HUBUNGAN LAMA HARI RAWAT DENGAN TINGKAT KECEMASAN KELUARGA PASIEN DI RUANG INTENSIVE CARDIAC CARE UNIT

2021 ◽  
Vol 5 (2) ◽  
pp. 74
Author(s):  
Nifa Viranda Amelia

Selama pasien dirawat di ruang Intensive Cardiac Care Unit (ICCU), keluarga pasien mengalami kesulitan dan ketidakberdayaan. Bagi keluarga pasien, ruang rawat intensif merupakan tempat yang tidak menyenangkan.  Keluarga masuk dalam kondisi yang tidak terduga dan dibutuhkan ketepatan keluarga dalam mengambil keputusan guna keberlangsungan hidup terkait kondisi pasien yang membutuhkan penanganan.Lama perawatan pasien di ruang ICCU sangat beragam.  Lama rawat pasien ICCU berdampak langsung terhadap kualitas hidup pasien dan keluarga, risiko terjadinya di masa depan, dan besarnya pembiayaan dampak dari perawatan. Selama keluarga mendampingi perawatan pasien di ruang ICCU, keluarga akan mengalami berbagai reaksi emosional seperti kecemasan. Tujuan: Mengetahui hubungan lama hari rawat dengan tingkat kecemasan keluarga pasien di ruang ICCU. Metode: Korelasi dengan pendekatan cross sectional dengan sampel 42 responden di ruang ICCU, yang dipilih dengan menggunakan metode purposive sampling. Instrumen penelitian ini menggunakan kuesioner HARS.  Data dianalisis dengan uji korelasi Spearman. Hasil: Lama hari rawat pasien rata-rata 3,14 hari.  Kecemasan keluarga pasien ICCU paling banyak berada pada tingkat kecemasan berat (33,3%). Terdapat hubungan yang bermakna antara lama hari rawat dengan tingkat kecemasan keluarga pasien (p=0,0003) dengan keeratan hubungan yang sedang (r=0,532) di ruang ICCU. Diskusi: Semakin lama pasien dirawat di ruang ICCU maka semakin tinggi tingkat kecemasan yang dirasakan keluarga pasien karena kondisi pasien yang tidak stabil ataupun semakin parah. Kesimpulan: Keluarga pasien perlu diberikan informasi dan edukasi yang jelas terkait kondisi pasien dalam sehari atau saat ada perburukan kondisi.Kata kunci: kecemasan, keluarga, lama hari rawat, perawatan intensif, perawatan kritis. Correlation Between Length of Stay and Anxiety Levels of Patients’ Family in Intensive Cardiac Care Unit Room ABSTRACTWhile a patient is being treated in the Intensive Cardiac Care Unit (ICCU), the patient's family experiences difficulties and helplessness. For the patient's family, the intensive care unit is an unpleasant place. The family enters into unexpected conditions and is required to make proper decisions for survival related to patient conditions. The patient's length of stay in the ICCU room is very diverse. The length of stay of ICCU patients directly impacts patients' quality of life and their families, the risk of future incidence, and the extent of the treatment cost. While the family accompanies the patient treated in the ICCU room, the family will experience various emotional reactions such as anxiety. Objective: To reveal the correlation between length of stay and the anxiety levels of the patient’s family in the ICCU room. Methods: Correlation with cross-sectional approach with a sample of 42 respondents in the ICCU room, who were selected using a purposive sampling method. The research instrument used the HARS questionnaire. Data were analyzed using the Spearman correlation test. Results: The average length of the patient's stay was 3.14 days. Family anxiety of ICCU patients was mostly at the level of severe anxiety (33.3%). There was a significant correlation between length of stay and anxiety levels of the patient’s family (p=0.0003) with a moderate correlation coefficient (r=0.532) in the ICCU room. Discussion: The longer the patient is treated in the ICCU room, the higher the anxiety level felt by the patient’s family due to the patient's unstable or worsened condition. Conclusion: Clear information and education should be given to the patient's family regarding the patient's condition within one day or when the condition worsens.Keywords: anxiety, family, length of stay, intensive care, critical care

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Mita E. D. Muabuay ◽  
Frans E. Wantania ◽  
Linda W. A. Rotty

Abstract: Acute myocardial infarction (AMI) occurs due to a decrease of myocardial blood flow following a coronary arterial occlusion caused by an atherosclerotic plaque. This study aimed to determine the correlation between the hematocrit level and the occurence of AMI among patients with congestive heart failure (CHF). This was an observational analytic study with a cross sectional design. The population was both CHF patients with old myocardial infarction in the Cardiology Clinic and all AMI patients with CHF histories in the Intensive Cardiac Care Unit (ICCU) of Prof. Dr. R.D. Kandou Hospital, Manado, from November through December 2012. Samples were selected by using a purposive sampling method. Data were statistically analyzed by using a chi-square test. The results showed that the total samples were 41 patients. The chi-square test showed that there was a correlation between the hematocrit level and the occurence of AMI among CHF patients with a P-value of 0.008. Conclusion: Hematocrit levels were significantly correlated with the occurence of AMI among CHF patients in Prof. Dr. R.D. Kandou Hospital, Manado Keywords: CHF, AMI, hematocrit     Abstrak: Infark miokard akut (IMA) terjadi oleh karena penurunan aliran darah miokard akibat oklusi arteri koroner oleh plak aterosklerotik. Penelitian ini bertujuan untuk mengetahui hubungan kadar hematokrit dengan kejadian infark miokard akut (IMA) pada pasien gagal jantung kongestif (CHF). Penelitian ini bersifat analitik observational dengan cross-sectional design. Populasi penelitian ialah semua pasien CHF di Poliklinik Jantung dan semua pasien IMA dengan riwayat CHF di Intensive Cardiac Care Unit (ICCU) BLU/RSUP Prof. Dr. R.D. Kandou, Manado, periode November-Desember 2012. Sampel penelitian diambil dengan teknik purposive sampling. Kriteria inklusi yaitu pasien CHF et causa old  myocardial infarction (OMI) dan pasien IMA dengan riwayat CHF, sedangkan kriteria eksklusi yaitu pasien IMA dengan penyakit infeksi dan pasien CHF dengan keganasan hematopoietik. Data hasil penelitian dianalisis dengan uji chi-square. Hasil penelitian memperlihatkan jumlah sampel sebanyak 41 pasien. Uji chi-square terhadap hubungan hematokrit dan infark miokard akut pada pasien gagal jantung menunjukkan nilai P = 0.008. Simpulan: Terdapat hubungan bermakna antara kadar hematokrit dan infark miokard akut pada pasien gagal jantung kongestif di BLU/RSUP Prof Dr. R.D. Kandou Manado. Kata kunci: CHF, IMA, Hematokrit


2016 ◽  
Vol 12 (2) ◽  
pp. 143
Author(s):  
Muhammad Rizal Amin ◽  
Edi Hartoyo ◽  
Donna Marisa

Abstract: Good nutritional status can reduce the risk of diarrhea, while children with less or poor nutritional status enables more frequent and more susceptible to diarrhea. The worse the nutrition of a children, the frequency of diarrhea increases. This situation may have a relationship with length of stay. Length of stay of childhood diarrhea is influenced by the child's physical condition (good nutritional status, less, or worse). The purpose of this study is analyzing the relationship between nutritional status and length of stay of pediatric patient on acute diarrhea in Ulin General Hospital Banjarmasin 2014. This study was done by observational analytic with cross sectional approach. Total of 50 samples were obtained by purposive sampling; 2 patients with excess nutritional status, 37 patients with good nutritional status, 8 patients with less nutritional status, and 3 patients with poor nutritional status. Data was analyzed using the Kruskal-Wallis test with a confidence level of 95%  showed that the average length of stay in each nutritional status have no significant value difference (p=0,193). It was concluded that there is no relationship between nutritional status and length of stay of pediatric patient on acute diarrhea in Ulin General Hospital Banjarmasin 2014. Keywords: nutritional status, length of stay, acute diarrhea Abstrak: Status gizi anak yang baik dapat mengurangi risiko terkena penyakit diare, sedangkan anak dengan status gizi kurang atau buruk memungkinkan lebih sering dan lebih mudah terkena diare. Makin buruk gizi seorang anak, ternyata frekuensi diare semakin banyak. Keadaan ini mungkin memiliki hubungan dengan lama hari rawat inap. Hari rawat diare anak salah satunya dipengaruhi oleh kondisi fisik anak (status gizi baik, kurang, atau buruk). Tujuan penelitian ini adalah untuk menganalisis hubungan antara status gizi dengan lama hari rawat inap pasien anak diare akut di RSUD Ulin Banjarmasin tahun 2014. Penelitian ini bersifat observasional analitik dengan pendekatan cross sectional. Sebanyak 50 sampel didapat secara purposive  sampling sesuai kriteria inklusi, 2 pasien  status gizi lebih, 37 pasien status gizi baik, 8 pasien status gizi kurang, dan 3 pasien status gizi buruk. Analisis data menggunakan uji Kruskal Wallis dengan tingkat kepercayaan 95% menunjukkan bahwa rerata lama hari rawat inap di setiap status gizi tidak memiliki perbedaan nilai yang bermakna (p=0,193). Hal ini berarti bahwa tidak terdapat hubungan antara status gizi dengan lama hari rawat inap pasien anak diare akut di RSUD Ulin Banjarmasin Tahun 2014. Kata-kata kunci: status gizi, lama hari rawat inap, diare akut


2019 ◽  
Vol 7 (1) ◽  
pp. 33-38
Author(s):  
Ida Rosidawati ◽  
Siti Hodijah

Intensive Care Unit (ICU) is a unit care of critical patients with mood in fast. The activity in an ICU is always busy and limited time visit, which find the family difficult to communicate with patient,while critically ill patients are usually treated for a long time, this can trigger families to experienced anxiety. The purpose of this research is to determine the relationship between length of stay and the level of anxiety family patients who being treated in dr. Soekardjo Tasikmalaya Hospital. This method of this research is used quantitative correlative with cross sectional approach. The sample of this research is family of patients who were waiting in the ICU room as many as 16 persons by using accidental sampling for two weeks. The data collected by using HARS scale and Chi Square analysis. The research result showed that patients with new length of stay (mean = 3.81) as many as 7 people, families of patients not experiencing anxiety as many as 5 people (71%) and families who experienced anxiety as many as 2 people (29%). While patients with long duration of care (≥ mean = 3.81) as many as 9 people, the patient's family all experienced anxiety (100%). Chi-square test result showed p-value of 0.005 α 0.05. The conclusion of the results of this study is that there is a relationship between length of stay with the level of anxiety of the patient's family, so it is recommended that the nurse or other medical team always coordinate with the family regarding the actions taken to the patient.Keywords: Intensive Care Unit (ICU), Long Care, Anxiety, Family Patients


2019 ◽  
Vol 7 (20) ◽  
pp. 3455-3458
Author(s):  
Gema Nazri Yanni ◽  
Munar Lubis ◽  
Muhammad Ali

BACKGROUND: The use of albumin in the critical care setting is a very controversial issue. Low serum albumin concentration in critical illness is associated with a poor outcome. AIM: We aimed to evaluate the influence of albumin level in critically ill children to the length of stay and mortality in the Pediatric Intensive Care Unit (PICU) Haji Adam Malik General Hospital, Medan, Indonesia. METHODS: The study used an observational method with a cross-sectional design. The population of the study was all patients with major postoperative surgery and critically ill that admitted to the PICU at Haji Adam Malik Hospital from the period of June 2008 to September 2008. The albumin level of the subjects was determined on the first day admitted. RESULTS: The group with hypoalbuminemia (< 3 g/dL) was given albumin supplementation according to a protocol in the PICU. The group with hypoalbuminemia have an average length of stay 7.6 days (9.7%) and mortality of 12 subjects (36.4%). The group with normal albumin level have 4.7 days (5.0%) and mortality 13 subjects (37.1%). There was no significant effect of albumin level to mortality. CONCLUSION: Albumin level did not affect the length of stay and mortality in PICU.


2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Saiful Nurhidayat

Abstract : Hypertension or high blood pressure is an abnormal increase in blood pressure in the arteries continuously over a period. The dangers of hypertension can lead to damage to various organs including kidneys, brain, heart, eye, causing vascular resistance and stroke. Hypertension takes care of the old and continuously. One effective way to lower blood pressure is to obediently take medicine so that it takes the role of families in monitoring patients taking the medication. With the participation of the family are expected to hypertension sufferers can be controlled. This study aims to determine the family's role in monitoring the adherence of hypertensive patients. The study was conducted in rural communities Slahung Ponorogo, a representative sample of 53 respondents taken by purposive sampling. Quantitative design with cross sectional design of the study the family's role in monitoring the adherence of hypertensive patients. Instruments in this study using questionnaires and observation sheets. The results of 53 respondents obtained the majority of the 29 respondents (55%) has the role of both families and 24 respondents (45%) families have a bad role in monitoring medication adherence. Age and education contribute to determining the role family. Intermediate (41-60 years old) and college education contribute to determining the role well. Conversely > 61 years of elementary education and contribute in a bad role.Keywords : the role of the family, medication adherence, hypertension. Abstrak : Hipertensi atau tekanan darah tinggi adalah suatu peningkatan abnormal tekanan darah dalam pembuluh darah arteri secara terus-menerus lebih dari suatu periode. Bahaya hipertensi dapat memicu rusaknya berbagai organ tubuh diantaranya: ginjal, otak, jantung, mata, menyebabkan resistensi pembuluh darah dan stroke. Penyakit hipertensi membutuhkan perawatan yang lama dan terus menerus. Salah satu cara yang efektif untuk menurunkan tekanan darah adalah dengan patuh minum obat sehingga dibutuhkan peran keluarga dalam memantau minum obat penderita. Dengan adanya peran serta keluarga diharapkan penyakit hipertensi penderita dapat terkontrol. Penelitian ini bertujuan untuk mengetahui peran keluarga dalam memantau kepatuhan minum obat penderita hipertensi. Penelitian dilakukan pada masyarakat desa Slahung Ponorogo,sampel representatif sejumlah 53 responden diambil secara Purposive Sampling. Desain kuantitatif dengan rancangan Cross sectional yang mempelajari peran keluarga dalam memantau kepatuhan minum obat penderita hipertensi. Instrumen pada penelitian ini menggunakan kuesioner dan lembar observasi. Hasil penelitian dari 53 responden didapatkan sebagian besar 29 responden (55 %) keluarga mempunyai peran baik dan 24 responden (45 %) keluarga mempunyai peran buruk dalam memantau kepatuhan minum obat. Faktor usia dan pendidikan berkontribusi dalam menentukan peran keluarga. Usia madya (41-60 tahun) dan jenjang pendidikan perguruan tinggi berkontribusi dalam menentukan peran baik. Sebaliknya > 61 tahun dan jenjang pendidikan SD berkontribusi dalam peran buruk.Kata Kunci : peran keluarga, kepatuhan minum obat, penyakit hipertensi.


2020 ◽  
Vol 41 (S1) ◽  
pp. s173-s174
Author(s):  
Keisha Gustave

Background: Methicillin-resistant Staphylococcus aureus(MRSA) and carbapenem-resistant Klebsiella pneumoniae (CRKP) are a growing public health concern in Barbados. Intensive care and critically ill patients are at a higher risk for MRSA and CRKP colonization and infection. MRSA and CRKP colonization and infection are associated with a high mortality and morbidly rate in the intensive care units (ICUs) and high-dependency units (HDUs). There is no concrete evidence in the literature regarding MRSA and CRKP colonization and infection in Barbados or the Caribbean. Objectives: We investigated the prevalence of MRSA and CRKP colonization and infection in the patients of the ICU and HDU units at the Queen Elizabeth Hospital from 2013 to 2017. Methods: We conducted a retrospective cohort analysis of patients admitted to the MICU, SICU, and HDU from January 2013 through December 2017. Data were collected as part of the surveillance program instituted by the IPC department. Admissions and weekly swabs for rectal, nasal, groin, and axilla were performed to screen for colonization with MRSA and CRKP. Follow-up was performed for positive cultures from sterile isolates, indicating infection. Positive MRSA and CRKP colonization or infection were identified, and patient notes were collected. Our exclusion criteria included patients with a of stay of <48 hours and patients with MRSA or CRKP before admission. Results: Of 3,641 of persons admitted 2,801 cases fit the study criteria. Overall, 161 (5.3%) were colonized or infected with MRSA alone, 215 (7.67%) were colonized or infected with CRKP alone, and 15 (0.53%) were colonized or infected with both MRSA and CRKP. In addition, 10 (66.6%) of patients colonized or infected with MRSA and CRKP died. Average length of stay of patients who died was 50 days. Conclusions: The results of this study demonstrate that MRSA and CRKP cocolonization and coinfection is associated with high mortality in patients within the ICU and HDU units. Patients admitted to the ICU and HDU with an average length of stay of 50 days are at a higher risk for cocolonization and coinfection with MRSA and CRKP. Stronger IPC measures must be implemented to reduce the spread and occurrence of MRSA and CRKP.Funding: NoneDisclosures: None


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Nathanael Lapidus ◽  
Xianlong Zhou ◽  
Fabrice Carrat ◽  
Bruno Riou ◽  
Yan Zhao ◽  
...  

Abstract Background The average length of stay (LOS) in the intensive care unit (ICU_ALOS) is a helpful parameter summarizing critical bed occupancy. During the outbreak of a novel virus, estimating early a reliable ICU_ALOS estimate of infected patients is critical to accurately parameterize models examining mitigation and preparedness scenarios. Methods Two estimation methods of ICU_ALOS were compared: the average LOS of already discharged patients at the date of estimation (DPE), and a standard parametric method used for analyzing time-to-event data which fits a given distribution to observed data and includes the censored stays of patients still treated in the ICU at the date of estimation (CPE). Methods were compared on a series of all COVID-19 consecutive cases (n = 59) admitted in an ICU devoted to such patients. At the last follow-up date, 99 days after the first admission, all patients but one had been discharged. A simulation study investigated the generalizability of the methods' patterns. CPE and DPE estimates were also compared to COVID-19 estimates reported to date. Results LOS ≥ 30 days concerned 14 out of the 59 patients (24%), including 8 of the 21 deaths observed. Two months after the first admission, 38 (64%) patients had been discharged, with corresponding DPE and CPE estimates of ICU_ALOS (95% CI) at 13.0 days (10.4–15.6) and 23.1 days (18.1–29.7), respectively. Series' true ICU_ALOS was greater than 21 days, well above reported estimates to date. Conclusions Discharges of short stays are more likely observed earlier during the course of an outbreak. Cautious unbiased ICU_ALOS estimates suggest parameterizing a higher burden of ICU bed occupancy than that adopted to date in COVID-19 forecasting models. Funding Support by the National Natural Science Foundation of China (81900097 to Dr. Zhou) and the Emergency Response Project of Hubei Science and Technology Department (2020FCA023 to Pr. Zhao).


2019 ◽  
Vol 71 (1) ◽  
Author(s):  
Hala Mahfouz Badran ◽  
Marwa Ahmed Elgharably ◽  
Naglaa Faheem

Abstract Background This study represents figures from a cardiac care unit (CCU) of a university hospital; it describes an example of a tertiary academic center in Egypt and provides an epidemiological view of the female HF patients, their risk profile, and short-term outcome during hospitalization. Results It is a local single-center cross-sectional observational registry of CCU patients 1 year from July 2015 to July 2016. Patient’s data were collected through a special software program. Women with evidence of HF were thoroughly studied. Among the 1006 patients admitted to CCU in 1 year, 345 (34.2%) patients were females and 118 (34.2%) had evidence of HF, whereas 661 (65.7%) were males and 178 (26.9%) of them had HF. Women with HF showed 11.7% prevalence of the total population admitted to CCU. 72.7% were HFrEF and 27.3% were HFpEF. Compared to men, women with HF were older in age, more obese, less symptomatic than men, had higher incidence of associated co-morbidities, less likely to be re-admitted for HF, and less likely to have ACS and PCI. Valvular heart diseases and cardiomyopathies were the commonest etiologies of their HF. Women had more frequent normal ECG, higher EF%, and smaller LA size. There is no difference in medications and CCU procedures. While females had shorter stay, there is no significant difference in hospital mortality compared to male patients. Conclusions Despite higher prevalence of HF in females admitted to CCU and different clinical characteristics and etiology of HF, female gender was associated with similar prognosis during hospital course compared to male gender.


2019 ◽  
Author(s):  
RP Neupane ◽  
S Raut ◽  
TM Shrestha ◽  
R Aacharya

Abstract Background: Access block and overcrowding leading to prolonged stay in emergency room is a common problem of Emergency services of Tribhuvan University Teaching Hospital (TUTH) Kathmandu. Those patients who stayed longer in emergency department might affect continuing care and the ultimate outcome of patients. Study aims to evaluate the association of emergency services length of stay and outcome of admitted patients in wards or Intensive Care Unit at the predefined cut-off value of 6 hour. Methods: It was a prospective cross sectional comparative study done in TUTH, Kathmandu. Data were collected from records from emergency services, wards, ICU and hospital record section from October, 2018 to April, 2019. Adult patients were grouped in to two groups; Emergency services to wards (ES to Wards) and Emergency services to ICU (ES to ICU). Outcome was compared between those admitted within 6hr and those admitted after 6hr of stay in emergency services. Results: A total of 2,059 patients were enrolled over 6 months. Out of them, Male were 55.5% and 42.6% patients were at the age of equal to or above 60 years. Total admitted patients who stayed equal to or less than 6 hr in emergency services was 26.7%. It was found that there was no significant association between Emergency services length of stay (ESLOS) and outcome of admitted total patients (p= 0.160) as well as in ICU (p= 0.559) or Ward admitted patients (p= 0.361). Age was found independent predictor for outcome (p= <0.01). Association of ESLOS and age was also found statistically significant (p= 0.02). Conclusions: Emergency service length of stay is not predictor for outcome of admitted patients. Key words: Emergency services, intensive care unit, length of stay, mortality.


Author(s):  
Siân Jaggar ◽  
Helen Laycock

◆ Cardiac intensive care units admit a heterogeneous patient group◆ Pain is common, occurring in up to 70% of medical and surgical patients◆ Effective analgesia is important◆ Pain is under-recognized and inadequately treated, particularly in medical patients◆ Consequences of pain are widespread, involving multisystem physiological changes◆ Pain causes significant psychological sequelae for patients, and ethical implications for physicians◆ Pain management should utilize a systematic approach. Ensuring optimal patient comfort requires:○ Understanding of the potential causes of pain in cardiac intensive care○ Using validated pain assessment tools to identify the presence of pain and evaluate treatment effects○ Employing a multimodal, multidisciplinary management strategy


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