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Abstrak :
Latar Belakang Pandemi COVID-19 telah dinyatakan berakhir oleh World Health Organization sehingga anak- anak dengan gangguan neurologis dan neurodevelopmental perlu untuk beradaptasi kembali. Oleh karena itu, penelitian mengenai adaptasi pascapandemi terkait layanan kesehatan, perkembangan masalah medis anak, hubungan anak dengan keluarga dan teman, perilaku anak, dan masalah yang dihadapi oleh orang tua, pengasuh, dan keluarga dalam penanganan anak perlu dilakukan untuk merancang intervensi dan kebijakan yang mendukung mereka dalam menghadapi situasi serupa di masa depan. Metode Penelitian ini merupakan studi potong lintang pada orang tua atau pengasuh pasien Poliklinik Neurologi Anak RSCM Kiara pada Oktober-November 2023 dengan instrumen penelitian berupa kuesioner yang berisi 48 pertanyaan untuk mengetahui adaptasi pascapandemi COVID-19 terhadap anak-anak dengan gangguan neurologis dan neurodevelopmental. Data disajikan dalam N dan persentase serta rerata dan standar deviasi (jika terdistribusi normal) atau median dan nilai minimum-maksimum (jika tidak terdistribusi normal). Hasil Jumlah subjek yang terlibat adalah 125 orang, yang didominasi oleh ibu (85,6%), dengan median (min-maks) usia anak 7 (2-17) tahun, dan diagnosis anak didominasi oleh epilepsi (58,3%). Setelah pandemi, sebanyak 54,4% responden mengalami kesulitan layanan kesehatan dalam aspek waktu tunggu rawat jalan dan 56,8% melaporkan adanya perbaikan dalam masalah medis. Mayoritas hubungan anak dengan keluarga adalah baik ketika sebelum dan selama pandemi (48,8%) serta setelah pandemi (49,6%). Terkait hubungan anak dengan teman, selama pandemi, hampir separuh anak tidak melakukan kontak dengan teman-teman mereka (44,8%), tetapi sekarang, mayoritas anak telah kembali bermain secara langsung (62,4%). Terkait perubahan perilaku pascapandemi, sebanyak 43,2% melaporkan relatif sama saja. Sementara terkait masalah yang dihadapi oleh orang tua, pengasuh, dan keluarga dalam penanganan anak, 40,8% menyatakan bahwa tidak ada kesulitan dalam menangani anak-anak mereka setelah pandemi.  Kesimpulan Adaptasi pascapandemi COVID-19 memberikan dampak pada layanan kesehatan, perkembangan medis anak, perubahan perilaku, dan hubungan dengan teman terhadap anak-anak dengan gangguan neurologis dan neurodevelopmental, meskipun sebagian besar hubungan keluarga tetap baik, dan sebagian besar orang tua melaporkan tidak adanya perubahan signifikan dalam situasi kerja atau tidak ada kesulitan yang dihadapi dalam menangani anak. ......Introduction The World Health Organization has declared the COVID-19 pandemic over, so children with neurological and neurodevelopmental disorders need to adapt again. Therefore, research on post- pandemic adaptation related to health services, the development of children's medical problems, children's relationships with family and friends, children's behavior, and problems faced by parents, caregivers, and families in treating children needs to be carried out to design interventions and policies that support them in facing similar situations in the future. Method This research is a cross-sectional study on parents or caregivers of patients at the Children's Neurology Polyclinic RSCM Kiara in October-November 2023 with a research instrument in the form of a questionnaire containing 48 questions to determine post-COVID-19 pandemic adaptation for children with neurological and neurodevelopmental disorders. Data are presented in N and percentage as well as mean and standard deviation (if normally distributed) or median and minimum-maximum values (if not normally distributed). Results The number of subjects involved was 125 people, dominated by mothers (85,6%), with a median (min-max) child age of 7 (2-17) years, and the child's diagnosis was dominated by epilepsy (58,3%). After the pandemic, 54,4% of respondents experienced health service difficulties regarding outpatient waiting times, and 56,8% reported improvements in medical problems. Most children's relationships with their families were good before and during the pandemic (48,8%) and after (49,6%). Regarding children's relationships with friends, during the pandemic, almost half of children had no contact with their friends (44,8%), but now, most children have returned to playing in person (62,4%). Regarding changes in post-pandemic behavior, 43,2% reported that it was relatively the same. Meanwhile, regarding the problems parents, caregivers, and families faced in handling children, 40,8% stated there were no difficulties managing their children after the pandemic. Conclusion Post-pandemic COVID-19 adaptation has had an impact on health services, children's medical development, changes in behavior, and relationships with friends for children with neurological and neurodevelopmental disorders; although most family relationships remain good, and most parents report no significant differences in a work situation, or there are no difficulties faced in dealing with children.

Abstrak :
Latar Belakang. Anak dengan gangguan neurodevelopmental memerlukan upaya terapi terpadu untuk meningkatkan kualitas hidupnya. Studi ini bertujuan mengetahui pengaruh implantasi eksosom, stimulasi auditori binaural beat, dan terapi konvensional terhadap lima domain BDI-2 pada anak dengan gangguan neurodevelopmental. Metode. Studi kohort retrospektif dengan rekam medis di RSUPN dr. Cipto Mangunkusumo dan RSAB Harapan Kita dilakukan pada anak dengan gangguan neurodevelopmental yang menjalani terapi sejak Januari 2021-April 2023. Subjek dikelompokkan menjadi kelompok perlakuan mendapatkan implantasi eksosom, stimulasi auditori binaural beat, dan terapi konvensional, sedangkan kelompok kontrol hanya mendapatkan terapi konvensional. Luaran yang dinilai yaitu domain perkembangan BDI-2. Analisis univariat dan bivariat dilakukan sesuai kebutuhan. Hasil. Terdapat 25 subjek kelompok perlakuan dan 25 subjek kelompok kontrol. Tidak ada perbedaan karakteristik kedua kelompok sebelum perlakuan, kecuali domain motorik. Terdapat perbedaan usia developmental global maupun lima domain BDI-2 sebelum dan sesudah perlakuan pada kelompok perlakuan dan kontrol dengan median peningkatan usia developmental global masing-masing yaitu 7,5 dan 2,2 bulan. Tampak perbedaan peningkatan usia developmental global dan lima domain setelah perlakuan yang bermakna antara kelompok perlakuan dan kelompok kontrol. Kesimpulan. Implantasi eksosom dan stimulasi auditori binaural beat dapat meningkatkan usia developmental global dan lima domain perkembangan berdasarkan penilaian BDI-2 secara signifikan pada anak dengan gangguan neurodevelopmental. ......Background. Children with neurodevelopmental disorders require integrated therapeutic efforts to improve their quality of life. This study aimed to determine the effect of exosome therapy, binaural beat auditory stimulation, and conventional therapy on five BDI-2 domains in children with neurodevelopmental disorders. Method. Retrospective cohort study using medical records at dr. Cipto Mangunkusumo National Center General Hospital and RSAB Harapan Kita was conducted for children with neurodevelopmental disorders who underwent therapy from January 2021 to April 2023. Subjects were grouped into a treatment group receiving exosome therapy, binaural beat auditory stimulation, and conventional therapy, while the control group only received conventional therapy. The BDI-2 developmental domains were assessed. Univariate and bivariate analysis were performed as needed. Results. There were 25 subjects in the treatment group and 25 subjects in the control group. There were no differences in subjects’ characteristics between the two groups before treatment, except for the motor domain. There were differences in global and five BDI-2 domains developmental age before and after treatment in the treatment and control groups with a median increase in global developmental age, respectively, 7.5 and 2.2 months. There were significant differences in the increase of global and five domains developmental age after treatment between the treatment group and the control group. Conclusion. Exosome therapy and auditory binaural beat stimulation improve global and five domains developmental age significantly based on BDI-2 assessment in children with neurodevelopmental disorders.