Private Hospital In Jakarta Research Articles

Analysis of Nursing Quality Services

This study is focused on the analysis of nursing quality services, and it was done to know how the quality services of the nurses. The population of this study were the nurses and the patients at private hospitals in Jakarta, and the sampling tecnique used was cluster random sampling. The sample were the nurses and patients who were hospitalized at East Jakarta. The method of the study used was explanatory using a survey method with a cross-sectional approach, where the instruments of the study were a set of questionnaire with likert-scale 1-5. The results of the study show (α<0.05) show that: a) there is a significant effect of commitment of the nurses to the quality services improvement having by the nurses; b) there is a significant effect of the leadership to the quality services improvement having by the nurses; c) there is a significant effect of the ethics of the hospital to the quality services improvement having by the nurses; d) there is a significant effect of the nurses’ performance to the quality services improvement having by the nurses; and e) there is a direct significant effect of the ability of the nurses, the ethics of the hospital, and leadership behaviour on the commitment of the nurse.

Nonalcoholic fatty liver disease is associated with increased hemoconcentration, thrombocytopenia, and longer hospital stay in dengue-infected patients with plasma leakage.

A prominent histopathological feature of fatal dengue cases is hepatic steatosis. However, the association between hepatic steatosis and dengue severity is unknown. We conducted a study to determine the associations of nonalcoholic fatty liver disease (NAFLD) with laboratory markers of dengue severity and length of hospital stay (LOS). A retrospective study was conducted at a private hospital in Jakarta, Indonesia, from December 2011 to December 2016. Bivariate analysis was performed to analyze the associations of laboratory markers of dengue severity and LOS with the presence or absence of NAFLD in no-plasma-leakage (no leakage) and plasma-leakage (leakage) groups. There were 267 dengue-infected patients included in this study. Of these patients, 115 (43.1%) were classified as belonging to the no leakage group, and 152 (56.9%) were classified as belonging to the leakage group. Of the 115 patients belonging to the no leakage group, 53 (46.1%) did not have NAFLD, and 62 (53.9%) had NAFLD. Of the 152 patients belonging to the leakage group, 85 (55.9%) did not have NAFLD, and 67 (44.1%) had NAFLD. Leakage group patients with NAFLD experienced significantly higher hemoconcentration severity (p = 0.04), lower platelet count (p = 0.004) and higher LOS (p = 0.042) than did leakage group patients without NAFLD. The presence of NAFLD in dengue-infected patients with plasma leakage was associated with more severe hemoconcentration, thrombocytopenia and prolonged hospital stay.

Dengue score as a diagnostic predictor for pleural effusion and/or ascites: external validation and clinical application

BackgroundThe Dengue Score is a model for predicting pleural effusion and/or ascites and uses the hematocrit (Hct), albumin concentration, platelet count and aspartate aminotransferase (AST) ratio as independent variables. As this metric has not been validated, we conducted a study to validate the Dengue Score and assess its clinical application.MethodsA retrospective study was performed at a private hospital in Jakarta, Indonesia. Patients with dengue infection hospitalized from January 2011 through March 2016 were included. The Dengue Score was calculated using four parameters: Hct increase≥15.1%, serum albumin≤3.49 mg/dL, platelet count≤49,500/μL and AST ratio ≥ 2.51. Each parameter was scored as 1 if present and 0 if absent. To validate the Dengue Score, goodness-of-fit was used to assess calibration, and the area under the receiver operating characteristic curve (AROC) was used to assess discrimination. Associations between clinical parameters and Dengue Score groups were determined by bivariate analysis.ResultsA total of 207 patients were included in this study. The calibration of the Dengue Score was acceptable (Hosmer-Lemeshow test, p = 0.11), and the score’s discriminative ability was good (AROC = 0.88 (95% CI: 0.83–0.92)). At a cutoff of ≥2, the Dengue Score had a positive predictive value (PPV) of 79.03% and a negative predictive value (NPV) of 90.36% for the diagnostic prediction of pleural effusion and/or ascites. Compared with the Dengue Score ≤ 1 group, the Dengue Score = 2 group was significantly associated with hemoconcentration> 20% (p = 0.029), severe thrombocytopenia (p = 0.029), and increased length of hospital stay (p = 0.003). Compared with the Dengue Score = 2 group, the Dengue Score ≥ 3 group was significantly associated with hemoconcentration> 20% (p = 0.001), severe thrombocytopenia (p = 0.024), severe dengue (p = 0.039), and increased length of hospital stay (p = 0.011).ConclusionThe Dengue Score performed well and can be used in daily practice to help clinicians identify patients who have plasma leakage associated with severe dengue.

Improving the interpersonal competences of head nurses through Peplau's theoretical active learning approach

Effective interpersonal skills are essential for head nurses in governing and managing their work units. Therefore, an active learning strategy could be the key to enhance the interpersonal competences of head nurses. This study aimed to investigate the effects of Peplau's theoretical approach of active learning on the improvement of head nurses' interpersonal skills. This study used a pre-experimental design with one group having pretests and posttests, without control group. A total sample of 25 head nurses from inpatient units of a wellknown private hospital in Jakarta was involved in the study. Data were analyzed using the paired t-test. The results showed a significant increase in head nurses' knowledge following the training to strengthen their interpersonal roles (P=.003). The results also revealed significant increases in the head nurses' skills in playing the roles of leader (P=.006), guardian (P=.014), and teacher/speaker (P=.015). Nonetheless, the results showed no significant increases in the head nurses' skills in playing the roles of counselor (P=.092) and stranger (P=.182). Training in strengthening the interpersonal roles of head nurses significantly increased the head nurses' knowledge and skills. The results of the study suggested the continuation of active learning strategies to improve the interpersonal abilities of head nurses. Furthermore, these strategies could be used to build the abilities of head nurses in other managerial fields.

THE INFLUENCE OF PATIENT-PERCEIVED SERVICE QUALITY AND BRAND TRUST ON WORD OF MOUTH

The health care service providers such as the hospitals are facing the challenges ofgaining customer loyalty. Health care service is a high involvement and high risk service.Therefore, brand trust can play an important role in influencing customer loyalty andword of mouth. This empirical research was conducted to find out the influence of servicequality on brand trust and word of mouth in a private hospital. The data were collectedusing a six-item Likert scale with closed questions. The dimensions of service qualityare reliability, assurance, tangibility, empathy, and responsiveness. Questionnaires weredistributed using stratified random sampling to 215 respondents who have had in-patientcare in a private hospital in Jakarta, St. Carolus Hospital. They were chosen because theywould have a more intensive interaction with the service provider and the facility duringtheir treatment. The sampling technique used is stratified random sampling method. Thedata were analyzed using the Structural Equation Modeling (LISREL). The result showedthat brand trust mediated the influence of service quality on word of mouth. The ability ofa hospital to build trust among its customers can influence its future performance throughpositive word of mouth.

Gastric Mucous Atrophy and Metaplasia in Patient with Helicobacter pylori Infection

Background: Helicobacter pylori (H. pylori) is one of the most common bacteria found in human and cause chronic infection. Recent study conducted in one of private hospitals in Jakarta shows that there is a trend of declining prevalance of H. pylori from 12.5% in 1998 to 2.9% in 2005. The aim of this study is to obtain` the prevalance of gastric atrophy and metaplasia in patients with H. pylori infection based on histopathology.Method: This was a case control study between June to August 2014 with 69 cases and 71 controls using medical records datas and histopathology results. Control sample was taken consecutively from patient undergone esophagogastroduodenoscopy procedure in 2013.Results: The average age for patient with H. pylori was 51 years slightly higher than patient with negative H. pylori (p 0.05). Generally, the prevalence rate among males was slightly lower than females (p 0.05). From Histopathology findings, active chronic gastritis was found in 62.3% patients with positive H. pylori than only 12.7% in patient with negative H. pylori (95% CI = 4.86-26.7; OR = 11.31). Mild and moderate atrophy was higher among H. pylori positive (p = 0.09). gastric mucous metaplasia was also higher (10% vs. 1.4%) among positive H. pylori patient (p = 0.03).Conclusion: H. pylori infection can cause atrophy and metaplasia in gastric mucosa. Prevalence of gastric metaplasia caused by H. pylori infection is lower in this study compared to the same study abroad.

P0037 Chemotherapy for advanced colorectal cancer among indonesians in a private hospital in Jakarta: Survival when best treatment is given

Background Survival of colorectal cancer in Indonesia is thought to be shorter than in developed countries due to low affordability of treatment. We evaluated survival of patients with advanced colorectal cancer when given regimens as recommended by international guidelines. Methods An historical cohort study was done in advanced colon or rectal cancer between 2008, and 2010, at our hospital. Cases were retrieved from medical records. Patients were followed up until they died or were lost to follow-up. All patients received six cycles of combination fluorouracil, leucovorin, and oxaliplatin (FOLFOX4) as the standard first-line regimen for metastatic colorectal cancer. Oral capecitabine and targeted therapy were also given, whenever indicated. Findings Nineteen patients (50%) died during the study period. Median overall survival of patients was 18 months (95% confidence interval 6.98–29.02). The longest survival was 76 months. Patients with colon cancer tended to live longer than those with rectal cancer (21 versus 15 months; p = 0.147). There was no significant difference of survival between patients with stage IV disease and relapse cases. Interpretation With proper treatment and access to cytostatics and biologicals, Indonesian patients with advanced colorectal cancer have the same survival rates as those reported in the literature for patients living in more developed countries.

Chemotherapy for Advanced Colorectal Cancer among Indonesians in a Private Hospital in Jakarta: Survival when Best Treatment is Given

Background : Survival of colorectal cancer in Indonesia is thought to be shorter due to to several factors, among these: ethnic, nutritional, and the low affordability factors. Aim of this study to assess and evaluate survival in advanced colorectal cancer when given the best drugs available as recommended by international guidelines. Method : A historical cohort study was done in patients with advanced colon or rectal cancer between 2008 and 2010 at Medistra Hospital. Cases were retrieved from medical record data. Subjects were included if they were diagnosed or had a relapse of their disease during the study period and were followed until they died or lost to follow-up. Staging procedure was done using the tumor node metastasis (TNM) system. All patients received the combination of 5-uorouracil (5-FU)/leucovorin (LV), oxaliplatin for 6 cycles (FOLFOX4) as the standard  rst-line regimen for metastatic colorectal cancer (mCRC) in Indonesia. Oral capecitabine and targeted therapy such as bevacizumab and cetuximab might were also given, whenever indicated. Results : Nineteen patients (48.7%) died during the study period, while the rest were alive or lost to follow-up. The median overall survival of patients was 18 months (95% CI = 6.98 – 29.02 months). The longest survival was 76 months (the patient is still alive when this manuscript was being prepared). Patients with colon cancer tended to live longer than rectal cancer, i.e. 21 vs. 15 months; log-rank p = 0.147. There was no signi cant difference of survival between patients with stage IV disease and relapse cases, i.e. 18 vs. 12 months, log-rank p = 0.807. Conclusion : With proper treatment and access to cytostatics and biologicals, advanced colorectal cancer among Indonesian patients have the same survival rates as patients in more developed countries as reported in the literature. Keywords : advanced colorectal cancer, chemotherapy, survival

Early Experiences with Percutaneous Endoscopic Gastrostomy in Pondok Indah Hospital

Background: Percutaneous endoscopic gastrostomy (PEG) is only recently being introduced in Indonesia with limited clinical experience. Clinical study of patients underwent PEG is very limited. This study was aimed to evaluate clinical profile of patients underwent PEG in a private hospital in Jakarta. Method: A retrospective study was done to patients underwent PEG in Pondok Indah hospital, Jakarta using medical record. Clinical data collected were patients’ demographics, diagnosis of underlying disease, indication for PEG insertion, and follow-up visits. Results: Ten cases were found between 2000 and 2008, six among them were men. All but one cases aged more than 50 years. Ninety percents of the patients had cerebrovascular disorder as their primary diagnosis and 60% of the main indication was dysphagia. Conclusion: No procedure-related major complications and death has occurred. This procedure was safe and potentially be offered to more widely clinical settings. Keywords: dysphagia, percutanelus endoscopic gastrostomy, enteral feeding

Populasi bakteri pada Feses Neonatus: Penelitian pendahuluan

Recent published data have outlined a relationship between the composition of the intestinal microflora and allergic inflammation, autoimmunity, chronic bowel inflammation, psychiatric, cognitive and behavioral disturbances. Factors influencing intestinal microflora are environment, genetic predisposition, diet, age, diseases, drugs, stressor. This preliminary study is to establish local reference of microbial flora in neonates. This study included samples taken from 20 neonates, age 1 – 7 days, from a private hospital in Jakarta. All samples were sent to microbiology laboratory without transport media and processed immediately. Bacteriological cultures for aerob and anaerob bacteria were performed according to the standard methods. Aerob and anaerob bacterial species were isolated from all samples, ranged 2 – 5 species per sample. Enterobacteriaceae were found to be dominant isolates (25% - 75%); followed by Streptococcus anhaemolyticus (60%), Staphylococcus epidermidis (40%), Staphylococcus aureus (5%),Clostridium difficile (5%), Bacteroides fragilis (5%), Bifidobacterium sp. (10%), Lactobacillus sp. (5%) and yeast (5%). These data indicated that aerob and facultative anaerob bacteria were predominant in neonates. However Bifidobacterium, Lactobacillus and Clostridium difficile could be found. Further studies are needed to confirm this finding using larger number of samples and involving various age group.

PERANAN SERVICE QUALITY TERHADAP PATIENT REVISIT INTENTION MELALUI PATIENT SATISFACTION PADA RUMAH SAKIT UMUM DAN RUMAH SAKIT SWASTA TIPE B

Backg of nd: the increasing of awareness in health care by Indonesian people especially in Jakart Healthcare that health care professionals are highly dependent on each other to provide and coordi ate services of high value for human beings. Patients usually prefer to go to private hospitals hoping tc receive high service quality. But in fact, public hospitals have a good quality service also becau e ft is supported by the government.Object ve to compare service quality, patient satisfaction and patient revisit intention of public and privatE hospitals.Resea h design: this research applies to public and private hospitals in Jakarta and questionnaires were s read away to 97 respondents or patients from some public and private hospitals in Jakarta by usi g purpose sampling.Findin s: There are no differences between private and public hospitals in service quality, patient satisf Um and patient revisit intention. Finally the implications of the results are highlighted for health :are managers.

Clinical manifestation of HIV/AIDS patients: differences between public and private hospitals in Jakarta

The aims of this study is to determine the demographic data, risk factors, clinical presentations, opportunistic/co-infections and its difference between public and private hospitals. A retrospective -descriptive study was conducted in Dr. Cipto Mangunkusumo National General Hospital (public hospital) and Medistra Hospital (private hospital), Jakarta. The inclusion criteria were new HIV/AIDS cases admitted in year 2002-2003 and positive HIV serology (Elisa method). Secondary data were collected form medical record. Sixty-six subjects were enrolled in this study (public hospital 30 subjects and private hospital 36 subjects), consist of 59 male (89.4%) and 7 female (10.6%). Thirty-seven percent subjects were defined as HIV and 62% AIDS. Risk factors obtained include drug user (59.1%), homosexual (13.6%), heterosexual (21.1%), transfusion (1.5%) and maternal-child (perinatal) (1.5%). The clinical symptoms mainly present as acute fever (56.2%), weight loss (39.4%), cough (38.8%), shortness of breath (27.2%), chronic diarrhea (22.8%), prolong fever (19.7%), loss of conciousness (15.3%), anorexia (15.3%). Significant differences between public and private hospitals were seen in fever and cough symptoms. Clinical presentation of HIV/AIDS patients during admission were : pneumonia (56%), oral trush (22.6%), anemia (56.5%), leucopenia (32.3%), lymphopenia (55.9%), elevated AST/ALT (66.1%), hypoalbuminemia (46.9%), limphadenopathy (10.6%), brain space occuping lesion (7.6%), encephalopathy (6.0%), pulmonary tb and pleural effusion (10.6%). The opportunistic and co-infections present were candidiasis (25.8%), chronic hepatitis C (24.2%), chronic hepatitis B and C (4.5%), pulmonary tb, lymphadenitis and miliary tb. Candidiasis and pulmonary tb were frequently found in public hospital. In conclusion from this study that clinical manifestation of HIV/AIDS were young man or woman, with one or more possible risk factor, had fever, respiratory complain, loss of body weight, chronic diarrhea, fatique, oral trush, anemia, leucopenia, lymphopenia. Patients admitted in private hospital had varied complain; and patients that admitted in public hospital had more severe and advance condition. (Med J Indones 2004; 13: 232-6)

HISTOLOGICAL ANALYSIS OF GASTRITIS AND HELICOBACTER PYLORI INFECTION IN RELATION TO THE PRESENCE OF DUODENAL ULCER

BackgroundHelicobacter pylori (Hp) infections have different clinical courses resulting probably from the differences of its virulence.Aimsto describe the features of gastritis and Hp infection and to determine which histological features would increase the risk of duodenal ulcer in patients with Hp infection.MethodsThe histopathologic characteristic of gastric biopsy specimens taken from antrum and stained with Giemsa and Hematoxiline‐Eosin stain were investigated among 142 patients (M=72, F=70) diagnosed as dyspepsia and recognized as Hp positive. Grade and activity of gastritis was examined according to the Sydney System (chronic inflammation, neutrophilic infiltration, intestinal metaplasia and glandular atrophy). The presence of Hp was determined by histology. All the patients were from the private hospital in Jakarta. The presence of duodenal ulcer was recognized in 6 patients.ResultsSix patients with duodenal ulcer and 136 patients with gastritis were examined. The grade of mononuclear infiltration, intestinal metaplasia and the activity of polymorphonuclear were higher in duodenal ulcer group, but statistically have of no significant. On other hand glandular atrophy increased significantly in the group of duodenal ulcer compare to chronic gastritis group (p&lt;0.05). Bacterial density was higher in the antrum compare to the corpus (p&lt;0.05).ConclusionThe result suggest that chronic gastritis induced by Hp infection may associate with the presence of duodenal ulcer through the development of atrophic gastritis.

HISTOLOGICAL DEGREE IN HELICOBACTER PYLORI GASTRITIS IN RELATION TO THE ABSENCE OR PRESENCE OF BILE REFLUX

Background:the presence of Helicobacter pylori (Hp) in gastric mucosa could be influenced by bile reflux.Aims:to compare the histological parameters of gastric mucosal biopsies in bile reflux positive and bile reflux negative among the Hp gastritis.Methods:One hundred and forty four patients (M=73, F=71) with Hp gastritis from the private hospital in Jakarta were enrolled in this study. Two biopsy specimens (antrum and corpus of gaster) were taken from all consecutive patients during the period of January 1998 to December 1999. The grade of gastritis was examined according to the Sydney System (chronic inflammation, neutrophillic infiltration, glandular atrophy and intestinal metaplasia). Presence of Hp infection was determined by histology. A single senior Pathologist did all histopathological assessment. Bile reflux was defined as an evidence of significant amount of bile in gastric lumen with or without hyperemia and/or erosion on gastric mucosa. The presence of raptor during the procedure was an exclusion criteria.Result:twelve (M=4, F=8) out of 144 were positive for bile reflux. Comparison of the average scores of the different histologic features of the biopsy specimens among those with bile reflux and without bile reflux showed that chronic inflammation, neutrophillic infiltration, glandular atrophy and intestinal metaplasia was statistically not significant.Conclusion:chronic gastritis induced by Hp, suggestively not related to the absence or presence of bile reflux