Manfaat Pijat Refleksi Untuk Mengurangi Depresi Pada Lansia

Pertumbuhan pada populasi lansia telah menyebabkan peningkatan penyakit terkait dengan usia, terutama depresi yang mempengaruhi kualitas hidup. Seiring bertambahnya usia pada lansia, depresi juga akan meningkat. Depresi adalah gangguan mental yang umum, ditandai oleh kesedihan, kehilangan minat atau kesenangan, perasaan bersalah atau rendah diri, gangguan tidur atau nafsu makan, perasaan lelah dan konsentrasi yang buruk. WHO memperkirakan bahwa tingkat prevalensi keseluruhan gangguan depresi di kalangan lansia umumnya bervariasi antara 10 dan 20%, tergantung pada budaya (WHO,2011)Pijat refleksi adalah metode medis komplementer dan alternatif dan merupakan aplikasi manipulasi berbasis tubuh yang sering digunakan (Wang, 2008). Pijat refleksi adalah metode terapi yang bertujuan untuk merangsang organ target dengan pesan elektrokimia yang disampaikan ke organ melalui neuron yang distimulasi melalui titik refleks di tangan dan kaki (Ernst, Lee, 2010). Penelitian yang dilakukan oleh Aydin, Aslan, Yalcin, 2016, pada wanita dengan OAB (Overactive Bladder Symptom) yang memiliki gejala depresi, ditemukan bahwa gejala depresi ringan dan tingkat sedang ditemukan menurun secara berarti setelah dilakukannya pijat refleksi, dan gejala depresi berat ditemukan tidak ada setelah dilakukannya pijat refleksi.Penelitian ini bertujuan untuk mengetahui efektifitas pijat refleksi pada kaki terhadap depresi pada lansia di Desa Puraseda, Kecamatan Leuwiliang, Kabupaten Bogor, Jawa Barat.Penelitian ini menggunakan design quasi experimental design dengan rancangan pre dan post pada kelompok lansia ≥ 60 tahun. Pada penelitian ini lansia dilakukan wawancara dan observasi dengan GDS terlebih dahulu sebelum mendapat perlakuan. Langkah berikutnya adalah diberikan perlakuan pijat refleksi pada kaki. Setelah selesai intervensi kemudian dilakukan wawancara dan observasi dengan GDS yang kedua. Hasil rata-rata selisih GDS sebelum dan sesudah intervensi dibandingkan untuk melihat sejauh mana pengaruh pijat refleksi pada kaki terhadap depresi setelah dilakukannya pijat refleksi pada kaki.Kata Kunci : Refleksi, Depresi, Lansia

P159 Successful treatment of sleep disordered breathing improves comorbidities in patients with nocturia

Introduction Sleep disordered breathing (SDB) has been shown to increase nocturia (waking with the need to void urine) frequency. Nocturia negatively affects sleep, autonomic dysfunction, mental health and mortality. Nocturia and these co-morbidities share central control areas in the brainstem. We hypothesised that treatment of SDB would decrease nocturia frequency and impact these co-morbidities. Methods A prospective repeated measures study with participants ≥40 years, naïve to treatment, with an AHI ≥30/hr and experiencing ≥1 episodes of nocturia was conducted. Participants undertook two months of CPAP with before and after measures of lower urinary tract symptoms (Overactive Bladder Symptom Score (OABSS) and urine volume), sleep quality (PSQI and actigraphy), autonomic dysfunction (blood pressure and orthostatic change) and wellbeing (Nocturia quality of life score (NQoL) and the Hospital anxiety and depression scores (HADS)). Results 490 diagnostic studies screened, 36 patients met criteria, and 30 participants (57% male) were recruited. 15 patients completed treatment with 55% of completed participants meeting the required compliance of >4 hours. Significant changes in OABSS (p=0.035), nocturnal voiding frequency (p=0.007), nocturnal urine volume (p=0.013) and nocturnal diuresis (p=0.013). Improvement was observed in PSQI perceived sleep quality (p=0.018) and actigraphy derived sleep efficiency (p=0.002). NQoL global score also showed significant improvement (p=0.037).No change was observed in autonomic dysfunction measurements. Conclusion With appropriate treatment of SDB an improvement was observed in nocturia frequency and associated co-morbidities in a sample of relatively healthy individuals. These results suggests that significant nocturia should prompt the assessment for and treatment of SDB.

Protocol for development and validation of a prediction model for 5-year risk of incident overactive bladder in the general population: the Nagahama study

Background An accurate prediction model could identify high-risk subjects of incident Overactive bladder (OAB) among the general population and enable early prevention which may save on the related medical costs. However, no efficient model has been developed for predicting incident OAB. In this study, we will develop a model for predicting the onset of OAB at 5-year in the general population setting. Methods Data will be obtained from the Nagahama Cohort Project, a longitudinal, general population cohort study. The baseline characteristics were measured between Nov 28, 2008 and Nov 28, 2010, and follow-up was performed every 5 years. From the total of 9,764 participants (male: 3,208, female: 6,556) at baseline, we will exclude participants who could not attend the follow-up assessment and those who were defined as having OAB at baseline. The outcome will be incident OAB defined using the Overactive Bladder Symptom Score (OABSS) at follow-up assessment. Baseline questionnaires (demographic, health behavior, comorbidities and OABSS) and blood test data will be included as predictors. We will develop a logistic regression model utilizing shrinkage methods (LASSO penalization method). Model performance will be evaluated by discrimination and calibration. Net benefit will be evaluated by decision curve analysis. We will perform an internal validation and a temporal validation of the model. We will develop a web-based application to visualize the prediction model and facilitate its use in clinical practice. Discussion This will be the first study to develop a model to predict the incidence of OAB.

Dietary glycine improves urine storage symptoms in urology outpatients

Objectives Spinal glycinergic mechanisms inhibit the micturition reflex, and administration of glycine inhibits bladder activity in rats. Therefore, we examined whether dietary glycine would improve storage symptoms in urological outpatients. Methods We enrolled 20 participants (16 men and four women) with an overactive bladder symptom score (OABSS) ≥ 3. All participants took 3 g of glucose (placebo) twice a day for the first four weeks, then 3 g of glycine twice a day for the next four weeks. We evaluated blood pressure, international prostate symptom score (IPSS), nocturia quality of life (N-QOL) score, OABSS, frequency of urination, sleep latency, time to first nighttime void, bladder pain, global self-assessment (GSA) evaluated urinary symptom improvement, and adverse events. Results Glucose administered as a placebo improved urinary frequency, urine force on the IPSS, and five of the 13 items on the N-QOL. However, compared to the results before and after glucose administration, glycine treatment decreased the number of nocturnal voids, urgency, and total score for urine storage items on the IPSS. It also reduced blood pressure and improved IPSS-QOL. For the OABSS, improvements with glycine were noted in the number of nocturnal urinations, urinary urgency, urge incontinence, and total score. For the N-QOL, eight of 13 items, and the total score, improved. The actual number of nighttime urinations, sleep latency, latency to first nighttime urination, bladder pain, and GSA also improved. There were no adverse events. Conclusions Glycine might improve urine storage symptoms, cardiovascular function, pain, and sleep.

Efficacy of salt reduction for managing overactive bladder symptoms: a prospective study in patients with excessive daily salt intake

This study aimed to investigate the efficacy of salt intake restriction on overactive bladder (OAB) symptoms in patients with excessive salt intake. Patients received a brochure on nutritional guidance regarding salt intake reduction and received health education every 4 weeks for 12 weeks. Data from overactive bladder symptom score (OABSS) questionnaires and frequency volume charts (FVCs) were evaluated. The daily salt intake was estimated by determining the urinary sodium and creatinine concentrations using spot urine samples. Of the 98 patients included, 71 (72.4%) successfully restricted their daily salt intake after 12 weeks (salt restricted [R] group), while 27 (27.6%) did not (salt non-restricted [N-R] group). The scores to each OABSS question and the resulting total score improved significantly in the R group; however, the individual scores remained unchanged and the total score increased in the N-R group. The FVC data indicated improved voided volumes in the R group as compared to in the N-R group. Ultimately, 17 (23.9%) patients in the R group no longer fulfilled the OAB diagnostic criteria after salt intake reduction. Thus, salt intake reduction improved urinary symptoms in patients with OAB and may be a therapeutic option for OAB in patients with excessive daily salt intakes.

Validating 7-items Overactive Bladder Symptom Score (OABSS) through Arabic linguistic version

The scoring of the 7-item Overactive Bladder Symptom Score (OABSS) questionnaire is unusual because its scale varies with the same maximum and minimum scoring values and quantifies all aspects of OAB. The questionnaire also contains a graded response for urgency. The current study is mainly concerned with the development and validation of the OABSS questionnaire for Jordanian patients. The process of translating the English OABSS questionnaire into the Arabic language involved forward and backward translations. Afterward, a prospective study was conducted to validate the Arabic version of the OABSS questionnaire by examining 235 patients from the outpatient clinics of Karak Governorate Teaching Hospital. The Arabic OABSS questionnaire was completed by all the enrolled patients before and after three months of treatment with solifenacin 5 mg taken once daily. The study included 235 regular patients (152 females and 83 males) diagnosed with OAB in accordance with the definition of the International Continence Society (ICS). The results showed major and significant differences on all seven domains of the questions on the OABSS questionnaire before and after receiving treatment (p < 0.05). Confirmatory Factor Analysis was used to measure the reliability and the questionnaire was found to be highly reliable for the construct variables. The findings derived from the current study would be beneficial for local urologists and researchers, as the Arabic version of the OABSS questionnaire was proven to be a reliable instrument for use in the assessment of OAB. Future studies are needed to compare different translated questionnaires relating to OAB.Trial registration number: NCT04309890.