Regional Public Hospital Research Articles

Association between benzodiazepine prescriptions and potential risk factors of adverse drug reactions among elderly and very elderly: findings from Friuli Venezia Giulia region, Italy

Background: benzodiazepines (BDZs) highly increase the risk of adverse drug reactions (ADRs), especially in the elderly with certain medical conditions. 
 Methods: point-prevalence study in December 2017; 2,456 patients ≥65 years were included from 14 regional public and private hospitals, 24 long-term chronic care facilities (LTCCFs) and 20 nursing homes (NHs). Data regarded BDZ prescriptions and comorbidities, co-prescriptions, or concurrent diseases, which could increase the risk of ADRs in BDZ users. Univariate and multivariate logistic regression analyses were used to assess associations between ADRs in BDZ users vs. non-users, as well as within users. 
 Results: 671 patients were prescribed BDZ, whose half were in NHs. Being prescribed 10 or more drugs was twice more common among BDZ users compared to non-users. BDZs were prescribed for long-term to 80% of patients in NHs, while proportions were halved in hospitals and LTCCFs. In the analyses within BDZ users, patients in NHs and LTCCFs were at higher risk of dementia and concurrent use of opioid analgesic and antipsychotics compared to hospitalized patients. 
 Conclusions: the use of BDZs in older patients is common in FVG. A great extent of comorbidities and concurrent medications at higher risk of ADRs was found. Analyses in different healthcare settings can allow to drive evidence-based interventions in order to discourage the use of BDZs and monitor the raise of ADRs.

The Anesthetic Techniques for Earthquake Victims in Indonesia.

IntroductionIn Lombok, three-large magnitude earthquakes occurred in July 2018 and caused major losses: 564 victims died, 1684 were injured, 445,343 people became refugees, and 215,628 houses were damaged. It damaged 408 health facilities, consisting of 89 public health centers, 13 hospitals, 174 auxiliary public health centers, 132 village health posts.AimThe purpose of this study is to describe the anesthetic techniques that were used to treat earthquake victims.MethodsThis study was a descriptive cross-sectional study that was conducted by collecting total sampling from all earthquake victims treated in the emergency room (ER) of the regional public hospital (RSUD NTB) on August 6th and 7th, 2018, and all victims who underwent surgery during August 5th–25th, 2018. The data that were collected were surgery type, anesthetic techniques, and anesthesia drugs that were used.ResultsThe results show that the highest number of patients were treated in the ER during the first seven days after the earthquake and that this number then decreased over several weeks. The majority of patients treated were trauma patients who needed orthopedic surgery. General anesthesia was more widely used than regional anesthesia, but the difference was not significant. The most commonly used regional anesthetic was lidocaine hyperbaric 75–100 mg and clonidine 30–50 mcg combination. Regional anesthesia techniques have better results in cases of lower limb injury, but it is difficult to be applied in earthquake victims who present with complex injuries and limited resources.

The pattern of vancomycin, gentamycin, and meropenem prescriptions for the inpatients of a regional public hospital in Yogyakarta, Indonesia

Background: The mechanism of action of gentamycin is inhibiting protein synthesis inside bacteria. Meropenem and vancomycin have the same mode of action that inhibit bacterial cell wall activity. Antibiotic resistance occurs when antibiotic use does not follow the guidelines. Therefore, this study aims to determine how vancomycin, gentamycin, and meropenem are prescribed in a regional public hospital. Objective: This study aimed to evaluate the prescription of vancomycin, gentamycin, and meropenem in Yogyakarta Regional Public Hospital in 2017. Methods: This research employed a descriptive analysis with a cross-sectional design. The study was conducted to describe the profiles of vancomycin, gentamycin, and meropenem utilization. Data collection was performed retrospectively using patients’ medical record data including the diagnosis, dosage, and duration of administration. Results: The study showed that the total number of patients who received aminoglycoside: meropenem: vancomycin antibiotics in 2017 and met the research criteria was 6:8:24. According to the diagnosis, gentamycin was used for post-operation (75%), then sepsis and encephalitis. Meropenem was used for sepsis with a percentage of 67% while vancomycin was for endocarditis, intraabdominal, MRSA, cellulitis, pneumonia, and sepsis. Based on the appropriate dosage in the guidelines, the prescribing of gentamycin and meropenem resulted in 100% properness and 69.23% for vancomycin. For the duration of appropriate utilization, it was found that the most prolonged use was in patients given meropenem for 29 days, and the fastest use was a day for patients using vancomycin. Conclusion:Vancomycin, gentamycin, and meropenem had the appropriate dosage. However, discrepancies were still found in the indication and duration of the treatment using these antibiotics. Keywords: Vancomycin, gentamycin, meropenem, antibiotics

Evaluation Conformity Rejimen Peptic Ulcer Drug Therapy In Inpatient Care Facility At West Nusa Tenggara Regional Public Hospital

Evaluation Conformity Rejimen Peptic Ulcer Drug Therapy In Inpatient Care Facility At West Nusa Tenggara Regional Public Hospital

The Korea National Patient Safety Incidents Inquiry Survey: Feasibility of Medical Record Review for Detecting Adverse Events in Regional Public Hospitals.

ObjectivesWe aimed to examine the Korea National Patient Safety Incidents Inquiry conducted in the Republic of Korea; specifically, we assessed the validity of screening criteria, interreviewer reliability, quality of medical records, and the time required for reviewing medical records.MethodsA 3-stage retrospective medical record review was performed. The sensitivity and positive predictive value of the screening criteria for the adverse events were calculated, and interreviewer reliability was verified using the overall agreement rate and κ value. In addition, the results of medical record quality assessment and time required for review were analyzed.ResultsThere were a total of 4159 patients (55.5%) with at least 1 of the 41 screening criteria. In stage 1, the overall percent of agreement was 81.9% when all negatives from the 2 reviewers were included, and the κ value was 0.64 (95% confidence interval [CI], 0.61–0.66). In stage 2, 84.6% of cases were a perfect match, and 87.4% were a partial match. The κ values were 0.159 (95% CI, 0.12–0.20) and 0.389 (95% CI, 0.35–0.43), respectively. The mean quality assessment scores were 3.18 of 4 points in stage 1 and 3.05 of 4 points in stage 2. In stage 1, it took an average of 13.02 minutes to asses each patient file; in stage 2, it took an average of 5.06 minutes.ConclusionsTo increase the feasibility of medical record review for detecting adverse events, it is important not only to improve the reliability between reviewers but also to monitor the quality of medical records and the time required for review.

Chemotherapy Effect on Estradiol Levels in Patients with Triple-negative Breast Cancer: A Clinical Prospective Study from Indonesia

Research Background: This study aimed to scrutinize the chemotherapy’s effect on estradiol levels in patients with triple-negative breast cancer (TNBC) at low-resource country. Methods: This prospective analytic observational cohort study involved patients with TNBC who had undergone surgery and had never received chemotherapy or hormonal therapy before. Patients were checked for estradiol levels before and after chemotherapy. This study was conducted at the Surgical Oncology Department of Regional Public Hospital Dr. Moewardi, Surakarta Indonesia, from April 2020 to March 2021. Descriptive data were presented in a frequency table based on age, menopausal status, parity status, breastfeeding status, hormonal contraception, hormonal contraception duration, family history, stage, and histological grade. Differences in estradiol changes before and after chemotherapy (mean+sd) were then reported.
 Results: From a total of 23 patients, 21 patients (91.3%) experienced a decrease in estradiol levels, while two patients (8.7%) underwent an increase in serum estradiol levels after chemotherapy. The mean decrease was 11.57 pg/ml. The two samples that experienced an increase in estradiol levels had a mean increase of 16.5 pg/ml. There was a significant difference between estradiol levels before and after undergoing chemotherapy, with p-value=0.001.
 Conclusions: In this research, chemotherapy reduced estradiol levels in TNBC patients. Statistically significant reductions in estradiol levels were based on the disease stage.

The Relationship Between Patient Characteristics Diabetes Self-Care Management with Diabetic Peripheral Neuropathy in Type 2 DM Patients in Regional General Hospital in Indonesia

One of the microvascular complications is loss of sensation in the leg area (peripheral neuropathy) which causesfoot ulcers and the risk of amputation. The purpose of this study was to determine the relationship betweenpatient characteristics and Diabetes Self-Care Management (DSCM) with Diabetic Peripheral Neuropathy (DPN)in type 2 diabetes mellitus patients in a regional public hospital in one of the provinces in Indonesia. This studyused a correlative design with a cross-sectional approach to 154 patients with type 2 diabetes mellitus who wereselected using a proportionate stratified random sampling technique. The data were obtained using a Summaryof Diabetes Self-Care Activities and the Michigan Diabetic Neuropathy Score and analyzed using the Chi-squaretest and logistic regression. The results showed that age and duration of diabetes were the sub-variables ofpatient characteristics that were most associated with neuropathy in diabetic patients. Patients are expectedto be able to do diabetes management regularly so that no more diabetes patients are injured due to a lack ofself-management. Hospitals are expected to routinely carry out training and counseling for diabetic patients toprevent serious complications caused by peripheral neuropathy.

Job Demands-job Resources and Organizational Trust: Mediation Role of Employee Engagement, Psychological Well-being, and Transformational Leadership

This study aims to determine the relationship of job demands and job resources with organizational trust through employee engagement, psychological well-being, and transformational leadership. This study involved 235 participants from Dr. Moewardi Regional Public Hospital and Universitas Sebelas Maret Hospital in Surakarta, uses a quantitative approach with convenience sampling technique by considering the risk level of being exposed to COVID-19. Data is collected by an online survey using google form questionnaire. Using SEM PLS analysis, this study finds that job demands has a significant and negative relationship with employee engagement and psychological well-being. Job resources has a significant and positive relationship with employee engagement and psychological well-being. Employee engagement has a significant and positive relationship with organizational trust. There are mediating effects of psychological well-being and transformational leadership on the relationship of employee engagement and organizational trust. Future studies are recommended to add moderating variables such as age, gender, and working period so that the research expected to reveal a more in-depth aspects of organizational trust in a comprehensive manner.

HEMORRHAGIC STROKE PROFILE ON SALATIGA REGIONAL PUBLIC HOSPITAL PATIENTS

Introduction: There is an increasing number of new hemorrhagic stroke cases from 2017 to 2018 on The Province of Central Java and Salatiga. A study of demographics, laboratory examination, radiology, outcome, risk factor, and clinical presentation on hemorrhagic stroke patients are rarely done at Salatiga Regional Public Hospital. Objectives: This study aims to describe the hemorrhagic stroke profile on Salatiga Regional Public Hospital patients. Materials and Methods: Hemorrhagic stroke inpatient of Salatiga Regional Public Hospital in the period between October 2018 and October 2019 is studied. Demographic, laboratory examination, radiology, outcome, risk factor, and clinical presentation data are reported. Results: From a total of 192 data gathered, 120 meet the inclusion and exclusion criteria. 47,5% male and 52,5% female with highest age range (55-64) 33%. The majority of patients came from outside of Salatiga city 71,7%. Patients with blood pressure classification stage 1 11,7%; stage 2 80%. Laboratory examination data shows 52,5% high leucocyte count; normal thrombocyte count; normal lymphocyte count; normal monocyte count; 72,5% high neutrophil count; 71,7% high Neutrophil-Lymphocyte Ratio; 89,2% high ureum level; normal creatine serum; 80% not at risk based on eGFR. Types of hemorrhages are ICH, IVH, and SAH with percentages 68,7%; 25,3%; 6% respectively. Basal Ganglia (48,1%) are the most common location for ICH and lateral ventricle (61,9%) are the highest for IVH. Clinical presentation for GCS (14-15) are the highest 58%. Patients with mortality are dominant in males with mean age 59,61 (year); followed by high counts of leucocyte, neutrophil, NLR, and ureum. Conclusion: Hemorrhagic stroke patients at Salatiga Regional Public Hospital are mainly female with the age range of 55-64 are the highest, came from outside of Salatiga city. The most frequent risk factor is hypertension. Most patients have GCS of 14-15 and stage 2 blood pressure classification. Most of the patient have leucocytosis, neutrophillia, high NLR and ureum level. ICH is the highest stroke subtype with the most frequent location of basal ganglia. More patients with good outcomes compared with a bad outcome.

Evaluation on public and private health care delivery in COVID19

Background: In Korea, there are two healthcare delivery sectors: public and private. The purpose of this study is to compare public and private healthcare delivery in the context of COVID-19 and evaluate healthcare delivery to patients with medical benefits.Methods: Data from the Korea Centersfor Disease Control and Prevention (KCDC), the Health Insurance Reviewand Assessment Service claimdata, and the Ministry ofHealth andWelfarewere analyzed fromJanuary 2020 to February 2021.Results: During the observation period, the cumulative number of patients with the most severe cases was 1,566, and the proportion of inpatients with the most severe cases by healthcare facilities types were: 44.2% (692 patients) in regional public hospitals, 8.9% (140 patients) in national university hospitals, and 22.9% (358 patients) in other types of public hospitals, and 24.0% (376 patients) of private hospitals. The proportion of patients receiving medical benefits by health care institutions was 13.9% in regional public hospitals, 6.7% in national university hospitals, and 7.1% in other public hospitals.Conclusions: The debate about the roles and functions of public and private hospitalsis ongoing. Ratherthan classifying according to the establishment entity, it is necessary to seek ways to achieve the ultimate goal of the medical system, which isto protect people’slives and promote health.

Analysis of Antiretroviral Drugs (ARV) Logistic Management in the Province of Sumatera Utara (Case Study: Regional Public Hospital Dr. Pirngadi Medan And Public Hospital HKBP Balige)

Good drug management including planning, procurement, storage, distribution, destruction, recording and reporting is one of the tasks of the North Sumatra Provincial Health Office and HIV Services in the Regency/City. The purpose of this study was to analyze the drug management of the Antiretroviral program drugs in 2019 and 2020 at the Pharmacy Warehouse of the Health Office of North Sumatra Province, the Pharmacy Installation of Pirngadi Hospital Medan, and Pharmacy Installation at HKBP Balige Hospital. The research was conducted in January-April 2021. This research is descriptive with quantitative data obtained retrospectively and concurrently, qualitative data obtained through observation and interviews with informants. The data obtained were analyzed using indicators and compared to standard research results. The results showed in the North Sumatra Provincial Health Office 5 indicators have not met the standards and 9 indicators have met the standards, in Pirngadi Hospital Medan 4 indicators have not met the standards and 8 indicators have met the standards, but have not done the process of planning drug needs, and in HKBP Balige Hospital there are no indicators that meet the standards and do not do the planning of drug needs. The conclusion of this study is drug planning at the North Sumatra Provincial Health Office using the consumption method of the previous period. Pirngadi Hospital Medan and HKBP Balige Hospital did not plan for drug needs. Drug distribution at the North Sumatra Provincial Health Office uses a decentralized system starting in 2020 from the previous centralized system. In Pirngadi Hospital Medan the system is decentralized, while at HKBP Balige Hospital the distribution system is centralized.

Analysis Of Factors Related To Response Time Nurses In The Handling Of Emergency Patients In The Emergency Room

Background : As a nurse that work on emergency department, they are demanded to always do their jobs in any situation and condition that include rescuing patient with professional attitude especially on treating emergency patients. Emergency department as the first gateway to handling emergency case in hospital hold important role on attempt to save patients life. Those respond time have to be taken advantage of to fulfill prime procedure within handling emergency cases or ABCD procedure (Airway, Breathing, Circulation, and Disability). It will able to lessen the spread of internal organ damage and also lessen the cost. Goal : To realize factor that is related to Respond Time on treating emergency patients in Ulin Regional Public Hospital and Dr. Moch. Ansari Saleh Banjarmasin Regional Public Hospital. Meanwhile, independent variables in this research are : age, sex, education, years of service, training, motivation, and job design. Method : Research will use correlation analytic with cross sectional design. The total sampling in this research are 77 responden. Tools that will be used are respond time observation sheet, stopwatch/wristwatch to count responden's respond time, and questionnaire about characteristic, motivation, and nurse's working design in Ulin Regional Public Hospital and Dr. Moch. Ansari Saleh Banjarmasin Regional Public Hospital.
 Result : Nurses that are inside emergency department which is less than 30 years old are mostly woman, They are mostly have D3 (Diploma 3) education, most nurses also have 5 years of service, and lastly most nurses have BTCLS training. Based on logistic regression analysis, it can be gathered that 1 variable whose have the most common response time are based on age. Implication to nurses : In order to improve nurse's human resourcefulness on subject of emergency, it is hoped that the regarded installation hold training about emergency handling for nurses so that competency, skill, and continually increase nurse's experience and their up-to-date, and also provide facilities and infrastructure that are required within emergency patient needs.

Prescription Screening Study for Outpatient Prescribing Administration of Social Security Administrator Patients at Dr R.M Djoelham Regional General Hospital, Binjai City

<div><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td align="left" valign="top"><p><em>The Impact of errors in prescription incompleteness is diverse, started from those that do not provide any risk at all to the occurrence of disability or even death. The Prescription screening is useful to prevent omissions information, poor prescribing and inappropriate prescribing. The goal of this study was to screen the completeness of administration of outpatient prescriptions for social security administrator patients in regional public hospital Dr. R.M. Djoelham at Binjai City. This is a observational research with a retrospective descriptive design, and use the purposive sampling. This research was conducted at the General Hospital Pharmacy Installation Dr. R.M. Djoelham City of Binjai. This research was conducted from April-June 2021. The population of this study was the number of patient prescriptions from January 2021 to March 2021, namely 3722 prescriptions. The total sample is 98 recipes.The data analysis used is univariate data analysis. The results of the 98 recipes show the percentage of administration of the Inscriptio reached 68.4% and was incomplete reached 31.6%, on complete Invocatio it reached 100%, on Prescriptio the complete reached 95% and the incomplete reached 5%, the Signatura complete reached 91.84% and incomplete reached 8.16%, on Subscriptio the full one reaches 100%, the complete Pro reaches 58.84% and incomplete reached 41.16%. The conclusion of this study is the percentage of complete recipes reached 67.35% while incomplete reached 32.65%.<strong> </strong>If an incomplete prescription is found, it is hoped that the pharmacy staff will confirm it with the doctor concerned.</em></p><p><em> </em></p></td></tr></tbody></table></div><p><strong><em>Keyword: Pharmaceutical Installation, Prescription Completeness, Screening</em></strong></p>

HUBUNGAN ANTARA 5 ASPEK QUALITY OF WORK LIFE DENGAN KINERJA DOKTER Survei Pada Dokter RSUD Kota Pinang Tahun 2021

The purpose of this study was to determine the significant relationship between the five aspects of QWL with the performance of doctors at the Regional Public Hospital Pinang City in providing health services. This research is a quantitative research which uses a correlational method with a survey approach. This study did not use sample, because from the calculation of the Minimum Sample Size with the Slovin formula, it turned out that the sample size that must be taken also amounted to 39, the same as the total population, namely all doctors at Regional Public Hospital Pinang City at the time this research was conducted. The instrument for the doctor’s performance variable based on ACGME and the QWL variable based on the 2006 Cascio theory which had been tested for reliability and validity not at the research location. Data analysis was carried out by using univariate analysis test, bivariate test with chi-square statistical test, and multivariate test with Anova analysis. The QWL component that has a very significant effect is the available facilities, because the availability of facilities can provide welfare and satisfiy the needs of doctors at work. The least significant component of QWL is career development, because the doctor’s status is a civil servant and the promotion goes according to central regulation not from the hospital management.

HUBUNGAN DISIPLIN DAN KOMPENSASI DENGAN KINERJA PERAWAT UNIT PELAYANAN KHUSUS DI RUMAH SAKIT UMUM DAERAH KOTA LANGSA TAHUN 2017

Nurse performance is a determining factor in the image and quality of the hospital. Achieving maximum performance from a nurse can be seen from various factors,including discipline, employee satisfaction,which includes several aspects, namely salary increase, compensation, incentives, promotion, and so on. This research uses analytic survey with cross sectional design, which aims to analyze the relationship of discipline and compensation with the performance of special service unit nurses in Langsa City Regional Public Hospital. The population in this study were all special service unit nurses in Langsa City Regional Public Hospital in the Central Surgery (Room OK), IGD, Radiology, ICU, ICCU, NICU, PICU and Hemodialysis totaling 55 nurses. All of them are made into samples or called total sampling. The data used in this study are primary data obtained by questionnaires by respondents (nurses) and analyzed using the chi square test and multiple correlation test. Where it says there is a relationship if the value of p <0.05. Based on the results of the study, it was found that there was a relationship between discipline and the performance of special service unit nurses in Langsa City Regional Public Hospital in 2017 with a value of p = 0,000 (p <0.05); there is a relationship between compensation and the performance of special service unit nurses in Langsa City Regional Public Hospital in 2017 with a value of p = 0.005 (p <0.05); and there is a relationship of discipline and compensation with the performance of special service unit nurses in Langsa City Regional Public Hospital in 2017 with a value of p = 0,000 (p <0.05). The conclusion of this study is that there is a significant relationship between discipline and compensation with the performance of special service unit nurses in Langsa City General Public Hospital in 2017.

Australian nurses' perceptions about workplace violence management, strategies and support services.

This study ascertained nurses' perceptions about workplace violence management, strategies and support services. Nurses regularly encounter verbal and physical violence in their workplace. Workplace violence has long-term consequences on nurses' personal lives and professional work ability. However, more needs to be known about nurses' perceptions of violence management and interventions used. Ninety-eight nurses from a regional public hospital in Queensland, Australia, completed a survey about workplace violence. Nurses worked in the Emergency Department, Intensive Care Unit or Mental Health Department. Ninety-five per cent of nurses stated that all violence should be reported, but 18% would take no action, and 22% would not complete an incident from. Perceptions and preferred responses differed for verbal and physical violence. Low-level interventions and aggression management training were preferred by nurses. Nearly all nurses felt that they should be involved in the development of workplace violence policies. Nurses rate aggression management training highly, and they desire more input into violence policies. The under-reporting of violent incidents remains an issue for future management. Understanding nurses' perceptions of workplace violence management enables the identification of gaps when applying policy and adopting practical approaches to reduce the incidence and severity of workplace violence.

Analysis of Solid Medical Waste Management at Uptd Regional General Hospital Datu Beru, Central Aceh Regency

The purpose of this study was to analyze the management of solid medical waste at a Regional Public Hospital. which includes minimization, sorting, separation, storage, transportation, destruction/final disposal of waste. The results of the study are that the management of solid medical waste in a Regional Public Hospital in general does not meet the requirements of the Minister of Health Regulation No. 7 of 2019 concerning Hospital Environmental Health, but there are several things that are already optimal, so it needs to be further improved. Lack of concern for waste producers, both health service providers, visitors and patients, which can trigger the mixing of solid medical waste with non-medical waste. It is recommended that waste management officers need to increase supervision and good cooperation with nurses and cleaners in separating medical and non-medical waste. Management pays more attention to facilities and infrastructure both regarding procurement and in the implementation process and pays attention to the availability of its human resources.

Analysis Of Nurses Competency To Preparedness In Facing Disasters In Regional Public Hospitals Of Ende District, East Nusa Tenggara Province 2020

Disasters are a series of events that threaten and disrupt people's lives and livelihoods which can be caused by natural and non-natural factors. One of the ways to handle disasters in hospitals is by nurses who have standardized competence. This study aims to determine the relationship between nurse competence and disaster preparedness. This study uses a quantitative design method with a correlational analytic approach. Processing data using the Spearman Rank correlation test with the help of the SPSS program for Windows 16.00. Results of reseacrh is Knowledge has a significant relationship with disaster preparedness with a value of 0.001 (p-value <0.05) and attitude variables also have a significant relationship with disaster preparedness with a value of 0.007 (p-value <0.05). ) and the skill variable also has a significant relationship to disaster preparedness with a value of 0.043 (p-value <0.05). Nurse competence has a relationship with disaster preparedness in the hospital.

Tuberculosis infection control measures in healthcare facilities in Moyen-Ogoou\xe9 Province, Gabon

BackgroundHealthcare workers (HCW) are at higher risk of tuberculosis (TB) than the general population. We assessed healthcare facilities for their TB infection control standards and priorities.MethodsA standardised tool was applied. The assessment was conducted by direct observation, documents review and interviews with the facility heads.ResultsTwenty healthcare facilities were assessed; 17 dispensaries, an HIV-clinic, a private not-for-profit hospital and a public regional hospital. In both hospitals, outpatient departments, internal medicine wards, paediatric wards, emergency departments; and the MDR-TB unit of the public regional hospital were assessed. In Gabon, there are currently no national guidelines for TB infection control (TBIC) in healthcare settings. Consequently, none of the facilities had an infection control plan or TBIC focal point. In three departments of two facilities (2/20 facilities), TB patients and presumed TB cases were observed to be consistently provided with surgical masks. One structure reported to regularly test some of its personnel for TB. Consultation rooms were adequately ventilated in six primary care level facilities (6/17 dispensaries) and in none of the hospitals, due to the use of air conditioning. Adequate personal protective equipment was not provided regularly by the facilities and was only found to be supplied in the MDR-TB unit and one of the paediatric wards.ConclusionsIn Moyen-Ogooué province, implementation of TBIC in healthcare settings is generally low. Consequently, HCW are not sufficiently protected and therefore at risk for M. tuberculosis infection. There is an urgent need for national TBIC guidelines and training of health workers to safeguard implementation.

Effect of Cognitive Behavioral Therapy on Improving Anxiety, Depression, and Quality of Life in Pre-Diagnosed Lung Cancer Patients.

Objective:To evaluate the effectiveness of cognitive behavior therapy on anxiety, depression, and quality of life of pre-diagnosed lung cancer patients. Methods:A total of 32 pre-diagnosed subjects were divided into 16 Cognitive behaviour theraphy (CBT)-intervention patients and 16 control subjects. The study subjects were pre-diagnosed lung cancer patients hospitalized at Regional Public Hospital Dr. Moewardi Surakarta. For the treatment group, CBT psychotherapy interventions were given for up to 6 sessions every 2 days. The patient was tested for Hamilton Anxiety Rating Scale (HARS)-based anxiety symptom criteria and Hamilton Depression Rating Scale (HRSD)-based depression and followed The World Health Organization Quality of Life- Brief version (WHOQOL-BREF)-based quality of life criteria. The effect of CBT intervention was measured using an independent t-test and the Mann–Whitney test.Results:There was a significant difference in the intervention group post-test: HARS criteria decreased by −8.38 ± 2.90, HRSD decreased by an average of −6.75 ± 3.30, and WHOQOL-BREF increased by an average of 16.80 ± 10.13 compared with the control group. Conclusion:CBT affects the improvement of anxiety, depression, and quality of life for pre-diagnosed lung cancer patients.