Penerapan Terapi Range Of Motion (Rom) Terhadap Peningkatan Kekuatan Otot Pada Pasien Dengan Stroke

A stroke is an injury to the brain caused by a blockage obstruction of blood flow to the brain. Weakness in the limbs is often found in patients with strokes. Range Of Motion therapy may help to increase the muscle strength that is experencing weakness, avoiding complications from inactivity, such us contractions. This study aims to describe the effect of ROM Therapy in stroke patients with impaired physical mobility. The design of the scientific essay was a case study of two stroke clients who had msucle weakness. A research instrument is an obsevation sheet on the scale of the muscle strength. This case study was conducted for six days of ROM therapy with a frequency of twice a day.The case study result showed that two respondents experienced an increase in muscle strength after ROM therapy. This study concludes that ROM therapy may increase muscle strength among stroke patients. Stroke patient families are expected to assist and support the patient during Range Of Motion exercises.Keywords: Muscle weakness strength, Range Of Motion, Stroke. Abstrak Stroke merupakan keadaan cidera pada otak yang disebabkan sumbatan atau obstruksi aliran darah menuju otak. Kelemahan pada anggota gerak sering dijumpai pada pasien dengan stroke. Pemberian terapi Range Of Motionbermanfaat untuk meningkatkan kekuatan otot yang mengalami kelemahan, menghindari komplikasi akibat kurang gerak, seperti kontraktur. Penelitian ini bertujuan untuk menggambarkan penerapan terapi ROM pada pasien stroke dengan gangguan mobilitas fisik. Desain karya tulis ilmiah berupa studi kasus pada 2 klien stroke yang mengalami masalah kelemahan otot. Instrumen penelitian berupa lembar observasi mengenai skala kekuatan otot. Studi kasus ini dilakukan selama 6 hari dengan frekuensi 2 kali sehari dengan intervensi penerapan terapi Range Of Motion (ROM). Hasil studi kasus menunjukan masalah gangguan mobilitas fisik yang dialami kedua responden mengalami peningkatan kekuatan setelah dilakukan terapi ROM. Kesimpulan terapi Range Of Motion(ROM) dapat untuk mningkatkan kekuatan otot pada pasien stroke. Saran bagi keluarga diharapkan keluarga untuk selalu melakukan pendampingan saat dilakukaSaran bagi keluarga diharapkan keluarga untuk selalu melakukan pendampingan saat dilakukan implementasi agar dapat menjadi supporting sistem bagi pasien dan dapat mengerti sehingga dapat membantu klien dalam melakukan latihan rentang gerak otot.Kata kunci: Kelemahan kekuatan otot, Range Of Motion, Stroke.

Identification of limb-specific Lmx1b auto-regulatory modules with Nail-patella syndrome pathogenicity

LMX1B haploinsufficiency causes Nail-patella syndrome (NPS; MIM 161200), characterized by nail dysplasia, absent/hypoplastic patellae, chronic kidney disease, and glaucoma. Accordingly in mice, Lmx1b has been shown to play crucial roles in the development of the limb, kidney and eye. Although one functional allele of Lmx1b appears adequate for development, Lmx1b null mice display ventral-ventral distal limbs with abnormal kidney, eye and cerebellar development, more disruptive, but fully concordant with NPS. In Lmx1b functional knockouts (KOs), Lmx1b transcription in the limb is decreased nearly 6-fold, indicating autoregulation. Herein, we report on two conserved Lmx1b-associated cis-regulatory modules (LARM1 and LARM2) that are bound by Lmx1b, amplify Lmx1b expression with unique spatial modularity in the limb, and are necessary for Lmx1b-mediated limb dorsalization. These enhancers, being conserved across vertebrates (including coelacanth, but not other fish species), and required for normal locomotion, provide a unique opportunity to study the role of dorsalization in the fin to limb transition. We also report on two NPS patient families with normal LMX1B coding sequence, but with loss-of-function variations in the LARM1/2 region, stressing the role of regulatory modules in disease pathogenesis.

The role of Magnetic Resonance Images (MRIs) in coping for patients with brain tumours and their parents: a qualitative study

Background When children and young people (CYP) are diagnosed with a brain tumour, Magnetic Resonance Imaging (MRI) is key to the clinical management of this condition. This can produce hundreds, and often thousands, of Magnetic Resonance Images (MRIs). Methods Semi-structured interviews were undertaken with 14 families (15 parents and 8 patients), and analysed using Grounded Theory. Analysis was supported by the Framework Method. Results Although the focus of the research was whether paediatric patients and their families find viewing MRIs beneficial, all patients and parents discussed difficult times during the illness and using various strategies to cope. This article explores the identified coping strategies that involved MRIs, and the role that MRIs can play in coping. Coping strategies were classified under the aim of the strategy when used: ‘Normalising’; ‘Maintaining hope and a sense of the future’; ‘Dealing with an uncertain future’; and ‘Seeking Support’. Conclusions Coping and finding ways to cope are clearly used by patients and their families and are something that they wish to discuss, as they were raised in conversations that were not necessarily about coping. This suggests clinicians should always allow time and space (in appointments, consultations, or impromptu conversations on the ward) for patient families to discuss ways of coping. MRIs were found to be used in various ways: to maintain or adapt normal; maintain hope and a sense of the future; deal with an uncertain future; and seek support from others. Clinicians should recognise the potential for MRIs to aid coping and if appropriate, suggest that families take copies of scans (MRIs) home. Professional coaches or counsellors may also find MRIs beneficial as a way to remind families that the child is in a more stable or ‘better’ place than they have been previously.

KARAKTERISTIK PEMENUHAN KEBUTUHAN SPIRITUALITAS PADA PASIEN YANG DIRAWAT DI RUANG ICU

Spirituality was important when an individual is sick. Patients ICU with spiritual distress, so they need to fulfill their spiritual needs. Fulfillment spirituality needs can be done by nurses and families. The purpose was to determine how nurses and patients' families fulfilling the spiritual needs of ICU patients. This study was a descriptive design. Nurses who work in the Intensive Care Unit (ICU) and families of ICU patients were the populations of this study. The sample size was determined using a purposive sampling technique, which 30 ICU nurses and 32 ICU patient families. The data collection tool used a questionnaire. Data analysis used univariate analysis with frequency distribution. The results show that 66.7% of the nurses fulfilled the spiritual needs of patients with a good category, 53.1% of the patients' families were a not good category in fulfilling ICU patient's spiritual needs. This study concludes that the fulfillment of spirituality needs in ICU patients has been optimally implemented by nurses but has not been optimally implemented by the family. Fulfillment spirituality needs in ICU patients by nurses with good categories so nurses are improved it through training and nurses can increase the family role.

The Application of Trauma-Informed Care to Substance Use Disorder

Trauma-informed care (TIC) has been described to apply to several groups of traumatized patient/families in the NICU. Trauma is multidimensional, including physical and psychological injuries with long-term effects on well-being and function. A newborn experiences the best outcomes when the mother also experiences the best outcomes. Thus, the TIC approach is applicable to the care of the infant with neonatal abstinence syndrome (NAS) and mother. Organizational adoption of this model is likely to provide a supportive and therapeutic environment for the infant with NAS and family.

How to talk with the family of a dying patient: anger to understanding, rage to compassion, loss to acceptance

Informing families about the impending or actual death of their relatives is one of the most challenging and complex tasks a physician may face. The following article describes goal setting and provides five roles/recommendations for conducting the encounter with patient families regarding the imminent or actual death of their relatives. Importantly, the encounter should be family-centred, and the physician should be highly attentive to family needs. The following roles should be applied based on family needs and should not be sequential as numbered. The first and basic role is to inform the family at the earliest possible time and as often as possible. The second goal of the physician is to convey to the family that their relative received the needed therapy during his hospitalisation or in the community. The third goal of the physician is to help the family reach acceptance of the death of their relative and leave the hospital having moved beyond anger and bargaining. The fourth goal of the physician during the encounters is to reduce or alleviate guilt by stating that nothing could have changed the course of the disease and that all efforts were made to save the patient. The fifth role of the physician is to try and help the family as a single entity and maintain their unity during this stressful situation. Following these roles/methods will help families in the stressful situation and will create the difference between anger and understanding, rage and compassion, and loss and acceptance.

A Retrospective Examination of Home PCA Use and Parental Satisfaction With Pediatric Palliative Care Patients

Introduction: Home Patient-Controlled Analgesia (PCA) is an effective and often preferred therapy for the treatment of chronic pain symptoms in the pediatric palliative care patient. There is little previous research of patient experience with Home PCA. The purpose of this study was to investigate use of home PCA devices in pediatric patients to inform palliative care providers considering an alternative management option for the treatment of end-of-life or chronic pain. Methods: A chart review was performed of patients prescribed home PCA. Surveys were sent to patients’ guardians/caregivers. Questions referred to caregiver impression/satisfaction with information provided regarding use of the PCA machine, the medication used, the benefits and risks of PCA, monitoring of patient pain level and alertness, machine efficacy, and fears and concerns. Results: Thirty-four patients met inclusion criteria, and 18 patient families completed surveys. Demographic data showed that the majority were Caucasian and had a cancer diagnosis. Patient age and duration of home PCA use varied greatly. Overall, participants were satisfied with information received and felt positively about home PCA, albeit expressing concerns. The majority described the machine as easy to use and were satisfied with their child’s pain management and level of alertness. Conclusion: Responses indicated that home PCA is a manageable and effective alternative to traditional analgesic medications for management of chronic pain in the pediatric patient.

Differential Use of Pediatric Video Visits by a Diverse Population During the COVID-19 Pandemic: A Mixed-Methods Study

Objective: To describe and explore pediatric ambulatory video visit use by patient characteristics during the coronavirus disease 2019 (COVID-19) pandemic.Methods: We conducted an explanatory sequential mixed methods study with integration at the design and methods level. Phase 1 was a cross-sectional analysis of general and specialty pediatric ambulatory encounters to profile the use of video visits by patient characteristics. We performed descriptive analyses for each variable of interest and estimated a multivariable logistic regression model to analyze factors associated with the odds of having a video visit. Phase 2 was a qualitative exploration using semi-structured interviews with healthcare team members to understand the contextual factors influencing video visit usage. We used an interview guide to solicit information related to general perceptions about ambulatory video visits, reactions to the quantitative phase data, and strategies for optimizing equitable reach of video visits. Data were analyzed using a combination of deductive and inductive analysis.Results: Among the 5,464 pediatric ambulatory encounters completed between March 11 and June 30, 2020, 2,127 were video visits. Patient factors associated with lower odds of having a video visit rather than an in-person visit included being Spanish-speaking (aOR 0.27, 95% CI 0.20–0.37) and other non-English-speaking (aOR 0.50, 95% CI 0.34–0.75) in comparison to English-speaking. Patients with public insurance also had a lower odds of having a video visit in comparison to privately insured patients (aOR 0.77, 95% CI 0.67–0.88). Qualitative interviews identified five solution-based themes: (1) Promoting video visits in a way that reaches all patient families; (2) Offering video visits to all patient families; (3) Mitigating digital literacy barriers; (4) Expanding health system resources to support families' specific needs; and (5) Engaging and empowering health system personnel to expand video visit access.Conclusion: We identified differences in pediatric ambulatory video visit use by patient characteristics, with lower odds of video visit use among non-English-speaking and publicly insured patients. The mixed-methods approach allowed for the perspectives of our interview participants to contextualize the finding and lead to suggestions for improvement. Both our findings and the approach can be used by other health systems to ensure that all patients and families receive equal video visit access.

Covid-19 & Stigma of Patient Families and Health Workers in Makassar City, Indonesia

Covid-19 has now become an epidemic that has spread almost all over the world and has caused morbidity and mortality. covid-19 in addition to having an impact on physical health also has an impact on the social and economic life of the community as well as mental disorders due to the stigma experienced by infected people, families, and health workers. This study aims to determine the role of knowledge about community stigma towards health workers and families of covid-19 patients in Makassar City, Indonesia. In this study using a quantitative method with a descriptive survey approach, the sample in this study was 105 respondents, which were taken by simple random sampling technique. The study found that public knowledge about covid-19 was related to stigma in the families of covid-19 patients (p=0.010) and knowledge was also associated with stigma to health workers (p=0.000). Stigma against families and health workers still occurs in Makassar City, due to the lack of knowledge possessed by the community and the existence of fake news or hoaxes that trigger the emergence of stigma against health workers and families of covid-19 patients.