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"[ABSTRAKGangguan pendengaran akibat stroke yang terjadi pada jalur auditorik merupakan aspek yang sedikit sekali dieksplorasi pada pasien pasca stroke dan berpotensi menimbulkan dampak pada fungsi dan kualitas hidup. Pendengaran memfasilitasi komunikasi verbal sehingga hal ini penting untuk memberikan penatalaksanaan yang sesuai dan maksimal. Untuk mengukur proporsi gangguan pendengaran dan gangguan komunikasi verbal pada pasien pasca stroke dapat dilakukan pemeriksaan audiometri nada murni, audiometri tutur, dan audiometri tutur dalam bising untuk mengkaji bagaimana gangguan pendengaran berkorelasi dengan karakteristik demografik dan karakteristik klinis serta faktor yang mempengaruhi. Penelitian potong lintang ini dilakukan di RSUPN dr. Cipto Mangunkusumo Jakarta pada bulan November 2014 sampai Mei 2015, melibatkan 40 subyek pasien pasca stroke otak (eksklusi afasia, gangguan fungsi luhur dan gangguan kognitif) yang terdiagnosis dari pencitraan tomografi komputer kepala. Sebanyak 40% mengalami gangguan pendengaran sensorineural (ringan 37,5% dan sedang 20%). Gangguan pendengaran sentral didapatkan 12,5 dan campuran (sensorineural dan sentral) sebanyak17,5%. Didapatkan gangguan komunikasi verbal dalam suasana tenang dan bising 12,% sedangkan gangguan dalam suasana bising sebanyak 32,5%. Berdasarkan nilai odds rasio didapatkan kecenderungan faktor risiko usia lebih dari 60 tahun, letak lesi kortikal dan atau subkortikal serta vaskularisasi lesi dapat mempengaruhi gangguan pendengaran dengan atau tanpa disertai gangguan komunikasi dan secara statistik bermakna.

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ABSTRACTHearing loss due to stroke which disturb the auditoric path is less known, and may potentially effect the function and quality of life. Hearing facilitates a good speech hence it is important to give appropriate and optimal treatment. To measure the proportion of hearing loss and speech disorder in post stoke patient, we did pure tone audiometry, speech audiometry, and word in noise and to analyze how it could correlate with demographic, clinical characteristic and other factors. This cross sectional study was conducted in Cipto Mangunkusumo hospital Jakarta which started from November 2014 to May 2015, involving 40 samples after stroke patient (with the exclusion of aphasia and cognitive disorder) which were diagnosed with brain CT scan. Fourty percents patients had sensoryneural hearing loss (mild 37,5% and moderate 20%,). Central Hearing loss was found in 12.5% patients and mixed (sensorineural and sentral) hearing loss was found in 17.5%. Speech disorder in quite and noise background was found in 12.5% patients and disorder in noise background was found in 32.5% patients. Based on the odds ratio it is found that age older than 60 year old, cortical and or subcortical lesion, and vascularization of the lesion is the risk factor that can influence hearing disorder with or without speech disorder and it is statistically significance.;Hearing loss due to stroke which disturb the auditoric path is less known, and may potentially effect the function and quality of life. Hearing facilitates a good speech hence it is important to give appropriate and optimal treatment. To measure the proportion of hearing loss and speech disorder in post stoke patient, we did pure tone audiometry, speech audiometry, and word in noise and to analyze how it could correlate with demographic, clinical characteristic and other factors. This cross sectional study was conducted in Cipto Mangunkusumo hospital Jakarta which started from November 2014 to May 2015, involving 40 samples after stroke patient (with the exclusion of aphasia and cognitive disorder) which were diagnosed with brain CT scan. Fourty percents patients had sensoryneural hearing loss (mild 37,5% and moderate 20%,). Central Hearing loss was found in 12.5% patients and mixed (sensorineural and sentral) hearing loss was found in 17.5%. Speech disorder in quite and noise background was found in 12.5% patients and disorder in noise background was found in 32.5% patients. Based on the odds ratio it is found that age older than 60 year old, cortical and or subcortical lesion, and vascularization of the lesion is the risk factor that can influence hearing disorder with or without speech disorder and it is statistically significance., Hearing loss due to stroke which disturb the auditoric path is less known, and may potentially effect the function and quality of life. Hearing facilitates a good speech hence it is important to give appropriate and optimal treatment. To measure the proportion of hearing loss and speech disorder in post stoke patient, we did pure tone audiometry, speech audiometry, and word in noise and to analyze how it could correlate with demographic, clinical characteristic and other factors. This cross sectional study was conducted in Cipto Mangunkusumo hospital Jakarta which started from November 2014 to May 2015, involving 40 samples after stroke patient (with the exclusion of aphasia and cognitive disorder) which were diagnosed with brain CT scan. Fourty percents patients had sensoryneural hearing loss (mild 37,5% and moderate 20%,). Central Hearing loss was found in 12.5% patients and mixed (sensorineural and sentral) hearing loss was found in 17.5%. Speech disorder in quite and noise background was found in 12.5% patients and disorder in noise background was found in 32.5% patients. Based on the odds ratio it is found that age older than 60 year old, cortical and or subcortical lesion, and vascularization of the lesion is the risk factor that can influence hearing disorder with or without speech disorder and it is statistically significance.]"

"[ABSTRAKLansia paska stroke merupakan kelompok rentan (vulnerable population) karena memiliki masalah kesehatan yang terus meningkat, sulit mengakses pelayanan kesehatan, penghasilan menurun atau harapan hidup lebih singkat akibat kondisi kesehatan, memiliki penyakit kronik dan adanya ketidakmampuan dalam beraktifitas. Penulisan bertujuan memberikan gambaran pelaksanaan model intervensi? MABES? (Mandiri Bersama Stroke) dalam manajemen pelayanan dan asuhan keperawatan pada agregat lansia untuk meningkatkan kemandirian melalui integrasi teori dan model Community as Partner, Family Center Nursing, Konsekuesi dan teori self care serta integrasi CDM model dengan paskastroke di Kelurahan Sukatani. Hasil dari penerapan pelaksanaan model intervensi MABES secara mandiri oleh keluarga dengan kader sebagai pendukung dengan menggunakan buku pedoman dan kartu evaluasi diri mendapatkan hasil yang baik, dimana terjadi peningkatan rerata tingkat kemandirian lansia paskastroke dengan rerata nilai bartel pada bulan pertama 62,581, pada bulan kedua 60,806 dan pada bulan ketiga sebesar 74,032. Hasil uji statistik mendapat nilai <0,05 yang berarti ada perbedaan yang signifikan nilai bartel indeks dari pengukuran bulan pertama hingga bulan ketiga.

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ABSTRACTElderly post-stroke are vulnerable groups (vulnerable population) because they have health problems that continue to increase, they difficult to access health services to care the health problems, declining income or a shorter life expectancy due to health conditions, has a chronic disease and their inability in the activity. This application aims to provide an overview the implementation of the intervention model of 'MABES' in service management and nursing care to the elderly aggregate to increase independence through the integration of theory and models Community as Partner, Family Center Nursing, concquencys theory and the theory of self-care and also the integration of CDM models with post-stroke in Sukatani, Results of the application execution model of intervention MABES independently by a family with a health working of supporters by using the guidebook and self-evaluation card to get good results, where an increase in the average level of independence of elderly post-stroke with a mean value of 62.581 Bartel in the first month, in the second month 60.806 and in third at 74.032. Statist ical test results received value <0.05, which means there are significant differences bartel index value of the measurement of the first month until the third month. , Elderly post-stroke are vulnerable groups (vulnerable population) because they have health problems that continue to increase, they difficult to access health services to care the health problems, declining income or a shorter life expectancy due to health conditions, has a chronic disease and their inability in the activity. This application aims to provide an overview the implementation of the intervention model of 'MABES' in service management and nursing care to the elderly aggregate to increase independence through the integration of theory and models Community as Partner, Family Center Nursing, concquencys theory and the theory of self-care and also the integration of CDM models with post-stroke in Sukatani, Results of the application execution model of intervention MABES independently by a family with a health working of supporters by using the guidebook and self-evaluation card to get good results, where an increase in the average level of independence of elderly post-stroke with a mean value of 62.581 Bartel in the first month, in the second month 60.806 and in third at 74.032. Statist ical test results received value <0.05, which means there are significant differences bartel index value of the measurement of the first month until the third month. ]"

"Inkontinensia urin (IU) pasca stroke merupakan salah satu gejala sisa stroke yang mempengaruhi seluruh kehidupan pasien baik fisik, psikologis, sosial, dan spiritual pasien. Penelitian ini bertujuan mengembangkan model asuhan keperawatan berbasis teori human becoming dan self-care deficit theory of nursing dan teridentifikasi pengaruhnya terhadap penurunan insomnia dan peningkatan kualitas hidup pasien IU pasca stroke. Penelitian ini terbagi atas dua tahap yaitu penelitian kualitatif (studi kasus) yang melibatkan 18 informan, kemudian dilanjutkan dengan penyusunan model dan penelitian kuantitatif (non-equivalent control group pretest-posttest design) yang melibatkan 56 responden secara consecutive sampling, yang dibagi dalam kelompok intervensi dan kelompok kontrol dengan lama intervensi 8 minggu. Penelitian tahap ini dilakukan di empat rumah sakit di Kota Kendari kemudian dilanjutkan di rumah pasien. Hasil penelitian tahap satu didapatkan lima tema dari hasil wawancara mendalam sehingga dihasilkan model pengelolaan IU pasca stroke beserta buku panduan intervensi model, modul untuk pasien dan perawat. Hasil penelitian tahap dua membuktikan bahwa model ini berpengaruh dalam menurunkan insomnia dan meningkatkan kualitas hidup dengan p value < 0,05. Kesimpulan hasil penelitian yaitu model asuhan keperawatan berbasis teori human becoming dan self-care deficit theory of nursing berpengaruh dalam menurunkan insomnia dan meningkatkan kualitas hidup pasien

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Post-stroke urinary incontinence (UI) is one of the sequelae of stroke that affects the patient's entire life (physically, psychologically, socially, and spiritually). This study aims to develop a nursing care model based on the theory of human becoming and self-care deficit theory of nursing and identify its effect on decreasing insomnia and improving quality of life. This research was divided into two stages, namely qualitative research (case study) involving 18 informants, then continued with model development and quantitative research (non-equivalent control group pretest-posttest design) involving 56 respondents by consecutive sampling. Respondents were divided into the intervention group and the control group with an intervention duration of 8 weeks. This research was conducted in four hospitals in Kota Kendari and then continued at the patient's home. The results of the first phase of the study obtained five themes from the results of in-depth interviews so that a post-stroke UI management model was produced along with a model intervention guide, modules for patients and nurses. The results of the second stage of the study proved that the post-stroke UI management model had an effect on reducing insomnia and improving quality of life with p value <0.05. The conclusion of the research is that nursing care model based on the theory of human becoming and self-care deficit theory of nursing has an effect on reducing insomnia and improving the patient's quality of life"

"Gangguan tidur dipandang sebagai masalah potensial yang terjadi pada pasien pasca stroke. Dalam mengatasi gangguan tidur dibutuhkan intervensi psikologis dan perilaku. Penelitian ini bertujuan mengetahui pengaruh teknik relaksasi Benson dikombinasikan dengan Sleep Hygiene Education (SHE) terhadap kualitas tidur pasien pasca stroke. Metode yang digunakan quasi experiment pre-post test design with control group. Dari 58 responden, 30 responden kelompok intervensi menerapkan relaksasi Benson dikombinasikan dengan SHE dan 28 responden menerapkan relaksasi Benson sebagai kelompok kontrol.Hasil penelitian menunjukkan ada peningkatan kualitas tidur pada kedua kelompok (p=0,0001) setelah perlakuan dan terdapat perbedaan yang bermakna antara dua kelompok tersebut (p=0,0001). Relaksasi Benson dikombinasikan dengan SHE direkomendasikan sebagai salah satu terapi non farmakologi untuk mengoptimalkan kualitas tidur pada pasien pasca stroke.

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Sleep disorder was considered as a potential problem for post-stroke patients. To prevent sleep disorders, psychological and behavioral interventions are needed. The purpose of this study to evaluate the effect of Benson`s relaxation techniques combined with Sleep Hygiene Education (SHE) towards sleep quality of poststroke patients. Quasi experiment pre and post test design with control group was used. From 58 respondents, 30 person were implement Benson`s relaxation combined with SHE as intervention group and 28 person implement Benson`s relaxation as control group.The result shows there was increased sleep quality in both groups (p=0,000) and there was significant differences between the groups (p=0,0001). Benson`s relaxation combined with SHE was recommended as one of the non-pharmacological method to optimize sleep quality in post-stroke patients."

"ABSTRAKPasien pasca stroke saat kembali ke rumah, mereka mengalami masa transisi untuk mengembangkan fungsi fisik dalam aktivitas harian, kemandirian dalam fungsi sehari-hari dan kembali ke kehidupan komunitas. Mereka dihadapkan dengan hambatan kogntif, dependensi, kehilangan identitas, isolasi, kepercayaan diri, dan ketakutan akan kematian. Seluruh isu ini melibatkan persepsi seseorang mengenai self efficacy dalam aktivitas harian mereka. Self efficacy yang rendah dalam aktivitas harian dapat meningkatkan stres dan resiko depresi. Pasien pasca stroke perlu memegang kendali dan mengembangkan kemampuan dalam mengatur self control untuk adaptasi kondisi pasca stroke. Program self control merupakan salah satu penerapan modifikasi perilaku, yang dimana pasien pasca stroke diminta untuk memantau aktivitas harian, melakukan evaluasi, serta memberikan konsekuensi yang mengikuti kemunculan aktivitas harian secara mandiri. Desain penelitian ini termasuk dalam one group pretest-posttest design (before and after) yang diawali dengan pretest dan asesmen awal. Sebagai hasilnya pemberian 6 sesi program self control dapat meningkatkan self efficacy aktivitas harian pada partisipan, dimana secara kuantitatif terjadi peningkatan skor DLSES. Selain itu partisipan juga mengalami peningkatan dalam aktivitas harian. Partisipan merasa yakin akan kemampuan serta potensi yang dimiliki untuk menjalankan aktivitas harian. Partisipan mampu menetapkan tujuan, merencanakan aktivitas harian, serta solusi dalam menghadapi hambatan terkait kondisi pasca stroke. Untuk memperkuat komitmen dalam mempertahakan aktivitas harian diperlukan intervensi lanjutan berupa terapi keluarga atau support group.

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ABSTRACTWhen post-stroke patients come back to their homes, they endure a transition phase for developing their physical function in daily activities, independence in everyday function and returning to their community lives. They are faced with cognitive boundary, dependency, identity loss, isolation, self-trust, and fear of death. All of these issues involve other people?s perception about self-efficacy in their daily activities. Low self-efficacy in daily activities can increase both stress and risk of depression. Post-stroke patients need to hold control and develop their ability in adjusting self-control to adapt post-stroke condition. Self-control program is one of the applications behavior modification, in which post-stroke patients are asked to observe daily activities, evaluate, and give consequences which follows the emergence of independent daily activities. With the one group pretest-posttest design (before and after) in which it starts with a pretest and early assessment. As a result, giving six session of self-control program may improve self-efficacy in the daily activities of the participants, in which quantitatively there is an increase in DLSES score. Other than that, participants also experience an increase in daily activities. Participants feel assured with the ability and potential they have to do daily activities. Participants are able to establish a goal, plan daily activities, and give solution in facing obstacle related to post-stroke condition. To strengthen the commitment in maintaining daily activities, they need further intervention in the form of family therapy or support group.;"

"Mendampingi pencapaian perkembangan lanjut usia pasca stroke merupakan pengalaman unik dan berdampak pada keluarga. Keluarga memiliki cara, sikap dan perlakuan yang berbeda selama mendampingi lanjut usia. Tujuan penelitian memberikan gambaran pengalaman keluarga mendampingi pencapaian perkembangan lanjut usia pasca stroke dan memaknainya. Penelitian menggunakan desain kualitatif dengan pendekatan fenomenologi deskriptif. Partisipan adalah 14 orang caregiver utama lanjut usia di Rumah purposive sampling. Analisa data menggunakan Collaizi. Hasil penelitian teridentifikasi 5 tema yaitu : 1 dampak bio-psiko-sosio-spiritual pada lanjut usia pasca stroke, 2 keluarga memenuhi kebutuhan lanjut usia pasca stroke, 3 dampak pasca stroke pada lanjut usia yang dirasakan keluarga, 4 pencapaian perkembangan lanjut usia pasca stroke menurut keluarga, 5 makna merawat lanjut usia pasca stroke menurut keluarga. Rekomendasi penelitian adalah meningkatkan Psikoedukasi dan pembentukkan kelompok suppotif untuk keluarga. Kata Kunci : keluarga, lanjut usia, pasca stroke, perkembangan.

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Family Experience Accompanies the Achievement of Post Stroke Elderly Development Accompanies the achievement of post stroke elderly development is a unique experience and impact on the family. Families have different ways, attitudes and treatment during the elderly. The purpose of the study provides an overview of family experiences accompanies the achievement of post stroke elderly development and interpret it. The research used qualitative design with descriptive phenomenology approach. Participants were 14 primary caregiver of elderly at home purposive sampling . Data analysis using Collaizi. The results of the study identified 5 themes 1 the impact of bio psycho socio spiritual in the elderly post stroke, 2 the family meet the needs of elderly post stroke, 3 the post stroke impact on the elderly perceived by the family, 4 the achievement of the elderly development Post stroke by family, 5 the meaning of caring for elderly post stroke by family. The research recommendation is to improve Psychoeducation and formation of family suppotive groups. Keywords family, elderly, post stroke, development."

"Latar Belakang: Depresi merupakan dampak psikologis yang paling umum terjadi pada penderita stroke. Penanganan Depresi Pasca Stroke dapat membantu penderita beradaptasi dengan kondisi saat ini yang mempengaruhi kesehatan fisik dan kesejahteraan psikologis bagi para penderita, khususnya penderita lanjut usia. Tujuan: Untuk melihat efektivitas Rational Emotive Behavior Therapy (REBT) dalam menurunkan depresi pasca stroke pada penderita stroke lanjut usia. Metode: Satu orang lansia penderita depresi pasca stroke diberikan intervensi REBT sebanyak delapan kali pertemuan. Intervensi ini mencakup psikoedukasi, activity scheduling, restrukturisasi kognitif (disputing), pemecahan masalah, pemberian tugas rumah serta latihan relaksasi. Pengukuran efektivitas dilakukan sebelum dan sesudah intervensi diberikan dengan menggunakan Geriatric Depression Scale (GDS) dan Satisfaction With Life Scale (SWLS). Hasil: Partisipan mengalami penurunan depresi dan peningkatan kepuasan hidup setelah berpartisipasi dalam intervensi REBT. Kegiatan yang paling berperan dalam intervensi ini adalah latihan relaksasi dan activity scheduling. Kesimpulan: Intervensi REBT efektif dalam menurunkan depresi pada lansia penderita stroke.

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Background: Depression is the most common psychological effect that is found in stroke patients. Treating Post Stroke Depression (PSD) might help the patients to cope with current condition. It also affects the physical health and psyhological well being in patients, especially the elderly ones.

Purpose: To observe the effectiveness of Rational Emotive Behavior Therapy (REBT) in reducing depression in an elderly stroke patient.

Methods: The REBT intervention was given to an elderly PSD patient. The intervention consists of eight sessions with following activities: psychoeducation, activity scheduling, cognitive restructuring (disputing), problem solving, homework, and relaxation. The effectiveness of the therapy is measured by Geriatric Depression Scale (GDS) dan Satisfaction With Life Scale (SWLS) that was given before and after the intervention.

Results: The participant experienced a decrease in depression and improvement in life satisfaction after participating in this intervention. Relaxation and activity scheduling, among others, are considered to be the most influencing activities in the intervention.

Conclusion: A Rational Emotive Behavior Therapy (REBT) is effective to reduce depression in an elderly stroke patient."