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"Tesis ini disusun untuk mengetahui efektifitas alat ukur Modified Mobility Interaction Fall Chart (Modified MIF Chart), sebagai alat ukur untuk menapis risiko jatuh, khususnya pada populasi lansia di panti wreda. Desain penelitian adalah cohort prospective dengan menilai komponen performa fisik menggunakan Stop walking when talking (SWWT) dan Difference Time Up and Go (DiffTUG), komponen fungsi visual yang menilai ketajaman penglihatan dengan Snellen chart, dan komponen kognisi yang dinilai menggunakan Montreal Cognitive Assesment versi Bahasa Indonesia (MoCA-INA) pada awal studi dan ditentukan tingkat risiko jatuh. Didapatkan subjek penelitian (n=111) yang menyelesaikan Modified MIF Chart kemudian dilakukan observasi kejadian jatuh selama tiga bulan. Terdapat 12 (10,8%) kejadian jatuh dari seluruh subjek. Terdapat perbedaan bermakna (p=0,038) antara kelompok risiko jatuh tinggi yang mengalami kejadian jatuh sebanyak 8 (18,6%) dibandingkan 4 kejadian jatuh (5,9%) pada kelompok risiko jatuh rendah dengan AUC 0,657 (95% CI: 0,49-0,82). Didapatkan sensitifitas dan spesifisitas Modified MIF chart secara berurutan adalah 64,6% dan 66,7%. Kesimpulan penelitian ini adalah Modified MIF Chart dapat digunakan sebagai alat penapis risiko jatuh pada lansia di panti wreda, tetapi tetap perlu memperhatikan faktor-faktor risiko jatuh internal dan eksternal lain yang belum dinilai oleh Modified MIF Chart.......This thesis is designed to determine the effectiveness of the Modified Mobility Interaction Fall Chart (Modified MIF Chart) as a tool to screen the risk of falls, especially in the elderly population in nursing homes. The research design was a prospective cohort by assessing the physical performance components using Stop walking when talking (SWWT) and Difference Time Up and Go (DiffTUG), a visual function component that assessed visual acuity using a Snellen chart, and a cognitive component assessed using the Montreal Cognitive Assessment. Indonesian language version (MoCA-INA) at the start of the study and the level of risk of falling was determined. Obtained research subjects (n = 111) who completed the Modified MIF Chart then observed the fall for three months. There were 12 (10.8%) incidence of falls for all subjects. There was a significant difference (p = 0.038) between the high risk group who experienced falls as much as 8 (18.6%) compared to 4 falls (5.9%) in the low risk group with AUC 0.657 (95% CI: 0, 49- 0.82). The sensitivity and specificity of the Modified MIF chart are 64.6% and 66.7%, respectively. The conclusion of this study is that the Modified MIF Chart can be used as a means of screening for the risk of falls in the elderly in nursing homes, but still needs to consider other internal and external risk factors that have not been assessed by the Modified MIF Chart."

"Kualitas pelayanan sosial untuk kesehatan mental lansia dipengaruhi interaksi antara praktisi kesejahteraan sosial dan klien. Interaksi melibatkan banyak aspek, termasuk spiritualitas, maka penelitian ini menggali pemahaman spiritualitas praktisi dan praktiknya dalam pelayanan, bagaimana spiritualitas dihayati lansia, dan bagaimana lansia menghadapi penderitaan. Kajian kualitatif ini melibatkan 20 informan praktisi dan klien dengan metode wawancara, observasi, dan kajian dokumen. Proses coding menggunakan NVivo untuk mempermudah analisis. Hasil penelitian menunjukkan spiritualitas praktisi dihayati dan diekspresikan dalam berbagai komponen dan dipraktikkan ketika berinteraksi dengan klien. Spiritualitas lansia juga tercermin dalam sejumlah kategori yang punya peran penting menjaga kesehatan mental ketika menghadapi penderitaan hidup. ......Service quality for elderly mental health is influenced by interaction between practitioners and clients. The interaction involves spirituality, so this study explores practitioners? understanding of spirituality and its implementation in service, how the elders live spirituality, and how they cope with sufferings. This qualitative study recruited 20 informants explored through interview, observation, and document review. NVivo software was used to organize coding results for analysis process. This study finds that practitioners? spirituality is lived and expressed in various components that is used in interaction. The elders have also spiritual sides echoed through some categories having contributions to their mental health."

"ABSTRAKTujuan penelitian ini untuk mengetahui faktor-faktor yang berhubungan denganpemanfaatan posyandu lansia di Puskesmas Bambanglipuro. Desain cross sectionaldan wawancara menggunakan kuesioner digunakan pada 180 orang responden yangdipilih secara multistage random sampling. Hasil penelitian menunjukkan 73,3%responden memanfaatkan posyandu, dimana faktor jenis kelamin (p=0,004),pengetahuan (p=0,001), sikap (p=0,001), ketersediaan posyandu (p=0,001), jarak(p=0,012), dukungan keluarga (p= 0,001), peran petugas (p= 0,001), sikap petugas(p= 0,011), peran kader (p=0,001), sikap kader (p=0,010) dan kebutuhan (p=0,001)berhubungan dengan pemanfaatan posyandu lansia, untuk itu perlu ditingkatkansosialisasi, pembinaan, pengembangan dan penyediaan sarana posyandu, pelatihandan reward kader, jadwal dan rutinitas kegiatan, kemitraan, dukungan dan penelitianlebih lanjut.

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ABSTRACTThe objective of this study was to assess factors related to utilization of earlyintegrated health service post/posyandu in the area of Puskesmas Bambanglipuro.Cross-sectional design and interview with questionnaires was used on 180 elderlythat was selected by multistage random sampling. This study showed that 73,3%elderly people use the elderly posyandu. Sex (p=0.004), knowledge (p=0.001),attitude (p=0.001), availability of posyandu (p=0.001), distance (p=0.012), familysupport (p=0.001), the role of health worker (p=0.001), attitude of health worker(p=0,011), the role of cadre (p=0.001), attitude of cadre (p=0.010) and need(p=0.001) related to the usage of elderly posyandu. Based on the result above,socialization of posyandu lansia should be increased, beside to improve the capabilityof personel and facilities of elderly posyandu and give the reward to the cadre."

"Studi ini bertujuan untuk mengetahui karakteristik demografi, sosial, ekonomi, lingkungan, perilaku dan disabilitas penduduk lansia di Indonesia. Status kesehatan buruk ditunjukkan oleh apakah memiliki efek negative pada kegiatan lansia (aktifitas terganggu) dengan menggunakan data Susenas 2012. Hasil regresi logistik biner menunjukkan bahwa faktor demografi, sosial, ekonomi, lingkungan, perilaku dan disabilitas memiliki pengaruh signifikan terhadap kesehatan terganggu pada lansia. Selain itu, faktor-faktor tersebut juga mempengaruhi risiko kesehatan terganggu lansia. Lansia dalam kelompok umur tua, berstatus tidak kawin/lainnya, tidak bekerja, pengeluaran menengah keatas, tinggal di kota, mengkonsumsi lainnya air bersih, menggunakan mck tidak sendiri, menggunakan bukan listrik PLN dan mempunyai disabilitas, memiliki peluang lebih tinggi terhadap risiko mengalami kesehatan terganggu.

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This study aimed to determine the demographic, social, economic, environmental, behavioral and disability of elderly health status in Indonesia. Poor health status is indicated by whether is has negative effect on elderly activities (activitas terganggu) is using Susenas 2012 Data. The results of binary logistic regression showed that demographic factors, social, economic, environmental , behaviors and disabilities have a significant influence on poor health of elderly. In addition, these factors also affect the risk of impaired health of the elderly. Elderly in older age groups, status not married / other, not working, middle and upper expenditure, live in cities, consuming more water, using MCK did not own, using instead PLN and have disabilities, have the opportunity higher against the risk of having poor health."

"Tesis ini bertujuan untuk membuktikan kesahihan dan keandalan Physical Activity Scale For The Elderly (PASE) versi bahasa Indonesia (PASE-INA) untuk mendapatkan metode kuantifikasi penilaian aktivitas fisik yang sahih dan andal untuk dapat diterapkan pada populasi lansia di Indonesia. Uji kesahihan konstruksi dilakukan dengan uji korelasi Pearson, sedangkan uji keandalan dilakuan dengan menilai intraclass correlation (ICC) untuk keandalan test-retest dan Cronbach’s ? untuk konsistensi internal. Sebanyak 64 orang lansia diwawancara dengan menggunakan kuesioner PASE yang sudah diterjemahkan ke dalam Bahasa Indonesia. Wawancara dilakukan sebanyak dua kali, dengan rentang waktu 1-3 minggu. Rerata skor total PASE-INA adalah 123.09(SD 35.48). Seluruh butir PASE-INA terbukti sahih dengan rentang nilai koefisien korelasi 0.310-0.533. Konsistensi internal dari skor total PASE-INA menunjukkan keandalan yang baik, dengan nilai Cronbach’s ? 0.844. Dari uji keandalan ­test-retest didapatkan hasil yang moderat dengan nilai ICC 0.728 (CI 95% 0.590-0.825). Kesimpulan dari penelitian ini adalah PASE-INA merupakan kuesioner yang sahih dan andal dalam menilai aktivitas fisik lansia di Indonesia.......This thesis aims to prove the validity and reliability of the Indonesian version of the Physical Activity Scale for The Elderly (PASE-INA) to obtain a valid and reliable method of quantification of physical activity assessment to be applicable to the elderly population in Indonesia. Construction validity was tested using the Pearson correlation test, while the reliability test was performed by assessing the intraclass correlation (ICC) for test-retest reliability and Cronbach’s ? for internal consistency. A total of 64 elderly people were interviewed using the PASE questionnaire which had been translated into Indonesian. Interviews were conducted twice within a 1 to 3-weeks interval. The mean PASE-INA total score was 123.09(SD 35.48). All PASE-INA items were proven valid with a correlation coefficient value range of 0.310-0.533. The internal consistency of the PASE-INA total score shows good reliability, with a Cronbach’s ? value of 0.844. From the test-retest reliability test, moderate results were obtained with an ICC value of 0.728 (95% CI 0.590-0.825). The conclusion of this study is that PASE-INA is a valid and reliable questionnaire in assessing the physical activity of the elderly in Indonesia."

"This cross sectional study was carried out in Jakarta, among institutionalized elderly aged 60 - 74 years. Rabe study reported that there is a high prevalence of low body mass index (BMI) value among the elderly in Jakarta. Ferro-Luzzi et at (1992) and James et al (1988) stated that an adult person with BMI less than 18.5 kg/m2 was proposed being chronic energy deficient (CED) and had functioning and health impairment. General aim of this study is to investigate whether low BMI among elderly is associated with adaptation in energy expenditure and had negative consequences on health. Based on James and colleague classification of BMI, two groups of elderly with different BMI value represented this study. Twenty elderly subjects with BMI < 11.00 kg/m2 (low BMI group) and 20 elderly subjects with BMI 22.0 --25.00 kg/m2 (normal BMI group). To every subject in each group was conducted questionnaires, Hb level measurement, 2 days combined record and recall daily physical activity, 2 days combined food weighing and 24-hour food recall intake, and resting energy expenditure (REE). Body composition was assessed by skinfolds technique and bioelectrical impedance analysis (BIA) using Lukaski and Deurenberg equations. Result revealed that fat mass and fat free mass of low BMI subjects are significantly lower than the normal BMI subjects. The low BMI subjects had very low fat mass. However, both groups had same PAL [1.3 X basal Metabolic rate (BMR)]. The low BMI subjects who were considered as CED had similar level of activity of daily living (ADL) as those with normal BMI subjects. Both BMI group had no significant different on the number of health complaint. On the whole, findings indicated that the CED elderly had no physical adaptation and negative consequences on health. Anyway using the cut-off point to define CED proposed by Ferro-Luzzi and colleague for Indonesian elderly needs carefully consideration. "

"Strategi koping keluarga merupakan perilaku keluarga mengatasi masalah kesehatan dalam keluarga. Penelitian ini bertujuan untuk mengetahui hubungan karakteristik dan strategi koping keluarga dengan perawatan hipertensi oleh lansia. Penelitian menggunakan pendekatan desain deskriptif korelasi. Besar sampel 136 keluarga dengan lansia hipertensi, dipilih secara proportional cluster sampling.Hasil penelitian menunjukkan strategi koping keluarga (hubungan/kebersamaan keluarga; kognitif; komunikasi; dukungan sosial; dan dukungan spiritual) berhubungan secara bermakna dengan perawatan hipertensi oleh lansia. Dukungan sosial merupakan strategi koping yang paling dominan. Penelitian ini merekomendasikan perlu dilaksanakannya promosi kesehatan, pemberdayaan keluarga, pembentukan support group dan pemberdayaan masyarakat dengan pelibatan kader dalam meningkatkan perawatan hipertensi pada lansia.

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Family behaviors in addressing family members? health problems are known as family coping strategies. The study purposes to determine the relationship of family characteristics and coping strategies with hypertension treatment by the elderly. A descriptive correlation design applied to136 families with elderly hypertensive that chosen by proportional cluster sampling.The results indicate relationship/family togetherness; cognitive; communication, social support and spiritual support were significantly associated with the treatment of hypertension by elderly. The most dominant coping strategy is a social support. The study results recommend a provision of health promotion; family empowerment; family support group and empowering health volunteers are needed."

"Latar Belakang: Pendekatan indeks frailty 40 item (FI-40) dianggap sebagai alat terbaik untuk evaluasi mortalitas dan hospitalisasi sindrom frailty, tetapi sulit diterapkan dalam praktik klinis sehari-hari. Pendekatan dengan sistem skor CHS, SOF, dan FI-CGA lebih mudah diterapkan dalam praktik klinis sehari-hari, namun hingga saat ini belum ada data validasi di Indonesia. Tujuan: Mendapatkan rekomendasi mengenai alat ukur sindrom frailty yang mudah diterapkan dalam praktik klinis sehari-hari di Indonesia. Metode: Penelitian ini merupakan studi potong lintang dengan pendekatan uji diagnostik yang dilakukan pada pasien di poliklinik Geriatri Rumah Sakit Cipto Mangunkusumo, dengan usia ≥60 tahun, pada periode Mei-Juni 2013. Setiap subjek dinilai menggunakan sistem skor CHS, SOF, FI-CGA, dan FI-40. Dilakukan penilaian sensitivitas, spesifisitas, nilai prediksi positif (NPP), nilai prediksi negatif (NPN), rasio kemungkinan positif (RK+), dan rasio kemungkinan negatif (RK-) untuk masing-masing sistem skor CHS, SOF, dan FI-CGA dibandingkan dengan FI-40. Hasil: Proporsi individu yang termasuk dalam kategori frail, pre-frail, dan fit berdasarkan indeks frailty 40 item berturut-turut adalah 25,3%, 71%, dan 3,7%. Untuk membedakan individu frail dengan tidak frail, skor CHS memiliki sensitivitas 41,2%, spesifisitas 95%, NPP 73,7%, NPN 82,7%, RK+ 8,41 dan RK- 0,62. Skor SOF memiliki sensitivitas 17,6%, spesifisitas 99,5%, NPP 92,3%, NPN 78,1%, RK+ 35,2 dan RK- 0,83. Sedangkan skor FI-CGA memiliki sensitivitas 8,8%, spesifisitas 100%, NPP 100%, NPN 76,4%, RK+ tak terbatas, dan RK- 0,91. Kesimpulan: Tidak ada sistem skor yang dapat digunakan sebagai alat skrining yang baik untuk sindrom frailty, namun masing-masing sistem skor dapat digunakan sebagai alat diagnostik yang baik untuk sindrom frailty. ......Background: The Frailty Index 40-item (FI-40) approach is considered the best tool for evaluating mortality and hospitalization outcomes related to frailty syndrome, although it is challenging to implement in daily clinical practice. The CHS, SOF, and FI-CGA scoring systems are easier to use in daily practice, but there is no validation data available in Indonesia. Aim: To obtain recommendations for a frailty syndrome diagnostic tool that is easy to implement in daily clinical practice in Indonesia. Methods: This was a cross-sectional study with a diagnostic test approach conducted on patients aged ≥60 years at the Geriatric Outpatient Clinic of Cipto Mangunkusumo Hospital from May to June 2013. Each subject was assessed using the CHS, SOF, FI-CGA, and FI-40 scoring systems. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) were calculated for each scoring system compared to FI-40. Results: The proportions of frail, pre-frail, and robust individuals based on the 40-item frailty index were 25.3%, 71%, and 3.7%, respectively. To differentiate between frail and non-frail individuals, the CHS score showed a sensitivity of 41.2%, specificity of 95%, PPV of 73.7%, NPV of 82.7%, LR+ of 8.41, and LR- of 0.62. The SOF score showed a sensitivity of 17.6%, specificity of 99.5%, PPV of 92.3%, NPV of 78.1%, LR+ of 35.2, and LR- of 0.83. The FI-CGA score showed a sensitivity of 8.8%, specificity of 100%, PPV of 100%, NPV of 76.4%, LR+ infinite, and LR- of 0.91. Conclusion: No scoring system was found to be suitable as a screening tool for frailty syndrome; however, all scoring systems can be used as effective diagnostic tools for frailty with good predictive ability."