Penerapan Terapi Bermain Lego Terhadap Perkembangan Motorik Halus Pada Anak Usia Prasekolah Dengan Resiko Gangguan Perkembangan

Psychomotor skills are one of the developing chilg’s abilities that involve certain organs and muscles and requre well coordination. The purpose of this study is to describe the application of lego play therapy in improving psychomotor development in preschool-aged children who are at risk of developmental disorders participated in this study. The Developmenta Pre-Screening Questionnaire (KPSP) was used to assessthe psychomotor skills. The result show that KPSP value before the intervetion in both participant were 5 and 7. After the intervetion the values were increase to be 10 and 12. These result proved that lego play therapy can improve psychomotor development among preschool-aged chilidren who are at risk of devolpmenental disorders. Moreover nurses are strongly suggest to implement legp play therapy as an alternative intrvetion to improve psychomotor developmental in preschool-aged children.Keywords: Lego Play Therapy, Preschool Age, Psychomotor Development AbstrakMotorik halus merupakan salah satu kemampuan anak yang sedang berkembang yang melibatkan bagian-bagian tubuh tertentu dan otot-otot kecil dan memerlukan koordinasi yang cermat. Tujuan penulisan ini menggambarkan penerapan terapi bermain lego dalam meningkatkan perkembangan motorik halus pada anak usia prasekolah. Metode yang digunakan dalam studi kasus ini adalah metode deskriptif dengan subyek dua pasien anak usia prasekolah yang mengalami resiko gangguan perkembangan. Alat ukur menggunakan lembar observasi yang mengacu pada Kuisioner PraSkrining Perkembangan (KPSP). Hasil menunjukkan sebelum intervensi nilai observasi perkembangan motorik halus pada kasus satu yaitu 5 dan pada kasus dua yaitu 7. Setelah dilakukan intervensi nilai observasi kasus satu meningkat menjadi 10, sedangkan pada kasus dua meningkat menjadi 12. Kesimpulan bahwa terapi bermain lego membantu meningkatkan perkembangan motorik halus anak usia prasekolah yang mengalami resiko gangguan perkembangan. Diharapkan perawat menjadikan terapi bermain lego sebagai salah satu alternative tindakan untuk meningkatkan perkembangan motorik halus pada anak prasekolah.Kata kunci : TerapiBermain Lego; Motorikhalus; UsiaPrasekolah

Evaluation of a social determinants of health screening questionnaire and workflow pilot within an adult ambulatory clinic

Background There is increased recognition in clinical settings of the importance of documenting, understanding, and addressing patients’ social determinants of health (SDOH) to improve health and address health inequities. This study evaluated a pilot of a standardized SDOH screening questionnaire and workflow in an ambulatory clinic within a large integrated health network in Northern California. Methods The pilot screened for SDOH needs using an 11-question Epic-compatible paper questionnaire assessing eight SDOH and health behavior domains: financial resource, transportation, stress, depression, intimate partner violence, social connections, physical activity, and alcohol consumption. Eligible patients for the pilot receiving a Medicare wellness, adult annual, or new patient visits during a five-week period (February-March, 2020), and a comparison group from the same time period in 2019 were identified. Sociodemographic data (age, sex, race/ethnicity, and payment type), visit type, length of visit, and responses to SDOH questions were extracted from electronic health records, and a staff experience survey was administered. The evaluation was guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Results Two-hundred eighty-nine patients were eligible for SDOH screening. Responsiveness by domain ranged from 55 to 67%, except for depression. Half of patients had at least one identified social need, the most common being stress (33%), physical activity (22%), alcohol (12%), and social connections (6%). Physical activity needs were identified more in females (81% vs. 19% in males, p < .01) and at new patient/transfer visits (48% vs. 13% at Medicare wellness and 38% at adult wellness visits, p < .05). Average length of visit was 39.8 min, which was 1.7 min longer than that in 2019. Visit lengths were longer among patients 65+ (43.4 min) and patients having public insurance (43.6 min). Most staff agreed that collecting SDOH data was relevant and accepted the SDOH questionnaire and workflow but highlighted opportunities for improvement in training and connecting patients to resources. Conclusion Use of evidence-based SDOH screening questions and associated workflow was effective in gathering patient SDOH information and identifying social needs in an ambulatory setting. Future studies should use qualitative data to understand patient and staff experiences with collecting SDOH information in healthcare settings.

Bone health risk assessment in a clinical setting: an evaluation of a new screening tool for active populations (Preprint)

BACKGROUND Risk factors for poor bone health are not restricted to older, sedentary populations for whom current screening is focused. Furthermore, access to dual X-ray absorptiometry scanning can be limited in clinical practice. OBJECTIVE The purpose of the current study was to develop a bone health-screening tool suitable for inclusion of both younger and active populations, combined with radiofrequency echographic multi spectrometry technology (REMS). METHODS 88 participants attending a physiotherapy clinic in the UK were recruited to the study: 71 women (mean age 41.5 SD 14.0 years); 17 men (mean age 40.2 SD 14.9 years). Participants completed an online bone health-screening questionnaire developed specifically for this study covering a range of lifestyle, physiological factors, combined with medical interview and received bone mineral density (BMD) measurement at the lumbar spine and femoral neck using REMS. RESULTS Scoring of the bone health-screening questionnaire produced a distribution of bone health scores, with lower scores suggesting a higher risk for poor bone health. In women, scores ranged from -10 to +12, mean score 2.2 (SD 4.8). In men, scores ranged from 0 to 12, mean score 6.9 (SD 3.2). A positive correlation was observed between the bone health score derived from the questionnaire and lumbar spine and femoral neck BMD Z-scores (p<0.01). CONCLUSIONS This new and comprehensive bone health-screening questionnaire with interview was effective in identifying active individuals at risk of bone fragility, who might be missed by current screening methods. The use of REMS technology to measure bone health, was feasible in the clinical setting. CLINICALTRIAL NA

Prevalence of systemic lupus erythematosus-related symptoms assessed by using the Connective Tissue Disease Screening Questionnaire in a large population-based cohort

BackgroundTo assess the prevalence of self-reported SLE-related symptoms associated with demographic and biochemical data and connective tissue disease (CTD)-related autoantibodies in a large population-based cohort.MethodsParticipants of the Dutch Lifelines population cohort filled out the Connective Tissue Disease Screening Questionnaire (CSQ), including 11 questions focusing on SLE-related symptoms (SLE-CSQ) based on the American College of Rheumatology classification criteria. CTD autoantibody screen was performed in 25% of participants.ResultsOf 85 295 participants with complete SLE-CSQ data, after excluding patients with SLE and other CTDs (n=126), 41 781 (49.1%) had no positively answered questions and 2210 (2.6% of total) had ≥4 positive answers. Participants with ≥4 answers on the SLE-CSQ were significantly younger, more frequently female, had lower body mass index (BMI) and were more often smokers than those with negative scores. Furthermore, counts of leucocytes, neutrophils and monocytes were significantly higher in these participants, while the levels of haemoglobin and creatinine were lower. CTD autoantibodies were present in 2.2% of participants with SLE-CSQ score of 0, compared with 3.5% with SLE-CSQ score ≥4 (p=0.001). Multivariate analysis showed, after adjusting for age, gender, BMI and smoking, that haemoglobin levels remained significantly lower in participants with SLE-CSQ score ≥4.ConclusionsIn this large population-based cohort, 2.6% of participants without diagnosed CTD reported ≥4 positive answers on the SLE-CSQ, indicating high suspicion for SLE. These individuals had demographic and haematological characteristics that differed from the remaining population. Potentially, this questionnaire, in combination with autoantibody determination, can be used as a starting point of a screening cascade in order to detect SLE at an early stage.