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"Dalam peningkatan mutu berkesinambungan, diperlukan suatu instrumen yang dapat merangkum seluruh kegiatan dan upaya tersebut dalam penyelenggaraan pelayanan kesehatan di rumah sakit melalui clinical pathway, dan mampu meningkatkan kualitas pelayanan kesehatan bagi pengguna rumah sakit, dengan mutu yang baik serta biaya BLU RS. Prof.DR.R.D. Kandou Manado, saat ini belum memiliki dapat diperkirakan clinical pathway khusus pasien meningitis, yangmerupakan salah satu penyakit neuroinfeksi terbanyak. Penelitian ini bersifat kuantitatif dan kualitatif, bertujuan membuat clinical pathway dengan mortalitas cukup tinggi, memiliki lama hari rawat panjang, biaya perawatan cukup tinggi, perjalanan penyakit dan hasilnya dapat diperkirakan. meningitis, berdasarkan data karakteristik pasien, kapasitas rumah sakit dan utilisasi pelayanan. Hasil penelitian ini didapatkan tiga bentuk lembaran clinical pathway, untuk diagnosis meningitis di Departemen Neurologi BLU RSUP Prof.DR.R.D. Kandou yang hasilnya disesuaikan dengan keadaan rumah sakit, dan telah disetujui oleh pimpinan rumah sakit dan Departemen Neurologi divisi neuroinfeksi, untuk dapat digunakan.

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In order to improve the quality continuosly, an instrument embracing the whole activities in performance of heath service in hospital is needed, through clinical pathway. BLU RSUP Prof.Dr.R.D. Kandou Manado has no clinical pathway yet at the moment, for meningitis patient in particular, which is one of the most common neuro infection disease with high mortality, long lenght of stay, high cost of care, with predictable course of disease and outcome.

Method : This is a qualitative and quantitavie study, which aims to make a clinical pathway for meningitis, according to patien characteristic data, hospital capacity and service utility.

Result of this study is obatained three form of clinical pathway sheets for meningitis patients at neurology department BLU RSUP PROF.DR.R.D. Kandou Manado, which compatible with the hospital condition, approved by hospital administrators and division neuroinfection of Neurology department."

"Umrah dilaksanakan dengan cara melakukan beberapa tahapan ibadah di kota suci Mekkah, khususnya di Masjidil Haram. Berbeda dengan ibadah haji, ibadah umrah dapat dilakukan kapan saja dan tanpa dibatasi batasan umur. Umroh dan haji sebagai salah satu bentuk mass gathering yang rutin dan berulang dengan konsekuensi potensi masalah kesehatan antara lain penularan penyakit infeksi. Saat ini alat transportasi pilihan utama yang digunakan oleh jamaah umrah adalah menggunakan pesawat terbang. Lingkungan pesawat yang unik merupakan salah satu sarana penyebaran penyakit antar penumpang. Mobilitas yang tinggi dari perjalanan pesawat terbang akan menimbulkan penyebaran penyakit antar negara dan berpotensi menyebabkan pandemi. Disiplin Kedokteran Penerbangan berperan penting dalam mencegah terjadinya penularan penyakit pada jamaah umrah yaitu dengan cara memastikan seluruh Jemaah telah mendapatkan vaksinasi. Salah satu penyakit yang penularannya dapat terjadi di pesawat dan dapat dicegah dengan menggunakan vaksinasi adalah meningitis. Penelitian ini bertujuan untuk mengetahui faktor faktor yang berpengaruh terhadap kepatuhan jamaah umrah melaksanakan vaksinasi meningitis. Penelitian menggunakan potong lintang. Seratus jamaah umrah yang tiba di Bandara Soekarno Hatta diambil datanya menggunakan kuesioner. Hasil penelitian menunjukan faktor faktor yang berpengaruh adalah tingkat pendidikan, lokasi penyuntikan, dan asas manfaat. Jamaah umrah dengan tingkat pendidikan tinggi lebih patuh 3,56 kali daripada jamaah umrah yang berpendidikan rendah. Jamaah umrah yang melakukan vaksinasi di KKP lebih patuh 4,3 kali daripada jamaah umrah yang melakukan vaksinasi di klinik/rumah sakit. Sedangkan jamaah umrah dengan persepsi manfaat yang tinggi lebih patuh 4,82 kali daripada jamaah umrah dengan persepsi manfaat yang rendah

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Umrah is carried out by performing several stages of worship in the holy city of Mecca, especially at the Grand Mosque. Unlike the pilgrimage, Umrah can be done at any time and without age restrictions. Umrah and hajj are a form of routine and recurring mass gathering with potential consequences for health problems, including the transmission of infectious diseases. Currently, the main mode of transportation used by Umrah pilgrims is by airplane. The unique aircraft environment is one means of spreading disease between passengers. The high mobility of airplane travel will cause the spread of disease between countries and the potential to cause a pandemic. The Discipline of Aviation Medicine plays an important role in preventing the spread of disease in Umrah pilgrims, namely by ensuring that all Congregations have been vaccinated. One of the diseases that can be transmitted on board and can be prevented by using vaccination is meningitis. This study aims to determine the factors that influence the obedience of Umrah pilgrims in implementing meningitis vaccination. Research using cross sectional. One hundred Umrah pilgrims who arrived at Soekarno Hatta Airport were collected using a questionnaire. The results showed that the influencing factors were the level of education, the location of injection, and the principle of benefit. Umrah pilgrims with a higher level of education are 3.56 times more obedient than those with low education. Umrah pilgrims who vaccinate at the KKP are 4.3 times more obedient than Umrah pilgrims who vaccinate in clinics / hospitals. Meanwhile, those with a high perceived benefit were 4.82 times more obedient than those with a low perceived benefit."

"[ABSTRAKToxoplasma gondii merupakan protozoa intraselular obligat yang tersebar di seluruh dunia. Infeksi yang diakibatkannya disebut toksoplasmosis, dan diperkirakan sekitar sepertiga populasi dunia terinfeksi T. gondii. Toksoplasmosis akan menjadi masalah bahkan dapat mengancam jiwa bila infeksi terjadi pada orang imunokompromi. Ensefalitis toksoplasma (ET) terjadi akibat reaktivasi infeksi laten T. gondii, dan merupakan masalah yang sering terjadi pada pasien AIDS, terutama pada stadium akhir.Untuk menegakkan diagnosis pasti penyebab kelainan SSP pada pasien AIDS sangatlah sulit, karena banyaknya kemungkinan penyebab infeksi lain seperti bakteri, virus, dan jamur. Diagnosis ET ditegakkan hanya berdasarkan asumsi dari gejala klinis, gambaran radiologi, dan respons terhadap terapi yang diberikan. Pemeriksaan kadar IgG anti-Toxoplasma pada cairan organ yang terinfeksi T. gondii jarang dilakukan. Selama ini studi-studi lebih banyak yang memeriksa kadar IgG anti-Toxoplasma pada serum. Oleh karena masih jarangnya penelitian yang menggunakan CSS untuk penegakan diagnosis ET dan untuk mengetahui apakah kadar IgG anti-Toxoplasma pada CSS bermakna dalam menegakkan diagnosis ET, maka penelitian mengenai hal tersebut dilakukan pada pasien HIV & AIDS dengan dugaan meningitis.Dari 50 sampel CSS pasien AIDS yang dikirim ke Laboratorium Parasitologi FKUI, 24 (48%) positif dan 26 (52%) negatif IgG anti-Toxoplasma. Dari IgG positif, 5 (20,83%) kadar tinggi, dan 19 (79,17%) kadar rendah. Tidak ada perbedaan bermakna antara kadar IgG anti-Toxoplasma dengan hasil pencitraan maupun diagnosis klinis ET. Tidak ada hubungan antara kadar IgG anti-Toxoplasma dengan riwayat terapi profilaksis ko-trimoksazol.

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ABSTRACTToxoplasma gondii is obligate intracellular parasite that spread over the world. Toxoplasmosis, infection of this parasite, infected over one third world population. Toxoplasmosis become problem and life threatening in immunocompromised patients. Toxoplasma encephalitis (TE) is reactivation of latent infection of T. gondii, and usually manifest in severe stage of AIDS.Diagnosis of central nervous system infection in AIDS is very difficult, because many possibilities of infection that caused by bacteri, virus, and fungi. TE is only diagnosed by asumption of clinical signs, radiology, and therapeutic respons. The examination of IgG anti-Toxoplasma in organ fluid was rare. Because of this reason and to answer, is IgG anti-Toxoplasma in cerebro spinal fluid has important meaning for diagnosing TE, this study was done in HIV infection & AIDS patients with meningitis.From 50 LCS of AIDS patients that sent to Parasitology Laboratorium FKUI, 24 (48%) were positive, and 26 (52%) were negative of IgG anti-Toxoplasma. From IgG positive samples, 5 (20,83%) were high, and 19 (79,17%) were in low level. There is no difference between IgG anti-Toxoplasma level with radiology appearence, and with clinical diagnose for TE. No difference between IgG anti-Toxoplasma level with history of cotrimoxazole as prophylaxis therapy.;Toxoplasma gondii is obligate intracellular parasite that spread over the world. Toxoplasmosis, infection of this parasite, infected over one third world population. Toxoplasmosis become problem and life threatening in immunocompromised patients. Toxoplasma encephalitis (TE) is reactivation of latent infection of T. gondii, and usually manifest in severe stage of AIDS.Diagnosis of central nervous system infection in AIDS is very difficult, because many possibilities of infection that caused by bacteri, virus, and fungi. TE is only diagnosed by asumption of clinical signs, radiology, and therapeutic respons. The examination of IgG anti-Toxoplasma in organ fluid was rare. Because of this reason and to answer, is IgG anti-Toxoplasma in cerebro spinal fluid has important meaning for diagnosing TE, this study was done in HIV infection & AIDS patients with meningitis.From 50 LCS of AIDS patients that sent to Parasitology Laboratorium FKUI, 24 (48%) were positive, and 26 (52%) were negative of IgG anti-Toxoplasma. From IgG positive samples, 5 (20,83%) were high, and 19 (79,17%) were in low level. There is no difference between IgG anti-Toxoplasma level with radiology appearence, and with clinical diagnose for TE. No difference between IgG anti-Toxoplasma level with history of cotrimoxazole as prophylaxis therapy., Toxoplasma gondii is obligate intracellular parasite that spread over the world. Toxoplasmosis, infection of this parasite, infected over one third world population. Toxoplasmosis become problem and life threatening in immunocompromised patients. Toxoplasma encephalitis (TE) is reactivation of latent infection of T. gondii, and usually manifest in severe stage of AIDS.Diagnosis of central nervous system infection in AIDS is very difficult, because many possibilities of infection that caused by bacteri, virus, and fungi. TE is only diagnosed by asumption of clinical signs, radiology, and therapeutic respons. The examination of IgG anti-Toxoplasma in organ fluid was rare. Because of this reason and to answer, is IgG anti-Toxoplasma in cerebro spinal fluid has important meaning for diagnosing TE, this study was done in HIV infection & AIDS patients with meningitis.From 50 LCS of AIDS patients that sent to Parasitology Laboratorium FKUI, 24 (48%) were positive, and 26 (52%) were negative of IgG anti-Toxoplasma. From IgG positive samples, 5 (20,83%) were high, and 19 (79,17%) were in low level. There is no difference between IgG anti-Toxoplasma level with radiology appearence, and with clinical diagnose for TE. No difference between IgG anti-Toxoplasma level with history of cotrimoxazole as prophylaxis therapy.]"

"ABSTRAKNyeri kepala merupakan manifestasi dari inflamasi respon infeksi di meninges. Nyeri Kepala berdampak pada fisiologis dan psikologis klien sehinga membutuhkan penanganan. Karya Ilmiah Akhir Ners ini bertujuan menganalisis intervensi terapi musik klasik sebagai terapi non-farmakologis dalam mengurangi nyeri kepala pada meningitis. Intervensi terapi musik klasik dilakukan selama 3 hari menggunakan instrumen Beethoven Symphony 6. Evaluasi nyeri menggunakan McGill Pain Questionaire menunjukkan bahwa nyeri kepala berkurang pada hari ketiga dari skor 8 menjadi 6. Penerapan intervensi ini menunjukkan bahwa terapi musik klasik yang dilakukan selama tiga hari dapat meringankan nyeri kepala klien meningitis. Selanjutnya perawat direkomendasikan untuk menerapkan terapi stimulasi klasik pada klien dengan keluhan nyeri kepala untuk meringankan nyeri dan memberi ketenangan.

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ABSTRACTHeadache is a manifestation of inflammatory response from meningeal infection. Headache may affect client physically and psychologically thus it requires treatment. This paper aimed to analyze implementation of classical music therapy as non pharmacological intervention in relieving headache in patient with meningitis. The therapy was applied for 3 days long by playing Beethoven Symphony 6. The headache was evaluated by using McGill Pain Questionnaire and revealed a decrease in pain intensity from score of 8 to 6 in the third day of implementation. This result suggested that classical music therapy relieved headache in patient with meningitis. Nurses are suggested to implement classical music therapy on client with headache in order to relieve and alleviate pain."

"[ABSTRAKMeningitis dan ensefalitis merupakan infeksi sistem saraf pusat yang dapatmengancam jiwa. Apabila tidak ditangani dengan baik, akan menimbulkan defisitneurologis dan berdampak pada kehidupan sehari-hari. Tujuan penelitian iniadalah mengeksplorasi secara mendalam pengalaman hidup pasien postmeningitisdan ensefalitis terkait kualitas hidupnya. Penelitian kualitatif denganpendekatan fenomenologi pada delapan partisipan ini ditentukan dengan tekniksnowball sampling. Data dikumpulkan dengan wawancara mendalam dan catatanlapangan. Analisis data menggunakan metode Collaizi. Tema yang ditemukanadalah perubahan fungsi tubuh pasien, masalah sosial yang dihadapi pasien postmeningitisdan ensefalitis, strategi koping pasien, kebutuhan akan support systempasien, dan pengalaman pasien selama menerima pelayanan kesehatan. Hasilpenelitian diharapkan sebagai data dasar pengembangan format pengkajian asuhankeperawatan dan instrumen kualitas hidup neuroinfection.

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ABSTRACTMeningitis and encephalitis are life-threatening infection of the central nervoussystem. If it is not treated properly, will lead to neurological deficits and impacton daily life. The purpose of this study was to explore the life experiences of postmeningitisand encephalitis patients related to their quality of life. Qualitativeresearch with phenomenological approach on eight participants involved weredetermined by snowball sampling technique. The data was collected by in-depthinterviews and field notes. Collaizi?s method was used to data analysis. Theresults of this investigation were: the changes body function of patients; the socialproblems faced by post-meningitis and encephalitis patients; the coping strategiesof patients; the need support system of patients, and the experience patients duringreceiving health care. The study findings are expected to be the basic for both thedevelopment of nursing care assessment form and instrument of neuroinfectionrelated to quality of life., Meningitis and encephalitis are life-threatening infection of the central nervoussystem. If it is not treated properly, will lead to neurological deficits and impacton daily life. The purpose of this study was to explore the life experiences of postmeningitisand encephalitis patients related to their quality of life. Qualitativeresearch with phenomenological approach on eight participants involved weredetermined by snowball sampling technique. The data was collected by in-depthinterviews and field notes. Collaizi’s method was used to data analysis. Theresults of this investigation were: the changes body function of patients; the socialproblems faced by post-meningitis and encephalitis patients; the coping strategiesof patients; the need support system of patients, and the experience patients duringreceiving health care. The study findings are expected to be the basic for both thedevelopment of nursing care assessment form and instrument of neuroinfectionrelated to quality of life.]"

"Meningitis adalah penyakit infeksi sistem syaraf pusat yang menyerang meningens atau selaput otak. Tujuan dari penulisan karya ilmiah ini adalah untuk mengetahui manajemen asuhan keperawatan pada anak meningitis dengan risiko keterlambatan perkembangan. Metodologi penulisan adalah case study, dengan melaksanakan asuhan keperawatan langsung kepada klien. Data yang didapat melalui pengkajian dengan cara wawancara, pemeriksaan fisik dan mengumpulkan data dari rekam medik klien untuk data penunjang.Intervensi yang diberikan yaitu berupa stimulasi perkembangan pada klien untuk kelompok umur tahapan tumbuh kembang 0-4 bulan serta juga melakukan pengajaran stimulasi untuk orang tua sebagai persiapan pulang. Hasilnya klien belum mengalami keterlambatan tumbuh kembang dan klien mampu mengikuti beberapa stimulasi yangdiberikan. Orang tua klien paham dan mengerti bahwa anaknya berisiko untuk mengalami keterlambatan dan orang tua mampu melakukan stimulasi secara mandiri setelah dilakukannya demonstrasi stimulasi perkembangan kepada klien. Stimulasi dini penting dilakukan kepada klien yang mempunyai risiko keterlambatan perkembangan. Rekomendasi dari studi ini agar ada follow up berkelanjutan terhadap stimulasi yang diberikan.

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Meningitis is an infectious disease of the central nervous system that attacks the meningens or the lining of the brain. This study aims to find out the effect of nursing care in meningitis children with the risk of developmental delay. In this case study, data was obtained through assessment by interviews, physical examination and collecting data from the client`s medical records for supporting data. The interventions that implemented were developmental stimulation to clients for the age group of 0-4 months and teaching the stimulation to parents for discharge planning. The result is that the client has not experienced any developmental delays and the client is able to follow some of the stimulation given. The client`s parents know and understand that their child is at risk of experiencing delays. The parents are able to perform stimulation independently after a

demonstration of developmental stimulation is carried out to the client. This study concludes early stimulation is important for clients who have a risk of developmental delays. Continuous follow up for the stimulation is recommended."