Spondylolisthesis merupakan suatu pergeseran ke depan satu korpus vertebra (vertebral body) jika dibandingkan dengan vertebra yang terletak dibawahnya (inferior). Hal ini menyebabkan dampak mekanis, radikuler, atau nyeri. Tujuan: Studi kasus ini bertujuan untuk mengevaluasi pengaruh intervensi fisioterapi core stability exercise pada pasien wanita berusia 63 tahun dengan diagnosis spondylolisthesis dalam mengurangi nyeri dan meningkatkan aktivitas fungsional pada sendi lumbal. Metode: Core stability exercise yang diberikan pada penelitian ini berupa posterior pelvic tilt exercise, bridging exercise, bird-dog exercise, dan wall squat exercise dilakukan 9 kali treatment selama 3 minggu. Nyeri dievaluasi dengan menggunakan visual analog scale (VAS) dan aktivitas fungsional dengan oswestry disability index (ODI). Hasil Temuan: Setelah dilakukan 4 kali intervensi, terjadi penurunan nyeri pada gerak fleksi neck (2 poin), gerak fleksi trunk (1 poin), gerak fleksi hip bilateral(2 poin), nyeri tekan m. piriformis bilateral (1 poin), nyeri tekan m. hamstring bilateral (2 poin), nyeri tekan m. gastrocnemius bilateral (2 poin), dan nyeri tekan celah processus transversus vertebra L5(1 poin). Penurunan skor ODI menunjukkan penurunan disabilitas fungsional pasien sebanyak 9 poin. Kesimpulan: Berdasarkan hasil tersebut, dapat disimpulkan bahwa intervensi core stability exercise cukup efektif untuk mengurangi nyeri dan meningkatkan aktivitas fungsional pada pasien spondylolisthesis pada vertebra lumbal.
Alzheimer’s disease (AD) is the most common cause of dementia in older adults. Depression is an important co-morbid disorder in this group, as it may decrease their quality of life (QoL). Exercise or Reminiscence therapy (RT) is thought to be viable in lessening the degree of depression in older adults. To investigate and compare the impacts of integrated exercise and reminiscence therapy on depression level and QoL in older adults. A single-blinded quasi-experimental study with a comparison group design was conducted on 51 institutionalized older adults with mild-to-moderate AD and were grouped into (i) Reminiscence (RT, n = 17), (ii) exercise (EX, n = 16), and (iii) exercise coupled with Reminiscence (ER, n = 18). The depression level was assessed using the Cornell Scale for Depression in Dementia (CSDD); the QoL was assessed using the QOL–AD scale. A repeated-measures ANOVA was used for data analyses. Results: The reminiscence therapy alone or in combination with the exercise was effective in reducing depression levels and improved QoL in the older adults (p<.05). The reminiscence therapy alone or in combination with the exercise was effective in reducing depression levels and improved QoL in older adults. This study found significant improvements in the mean score of CSDD and QOL–AD of the ER, thus supporting its effectiveness in reducing depressive symptoms and improving QoL in mild AD. These results help as a contribute to the healthcare practices to deliver an integrated reminiscence and exercise in older adults’ rehabilitation.
Penelitian ini bertujuan untuk mengukur pelaksanaan program hand hygiene di Rumah Sakit Muhammadiyah Cirebon setelah akreditasi. Metode yang digunakan adalah metode analisis kualitatif, dengan rancangan studi kasus. Kasus penelitiannya adalah kelompok kerja Pencegahan Pengendalian Infeksi yang didalamnya terdapat program hand hygiene yang diukur dari strategi yang efektif, karakteristik organisasi, pengaruh perilaku petugas, pasien, dan pengunjung, serta dukungan anggaran dari manajemen setelah akreditasi. Instrumen penelitian menggunakan panduan wawancara dengan responden berjumlah 4 orang. Hasil Penelitian ini menunjukan bahwa Rumah Sakit Muhammadiyah Cirebon belum memiliki strategi yang efektif dalam membangun budaya hand hygiene. Organisasi Tim Pencegahan Pengendalian Infeksi setelah akreditasi tidak berjalan, sehingga belum ditetapkannya program kerja hand hygiene di Rumah Sakit Muhammadiyah Cirebon. Perilaku petugas dan pasien tingkat kepatuhan cuci tangan masih kurang, dikarenakan penggunaan bahan habis pakai setelah akreditasi masih rendah. Dari segi anggaran,karena tidak ada program kerja, maka usulan anggaran belanja dari tiap unit tidak menggambarkan kebutuhan program yang mencakup pelatihan, pengadaan bahan habis pakai, dan edukasi baik kepada petugas maupun pasien.
Community-Based Rehabilitation (CBR) units are growing in developing countries, including Indonesia. However, patient safety measures in CBR units have not yet been conducted, especially regarding flexible, unscheduled appointment system. This study aims to evaluate the unscheduled appointment system as a cause of errors in the care delivery of a CBR unit for children with disabilities in Makassar city. This case study conducted 278-hours observation and three structured interviews. The observation findings, encoded interview findings, field notes, and self-reflective notes were triangulated and link thematically. Four key findings were illustrated in an explorative model. The CBR unit implements a day-based scheduling system without time slots. Working in this system, the therapists experienced random visits, long waiting times, and excessive workload as results from this flexible scheduling system. Significant risks of human errors and patient safety were revealed due to these consequences. As flexible scheduling systems produce more negative effects to the therapists and children, it is suggested that a CBR unit or a health care unit implement a scheduled appointment system with timeslots to achieve prudent healthcare.
Physical activity has been evaluated to decrease mortality rates in people with diabetes mellitus. After the COVID-19 pandemic, healthcare delivery was leaned towards telemedicine or telehealth to conduct social distancing. The primary aim of this review is to evaluate formats and strategies used in telemedicine to improve physical activity in adults with diabetes mellitus. ProQuest, Medline, and CINAHL were searched for studies involving adults with diabetes mellitus (>18 years old); telemedicine; and physical activity outcomes. The quality of the studies was appraised using the JBI Critical Appraisal Checklists for risk of bias, study design, and quality of evidence. Data syntheses were conducted following simplified approach by Popay et al. Themes were developed based on the findings. Five randomized controlled trials met the inclusion criteria. The risk of bias was determined low in most of the studies. Text messages were the most common method. Pedometer, accelerometer, and International Physical Activity Questionnaires were commonly used to quantify the level of physical activity. Frequent reminders using text messages to the participants were the common strategy to ensure their adherence. The telehealth intervention has not yet shown significant positive effects on physical activity in people with diabetes mellitus. Further studies conducting synchronous and hybrid telehealth to improve physical activity in adults with diabetes mellitus were needed.
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