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"Latar Belakang: COVID-19 telah ditetapkan WHO sebagai Kedaruratan Kesehatan Masyarakat Yang Meresahkan Dunia dengan case fatality rate (CFR) di Indonesia mencapai 8,7% pada April 2020. Sampai saat ini belum ada biomarker prognosis untuk membedakan pasien yang membutuhkan perhatian segera dan menjadi prediktor mortalitas COVID-19 di ICU. Skor Simplified Acute Physiology Score 3 (SAPS 3) menilai kondisi pasien sejak pertama kali datang ke rumah sakit dan mengevaluasi data yang diperoleh saat masuk ICU dalam menentukan prediktor mortalitas 28 hari. Tujuan: Studi ini menganalisis hubungan skor SAPS 3 dengan mortalitas 28 hari pada pasien COVID-19 yang dirawat di ICU RSCM dan RSUI. Metode: Penelitian ini merupakan studi kohort retrospektif di Rumah Sakit Cipto Mangunkusumo selama bulan Maret-Agustus 2020. Sebanyak 208 subjek yang sesuai kriteria inklusi dianalisis dari data rekam medis. Data demografis dan penilaian skor SAPS 3 dicatat sesuai data rekam medis. Variabel SAPS 3 yang berpengaruh terhadap mortalitas 28 hari dilakukan analisis bivariat dan regresi logistik multivariat. Kesahihan dinilai menggunakan uji diskriminasi dengan melihat Area Under Curve (AUC) dan uji kalibrasi Hosmer Lemeshow. Titik potong optimal ditentukan secara statistik. Hasil: Angka mortalitas 28 hari akibat COVID-19 periode Maret-Agustus sebesar 43.8%. Variabel SAPS 3 yang secara statistik berpengaruh signifikan (p<0.05) terhadap mortalitas 28 hari pasien COVID-19 di ICU adalah usia, riwayat penggunaan obat vasoaktif sebelum masuk ICU, penyebab masuk ICU (defisit neurologis fokal dan gagal napas), kadar kreatinin dan trombosit. Skor SAPS 3 menunjukkan nilai diskriminasi yang baik (AUC 80.5% Interval Kepercayaan 95% 0.747-0.862) dan kalibrasi yang baik (Hosmer-Lemeshow p=0.395). Titik potong optimal skor SAPS 3 adalah 39 dengan sensitivitas 70.3% dan spesifisitas 74.4%. Kesimpulan: Skor SAPS 3 memiliki hubungan dengan mortalitas 28 hari pada pasien COVID-19 yang dirawat di ICU.

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Background: COVID-19 has been declared as a Public Health Emergency of International Concern by WHO with case fatality rate (CFR) of 8,7% in April 2020 in Indonesia. Until now, there is no prognostic biomarker to differentiate patients who require immediate attention and be a mortality predictor for COVID-19 patients in ICU. Simplified Acute Physiology Score 3 (SAPS 3) score assessed the patient’s condition since the first time he came to the hospital and evaluated the data obtained in the first hour of admission to the ICU in predicting 28-days mortality. Goals: This study aims to analyze the correlation between SAPS 3 score and 28-days mortality caused by COVID-19 in the ICU RSCM and RSUI.

Methods: This retrospective cohort study was conducted in Cipto Mangunkusumo Hospital from March to August 2020 on 208 subjects who met the inclusion criteria. Demographic data and SAPS 3 score were recorded, the data was taken from medical records. Bivariate and multivariate logistic regression was used to investigate the relationship between SAPS 3 variables and 28-days mortality. The validity of SAPS 3 score was assessed by measurement of the Area Under Curve (AUC) and Hosmer- Lemeshow calibration test. The optimal cut-off point was determined statistically.

Results: The mortality rate of COVID-19 in our study from March to August 2020 is 43.8%. Five SAPS 3 variables were found to be significantly associated with 28-days mortality of COVID-19 patients in the ICU (p<0.05) are age, use of vasoactive drugs before ICU admission, reason for ICU admission (focal neurologic defisit and respiratory failure), creatinine, and thrombocyte level. SAPS 3 showed a good discrimination ability (AUC 80.5% Confidence Interval 95% 0.747-0.862) and calibration ability (Hosmer-Lemeshow p=0.395). The optimal cut off point of SAPS 3 score was 39 with sensitivity 70.3% and specificity 74.4%.

Conclusion: SAPS 3 score have a correlation with 28-days mortality caused by COVID-19 in the ICU."

"Selarna masa kehamilan, ibu akan mengalami perubahan-perubahan dalam dirinya, baik perubahan fisik maupun perubahan psikologis. Tidak semua ibu dapat menerima berbagai perubahan yang terjadi. Masalah yang mungkin dialami adalah gangguan gambaran diri dan ideal diri. Jika masalah ini tidak segera diatasi, kemungkinana dapat berpengaruh terhadap perilaku ibu baik selama kehamilan maupun sesudah melahirkan. Penelitian ini mengunakan desain descriptive correlational dengan pendekatan cross sectional yang bertujuan untuk mengetahui hubungan gambaran diri dan ideal diri ibu primigravida dengan pemberian ASI 10 jam setelah melahirkan. Sampel penelitian adalah ibu primigravida yang berjumiah 104 orang yang diambil secara purposive sampling. Untuk menguji hubungan antara gambaran diri dan ideal diri dengan perilaku pemberian ASI 10 jam setelah melahirkan mengunakan uji statistik chi-square, kemudian dilakukan uji regresi logistik ganda model faktor risiko untuk mengetahui variabel yang paiing dominan berhubungan dengan perilaku pemberian ASI 10 jam setelah melahirkan.Hasil penelitian memperlihatkan bahwa setelah dikontrol variabel sikap, gambaran diri merupakan variabel yang paling dominan dan berhubungan secara bermakna dengan perilaku pemberian ASI 10 jam setelah melahirkan dengan nilai OR = 1,054. Saran: tenaga kesehatan khususnya perawat maternitas perlu memberikan dan meningkatkan pendidikan kesehatan dan konseling kepada ibu dan suami pada saat antenatal care (ANC) mengenai perubahan fisik dan psikologis yang terjadi selama kehamilan agar ibu dapat beradaptasi dan bersikap positifterhadap perubahan yang terjadi.

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During a period of pregnancy mother will have experience of the change in her self, physical and psychological changes. Not all of mother has been accepted this condition. The problem is body image and self image disturbances. If this problem not immediately overcome by hence it would be have an effect to mother's behavior during pregnancy and also delivery like breastfeeding behavior during I0 hour after delivery. This study was a co relational descriptive design with cross sectional approach. One hundred four primigravida mothers were recruited by using purposive sampling involved in this study. Chi-square test was performance to analyze the correlation of body image and self image with breastfeeding behavior during 10 hour after bearing, and use regression logistic risk factor model test to know the most dominant variable related to breastfeeding behavior during 10 hour after delivery after control confounder variable.

This research relevance that, after control by attitude, body image primigravida's was the most dominant variable and only significant with breastfeeding behavior during 10 hour after delivery with OR value = 1,054. It would be recommended for health service specially maternity nursing to provide and improve health education for mother and her husband during antenatal care (ANC) about physical and psychological changes during pregnancy so that mother can adapt and have positive attitude to face these changes."