BackgroundHealth-related quality of life (HRQoL) assessment is important for patients with functional dyspepsia. However, no studies have assessed factors associated with HRQoL reduction in such patients in an Asian population. This study aimed to determine the contribution of clinical, psychosocial, and demographic factors to HRQoL in affected patients in Indonesia.MethodsIn a cross-sectional study, we recruited 124 patients in a tertiary hospital with functional dyspepsia according to Rome III criteria. HRQoL was measured using the Medical Outcomes Study Short-Form 36 (SF-36) physical component summary (PCS) and mental component summary (MCS) and compared with 2009 United States population norms. The factors investigated were age, gender, symptom severity, education level, employment status, anxiety, depression, and ethnicity. Factors associated with reduced HRQoL were identified using linear regression analysis.ResultsAll domains of HRQoL except vitality were impaired in patients with functional dyspepsia. The mean PCS was 42.3 (SD = 8.4); and the mean MCS was 47.8 (SD = 10). Increasing age (p = 0.002), female gender (p = 0.006), low-to-mid education level (p = 0.015) and greater symptom severity (p < 0.001) were significantly associated with impaired PCS (R2 = 0.36). Female gender (p = 0.047), greater symptom severity (p = 0.002), anxiety (p = 0.001), and depression (p = 0.002 were all significantly associated with an impaired MCS (R2 = 0.41). There were no significant associations between HRQoL and with ethnic group (Javanese/non-Javanese) or employment status.ConclusionsThere was significant HRQoL impairment in these patients with functional dyspepsia in Indonesia. Anxiety, depression, increasing age, female gender, greater symptom severity, and low-to-mid education level were significant factors associated with low HRQoL. Trial registrationClinicalTrials.gov NCT03321383. Registered 18 October 2017 retrospectively registered.

Pendahuluan. Pendekatan holistik di bidang psikosomatik menekankan bahwa faktor spiritualitas dan dukungan padasisi spiritualitas dapat meningkatkan pelayanan serta memperbaiki kondisi psikologis pada pasien. Selama prosedurhemodialisis, respon inflamasi akan meningkat, dibuktikan dengan peningkatan konsentrasi interleukin-6 (IL-6). Aspekspiritual diyakini dapat menurunkan respon inflamasi. Oleh karena itu penelitian ini dilakukan untuk menguji hubunganantara tingkat spiritual dangan kadar IL-6 pada pasien hemodialisis kronik .Metode. Penelitian ini merupakan studi cross sectional yang dilakukan pada 51 pasien hemodialisis kronik di unit hemodialisisRSUP. H. Adam Malik dan RSU. Dr. Pirngadi Medan mulai bulan Juli-Agustus 2014. Pemeriksaan kadar IL-6 serum diukurdengan metode quantitative enzyme-linked immunosorbent assay (ELISA) serta dilakukan pengambilan sampel darah.Sementara itu, pengukuran spiritual dilakukan dengan pengisian kuesioner FACIT Sp-12 pada pagi hari, yaitu 30 menitsebelum hemodialisis berlangsung.Hasil. Didapatkan rerata skor subskala meaning (makna) 10,67 (SB 2,66), peace (damai) 9,63 (SB 2,19) dan faith (iman) 11,47 (SB 2,91). Nilai median kadar IL-6 serum pada penelitian ini adalah sebesar 5,63 (1,48-28,88) pg/mL, sedangkan nilai median FACIT Sp-12 adalah 30,00 (18-48). Hasil uji korelasi antara tingkat spiritual dengan kadar IL-6 serum menunjukkan koefisien korelasi (r) sebesar -0,330 dengan nilai p= 0,018, secara statistik menunjukkan korelasi negatif yang lemah.Simpulan. Spiritual pada pasien hemodialisis kronik tergolong tinggi serta terdapat korelasi negatif yang lemah antaraaspek spiritual dengan kadar IL-6 pada pasien hemodialisis kronik.Kata kunci: FACIT Sp-12, hemodialisis kronik, IL-6 Correlation between Spiritual Aspect and Serum Interleukin-6 Level in Chronic Hemodialysis PatientsIntroduction. Holistic approach in psychosomatic focus on spirituality factor and spiritual support is expected to improve services and psychological condition of the patients. Inflammatory response during hemodialisis procedure hence increased with the evidence of increasing level of serum interleukin-6 (IL-6). Further research is still needed to see the spiritual factors that can decrease the inflammatory factors. Methods. Cross sectional study on 51 chronic hemodialisis patients at RSUP. H. Adam Malik and RSU dr. Pirngadi Medan between July-August 2014. Serum IL-6 was measured using quantitative enzyme-linked immune sorbent assay (ELISA) methods. Blood samples and spiritual aspect assessment by handing out FACIT Sp-12 questionnaire to patients were taken in the morning, 30 minutes before hemodialisis. Results. Subscale meaning 10.67 (SB 2.66), peace 9.63 (SB 2.19) and faith 11.47 (SB 2.91). Median serum IL-6 level is 5,63 (1,48- 28,88) pg/mL. Median FACIT Sp-12 is 30,00 (18-48). Correlation test between serum IL-6 level and spiritual aspect have shown statistically weak negative correlation (correlation coefficient -0,330, p=0.018). Conclusions: spirituality level in chronic hemodialisis patients are higher. Weak negative correlation between serum IL-6 level and spiritual level on chronic hemodialisis patients was found in this study. Keywords: Chronic hemodialisis, FACIT Sp-12, IL-6

Pendahuluan. Artritis Reumatoid (AR) merupakan penyakit kronik sistemik yang sering disertai dengan depresi pada 20-30% pasiennya. Derajat aktivitas penyakit AR dinilai dapat memengaruhi terjadinya depresi. Penelitian ini dilakukan untuk mengetahui proporsi depresi pada pasien AR dan hubungan antara derajat aktivitas penyakit dengan depresi pada pasien AR. Metode. Penelitian ini merupakan studi potong lintang yang dilakukan dengan memeriksa pasien AR di Poliklinik Reumatologi Departemen Ilmu Penyakit Dalam RS Cipto Mangunkusumo Jakarta yang memenuhi kriteria inklusi secara konsekutif pada bulan Januari sampai Maret 2017. Derajat aktivitas penyakit AR dinilai dengan menggunakan Disease Activity Score-28 (DAS 28) dan depresi dinilai dengan kuesioner Back Depression Inventory (BDI). Analasis statistik dilakukan dengan menggunakan dengan program SPSS versi 20.0. Hasil. Dari 145 subjek yang ikut dalam penelitian, sebanyak 90,3% di antaranya adalah wanita (131 orang). Median usia subjek adalah 55 tahun (rentang 19-83 tahun). Sebanyak 45 subjek (31%) memiliki masalah psikososial (stresor). Hasil analisis menunjukkan bahwa proporsi depresi pada pasien AR sebesar 35,9% (IK 95%=30-42%). Derajat aktivitas penyakit subjek yang diukur dengan DAS 28 menunjukkan bahwa proporsi subjek dengan derajat aktivitas AR ringan, sedang, dan berat secara berturut-turut yaitu 24 (82,8%), 52 (66,7%), dan 4 (23,5%). Hasil analisis chi-square menunjukkan bahwa terdapat hubungan yang bermakna secara statistik antara derajat aktivitas penyakit dengan depresi pada pasien AR (p = 0,001). Simpulan. Proporsi kejadian depresi pada pasien AR di RSCM adalah sebesar 35,9%. Derajat aktivitas penyakit memiliki hubungan yang bermakna dengan depresi pada pasien AR.

Background. There is a strong association between chronic ischemia and autonomic imbalance. Percutaneous coronary intervention (PCI) may restore autonomic balance in patients with stable coronary artery disease (SCAD), which is characterized by increased heart rate variability (HRV). Anxiety is often found in patients who are going to undergo invasive procedures and has been identified to induce autonomic imbalance. The aim of our study is to identify the impact of preprocedural anxiety on increased HRV following an elective PCI. Methods. Our study was a pretest and post-test correlation study involving 44 SCAD patients who underwent elective PCI at Cipto Mangunkusumo National Hospital. The HRV was measured before and after PCI. Anxiety symptoms were evaluated using Hospital Anxiety Depression Score (HADS) questionnaires. Results. We found a higher increase on HRV parameter following the PCI of subjects in the nonanxiety group compared with the anxiety group (median = 9.11 vs. 2.83; U = 154.00; p=0.043). Conclusions. Preprocedural anxiety may inhibit HRV increase following PCI procedure.