scholarly journals Pengaruh Pelatihan Tentang Perawatan Pasien Pasca Stroke Terhadap Peningkatan Pengetahuan Kader

2021 ◽  
Vol 1 ◽  
pp. 2098-2104
Author(s):  
Wahyu Ersila ◽  
Lia Dwi Prafitri ◽  
Syavira Nooryana

AbstractStroke is a neurological disease that can cause damage to the brain, the damage has an impact on the decline of the body's functional organs. Physical exercise carried out by post-stroke patients is also able to restore recovery, it is necessary to have a companion when doing these exercises from family members or closest neighbors, one of which can be done by Elderly Cadres. Cadre training can increase the knowledge of cadres which is expected to be able to improve the services provided to post-stroke patients. The purpose of this community service is to determine the effect of training on increasing the knowledge of cadres regarding post-stroke patient care. The method used is a question and answer lecture, discussion, and demonstration. The number of cadres who participated in this activity was 20 cadres. The instrument used to determine the increase in knowledge is a questionnaire. The results of this community service show that before the cadre training was carried out there were 15 cadres (75%), and after the cadre training the knowledge increased to Good as many as 17 cadres (85%). The effect of increasing the knowledge of cadres statistically is training with a value of 0.003 (<0.05), this means that training changes the knowledge of cadres before and after regarding post-stroke patient care. Suggestions for puskesmas in order to increase the knowledge of cadres can be through similar training with other themes.Keywords: Cadre; training; knowledge AbstrakStroke merupakan penyakit neurologi yang dapat menyebabkan kerusakan pada otak, kerusakan tersebut berdampak pada kemunduran organ fungsional tubuh. Latihan fisik yang dilakukan pasien pasca stroke juga mampu mempercepat pemulihan, perlunya ada pendamping ketika lansia melakukan latihan tersebut bisa dari anggota keluarga atau tetangga terdekat salah satunya dapat dilakukan oleh Kader Lansia. Pelatihan kader dapat meningkatkan pengetahuan kader yang diharapkan mampu untuk meningkatkan pula pelayanan yang diberikan kepada pasien pasca stroke. Tujuan dari pengabdian masyarakat ini adalah untuk mengetahui pengaruh pelatihan terhadap peningkatan pengetahuan kader mengenai perawatan pasien pasca stroke. Metode yang digunakan adalah ceramah tanya jawab, diskusi, dan demontrasi. Jumlah kader yang mengikuti kegiatan ini adalah 20 kader. Instrumen yang digunakan untuk mengetahui peningkatan pengetahuan adalah kuesioner. Hasil pengabdian masyarakat ini bahwa sebelum dilakukan pelatihan pengetahuan kader ada pada kategori cukup sebanyak 15 kader (75%), dan setelah dilakukan pelatihan pengetahuan kader meningkat menjadi Baik sebanyak 17 kader (85%). Pengaruh pelatihan dalam meningkatkan pengetahuan kader secara statistic dengan nilai p 0,003 (<0,05) hal ini berarti pelatihan berpengaruh mengubah pengetahuan kader sebelum dan setelah pelatihan mengenai perawatan pasien pasca stroke. Saran bagi puskesmas agar dapat meningkatkan pengetahuan kader dapat melalui pelatihan sejenis dengan tema yang lain. Keywords: Kader;pelatihan;pengetahuan

2015 ◽  
Vol 776 ◽  
pp. 337-342 ◽  
Author(s):  
I. Made Londen Batan ◽  
Rodika ◽  
Muhamad Riva'i

Three wheel bike as a physical therapy equipment for post-stroke patients was designed with length of 1937 mm, 1010 mm in width and height of 905 mm. The bike is designd ergonomic and can be driven by rider foot or hand simultaneously. By using CATIA software the strength of material bike frame was analyst to support 100 kg of load. The design is realized into a prototype. The performance of bike prototype is tested, and the result sows that the function of bike mechanisme is fulfilled. By 10 respondents, who have a standard body mass index, the pedal test was conducted, and the result indicates that, the higher the speed of the pedal, the higher the energy consumption to pedaling. Leg tension muscles is measured by leg-dynamometer before and after pedaling, and the result shows the tension muscle is proportional to the increase of pedal speed. In order to evaluate the ergonomic aspect of bike design, the risk angle of extrem position of body during cycling are measured by goneo-set. By RULA method the risk of injury value of rider body is calculated while pedaling, and the result showed that 70% of respondents have a value of risk injury 2, while 30% had a value of 3. It means that, the bike design is ergonomic and comfortable to ride. In oder to evaluate the benefits of disigned bike, the pedal test is conducted by 4 post-stroke patients for 30 days periodical once every 3 days. The result shows that during 1 month exercise, the average number of cycling to pedal increase up to 100%. This means that the ability of post-stroke patients to pedal the bike increase significantly. That result showed that the bike design is useful as a tool for physical therapy post-stroke patients.


2021 ◽  
Vol 1 ◽  
pp. 1959-1967
Author(s):  
Rizqika Indah Yuli Yanti ◽  
Nurul Aktifah

AbstractStroke occurs when a blood vessel that carries oxygen and nutrients to the brain bursts or is blocked by a clot so that the brain does not get the blood it needs. Stroke affects physical limitations and disabilities in carrying out daily living activities. One of the rehabilitation interventions to increase daily living activities among them is propioceptive neuromuscular facilitation. Thisstudy aimed to describe the activity daily living in non-hemorrhagic post-stroke patients after propioceptive neuromuscular facilitation intervention. The selection of articles in the study usesthe PICO mnemonic. Searcharticles through the Indonesian Scientific Respirator Research, PubMed, GARUDA, and Google scholar with predetermined inclusion and exlusion criteria. The results show that propioceptive neuromuscular facilitation was proven in increase activity daily living in non-hemorrhagic post-stroke patients. The activity daily living was assessed using Barthel Index checklist. The average of Barthel Index before and after intervention were 42,493 and 75,372 respectively. The propioceptive neuromuscular facilitation has been shown to improve activity daily living in non-hemorrhagic post-stroke patients. Propioceptive neuromuscular facilitation can be a modality treatment to increase activity daily living in non-hemorrhagic post-stroke patients.Keywords: Activity Daily Living, Non-Hemorrhagic Post-Stroke, Propioceptive Neuromuscular Facilitation AbstrakStroke terjadi ketika pembuluh darah yang mengangkut oksigen dan nutrisi menuju otak pecah atau terblokir oleh bekuan sehingga otak tidak mendapat darah yang dibutuhkan. Kejadian stroke memunculkan gangguan keterbatasan fisik dan kecacatan dalam melakukan activity daily living. Peran fisioterapi pada penderita stroke yaitu tindakan rehabilitasi yang dapat meningkatkan ADL salah satuya adalah propioceptive neuromuscular facilitation. Penelitian ini bertujuan untuk mengetahui gambaran activity daily living pada pasien pasca stroke non hemoragic dengan pemberian propioceptive neuromuscular facilitation. Pemilihan artikel pada penelitian ini menggunakan mnemonic PICO. Penelusuran artikel melalui Neliti Respiratori Ilmiah Indonesia, PubMed, Garuda-Garba rujukan digital dan Google scholar dengan kriteria inklusi dan ekslusi yang telah ditentukan. Hasil literature review kelima artikel menunjukkan bahwa PNF terbukti meningkatkan ADL pada pasien pasca stroke non hemoragic dengan hasil rata-rata peningkatan sebesar 32.879 dengan menggunakan alat ukur indeks barthel sebelum intervensi 42.493 dan sesudah intervensi 75.372. Hasil literature review kelima artikel ini menunjukkan bahwa propioceptive neuromuscular facilitation terbukti dapat meningkatkan activity daily living pada pasien pasca stroke non hemoragic. Penetitian ini dapat digunakan sebagai dasar pengembangan praktisi fisioterapi pada masalah peningkatan activity daily living pada pasien pasca stroke non hemoragic dengan menggunakan latihan propioceptive neuromuscular facilitation.Kata Kunci: Activity Daily Living, Propioceptive Neuromuscular Facilitation, Pasca Stroke


2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Rumiati - Rumiati ◽  
I Made Kariasa ◽  
Agung Waluyo

Background: Educational interventions about stroke have been carried out by the health workers, one of which is by the nurse. However, the majority of the interventions focus more on the stroke patients than the stroke caregivers. Meanwhile, post-stroke patient care education interventions are urgently needed by the caregivers. Therefore, the author intends to review current literature about post-stroke patient care education interventions on stroke caregivers. Objective: This literature review aims to identify the effectiveness, methods, and impacts of daily care educational interventions for post-stroke patients on stroke caregivers. Methods: The method utilized was by analyzing online databases about the related topics from reputable sources.  Seven articles that met the inclusions criteria considering Randomized Controlled Trial (RCT) and Quasi-experimental design, time of publication, and English full text were obtained, and the results were presented. Result: Educational intervention could be carried out by several methods, including direct education at the patient's bedside, lectures followed by questions and answers, and booklets, home visits or telephone follow-up. Educational interventions could improve caregiver knowledge and skills in providing daily care for post-stroke patients, reduce burdens, reduce anxiety and improve the caregiver's quality of life. Educational interventions also positively impacted post-stroke patients, including improving the quality of life, functional abilities and the ability to do daily activities (ADL), reducing cognitive impairment, anxiety, and depression.Conclusion: Daily care education interventions for post-stroke patients can reduce the burden on the caregiver, either physical, psychological or social burdens.


Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Hetal Mistry ◽  
Madeline Levy ◽  
Meaghan Roy-O'Reilly ◽  
Louise McCullough

Background and Purpose: Orosomucoid-1 (ORM-1) is an abundant protein with important roles in inflammation and immunosuppression. We utilized RNA sequencing to measure mRNA levels in human ischemic stroke patients, with confirmation by serum ORM-1 protein measurements. A mouse model of ischemic stroke was then used to examine post-stroke changes in ORM-1 within the brain itself. Hypothesis: We tested the hypothesis that ORM-1 levels increase following ischemic stroke, with sex differences in protein dynamics over time. Methods: RNA sequencing was performed on whole blood from ischemic stroke patients (n=23) and controls (n=12), with Benjamini-Hochberg correction for multiple testing. Enzyme-linked immunosorbent assay was performed on serum from ischemic stroke patients (n=28) and controls (n=8), with analysis by T-test. For brain analysis, mice (n=14) were subjected to a 90-minute middle cerebral artery occlusion (MCAO) surgery and sacrificed 6 or 24 hours after stroke. Control mice underwent parallel “sham” surgery without occlusion. Western blotting was used to detect ORM-1 protein levels in whole brain, with analysis by two-way ANOVA. Results: RNA sequencing showed a 2.8-fold increase in human ORM-1 at 24 hours post-stroke (q=.0029), an increase also seen in serum ORM-1 protein levels (p=.011). Western blot analysis of mouse brain revealed that glycosylated (p=0.0003) and naive (p=0.0333) forms of ORM-1 were higher in female mice compared to males 6 hours post-stroke. Interestingly, ORM-1 levels were higher in the brains of stroke mice at 6 hours (p=.0483), while at 24 hours ORM-1 levels in stroke mice were lower than their sham counterparts (p=.0212). In both human and mouse data, no sex differences were seen in ORM-1 levels in the brain or periphery at 24 hours post-stroke. Conclusion: In conclusion, ORM-1 is a sexually dimorphic protein involved in the early (<24 hour) response to ischemic stroke. This research serves as an initial step in determining the mechanism of ORM-1 in the ischemic stroke response and its potential as a future therapeutic target for both sexes.


2020 ◽  
Vol 32 (3) ◽  
pp. 128-134 ◽  
Author(s):  
Masachika Niimi ◽  
Yuko Fujita ◽  
Tamaki Ishima ◽  
Kenji Hashimoto ◽  
Nobuyuki Sasaki ◽  
...  

AbstractObjective:Abnormalities in neurotransmission via N-methyl-d-aspartic acid receptor (NMDAR) play a role in the pathophysiology of neuropsychiatric disorders. The impact of repetitive transcranial magnetic stimulation (rTMS) on NMDAR-related amino acids remains unknown. We aim to investigate the effects of rTMS on NMDAR-related amino acids in serum of post-stroke patients.Methods:Ninety-five consecutive post-stroke patients with upper limb hemiparesis were recruited. In 27 patients, the Beck Depression Inventory (BDI) score was 10 or higher. Twelve depressed patients underwent rehabilitation in combination with rTMS and 15 non-depressed patients underwent rehabilitation only without rTMS for 14 days. 1 Hz rTMS was applied to the primary motor area in the non-lesional hemisphere. BDI was conducted before and after treatment. Serum glutamine, glutamate, glycine, l-serine, and d-serine levels were measured before and after treatment.Results:There were no differences between depressed patients and non-depressed patients in clinical characteristics, levels of the five amino acids in serum, and the ratio of amino acids. However, in 27 depressed patients, there was a significant correlation between levels of glutamate in serum and BDI (ρ = 0.428, p = 0.026). BDI decreased significantly in depressed patients after treatment with or without rTMS. d-serine decreased in the rehabilitation with rTMS group, but increased in the rehabilitation without rTMS group. l-serine increased in the rehabilitation with rTMS group, but decreased in the rehabilitation without rTMS group.Conclusion:The results suggest that rTMS can modulate NMDAR-related amino acids in blood, producing beneficial effects.


Author(s):  
Keerthana Chandrasekar ◽  
Nakka Gautam Sai ◽  
Princy Sabu John ◽  
Sruthi Ninan ◽  
Raja D ◽  
...  

Stroke is the third leading cause of death. Stroke occurs when an insufficient amount of blood is supplied to the brain due to a thrombus or an emboli leading to permanent tissue damage. Lesions in the brain can lead to psychiatric complications. The prevalence of psychiatric complications after stroke is very common. Psychiatric complications such as depression, anxiety, apathy, pseudobulbar effects (laughing and crying), mania, psychosis, and bipolar disorders are seen after stroke. In this review, various psychiatric disorders are reported among post-stroke survivors in which depression and anxiety are common. Consequently, apathy, pseudobulbar effects, catastrophic reactions, psychosis, bipolar disorder, and mania are also observed after stroke. Therefore, early detection and management of psychiatric disorders prevent further complications and improve the quality of life in post-stroke patients.


Author(s):  
Jade E. Basaraba ◽  
Michelle Picard ◽  
Kirsten George-Phillips ◽  
Tania Mysak

AbstractBackground:Pharmacists have become an integral member of the multidisciplinary team providing clinical patient care in various healthcare settings. Although evidence supporting their role in the care of patients with other disease states is well-established, minimal literature has been published evaluating pharmacist interventions in stroke patients. The purpose of this systematic review is to summarize the evidence evaluating the impact of pharmacist interventions on stroke patient outcomes.Methods: Study abstracts and full-text articles evaluating the impact of a pharmacist intervention on outcomes in patients with an acute stroke/transient ischemic attack (TIA) or a history of an acute stroke/TIA were identified and a qualitative analysis performed.Results: A total of 20 abstracts and full-text studies were included. The included studies provided evidence supporting pharmacist interventions in multiple settings, including emergency departments, inpatient, outpatient, and community pharmacy settings. In a significant proportion of the studies, pharmacist care was collaborative with other healthcare professionals. Some of the pharmacist interventions included participation in a stroke response team, assessment for thrombolytic use, medication reconciliation, participation in patient rounds, identification and resolution of drug therapy problems, risk-factor reduction, and patient education. Pharmacist involvement was associated with increased use of evidence-based therapies, medication adherence, risk-factor target achievement, and maintenance of health-related quality of life.Conclusions: Available evidence suggests that a variety of pharmacist interventions can have a positive impact on stroke patient outcomes. Pharmacists should be considered an integral member of the stroke patient care team.


2019 ◽  
Vol 25 (09) ◽  
pp. 910-921 ◽  
Author(s):  
Macarena Gil-Pagés ◽  
Rocío Sánchez-Carrión ◽  
Jose M. Tormos ◽  
Antonia Enseñat-Cantallops ◽  
Alberto García-Molina

AbstractObjectives: How brain damage after stroke is related to specific clinical manifestation and recovery is incompletely understood. We studied cognitive reserve (CR) in stroke patients by two types of measurements: (i) objectively verifiable static proxies (i.e., education, occupational attainment), and (ii) subjective, dynamic proxies based on patient testimony in response to a questionnaire. We hypothesized that one or both of these types of CR measurements might correlate positively with patient cognitive performance during the post-acute and chronic phases of recovery. Method: Thirty-four stroke patients underwent neuropsychological assessment at 2, 6 and 24 months after stroke onset. In chronic stage at 24+ months, self-rating assessments of cognitive performance in daily life and social integration were obtained. CR before and after stroke was estimated using static proxies and dynamic proxies were obtained using the Cognitive Reserve Scale (CRS-Pre-stroke, CRS-Post-stroke). Results: CRS-Pre-stroke and CRS-Post-stroke showed significant mean differences. Dynamic proxies showed positive correlation with self-assessment of attention, metacognition, and functional ability in chronic stage. In contrast, significant correlations between static proxies and cognitive recovery were not found. Conclusions: Dynamic proxies of CR were positively correlated with patients’ perception of their functional abilities in daily life. To best guide cognitive prognosis and treatment, we propose that dynamic proxies of CR should be included in neuropsychological assessments of patients with brain damage.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Candace J McAlpine ◽  
Rocio Garcia ◽  
Pablo Rojas

Background and Purpose: Providers recognize the need for quick recognition and allocation of resources when ischemic stroke patients arrive at the emergency department. Hemorrhagic stroke patients have not been always given the same priority. One Comprehensive Stroke Center noticed a deficiency in timely recognition, documentation and mobilization of resources for hemorrhagic stroke patients. The initiation of “code head bleed” in the emergency department was created to correct this deficiency. The purpose of this study was to bring awareness and education to the team initially caring for the hemorrhagic stroke patient. Methods: Using Lean methodology, to bring about quality patient care while reducing wasted time, the “code head bleed” was born. Education was provided for all emergency department staff members and physicians regarding “code head bleed.” When a code head bleed notification is paged out it mobilizes all required resources to the patient’s bedside (Faculty physician, Medical Resuscitation team, Patient Care Coordinator, Respiratory Therapy, Stroke Coordinators and Emergency Department leadership). Results: Since its inception in May, the “code head bleed” is the most used code notification in the hospital (n=163 ), surpassing ischemic stroke alerts (n= 89 ) in the same period. An increase of traumatic hemorrhages has been noticed since they are also included in the notification; which has led to an increased awareness in this population of patients as well. Code head bleed has improved neuro-check documentation by 21 % and documentation of vasoactive drip titration by 15% in the hemorrhagic stroke population. Conclusions: In conclusion, having all essential staff, services and resources lends to optimizing the hemorrhagic stroke patient’s care. The “code head bleed” initiative has been attributed to an increased awareness of the needs of the hemorrhagic stroke patient in the emergency department and an improvement in the documentation of care provided.


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