“TINGKAT KETERGANTUNGAN

PADA KLIEN STROKE”

Nursiswati

nursiswati@unpad.ac.id
Disampaikan pada 15 Oktober 2022,
@nursiswatiraharjo ZOOMINAR DPD PPNI KOTA MEDAN
Bismillahirrohmaanirrohiim

Welcome
Audience
 Prevalensi Stroke
Tingkat ketergantungan
Tingkat Ketergantungan pada
stroke
POKOK Perbedaan persepsi
BAHASAN ketergantungan antara keluarga
dan perawat.
Perawatan transisi dalam stroke
 Stroke is a global burden.
Every year stroke affects 15 million people
worldwide, with approximately 5.9 million cases
STROKE resulting in death
The burden of stroke in terms of mortality, morbidity
and disability is increasing across the world.
The prevalence of people suffering from a stroke has
steadily increased in Indonesia from 7% to 10.9%
between 2013 and 2018


DI INDONESIA

‘Stroke has steadily increased in Indonesia

from 7% to 10.9% between 2013 and 2018'.

Penyebab Kematian Tertinggi

 STROKE DAN KETERGANTUNGAN PERAWATAN

44% of stroke menyebabkan ketergantungan kepada keluarga dalam

ADL.

Tingkat Ketergantungan pada klien stroke bertahan dalam 6 bulan

pasca stroke.

Activities of daily living (ADL) are daily home-based

activities that people carry out to maintain health and
well-being.

 ADLs include the ability to: eat and drink

unassisted, move, go to the toilet, carry out
personal hygiene tasks, dress unassisted, and
groom.

Stroke causes impairment‐related functional

limitations that may result in difficulties
participating in ADLs independent of
supervision, direction, or physical assistance.
 TINGKAT KETERGANTUNGAN

Dependency can be influenced by both an individual and the person’s

environment.

for example, a stroke patient’s nurse or family caregiver and unsafe

home interiors that resulted in functional limitation.

If caregivers offer too much assistance, they might undermine the

patient´s independence, but if they offer too little assistance, the
patient’s needs are not met.

Ketergantungan perawatan didefinisikan sebagai pemberian

dukungan oleh perawat profesional untuk pasien yang
mengalami penurunan kemampuan perawatan diri dan
kemampuan yang mereka miliki (Patient’s care demand) di
tingkat ketergantungan dengan tujuan memulihkan
independensi pasien.
(Dijkstra et al 1998),

CARE DEPENDENCY

Kemampuan pasien dalam aktivitas kehidupan

sehari-hari dan tingkat ketergantungan
perawatan telah banyak digunakan sebagai
indikator penilaian perkembangan penyakit
kronis (Fernandez 2014, Köberich 2014,
Schussler2014).
 BARTHEL INDEX
NIHSS
CARE DEPENDENCY SCALE
INSTRUMEN (CDS)
KATZ INDEX

BERBASIS TEORI
CDS KEPERAWATAN: VIRGINIA
HENDERSON
CDS mengukur tingkat ketergantungan yaitu suatu
kondisi yang menggambarkan penyakit seseorang
atau ketidakmampuan.

Ketergantungan perawatan bisa menjadi kondisi

sementara, jangka panjang atau kondisi permanen

PENELITIAN

Empat belas kebutuhan dasar manusia,

menurut Henderson (1966), yang
digunakan dalam indikator tingkat
ketergantungan. Item tsb telah diuji oleh
proses Delphi dan Djikstra et al. 1998
menambahkan indikator lain yaitu
komunikasi.


Kissel (2012) menjelaskan bahwa indeks

Barthel dan CDS pada penderita penyakit
kronis memiliki nilai yang sangat baik
kesesuaian (indeks kappa 0ver 0,90), tetapi
indeks Barthel memiliki nilai validitas sedikit
lebih tinggi dari CDS.

An analysis of the results of the CDS tested on the

inpatient ward and in the outpatient clinic revealed
a high level of internal consistency.

The reliability analysis yielded the same Cronbach’s

a coefficient of 0.98 for both the inpatient and
outpatient data.
A significant, moderate correlation was observed
between the CDS and Barthel Index results
Publikasi terkait Komparasi tingkat ketergantungan klien stroke
PENGGUNAAN CDS di Rawat jalan maupun di
Rawat Inap memberikan solusi pada
pemantauan tingkat ketergantungan klien
stroke.

Mudah dan rata2 penilaian selama 5-15 menit.

Membantu continuous care for stroke

Menjembatani transisional care dan integrative
care.
 INTERVENSI MENINGKATKAN
INDEPENDENSI

adaptive
assessment treatment
techniques

Constraint
Induced
assistive environmental
Movement
technology, adaptations
Therapy

augmented
MIRROR
Virtual reality exercises
THERAPY
therapy
Care dependency in stroke patients decreased significantly from
admission to discharge, as well as from the 5th to the 13th week as
measured by the CDS.

At admission, 23.0% of the patients were completely dependent on care,

and at the 13th week about 1.0% were.

Patients' care dependency decreased significantly in all care dependency

items of the CDS in the inpatient ward, but five care dependency items
of the CDS did not significantly decrease in the outpatient unit.
Thank You
Do you have any questions
for me before we go?