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"ABSTRAKTujuan penelitian ini adalah untuk mengetahui pengalaman keluarga membangun koping dalam merawat anggota keluarga dengan penyakit kronis. Metode penelitian yang digunakan adalah pendekatan fenomenologi deskriptif. Hasil penelitian menggambarkan koping keluarga dibentuk dari kekuatan keluarga, koping individu dan dukungan masyarakat. Tema dalam penelitian ini yaitu respon psikologis keluarga, upaya untuk mempertahankan kesehatan, perubahan status kesehatan penderita, perubahan sistem keluarga, aksesibilitas terhadap layanan kesehatan, cara merawat di rumah, mempertahankan keseimbangan keluarga, persepsi keluarga : layanan kesehatan kurang baik, harapan keluarga : jenis dan kualitas layanan baik dan keyakinan keluarga dalam menjalani hidup. Hasil penelitian ini diharapkan dapat menjadi masukan dalam meningkatkan asuhan keperawatan pada keluarga dengan penyakit kronis.

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ABSTRACTThe aim of this research is to describe the experience of family in developing coping family in treating family members with chronic disease. The research method used was a descriptive phenomenological approach. Results of this research is family strengths, individual coping and community support were related to adaptive response of family and depend on disease, prognosis and how long family caring member with chronic disease. There were ten main domains which are family psychological response, efforts to maintain health, changes in health status of patients, family system changes, accessibility to health care, how to care for at home, maintaining family balance, family perceptions of the service healthcare received, family’s hope for health care service, and family beliefs in life. The result is expected to be input in improving nursing care in families with chronic illness."

"ABSTRAKKecemasan merupakan perasaan takut atau khawatir yang disebabkan oleh berbagai peristiwa yang bersifat subjektif. Tujuan penelitian ini yaitu mengetahui hubungan karakteristik lansia dan fungsi afektif keluarga terhadap kecemasan lansia dengan penyakit kronis di wilayah binaan UPF Puskesmas Pabuaran Indah. Desain penelitian adalah deskriptif korelatif dengan pendekatan cross-sectional. Sampel berjumlah 105 lansia dengan penyakit kronis berusia 60 tahun atau lebih yang dipilih dengan teknik cluster sampling. Hasil penelitian menunjukkan 83.8% responden berada pada usia lansia muda. Jenis penyakit kronis yang paling banyak dimiliki responden yaitu hipertensi dengan jumlah 67 lansia. Penelitian tidak menemukan hubungan antara fungsi afektif keluarga terhadap kecemasan lansia dengan penyakit kronis (P=0.719). Terdapat hubungan antara jumlah penyakit kronis terhadap kecemasan lansia dengan penyakit kronis (P=0.004). Pelayanan kesehatan disarankan untuk memberikan edukasi kesehatan dan meningkatkan peran keluarga untuk mengurangi kecemasan.

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ABSTRACTAnxiety is fear or worry feeling that caused by various event that subjectively. This study aimed to determine the relationship between elderly characteristics and family affective function towards anxiety of elderly with chronic disease in UPF Puskesmas Pabuaran Indah area. Descriptive correlative design with cross-sectional approach was applied. 105 elderly with chronic disease, age 60 years or above were taken in this study, which is using cluster sampling. The result of this study showed that 83.8% respondent were aged young old. The most kind of chronic diseases in respondent is hypertension (67 elderly). Study not found relationship between family affective function towards anxiety of elderly with chronic disease (P value= 0.719). There is relationship between amount of chronic disease towards anxiety of elderly with chronic disease (P value=0.004). Health center is advised to give health education, and increase family role to reduce anxiety."

"ABSTRAKLatar Belakang: : Peningkatan populasi usia lanjut di Indonesia diiringi denganmeningkatnya masalah kesehatan pada populasi tersebut, yang merupakan salahsatu dampak proses menua. Dampak serius proses menua terjadi pada otot rangka,yaitu terdapat penurunan massa dan kekuatan otot yang disebut sarkopenia.Kekuatan otot lebih berperan dari massa otot sebagai prediktor hendaya danmortalitas, sehingga penilaian kekuatan otot menjadi penting. Kekuatan genggamtangan dapat mewakili keseluruhan kekuatan otot dan pemeriksaannya sederhana,murah, serta mudah dilakukan. Berbagai faktor yang mempengaruhi kekuatangenggam tangan, faktor IMT dan lingkar pinggang masih kontroversi dan faktorpenyakit kronik terhadap kekuatan genggam tangan belum pernah diteliti sehinggaperlu diketahui faktor-faktor apa saja yang berhubungan dengan kekuatangenggam tangan.Tujuan: Mengetahui hubungan antara: usia, jenis kelamin, lingkar pinggang,status gizi dan penyakit kronik (DM, HT, stroke, PJK, PPOK) dengan kekuatangenggam tangan pada pasien usia lanjut.Metode: Penelitian potong lintang dilakukan bulan Agustus 2015 di poliklinikgeriatri RSCM Jakarta dan RSMH Palembang . Subjek adalah pasien usia lanjutberusia  60 tahun, yang kontrol rutin. Pemeriksaan meliputi anamnesis,pengukuran lingkar pinggang, lingkar lengan, lingkar betis, tinggi lutut, beratbadan, dan kekuatan genggam tangan. Uji analisis Cochran Mantel Haenzeldigunakan untuk menilai faktor-faktor yang berhubungan dengan kekuatangenggam tangan pada penelitian ini.Hasil: Dari 352 subjek ,didapatkan jenis kelamin terbanyak perempuan212(60,2)% rerata usia 69,7 (SB 6,3) tahun, rerata lingkar pinggang 90,6(SB10,7), Status gizi yang terbanyak adalah status gizi normal (86,4%),komorbiditas tertinggi hipertensi (44,3%), rerata kekuatan genggam tanganperempuan 19,8 (SB 5,1) dan laki=laki 29,1 (SB 6,9). Terdapat usia (p=<0,001,PR=3,6) dan status gizi /MNA (p<0,001, PR=2,8) berhubungan dengan kekuatangenggam tanganSimpulan: Faktor yang berhubungan dengan kekuatan genggam tangan pada usialanjut adalah usia dan status gizi

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ABSTRACTBackground: The increasing of the elderly population in Indonesia isaccompanied by increasing health problems in the population, which is one ofimpact of the aging process. Serious affect of the ageing process is occured inskeletal muscle. There is a decreasing of mass and muscle strength, calledsarcopenia. Muscle strength is more instrumental than muscle mass as predictorsof mortality and frailty status, so assessment of muscle strength becomesimportant. Handgrip strength can represent the overall muscle strength.Theexamination of handgrip strength is simple, inexpensive, and easy to do. There aremany determinand factors that can influence handgrip strength. Body mass indexand waist circumference still on controversy. Chronic diseases is still not observedyet. This aim of this research is to obtain determinant factors that can influencehandgrip strength in elderly.Objective : To obtain association of age, gender, waist circumference, nutrionalstatus, and chronic disease with handgrip strength in elderly patientMethods: This cross sectional study was conducted to elderly outpatient age 60years or above who visited Geriatric Clinic Cipto Mangunkusumo HospitalJakarta and Mohammad Hoesin Hospital Palembang in August 2015. Data of age,gender, nutritional status, chronic diseases, waist circumference, armcircumference, calf circumference, and handgrip strength were collected. CochranMantel Haenzel was used to obtain determinant factors of handgrip strengthResults: 352 subjects were recruited in this study. women which the most subjectwere 212 (60,2%), average of age was 69,7 years old (SB 6,3), average of waistcircumference was 90,6 (SB 10,7), the most nutritional status was normal(86,4%), the highest comorbidity was hyptertension (44,3%), and average ofhandgrip strength were 19,8 (SB 5,1) in women and 29,1 (SB 6,9) in men.Determinant factors of handgrip strength were age (p=<0,001, PR=3,6) andnutritional status (p<0,001, PR=2,8).Conclusions: Determinand factors of handgrip strength were comorbidity(hypertension, diabetes mellitus, stroke, coronary heart disase, chronic obstructivepulmonary disease), nutritional status, and increasing of age;;"

"Latar Belakang: Penyakit ginjal kronik (PGK) merupakan penyakit progresif dan ireversibel yang mempunyai berbagai komplikasi serius serta belum ada terapi yang dapat memperbaiki kerusakan ginjal yang telah terjadi. Beberapa studi menunjukkan stres oksidatif berperan dalam patogenesis penyakit ini. Stres oksidatif terjadi akibat ketidakseimbangan produksi ROS dan pertahanan antioksidan. Nrf2 merupakan faktor transkripsi yang terlibat dalam mekanisme pertahanan sel dalam mengatasi stres oksidatif. Penelitian ini bertujuan untuk mengetahui aktivitas kuersetin sebagai aktivator Nrf2 dalam menghambat progresivitas penyakit ginjal yang diinduksi nefrektomi 5/6. Metode: Tikus Sprague-Dawley jantan dikelompokkan secara acak dalam kelompok kontrol normal (C), kontrol nefrektomi 5/6 (Nx), nefrektomi 5/6 yang diberi kuersetin dengan dosis 100 mg/kgbb/hari/p.o. (NxQ), nefrektomi 5/6 dan diberi kaptopril dengan dosis 10 mg/kgbb/hari/p.o. (NxK). Hewan coba diterminasi diakhir perlakuan untuk diambil darah, urin, dan organ ginjalnya. Pemeriksaan yang dilakukan adalah pemeriksaan proteinuria, kreatinin urin dan plasma, ureum plasma, kadar MDA plasma dan jaringan, aktivitas glutation peroksidase (GPx), kerusakan jaringan (histopatologi) dan ekspresi Nrf2 (imunohistokimia). Hasil: Hasil penelitian menunjukkan bahwa nefrektomi 5/6 dapat menimbulkan peningkatan proteinuria, ureum plasma, dan derajat fibrosis ginjal secara signifikan. Nefrektomi 5/6 cenderung meningkatkan kreatinin plasma, kadar MDA ginjal, aktivitas GPx, dan menurunkan MDA plasma serta ekspresi Nrf2. Kuersetin tidak mempengaruhi proteinuria, ureum dan kreatinin plasma, dan derajat fibrosis ginjal. Kuersetin cenderung menurunkan kadar MDA dan meningkatkan aktivitas enzim GPx serta ekspresi Nrf2. Kesimpulan: Kuersetin tidak mempengaruhi proteinuria, ureum dan kreatinin plasma serta kerusakan struktur jaringan atau fibrosis ginjal. Kuersetin cenderung menurunkan kadar MDA dan meningkatkan aktivitas enzim GPx serta cenderung meningkatkan ekspresi Nrf2.

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Background: Chronic Kidney Disease (CKD) is a progressive and irreversible condition that has several serious complications and currently there has no single therapy that can repair kidney damage was occurred. Some studies suggest a role of oxidative stress in the pathogenesis of this disease. Oxidative stress is caused by an imbalance of ROS production and antioxidant defenses. Nrf2 is a transcription factor involved in cell defense mechanisms againts oxidative stress. This study was aimed to determine the quercetin activity as Nrf2 activator in inhibit the progression of 5/6 nephrectomy induced CKD in male rats.

Method: Sprague-Dawley rats were randomly divided into normal control group (C), untreated 5/6 nephrectomy (Nx), quercetin-treated 5/6 nephrectomy, NxQ (100 mg / kg / day orally), captopril-treated 5/6 nephrectomy, NxK (10 mg / kg / day orally). Animal models was sacrificed at the end of intervention to take blood to measure creatinine, urea, and MDA, urine to measure protein and creatinine, and kidney organ to measure levels of MDA, glutathione peroxidase (GPx) activity, and renal damage (histopathology) and Nrf2 expression (immunohistochemistry).

Results: The results showed that 5/6 nephrectomy may cause an increased of proteinuria, plasma urea, and grade of renal fibrosis significantly. 5/6 nephrectomy has trend to increased plasma creatinine, renal MDA levels, GPx activity, and decreased plasma MDA and Nrf2 expression. Quercetin did not decrease proteinuria, plasma urea and creatinine, and renal fibrosis grading. Quercetin tend to reduced levels of MDA, increased GPx enzyme activity, and expression of Nrf2.

Conclusion: Quercetin does not affect proteinuria, plasma urea,plasma creatinine, and tissue damage or kidney fibrosis. Quercetin tend to reduced levels of MDA and increased the activity of GPx and Nrf2 expression."

"Background: Diabetic kidney disease (DKD), as a common cause of end-stage renal disease (ESRD), is a chronic complication of diabetes mellitus (DM). It has been established that vitamin D deficiency is one of DKD risk factors, which may be related to vitamin D receptor (VDR) polymorphisms. This study aimed to analyze the association between VDR polymorphisms and DKD in Indonesian population, also risk factors that influence it. Methods: a cross-sectional study was conducted in Type 2 DM patients who visited internal medicine outpatient clinic at Dr. Cipto Mangunkusumo Hospital, Jakarta, from November 2014 until March 2015. Data collection includes characteristics of subjects and laboratory examination, including BsmI polymorphisms in the vitamin D receptor gene. Patients with acute and severe disease were excluded from the study. Bivariate and multivariate analyses were done. Results: of 93 DM subjects, 42 (45.2%) subjects were without DKD and 51 (54.8%) subjects had DKD. Most of the subjects had the Bb genotype (89.2%), with no subject having the BB genotype. The proportions of the B and b alleles were 44.6% and 55.4%, respectively. There is no association between BsmI polymorphisms in the vitamin D receptor gene and DKD (OR = 1.243; CI 95% 0.334-4.621; p value = 0.751). Conclusion: the profile of BsmI polymorphisms in the vitamin D receptor gene in the Indonesian population were genotypes Bb (89.2%) and bb (10.8%). There was no association between BsmI polymorphisms in the vitamin D receptor gene and DKD. Duration of DM more than five years influenced the association between those variables."

"Background: HIV/AIDS is a chronic, lifelong disease with a wide clinical spectrum which could decrease the quality of life. Objective symptoms measurement is important because it is correlated to treatment adherence and progressivity of the disease. Currently, there is no clinical tool available to evaluate symptoms of HIV infection and the treatment’s side effect for the outpatient setting. This study aimed is to assess the reliability of the Indonesian version of HIV Symptom Index for measuring symptoms of HIV/AIDS patients, and use it for assessment of their symptom profile. Methods: this is a cross sectional study in outpatient HIV/AIDS subjects (n=87) recruited in Cipto Mangunkusumo Hospital’s HIV clinic from September-November 2018. The HIV Symptom Index consisted of 20 items evaluating somatic, psychologic, and the combination of both symptoms, and its’ language adaptation to Indonesian was done with Beaton and Guillemin method. Reliability of the Indonesian version of HIV Symptom Index was tested by alpha cronbach’s a coefficient analysis, and the internal validity was tested with multitrait scaling analysis before being used to profile the symptom pattern of HIV/AIDS patients. Results: Indonesian version of HIV Symptom Index is reliable (cronbach alpha 0.76) and valid (multitrait correlation >0.4) for measuring symptoms of HIV/AIDS patients. The most common symptom is fatigue (55.7%), followed by insomnia (43.3%), dizziness and lightheadedness (42.3%), skin problems (42.3%), and pain, numbness, or tingling in the hands or feet (39.2%). Conclusion: Indonesian version of HIV symptom Index is reliable and valid to measure symptoms of HIV/AIDS patiens objectively."

"ABSTRAKPenelitian ini bertujuan menjelaskan faktor yang berhubungan dengan Fatigue pada pasien yang menjalani hemodialisis di RSUP Dr. Moh Hoesin Palembang. Desain penelitian analitik observasional. Teknik non probability sampling. Hasil penelitian tidak ada hubungan tingkat fatigue dengan pekerjaan, status dukungan, jenis kelamin, frekuensi, jarak fasilitas, komplikasi, merokok, alkohol, riwayat penyakit, dan status nutrisi. Ada hubungan tingkat fatigue dengan latihan fisik, lama menjalani hemodialisis, kadar hemoglobin, penghasilan dan pendidikan. Faktor dominan adalah penghasilan. Perawat hemodialisis diharapkan memonitoring fatigue, memberikan pendidikan kesehatan tentang latihan fisik dan memberikan asuhan keperawatan holistik.

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AbstractThis Research was aimed to explain the factor related to fatigue in pastients undergoing hemodialisis in RSUP Dr. Moh Hoesin Palembang. This Research was observasional analytic research. Technique sampel was non probability sampling Research result was no relation between level fatigue and job status, gender, support status, frequency, facility distance, complication, smoking habits and alcohol habits, disease history, nutrition status. There was relation between level fatigue and physical exercises, duration of hemodialisis and level of haemoglobin, education level and income. The dominant factor was income. Hemodialysis nurses are expected monitor fatique and give health education about physical practice and give holistic nursing care."

"ABSTRAKTesis ini membahas rinosinusitis kronik dan hubungannya dengan kelainan telinga tengah di poliklinik THT RSCM pada pasien dewasa. Penelitian ini bertujuan untuk mengetahui proporsi kelainan telinga tengah pada pasien rinosinusitis kronik dan hubungan antara rinosinusitis kronik dengan kelainan telinga tengah pada percontoh dengan keluhan hidung dan/atau keluhan telinga. Penelitian ini menggunakan metode potong lintang pada pasien usia 18-60 tahun dengan membran timpani intak yang datang ke poliklinik Umum THT RSCM dengan keluhan hidung dan/atau keluhan telinga yang kemudian menjalani rangkaian pemeriksaan nasoendoskopi, otomikroskopi, timpanometri dan uji cukit kulit. Hasil penelitian mendapatkan proporsi kelainan telinga tengah pada pasien rinosinusitis kronik sebanyak 14 percontoh (14/77=18,2%) dan hubungan antara rinosinusitis kronik dengan kelainan telinga tengah secara statistik tidak bermakna (p=0,75).

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ABSTRACTThis study investigates chronic rhinosinusitis and its association with middle ear inflammation in adult patient at ENT oupatient clinic, Cipto Mangunkusumo Hospital. The aim of this study is to determine the proportion of the middle ear inflammation among the chronic rhinosinusitis patients and its association between chronic rhinosinusitis and middle ear inflammation in a population with ear and/or nose complaint. This is a cross sectional study in patients between the age of 18-60 years old with intact tympanic membrane who came to ENT outpatient clinic with ear and/or nose complaints and underwent nasoendoscopic, otomicroscopic, tympanometric examination and skin prick test. The results were proportion of the middle ear inflammation among the chronic rhinosinusitis patients was 14 samples (18,2%) and there was no significant association between chronic rhinosinusitis and middle ear inflammation statistically (p=0,75)."