Acceptance, Perceived Benefits, and Helplessness among Coronary Heart Disease Patients Undergoing Treatment in A Different Ward

Background. One of the factors determining CHD patients' adherence to treatment is Illness Cognition (IC). IC is described as acceptance, perceived-benefits, and helplessness. This study aims to identify and compared IC in CHD patients treated in different wards. Method: This research used a descriptive quantitative method with a cross-sectional approach. The study population was CHD patients who were undergoing treatment at a referral hospital in West Java. Selection of respondents using consecutive sampling, and data collected within three months, using the Illness Cognition Questionnaire on 106 respondents. Data were analyzed using mean and frequency distribution. Furthermore, ICs were compared using the Kruskal Wallis Test. Results: The following are an average IC respondent based on different IC dimensions and ward. Dimensions of helplessness: High Care Cardiac Unit (HCCU) 16.1 (SD = 4.06); Regular ward 12.86 (SD = 4.95); Outpatient 14.05 (SD = 5); Cardiac-Rehabilitation (CR) 11.04 (SD = 3.52) with p = 0.013. Dimensions of acceptance: HCCU 14.00 (SD = 2.7); Regular-ward 18.26 (SD = 2.7); outpatient 19.34 (SD = 2.88); RJ 18.20 (SD = 3.47) p = 0.005. Dimensions of perceived-benefits of HCCU 18.00 (SD = 3.6); Regular-ward 19.96 (SD = 2.76); outpatient 20.95 (SD = 3.01); RJ 20.08 (SD = 3.46) p = 0.043. Conclusion: The worst ICs of all dimensions were owned by respondents who were undergoing treatment at HCCU. ICs with relatively better are seen in respondents who were undergoing treatment in outpatient and cardiac-rehabilitation. ICs in CHD patients differ in all dimensions and categories of the ward. Thus, patient acceptance at HCCU need to be increased and as well as participation in cardiac rehabilitation so that patient perceived-benefits increase.

The Impact of CPR Position (Kneeling, Footstool and Standing Beside Bed) on Cardiopulmonary Resuscitation Quality: A Literature Review

Background: Cardiopulmonary Resuscitation (CPR) is one of the measures to deal with emergency cardiac arrest (cardiac arrest) where the heart organ loses its function suddenly. Hence it is unable to pump blood throughout the body. CPR consists of aid in circulation (compression) and breathing (ventilation). AHA has determined guidelines for implementing CPR, especially an essential point in CPR, namely chest compression. The standing position is fundamental in the implementation of CPR, but kneeling and footstool positions can be carried out during CPR implementation. This paper aims to show the impact of standing, kneeling, and footstool positions on CPR quality.Method: The method used is by searching journals in Science Direct, PubMed, and Google Scholar. The keywords used are CPR, Kneeling Position, Footstool, standing beside the bed Obtained eight selected journals according to the topic, then analyzed.Results: Based on the search result, eight articles meet the criteria. The literature review results showed three positions that can be chosen when conducting CPR: standing, kneeling, and footstool. Those positions could give impact toward helper: pain level and exhaustion degree, and quality of CPR: compression strength, depth of compression, amount of compression, chest recoil, elbow movement, and movement in the lower back.Conclusion: Three CPR positions can be done, including standing beside the bed, kneeling, and standing on stepstool footing. Each position gives impacts both to helper condition and CPR quality. Researchers recommend standing on stepstool footing due to it provides the best effect on CPR quality.

Heat Therapy to Reduce Chest-Pain Among Patients with Acute Coronary Syndromes (ACS): A Literature Review

The main clinical manifestations of patients with Acute Coronary Syndrome (ACS) during the acute period is chest pain. Handling complaints of pain patients with ACS definitively done with medication; however, it is possible to do additional nonpharmacological therapies to optimize the results. Nonpharmacological treatment can be performed in various ways, one of them with heat therapy. This literature review aimed to determine the use of heat therapy as an additional nonpharmacological intervention in reducing the intensity of chest pain in patients with ACS. Four electronic databases were used to carry out systematic searches on articles, namely Proquest, Science Direct, Pubmed, and CINAHL-Ebsco. The combination of keywords was "heat therapy" AND "chest pain" AND "acute coronary syndrome" NOT "Literature review" OR "Literature review" OR "Overview" OR "Systematic Review" OR "Meta-analysis." The inclusion criteria used were experimental study articles, peer-reviewed articles, and research articles written in English and performed in the period between 2014-2019. The search results obtained three articles that met the inclusion criteria and analyzed. The results of the study found that heat therapy effective in reducing the intensity of chest pain, the use of analgesic opioids, and improving the patient's hemodynamics. In conclusion, the therapy can be considered used as adjunctive therapy to reduce chest pain in patients with ACS with certain criteria. In addition, further research is also needed to see the effectiveness of this therapy if it is implemented with more frequent frequencies and compare its effectiveness in reducing chest pain if the application is given to the anterior or posterior of the chest.

Quality Of Life Patients With CAD After Percutaneous Coronary Intervention At Cardiac Center Rsup Dr. Hasan Sadikin Bandung

Quality of life of patients CAD after PCI needs to be seen as an evaluation of the interventions carried out, which need to be studied continuously by looking at health status, socioeconomic, and differences in the measurement tools used can be found differences from each item measured. This study aims to look at the quality of life of patients with CAD after PCI at the cardiac center of RSUP Dr. Hasan Sadikin Bandung. This study uses a quantitative descriptive method with a cross-sectional approach. The samples in this study were all patients CAD after PCI who were outpatient at RSHS Bandung. Samples were taken using purposive sampling technique and obtained 100 respondents. Data is collected using Macnew instruments by analyzing data using frequency distribution.The results showed that 95 respondents (95%) had a high quality of life. The quality of life results based on subvariables from highest to lowest are obtained as follows; emotional subvariable (94%) with a mean of 5.90, social subvariable (94%) with a mean of 5.84 and physical subvariable (93%) with a mean of 5.60.In conclusion, almost all respondents have a high quality of life which is reinforced by the results of high social and emotional aspects, but the physical aspects still need to be improved by providing adequate information regarding the patient's disease and the benefits of attending cardiac rehabilitation to improve the quality of life. In addition, physical, emotional and social management plays an important role in improving the quality of life of patients.Keywords: After Percutaneous Coronary Intervention, Coronary Heart Disease, Quality of Life

Readiness of Nursing Profession Students Universitas Padjadjaran on Handling Emergency Patients in Emergency Department

Nursing profession students need readiness to attend profession learning. Optimal readiness is directly proportional to optimal capabilities. The characteristics of emergency department tend to make nursing profession students the first and most frequent resource to deal with patients entering the emergency department. This study aims to determine the readiness of nursing profession students on handling emergency patients in emergency department.This study uses quantitative descriptive methods through approaches cross sectional. The population in this study was a nursing profession students of the Faculty of Nurisng, Universitas Padjadjaran as many as 66 respondents. The total sampling technique was used in this study. This research measuring instrument uses the READI-JV The results of the study were calculated using quantitative descriptive analysis using a cross-sectional approach.The results showed that as many as 51 (77.3%) nursing profession students are not ready to handle emergency patients. The percentage of readiness obtained in the leadership and administrative support dimensions was 85.2%, the readiness obtained in the operational competency dimension was 63.9%, the readiness obtained in the establishment dimension was 63.1%, the readiness obtained in the stress handling dimension was 57.6%, the readiness obtained in the dimensions of group integration and identification of 57.5%, readiness obtained in the survival skills dimension was 56.6%, and readiness obtained in the clinical competency dimension was 47.2%.The unpreparedness of nursing profession students is because most of the respondents have not attended emergency department training. So that it is necessary to optimize the learning methods during pre- profession by applying in accordance with emergencies and based on case studies as well as providing stress management to students to reduce stress levels in nursing profession students.

Effects of Abdominal Massage to Overcome Gastrointestinal Dysfunction in Patients in Intensive Care Unit: A Literature Review

Patients who are receiving treatment at the ICU have at least one symptom of gastrointestinal dysfunction including decreased bowel noise, abdominal distension, constipation, decreased frequency of defecation, and increased GRV (gastric residual volume). Non-pharmacological interventions that can be done to improve gastrointestinal function include abdominal massage. This paper aimed to conduct a literature review on the effects of abdominal massage to overcome gastrointestinal dysfunction in patients in the ICU. Articles taken from the Google Scholar and Science Direct electronic databases with the keywords abdominal massage, gastrointestinal function, bowel function, and ICU were published from 2015 to 2019. There were four research articles discussing abdominal massage to improve gastrointestinal function. Three articles used the Randomized Controlled Design method and one article used the Quasi Experimental method. Abdominal massage has a positive effect to improve gastrointestinal function in patients receiving treatment in the ICU. Improved gastrointestinal function that can be seen from the existence of a faster time in the reduction in gastric residual volume (GRV), decreased abdominal circumference, decreased gastric distension, and decreased the incidence of constipation. It is expected that abdominal massage can be applied by ICU nurses considering this intervention has the effectiveness in terms of time and funding.Keywords: Abdominal Massage, Gastrointestinal Function, Intensive Care Unit

Analysis of Factors Affecting the Weaning of Mechanical Ventilation at ICU RSUD Prof.Dr.Margono Soekarjo Purwokerto

The weaning of mechanical ventilation is a complex process and depends on many factors. The failure to wean mechanical ventilation may lead to prolonged duration of mechanical ventilation, which may increase the risk of ventilator associated pneumonia (VAP), morbidity, mortality, increased hospital costs and lower quality of hospital services. In the year 2016, in ICU RSUD Prof.Dr.Margono Soekarjo Purwokerto, in average there is a 20% failure of mechanical ventilation, if not followed up will adversely affect the patient. Factors investigated in this study included patient, nurses, collaboration and organization. The purpose of this study is to analyze the factors that affect implementation of the weaning of mechanical ventilation in ICU Room Prof.Dr.Margono Soekarjo General Hospital Purwokerto.The method used in this research was descriptive quantitative analytic design with cross sectional approach on 47 mechanical ventilation weaning activities. The sample selection was conducted by accidental sampling technique. Measurements for nurses were carried out using validated values including knowledge, experience and collaboration. While the observation sheet included the implementation of standard operating procedures for mechanical ventilation weaning, collaboration, patients APACHE II score and weaning results.The result of bivariate test showed that there were influence of patient (0.000), nurse (0,021), collaboration (0,024) and organization (0,011) to mechanical ventilation weaning activity. The result of logistic regression test showed that the patient was the most influential factor on mechanical ventilation weaning activity with 87% probability.Nurses should pay more attention to patients especially with high APACHE II scores (≥20) because of the risk of mechanical ventilation weaning failure. Assessment of weaning readiness must be carried out daily with appropriate assessment. While hospitals need to revise policies on mechanical ventilation weaning procedure and continue education and training programme related to patients criticality and collaboration.

The Effect of Workbook on Illness Cognition in Coronary Heart Disease Patients

Introduction: Recurrence of coronary heart disease (CHD) occurs due to non-compliance patients in managing CHD. One predictor of compliance with CHD management is illness cognition (IC), and IC can be improved through illness stimuli that can be done through health education in this study through workbooks. Purpose: This study aimed to identify the effect of the workbook on illness cognition in CHD patients. Methods. This research was a quasi-experimental with pretest-posttest control design. A pretest was done to the patient who was treated in the Cardiac Intensive Unit; posttest was carried out at the end of the first and second month after the pretest. The population was all post-acute CHD patients who were admitted to the cardiac intensive unit in one of the referral hospital in West Java, Indonesia. Purposive sampling was used and obtained 39 respondents who were divided into control and intervention groups. The instrument used was the illness cognition questionnaire (ICQ). Data were analyzed using the mean, median, percentage, and to estimate the effect of the workbook to the patients' IC used Wilcoxon and Friedman test. Results: The results showed an increase in acceptance and perceived benefits for both groups while in the helplessness showed the decrease scores. The p-value of IC comparison in the pre-test, post-test I, and II between groups for helplessness, acceptance, and perceived benefits were 0.118; 0.376; and 0.424, respectively. Besides, the p-value for differences of IC within control and intervention groups was less than 0.05. Conclusions: The workbook in this study generally did not provide significant IC changes to respondents.

Quality of Life for End-Stage Renal Disease (ESRD) PatientsUndergoing Peritoneal Dialysis (PD) Therapy: A Literature Review

Introduction: ESRD adalah diagnosis akhir yang membutuhkan terapi pengganti ginjal seumur hidup seperti hemodialisa, peritoneal dialysis (PD) dan transplantasi ginjal. Populasi di dunia dan prevalensi penyakit ginjal stadium akhir terus meningkat, pasien semakin dihadapkan dengan keputusan untuk memulai terapi pengganti ginjal. Penelitian dan literature review yang menilai dampak perawatan terapi PD pada pasien ESRD masih terbatas. Tujuan dari literature review ini untuk menganalisis terapi CAPD pada pasien ESRD. Pencarian terbatas pada database elektronik seperti Pubmed, Proquest, dan Google Scholar, dengan kata kunci “ESRD”,”CAPD”,“Peritoneal Dialysis”,“Quality of Life” disusun berdasarkan MeSH Database dari NCBI. Methods: Strategi review artikel menggunakan PRISMA (Preferred Reporting Items for Systematic Reviews and Meta Analyses) dan dianalisa menggunakan konten analisis. Studi yang diterbitkan antara tahun 2009-2019, artikel penelitian dengan bahasa inggris, dipertimbangkan sebagai kriteria inklusi dalam tinjauan ini. Results: Didapatkan 25 artikel; 15 kuantitatif, 7 kualitatif, 2 case report dan 1 mixed methods. Discussion: Domain fisik; PD memberikan kelebihan pada peran-fisik, vitalitas, energik, dan bebas nyeri. Domain psikologis; PD menimbulkan depresi dan kecemasan yang lebih rendah daripada HD, bahkan 1 studi menyebutkan HD dapat menyebabkan depresi berat. Hubungan sosial; PD memberikan kemandirian pada gaya hidup, efikasi diri, kebebasan beraktivitas, fleksibilitas, dan mempertahankan kehidupan normal. Hubungan terkait lingkungan; pasien dengan PD lebih mungkin untuk melanjutkan pekerjaan mereka sehingga mereka secara finansial lebih baik dan lebih bebas untuk bepergian daripada HD, penghasilan terus dapat secara signifikan berkontribusi pada kesejahteraan pasien CAPD. Conclusion: PD terbukti memberikan kualitas hidup yang lebih baik. Dengan demikian, penting untuk mengembangkan terapi PD pada pasien ESRD yang membutuhkan dialisis jangka panjang, bahkan seumur hidup.

The Effect of Blended Learning Approach on Student Satisfaction in the Learning Process at Master Degree Nursing Program in Indonesian Context

Nursing education at post graduate degree aims to produce graduates with the essential competencies as researchers which are closely related to the capability of implementing information technology which are in the global health era. However, the implementation of blended learning which combines e-learning approach into the learning process has characterised with various challenges for students and lecturers. These study aims are to identify the effect of the blended learning approach to student satisfaction on the learning process in the master's degree nursing program in Indonesian context.Method: The study was conducted in 2018, the quantitative approach has been utilized. Participants in this study are 88 post graduate nursing students who were selected with purposive sampling. Data collection was conducted through survey and analysis correlational with Pearson test.Finding of the study has indicated that the Blended learning approach as indicated in: Quality of Learning Process (QLP) in terms of Student Engagement and Accessibility & interactivity on average is 83% favourable and 17% unfavourable; and QLP from students’ perspective is 58, 96% favourable and 41.04 % unfavourable. Student satisfaction with blended learning process on average is 54.75% favourable and 45.25% unfavourable. The results of the Pearson analysis have shown that there is a very weak correlation between the Blended Learning approach and Student Satisfaction with correlation value of 0.180 and Significance value of 0.864. In this case, almost all participants stated that blended learning is essential as it makes the learning process more innovative and it motivates independent learning.