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"Pembedahan Open Reduction and Internal Fixation menimbulkan pembengkakan jaringan dan nyeri hebat pada area pembedahan. Salah satu upaya nonfarmakologis mengurangi pembengkakan dan nyeri adalah melakukan elevasi bagian distal yang dilakukan pembedahan. Tujuan penelitian untuk mengetahui pengaruh elevasi 20 derajat terhadap pembengkakan dan tingkat nyeri pada pasien pascabedah Open Reduction and Internal Fixation ekstremitas bawah. Penelitian dilakukan dengan desain quasi eksperimental rancangan two group pretest-posttest with control group dengan subyek penelitian sebanyak 34 responden yang dibagi menjadi kelompok intervensi dan kelompok kontrol. Pengukuran circumference pembengkakan menggunakan pita meter dan tingkat nyeri dengan skala Numeric Rating Scale. Penggunaan uji statistik dengan uji T dependen, uji T independent dan korelasi Pearson. Hasil penelitian terdapat perbedaan yang signifikan selisih rerata penurunan circumference pembengkakan sebesar 1,93 cm dan tingkat nyeri sebesar 1,29 antara kelompok intervensi dan kelompok kontrol. Elevasi 20 derajat ekstremitas bawah dapat menjadi alternatif tindakan keperawatan mandiri dalam menurunkan pembengkakan dan nyeri.

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Surgery for Open Reduction and Internal Fixation causes tissue swelling and severe pain in the surgical area. One nonpharmacological effort to reduce swelling and pain is to perform distal elevation in the area of surgical. The purpose of this study was to determine the effect of a 20 degrees elevation on swelling and the level of pain in patients after surgery for Open Reduction and Internal Fixation of the lower extremities. The study with a quasi-experimental design of two group pre-test and post-test with control group with 34 subjects was divided into intervention and control groups. Swelling circumference measurements using tape meters and the level of pain with the scale of the Numeric Rating Scale. This study used dependent T test, independent T test and Pearson correlation. The results of the study showed that there were significant differences in the mean difference in the swelling circumference of 1.93 cm and the pain level of 1.29 between the intervention group and the control group. Elevation of 20 degrees of lower extremity can be an alternative for nursing intervention in reducing swelling and pain."

"ABSTRAKPerasaan takut akan jatuh dan penurunan status fungsional sering dialami pada pasien fraktur ekstremitas bawah yang telah menjalani pembedahan. Edukasi yang tepat diikuti dengan latihan ambulasi pada pasien pascapembedahan diperlukan untuk dapat meningkatkan status fungsional dan keyakinan pasien untuk melakukan ambulasi dini. Penelitian ini bertujuan untuk mengetahui pengaruh edukasi dan latihan ambulasi terhadap fall efficacy dan status fungsional pada pasien pascapembedahan ORIF ekstremitas bawah. Desain penelitian ini adalah kuasi eksperimen dengan rancangan pre test and post test without control group. Besar sampel pada penelitian ini adalah sebanyak 33 responden dengan consecutive sampling. Hasil penelitian ini menunjukkan bahwa terdapat perbedaan fall efficacy dan status fungsional antara sebelum dan setelah dilakukan edukasi dan latihan ambulasi (p value < 0,001). Penelitian ini menyimpulkan terdapat perbedaan nilai fall efficacy dan status fungsional setelah diberikan intervensi edukasi dengan latihan ambulasi

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ABSTRACTFear of falling and decreasing functional status are often experienced in patients with lower limb fractures who have undergone surgery. Appropriate education followed by ambulation training in postsurgery patients is needed to be able to increase the functional status and confidence of patients to carry out early ambulation. This study aims to determine the effect of education and ambulation training on fall efficacy and functional status in postsurgery patients with lower extremity ORIF. The design of this study was a quassy experimental with a pre test and post test design without control group. The sample size in this study was 33 respondents with consecutive sampling. The results of this study indicate that there are differences in fall efficacy and functional status between before and after education and ambulation training (p value <0.001). This study concluded that there were differences in fall efficacy and functional status after being given educational intervention with ambulation training"

"Tidur sangat diperlukan untuk proses penyembuhan, dimana gangguan tidur pasca pembedahan merupakan masalah yang penting untuk dipertimbangkan dalam program peningkatan pemulihan nyeri dan status fungsional pasca operasi. Penelitian ini bertujuan untuk mengidentifikasi faktor yang mempengaruhi kualitas tidur pasien fraktur ekstremitas bawah pasca pembedahan Open Reduction Internal Fixation (ORIF) yang menjalani rawat inap. Faktor-faktor yang diteliti dalam penelitian ini meliputi nyeri, penggunaan obat-obatan, stress dan kecemasan, fatigue, dan lingkungan ruang perawatan. Penelitian ini menggunakan desain penelitian analitik asosiatif dengan pendekatan Cross Sectional. Penelitian dilakukan pada 55 responden menggunakan metode consecutive sampling di ruang rawat inap bedah. Hasil penelitian menunjukkan faktor yang mempengaruhi kualitas tidur pasien fraktur ekstremitas bawah pasca pembedahan O RIF yang menjalani rawat inap adalah nyeri (p=0.002) dan lingkungan ruang perawatan (p=0.032), dimana nyeri merupakan faktor yang paling mempengaruhi kualitas tidur pasien (p) 0.004; Odd Ratio (OR) 28,482 (95% CI: 2,842-285,491). Penelitian ini merekomendasikan penggunaan manajemen nyeri yang efektif sehingga kualitas tidur pasien dapat terpenuhi.

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Sleep is indispensable for the healing process, where postoperative sleep disturbance are an important issue to consider in programs to improve patients postoperative pain and functional status. This study aims to identify factors that affecting sleep quality in patients with lower limb fractures post Open Reduction Internal Fixation surgery undergoing hospitalization. Those factors are pain, medications used, stress and anxiety, fatigue, and ward environment. This study using analitic assosiative design with Cross Sectional approach. 55 respondents were selected with consecutive sampling from surgical ward. The Results showed, factors that affecting sleep quality in patients with post-surgical lower limb fractures undergoing hospitalization are pain (p=0.002) and ward environment (p=0.032), where pain was considered as the most significant factor that affecting patients sleep quality with (p) 0.004; Odd Ratio (OR) 28,482 (95% CI: 2,842-285,491). This study recommends that the use of effective pain management are needed to improve patients sleep quality."

"Pendahuluan: Cedera yang disebabkan oleh gempa bumi seringkali memiliki pola kompleks dan bervariasi, dan maka dari itu menyebabkan krisis situasional dan serius untuk pusat layanan kesehatan. Dalam konteks terjadinya gempa, seringkali terjadi ketidakkeseimbangan antara kepadatan yang berlebihan dalam rumah sakit dan sumber daya inadekuat; hal ini menyebabkan penurunan standar pelayanan kesehatan. Sampai saat ini, di Indonesia, masih belum terdapat pedoman terkait tatalaksana cedera musculoskeletal setelah terjadinya gempa. Studi ini bertujuan untuk mengetahui analisa faktor-faktor resiko yang mempengaruhi profil luaran klinis, dan luaran radiologis pada pasien gempa Lombok 2018 dengan fraktur ekstremitas atas, ekstremitas bawah dan tulang belakang pasca tindakan orthopaedi. Metode: Penelitian ini merupakan studi potong lintang. Penelitian ini dilakukan pada bulan September 2019 di 2 Rumah Sakit dan 9 puskesmas di Lombok dan beberapa kecamatan paling terdampak di Lombok Utara. Korban bencana gempa Lombok Agustus 2018 dengan fraktur esktremitas bawah, esktremitas atas dan tulang belakang yang mendapat tindakan Orthopaedi dilibatkan dalam penelitian ini. Data diperoleh secara langsung dari pasien dan dari data kasus dan tindakan Orthoapedi tim bencana PABOI dan tim bantuan medis Orthopaedi lainnya. Hasil: Data hasil penelitian ini menunjukan bahwa mayoritas pasien berjenis kelamin perempuan 62,2% dan mayoritas berusia dewasa 75,7%. Distribusi diagnosis terbanyak adalah fraktur tertutup ekstremitas bawah 52,7%. Diagnosis jenis cedera dan tindakan ORIF memiliki hubungan yang signifikan dengan union rate (p=0,038 dan p=0,021). Faktor resiko diagnosis dan tindakan ORIF memiliki hubungan yang bermakna terhadap Infeksi (p=0,001 dan p=0,011). Faktor resiko diagnosis dan lokasi cedera memiliki hubungan yang signifikan dengan nilai SF 36 physical function (P=0,001 dan P=0,002) Diskusi: Tata laksana definitif ORID tidak realistis dilakukan sesaat setelah gempa. Damage control orthopaedic adalah tindakan pilihan penanganan kasus orthopaedi untuk patah tulang terbuka. Usia, diagnosis dan lokasi cedera dan tindakan ORIF memiliki pengaruh terhadap union rate, infeksi, dan skor fungsional SF-36 korban bencana gempa bumi. Kesimpulan: Usia, diagnosis dan lokasi cedera dan tindakan ORIF memiliki pengaruh terhadap union rate, infeksi, dan skor fungsional SF-36 korban bencana gempa bumi.

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Introduction: Injuries caused by earthquakes often have a complex and varied pattern, and therefore cause serious situational crises for health care centres. In the context of an earthquake, there is often an imbalance between overcrowding in hospitals and inadequate resources; this causes a decrease in the standard of health services. Until now, in Indonesia, there are still no guidelines regarding the management of musculoskeletal injuries after an earthquake. This study aims to determine the analysis of risk factors that affect the clinical outcome profile, and radiological outcomes in Lombok earthquake patients 2018 with fractures of the upper extremities, lower extremities and spine after orthopedic procedures.

Method: This research is a cross-sectional study. This research was conducted in September 2019 in 2 hospitals and 9 health centers in Lombok and some of the most affected sub-districts in North Lombok. Victims of the Lombok earthquake in August 2018 with fractures of the lower extremities, upper extremities and spine who received orthopedic procedures were included in this study. Data were obtained directly from patients and from data on cases and actions of the Orthopedic PABOI disaster team and other Orthopedic medical assistance teams.

Results: The data from this study showed that the majority of patients were female 62.2% and the majority were adults 75.7%. The most distribution of diagnoses were closed fractures of the lower extremities 52.7%. The diagnosis of the type of injury and the ORIF procedure had a significant relationship with the union rate (p=0.038 and p=0.021). Risk factors for diagnosis and ORIF treatment had a significant relationship to infection (p=0.001 and p=0.011). Risk factors for diagnosis and location of injury had a significant relationship with the SF 36 physical function value (P=0.001 and P=0.002)

Discussion: Definitive management of ORID is not realistic to be carried out immediately after the earthquake. Orthopedic damage control is the treatment of choice for orthopedic cases for open fractures. Age, diagnosis and location of injury and ORIF action have an influence on union rate, infection, and functional score of SF-36 earthquake victims.

Conclusion: Age, diagnosis and location of injury and ORIF action have an influence on union rate, infection, and functional score of SF-36 earthquake victims"

"Open Reduction and Internal Fixation (ORIF) adalah prosedur yang sering dilakukan untuk mengatasi fraktur. Masalah yang sering timbul pada post operasi ORIF adalah nyeri akut pada level severe. Manajemen nyeri yang tepat diperlukan untuk menangani respon nyeri. Tujuan penelitian untuk mengetahui pengaruh terapi musik terhadap nyeri post operasi ORIF di RSUDAM Propinsi Lampung. Desain penelitian menggunakan quasi experiment dengan non-equivalent pretestpostest with control group, pengambilan sampel menggunakan consecutive sampling. Jumlah sampel adalah 36 orang (18 orang kelompok kontrol dan 18 orang kelompok intervensi). Nyeri diukur dengan Numeric Rating Scale (NRS). Uji statistik menggunakan uji beda dua mean. Hasilnya ada pengaruh yang signifikan terapi musik terhadap penurunan tingkat nyeri pasien post operasi ORIF (P value = 0,000; α = 0,05). Tidak ada hubungan antara usia, jenis kelamin, dan riwayat pembedahan sebelumnya terhadap tingkat nyeri. Hasil penelitian ini merekomendasikan terapi musik sebagai intervensi mandiri keperawatan untuk mengurangi nyeri post operasi ORIF.

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Open Reduction and Internal Fixation (ORIF) is a common procedure for fracture treatment. Mostly problem in post ORIF surgery period is acute severe pain. The appropriate pain management is required. This research aimed to identify the effect of music therapy on post ORIF surgery pain at Abdul Moeloek Hospital Lampung Province. The design used quasi experiment with non-equivalent pretest-posttest with control group, recruting sample by consecutive sampling. There were 36 samples (18 respondents as the control group and 18 respondents as the intervention group). The pain was measured by Numeric Rating Scale (NRS). The analyze used T-test compare 2 mean. The result indicated that there was a significant effect of music therapy on reducing post ORIF surgery pain (P value = 0,000; α = 0,05). There was no significant correlation between age, sex, and surgical history with pain level. Music therapy is recommended."

"Fase rehabilitasi merupakan fase kemampuan fungsional berada pada tahap paling rendah dibandingkan fase lain. Pemulihan fungsi fisik menjadi prioritas dilihat dari status fungsional. Penelitian ini bertujuan mengidentifikasi faktor-faktor yang berhubungan dengan status fungsional pada paska ORIF fraktur ekstremitas bawah.Desain penelitian adalah cross-sectional dengan 35 responden dan pengumpulan data menggunakan kuesioner. Variabel independen adalah usia, lama hari rawat, jenis fraktur, nyeri, kelelahan, motivasi, fall-efficacy, dan dukungan keluarga sementara variabel dependen adalah status fungsional. Uji ANOVA digunakan untuk data kategorik serta korelasi pearson dan spearman rho untuk data numerik.Hasil penelitian menunjukan fall-efficacy (r = -0,490 dan nilai p=0,003) merupakan faktor yang berhubungan. Model multivariat memiliki nilai p=0,015 dan jenis fraktur, nyeri, dan fall-efficacy mampu menjelaskan 28,2 % status fungsional dengan nyeri sebagai faktor yang paling besar untuk memprediksi status fungsional setelah dikontrol fall-efficacy dan jenis fraktur. Penelitian ini merekomendasikan melakukan latihan meningkatkan status fungsional terintegrasi manajemen nyeri dan fall-efficacy.

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Rehabilitation phase is a phase of functional ability at the stage of the lowest compared to other phases. Recovery of physical function is a priority from functional status. Conducted research on the functional status as the basis for the restorative care. The research aimed to identify factors associated with functional status post ORIF fracture in the lower extremities.The study design was a crosssectional with 35 respondents and collecting data using questionnaires. Independent variables were age, length of day care, type of fracture, pain, fatigue, motivation, fall-efficacy, and family support; as the dependent variable was functional status. ANOVA test used for categorical data and Pearson correlation and spearman rho for numerical data.The results show the fall-efficacy (r = - 0.490 and p-value = 0.003) is related factors. Multivariat model have p value=0,015 and type of fracture, pain, and fall-efficacy explained 28,2 % functional status variable with pain as the biggest factor for predicting functional status after controlled fall-efficacy and type of fracture. This research recommended for exercises improved functional status integrated pain and fallefficacy managemen."

"Nyeri merupakan masalah yang sering dialami pasien setelah menjalani operasi bedah ortopedi. Intervensi yang dapat digunakan untuk menurunkan nyeri dan meningkatkan kenyamanan setelah menjalani operasi bedah ortopedi yaitu pemberian terapi komplementer dan alternatif. Tujuan penelitian ini yaitu mengidentifikasi pengaruh kompres dingin (cold pack) terhadap nyeri dan kenyamanan pada pasien post operasi fraktur ekstremitas bawah. Desain penelitian quasi eksperimen pretest posttest with control group. Metode pemilihan sampel menggunakan consecutive sampling dengan jumlah 32 responden, dibagi menjadi kelompok intervensi dan kontrol. Kelompok intervensi diberikan kompres dingin menggunakan media cold pack, sedangkan kelompok kontrol mendapatkan intervensi standar rumah sakit. Hasil penelitian menunjukkan bahwa terdapat pengaruh yang signifikan dari kompres dingin (cold pack) terhadap skor nyeri dan kenyamanan setelah diberikan intervensi antara kelompok kontrol dan kelompok intervensi (p < 0,05; α 0.05). Kompres dingin memberikan pengaruh terhadap nyeri dan kenyamanan, sehingga dapat direkomendasikan sebagai terapi untuk menurunkan tingkat nyeri dan meningkatkan kenyamanan pada pasien post operasi fraktur ekstremitas bawah.

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Pain is a common problem experienced by patients after undergoing orthopedic surgery. Several interventions to reduce pain and increase comfort after undergoing orthopedic surgery include the provision of complementary and alternative therapies. This research sought to investigate the effect of applying cold pack on pain and comfort of post-operative lower extremity fracture patients. This research employed a quasi-experimental design, using pretest posttest with control group. The samples were selected through consecutive sampling technique, with a total of 32 respondents assigned into intervention and control groups. The respondents in the intervention group were given cold compresses using cold pack, while the control group respondents received standard hospital intervention. The research results revealed that there is a significant effect of cold pack on pain and comfort scores after the intervention was given between the control group and the intervention group (p < 0.05; 0.05). Cold compress affects pain and comfort of experienced by patients, so it can be recommended as a therapy to reduce pain levels and increase comfort in post-operative lower extremity fracture patients."

"[ABSTRAK Mayoritas populasi masyarakat dunia menepati daerah perkotaan. Akibat darikepadatan penduduk di daerah perkotaan timbul masalah yang berkaitan dengan lalulintassalah satunya adalah tingginya jumlah kecelakaan lalu-lintas. Frakturmerupakan salah satu akibat dari kecelakaan lalu-lintas yang memerlukanpenanganan segera untuk mempertahankan anatomi dan fungsi tubuh seperti semula.Pasien post ORIF tibia dan fibula memerlukan tindakan ambulasi untukmemperlancar sistem peredaran darah pasien. Karya ilmiah ini bertujuan untukmenganalisis intervensi keperawatan ambulasi yang diberikan pada pasien post ORIFfraktur tibia dan fibula di Ruang Angrek tengah kanan RSUP Persahabatan. Pasienyang dilakukan tindakan ambulasi secara bertahap adalah pasien dapat terhindar darikomplikasi akibat vaskularisasi yang buruk, dapat mempercepat proses penyembuhanserta memperpendek masa perawatan pasien di rumah sakit.ABSTRACT The majority of world's population lived in urban areas. As a result of population

density in urban areas, problem relating to traffic is the high number of traffic

accident. Fracture is one result of a traffic accident that requires immediate action to

preserve the anatomy and function of the body as before. The tibia and fibula

fractures post ORIF patient requires ambulation intervention to expedite the

circulatory system of the patient. This scientific work aimed to analyze ambulation of

the nursing intervention which given to tibia and fibula fractures post ORIF patient

at Angrek tengah kanan ward RSUP Persahabatan. The patient who performed the

gradually ambulation intervention can avoid the complications due to poor

vascularization, accelerate the healing process, and shorten patient care in hospital.;The majority of world's population lived in urban areas. As a result of population

density in urban areas, problem relating to traffic is the high number of traffic

accident. Fracture is one result of a traffic accident that requires immediate action to

preserve the anatomy and function of the body as before. The tibia and fibula

fractures post ORIF patient requires ambulation intervention to expedite the

circulatory system of the patient. This scientific work aimed to analyze ambulation of

the nursing intervention which given to tibia and fibula fractures post ORIF patient

at Angrek tengah kanan ward RSUP Persahabatan. The patient who performed the

gradually ambulation intervention can avoid the complications due to poor

vascularization, accelerate the healing process, and shorten patient care in hospital.;The majority of world's population lived in urban areas. As a result of population

density in urban areas, problem relating to traffic is the high number of traffic

accident. Fracture is one result of a traffic accident that requires immediate action to

preserve the anatomy and function of the body as before. The tibia and fibula

fractures post ORIF patient requires ambulation intervention to expedite the

circulatory system of the patient. This scientific work aimed to analyze ambulation of

the nursing intervention which given to tibia and fibula fractures post ORIF patient

at Angrek tengah kanan ward RSUP Persahabatan. The patient who performed the

gradually ambulation intervention can avoid the complications due to poor

vascularization, accelerate the healing process, and shorten patient care in hospital., The majority of world's population lived in urban areas. As a result of population

density in urban areas, problem relating to traffic is the high number of traffic

accident. Fracture is one result of a traffic accident that requires immediate action to

preserve the anatomy and function of the body as before. The tibia and fibula

fractures post ORIF patient requires ambulation intervention to expedite the

circulatory system of the patient. This scientific work aimed to analyze ambulation of

the nursing intervention which given to tibia and fibula fractures post ORIF patient

at Angrek tengah kanan ward RSUP Persahabatan. The patient who performed the

gradually ambulation intervention can avoid the complications due to poor

vascularization, accelerate the healing process, and shorten patient care in hospital.]"