Objective To determine the impact of palliative care (PC) on end-of-life (EoL) care and the place of death (PoD) in children, adolescents, and young adults with life-limiting conditions. Method Eight online databases (PubMed, Medline, EMBASE, Cochrane Library, CINAHL, Airiti, GARUDA Garba Rujukan Digital, and OpenGrey) from 2010 to February 5, 2020 were searched for studies investigating EoL care and the PoD for pediatric patients receiving and not receiving PC. Results Of the 6,468 citations identified, 14 cohort studies and one case series were included. An evidence base of mainly adequate- and strong-quality studies shows that inpatient hospital PC, either with or without the provision of home and community PC, was found to be associated with a decrease in intensive care use and high-intensity EoL care. Conflicting evidence was found for the association between PC and hospital admissions, length of stay in hospital, resuscitation at the time of death, and the proportion of hospital and home deaths. Significance of results Current evidence suggests that specialist, multidisciplinary involvement, and continuity of PC are required to reduce the intensity of EoL care. Careful attention should be paid to the need for a longer length of stay in a medical setting late in life, and earlier EoL care discussion should take place with patients/caregivers, especially in regard to attempting resuscitation in toddlers, adolescents, and the young adult population. A lack of robust evidence has identified a gap in rigorous multisite prospective studies utilizing data collection.
Pendahuluan: Kecamatan Cerme merupakan salah satu kecamatan di Kabupaten Gresik dengan angka kejadian kecelakaan yang cukup tinggi dibandingkan dengan daerah lain. Kecelakaan ini memerlukan bantuan dan penanganan awal yang bisa dilakukan oleh orang awam, termasuk siswa SMU untuk mengurangi angka kecacatan dan kematian. SMU Muhammadiyah 8 dan SMK Muhammadiyah 3 berlokasi di tepi jalan raya dimana kecelakaan lalu lintas tersebut sering terjadi, namun pihak sekolah mengungkapkan belum bisa memberikan bantuan karena kurangnya pengetahuan dan ketrampilan dalam memberikan pertolongan pertama. Dengan demikian diperlukan suatu strategi untuk memberdayakan masyarakat dalam memberikan bantuan atau pertolongan pertama, yaitu melalui pengabdian masyarakat dalam rangka peningkatan kemampuan siswa SMU di Kabupaten Gresik dalam memberikan bantuan hidup dasar. Metode: Kegiatan pengabdian masyarakat dilakukan melalui pemberian edukasi melalui simulasi dan bermain peran (role play) kepada para siswa. Alasan dari pemilihan metode ini adalah karena siswa SMU pada dasarnya lebih menyukai pembelajaran partisipatif dibandingkan dengan ceramah. Pembelajaran simulasi akan memberi siswa kesempatan untuk belajar secara langsung melalui melihat, mempraktikkan, serta bermain peran cara melakukan pertolongan pertama pada kecelakaan atau memberikan bantuan hidup dasar. Dengan demikian diharapkan para siswa akan mengalami peningkatan pengetahuan, sikap dan tindakan dalam penanganan kecelakaan. Hasil: Kegiatan pengabdian masyarakat menghasilkan perubahan yang sesuai dengan target luaran yang telah ditetapkan yaitu peningkatan pengetahuan siswa tentang pertolongan pertama pada korban kecelakaan, meliputi tindakan bantuan hidup dasar, bebat bidai, dan transportasi khusus untuk orang awam. Kesimpulan: Pemberian edukasi melalui simulasi dan bermain peran dalam pengabdian masyarakat pada siswa SMU di Wilayah Kabupaten Gresik meningkatkan pengetahuan dan ketrampilan siswa akan pemberian pertolongan pertama pada korban kecelakaan.
Introduction: Foot ulcers cause women in Indonesia to lose opportunities to participate in religious and cultural activities due to the inability to wear certain footwear. This study examined body image as a mediator in the relationship between gender and quality of life (QoL) among patients with diabetic foot ulcer (DFU) in Indonesia. Method: A cross-sectional design with convenience sampling was used to recruit participants at the Surgical Outpatient Department and Wound Care Clinic in Bali, Indonesia. The Diabetic Foot Ulcer Scale–Short Form and the body image domain of the Body Investment Scale were administered. Results: We found gender differences in participants’ ( n = 201) QoL and body image ( p < .05). Body image fully mediated the effect of the relationship between gender and QoL (B = 6.68; 95% confidence interval [3.14, 10.52]) and explained 39.13% of the variance. Discussion: Health care providers should consider patients’ religious beliefs in DFU education and consider women’s body image issues. Diabetes foot ulcer may prevent women from performing religious rituals, thus, influencing their QoL. Protective strategies to prevent DFU among women in Indonesia warrant further development.
Abstract-In Indonesia, traditional healing, as it is known asSangkal Putung (SP) has been an alternative for fracture treatment. People with fracture at any age, anywhere and any case went to SP even there was a general hospital with surgery service. SP, where was the study taken is located in rural area where is approximately 40 km from Surabaya, the capital city of East Java Province. The study aimed to explore patient's experience of fracture healing at SP. The method and methodology were Hermeneutic Phenomenological study that used deep interviews. The participant was taken by purposive sampling, adult aged 25 to 55-years old and were at the second or more of healing series. Data originated from seven participants and 13 interviews. Interviews were recorded, transcribed verbatim and analysis. The findings showed that previous close friends, relatives and family's experience of SP were the main issued of decision-making process. Participants with several SP experience had different views of SP; they seemed that SP today is more convenient than before. Most of them stated that safety and comfort was the priority for the fracture healing. The concept of culture in the behavioral alteration of fracture healing can have on the participants.
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