scholarly journals Patterns of Outpatient Referral Cases before and after Implementation of National Health Coverage Program

2020 ◽  
pp. 161-167
Author(s):  
Eka R. Gunardi ◽  
Arresta Suastika
Keyword(s):  
Health Facility ◽  
National Health ◽  
Outpatient Clinic ◽  
Bivariate Analysis ◽  
Health Coverage ◽  
Chi Square ◽  
Obstetrics And Gynaecology ◽  
Number Of Patients ◽  
Significant Difference ◽  
Before And After

AbstractObjective: To understand the pattern of referral cases (accuracy of referral diagnosis, the accuracy of referral health facility and consistency of referral diagnosis) in obstetrics and gynaecology outpatient clinic before and after the implementation of JKN.Methods: This is an observational cross-sectional study using medical records of patients who were referred to obstetrics and gynaecology outpatient clinic in Dr. Cipto Mangunkusumo General Hospital in 2013 and 2014. Data were analyzed with bivariate analysis with chi-square, consisting of the accuracy of referral cases, accuracy of referral health facility, and consistency of referral cases before and after implementation of JKN.Results: There is a growing number of patients in obstetrics and gynaecology outpatient clinic after the implementation of JKN in 2014, which is 4.311 patients. Subjects were 222 cases, 104 cases from 2013 and 118 cases from 2014. From the analyzed data, the accuracy of referral diagnosis before JKN is 81.7% and after JKN 72.9%. (p=0.118), the accuracy of referral health facility before JKN is 63.5% and after JKN 71.2% (p=0.220), and the consistency of referral diagnosis before JKN is 89.4% and after JKN 84.7% (p=0.302).Conclusion: There is no statistically significant difference between the accuracy of referral diagnosis, the accuracy of referral health facility, and consistency of referral diagnosis before and after the implementation of JKN.Keywords: national health coverage program, obstetrics and gynaecology, outpatient clinic, referral AbstrakTujuan: Untuk memahami pola kasus rujukan (ketepatan diagnosis rujukan, ketepatan asal fasyankes perujuk, dan kesesuaian diagnosis rujukan) di Poliklinik Obstetri dan Ginekologi sebelum dan setelah pelaksanaan JKN.Metode: Penelitian ini adalah observasional potong lintang dengan menggunakan data rekam medis pasien yang dirujuk ke Poliklinik Obstetri dan Ginekologi RSUPN Dr. Cipto Mangunkusumo selama tahun 2013 dan 2014. Analisis dilakukan dengan analisis bivariat dengan chi square untuk membedakan ketepatan diagnosis rujukan, ketepatan asal fasyankes perujuk, dan kesesuaian diagnosis rujukan sebelum dan setelah pelaksanaan JKN.Hasil: Terdapat peningkatan jumlah kunjungan Poliklinik Obstetri dan Ginekologi sejak dilaksanakannya program JKN pada tahun 2014, yaitu sebanyak 4.311 pasien. Jumlah subjek adalah sebanyak 222 subjek, terdiri dari 104 subjek pada tahun 2013 dan 118 subjek pada tahun 2014. Dari analisis data, didapatkan tingkat ketepatan diagnosis sebelum JKN adalah 81,7% dan setelah JKN 72,9% (p=0,118), tingkat ketepatan fasyankes perujuk sebelum JKN adalah 63,5% dan setelah JKN 71,2% (p=0,220), serta tingkat kesesuaian diagnosis sebelum JKN adalah 89,4% dan setelah JKN 84,7% (p=0,302).Kesimpulan: Tidak ada perbedaan yang bermakna secara statistik antara ketepatan diagnosis rujukan, ketepatan fasyankes perujuk, dan kesesuaian diagnosis fasyankes rujukan sebelum dan sesudah pelaksanaan JKN.Kata kunci: jaminan kesehatan nasional, obstetri dan ginekologi, poliklinik, rujukan

scholarly journals Effectiveness of cadre empowerment toward the coverage of stimulation, detection and intervention of early development children

2020 ◽  
Vol 1 ◽  
pp. 60-65
Author(s):  
Retno Puji Hastuti ◽  
Fitarina Fitarina
Keyword(s):  
Health Workers ◽  
Wilcoxon Test ◽  
Average Score ◽  
Bivariate Analysis ◽  
P Value ◽  
Chi Square ◽  
Significant Difference ◽  
Before And After ◽  
Quasi Experimental ◽  
Chi Square Test

Stunting cases in North Lampung continuously increase due to lack of visits by mothers to perform stimulation, detection, early intervention for toddler development (SDIDTK). This study aims to determine the effectiveness of cadre empowerment on SDIDTK completion among children under five. The intervention of SDIDTK training for 50 cadres. The study used a Quasi-experimental Pre and Post-Test Design without control. Univariate data analysis with proportion, average, and standard deviation. Bivariate analysis using the Wilcoxon-test and Pearson Chi-Square Test. The results showed that there was a significant difference in the average score of knowledge of the cadres before and after the empowerment of cadres (p-value = 0.000). There was a significant correlation between cadre empowerment and the measurement completion of height, head circumference, and measurement of development (p-value = 0.000), however, there is no significant relationship between cadre empowerment and the completion of body weight measurement (p-value = 0.317). Suggestions for Health workers and health offices to carry out training on SDIDTK to all cadres, to provide guidance and motivation, and to provide SDIDTK facilities and infrastructure at Posyandu.

The effect of the COVID-19 pandemic on metabolic control in children with type 1 diabetes: a single-center experience

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Emre Sarıkaya ◽  
Dilek Çiçek ◽  
Ebru Gök ◽  
Leyla Kara ◽  
Uğur Berber ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Metabolic Control ◽  
Glycosylated Hemoglobin ◽  
Emergency Admissions ◽  
Single Center Experience ◽  
Number Of Patients ◽  
Significant Difference ◽  
Before And After ◽  
One Year

Abstract Objectives Coronavirus disease 2019 has caused a major epidemic worldwide, and lockdowns became necessary in all countries to prevent its spread. This study aimed to evaluate the effects of staying-at-home practices on the metabolic control of children and adolescents with type 1 diabetes during the pandemic period. Materials and Methods Eighty-nine patients younger than 18 years old who were diagnosed with type 1 diabetes at least one year before the declaration of the pandemic were included in the study. The last visit data of the patients before and after the declaration of the pandemic, and the frequency of presentation of diabetes-related emergencies from one year after diagnosis of type 1 diabetes to the declaration of the pandemic, and from the declaration of the pandemic to the last visit after the pandemic declaration were compared. Results The total number of patients was 89, and 48 (53.9%) were boys. The mean (± standard deviation [SD]) age at diagnosis was 8.4 ± 3.7 years (boys 7.9 ± 3.6 years; girls 8.9 ± 3.9 years). There was no statistically significant difference when the SD values of the anthropometric measurements, and the glycosylated hemoglobin (HbA1c) and lipid profile tests were compared. However, the frequency of admission to the emergency service related to diabetes was significantly different. Conclusions Although the pandemic did not significantly affect the metabolic and glycemic controls of the children with type 1 diabetes included in this study, an increase in the frequency of diabetes-related emergency admissions was noted.

scholarly journals SP9.1.1 The Impact of Anaesthetic Use on Healing in Sub-cutaneous Abscess Management: A Retrospective Before and After Cohort Study

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Hannah Elkadi ◽  
Eleanor Dodd ◽  
Theodore Poulton ◽  
William Bolton ◽  
Joshua Burke ◽  
...  
Keyword(s):  
Wound Healing ◽  
Local Anaesthetic ◽  
Surrogate Endpoints ◽  
Incision And Drainage ◽  
Number Of Patients ◽  
Significant Difference ◽  
Patient Reported ◽  
Before And After ◽  
The Impact

Abstract Aims Despite being the most common surgical procedure, there is wide variation that exists in the management of simple subcutaneous abscesses with no national guideline describing best practice. During the COVID-19 Pandemic national guidelines promoted the use of regional or local anaesthetic (LA) instead of general anaesthesia (GA) to avoid aerosol generating intubation associated with GA. This study aimed to assess the impact of anaesthetic choice in outcomes following incision and drainage of subcutaneous abscesses. Methods Two cohorts of patients undergoing abscess incision and drainage at St. James’ University Hospital Leeds were retrospectively identified over a 14-week period before and after the introduction of the new COVID-19 anaesthetic guidelines. Wound healing surrogate endpoints were used: i) total number of follow up appointments and ii) attendance to healthcare services after 30 days from I&D. Result 133 patients were included. Significantly more procedures were performed under LA after the intervention (84.1% vs 5.7%; p < 0.0001) with a significant reduction in wound packing (68.3% vs 87.1%. p=0.00473). Follow up data found no significant difference in the average number of follow-up appointments (7.46 vs 5.11; p = 0.0731) and the number of patients who required ongoing treatment after 30 days (n = 14 vs n = 14, p = 0.921). Conclusion Drainage of simple subcutaneous abscess under 5 cm is safe under local anaesthetic with no significant difference in surrogate endpoints of wound healing observed in this patient cohort. Recurrent packing may not be required. Future work should explore patient reported measures such as pain management and the health economics of this intervention.

scholarly journals The Use of Milrinone Versus Conventional Treatment for the Management of Life-Threatening Bronchial Asthma

2019 ◽  
Vol 13 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Amr Sobhy ◽  
Doaa M. K. Eldin ◽  
Hany V. Zaki
Keyword(s):  
Bronchial Asthma ◽  
Conventional Treatment ◽  
Controlled Trial ◽  
Blood Gases ◽  
Categorical Variables ◽  
Chi Square ◽  
Arterial Blood ◽  
Number Of Patients ◽  
Significant Difference ◽  
Life Threatening

Background and Aims: In our study, we investigated the effectiveness of intravenous milrinone in life-threatening bronchial asthma as compared to conventional treatment. Methods: Fifty patients aged 18-50 years, presenting with life-threatening asthma were enrolled in a Randomised Controlled Trial (RCT). They were randomly allocated into Group C (25 patients): who received the standard pharmacotherapy and placebo, and Group M (25 patients): who in addition to the standard therapy, received 25 μg milrinone as an initial slow IV bolus diluted in 10 ml of normal saline. The following data were recorded: PEFR (Peak Expiratory Flow Rate) expressed as a percentage of the patient’s previous value, Respiratory Rate (RR), MABP (Mean Arterial Blood Pressure), arterial blood gases, and the number of patients requiring mechanical ventilation. Differences between groups were tested using Analysis of Variance (ANOVA) for quantitative variables with post hoc using the Least Significant Difference (LSD) test, and Chi square test for categorical variables. Results: Group M showed marked improvement in PEFR that was highly significant (P < 0.001) 10 min after injection and significant after one hour from the start of treatment in comparison to Group C. There was also an improvement in RR and PO2 that was significant in group M. Milrinone was associated with a reduction in MABP only after 10 min from injection, and showed a statistically significant decrease in the number of patients requiring mechanical ventilator support (P ˂ 0.05). Conclusion: Milronine is a promising agent as a rescue drug in the treatment of life-threatening bronchial asthma.

scholarly journals CONDIÇÕES DE SAÚDE E ESTADO NUTRICIONAL DE AGENTES COMUNITÁRIOS DE SAÚDE NO INTERIOR DO NORDESTE BRASILEIRO

2020 ◽  
Vol 6 (1) ◽  
pp. 32-43
Author(s):  
Amanda Almeida Gomes Dantas ◽  
Nayara Priscila Dantas De Oliveira ◽  
Mercês de Fátima dos Santos Silva ◽  
Diego de Sousa Dantas
Keyword(s):  
Nutritional Status ◽  
Community Health ◽  
Prevalence Ratio ◽  
National Health Survey ◽  
Health Conditions ◽  
Bivariate Analysis ◽  
Chi Square ◽  
Anthropometric Measures ◽  
Exact Test ◽  
Significant Difference

 Introdução: A saúde do trabalhador é um campo de relevância, mas que ainda está sendo consolidado no âmbito do sistema único de saúde (SUS). Partindo dessa compreensão, esse estudo teve como objetivo avaliar o estado nutricional e as condições de saúde dos agentes comunitários de saúde do município de Currais Novos-RN. Metodologia: Participaram da pesquisa 80 indivíduos de ambos os sexos. A coleta de dados envolveu um questionário padronizado elaborado especificamente para o referido trabalho, baseado na Pesquisa Nacional de Saúde, realizada por o IBGE, para analisar as condições de vida e de saúde. Além disso, foram realizadas aferição de medidas antropométricas como peso, estatura, circunferência abdominal e dobras cutâneas, para analisar o estado nutricional. A análise bivariada foi realizada por meio do teste Qui-quadrado de Pearson ou Exato de Fisher, sendo verificada a magnitude da associação através da razão de prevalência com intervalo de confiança de 95%, por meio do programa estatístico SPSS for Windows versão 22.0. Resultados: De acordo com os resultados, viu-se que 63,8% dos participantes encontram-se com Sobrepeso/Obesidade. Conclusão: Todos os dados antropométricos apresentaram diferença significativa na análise bivariada, demonstrando que essas variáveis exercem influência no estado nutricional desses.   Descritores: Agente Comunitário de Saúde; Saúde do Trabalhador; Condições de Saúde; Estado Nutricional.   ABSTRACTIntroduction:Workers' health is a field of relevance, but it is still being consolidated within the scope of the single health system (SUS). Based on this understanding, this study aimed to evaluate the nutritional status and health conditions of community health agents in the municipality of Currais Novos-RN. Methodology: Participated in the study 80 individuals of both sexes. The data collection involved a standardized questionnaire elaborated specifically for the aforementioned study, based on the National Health Survey, conducted by the IBGE, to analyze the living and health conditions. In addition, anthropometric measures such as weight, height, waist circumference, and skinfolds were performed to analyze the nutritional status.The bivariate analysis was performed using the Pearson's Chi-square test or the Fisher's exact test, and the magnitude of the association was verified through the prevalence ratio with a 95% confidence interval, using the statistical program SPSS for Windows version 22.0. Results: According to the results, it was found that 63.8% of the participants they are Overweight / Obesity. Conclusion: And all anthropometric data presented a significant difference in the bivariate analysis, demonstrating that these variables influence the nutritional status of these.  Descriptors: Community Health; Agent Worker’s Health; Health Conditions; Nutritional Status.

scholarly journals Born Too Soon; Implications in a Tertiary Health Facility in Enugu State Nigeria

2021 ◽  
Vol 11 (6) ◽  
pp. 190-196
Author(s):  
Nwoga Hope Obiageli ◽  
Ajuba Miriam Obinwanne ◽  
Igweagu Chukwuma Paulinus
Keyword(s):  
Caesarean Section ◽  
Health Facility ◽  
Preterm Delivery ◽  
Tertiary Education ◽  
Binary Logistic Regression ◽  
Bivariate Analysis ◽  
P Value ◽  
Chi Square ◽  
Chi Square Test ◽  
Enugu State

Background: Preterm birth (PTB) is a complex complication of pregnancy with multiple etiologies. This results in long term medical burdens to the families and health care system at large. The objective of the study was to determine the socio-demographic and obstetric characteristics that affect preterm delivery. Methods: The study was a prospective cohort study conducted at the Obstetrics and Gynecology Department of a tertiary health facility in Nigeria. Data for the study were retrieved from the ante-natal and delivery card of the women that delivered at the unit within the time of data collection. Data was analyzed using SPSS version 25 and variables were presented as frequencies, percentages, means, and standard deviation. Bivariate analysis was done using chi-square test. The level of significance was set at p value ≤ 0.05. Binary logistic regression was used to determine factors that predicted preterm delivery. Results: Majority of them were married 746(96.9%), Igbos 763(99.1) and Christians 766(99.5%). Most of the women were civil servants 429(55.7%), while about 31.3% of them were unemployed 241(31.3%). Majority of the women 484(62.9%) had tertiary education. About 48% of them delivered through caesarean section while 53.9% booked within 14-28weeks gestation. Delivering through caesarean section and gestational age at booking predicted preterm delivery. Un-booked mothers have about 7times odds of having PTB when compared to those that booked at ≥28 week’s gestation. Conclusion: The prevalence of PTB is still high in Nigeria. Booking status of the mother and C/S delivery were found to be strongly associated with preterm delivery. Key words: Enugu State, Nigeria, Preterm delivery, Prevalence, Tertiary health facility.

scholarly journals The Effect of the Covid-19 Free Operation Path Protocol on the Incidence of Lung Complications in Postoperative Elective Patients at dr. Moewardi Hospital Surakarta

2021 ◽  
Vol 5 (11) ◽  
pp. 1030-1036
Author(s):  
Galih Aktama ◽  
Henky Agung Nugroho ◽  
Muhammad David Perdana Putra
Keyword(s):  
Cancer Patients ◽  
Elective Surgery ◽  
Pulmonary Complications ◽  
P Value ◽  
Chi Square ◽  
Elective Surgical Procedures ◽  
Significant Difference ◽  
Before And After ◽  
Chi Square Test ◽  
Elective Patients

The pandemic that began in late 2019, COVID-19, affects all patients, including cancer patients. Patients with cancer that continues to spread and  there is no other effective alternative treatment must undergo surgery so that cancer does not get worse. Given this problem, many health care centers have developed a protocol system in the form of a COVID-19-free surgical route. This study is a retrospective cohort study comparing the incidence of pulmonary complications in patients undergoing elective cancer surgery at dr. Moewardi Surakarta before and during the COVID-19 pandemic. The study sample was adult patients  aged ≥ 18 years which underwent elective surgical procedures with the aim of curative cancer starting before COVID-19 (March 2019-February 2020) until the time the COVID-19 pandemic emerged (March 2020 - February 2021). The data obtained were 768 patients. Of these patients, 384 were classified as having a COVID19-free operation route during the pandemic, and 384 others underwent elective surgery in the pre-pandemic period. Based on the Chi-Square test, a p-value of 0.850 was obtained (P>0.05) which shows that there is significant difference between cases of pulmonary complications in surgical patients before and after the pandemic who were carried out through the COVID-19-free protocol route. In conclusion, there is no significant change in effect of the covid-19 free operation path protocol on the incidence of lung complications in postoperative elective patients at dr. Moewardi Hospital Surakarta, although this patented and mandatory protocol can reduce cancer patients’ morbidity and mortality who undergoing elective surgery during a pandemic.

Effect of Single Dose In Vivo Propranolol Therapy on In Vitro Adhesion of Human SS RBC.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 1234-1234 ◽  
Author(s):  
Laura M. De Castro ◽  
Jude C. Jonassaint ◽  
Jennifer G. Johnson ◽  
Milena Batchvarova ◽  
Marilyn J. Telen
Keyword(s):  
Safety Data ◽  
Study Drug ◽  
Flow Chamber ◽  
In Vivo Studies ◽  
Dependent Manner ◽  
Number Of Patients ◽  
Significant Difference ◽  
Before And After

Abstract Sickle red blood cells (SS RBC) are abnormally adhesive to both endothelial cells (ECs) and components of the extracellular matrix (ECM). Epinephrine (epi) has been shown to elevate cAMP in SS RBC and increase adhesion of SS RBC to ECs in a protein kinase A-dependent manner. In vitro and in vivo studies performed in our lab have led to the hypothesis that adrenergic stimuli such as epi may initiate or exacerbate vaso-occlusion and thus contribute to the association of vaso-occlusive events with physiologic stress. We are conducting a prospective, dose-escalation pilot clinical study to investigate whether in vivo administration of one dose of propranolol either down-regulates baseline SS RBC adhesion in vitro or prevents its upregulation by epi. In addition, this study will provide additional safety data regarding the use of propranolol in normotensive patients with sickle cell disease (SCD). Figure Figure To date, we have completed the first two dose cohorts. 11 subjects (9 SS and 1 Sβ° thalassemia; 7 females, 3 males) have participated. No severe adverse events were noted. Cohorts 1 and 2 had mean pre-propranolol blood pressure (BP) of 116 (5.9 SD)/ 60.4 (3.98 SD) and 106.8 (4.68 SD)/ 58 (3.9 SD), respectively; this difference was not statistically significant. Minimal and asymptomatic changes in BP were noted in both cohorts after drug administration, with biphasic systolic and diastolic BP nadirs at 45 and 240 minutes. No clinically significant changes in heart rate were observed. Adhesion studies were performed using a graduated height flow chamber on the day of RBC collection. RBC adhesion to ECs was studied before and after epi stimulation and was measured at sheer stresses ranging from 1 to 3 dyne/cm2. Baseline adhesion measurements were validated by comparing percent (%) adhesion assayed at 2 different times within 7 days—at screening and before propranolol dose on the study drug day. We observed no significant difference in adhesion at the 2 different time points without propranolol. Comparison of % adhesion of epi-stimulated RBC to ECs before and 1 hour after propranolol showed that propranolol given in vivo significantly inhibited both non-stimulated and epi-stimulated SS RBC adhesion (p=0.04 and p=0.001, respectively). Lastly, comparison of SS RBC adhesion at both drug doses confirmed the drug-related inhibition of adhesion (p&lt;0.004). We conclude that propranolol administered in vivo decreases SS RBC baseline adhesion to ECs and substantially abrogates epi-stimulated adhesion to ECs, as measured in vitro. Although we have thus far studied only a small number of patients and low propranolol doses, we expect to confirm these results with the 3rd cohort, in which a higher dose of propranolol will be used. If our findings continue to show that propranolol can decrease both SS RBC baseline and epi-stimulated adhesion to ECs, study of propranolol on a larger scale would be warranted in order to ascertain its safety and efficacy as an anti-adhesive therapy in SCD.

scholarly journals THE RELATIONSHIP OF FAMILY SUPPORT REGARDING THE PATIENTS WITH CHRONIC KIDNEY FAILURE WHO HAVE HEMODIALIZED THERAPY TREATMENT IN PMI HOSPITAL BOGOR

2020 ◽  
Vol 10 (2) ◽  
pp. 80-88
Author(s):  
Sara Sara Tania Aprianty ◽  
Hani Siti Hanifatun Fajria
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Family Support ◽  
Patient Compliance ◽  
Kidney Failure ◽  
Statistical Test ◽  
Bivariate Analysis ◽  
P Value ◽  
Chi Square ◽  
Number Of Patients

Chronic Renal Failure (CRF) is a disease that has occurred after various diseases that damage the kidney nephrons period up to the point the two are not capable of functioning regulatory and ekstetoriknya to maintain homeostasis. Number of patients with kidney failure in Indonesia is estimated to reach 300.000 people. As many as 12.804 patients with renal failure undergoing hemodialysis. To determine correlation family support patient compliance with chronic renal failure undergo hemodialysis therapy in RS PMI Bogor. This type of research is descriptive quantitative analytical research with cross sectional design. How sampling in this study with purposive sampling with a sample of 152 respondents. The instrument used is questionnaire while data analysis techniques using univariate and bivariate analysis using statistical test Chi-Square. Of the 152 respondents with a family to support as many as 139 respondents (91.4%), adherent patients as many as 128 respondents (84.2%) and family support with adherent patients as many as 121 respondents (79.6%). Statistical test results using Chi-square test p value value 0,007 (p <0.05) and the value of OR 5.762. The conclusion of this research that, There is a correlation between family support patient compliance with chronic renal failure through hemodialysis therapy in PMI Hospital Bogor, 2016. The researchers recommend that increased family support by distributing leaflets to the patients and families about the importance of family support for compliance patients undergo hemodialysis therapy.

scholarly journals Manfaat Relaksasi Otot Progresif Bagi Klien DM Tipe II Untuk Mengurangi Gejala Fatigue

2021 ◽  
Vol 6 (2) ◽  
pp. 45-52
Author(s):  
Reny Sulistyowati
Keyword(s):  
Muscle Relaxation ◽  
Intervention Group ◽  
Progressive Muscle Relaxation ◽  
Wilcoxon Test ◽  
Bivariate Analysis ◽  
Control Group ◽  
P Value ◽  
Diabetic Patients ◽  
Significant Difference ◽  
Before And After

Fatigue is a widespread clinical complaint among adults with type 2 diabetes. Fluctuating glucose levels can cause fatigue. Several factors are associated with fatigue in diabetic patients, including physiological factors such as hypoglycemia or hyperglycemia, psychological factors such as depression associated with diabetes. Progressive muscle relaxation is a procedure to get relaxation in the muscles through two steps, namely by applying tension to a muscle group and stopping the tension then focusing on how the muscle relaxes, feeling the sensation of relaxation and fatigue is reduced. The aim of this study was to identify the effect of progressive muscle relaxation on fatigue symptoms in type II DM clients in 15 control groups and 15 intervention groups. The research method used a quasi-experimental design with a pretest-posttest control group design approach, consisting of one treatment (in the intervention group) and a control group. Data analysis was performed using univariate and bivariate analysis using t-independent and t-dependent tests. Wilcoxon test results in the intervention group and the control group showed a significant p-value of 0.002 (<0.05), meaning that there was a significant difference in fatigue symptoms in the intervention group before and after the intervention. This shows that there was a decrease in fatigue symptoms in the intervention group before and after combination OHO therapy and progressive muscle relaxation exercises (previously the average respondent in the intervention group experienced symptoms of severe fatigue, after intervention, the average value of fatigue symptoms turned into mild fatigue ). Conclusion: Progressive muscle relaxation combined with OHO therapy can reduce symptoms of fatigue compared to only OHO therapy.

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