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"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."

"Stroke merupakan kondisi emergency yang terjadi karena iskemi serebral, dengan penurunanaliran darah dan oksigen ke jaringan serebral yang dapat menyebabkan kerusakan otak yangpermanen bahkan sampai dengan kematian. Latar belakang dalam pengambilan kasusStroke dikarenakan terdapat 15 juta orang yang mengalami stroke setiap tahun danmerupakan penyebab kematian kedua diatas usia 60 tahun dan penyebab kematian kelimapada usia 15-59 tahun. Tujuan penelitian ini untuk mengetahui hubungan antara karakteristik,tingkat kecemasan dan ketergantungan dengan penerimaan diri pasien keterbatasan gerakakibat stroke. Hasil penelitian didapatkan terdapat hubungan karakteristik usia dan tingkatkecemasan dengan penerimaan diri pasien keterbatasan gerak akibat stroke. Hasil penelitian merekomendasikan Rumah Sakit umum sebagai pemberi layanan kesehatanyang berfokus pada pelayanan kesehatan fisik hendaknya juga meningkatkan layanankesehatan jiwa dalam memberika asuhan keperawatan yang komperhensif.

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Stroke is an emergency condition that occured as the cerebral ischemic, with decreased inblood flow and oxygen to the cerebral tissues that can caused permanent brain damaged andeven up to death, basic in decision Stroke cased because there are 15 million people whosuffered stroke each year and the second leading caused of death above the age of 60 yearsand the fifth leading caused of death at the age of 15 59 years.

The purpose of this study todetermine the relationship between the characteristics, the level of anxiety and selfacceptancedependence with reduced mobility as stroke patients.

The results showed there arerelation characteristics of the age and level of anxiety with self acceptance limitation ofmotion in stroke patient.

The results of the study recommended to general hospital as thehealth care provider that focuses on physical health services should be also improving mentalhealth services in providing a comprehensive nursing care. "

"[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]"

"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."

"Ansietas merupakan masalah psikososial yang banyak terjadi pada klien stroke. Ansietas yang tidak ditangani dapat menjadi penyulit bagi klien untuk mengikuti program pengobatan secara efektif dan memperlambat proses pemulihan. Salah satu psikoterapi yang dapat diberikan untuk mengatasi ansietas adalah Acceptance and Commitment Therapy (ACT). Penelitian ini bertujuan untuk mengetahui pengaruh ACT terhadap ansietas klien stroke yang dirawat di Rumah Sakit Stroke Nasional (RSSN) Bukittinggi. Desain penelitian yang digunakan adalah quasi experimental pre-post test with control group. Sampel penelitian berjumlah 60 orang dengan teknik pengambilan sampel consecutive sampling.Hasil penelitian menunjukkan ada perbedaan yang signifikan skor rata-rata ansietas antara kelompok yang mendapatkan ACT (intervensi) dengan kelompok yang tidak mendapatkan ACT (kontrol) p value=0,002 (P<0,05). ACT direkomendasikan untuk diterapkan sebagai terapi keperawatan untuk mengatasi ansietas pada klien stroke yang dirawat di rumah sakit umum.

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Anxiety is a psychological problem that experienced by patients with stroke. Untreated anxiety can be a serious barrier for the patient to follow an effective treatment program and also slowing down the recovery process. One of psychotherapy that can be provided to treat anxiety is Acceptance and Commitment Therapy (ACT).

The purpose of this study was to determine the effect of ACT towards stroke patient's anxiety who are hospitalized at the National Stroke Hospital Bukittinggi. This study used a quasi-experimental prepost test with control group design. The research sample consisted of 60 people with consecutive sampling technique.

The results of the study revealed that the significant difference of anxiety scores between the groups who received ACT (intervention) with the group without receiving ACT (control), p value=0.002 (P <0.05). ACT was recommended to be applied as a nursing therapy to overcome anxiety to the patient who are hospitalized in the general hospital."

"Tujuan Kadar plasminogen activator inhibitor-1 (PAI-1) yang tinggi menyebabkan penurunan aktivitas sistem fibrinolisis. Saat ini kadar PAI-1 yang tinggi diketahui merupakan faktor risiko penyakit jantung iskemik tetapi pada penderita stroke iskemik hal ini masih belum jelas. Pada penelitian ini ingin diketahui hubungan antara kadar PAI-1 dengan stroke iskemik. Metode Dengan menggunakan desain kasus kontrol, kami melibatkan 38 subjek penderita stroke iskemik dan 38 subjek kontrol yang memenuhi kriteria penelitian. Kadar PAI-1 diperiksa dengan metode ELISA menggunakan reagen Asserachrom PAI-1 dari Stago. Hasil Kadar PAI-1 yang tinggi ditemukan lebih sering pada penderita stroke iskemik daripada subjek kontrol (21.1% vs. 7.9 % dengan OR 3.1; 95 % CI 0.757 ? 12.790). Analisa terhadap semua subjek yang diteliti menunjukkan adanya hubungan negatif yang lemah namun bermakna antara kadar PAI-1 dengan usia (r = - 0.4; P = 0.000). Kadar PAI-1 yang tinggi ditemukan lebih sering pada subjek berusia muda (40 ? 58 tahun) daripada subjek berusia lebih tua ( 60 ? 84 tahun) (20 vs. 9.8 %) (P = 0.004). Kesimpulan Dari hasil penelitian pendahuluan ini diduga ada hubungan antara kadar PAI-1 dengan stroke iskemik pada usia muda. Penelitan lebih lanjut dengan jumlah subjek yang lebih besar diperlukan untuk memastikan keadaan ini.

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AbstractAim Recently, increased plasminogen activator inhibitor-1 (PAI-1) has been known a risk factor for ischemic heart disease. However, the association of increased PAI-1 level with ischemic stroke remains unclear. The aim of this study was to analyze the association of PAI-1 level with ischemic stroke. Methods By case control design we involved 38 ischemic stroke and 38 risky-matched control subjects who fulfilled the criteria. The PAI-1 level was determined by ELISA method using Asserachrom PAI-1 from Stago. Results High PAI-1 level was found more frequent in ischemic stroke subjects than in control subjects (21.1% vs. 7.9 % with OR 3.1; 95 % CI 0.757 ? 12.790). The analysis of all studied subjects showed that there was a weak negative correlation between PAI-1 level and age (r = -0.4; P = 0.000). High PAI-1 level was found more frequent in younger (40 ? 58 years old) than in the older subjects (60 ? 84 years old) (20% vs. 9.8 %) (p=0.004). Conclusion The result of this preliminary study suggested an association between PAI-1 level and ischemic stroke in younger age. Further study with larger subjects is recommended to confirm this association."

"Stroke merupakan penyakit yang timbul secara tiba-tiba, keluarga dan penderita biasanya tidak siap menerima hal tersebut. Penderita stroke menjadi sangat tergantung kepada keluarga, akibatnya keluarga sebagai pelaku rawat mengalami berbagai penurunan kondisi kesehatan baik fisik dan mental yang mempengaruhi kualitas hidup pelaku rawat dan lansia stroke. Pelaku rawat pada penderita stroke umumnya memiliki perilaku yang tidak memadai dalam memberikan perawatan pada anggota keluarga dengan stroke. Penelitian ini bertujuan untuk mengetahui hubungan perilaku dengan kualitas hidup perilaku rawat dan lansia stroke. Desain penelitian yang digunakan adalah penelitian kuantitatif dengan metode deskriptif korelasional dan pendekatan cross sectional. Metode pengambilan sampel dalam penelitian ini adalah non probability sampling dengan teknik purposive sampling. Analisis bivariat menggunakan regresi linear berganda, t-independen, dan ANOVA. Analisis regresi linear berganda digunakan untuk mengetahui variabel yang paling berhubungan terhadap kualitas hidup pelaku rawat dan lansia stroke. Hasil penelitian menunjukkan bahwa pendidikan, usia, lama merawat, dan kekerabatan memiliki hubungan yang signifikan terhadap kualitas hidup pelaku rawat (p-value 0,001; p-value 0,022; p-value 0,038 dan p-value 0,004). Selain itu usia dan lama merawat memiliki hubungan yang signifikan dengan kualitas hidup lansia stroke (p-value 0,018 dan p-value 0,000). Namun perilaku pelaku rawat tidak memiliki hubungan yang signifikan dengan kualitas hidup pelaku rawat (p-value 0,640), perilaku pelaku rawat tidak memiliki hubungan yang signifikan dengan kualitas hidup lansia stroke (p-value 0,558). Pendidikan menjadi faktor yang paling berpengaruh terhadap kualitas hidup pelaku rawat dengan nilai Beta = 0,309, lama merawat menjadi faktor yang paling berpengaruh terhadap kualitas hidup lansia stroke dengan nilai Beta = -0,376. Hasil dari penelitian ini diharapkan dapat menjadi landasan dalam mengembangkan intervensi untuk peningkatan perilaku pelaku rawat sehingga kualitas hidup pelaku rawat dan lansia stroke dapat meningkat

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Stroke is a disease that arises suddenly, families and sufferers are usually not ready to accept it. Stroke sufferers become very dependent on their families, as a result, families as caregiver experience various decreases in both physical and mental health conditions that affect the quality of life of stroke caregivers and elderly. Family caregiver for stroke patients generally have inadequate behavior in providing care to family members with stroke. This study aims to determine the relationship between behavior and the quality of life of family caregiver and stroke elderly. The research design used is quantitative research with correlational descriptive method and cross sectional approach. The sampling method in this study is non-probability sampling with purposive sampling technique. Bivariate analysis used multiple linear regression, t-independent, and ANOVA. Multiple linear regression analysis was used to determine the variables most related to the quality of life of caregivers and the elderly with stroke. The results showed that education, age, length of care, and kinship had a significant relationship to the quality of life of caregivers (p-value 0.001; p-value 0.022; p-value 0.038 and p-value 0.004). In addition, age and length of care have a significant relationship with the quality of life of the elderly with stroke (p-value 0.018 and p-value 0.000). However, the behavior of the caregivers did not have a significant relationship with the quality of life of the caregivers (p-value 0.640), the behavior of the caregivers did not have a significant relationship with the quality of life of the stroke elderly (p-value 0.558). Education is the most influential factor on the quality of life of caregivers with a value of Beta = 0.309, length of care is the most influential factor on the quality of life of the elderly with stroke with a value of Beta = -0.376. The results of this study are expected to be the basis for developing interventions to improve the behavior of caregivers so that the quality of life of caregivers and the elderly with stroke can improve."