychosocial adaptation response, and quality of life between measurements 3 months to 4 months after the intervention between groups. We conclude that IMAPS effectively improve the response of physiological and psychosocial adaptation, and quality of life after stroke]"

"ABSTRAKStroke merupakan penyebab kematian nomor satu di Indonesia. Berdasarkan data Riskesdas, prevalensi kejadian stroke berdasarkan diagnosis tenaga kesehatan di Indonesia mengalami peningkatan dari 8,3? pada tahun 2007 menjadi 12,1? pada tahun 2013. Provinsi Sulawesi Barat merupakan salah satu provinsi yang mengalami kenaikan prevalensi yang tinggi di Indonesia. Penelitian ini bertujuan untuk menganalisis faktor risiko yang berhubungan kejadian stroke pada penduduk usia ≥ 15 Tahun di Provinsi Sulawesi Barat tahun 2007 dan 2013. Penelitian ini merupakan analisis dari Riskesdas 2007 dan Riskesdas 2013 yang menggunakan desain cross-sectional. Sampel penelitian ini adalah penduduk provinsi Sulawesi Barat yang berusia ≥ 15 tahun yang berhasil diwawancarai sebagai sampel Riskesdas 2007 dan/atau Riskesdas 2013 dan memiliki data variabel penelitian yang lengkap. Hasil penelitian ini menunjukkan bahwa faktor risiko yang berhubungan dengan kejadian stroke pada tahun 2007 adalah usia, hipertensi, dan aktivitas fisik sedangkan pada tahun 2013 yaitu usia, hipertensi, obesitas, obesitas sentral dan aktivitas fisik.

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ABSTRACTStroke is leading cause of death in Indonesia. According to Riskesdas, prevalence of stroke based on health workers diagnosis in Indonesia has increased from 8,3? in 2007 became 12,1? in 2013. West Sulawesi is one of province that has biggest increasing of stroke prevalence in Indonesia. This study aims to analyze the risk factor that have relationship of stroke cases among population aged ≥ 15 years old in West Sulawesi in 2007 and 2013. This study using cross-sectional design. The participants were member of population of ≥ 15 years old in West Sulawesi who had complete variable data needed. The result showed that the risk factor that have relationship with stroke cases in 2007 are age, hypertension, and physical activity. In 2013, are age, hypertension, obesity, abdominal obesity, and physical activity."

"Tesis ini disusun untuk menilai hubungan tingkat disabilitas pasien stroke dengan tingkat kualitas hidup pelaku rawat informal. Desain penelitian adalah studi potong lintang dengan menilai tingkat disabilitas pasien stroke menggunakan Indeks Barthel Modifikasi Shah dan tingkat kualitas hidup pelaku rawat informal dengan SF-36. Subjek penelitian adalah 50 orang pasien stroke kronis dan 50 orang pelaku rawat informal. Wawancara dilakukan melalui tatap muka langsung (23 orang pasien stroke dan 23 orang pelaku rawat informal) dan melalui tatap muka video call (27 orang pasien stroke dan 27 orang pelaku rawat informal). Penelitian ini mendapatkan bahwa nilai tengah tingkat disabilitas pasien stroke adalah 82,5 (16 – 100) dan nilai rerata tingkat kualitas hidup pelaku rawat informal adalah 69,69 + 20,32. Nilai subskala kualitas hidup pelaku rawat informal untuk komponen fisik adalah 73,7 (20,63 – 97,5) dan komponen mental adalah 69,8 + 21,93. Dilakukan uji korelasi Spearman antara Indeks Barthel Modifikasi Shah dan SF-36 dengan hasil yang didapatkan adalah korelasi positif sedang yang signifikan (r=0,6, p<0,001). Kesimpulan penelitian ini adalah terdapat hubungan korelasi positif sedang yang bermakna antara tingkat disabilitas pasien stroke dengan tingkat kualitas hidup pelaku rawat informal.

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This thesis is designed to determine the correlation between disability level of stroke patient and quality of life of informal caregiver. The research design is a cross sectional study using Shah Modified Barthel Index to assess the disability level of stroke patient and SF-36 to assess quality of life of informal caregiver. Subjects of this study is 50 stroke patients and 50 informal caregivers. The interview was done by direct face to face setting (for 23 stroke patients and 23 informal caregivers) and indirect face to face setting using video call (for 27 stroke patients and 27 informal caregivers). The median score of disability level of stroke patient in this study is 82,5 (16 – 100) and mean score of quality of life of informal caregiver is 69,69 + 20,32. The score for the subscales of quality of life are 73,7 (20,63 – 97,5) for physical components and 69,8 + 21,93 for mental components. Spearman correlation test was done for disability level of stroke patient and quality of life of informal caregiver which resulted moderate positive correlation (r=0,6, p<0,001). This study concluded that there is moderate positive correlation between disability level of stroke patient and quality of life of informal caregiver."