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Pelayanan Home Care
Pelayanan Home Care
Pelayanan Home Care
Home Care
DinKes
Medical Terminilogy
Home care
Adalah pelayanan kesehatan yang berkesinambungan dan
komprehensif yang diberikan kepada individu dan keluarga di tempat
tinggal mereka yang bertujuan untuk meningkatkan, mempertahankan,
atau memulihkan kesehatan atau memaksimalkan tingkat kemandirian
dan meminimalkan akibat dari penyakit
(DepKes 2002)
What is Home Healthcare?
Home healthcare
skilled care to help someone get healthy while at home. It comes after a
doctors visit OR a hospital stay and provided by medical professionals.
What you get from home health care:
Skilled nursing
At-home physical therapy
Pain Management
Caring for wounds
Prescription management
What is Home Care?
Palliative/supportive care
Bereavement
Death
Presentation of illness
Patient is identified as dying
(usually prognosis 6 months)
Summary of
Symptom prevalence and Impact Management
severity
Uremic pruritus a mean prevalence of Associated with decreased The highest levels of evidence for
40.6%. HRQL, and contributes to efficacy are for topical agents (e.g.,
other symptoms such as capsaicin, emollients if concurrent dry
poor sleep and depression skin), oral medications (e.g.,
gabapentinoids), and ultraviolet B
therapy.
Sleep disorders a mean prevalence of Associated with fatigue, Management involves basic sleep
60.1% poor HRQL, and depression. hygiene measures, management of
concurrent symptoms,
nonpharmacologic interventions
including exercise and cognitive
behavioural therapy, and
pharmacologic management
including simple sedatives.
Symptoms in CKD: literature synthesis
Summary of
Symptom prevalence and Impact Management
severity
Restless legs Prevalence 1020% Associated with impaired Nonpharmacologic measures may
syndrome (RLS) of long-term sleep and HRQL, premature include removal of stimulants, good
dialysis, withdrawal from dialysis, sleep hygiene, changes in the dialysis
80% of RLS and increased regime, aerobic exercise, pneumatic
sufferers also cardiovascular morbidity compression devices, and correction
experience the and mortality of hyperphosphatemia and iron
sleep disorder deficiency.
periodic limb Pharmacologic approaches might
movements (PLMS) include cessation of medications that
interfere with the dopamine pathway,
or trials of levodopa, nonergot
dopamine agonists, or low-dose
gabapentinoids.
Symptoms in CKD: literature synthesis
Summary of
Symptom prevalence and Impact Management
severity
Anorexia prevalence of 56% Associated with Management has not been studied
(range 982%). malnutrition, poor HRQL, systematically in CKD.
depression, greater
hospitalization rates, and
increased mortality
Nausea prevalence of 46% Impact has not been Management has not been studied
(range 990%). assessed systematically in systematically in CKD.
CKD.
Vomiting prevalence of 23% Impact has not been Management has not been studied
(range 1168%). assessed systematically in systematically in CKD.
CKD.
Constipation prevalence of 40% Impact has not been Management has not been studied
(range 865%). assessed systematically in systematically in CKD.
CKD.
Symptoms in CKD: literature synthesis
Summary of prevalence and
Symptom Impact Management
severity
Diarrhea prevalence of 21% (range 8 Impact has not been assessed Management has not been studied
33%). systematically in CKD. systematically in CKD.
Depression prevalence of 21.5% in Associated with increased A systematic review assessed
CKD stages 14, morbidity, hospitalization, and pharmacologic treatment in CKD stages
22.8% in dialysis Patients, mortality rates, and is 35, including 28 studies assessing 24
25.7% in kidney transplant integral to the assessment of antidepressants.
recipients, HRQL. Efficacy of nonpharmacologic treatments
prevalence of depressive (e.g., more frequent hemodialysis,
symptoms was 26.5% in cognitive behavioral therapy, and
CKD stages 14, exercise) have also been demonstrated.
39.3% in dialysis patients,
26.6% in kidney transplant
recipients
Symptoms in CKD: literature synthesis
Summary of prevalence
Symptom Impact Management
and severity
Pain ~ 58% of CKD patients associated strongly with Management is determined by both etiology and
experience pain, and many substantially lower HRQL severity. Nonpharmacological approaches may be
rate their pain as and greater psychosocial appropriate (such as exercise and local heat) for
moderate or severe in distress, insomnia, and musculoskeletal pain. For pharmacologic management,
intensity. depressive an adapted World Health Organization (WHO) analgesic
Although data on symptoms ladder that takes into account pharmacokinetic data of
peritoneal dialysis patients analgesics in CKD is recommended.
This may include the conservative dosing of opioids for
and stage 5 CKD patients
moderate to severe pain that adversely affects physical
cared for conservatively
function and HRQL and that does not respond to non-
without dialysis are more opioid analgesics.
limited, evidence suggests
similar prevalence rates
and severity to HD
patients
Take Home Message