Search

Severity level is one of the variables used to determine the treatments of acute coronary syndrome patients. There are many ways to see the success of treatment such as measuring the patient’s quality of life. This study aims to determine the correlation between severity level and quality of life among patients with post-acute coronary syndrome at Hasan Sadikin Central Hospital Bandung. This research was a quantitative study with a descriptive-analytic approach. Sampling of 100 patients with post-acute coronary syndrome patients was collected during a period of one month using consecutive sampling technique. The severity was assessed based on the stenosis number and the quality of life data were collected using the MacNew QLMI. Somers’d Gamma was used to analyze the data. Data showed that most of the patients had angina without stenosis (36%) and coronary 1 stenosis (29%). The results of the quality of life measurement show that 58% patients have a good quality of life, 64% are good in the emotional domain, 52% are good in the physical domain, and 60% are good in the social domain. Bivariate analysis (CI 95%) showed that there was a significant correlation between severity level and quality of life (p-value 0.033), as well as with the physical domain (p-value 0,008). There is a correlation between severity level and quality of life of post-acute coronary syndrome patients in Hasan Sadikin Central Hospital Bandung. Based on the quality of life domain, the severity level was significantly related to the physical-domain. Regular screening is necessary to improve the quality of life of post-acute coronary syndrome patients.

Coronary heart disease (CHD) patients experience various physical and psychological changes after an acute attack. Depression has been identified as a substantive psychological problem in CHD patients. Cardiac rehabilitation (CR) intends to restore optimal physical and psychological condition of the patients. However, less attention is bestowed towards the psychological aspect of CR. Research on the effects of CR on patient psychological problems has not been discussed in many studies in Indonesia. This study aimed to compare depression, recurrence, and fitness levels among CHD patients based on participation in Phase II CR Program. This research used a quantitative comparative method involving 66 CHD patients recruited by a purposive sampling technique. After applying the selection criteria for this study, the patients were assigned to the CR group (nCR=29) and the non-CR group (nNCR=37). Data were collected using the Beck Depression Inventory-II (BDI II) and instruments developed by researchers to measure recurrence and fitness levels. Data were analyzed using frequency distribution, chi-squared, and Mann-Whitney tests. Depression experienced by CHD patients in both groups with mean in non-CR and CR groups of 11.11 (± 7.8) and 8.59 (± 6.5), respectively. There was no significant difference in depression level among the groups (p>0.05)). Meanwhile, as many as 45% of the patients in the CR group and 22% in the non-CR group had never experienced chest pain (recurrence) within the past month. In addition, the physical fitness was perceived increased by 90% of the patients in the CR group and 0% in the non-CR group. It was also found that there were significant differences in the recurrence and physical fitness among the two groups (p

Penyakit Jantung koroner (PJK) merupakan salah satu penyebab utama dan pertama angka kematian di negara maju dan berkembang, termasuk Indonesia. Angka kematian akibat PJK yang semakin meningkat perlu mendapatkan perhatian khusus. Upaya yang dapat dilakukan yaitu dengan tindakan Bedah Pintas Arteri Koroner (BPAK) yang dapat meningkatkan kualitas hidup pasien. Pasien pasca BPAK mengalami perubahan dalam hal bio-psiko-sosio-spiritual yang dapat memengaruhi kualitas hidup. Instrumen yang digunakan untuk mengukur kualitas hidup selama ini masih umum dan mengacu pada budaya dan pelayanan kesehatan di luar negeri, padahal kualitas hidup dipengaruhi oleh budaya setempat. Tujuan penelitian ini adalah untuk mengeksplor kualitas hidup pasien pasca BPAK di RSUP Dr. Hasan Sadikin Bandung. Metode penelitian yang digunakan adalah deskriptif kualitatif, dengan jumlah partisipan sebanyak 6 orang. Pengumpulan data dilakukan dengan cara wawancara semi terstruktur yang mengacu pada intrumen Short Form36. Analisa data menggunakan content analysis. Hasil Penelitian yaitu secara fisik semua partisipan masih merasakan nyeri di bekas luka operasi seperti kesemutan dan baal, tetapi tidak sampai mengganggu aktivitas sehari-harinya. Secara emosional semua partisipan mengungkapkan rasa bahagia karena sudah terbebas dari penyakitnya, walaupun tidak sembuh secara total tetapi semua partisipan menerima keadaan dirinya. Secara Sosial semua partisipan mengungkapkan bahwa dukungan keluarga dan dukungan orang sekitar sangat dibutuhkan. Bentuk spiritualitas pada penelitian ini adalah partisipan merasa lebih dekat dengan Tuhan dan lebih mensyukuri keadaannya sekarang. Berdasarkan hasil penelitian terdapat aspek baru yang didapatkan dari hasil penelitian ini yaitu pentingnya spiritualitas dalam kualitas hidup partisipan. Hasil penelitian ini diharapkan menjadi bahan pertimbangan dalam proses asuhan keperawatan. Kata kunci:Bedah Pintas Arteri Koroner, Kualitas Hidup,Short Form36. Quality of Life among Patients with Post Coronary Artery Bypass Surgery Abstract Coronary Artery Diseases (CAD) remains one of the major problems lead to a high mortality rate in many countries including Indonesia. Thus, treatment such as coronary artery bypass surgery is considered as a common treatment to reduce the fatal risks. However, post-surgical problems may arise which can diminish the patient’s quality of life regardless cultural and contextual causal factors. This descriptive qualitative study aimed to explore the quality of life among patients undergone the coronary artery bypass surgery in Dr. Hasan Sadikin General Hospital Bandung. Data were collected using an individual semi-structured interview following the Short Form 36 instrument (SF-36) with six participants were recruited. Content analysis was employed to analysis the transcribed data. Findings revealed that all participants have experienced pain, numbness and tingling sensations particularly on the surgical sites without the presence of any daily activity living disturbances. They expressed more positive emotional feelings because of having freedom from their illness. The presence of strong social supports given by families and relatives has motivated the patients to face their recovery phase. In addition, participants expressed the need to have spiritual care which can help them to feel getting closer to the Lord and being more grateful for whatever situations they may have at the moment. Findings have further emphasised the importance of spirituality in the achievement of good quality of life among the participants. The result is expected to contribute to the improvement of best quality of post-operative nursing care plan. Keywords: Coronary Arterial By-Passed Surgery, post-operative care, quality of life, spirituality.

Background: Cardiac rehabilitation (CR) is an important post-acute management for Cardiovascular Heart Disease (CHD) patients. CR has benefits, such as preventing recurrence and improving patients physically. However, the CR participation rate is low. This condition can produce negative effects, such as recurrence and depression. There are inhibiting factors contribute to the CR participation. The purpose of this study is to identify the distinction of inhibiting factors in patients who actively and inactively participate in phase II CR in Bandung. The result will be as advices to improve policy and nursing intervention to improve the participation number of phase II CR in Bandung. Method: This study used comparative design with cross-sectional approach on 72 respondents who recruited by using purposive sampling at a hospital in Bandung, Indonesia. Data were collected by using Cardiac Rehabilitation Barrier Scale (validity r = 0.46-0.55 and reliability 0.887). Data were analyzed by using descriptive frequency and comparative analysis by using Mann-Whitney. Result: It was showed that there were two significant differences between both of the group in terms of health services aspect (p-value = 0.002) and time (p-value = 0.001). However there were no significant differences between both of the group in logistics aspect (p-value = 0.134), and functional status aspect (p-value = 0.057). It indicates that there were distinctions in inhibiting factors on health services and time aspects. Conclusion: There were differences in the health services, which was related to the lack of CR information and also time aspects, which was related to the lack of CR facilities in remote areas. Therefore, providing information about CR and community or home-based CR are needed.

Background: Ventilator associated pneumonia (VAP) has been known to be the most common nosocomial infection in Intensive Care Unit (ICU). VAP increases length of care, cost, morbidity and mortality of patients in ICU. The ICU of RSMH Palembang have already been doing prevention of VAP incidence through VAP bundles, but the number of incidence were still high. Purpose: This study aimed to identify the factors associated with VAP incidence among the patients in ICU RSMH Palembang. Method: this study was quantitative study with kohort prospective approach. Samples were recruited from ICU RSMH Palembang using consecutive sampling technique for 4 months period (n=61). Data were collected using a questionnaire package consisting of a demographic questionnaire, CPIS instrument, APACHE II, an observation sheets that measure duration of using antibiotics, duration of using ventilator, reintubation and hand hygiene compliance. Data were analyzed using descriptive quantitative and logistic regression analysis. Results: VAP occured in 12 patients (19.7%). Bivariate test result with α:5% have shown that APACHE II (p:0.043), duration of using antibiotic (p:0.023), duration of using ventilator (p:0.001) and reintubation p:(0.001) were related to the incidence of VAP. Logistic regression analysis shows that reintubation (OR=0.035; CI 95%:0.28-0.658; p=0.013) and duration of ventilator > 5 days (OR=0.082; CI 95%: 0.09-0.74; p=0.026) were significant factor that affecting VAP. Conclusion. Reintubation was the most related factor with VAP incidence. It is recommended for doctors and nurses to conduct a proper and thorough assessment before extubation to minimalize the risk of reintubation.

Spiritual care merupakan hal yang penting bagi pasien kanker. Namun pelayan keperawatan masih terfokus pada aspek fisik, sehingga data mengenai kebutuhan spiritual pasien kanker di Indonesia belum komprehensif. Penelitian ini bertujuan mengidentifikasi kebutuhan spiritual pada pasien kanker serta tingkat kebutuhannya. Penelitian deskriptif kuantitatif ini melibatkan 76 pasien kanker yang sedang menjalani perawatan di salah satu RS di Bandung yang diambil dengan accidental sampling. Data dikumpulkan dengan menggunakan instrumen Spiritual Needs Questionaire 2.1 (SPNQ 2.1) yang meliputi aspek religi, kedamaian dan eksistensi diri. Analisa data kebutuhan spiritualitas menggunakan distribusi frekuensi dan persentase, sedangkan nilai rerata digunakan untuk mengidentifikasi seberapa kuat kebutuhan spiritual tersebut bagi responden dengan kategori 1 – 1,9 agak dibutuhkan; 2 – 2,9 dibutuhkan; 3 sangat dibutuhkan. Hasil penelitian menunjukkan bahwa pada aspek religi, berdoa dengan orang lain dan seseorang berdoa untuk responden memiliki persentase paling tinggi (96,05%). Pada aspek kedamaian, tinggal di tempat yang tenang dan damai serta menemukan kedamaian batin memiliki persentase paling tinggi (89,47%). Pada aspek eksistensi diri, menemukan makna dalam sakit dan penderitaan memiliki persentase paling tinggi (94,74%). Adapun pada kebutuhan untuk memberi, beralih menjadi orang yang penuh cinta kasih memiliki persentase paling tinggi (89,47%). Kebutuhan tersebut masuk ke dalam kategori dibutuhkan dengan nilai rerata sebagai berikut : kebutuhan religi (2,28±0,47); kedamaian (2,19±0,47); eksistensi diri (2,11±0,76); dan kebutuhan untuk memberi (2,08±0,55). Penelitian ini menunjukkan bahwa semua dimensi kebutuhan spiritual sangat dibutuhkan oleh responden, dan kebutuhan religi merupakan kebutuhan yang paling banyak dipilih dan dirasakan paling dibutuhkan. Kata kunci: Kanker, kebutuhan spiritual, pasien.Spiritual Needs of Patients with CancerAbstractCancer affects a patient’s various life aspects, physical, psychological, as well as spiritual. However, more often than not, nursing care focuses only on the physical aspect, and neglects the spiritual side. This study aimed to identify the types and levels of spiritual needs affecting cancer patients. This quantitative descriptive study involved 76 cancer patients, selected using accidental sampling method, who were undergoing treatment in a hospital in Bandung, West Java. Data were collected using Spiritual Needs Questionnaire 2.1 (SPNQ 2.1) consisting of Religious, Inner Peace, Existential, and Actively Giving aspects. To analyse data of spiritual needs, the study used distribution of frequency and percentage. Mean value was used to identify how important those spiritual needs were to respondents (1-1.9: somewhat needed, 2-2.9: fairly needed, 3: strongly needed). The results showed that on Religious aspect, “praying with others” and “having someone pray for me” have the highest percentage (96.05%). On Inner Peace, “living in a calm and peaceful place” and “finding inner peace” have the highest precentage (89.47%). On Existential aspect, “finding meaning in pain and suffering” has the highest percentage (94.74%). On Actively Giving, “becoming a loving person” has the highest percentage (89.47%). Those needs were identified as “fairly needed”, with the following mean values: Religious (2.28±0.47), Inner Peace (2.19±0.47), Existential (2.11±0,76), and Actively Giving (2.08±0,55). This study indicated all dimensions of spiritual aspects were needed by respondents and religious aspects were most needed. Key words: Cancer, patient, spiritual needs.

Salah satu permasalahan psikologis yang paling sering ditemukan pada pasien gagal ginjal kronis (GGK) yang menjalani hemodialisis yaitu cemas. Kecemasan yang tidak diatasi dapat mengakibatkan dampak negatif untuk pasien. Salah satu intervensi nonfarmakologis untuk mengurangi kecemasan, yaitu dengan teknik relaksasi. Teknik relaksasi yang digunakan dalam penelitian ini adalah relaksasi dzikir, yaitu suatu metode yang memadukan antara relaksasi dan dzikir dengan fokus latihan pada relaksasi dan kata yang terkandung di dalam dzikir yang dapat memunculkan respon relaksasi. Tujuan penelitian ini adalah untuk melihat pengaruh relaksasi dzikir terhadap kecemasan pada pasien GGK yang menjalani hemodialisis di RSUD dr. Slamet Garut. Metode penelitian menggunakan pre experimental one group pre and post test design dengan jumlah sampel 17 responden yang diambil berdasarkan teknik purposive sampling . Penelitian ini mengukur skor kecemasan menggunakan instrument HAM-A (Hamilton Anxiety) sebelum dan sesudah intervensi relaksasi dzikir. Relaksasi dzikir dilaksanakan dua kali dalam sehari selama 2 hari, selanjutnya data dianalisa menggunakan uji t. Hasil penelitian menunjukan terdapat perbedaan yang bermakna antara tingkat kecemasan sebelum dan sesudah intervensi (p

Prevalensi Penyakit Jantung Koroner (PJK) terus mengalami peningkatan setiap tahunnya dan menjadi masalah kesehatan utama di masyarakat saat ini. PJK berdampak terhadap berbagai aspek kehidupan penderitanya baik fisik, psikososial maupun spiritual yang berpengaruh terhadap kualitas hidup pasien. Isu kualitas hidup dan faktor-faktor yang berhubungan didalamnya belum tergambar jelas di Indonesia. Tujuan dari penelitian ini adalah mengidentifikasi faktor yang memengaruhi kualitas hidup pada pasien PJK yang sedang menjalani rawat jalan. Faktor-faktor yang diteliti dalam penelitian ini meliputi jenis kelamin, tingkat penghasilan, revaskularisasi jantung, rehabilitasi jantung, kecemasan, depresi dan kesejahteraan spiritual. Kecemasan diukur dengan Zung Self-rating Anxiety Scale, depresi diukur dengan Beck Depression Inventory II, kesejahteraan spiritual diukur dengan kuesioner Spirituality Index of Well-Beingdan kualitas hidup diukur menggunakan Seattle Angina Questionnaire. Penelitian ini menggunakan rancangan kuantitatif deskriptif dan analitik multivariatedengan regresi logistic. Diteliti pada 100 responden yang diambil secara randomdalam kurun waktu 1 bulan di Poli Jantung. Hasil penelitian menunjukkan faktor yang memengaruhi kualitas hidup pada pasien PJK adalah cemas (p) 0,002; Odd Ratio(OR) 4,736 (95% confidence interval(CI), 1,749 – 12,827); depresi (p) 0,003; OR 5,450 ( 95% CI, 1,794 – 16,562); dan revaskularisasi (p) 0,033; OR 3,232 (95% CI, 1,096 – 9,528). Depresi menjadi faktor yang paling berpengaruh terhadap kualitas hidup pasien PJK. Faktor yang memengaruhi kualitas hidup pada pasien PJK meliputi depresi, cemas dan revaskularisasi. Dari ketiga variabel tersebut depresi merupakan variabel yang paling signifikan berpengaruh, sehingga manajemen untuk mencegah depresi perlu mendapatkan perhatian lebih baik lagi dalam discharge planningataupun rehabilitasi jantung. Kata kunci: Cemas, depresi, faktor yang memengaruhi, kualitas hidup, spiritual. Factors Influenced the Quality of Life among Patients Diagnosed with Coronary Heart Disease Abstract Coronary Heart Disease (CHD) has affected multidimensional aspects of human live nowadays. Yet, quality of life and factors associated with quality of life among people who live with heart disease has not been explored in Indonesia. This study aimed to identify factors influenced the quality of life among people with CHD received outpatient services. Those factors are gender, income, revascularization, cardiac rehabilitation, anxiety, depression and spiritual well-being. Zung Self-rating Anxiety Scale was used to measure anxiety where depression level measured using Beck Depression Inventory II. Spirituality index was used to measure spiritual well-being. The quality of life level was measured using the Seattle Angina Questionnaire. This study used quantitative descriptive with multivariate analysis using logistic regression. 100 respondents were randomly selected from the Cardiac Outpatient Unit. Findings indicated factors influenced the quality of life of CHD patients using a significance of ƿ-value < 0.005 were: anxiety (ƿ=0,002, OR = 4,736, 95% CI, 1,749 – 12,827); depression (ƿ=0,003; OR=5,450, 95% CI, 1,794 – 16,562); and revascularizations (ƿ=0,033; OR=3,232, 95% CI, 1,096 – 9,528). Depression was considered as the most significant factor; therefore, managing depression is a priority in the discharge planning or cardiac rehabilitation programme. Keywords: Anxiety, depression, quality of life, spiritual, well-being.

Jumlah pasien pasca kolostomi akibat kanker kolon dan rektal di Indonesia mengalami peningkatan yang signifikan. Kolostomi menyebabkan masalah fisik, psikososial dan spiritual serta ekonomi. Tenaga kesehatan terutama perawat perlu memberikan asuhan keperawatan terhadap pasien pasca kolostomi secara menyeluruh. Penelitian kualitatif terhadap pasien kolostomi sangat diperlukan sebagai upaya untuk mengungkap secara mendalam pengalaman hidup pasien pasca kolostomi dan menemukan new insight, sehingga dapat menambah pengetahuan perawat dalam upaya meningkatkan kualitas asuhan keperawatan yang diberikan pada pasien. Penelitian ini menggunakan metode kualitatif dengan pendekatan fenomenologi. Data didapatkan dengan wawancara mendalam terhadap delapan informan yang merupakan pasien rawat jalan, terdiri dari lima laki-laki dan tiga perempuan, usia antara 30 tahun sampai dengan 73 tahun. Lamanya hidup dengan kolostomi antara empat bulan sampai dengan enam tahun. Analisis hasil wawancara menggunakan metode Colaizzi. Tema yang didapatkan dari pengalaman hidup pasien kolostomi antara lain: keterbatasan dalam melakukan aktivitas sehari-hari, perubahan psikososial informan, perubahan dalam perilaku ibadah dan distres spiritual, perubahan pada aktivitas seksual, sumber-sumber dukungan bagi informan, upaya menjalani hidup dengan kolostomi, adaptasi terhadap perubahan yang terjadi, serta penyulit dalam menjalani hidup dengan kolostomi. Individu yang hidup dengan kolostomi mengalami keterbatasan dalam pemenuhan kebutuhan dasarnya, termasuk perubahan psikososial, distres spiritual dan masalah ekonomi. Berdasarkan penelitian ini, perawat disarankan memberikan dukungan dan dan perhatian pada pasien pasca kolostomi.Kata kunci: Kanker kolorektal, kolostomi, pengalaman hidup The Life Experiences of Patients with Post ColostomyAbstractThe number of patient with colostomy that it caused by colorectal cancer has been increasing significantlyin Indonesia. Colostomy was affected to physical, psychosocial, spiritual and economic of patients. Health providers, especially nurses need to provide holistic care for post colostomy patients. The aims of this qualitative study were to describe the life experience of post colostomy patients and to explore new insight of nursing interventions. The new insight would increase nurses’ knowledge and improve the quality of nursing care. This phenomenological study was obtained data using in-depth interviews to 8 informants. The informants consist of 5 men and 3 women. The characteristic of informants included age between 30-73 years, and the length of time living with a colostomy between 4 months to 6 years. The data were analyzed using the Colaizzi method. This study found several themes such as limited daily activities, psychosocial changes; spiritual distress; changes in sexualactivities;sources of support;live with a colostomy; live adaptation; the burdens living with a colostomy. Living with a colostomy faced problems including the limitation to fulfill their needs, psychosocial changes, spiritual distress, and economic problems. Based on those problems, nurses can give support and attention for post colostomy patients.Key words: Colorectal cancer, colostomy, life experiences

Penelitian ini dilatarbelakangi oleh tingginya angka kematian dan kecacatan di dunia akibat sindrom koroner akut (SKA). Perawatan klien dengan SKA masih terfokus pada aspek fisik, sedangkan aspek spiritualitas banyak dilupakan.Tujuan penelitian ini adalah untuk menggali secara mendalam makna spiritualitas yang dipersepsikan oleh klien dengan SKA yang menjalani perawatan di ruang intensif jantung RSUP dr. Hasan Sadikin Bandung. Untuk mencapai tujuan tersebut penelitian ini menggunakan desain deskriptif kualitatif, dengan jumlah partisipan sebanyak sepuluh orang. Pengumpulan data dilakukan dengan wawancara dan observasi. Analisis data dilakukan dengan menggunakan content analysis.Berdasarkan hasil penelitian teridentifikasi empat kategori makna spiritualitas dengan sepuluh buah tema, yaitu: (1) Spiritual adalah hubungan dengan diri sendiri dengan dua buah tema antara lain, menerima penyakit sebagai suatu teguran atau cobaan, dan hidup menjadi lebih baik; (2) Spiritual adalah hubungan dengan Tuhan dengan lima buah tema yaitu: kepasrahan pada Tuhan, ibadah atau komunikasi dengan Tuhan, harapan, permohonan ampunan (pertobatan), dan rasa syukur; (3) Spiritual adalah hubungan dengan orang lain dengan dua buah tema yaitu: perhatian, cinta, dan kasih sayang dari orang lain, serta keberhasilan keluarga, memberikan manfaat bagi sesama; dan (4) Spiritual adalah hubungan dengan alam dengan satu buah tema yaitu menyalurkan hobi atau aktivitas di alam. Berdasarkan hasil penelitian tersebut diharapkan perawat lebih sensitif terhadap makna spiritualitas klien dan mendorong penggunaan sumber spiritualitasnya untuk proses penyembuhan klien. Institusi pendidikan diharapkan mampu mempersiapkan perawat yang peka terhadap kebutuhan spiritualitas klien serta diperlukan penelitian lebih lanjut dan lebih luas dalam lingkup perawatan spiritualitas. Kata kunci:Persepsi, spiritualitas,sindrom koroner akut Abstract This research was conducted due to the high of mortality and disability rate in the world caused by Acute Coronary Syndrome (ACS), however the treatment of ACS’ clients are still focusing on physical aspects rather than spirituality aspects. Actually, these aspects are equally important. Through awareness of the meaning of spirituality, the clients can achieve spirituality comfort. Spiritual comfort can give peacefulness and positive impact to clients’ health. The purpose of the study was to explore the meaning of spirituality in clients with ACS who undergone treatment in the cardiac intensive care RSHS Bandung. The study used a descriptive exploratory design with 10 participants. The data was collected through interviews and observations. The data were analysed using content analysis the data analysis performed using content analysis. The result identified four categories of the meaning of spirituality followed by 10 themes, namely : (1) Spirituality was self-relationship that consists of two themes, include a. Accepted of disease as a reproach or temptation b. Better in life; (2) Spirituality was relationship between human and God, it consists of five themes, namely : a. Self-reliance, b. Worship or communication with God, c. Hope, d. Asking forgiveness or repentance, e. Grateful; (3) spirituality was a relationship with others, it consists of two themes, namely : a. caring, love, affection from others, and the success of the family b. Giving to others; (4) Spirituality was relationship between human with nature, consist of one theme, namely : doing personal interest or activity in the nature environment. Based on the results, nurses are expected to be more understood to the meaning of clients’ spirituality and encouraging them to use their spirituality sources for their healing process. Educational institutions are expected to prepare the student with high sensitivy of clients’ spirituality needs, and then further research of spirituality care is needed with broader scopes Key words: Acute Coronary Syndrome, perception, spirituality