scholarly journals PERSEPSI PERAWAT INSTALASI GAWAT DARURAT TERKAIT HAMBATAN DAN PERILAKU SUPORTIF DALAM PELAKSANAAN PERAWATAN END OF LIFE

2019 ◽  
Vol 2 (3) ◽  
Author(s):  
Santi Ariyanti ◽  
Etika Emaliyawati ◽  
Ristina Mirwanti

The high mortality rate in Emergency Department (ED) is consistent with the high demand for end of life (EOL) care. However, ED work system required to life saving quickly and precisely often makes EOL care is not working optimally.The purpose of this study was to determine nurses’perceptions in emergency departments related to obstacles and supportive behaviors (SB) in providing EOL care to dying patients. Descriptive-quantitative method was used with cross-sectional approach in 50 nurses Emergency Department at one of the tertiary hospitals in Indonesia. The samples were chosen using the total sampling technique. Data collection used the emergency nurse perceptions of end of life care questionnaire. Data were analyzed using univariate analysis in the form of distribution, frequency, and mean. The result of the study showed that the main obstacles in EOL care were:  ED nurses’ work loads (10.626), intra-family disagreements (9,802), and dealing with angry family members (9.472). The three main perceptions in supportive behaviors were teaching families how to act (11.962), allowing family members adequate time with the patient after patient died (11.09), and good collaboration from paramedics personnel (10.886. It can be conclude that nurses facing obstacles in taking care end-of-life patients. Based on this research, further studies are needed to minimize obstacles and improve supportive behaviors related to the nurse's workload, the provision of spiritual teams, special training for nurse and the provision of special rooms for EOL patients and their families.

2020 ◽  
Vol 38 (1) ◽  
pp. 25-31
Author(s):  
Yat Chun Chan ◽  
Marc L. C. Yang ◽  
Hiu Fai Ho

Background: This study describes the characteristics and outcomes of patients referred to an emergency department (ED)-based end-of-life (EOL) service in a tertiary acute hospital in Hong Kong. We examine how emergency physicians (EPs) perform in recognizing and managing dying patients. Methods: From September 2010 to April 2018, patients referred to this EOL service in this hospital were included. A group of 5 EPs assessed whether the referred patient would die within a few days. Dying patients (EOL group) were admitted to ED-based EOL service whereas those not likely dying within few days (non-EOL group) would continue management in respective specialty wards. Baseline characteristics of these 2 groups were compared. The time-to-death and use of opioids and anticholinergics were compared. Results: In total, 783 of 830 patients assessed were recognized as being in dying phase, with 688 admitted under ED-based EOL care. Their demographics and characteristics were described. Mean time from assessment to death (time-to-death) was significantly less in EOL group (38.93 hours) than in non-EOL group (250.36 hours; P = .004). Mean time-to-death was not significantly different between those under EP-based EOL service or not. The ED-based EOL care had significantly more patients receiving symptomatic treatment. Interpretation: The characteristics of patients under an ED-based EOL service are described. Emergency physicians are capable of recognizing dying patients. Emergency department-based EOL service does not alter the dying process and offers adequate palliation of symptoms. Emergency physician should assume a more active role in providing adequate EOL care to suitable patients.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S727-S727
Author(s):  
Jooyoung Cheon

Abstract Knowledge of end-of-life (EOL) care and being able to make the appropriate decisions for patients who are dying is important for nursing students, who will soon play a critical role in EOL decision-making among patients and their caregivers. Accordingly, the purpose of this study was to examine the level of knowledge of EOL care, life-sustaining treatment, and advance directives among nursing students in South Korea. This cross-sectional descriptive study was conducted from December 2017 to February 2018. Data were collected from 220 undergraduate nursing students and analyzed using descriptive statistics, t-tests, one-way ANOVA, and a post hoc test with the SPSS 19.0 program. The score for knowledge of EOL care was 7.8 out of 11 points, for knowledge of life-sustaining treatment was 4.6 out of 6 points, and for knowledge of advance directives was 7.0 out of 9 points. There were significant differences in knowledge of EOL care scores by year of study, experiences in clinical practicum education, and experiences of caring for dying patients. Knowledge of life-sustaining treatment significantly differed by year of study, experiences in clinical practicum education, experiences of caring for and observing dying patients during clinical practicum education, and perceived self-rated health. There were significant differences in knowledge of advance directive scores by year of study, satisfaction with nursing major, experiences in clinical practicum education, and experiences of caring for and observing dying patients during clinical practicum education. Further studies should develop educational intervention programs that improve knowledge of EOL care, life-sustaining treatment, and advance directives.


2018 ◽  
Vol 1 (2) ◽  
pp. 58
Author(s):  
Setia Budi ◽  
Ria Dila Syahfitri

The rate of stroke incidence is about 200 per 100,000 people throughout the world. This study aims to determine the Relation Suffer Stroke With Independence Level In Neurology Polyclinic TK II DR Ak Gani Palembang Year Hospital 2017. The research method used is descriptive quantitative with cross sectional design that is done by interviewing techniques with questionnaires on 42 respondents with Accidental sampling technique. This research was conducted in August 2017. Data analysis used is univariate data analysis and bivariate data analysis with one way anova test result. The results of univariate analysis showed that the duration of the respondents suffering from stroke was between 2.10 years to 3.38 years. Also found that most respondents were at the level of independence f; independent, except bathing, dressing, moving, and one other function with a total of 12 respondents. The results showed that there was a significant relationship between the long suffering stroke with the level of independence with the value of p value 0.025. For that the need for rehabilitation to patients and families of patients in order to help improve the independence of stroke patients in doing their daily activities. Keywords : Long Suffer Stroke, Level of Independence


2021 ◽  
pp. 003022282199770
Author(s):  
Janet Sopcheck ◽  
Ruth M. Tappen

Residents who are terminally ill often experience transfers to the emergency department resulting in hospitalizations, which may be potentially avoidable with treatment in the nursing home. This qualitative study explored the perspectives of 15 residents, 10 family members, and 20 nursing home staff regarding end-of-life care and the circumstances prompting resident transfers. Data analysis of participant interviews conducted January to May 2019 in a South Florida nursing home identified four themes related to transfer to the hospital: time left to live, when aggressive treatments would be unavailing, not knowing what the nursing home can do, and transfer decisions are situation-dependent. Study findings underscore the importance of increasing resident and family awareness of treatments available in the nursing home and person-centered advance care planning discussions. Further research should explore the reasons for residents’ and family members’ choice of aggressive therapies and their goals for care at the end of life.


Author(s):  
James Alton Croker ◽  
Julie Bobitt ◽  
Sara Sanders ◽  
Kanika Arora ◽  
Keith Mueller ◽  
...  

Introduction: Between 2013 and 2019, Illinois limited cannabis access to certified patients enrolled in the Illinois Medical Cannabis Program (IMCP). In 2016, the state instituted a fast-track pathway for terminal patients. The benefits of medicinal cannabis (MC) have clear implications for patients near end-of-life (EOL). However, little is known about how terminal patients engage medical cannabis relative to supportive care. Methods: Anonymous cross-sectional survey data were collected from 342 terminal patients who were already enrolled in ( n = 19) or planning to enroll ( n = 323) in hospice for EOL care. Logistic regression models compare patients in the sample on hospice planning vs. hospice enrollment, use of palliative care vs. hospice care, and use standard care vs non-hospice palliative care. Results: In our sample, cancer patients ( OR = 0.21 (0.11), p < .01), and those who used the fast-track application into the IMCP ( OR = 0.11 (0.06), p < .001) were less likely to be enrolled in hospice. Compared to patients in palliative care, hospice patients were less likely to report cancer as their qualifying condition ( OR = 0.16 (0.11), p < .01), or entered the IMCP via the fast-track ( OR = 0.23 (0.15), p < .05). Discussion: Given low hospice enrollment in a fairly large EOL sample, cannabis use may operate as an alternative to supportive forms of care like hospice and palliation. Clinicians should initiate conversations about cannabis use with their patients while also engaging EOL Care planning discussions as an essential part of the general care plan.


Author(s):  
Zahra Rahemi ◽  
Veronica Parker

Background: An increase of cultural diversity and treatment options offer opportunities and challenges related to end-of-life (EOL) care for healthcare providers and policymakers. EOL care planning can help reduce confusion and uncertainty when individuals and family members need to make decisions about EOL care options. Objective: The purpose of this study was to investigate preferences, attitudes, and behaviors regarding EOL care planning among young and middle-aged Iranian-American adults. Methods: A cross-sectional national sample of 251 Iranian-American adults completed surveys. Paper and online surveys in English and Persian were offered to potential participants. Results: All the participants completed online survey in English language. In incurable health conditions, 56.8% preferred hospitalization and intensive treatments. From the 40.6% participants who preferred comfort care, most preferred care at home (29.5%) compared to an institution (11.1%). Those who preferred hospitalization at EOL mostly preferred intensive and curative treatments. The mean score of attitudes toward advance decision-making was moderately high (11.48 ± 2.77). Favorable attitudes were positively associated with acculturation (r = .31, p < .001), age (r = .15, p < .05), and number of years living in the U.S. (r = .26, p < .001). Conversely, spirituality and favorable attitudes were negatively associated (r = −.17, p < .05). Conclusion: Immigrant and culturally diverse individuals have experienced different living and healthcare environments. These differences can influence their EOL care planning and decisions. Knowledge of diverse perspectives and cultures is essential to design culturally congruent plans of EOL care.


2021 ◽  
Vol 7 (01) ◽  
pp. 22-29
Author(s):  
Ni Nengah Nikawati ◽  
Ni Made Sri Muryani

Background: Anxiety is a feeling felt by respondents regarding disturbing mental tension, which as a general reaction with the inability to overcome a problem or there is no sense of security, which later leads to a physiological and psychological change. The level of family anxiety can be assessed by using a questionnaire with each respondent's characteristics and level of anxiety can be divided into several parts, namely: normal anxiety levels, mild anxiety levels, moderate anxiety levels, severe anxiety levels and panic. Objective: Knowing the description of the level of family anxiety in caring for patients with schizophrenia at the Mental Poliklinik UPTD. Rumah Sakit Jiwa Provinsi Bali and the characteristics of families caring for patients with schizophrenia based on education, age, and type of work. Methods: The research method that used in this study was descriptive research. This study used a cross sectional study, which was a study in which the subjects were evaluated only once and the measurement of each only one variable at the same time that using sampling consecutive sampling technique. The sample used was 32 people consisting of family members of hallucinations patients. Results: Based on research conducted at the Poliklinik UPTD. Rumah Sakit Jiwa Provinsi Bali toward 32 family members who was caring for patients by schizophrenia, most family members did not experience anxiety or anxiety in the normal range which was 29 family members of 32 family members and 3 families who experienced mild anxiety levels. Conclusion: That most family members who treated patients by schizophrenia at the Poliklinik UPTD. Rumah sakit Jiwa Provinsi Bali does not experience anxiety or anxiety still within normal limits. Latar Belakang: Kecemasan adalah suatu perasaan yang dirasakan oleh responden mengenai ketegangan mental yang menggelisahkan, dimana sebagai reaksi umum dengan ketidakmampuan dalam mengatasi suatu masalah atau tidak ada rasa aman, yang nantinya menimbulkan suatu perubahan fisiologis dan psikologis. Keluarga yang memiliki anggota keluarga dengan  gangguan jiwa dapat mengalami kecemasan Tingkat kecemasan keluarga dengan skizofrenia yaitu cemas ringan (80,49%) dan 8 keluarga mengalami cemas sedang (19,51%). Tujuan: Mengetahui gambaran tingkat kecemasan keluarga dalam merawat pasien dengan skizofrenia di Poliklinik Jiwa UPTD Rumah Sakit Jiwa Provinsi Bali dan karakteristik keluarga yang merawat pasien dengan skizofrenia berdasarkan pendidikan, umur, dan jenis pekerjaan. Metode: Metode penelitian yang digunakan dalam penelitian ini adalah penelitian bersifat deskriptif. Penelitian ini menggunakan penelitian cross sectional yaitu suatu penelitian dimana subjek diobsevasi hanya satu kali saja dan pengukurannya masing-masing satu variabel pada waktu yang sama yang menggunakan teknik sampling consecutive sampling. Sampel yang digunakan berjumlah 32 orang terdiri dari anggota keluarga pasien Halusinasi. Hasil: Berdasarkan penelitian yang dilakukan di Poliklinik Jiwa UPTD. Rumah Sakit Jiwa Provinsi Bali terhadap 32 anggota keluarga yang merawat pasien dengan skizofrenia, sebagian besar anggota keluarga tidak mengalami kecemasan atau kecemasan masih dalam batas normal jumlah 29 anggota keluarga dari 32 anggota keluarga dan 3 keluarga yang mengalami tingkat kecemasan ringan. Kesimpulan: Sebagian besar anggota keluarga yang merawat pasien dengan skizofrenia di Poliklinik Jiwa UPTD. Rumah Sakit Jiwa Provinsi Bali tidak mengalami kecemasan atau kecemasan masih dalam batas normal.


Author(s):  
Suryono ◽  
Bambang Wiseno ◽  
Fannidya Hamdani Zeho

The ongoing COVID-19 pandemic has had a very significant impact on every area of ​​the organization, especially the health sector, especially hospitals. One of the impacts experienced is the work pressure felt by hospital employees. This study aims to analyze the work pressure experienced by hospital employees during the covid-19 pandemic which was obtained from the type of work and stressor factors that influenced it. This type of research was quantitative with a cross sectional approach. The sample of this study was 120 employees at Hospital "X" in Indonesia. The sampling technique is probability sampling with random sampling method. Univariate analysis test was used to see the distribution of frequency and percentage of each variable and bivariate analysis with chi-square test to determine the relationship between variables (p value <0.05). It was found that the type of employee's work was significantly related to the employee's work pressure. Then an analysis of the level of work pressure is carried out with the influencing work pressure stressor. Based on the Spearman Correlation Test, a correlation value of 0.589 with a sig value of 0.000 means that the sig value is smaller than 0.05 (0.000 <0.05) indicating that there is a significant effect between stressor and work pressure at Hospital "X". The cause of high work pressure from this type of work is the demands of the organization in relation to the high role of tasks, especially medical personnel, which increases during the pandemic. Then the stressor factors that influence are role overload, role conflict and role ambiguity caused by the demands of the duties and roles of employees, poor communication, and lack of direct guidance from the leadership on the tasks and regulations given.


2019 ◽  
Vol 4 (1) ◽  
pp. 21
Author(s):  
Yusi Desriyani ◽  
Ikeu Nurhidayah ◽  
Fanny Adistie

Children with disabilities are children who have limited whether physical, intellectual, mental, sensory, and multiple disability. Children with disabilities tend to have poor quality of life due to low ability fulfilled basic needs independently. Therefore, they need special treatment from their parents and that could be the reasons of burden for parents as primary caregiver. This research aims to find the general burden of parents in disabilities children who attended Sekolah Luar Biasa (SLB) Negeri Cileunyi. This is a quantitative descriptive research with cross sectional approach. The population in this research were 158 parents (father/mother) of children with disability. The sample in this research was obtained 67 people by using convenience sampling technique. The research used Zarit Burden Interview (ZBI) as research instrument. The data have been obtained and analyzed by univariate analysis. The results will be analyzed by using frequency distribution. The result showed that 46.3% means little or no burden, 37.3% means mild to moderate burden, 14,9% means moderate to severe burden and 1,5% means severe burden. The conclusions of this research show that almost half of respondents are in the category of little or no burden. However, there were still respondents who had a severe burden, this is due to parents and children characteristics, poor self-control and lack of social support. Nurses need to provide family center care such as counseling and providing health education to parents with disabilities children and optimize existing support groups.


Author(s):  
Festy Ladyani ◽  
Nur Fitria Dewi

Background: Acute appendicitis is one of the most common acute abdominal pain. A late check up and diagnosis could bring harms which is turning into perforated appendicitis. Leukocyte count is a laboratory collation that is generous and quick to diagnose the acute apendicitis and perforated appendicitis, however there’s no certain limit of the leukocytes count to recognize whether it is acute apendicitis or perforated appendicitis.Purpose: This research was to find out the comparison of leucocyte count average between acute appendicitis and perforation appendicitis in Dr. H. Abdul Moeleok public hospital of Lampung province in 2014-2016.Methods: An analytic research with cross sectional approach. Population was 382 patients with appendicitis in Dr. Hi. Abdul Moeloek public hospital. Samples were taken using total sampling technique with 196 respondent samples for acute appendicitis and 196 respondent samples for perforation appendicitis. Data were analyzed by using univariate analysis with percentage and bivariate analysis with t-test.Results: the average of leucocyte count of acute appendicitis patients was 10,907 with minimum and maximum leucocyte count of 5,000 and 18,500 respectively. The average of leucocyte count of perforation appendicitis patients was 22,789 with minimum and maximum leucocyte count of 16,500 and 31,000 respectively. There were differences of leucocyte counts between acute appendicitis patients and perforation appendicitis patients with p-value < 0.05.Conclusion: there were significant differences of leucocyte count averages between acute appendicitis and perforation appendicitis.


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