Patients In Indonesia Research Articles

The efficient use of smartphone apps to improve the level of asthma knowledge

Patient education is one of the important aspects of improving knowledge and quality of asthma control. In this digital era, it can be made with the support of an app – or known as mHealth. Unfortunately, implementing applications for patient education is relatively new among asthmatic patients in Indonesia. This study aimed to determine the efficacy of the educational content of the AsmaDroid® app on the levels of asthma knowledge among asthmatic patients. This study was a randomized controlled trial carried out from December 2019 to March 2020 in the Special Region of Yogyakarta, Indonesia. A quota sampling was employed, resulting in 140 study participants being categorized into control and treatment groups. Before and after the 4-week treatment period, all participants were asked to complete a pre-test and post-test of the Asthma General Knowledge Questionnaire for Adults (AGKQA) questionnaire. All the scores were then compared to determine the efficacy of educational content on the levels of asthma knowledge. The results of descriptive statistics reported that the pretest scores of AGKQA from the control group (minimum, maximum, and mean) were 9, 25, and 19.04±2.56, respectively, and post-test scores were 10, 27, and 18.79±3.59 (p=0.47). Meanwhile, in the treatment group, these were 13, 25, and 19.11±2.87, while post-test scores were 16, 31, 23.6±3.95 (p=0.01). Additionally, there was a difference between the post-test scores of the control and treatment groups, namely 4.81 (p=0.01). The educational content of the app significantly improved the levels of asthma knowledge.

Features of COVID-19 adult patients and the treatment in Indonesia: a retrospective cohort study

Background: Coronavirus disease of 2019 (COVID-19) is a new disease that causes clinical symptoms that vary from mild to severe. As a new disease, there is no standard treatment for the disease. Several drugs are used to treat COVID-19, most of which were previously used for other diseases, and the efficacy in COVID-19 is not yet known. This study aimed to evaluate COVID-19 therapy in the early phase of the pandemic. Methods: In this study, we evaluate data on the characteristics of hospitalized COVID-19 patients in several hospitals in Indonesia from March until December 2020. We also evaluate the therapy given and the results of the therapy. Results: Most hospitalized patients in this study were mild to moderate COVID-19 patients. The most common combination therapy was chloroquine/ hydroxychloroquine + Azithromycin (79.4%). A small number of patients received chloroquine/ hydroxychloroquine without Azithromycin (9.3%), and only a few did not get chloroquine/ hydroxychloroquine therapy (10.8%). The clinical outcome appeared to be better in the chloroquine/ hydroxychloroquine + azithromycin group than in the other groups. The mortality rate was lower in the chloroquine/ hydroxychloroquine + azithromycin group (2.6%) compared to those in the chloroquine/ hydroxychloroquine group (52%) and the group without chloroquine/ hydroxychloroquine (38%). However, the chloroquine/ hydroxychloroquine + azithromycin group had better baseline characteristics and received more additional medications, such as oseltamivir, corticosteroid, and levofloxacin, rather than levofloxacin, the other groups. Conclusion: Hospitalized COVID-19 patients in Indonesia from March until December 2020 mostly had mild to moderate COVID-19. Most of them received treatment combinations consisting of chloroquine/ hydroxychloroquine and Azithromycin. The most common combination therapy for hospitalized COVID-19 patients was chloroquine/ hydroxychloroquine + Azithromycin. The clinical symptom improvement was seen mainly in this group.

The influence of health, lifestyle and socio-economic factors of liver disease patients in Indonesia

The influence of health, lifestyle and socio-economic factors of liver disease patients in Indonesia

Quality of Life Determinant Factors in Tuberculosis Patients in Indonesia: Literature Review

Tuberculosis patients undergo treatment and care for a long time which will have an impact on their well-being. Good patient welfare will have an impact on the patient's quality of life in their daily lives. The quality of life possessed by tuberculosis patients is important because it can affect the success of treatment. The purpose of this study was to analyze the factors that influence the quality of life of tuberculosis patients in Indonesia. The research design used is a literature review using keywords based on PICo using a database of research articles, namely ScienceDirect, ProQuest, PubMed, Google Scholar and Garuda from 2016-2021. There were 13,782 articles with 18 relevant articles for review and analysis. The low quality of life of tuberculosis patients is influenced by factors of age, education, stress, depression, stigma, medication adherence and social support . Abstrak: Pasien tuberkulosis menjalani pengobatan dan perawatan yang cukup lama yang akan berdampak pada kesejahteraan yang dialaminya. Kesejahteraan pasien yang baik akan berdampak pada kualitas hidup pasien dalam kesehariannya. Kualitas hidup yang dimiliki oleh pasien tuberkulosis merupakan hal yang penting, karena dapat mempengaruhi kesuksesan pengobatan. Tujuan penelitian ini adalah untuk menganalisis faktor-faktor yang mempengaruhi kualitas hidup pasien tuberkulosis di indonesia. Desain penelitian yang digunakan merupakan literature review dengan menggunakan kata kunci berdasarkan PICo dengan menggunakan data base artikel penelitian yaitu ScienceDirect, ProQuest, PubMed, Google Scholar dan Garuda dari tahun 2016-2021. Didapatkan 13.782 artikel dengan 18 artikel yang relevan untuk dikaji dan dianalisis. Rendahnya kualitas hidup yang dimiliki oleh pasien tuberkulosis dipengaruhi oleh faktor usia, pendidikan, stres, depresi, stigma, kepatuhan pengobatan dan dukungan sosial.

Adding rituximab to chemotherapy for diffuse large B-cell lymphoma patients in Indonesia: a cost utility and budget impact analysis

BackgroundRituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) has been used to treat patients with diffuse large B-cell lymphoma (DLBCL) under National Health Insurance (NHI) scheme in Indonesia. This study aims to estimate its cost-effectiveness and budget impact.MethodsWe conducted a cost utility analysis using Markov model over a lifetime horizon, from a societal perspective. Clinical evidence was derived from published clinical trials. Direct medical costs were gathered from hospital data. Direct non-medical costs, indirect costs, and utility data were primarily gathered by interviewing the patients. We applied 3% discount rate for both costs and effect. All monetary data are converted into USD (1 USD = IDR 14,000, 2019). Probabilistic sensitivity analysis was performed. In addition, from a payer perspective, budget impact analysis was estimated using price reduction scenarios.ResultsThe incremental cost-effectiveness ratio (ICER) of R-CHOP was USD 4674/LYG and 9280/QALY. If we refer to the threshold three times the GDP per capita (USD 11,538), R-CHOP could thus be determined as a cost-effective therapy. Its significant health benefit has contributed to the considerable ICER result. Although the R-CHOP has been considered a cost-effective intervention, the financial consequence of R-CHOP if remain in benefit package under National Health Insurance (NHI) system in Indonesia is considerably substantial, approximately USD 35.00 million with 75% price reduction scenario.ConclusionsAs a favorable treatment for DLBCL, R-CHOP ensures value for money in Indonesia. Budget impact analysis provides results which can be used as further consideration for decision-makers in matters related to benefit packages.

The Effectiveness of Eye Movement Desensitization for Post-traumatic Stress Disorder in Indonesia: A Randomized Controlled Trial.

ObjectivePost-traumatic stress disorder (PTSD) may affect individuals exposed to adversity. Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based trauma-focused psychotherapy for PTSD. There is still some debate whether the eye movements (EMs) are an effective component of EMDR. The primary aim of this study was to investigate the effectiveness of Eye Movement Desensitization (EMD) treatment in reducing PTSD symptoms compared to a retrieval-only active control condition. We also investigated whether PTSD symptom reduction was associated with reductions in depression and anxiety, and improvements in quality of life.MethodologyAdult PTSD patients (n = 91) were recruited at public psychological services in Jakarta, Bandung and Cimahi, Indonesia. PTSD was diagnosed with the Structured Clinical Interview for DSM-5 disorders (SCID-5). Participants were randomized into: EMD (n = 47) or retrieval-only (n = 44). EMD consisted of clinical history and treatment planning, preparation, assessment, EMs, closure, whereas retrieval-only consisted of the same elements except EMs. Data were collected at baseline (T0), 1-week post-treatment (T1), 1-month follow-up (T2), and 3-months follow-up (T3). Outcome measures included the PTSD Checklist for DSM-5 (PCL-5), Hopkins Symptoms Checklist-25 (HSCL-25), and the World Health Organization Quality of Life–BREF (WHOQoL–BREF). Data were analyzed with linear mixed model analysis in R Statistics.ResultsAlthough there were main effects of time indicating reductions for both EMD and retrieval-only in PCL-5 and HSCL-25 scores, and improvements in WHOQoL-BREF scores at T1, T2, and T3, no significant differences in PCL-5, HSCL-25, and WHOQoL-BREF total scores between the EMD and retrieval-only groups at T1, T2, and T3 were found (all group x time interaction p’s > 0.005).ConclusionWithin a clinical sample of PTSD patients in Indonesia, both EMD and retrieval-only was associated with reductions in symptoms of PTSD, anxiety and depression, and improvements in quality of life, although EMs did not add to the efficacy of the treatments. Further research to examine the underlying mechanisms of EMDR’s effective treatment elements in clinical samples is needed.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [ISRCTN55239132].

Pre-Hospital and In-Hospital Delay in Acute Ischemic Stroke Patients in Indonesia: A Multi-center Study

Introduction: Little is known regarding pre-hospital and in-hospital delays in acute ischemic stroke (AIS) patients in Indonesia. This study aimed to evaluate the nature of these delays and identify factors causing pre-hospital delays among AIS patients in Indonesia. Methods: This was a prospective, observational study conducted among adult AIS patients in 3 hospitals in Surabaya during March–August 2019. Baseline characteristics along with time intervals both pre- and post-arrival of patients to the study sites were collected and analysed. Multiple logistic regression analyses with a stepwise forward model were performed to evaluate the factors contributing to the pre-hospital delay. Results: A total of 126 patients were recruited in this study. Mean age ± S.D. was 58.56 ± 10.71 years old. The mean ± S.D. time of pre-hospital delay and mean ± S.D. time to computerized tomography scan were 1,004±1,116.09 and 189±166.44 minutes, respectively. Only 18 out of 126 patients (14.29%) presented to the hospitals within 4.5-hour of intravenous thrombolysis (IVT) time window. However, only 3 patients (2.38%) ultimately received IVT. Wake-up stroke (OR=17.865; p=0.019), unawareness of the gravity of symptoms (OR=11.025; p=0.007), unawareness of stroke symptoms (OR=7.880; p=0.003) and referral patient (OR=7.819; p=0.008) were significantly associated with pre-hospital delay. Conclusion: Pre-hospital delay of AIS was very common and represented a challenging problem to improve stroke care in Indonesia. Wake-up stroke along with lack of patient understanding in recognizing stroke symptoms and ineffective referral system were the most prominent risk factors for pre-hospital delay in Indonesian AIS patients.

Factors Affecting Quality of Life of Post-Acute Coronary Syndrome Patients in Indonesia

BACKGROUND: This study was to examine potential factors associated with quality of life of post-acute coronary syndrome (ACS) patients. AIM: This study needs to be done because studies about post-ACS patient populations in Indonesia are limited. METHODS: It was a quantitative research with a descriptive-analytic approach. Post-ACS patients (n = 100) were taken from a central referral hospital in West Java Province, Indonesia. The dependent data were quality of life and measured using MacNew QLMI. The independent data were depression measured using Zung SDS, severity level, and knowledge, and demography data were measured using instruments developed by researchers. Statistical analysis was carried out in stages from univariate, bivariate, and multivariate. RESULTS: Data showed that 58% patients had a good quality of life, 36% patients had CAD without significant stenosis, and 33% got mild depression. About 59% patients got underwent revascularization, 52% had difficult time to hospital, 94% had BPJS insurance, and 86% were Sundanese. Bivariate analysis (CI 95%) showed that there was a significant correlation between depression and quality of life (p = 0.000), severity level (p = 0.033), type of intervention (p = 0.011), and also access to hospital (p = 0.002). Multivariate analysis showed that depression was the most significant factor associated with QOL (OR = 4.637, p < 0.05). DISCUSSION: Seven factors studied, only four factors significantly related to the quality of life of post-ACS patients, they were severity, depression, last medical treatment, and travel time to the hospital. CONCLUSION: Depression was the most significant factor related to the quality of life of post-ACS patients in this study. Changes in physical, emotional, and social conditions will affect depression. The findings of this study are expected to be evidence based for hospital institutions in identifying the quality of life of post-acute coronary syndrome patients.

Tuberculosis Among Patients With Systemic Lupus Erythematosus in Indonesia: A Cohort Study.

BackgroundIn previous studies, researchers have identified systemic lupus erythematosus (SLE) as a risk factor for tuberculosis (TB), but data from TB-endemic countries are still relatively scarce. We examined TB in a large cohort of SLE patients in Indonesia.MethodsAll patients registered in a lupus registry of the top referral hospital for West Java between 2008 and 2020 were included. Data on SLE characteristics and treatment were retrieved from the registry, and data on TB diagnosis, localization, and outcome were extracted from medical records. Cox-proportional hazard model was used to examine risk factors for development of TB.ResultsAmong 1278 SLE patients observed over a total of 4804 patient-years, 131 patients experienced 138 episodes of TB, a median of 2 years (interquartile range, 0.6–5.4) after diagnosis of SLE. A total of 113 patients (81.9%) had pulmonary involvement and 61 (44.2%) had extrapulmonary involvement, with disseminated disease in 26 of 138 episodes (18.8%), and 13 of 131 patients (9.9%) died from TB. The estimated TB incidence was 2873 cases per 100 000 person years. In multivariate cox regression analysis, development of TB was associated with household TB contact (hazard ratio [HR], 7.20; 95% confidence interval [CI], 4.05–12.80), pulse methylprednisolone therapy (HR, 1.64; 95% CI, 1.01–2.67), and age ≤25 years old at SLE diagnosis (HR, 1.54; 95% CI, 1.00–2.35).ConclusionsThere is a high burden of TB in SLE patients in this TB-endemic setting, underlining the need for evaluation or implementation of TB preventive strategies.

Assessing Burden, Anxiety, Depression, and Quality of Life among Caregivers of Hemodialysis Patients in Indonesia: A Cross-Sectional Study.

Family caregivers endure the burden of caring for patients receiving hemodialysis, which can affect their psychological status and may disrupt the care process. This study aims to assess the level of burden, anxiety, depression, and quality of life (QOL) among family caregivers, to investigate the influence of caregivers’ sociodemographic factors and patients’ clinical conditions on the level of burden, and investigate how burden affects anxiety/depression and QOL. A descriptive, cross-sectional study was conducted from September to October 2020. A total of 104 caregivers with a mean age of 44.4 ± 12.7 years (63.5% women) in the hemodialysis department of a hospital in Indonesia were examined. Zarit Burden Interview (ZBI), Hospital Anxiety and Depression Scale, and WHOQOL-BREF were used. Descriptive analysis was conducted to assess the level of psychological status, and multiple regression analysis and path analysis were performed to evaluate the association among all factors. As result, regarding burden, 10.2% had a moderate-to-severe burden, and in terms of anxiety and depression, 25% and 9.6% showed abnormal cases; the mean scores of 4 domains of QOL were about 60 points. Burden and anxiety/depression were significantly negatively associated with all domains of QOL (p < 0.001); however, sociodemographic and clinical factors were not associated with any of the QOL domains. The path analysis results showed that burden positively correlated with anxiety/depression and negatively correlated with QOL via anxiety/depression. In conclusion, family caregivers’ QOL was found to be indirectly influenced by burden through anxiety/depression. Further evaluation of clinical significance and implications for caregiver’s lifestyle regarding anxiety and depression, which result in caregiver burden, is warranted.

Correlation between Age and Defect Size with Increased Pulmonary Arterial Pressure in Adult Atrial Septal Defect (ASD) Patients at Cardiology and Vascular Medicine Department dr. Seotomo Public Hospital Surabaya 2019-2021

Abstract: Atrial Septal Defect (ASD) is one of the three most common types of congenital heart disease in the world. Pulmonary arterial hypertension (PAH) is a complication that can be found in patients with secundum type of ASD. There is no research that shows the relationship between patient’s age and defect size with increased pulmonary artery pressure in secundum type of ASD patients in Indonesia, so further research needs to be done. Material and Methods: This study is a retrospective study using an observational analytical research design with cross sectionalapproach. The data from this study were taken from the medical records of ASD patients at the Cardiology and Vascular Department of Dr. Soetomo Public Hospital Surabaya. Results: Sex distribution of patients with secundum ASD was dominated by female patients with a total of 53 people (81.5%), the age distribution of patients was dominated by patients in the age group of 20-24 years as many as 18 people (27.7%). The most common comorbidities in adult secundum ASD patients were hypertension (3.08%) and minor CAD (3.08%). The mean diameter of the secundum ASD defect was 28.03±9.57 mm, and the data for the smallest defect diameter was 4 mm and the largest was 48 mm. Complications of increased PA pressure were dominated by 20 patients with mild PH (30.8%) and the mean mPAP pressure was 39.87±19.03. There were no patients with Eisenmenger syndrome.Conclusion: There was no correlation between patient age and inter-atrial septal diameter with mPAP pressure.

The Potential of Home-based Cardiac Rehabilitation Via Telehealth in Patients with the Post- Acute Coronary Syndrome in Indonesia: A Literature Review Study

Patients with post-acute coronary syndrome (ACS) require cardiac rehabilitation.However, there were obstacles in in-hospital cardiac rehabilitation (IHCR), so that itimpacts on recurrence and a decreased quality of life. This paper analyzes the potentialof home-based cardiac rehabilitation (HBCR) via Telehealth in post-ACS patients inIndonesia. It was a literature review study. We used articles from electronic mediathrough the keywords home-based cardiac rehabilitation, Telehealth, and acute coronarysyndrome. Journals were obtained through search sites on Google Scholar, ScienceDirect, PubMed, and ProQuest. The identification criteria were using Indonesian andEnglish with the year of publication from 2015 to 2020. Then, we analysed andsynthesized eligible publications using the PRISMA method. Findings from eightjournals showed that the most common barriers for patients in in-hospital cardiacrehabilitation were logistical barriers (distance, time, functional status) and the patient'sinsufficient knowledge regarding the importance of cardiac rehabilitation. HBCR is animplementation model that has the potential as an effective solution in overcominglogistical limitations between patients and doctors. Care providers in several developedcountries have implemented HBCR. It significantly improved medication adherence,outcome, and safety profile in patients. Furthermore, virtual cardiac rehabilitationprovided the same outcome and safety profile as IHCR. Indonesia needs to developHBCR via Telehealth for secondary prevention management in patients after heartevents, especially ACS. Developing Telehealth could reduce complications andrecurrence, improve lifestyle and physical

Breast Cancer in Indonesia in 2022: 30 Years of Marching in Place

Breast Cancer in Indonesia in 2022: 30 Years of Marching in Place

Cost-Effectiveness Analysis of Two Chemotherapy Regiments FAC vs. Taxane for Operable Breast Cancer Patients in Indonesia.

Background:Breast cancer is the deadliest cancer among women worldwide including Indonesia. Both FAC and Taxane-based chemotherapies are often used for patients with early node-positive breast cancer. However, the study regarding the cost-effectiveness of those regiments is still rare. This study aims to analyze the cost-effectiveness of Taxane versus FAC in the Indonesia setting. Methods:Twenty-four patients with stage I-IIIA breast cancer who had received surgery, FAC or Taxane-based adjuvant chemotherapy, and radiation were included in this study. Health-related quality of life was assessed using INA-BCHRQoL. INA-BCHRQoL was mapped to the EuroQoL 5D (EQ-5D) index calculator to get the utility score. All direct cost was retrieved from electronic medical records and hospital information system. Whereas, a questionnaire was designed to collect information about society cost from patients. ICER was counted to summarize the cost-effectiveness of two chemotherapy regiments (Taxane versus FAC). A sensitivity analysis was done to assess the uncertainty result. Results:The results showed there was no significant difference between the score of quality of life and utility in respondents who received FAC chemotherapy and Taxane-based chemotherapy. However, in terms of cost, Taxane was 6.5 times higher than the FAC group per patient for chemotherapy drugs only. Moreover, the total cost of treatments in Taxane-based chemotherapy was approximately 3.7 times more costly than the counterpart in the FAC arm (p=0.000). Taxane-based chemotherapy dominated with ICER IDR 765.213.092 per QALY gained. Overall, FAC was found more cost-effective compared to the Taxane regiment. Conclusion:FAC represents the value of money compared to Taxane-based for breast cancer patients with stage I-IIIA in Indonesia.

Social support and self-management among end-stage renal disease patients undergoing hemodialysis in Indonesia.

Background: Self-management is the latest multidisciplinary intervention that empowers end-stage renal disease (ESRD) patients to be active in maintaining their health status. The implementation of self-management among ESRD patients undergoing hemodialysis in Indonesia remains relatively low, contributing to the high prevalence of complications and morbidity. The social cognitive theory proposes that social support is one of the environmental factors affecting health behavior change. Therefore, this study aimed to investigate the association between social support and self-management among ESRD patients undergoing hemodialysis in Indonesia.Design and Methods: A cross-sectional study was conducted among 107 ESRD patients selected by consecutive sampling. Data were collected online from four chronic kidney disease communities in Indonesia in June 2020. Medical Outcome Study Social Support Survey and Hemodialysis Self-Management Instrument were used to measure patients’ functional social support and selfmanagement levels. Statistical analysis using the Chi-square test was applied to evaluate the association between social support and self-management.Results: More than half of the patients had high social support (51%) and good self-management (53%). There was a significant relationship between social support and self-management (p=0.027; α=0.05; odds ratio 95% CI = 2.386).Conclusions: Social support is a potential environmental factor that can be modified to enhance health behavior change among ESRD patients in Indonesia, with the specific behavior being selfmanagement. This study recommends functional social support as an integral part of self-management intervention provided through cooperation between health workers, chronic kidney disease community, and patient companions. Significance for public health The prevalence of end-stage renal disease (ESRD) has significantly increased year over year, yet more than 50% of ESRD patients still do not comply with the recommended lifestyle modifications. Self-management is a new multidisciplinary treatment that empowers ESRD patients to monitor and participate in health care and lifestyle modifications, replacing previous compliance-based treatments. However, the implementation of self-management in Indonesia is still far from ideal. This study indicates a significant relationship between social support on self-management among ESRD patients undergoing hemodialysis in Indonesia. This study can provide new insights for health workers and social networks active in the interaction and care of ESRD patients regarding functional forms of social support that can be applied to support self-management among ESRD patients undergoing hemodialysis.

Medication adherence of diabetes mellitus patients in Indonesia: A systematic review

Background: Diabetes mellitus is a chronic disease that requires long-term drug therapy. Adherence in taking medication increases the potential to obtain the optimum therapeutic target. Aim: This systematic review aimed to identify and describe medication adherence of diabetes mellitus patients in Indonesia. Methods: A systematic review was carried out on published research articles from three electronic databases (Pubmed, Scopus, and DOAJ). The eligibility criteria were that studies should be cross-sectional designs, and should display the result data of the measurement of medication adherence level of diabetes mellitus patients in Indonesia. A manual search was also carried out using Google Scholar and from the bibliography of the articles found. The risk of bias was assessed using the NIH quality assessment tool for cross-sectional studies. The synthesis of the results was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart. Results: Thirty published research articles were selected. Medication adherence of diabetes mellitus patients in Indonesia had varying levels. It was dominated by the category of low level and non-adherence. The limitations of the evidence used were: small sample size, the majority using only one method to measure adherence, and the validity and reliability tested was only used in a small number of studies. Conclusion: This finding showed that non-adherence to medication was still a problem for patients undergoing diabetes mellitus treatment in Indonesia.

Breast Cancer Awareness among Bandung Adolescents

Most breast cancer patients in Indonesia experienced a delay in their diagnosis due to a lack of awareness and other factors. Female adolescents are the key population for an educational intervention to raise breast cancer awareness. This study assessed knowledge of breast cancer risk factors, signs, and symptoms, attitudes toward breast cancer prevention, barriers in breast cancer screening, and behavior regarding breast cancer awareness among female adolescents in Bandung using the Breast Cancer Awareness Scale – Indonesia (BCAS-I) instrument. Among 371 female high school and undergraduate students, 53.1% of them had limited knowledge about breast cancer risk factors, and 99.2% of these respondents had negative behaviors. However, most of them understood the early breast cancer signs and symptoms (89.8%) and had positive attitudes toward seeking health support (98.7%). Preference of health information sources and educational level are the significant factors for breast cancer awareness. Our initial assessment may provide the basis for further research and surveys on a larger scale to develop breast cancer prevention educational materials appropriate for young female populations.

Validity and Reliability Test of Vitiligo Quality of Life Index (VitiQoL) Indonesian Version in Vitiligo Patients

Background: Vitiligo is a multifactorial skin disorder that causes depigmentation. Vitiligo can affect a patient's quality of life due to aesthetic issue. The prevalence of vitiligo in the world is 0.5 – 1.0%. An instrument for measuring the quality of life that is specific to vitiligo patients in Indonesia is required. Purpose: This study aims to translate the Vitiligo Specific Quality of Life (VitiQoL) questionnaire into Indonesian: and assess the validity and reliability of the Indonesian language VitiQoL as a quality of life instrument. Methods: An observational method with analytical survey and cross-sectional approach was conducted on 48 vitiligo patients at Sardjito General Hospital Yogyakarta in May – September 2021. The research was carried out in 3 stages. The first stage was the translation of VitiQoL into Indonesian and then back into English. The second and third stages were measuring the validity and reliability of the VitiQoL Indonesian version. Result: The validity test using Pearson product moment showed that the average correlation coefficient for each question is 0.683. Reliability test using Cronbach's alpha of 0.924 VitiQoL. VitiQoL has 3 domains, namely limited participation, stigma, and behavior. The correlation of each domain has a value range of 0.756 - 0.918 with a variation of Cronbach's alpha value per item ranging from 0.808 - 0.89. The limited participation domain (84.2%) has the largest contribution to the value of quality of life. Conclusion: The Indonesian language VitiQoL as an instrument with good validity and reliability can be used to measure the quality of life of vitiligo patients in Indonesia.

PENGARUH PENGGUNAAN TAS PENYIMPANAN OBAT TERHADAP KONTROL TEKANAN DARAH PASIEN HIPERTENSI

Number of people with hypertension in Indonesia is increasing. In addition, not all patients diagnosed with hypertension are adherent to treatment. Based on the 2018 Basic Health Research data, Yogyakarta was ranked second as the province with the highest hypertension patients in Indonesia. The purpose of this study is to determine the effect of using a medicine storage bag on blood pressure control of hypertension patients. This study used a pretest and posttest design with a control group of 36 patients’ sample at the Puskesmas Gamping 1 Yogyakarta from March to August 2019. At the beginning of the study, blood pressure data of patients in both groups were taken. The intervention group was given counseling to patients with medicine storage bags. Observations were made on the results of therapy in the form of controlled blood pressure attainment. The intervention resulted in a p-value of 0.031 for systolic and 0,000 for diastolic (p-value &lt;0.05) indicated that there was an effect of using a medicine storage bag on the control of systolic and diastolic blood pressure in hypertensive patients. This study might conclude that medication aids are useful for hypertensive patients because they can increase the achievement of therapeutic targets.

What Are the Predictors of Intracranial Aneurysm Rupture in Indonesian Population Based on Angiographic Findings? Insight from Intracranial Aneurysm Registry on Three Comprehensive Stroke Centres in Indonesia.

Objectives What are the Predictors of Intracranial Aneurysm (IA) Rupture based on angiographic findings among patients in Indonesia's Population Based on Angiographic Findings. Materials and Methods We conducted a cross-sectional study on subjects with IA not caused by congenital aetiologies or other vascular malformations with cerebral angiography performed from January 2017 to January 2021. Demographic data and aneurysm profile, which include aneurysm count, size, location, and rupture event, were collected. The correlation between risk factors and IA rupture events was determined using bivariate and multivariate analysis. Results From 100 angiography data (33 males and 67 females), the mean subject age is 51.94 ± 10.78. We observe a total of 121 IAs from all subjects. Most of the IAs are in the anterior circulation (104 aneurysms, 85.96%), have small size (77 aneurysms, 63.64%), and are found in ruptured conditions (90 aneurysms, 74.38%). Males have a greater aneurysm count (1.36 ± 0.74 vs. 1.13 ± 0.55, p = 0.036) and larger aneurysm size (p = 0.002). Aneurysm size is significantly correlated with its location (p = 0.008). Medium size (p = 0.019; OR 2.62, 95% CI 1.08-6.36) and location other than the internal carotid artery are associated with increased rupture event. Multivariate analysis revealed that gender (p = 0.031; aOR 5.37, 95% CI 1.17-24.70) is a significant risk factor of IA rupture event. Conclusion IA profiling will enable clinicians to determine the risk of rupture and treatment plans for the Indonesian population. Further studies with a larger sample size are required to confirm these findings.