Depression in Patients with Heart Failure: A Phenomenological Study

Depression is a common comorbid condition among patients with heart failure (HF). Depression in HF is associated with poor health outcomes, increased risk of mortality, readmission, and decrease in functional status. The aim of this study was to explore the experience of HF patients related to symptoms of depression. The study was conducted at a government hospital in East Java, Indonesia and used a phenomenological approach. The population of this study was inpatients with HF who were obtained through a purposive sampling technique. Eighteen HF patients were recruited as participants. Data collection took place from February to May 2016 by interview and field notes. Collected data was analyzed through thematic analysis. There were three main themes that emerged from the data: cognitive function, emotional, and somatic responses to disease. HF patients reported impaired cognitive functions, especially in decision making and perception of disease. They also had several emotional responses including sadness, guilt, hopelessness, suicide, crying, and anger. There were also somatic responses including energy loss, fatigue, disruption of sleep patterns, decreased appetite and sexual interest. Understanding the description of depressive symptoms in HF patients can help nurses and other health professionals provide appropriate interventions to reduce depression. Keywords: heart failure, depression, symptom, qualitative, patient’s experienc

SLEEP THERAPY AS IMMUNOMODULATOR OF ELDERLY WITH SLEEP DISORDER

Introduction: Sirep is one of the nursing intervention to solve sleep problems. Moreover, sirep as immunomodulator for cortisol level, IFN-γRa and IL-10 is still unknown.       Sleep disorder can make decrease of immunity, concentration disability, decrease of coordination, alteration of personality, etc. Decrease of immunity can caused by increase or imbalance of stress hormone (cortisol). Increase of cortisol in along time can suppresed T lymphocytes. Objective of this study was to analyze the effect of sleep therapy (sirep) as immunomodulator in elderly with sleep disorder Method: This study used Quasy-Experimental Pre-Post Test Control Group Non Randomised design. Result: Result showed that Sleep therapy (sirep) can changed IFNgRa level in serum elderly with Wilcoxon Sign Rank Test had p0.01. Discussion: Sleep therapy of elderly can released cortisol level serum changing, so sleep therapy as immunomodulator in elderly with sleep dissorder was verified. Discussion: Sleep therapy must applied on elderly with sleep disorder, because sleep therapy become immunomodulator on elderly with sleep disorder was verified

Oral squamous cell carcinoma patients which human papilloma virus infection: a case control study in Muwardi Hospital Surakarta, Central Java, Indonesia

Abstract. Prayitno A, Aznar E, Poernomo, Putra ST. 2011. Oral squamous cell carcinoma patients which human papilloma virus infection: a case control study in Muwardi Hospital Surakarta, Central Java, Indonesia. Nusantara Bioscience 3: 64-67. Annual incidence rates for oral and pharyngeal cancer are estimated at 25 cases per 100,000 in developing countries. Human papilloma virus (HPV) was implicated in pathogenesis of Oral Squamous Cell Carcinoma (OSCC). Aims of this research were to know the incidence of OSSC patient which realized HPV infection. Women OSCC (15) and Benign Oral Squamous Cells (BOSC) (40) tissue biopsy frozen sections were from Departement of Oral and Dental, Muwardi Hospital in Surakarta from January to December 2007. Tissue was cut into two parts. To ascertain the type of neoplasm was subsequently stains with HE. To amplify the L1-HPV gene for 450bp long. The collected data was analyzed by Chi Square Test. The result of this experiment showed nine patients from 40 patients BOSC identified have HPV infections (9/40 = 23%). Eleven patient from 15 patient OSCC identified have HPV infections (11/15 = 73%). From Chi Square analysis have significant differences between BOSC and OSCC. HPV is a factor for OSCC pathogenesis. Key words: developing countries, HPV, pathogenesis, OSCC, Moewardi Hospital. Abstrak. Prayitno A, Aznar E, Poernomo, Putra ST. 2011. Pasien oral squamous cell carcinoma dengan infeksi virus papiloma manusia: studi kasus kontrol di Rumah Sakit Muwardi Surakarta, Jawa Tengah, Indonesia. Nusantara Bioscience 3: 64-67. Tingkat insiden tahunan untuk kanker mulut dan faring diperkirakan mencapai 25 kasus per 100.000 di negara-negara berkembang. Human papilloma virus (HPV) terlibat dalam patogenesis Oral Squamous Cell Carcinoma (OSCC). Tujuan penelitian ini adalah untuk mengetahui kejadian pasien OSSC yang mengalami infeksi HPV. Irisan beku biopsi jaringan OSCC (15) dan Benign Oral Squamous Cells (BOSC) (40) wanita diperoleh dari Bahian Mulut dan Gigi Rumah Sakit Muwardi Surakarta, dari bulan Januari sampai Desember 2007. Jaringan dipotong menjadi dua bagian. Untuk memastikan jenis neoplasma, maka diwarnai dengan HE. Untuk gen L1-HPV digunakan penanda berukuran 450bp. Data yang dikumpulkan dianalisis dengan Chi Square Test. Hasil penelitian ini menunjukkan sembilan pasien dari 40 pasien BOSC diidentifikasi mengalami infeksi HPV (9/40 = 23%). Sebelas pasien dari 15 pasien OSCC diidentifikasi mengalami infeksi HPV (11/15 = 73%). Dari analisis Chi Square terdapat perbedaan yang signifikan antara BOSC dan OSCC. HPV merupakan faktor patogenesis OSCC. Kata kunci: negara berkembang, HPV, patogenesis, OSCC, Rumah sakit Muwardi

The Expression of CD8+ and MHC-I in Cervical Cancer with HPV Infection

Introduction: The immunity against cervical cancers is many unknown. Major histocompatability complex class I (MHC-I) with the alpha domain has binding site for Cytotoxic T cells (CD8+) to target cells. The objective of this ex- periment is to known the expression of CD8+ and MHC-I in cervical cancer with HPV infection. Method: DNA was isolated from seventeen sample cervical cancer tissues frozen section. Diagnose related with HPV was made by PCR. Paraffin block of the tissues was cut in thoroughly cleaned cryotome and place in glass plate that covered with poly-elysine. The immunohistochemistry is done with monoclonal antibody again MHC-I and CD8+ with TSA-indirect method. The power of expression was counted the number of positive cells to express the MHC-I and CD8+ every 100 cells per one view look. Result: The Result of this experiment show that expression of MHC-I and CD8+ in cervical cancer with HPV infection is in mild category (30% - 70%). Conclusion: Immunity against uterine cancer that played by MHC-I and CD8+ are in milt category. The experiment that related with uterine cancer immunology is suggested

Development of the Mind-Body-Spiritual Nursing Care Model (MBS) for Coronary Heart Disease Patients

Introduction:Patients with coronary heart disease (CHD) may experience various physical, psychological or spiritual issues. A holistic mind-body spiritual nursing care (MBS) model is needed to help patients' cope with the issues. This study aimed to develop an MBS nursing care model for CHD patients.Method:The study employed a crossectional design with 110 CHD patients participated in the study. Respondents were asked to fill out questionnaires to gather the required data. Criteria for respondent selection were Moslem, aged 40-75 year, medical diagnosis of CHD, and haemodynamically stable. The independent variables were focal, contextual and residual stimuli, while the dependent variables were coping and spirituality. Data were analyzed using partial least square.Results:The results show that the mind-body-spiritual nursing care formed focal stimuli. Spirituality is formed by focal, contextual, residual stimuli and coping style. Nursing care significantly affects spirituality, shown by T-statistics of 6.795. Spirituality can be explained by patience, endeavour toward wellness, and offer the results only to the God by 72%, while the rest is explained by other factors.Conclusion:MBS nursing care model has a strong relationship with spirituality. This model needs to beapplied in a further research to see its effectiveness in improvingspirituality and expression ofcardiovascular risk inflammatory markers

THE ELEVATION OF OSTEOBLAST ACTIVITY IN RAT BONE MARROW MESENCHYMAL STEM CELLS IN OSTEOGENIC MEDIUM EXPOSED WITH MELATONIN IN PHYSIOLOGICAL DOSES

The objective of this study was to analyze the elevation of osteoblast activity in bone marrow mesenchymal stem cells (BM-MSCs) in osteogenic medium by physiological doses of melatonin administration by measuring alkaline phosphatase (ALP) and osteocalcin level.This studyused BM-MSCs from Rattusnorvegiccus femur bone. Rat BM-MSCs were cultured in a-Mem medium, differentiated in osteogenic medium, and administrated melatonin up to 21 days. This study was divided into 4 groups, K0 (control group), K1 (administrated of 25 nM melatonin), K2 (administrated of 50 nM melatonin), and K3 (administrated of 100 nM melatonin). Rat BM-MSCs were characterized CD 45- and CD 105+ marker using imunocytochemistry analysis and stained with Alizarin red after 15 days treatment. ALP and osteocalcin level were measured using ELISA Kit in days 21st.There weren’t differences ofALP level beetwen groups and there are differences ofosteocalcin level between control groups (K0) withK1, K2, dan K3, and beetwen K1 and K2. The conclusion of this study was that there were an elevation of osteoblast activity in rat BM-MSCs in osteogenic medium by physiological doses of melatonin administration characterized by the elevation of osteocalcin level

PENINGKATAN COPING KELUARGA DALAM MERAWAT PASIEN GANGGUAN JIWA MELALUI TERAPI SPIRITUAL DIRECTION, OBEDIENCE, DAN ACCEPTANCE (DOA) (The Improvement of Family Coping in Taking Care of Patient Mental Disorder with Spiritual Therapy; Direction, Obedience and Acceptance (DOA)

Introduction: Mental disorder remains a stigma in society, even until now. A family who have a member with mental disorder, will experience continues objective and subjective burden, experience serious stress for a lifetime, which may cause ineffective coping. Method: Design used in this study was experimental (pre post test control group design). The population was every family of patient with mental disorder in Menur Mental Hospital along the year of 2010, has been taking care there twice, in minimum, lived in Surabaya. The samples were chosen by allocation simple random. Samples were 13 persons in each treatment and control group. The intervention was given in 60–120 minute in 8 times meeting with average interval about 1 week. Data analysis was done using paired t-test and independent t-test. Result: Results in this study showed that there was signi fi cant change in total of family coping (p = 0.040), maintaining family integration, cooperation and an optimistic de fi nition of the stuation (p = 0.009), maintaining social support, self esteem, and psychological stability (p = 0.230), understanding the medical situations through communication with other parents and concultation with medical staff (p = 0.025). Discussion: The provision of family therapy with spiritual approach (DOA) can increase family coping in taking care of patient with mental disorder

SELF MANAGEMENT PROGRAM MENINGKATKAN KOPING, NIAT DAN KEPATUHAN BEROBAT PASIEN PJK (Self Management Programme Improve Coping, Intention, and Medication Adherence in Patients with Coronary Heart Disease)

Manajemen penyakit jantung koroner (PJK) memerlukan pengobatan seumur hidup. Keberhasilan pengelolaan PJK membutuhkan koping efektif, niat dan kepatuhan berobat dari pasien PJK. Tujuan penelitian ini untuk menjelaskan perubahan koping, niat, dan kepatuhan minum obat pada pasien dengan PJK setelah memberikan program manajemen diri di RSUD Jombang berdasarkan Teori Perilaku Direncanakan. Metode: Desain penelitian adalah quasy exsperimental pretest-posttest group design dengan jumlah sampel 28 secara konsekutif sampling. Variabel independen yaitu self management program dan variabel dependen yaitu koping, niat, kepatuhan berobat. Data dikumpulkan dengan menggunakan kuisioner dengan mengukur tingkat koping, niat dan kepatuhan berobat. Uji statistik yang digunakan adalah mann whitney, wilcoxone signed rank dan t-test. Hasil: Hasil penelitian menunjukkan bahwa 1) program pengelolaan diri meningkatkan tingkat mengatasi pada pasien dengan PJK (p < 0,001), 2) program manajemen diri meningkatkan tingkat niat pada pasien dengan PJK (p < 0,001), 3) program manajemen diri meningkatkan tingkat kepatuhan pengobatan pada pasien dengan PJK (p < 0,001). Diskusi: Untuk mengubah sebuah perilaku membutuhkan perbaikan tingkat koping dan niat. Hal ini sesuai dengan Teori Perilaku Direncanakan bahwa perubahan perilaku dipengaruhi oleh sikap terhadap perilaku, norma subjektif, kontrol perilaku yang dirasakan, dan niat

Psikoedukasi Dzikr Menurunkan Kadar Kortisol dan Meningkatkan Kadar IGG pada Ibu Primipara

Background: Unstable emotions that are common during the perinatal period affect hormonal regulation and affect immunity. Research of psychoeducation dhikr be important was done to reduce perceived stress so that cortisol levels can be controlled hence IgG increases.Purposes: to prove additional psychoeducation of dhikr in routine midwifery care more influential on decreasing cortisol and increasing IgG among primiparous women.Methods: This study was an experimental study. A number of 24 participants as intervention group and a number of 23 participants as control group. Cortisol and IgG levels measured using ELIZA kits in the third trimester of pregnancy, the three days and tenth days after birth. Statistical test using General Linear Model and independent t test to compare Δ score.Results: The result showed mean difference between groups on the end of interventions, cortisol 18.95, CI 95% (-13.42 – 51.33) and p value is 0.245. The difference of the IgG between groups 482.72, CI 95% (55,51 - 909,93) and p value is 0.028.Conclusions: Additional psychoeducation of dhikr in routine midwifery care has more decrease Cortisol and increase IgG levels in primiparous women. Keywords: Cortisol, Psychoeducation Dzikr, IgG, Primiparou