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"Penelitian ini membahas mengenai hubungan motivasi dengan kepatuhan melakukan senam kaki pada penderita Diabetes Mellitus dengan menggunakan instrumen Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2) untuk mengukur tipe motivasi dan Exercise Adherence Rating Scale (EARS) untuk mengukur kepatuhan melakukukan senam kaki. Penelitian ini bersifat cross-sectional dengan 128 responden yang berasal dari Poliklinik Penyakit Dalam di Rumah Sakit Umum Pusat Fatmawati dan didapatkan hasil gambaran motivasi penderita DM melakukan senam kaki menunjukkan rerata skor elemen teridentifikasi (10,47) dan intrinsik (11,49) lebih tinggi dibandingkan rerata skor elemen amotivasi (5,29), external 6,83), dan terinterojeksi (3,27). Rerata skor Relative Autonomy Index (RAI) yaitu 22,62. Gambaran kepatuhan penderita DM melakukan senam kaki menunjukkan rerata skor yaitu 32,37 atau dalam persen yaitu 50%. Terdapat hubungan antara skor RAI motivasi, elemen amotivasi, elemen terinterojeksi dan elemen intrinsik dengan skor kepatuhan melakukan senam kaki pada penderita DM di Rumah Sakit Umum Pusat Fatmawati. Rekomendasi dari hasil penelitian ini yaitu pentingnya meningkatkan motivasi berupa dukungan dari tenaga kesehatan terhadap pasien di Rumah Sakit dan membuat program senam kaki bagi penderita DM yang terjadwal baik di dalam lingkungan poliklinik maupun diluar lingkungan poliklinik sehingga penderita DM merasa didukung oleh lingkungannya baik. Selain itu, peneliti melihat perlu adanya suatu logbook atau buku harian bagi penderita DM yang berisi tatalaksana DM baik dari edukasi, perencanaan makan, farmakologi dan latihan fisik yang dapat diisi oleh penderita dan dapat dilihat kepatuhan dari tatalaksana DM di buku tersebut.

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This study examines the relationship between motivation and adherence to foot exercises in patients with Diabetes Mellitus using the Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2) to measure motivation types and the Exercise Adherence Rating Scale (EARS) to measure adherence to foot exercises. It is a cross-sectional study with 128 respondents from the Internal Medicine Clinic at Fatmawati General Hospital, and the results show that the motivation of DM patients to perform foot exercises indicated higher mean scores for identified and intrinsic elements compared to mean scores for amotivation, external, and introjected elements. The mean Relative Autonomy Index (RAI) score was 22.62. The description of adherence of DM patients to foot exercises showed a mean score of 32.37 or 50% in percentage. There is a relationship between RAI motivation scores, amotivation elements, introjected elements, and intrinsic elements with adherence scores to foot exercises in DM patients at Fatmawati General Hospital. Recommendations from this study emphasize the importance of increasing motivation through support from healthcare professionals for patients in the hospital and implementing a scheduled foot exercise program for DM patients both within and outside the clinic environment to make them feel supported by their surroundings. Additionally, researchers see the need for a logbook or daily book for DM patients containing DM management including education, meal planning, pharmacology, and physical exercise which can be filled out by patients and used to assess adherence to DM management in the book."

"ABSTRAKKanker serviks menempati urutan keempat di dunia. Menurut WHO, kasus baru kanker serviks tahun 2018 sebanyak 570.000 dengan angka kematian sebanyak 311.000. Di Indonesia, berdasarkan data Globocan tahun 2018, kasus baru kanker serviks sebanyak 32.469 menempati urutan kedua setelah kanker payudara. Angka kematian kanker serviks di Indonesia mencapai 18.279 per tahun. Salah satu faktor yang membuat tingginya angka kejadian kanker serviks dikarenakan terlambatnya penemuan kasus kanker serviks. 70% kasus kanker serviks yang ditemui di rumah sakit berada pada stadium lanjut sehingga angka kematian kanker serviks menjadi tinggi. Skrining kanker serviks bertujuan mengurangi angka kejadian dan angka kematian kanker serviks. Jika kanker serviks terdeteksi sejak awal tahap pra kanker, maka dapat diberikan tindak lanjut pengobatan sehingga tidak berkembang menjadi kanker serviks. Namun, kenyataannya cakupan skrining kanker serviks masih rendah. Tujuan penelitian ini untuk mengetahui gambaran pengetahuan, sikap, dan hambatan terkait dengan perilaku pemanfaatan skrining kanker serviks. Penelitian ini menggunakan metode kualitatif dengan pendekatan studi kasus. Pengumpulan data melalui wawancara mendalam. Informan penelitian terdiri dari 5 orang yang sudah pernah skrining kanker serviks dan 5 orang yang belum pernah skrining kanker serviks. Hasil penelitian menunjukkan bahwa informan yang pernah skrining kanker serviks memiliki pengetahuan yang lebih baik, sebagian besar informan memiliki sikap positif terhadap skrining kanker serviks. Ketakutan merupakan faktor yang menjadi hambatan melakukan skrining kanker serviks. Alasan informan tidak melakukan skrining kanker serviks karena takut, tidak ada gejala, dan kurangnya informasi. Hampir semua informan yang pernah melakukan skrining kanker serviks karena motivasi diri sendiri. Pengetahuan yang baik, sikap yang positif, serta tidak adaya hambatan memungkinkan informan untuk melakukan skrining kanker serviks.

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ABSTRACT

Cervical cancer ranks fourth in the world. According to WHO, new cases of cervical cancer in 2018 were 570,000 with a death rate of 311,000. In Indonesia, based on Globocan data in 2018, 32,469 new cases of cervical cancer rank second after breast cancer. Cervical cancer mortality rate in Indonesia reaches 18,279 per year. One of the factors that make the high incidence of cervical cancer is due to the late discovery of cervical cancer cases. 70% of cervical cancer cases found in hospital are at an advanced stage so that the cervical cancer mortality rate is high. Cervical cancer screening aims to reduce the incidence and mortality rate of cervical cancer. If cervical cancer is detected early in the pre-cancer stage, follow-up treatment can be given so that it does not develop into cervical cancer. However, the reality is that cervical cancer screening coverage is still low. The purpose of this study was to describe the knowledge, attitudes, and barriers associated with cervical cancer screening behavior. This study uses a qualitative method with a case study approach. Data collection through indepth interviews. The research informants consisted of 5 people who had been screened for cervical cancer and 5 people who had never been screened for cervical cancer. The results showed that the informants who had cervical cancer screening had better knowledge, most of the informants had a positive attitude towards cervical cancer screening. Fear is a factor that hinders cervical cancer screening. The reason the informants did not do cervical cancer screening was because of fear, no symptoms, and lack of information. Almost all informants who had cervical cancer screening were self-motivated. Good knowledge, a positive attitude, and no obstacles allowed the informants to do cervical cancer screening."

"ABSTRAK

Latar belakang : Purpura Henoch-Schӧnlein (PHS) merupakan sindrom klinis

yang disebabkan vaskulitis akut sistemik pada pembuluh darah kecil yang paling

sering pada anak. Manifestasi klinis PHS sering melibatkan berbagai organ seperti

kulit, sendi, gastrointestinal, dan ginjal. Rekurensi terjadi pada hampir 50 % kasus

dan memengaruhi prognosis PHS. Sejauh ini belum ada publikasi penelitian PHS

yang meliputi manifestasi klinis, laboratorium, serta rekurensi di Indonesia.

Tujuan : Mengetahui manifestasi klinis, laboratorium serta rekurensi PHS anak di

Indonesia.

Metode : Penelitian deskriptif retrospektif. Data diperoleh dari rekam medis

pasien anak berusia 0-18 tahun dengan diagnosis PHS selama periode 1 Januari

2009 hingga 31 Desember 2012 di Rumah Sakit Cipto Mangunkusumo, Jakarta.

Hasil : Terdapat 71 kasus PHS dengan rentang usia 2 sampai 16 tahun dan usia

tersering pada kelompok 6-8 tahun. Proporsi anak wanita lebih tinggi dibanding

lelaki dengan rasio 1,2:1. Semua pasien mengalami purpura palpabel dan

manifestasi tersering lainnya adalah gangguan gastointestinal (79 %), artritis atau

artralgia (68 %), dan keterlibatan ginjal (41 %), sedangkan yang jarang adalah

gangguan neurologis (1 %), dan edema skrotum (4 %). Riwayat infeksi yang

mendahului gejala PHS didapatkan pada 56 % kasus. Peningkatan laju endap

darah (88 %) dan trombositosis (60 %) merupakan kelainan laboratorium yang

paling sering ditemukan, diikuti dengan hematuria (41 %), leukositosis (32 %),

dan anemia (31 %). Penurunan fungsi ginjal ditemukan pada 6/42 kasus.

Perbaikan gejala klinis terlihat dalam waktu kurang dari 4 minggu untuk

manifestasi kulit, gastrointestinal, dan persendian. Sebanyak 18/24 subjek dengan

hematuria mengalami perbaikan dalam waktu 6 bulan. Penurunan fungsi ginjal

menetap tidak ditemukan dalam penelitian ini. Rekurensi didapatkan pada 5/57

subjek yang memiliki data pemantauan.

Simpulan : Manifestasi klinis tersering pada PHS adalah purpura palpabel,

gangguan gastrointestinal, artritis atau artralgia, dan keterlibatan ginjal, sedangkan

yang jarang adalah gangguan neurologis dan edema skrotum. Pemeriksaan darah

perifer lengkap dan urinalisis sebaiknya dilakukan pada semua pasien PHS untuk

mendukung diagnosis dan menilai keterlibatan ginjal. Pada semua pasien PHS

sebaiknya dilakukan pemantauan minimal selama 6 bulan untuk menilai

keterlibatan ginjal yang mungkin timbul terlambat serta rekurensi

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ABSTRACT

Background : Henoch-Schӧnlein purpura (HSP) is a clinical syndrome which

caused by systemic acute vasculitis in small vessel. Henoch-Schӧnlein purpura is

the most common etiology of vasculitis in children. Clinical manifestations

usually involved several organs, such as skin, joint, gastrointestinal, and kidney.

Recurrency occured in almost 50 % cases, and lead to poor prognosis. Up to now,

there was no publications of HSP study in Indonesia regarding in clinical profiles,

laboratory, and recurrency.

Objective : To investigate the clinical characteristics, laboratory, and recurrency

of HSP in Indonesian’s children.

Method : A retrospective descriptive study was conducted from medical records

of children up to 18 years, in Cipto Mangunkusumo Hospital (CMH). Our

participants were children diagnosed as having HSP from January 1st 2009 to

December 31st 2012.

Results : There were 71 cases of HSP, with the range of age from 2 years old to

16 years old. Mostly subjects were at group age between 6 and 8 years old. Girl

was commonly affected compared to boy (1.2:1). All patients had palpable

purpura, other clinical symptoms that usually occured were gastrointestinal

(79 %), arthritis or arthralgia (68 %), and kidney disorder (41 %). Neurologic

symptoms (1 %) and scrotal edema (4 %) were the least found. 56 % of HSP

patient was preceeded by infection history. Laboratory results that commonly

found were increasing of ESR (88 %), thrombocytosis (60 %), hematuria (41 %),

and anemia (31 %), respectively. Kidney function impairment was occured in 6/42

cases. Clinical symptoms improvement had shown in less than 4 weeks for skin,

gastrointestinal, and joint disorder. Eighteen of twenty four subjects with

hematuria had recovery within 6 months. There were no cases of persistent kidney

function impairment. Recurrency occured in 5/57 subjects.

Conclusion : Clinical manifestations that commonly found in HSP patients were

palpable purpura, gastrointestinal disorder, arthritis or arthralgia, and kidney

involvements. Neurological disorder and scrotal edema were less found. Routine

blood and urine examination should be done in all HSP patients to confirm the

diagnosis and evaluate kidney involvement. In all HSP patients, we suggest to do

follow up on evaluating late kidney involvement and recurrency minimally in 6

months period."

"[ABSTRAKLatar belakang: Hiponatremia pasca tindakan operasi mayor pada populasi anak merupakan gangguan elektrolit yang sering terjadi. Penggunaan cairan yang belum tepat sering menimbulkan peningkatan kejadian hiponatremia yang berhubungan erat dengan meningkatnya berbagai komplikasi seperti edema otak, kejang, bahkan kematian. Populasi anak merupakan risiko tinggi karena perbandingan jaringan otak dan tulang tengkorak yang lebih besar sehingga ruang yang tersedia saat terjadi edema otak lebih sempit.Tujuan: Mengetahui insidens hiponatremia pada anak pasca tindakan operasi mayor.Metode: Studi retrospektif potong lintang dilakukan terhadap anak usia 1 bulan hingga 18 tahun yang menjalani tindakan operasi mayor dan masuk ruang perawatan intensif. Penelusuran status medik sesuai kriteria inklusi dilakukan sampai jumlah sampel terpenuhi. Pencatatan terhadap subjek yang meliputi data praoperasi, intraoperasi, serta pemantauan pascaoperasi dilakukan. Subjek yang memenuhi definisi hiponatremia (<135 mEq/L) diklasifikasikan sesuai derajat hiponatremia dan dilakukan pencarian lebih lanjut terhadap komplikasi.Hasil : Studi dilakukan terhadap 90 subjek yang terdiri dari 56,7% lelaki, dengan 51,1% memiliki rentang usia 1 bulan hingga 4 tahun. Sebanyak 47,8% subjek menjalani tindakan laparatomi dengan berbagai indikasi. Hampir semua subjek (93,3%) mendapat cairan hipotonik pascaoperasi. Insidens hiponatremia pascaoperasi sebesar 28,9% dengan 11,1% diantaranya merupakan hiponatremia sedang-berat. Rerata kadar natrium pascaoperasi adalah 130,1 ± 4,1 mEq/L dengan rerata total cairan 79,8 ± 27,4 ml/kg. Sebesar 30,9% subjek yang mendapatkan cairan hipotonik pascaoperasi mengalami kejadian hiponatremia dengan rerata lama rawat 5,6 ± 4 hari. Terdapat 1/26 subjek yang mengalami komplikasi berupa kejang dan edema otak.Simpulan: Insidens hiponatremia pasca tindakan operasi mayor di ruang perawatan intensif hampir mencapai 30% dan sebagian besar mendapat cairan hipotonik pascaoperasi. Penelitian lebih lanjut perlu dilakukan untuk mengevaluasi pemberian cairan pascaoperasi yang tepat untuk mencegah hiponatremia.

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ABSTRACTBackground: Hyponatremia is commonly found post major surgery in pediatric population. The use of improper fluid often leads to increasing incidence of hyponatremia which causes complications such as cerebral edema, seizure, and death. Pediatric is a high risk population due to the large ratio between the brain tissue and skull, so that the availability space.Hyponatremia after major surgery in pediatric population is a common electrolyte disorder. The use of improper fluid often lead to increased incidence of hyponatremia which is closely linked to the increasing variety of complications such as cerebral edema, seizures, and even death. Pediatric is high risk population due to the larger comparison of brain tissue and the skull so that the space available in the event of brain edema narrower.Objective: To describe the incidence of hyponatremia in children after major surgery.Methods: A retrospective cross-sectional study was conducted on children aged 1 month to 18 years who underwent major surgery and entered the intensive care ward. The inclusion subjects was traced from medical records. The data was recorded from preoperative, intraoperative, and postoperative monitoring. Subjects who met hyponatremia (<135 mEq/L) were classified according to the severity of hyponatremia and its complications.Results: Ninety subjects were enrolled in this study (56.7% male, 51.1% age 1 month-4 years). There were 47.8% subjects underwent laparotomy with a variety of indications. Almost all subjects (93.3%) received postoperative hypotonic fluid. The incidence of postoperative hyponatremia was 28.9%, while 11.1% among them were moderate-severe hyponatremia. The mean postoperative sodium levels was 130.1 ± 4.1 mEq/L with a mean total fluid 79.8 ± 27.4 ml/kg. There were 30.9% subjects who received hypotonic fluids and experienced hyponatremia with a mean length of stay 5.6 ± 4 days. One of 26 subjects with hyponatremia suffered from seizures and brain edema.Conclusions: The incidence of postoperative hyponatremia in pediatric intensive care reached nearly 30%, and almost all of them received hypotonic fluid. Therefore, further research should be performed to evaluate the appropriate fluid in order to anticipating postoperative hyponatremia, Background: Hyponatremia is commonly found post major surgery in pediatric population. The use of improper fluid often leads to increasing incidence of hyponatremia which causes complications such as cerebral edema, seizure, and death. Pediatric is a high risk population due to the large ratio between the brain tissue and skull, so that the availability space.Hyponatremia after major surgery in pediatric population is a common electrolyte disorder. The use of improper fluid often lead to increased incidence of hyponatremia which is closely linked to the increasing variety of complications such as cerebral edema, seizures, and even death. Pediatric is high risk population due to the larger comparison of brain tissue and the skull so that the space available in the event of brain edema narrower.Objective: To describe the incidence of hyponatremia in children after major surgery.Methods: A retrospective cross-sectional study was conducted on children aged 1 month to 18 years who underwent major surgery and entered the intensive care ward. The inclusion subjects was traced from medical records. The data was recorded from preoperative, intraoperative, and postoperative monitoring. Subjects who met hyponatremia (<135 mEq/L) were classified according to the severity of hyponatremia and its complications.Results: Ninety subjects were enrolled in this study (56.7% male, 51.1% age 1 month-4 years). There were 47.8% subjects underwent laparotomy with a variety of indications. Almost all subjects (93.3%) received postoperative hypotonic fluid. The incidence of postoperative hyponatremia was 28.9%, while 11.1% among them were moderate-severe hyponatremia. The mean postoperative sodium levels was 130.1 ± 4.1 mEq/L with a mean total fluid 79.8 ± 27.4 ml/kg. There were 30.9% subjects who received hypotonic fluids and experienced hyponatremia with a mean length of stay 5.6 ± 4 days. One of 26 subjects with hyponatremia suffered from seizures and brain edema.Conclusions: The incidence of postoperative hyponatremia in pediatric intensive care reached nearly 30%, and almost all of them received hypotonic fluid. Therefore, further research should be performed to evaluate the appropriate fluid in order to anticipating postoperative hyponatremia]"