Improving the Health and Functional Status of Institutionalized Older Adults Through the Nurse, Caregiver, and Older-Adults Partnership Model (Miradasia)

Abstract

Health and functional status are standard measurements in older adult’s services that showed physical and mental condition. However, institutionalized older adults with several adjustments and their limited source might cause compromised health and functional status. The quasi-experimental study aimed to investigate the effect of MiRaDaSia (nurses and caregivers joined the partnership model) on health and functional status among institutionalized older adults in Jakarta. It included 106 participants as intervention groups and 106 participants as control groups, who selected by multistage random sampling. We used the SF-12 and Barthel index to measure older-adults health and functional status. MiRaDaSia model was implemented for twelve weeks. Generally, there has been an increase in the mean of health and functional status after the intervention. There were significant improvements in functional condition between each group (p=0,001); however, mean difference oh health status show the significant increase only on six weeks following the intervention. MiRaDaSia can be implemented as a practical model to enhance services among institutionalized older-adults by professional’s staff as it encourages partnership among the nurse, caregiver, and the institutionalized older-adults. Future research may consider the effectiveness of the model in private institutional, with widening variation of older adults and caregivers’ characteristics as well as the different working environment of the institution. Keywords: caregiver, health status, functional status, institutionalized older-adult, older-adults, MiRaDaSia. Abstrak Model Kemitraan Perawat, Caregiver, dan Lansia (Miradasia) Dalam Meningkatkan Status Kesehatan Dan Fungsional Lansia di Panti. Status kesehatan dan fungsional merupakan pengukuran standar yang harus dilakukan dalam menilai pelayanan kesehatan lansia yang meliputi pengkajian sampai evaluasi. Kedua pengukuran tersebut pada akhirnya menggambarkan kondisi fisik dan mental lansia. Namun, kondisi lansia yang berada di panti dengan berbagai permasalahan kesehatan dan keterbatasan sumber daya dapat menimbulkan gangguan pada status kesehatan dan fungsional lansia. Penelitian ini bertujuan untuk mengetahui pengaruh pelaksanaan model praktik Kemitraan antara perawat, caregiver, dan lansia (MiRaDaSia) terhadap status kesehatan dan fungsional pada lansia yang tinggal di panti wilayah Jakarta. Penelitian dengan desain quasi-eksperimental melibatkan 2 kelompok yang terbagi menjadi 106 partisipan di kelompok intervensi serta 106 partisipan di kelompol kontrol. Pemilihan sampel dilakukan melalui multistage random sampling dengan alat pengukuran berupa SF-12 dan Barthel index untuk melihat staus kesehatan dan fungsional lansia. Model praktik keperawatan MiRaDaSia diimplementasikan selama 12 minggu pada kelompok intervensi. Secara umum, hasil penelitian menunjukkan bahwa terdapat peningkatan status kesehatan maupun fungsional status setelah intervensi model MiRaDaSia. Status fungsional secara signifikan mengalami peningkatan antara kelompok perlakuan (p=0,001) namun, beda reratastatus kesahatan menunjukkan peningkatan signifikan pada pengukuran 6 minggu setelah intervensi. terdapat peningkatan rerata status kesehatan setelah intervensi. Status kesehatan dan fungsional pada lansia dipengaruhi Model praktik keperawatan MiRaDaSia dapat diimplementasikan sebagai model praktik untuk meningkatkan pelayanan lansia oleh petugas maupuun tenaga profesional pada setting panti, karena memberikan penguatan pada kemitraan antara perawat, caregiver, dan lansia. Penelitian yang akan datang sebaiknya perlu mempertimbangkan penerapan model prakting di setting panti swasta, dengan variasi karakteristik lansia dan caregiver yang lebih banyak maupun lingkungan kerja institusi, untuk mengetahui lebih jauh tentang efektivitas model. Kata kunci: caregiver, lansia, lansia di panti, MiRaDaSia, status fungsional, status kesehatan

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