AV fistula allows external vascular access for hemodialysis patients. Because hemodialysis patients experience puncture wounds and stabbing pain approximately 300 times a year, development of methods to decrease pain intensity are of great importance. Some techniques, such as the Valsalva maneuver, are known to reduce pain. This study aims to assess the effect of the Valsalva maneuver on decreasing the intensity of AV fistula pain in patients receiving hemodialysis. The quasi-experimental research of pre and post without control applying consecutive sampling to get as many as 63 respondents. Pain intensity was measured by using the Numerical Pain Rating Scale (NPRS). The Valsalva maneuver was performed during insertion of the AV fistula needle for 16-20 seconds. The results showed significant differences in pain intensity between before and after the intervention with the difference in mean that is 1.35 (SD= 0.54), t= 19.70, p= 0.001. The Valsalva maneuver is effective in reducing the pain of AV fistula insertion because it stimulates the vagus nerve to induce an antinociceptive effect. Nurses are highly recommended to teach the Valsalva maneuver to patients undergoing routine hemodialysis.
AV fistula allows external vascular access for hemodialysis patients. Because hemodialysis patients experience puncture wounds and stabbing pain approximately 300 times a year, development of methods to decrease pain intensity are of great importance. Some techniques, such as the Valsalva maneuver, are known to reduce pain. This study aims to assess the effect of the Valsalva maneuver on decreasing the intensity of AV fistula pain in patients receiving hemodialysis. The quasi-experimental research of pre and post without control applying consecutive sampling to get as many as 63 respondents. Pain intensity was measured by using the Numerical Pain Rating Scale (NPRS). The Valsalva maneuver was performed during insertion of the AV fistula needle for 16-20 seconds. The results showed significant differences in pain intensity between before and after the intervention with the difference in mean that is 1.35 (SD= 0.54), t= 19.70, p= 0.001. The Valsalva maneuver is effective in reducing the pain of AV fistula insertion because it stimulates the vagus nerve to induce an antinociceptive effect. Nurses are highly recommended to teach the Valsalva maneuver to patients undergoing routine hemodialysis.
The elderly are old people who already have a lot of time to practice their religious activities, including taking part in recitations. The elderly who do not regularly participate in recitation activities experience depressive symptoms such as; a lack of confidence, feeling lonely, and loss of enthusiasm and hope in life. This study aims to determine the difference in the level of depression in the elderly who attend recitations and do not attend recitations at Kaye Lee Village, Ingin Jaya District, and Aceh Besar District. This research is quantitative with a comparative descriptive approach. The number of respondents in this study was 88 seniors, with the condition 44 elderly people attended the recitation and 44 did not attend the recitation. Sampling was carried out using purposive sampling. The results showed that results of the Mann-Whitney test showed that the mean rank level of depression in the elderly in the group taking part in recitation was 38.52 and in the group not attending recitation was 50.49 and the p-value was 0.025. The level of depression in the group attending the recitation was lower than the group who did not attend the recitation, meaning that the elderly who were active in recitation activities had a lower risk of experiencing depression. It is recommended that the results of this study form the basis for establishing programs to empower the elderly in the community, such as recitation programs in the village for social interaction and spiritual needs with the surrounding community, especially on aspects of the quality of life for the elderly in facing old age.Keywords: depression; elderly; recitationPerbedaan Tingkat Depresi pada Lansia yang Mengikuti Pengajian dan Tidak Mengikuti Pengajian di Kecamatan Ingin Jaya Kabupaten Aceh BesarABSTRAK Lansia merupakan usia lanjut yang sudah memiliki banyak waktuuntuk mengamalkan kegiatan keagamaannya termasuk mengikuti pengajian. Lansia yang tidak mengikuti kegiatan pengajian secara rutin mengalami gejala-gejala depresi seperti merasa kesepian, kurang percaya diri, kehilangan semangat dan harapan. Penelitian ini bertujuan mengetahui perbedaan tingkat depresi pada lansia yang mengikuti pengajian dan tidak mengikuti pengajian di Desa Kaye Lee Kecamatan Ingin Jaya Kabupaten Aceh Besar. Penelitian ini bersifat kuantitatif dengan pendekatan deskriptif comparative. Jumlah responden dalam penelitian inisebanyak 88 orang lansia, dengan ketentuan lansia yang mengikuti pengajian 44 orang dan tidak mengikuti pengajian 44 orang. Pengambilan sampel dilakukan dengan menggunakan purposive sampling. Hasil penelitian menunjukkan dari hasil uji Mann-whitney didapatkan nilai mean rank tingkat depresi lansia pada kelompok megikuti pengajian sebesar 38,52 dan pada kelompok tidak mengikuti pengajian 50,49 serta nilai p-value 0,025. Tingkat depresi pada kelompok mengikuti pengajian lebih rendah dibandingkan kelompok yang tidak mengikuti pengajian, artinya lansia yang aktif dalam kegiatan pengajian memiliki resiko lebih rendah dalam mengalami depresi. Disarankan hasil penelitian ini menjadi dasar penetapan program-program pemberdayaan lansia dalam masyarakat, seperti program pengajian di desa untuk interaksi sosial dan kebutuhan spiritual dengan masyarakat sekitar, terutama pada aspek kulitas hidup lansia dalam menghadapi masa tua.Kata Kunci: depresi; lansia; pengajian
Introduction: combination between spinal cord injury without radiological abnormality (scIWOrA) and brown-sequard syndrome in a patient is a rare condition. In scIWOrA, there is usually a delay in neurologic deficits which can potentially lead to misdiagnosis. therefore, the clinician should have a good understanding of the course of the disease to make a good diagnosis and treatment. case report: reporting a case of female 20-yearold with chief complaint of severe neck pain and delayed limbs weakness. the mechanism of injury was fall with the head hit the ground in left lateral flexion position. the physical examination showed zero motor power of the right limbs and contralateral pain and temperature deficit one hour after the injury. We diagnosed the patient with incomplete spinal cord injury at c4 level with associated brown-sequard syndrome. We gave soft collar neck for immobilization, medication with NsAID for analgetic and Methylprednisolon. We found dramatic improvement in 10 hours
Arteriovenous fistula (AVF) merupakan akses vaskuler eksternal sebagai tempat penusukan berulang pada pasien hemodialisa yang menyebabkan nyeri berulang. Pemberian teknik valsava manuver salah satu terapi nonfarmakologi yang dapat digunakan untuk menurunkan nyeri berulang penusukan AVF. Penelitian ini bertujuan mengidentifikasi pemberian teknik valsava manuver terhadap intensitas nyeri penusukan AVF pasien hemodialisa. Penelitian kuantitatif ini dengan desain quasi experiment pre and post one sampel test. Pengambilan sampel dengan teknik consecutive sampling pada 33 orang. Analisis data menggunakan paired t-test. Hasil menunjukkan sebelum dilakukan teknik valsava manuver skala nyeri penusukan AVF adalah 4,82 (SD=1,402) dan sesudah dilakukan teknik valsava manuver skala nyeri penusukan AVF adalah 3,45 (SD=1,301). Ada perbedaan skala nyeri penusukan AVF sebelum dan sesudah pemberian teknik valsava manuver pasien hemodialisa dengan p value 0,000. Diharapkan pemberian teknik valsava manuver dapat menjadi intervensi mandiri keperawatan dalam menurunkan nyeri penusukan sehingga kenyamanan pasien hemodialis meningkat.Kata kunci: arteriovenous fistula; hemodialisa; nyeri penusukan, valsava manuverValsava Manuver Techniques To Pain Intensity Arteriovenous Fistula (AVF) Pain In Hemodialized PatientsAbstractArteriovenous fistula (AVF) is an external vascular access as a site for repeated punctures in hemodialysis patients which causes recurrent pain. The Valsalva maneuver is one of the non-pharmacological therapies that can be used to reduce repeated AVF stabbing pain. This study was purposed to identify the effectiveness of the Valsalva maneuver technique in reducing the intensity of AVF stabbing pain in hemodialysis patients. This quantitative research was a quasi-experimental pre and post one sample test design. Sampling technique used consecutive sampling technique on 33 people. Data analysis using paired t-test. The results showed that before the Valsalva maneuver the AVF stabbing pain scale was 4.82 (SD=1.402) and after the Valsalva maneuver the AVF stabbing pain scale was 3.45 (SD=1.301). There is a difference in the AVF stabbing pain scale before and after the Valsalva maneuver technique for hemodialysis patients with a p value of 0.000. It is hoped that the Valsalva maneuver technique can be an independent nursing intervention in reducing stabbing pain so that the comfort of hemodialysis patients increases. Keywords: Arteriovenous fistula, hemodialysis, stabbing pain, valsalva maneuver
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