Search

Endotracheal suctioning is an effective nursing intervention for intubated infants undergoing invasive mechanical ventilation. However, this intervention has the potential to cause side effects, such as hypoxemia, which typically requires hyperoxygenation. Despite the widespread use of hyperoxygenation in clinical practice, there are limited reports on its effectiveness in infants. This study aims to determine the effect of hyperoxygenation on oxygen saturation of intubated infants. The study procedures were carried out using a quasi-experimental method with a cross-over approach. In addition, the sample population comprised 22 intubated infants who were treated at the perinatology unit of Dr. Cipto Mangunkusumo Hospital in Jakarta from March to April 2018. The participants were then divided into 2 groups based on their condition, and oxygen saturation level was assessed. The intervention comprised endotracheal suctioning with and without hyperoxygenation, with a 3-hour washing period. Data collection was performed at different measurement intervals, namely before, during, and after suctioning, followed by statistical analysis. The paired-sample t-tests and Wilcoxon test showed that there was a significant difference in oxygen saturation at certain measurement intervals (p=0.006; p=0.010; p=0.001; p=0.001; p=0.001). In addition, Friedman test also showed the presence of a significant difference in the reduction of oxygen saturation between the control and intervention groups (p=0.001). In conclusion, hyperoxygenation had the potential to prevent the reduction of oxygen saturation during endotracheal suctioning in intubated infants. However, individual assessment of the need for suctioning and hyperoxygenation was necessary for a safe and effective procedure.

It has been suggested that a corona virus infection is linked to chronic periodontitis (COVID-19). Our objectives were to look at the expression of angiotensin-converting enzyme-2 (ACE2) in periodontal compartments containing periodontal infections to determine if ACE2 is directly or indirectly responsible for the inflammation in periodontal tissues getting worse. In this study, six non-COVID-19 periodontitis patients without diabetes served as controls, and 23 hospitalized periodontitis patients were admitted with PCR-confirmed COVID-19 with diabetes mellitus (Group 1/G1, n = 10), and without diabetes (Group 2/G2, n = 13). We evaluated the mRNA expression of ACE2, IL-6, IL-8, complement C3, and LL-37, as well as the relative proportion of Porphyromonas gingivalis, Fusobacterium nucleatum, and Veillonella parvula to represent the dysbiosis condition in periodontal microenvironment using subgingival plaque and gingival crevicular fluids (GCF) samples and quantitative real time PCR (qPCR). Every analysis was done to ascertain how they related to one another. The area under the curve (AUC) and receiver operating characteristic (ROC) curve were used to determine the sensitivity and specificity of inflammatory indicators. All the grouped patients had ACE2 detected, according to our findings, but only the G1 patients had a positive correlation (p

Background The available evidence suggests that inflammatory responses, in both systemic and oral tissue, contribute to the pathology of COVID-19 disease. Hence, studies of inflammation biomarkers in oral fluids, such as saliva, might be useful to better specify COVID-19 features. Methods In the current study, we performed quantitative real-time PCR to measure salivary levels of C-reactive protein (CRP) and interleukin-6 (IL-6) in saliva obtained from patients diagnosed with mild COVID-19, in a diabetic group (DG; n = 10) and a non-diabetic group (NDG; n = 13). All participants were diagnosed with periodontitis, while six participants with periodontitis but not diagnosed with COVID-19 were included as controls. Results We found increases in salivary total protein levels in both the DG and NDG compared to control patients. In both groups, salivary CRP and IL-6 levels were comparable. Additionally, the levels of salivary CRP were significantly correlated with total proteins, in which a strong and moderate positive correlation was found between DG and NDG, respectively. A linear positive correlation was also noted in the relationship between salivary IL-6 level and total proteins, but the correlation was not significant. Interestingly, the association between salivary CRP and IL-6 levels was positive. However, a moderately significant correlation was only found in COVID-19 patients with diabetes, through which the association was validated by a receiver operating curve. Conclusions These finding suggest that salivary CRP and IL-6 are particularly relevant as potential non-invasive biomarker for predicting diabetes risk in mild cases of COVID-19 accompanied with periodontitis.

Abstract Background In the healthcare systems of the world, reinforcing the competence and professionalism of nurses has become a concern. Gaining clinical nursing competence in the healthcare system requires more effort, and additional training is required. Medical education and training have begun using digital technologies, such as virtual reality (VR). The purpose of this research was to examine the efficacy of VR in terms of cognitive, emotional, and psychomotor outcomes and learning satisfaction in nurses. Method The study searched eight databases (Cochrane library, EBSCOHost, Embase, OVID MEDLINE, ProQuest, PubMed, Scopus, and Web of Science) for articles that met these criteria: (i) nursing staff, (ii) any virtual reality technology intervention for education, all levels of immersion, [1] randomized control trial and quasi-experiment study, and (iv) published articles and unpublished theses. The standardized mean difference was measured. The random effect model was applied to measure the main outcome of the study with a significance level of p

Background: /Purposes: Studies have indicated that salivary molecules from patients with periodontitis and diabetes are confounded with pathological conditions associated with SARS-CoV-2 infection. The study aimed to address whether the abundance of Porphyromonas gingivalis which causes periodontitis, differed compared with that of Aggregatibacter actinomycetemcomitans (used as control) and to analyze the correlation of periodontitis with the expression levels of severe acute respiratory syndrome coronavirus 2 receptor (ACE2) and periodontitis inflammatory markers (TLR-2/TLR-4, TNFα, and miR-155). Materials and Methods: A saliva sample (5 mL) was obtained from 23 hospitalized patients with COVID-19, categorized into two groups: diabetic (G1, n = 10) and non-diabetic (G2, n = 13). Saliva from patients with periodontitis without diabetes and coronavirus disease 2019 (COVID-19; n = 6) were included as control. The quantitative real-time polymerase chain reaction measured the levels of P. gingivalis and A. actinomycetemcomitans, as well as periodontitis markers in saliva. The obtained data were analyzed using one-way ANOVA and the Spearman correlation test. Results: The abundance of P. gingivalis was observed to be higher (p

Background: Work of breathing (WOB) and non-comorbidities factors in the respiratory system are the two probable findings in pediatric COVID-19 patients. However, the association of those factors with level of care was not well reported. Purpose: This study aimed to identify the relation between potential predictors including comorbidity, low nutritional fulfillment, infectious disease, shock, cough, O2 saturation reduction, abnormal blood gas analysis and sore throat with the level of care among pediatric COVID-19 patients. We also analyzed the synergistic correlation of non-comorbidities factors in the respiratory system and work of breathing to predict level of care in pediatric COVID-19 patients. Methods: A cross-sectional study was conducted in the six referral hospitals from July to September 2020 in four provinces in Indonesia. An observation checklist was used to collect data from the medical records of pediatric patients with COVID-19, including medical diagnosis, demographic, and clinical manifestation. This study included 423 participants aged from 0 to 18. The multivariate logistic regression was performed to test the adjusted odds ratios (AORs) with the 95% confidence intervals (CIs) of the association between WOB, non-comorbid respiratory, and level of care. Moreover, dummy variables (2x2) were made to analyze synergistic correlation of non-comorbid respiratory disease and WOB. The AOR with the 95% CIs was applied in the association between the complication of non-comorbid respiratory diseases and high work of breathing with level of care among pediatric patients with COVID-19. Results: Results showed that age, presence of comorbidity, nutritional fulfillment, infectious disease, shock, work of breathing, O2 saturation reduction, abnormal blood gas analysis, sore throat, and convulsive meningeal consciousness were significantly associated with the level of care (p

Background: Pain assessment scale in neonates is the cornerstones of pain management so that the impact of pain can be prevented to maximize neonatal growth and development. Purpose: This study aimed to identify the most appropriate pain assessment scale used for neonates in Indonesia. Methods: A cross sectional study design was used in 30 neonates hospitalized using Neonatal Infant Pain Scale (NIPS), Neonatal infant Acute Pain Assessment Scale (NIAPAS) and Pain Assessment Tool (PAT). Pain assessment was performed by nurses (n=30) and expert nurses (n=5) participated in the validation of scales. Statistical analysis using validity (content, construct and concurrent validity) and reliability (inter-rater reliability and internal consistency) test. Results: NIPS instrument have excellent validity, reliability, and feasibility value compared with NIAPAS and PAT. Conclusion: NIPS was shown a valid, reliable, and practical scale for assessing pain in neonates. It allows nurses to identifying pain and help to provide of appropriate pain management

Background: The coverage of immunization among children in Jambi City decreased during COVID-19 pandemic. Purpose: This study aims to identify the factors that might be associated with basic vaccination compliance among mothers in Jambi, Indonesia. Methods: This study uses a case control design in 5 Jambi City Regions in March-May 2021. The sample in this study is mothers who have children in age 9-24 months. The sampling that is used in this study is cluster sampling with total sample of 506 mothers. The data analysis used in this study is descriptive statistical analysis of univariate, bivariate using chi square test. Results: The results of data analysis showed that the variables related to compliance were perceptions of receiving immunization, attitudes, knowledge, husband's support with p value < 0.01, and distance traveled with p value < 0.05. Conclusion: Effort to improve compliance in the pediatric immunization Pandemic are needed to strengthen mother’s perception, knowledge, attitudes during COVID-19. Analysis with predictive models is highly recommended to determine the odd-ratios and adjusted odd-ratios between factors related to the complying for basic vaccination.

Background: A relationship between oral microbiota and susceptibility to SARS-CoV-2 infection has been extensively studied. However, the relationship between oral commensal flora and expression of angiotensin-converting enzyme 2 (ACE2) remains to be established. In this observational study, we collected saliva from patients with COVID-19 and evaluated the relationship between ACE2 expression and Candida albicans as well as with selected gram-negative bacteria (Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, and Veillonella parvula). We investigated how this may be directly or indirectly involved in oral dysbiosis in patients with COVID-19. Methods: We included 23 hospitalized patients admitted to Universitas Indonesia Hospital with PCR-confirmed COVID-19, with six healthy participants serving as controls. Saliva and tongue surface swabs were collected from patients with diabetes (DG) and without diabetes (NDG) and subject controls. Using quantitative PCR (qPCR) we assessed the mRNA expression of ACE2, the abundance of C. albicans, and the transcription levels of its biofilm-associated genes, agglutinin-like protein 3 (ALS3), hyphal wall protein 1 (HWP1), and yeast-form wall protein 1 (YWP1). We also counted the relative proportion of the three selected gram-negative oral bacteria in saliva. All analyses were performed to determine the relationship between ACE2 expression and C. albicans and gram-negative bacteria. Results: ACE2 mRNA expression was significantly higher in tongue swab samples than in saliva. However, no significant difference was observed between the patient groups. Conversely, DG patients had a significantly higher abundance of C. albicans in saliva compared to NDG patients and control group patients. The correlation and sensitivity/specificity relationship between ACE2 expression and C. albicans or the selected oral bacteria were also observed. Conclusions: The data show that ACE2 expression can be detected in saliva of patients with COVID-19 and its association with C. albicans and gram-negative oral bacteria might contribute toward developing an oral dysbiosis based predictor for prognosis of COVID-19 severity.

Introduction: A good comprehension of the clinical profile and nursing diagnosis of newborn in Special Care Nursery (SCN) unit guides decision-making by nurses. In addition, it can become an initial basis for making plans for improving quality of care, management and nursing research. The purpose of this study was to identify clinical profile and nursing diagnosis of newborns in an SCN unit. Methods: It is a quantitative, cross-sectional, descriptive study in SCN (Level II and III) with a sample of 77 medical records of newborns less than 31 days old in a national referral hospital. Descriptive analysis was used to identify demographic characteristic, the medical diagnosis and nursing diagnosis of newborns at birth and hospitalization. Results: Newborns treated in SCN unit are dominated by preterm with low birth weight (74%). Respiratory system disorders (55.8%) and infections (35.1%) dominate newborn problems both at birth or coming. Most nursing diagnoses when the baby is born or coming are the risk of infection (90.9%) and ineffective breathing patterns (76.6%). As for the treatment, most diagnoses show the risk of infection and hypovolemia. Conclusion: A good clinical profile and nursing diagnosis of newborns can guide nurses to decision-making. Continuous update on nursing diagnosis determination, improvement of nurses’ knowledge about the signs of deterioration, and future research that prioritizes issues in neonates are required to optimize nurses’ role in SCN units.

The need for continuous positive airway pressure (CPAP) was vital for preterm infant with respiratory distress, but the impact of long-term use was very harmful. The effort to do weaning must be done and facilitate the infant to adapt wean off CPAP. The effect of positioning on stabilized physiological parameters may help preterm infant to adapt under gradual weaning from CPAP. Aim in this study to determine the effect of prone positioning on physiological parameters in preterm infants under gradual weaning CPAP. From Mei to September 2020 total sample 60 preterm infants on non-invasive ventilation or CPAP were randomized into prone position (intervention group, n = 30) and supine position (control group, n = 30). Oxygen saturation, respiratory and heart rate between groups were compared. In the prone position was significant higher than supine position at 30th minute. The mean oxygen saturation in the prone position (99.87±0.35) was higher than in the supine position (97.63±1.45; p=0.001), the mean respiratory rate in the prone position (42.10±8.59 breaths/min) was lower than in the supine position (53.20±6.24 breaths/min; p=0.001), and the mean heart rate in the prone position (144.63±13.07/beats/min) was lower than in the supine position (153.53±10.02/beats/min; p=0.001), so that the prone position can be applied to increase oxygen saturation and to maintain the stability of respiratory rate in preterm infants during gradual weaning. The failure to wean off CPAP (re-CPAP) in the prone group was less frequent which is 3 respondents (5% versus 10%). However, there is no relation between positioning and re-CPAP (p=0.472).

Background: Impairment of nutritional fulfillment is one of the problems that is often encountered in premature infants. Purpose: This study aims to determine the effect of the type of nutrition on the weight increase of premature babies. Methods: A retrospective study was conducted through a medical record review in a top national referral hospital, Indonesia. Total of 75 preterm infants divided into groups of 15 infants by nutrition type (100% BM, 75% BM, 50% BM, 25% BM, and 0% BM). Weight gain was assessed for 12 days through the patients’ medical records. Weighing observation was devided into four times: birth weight in day-1, day-4, day-8, and day-12. Subjects were recruited using consecutive sampling with the following criteria: preterm infants with chronological age > 7 days and weight > 1000 grams. Meanwhile, the exclusion criteria were preterm infants treated in the neonatal intensive care unit (NICU), preterm infants with medical diagnosis of hydrocephalus, sepsis, and congenital anomalies, conjoined twin babies. The general linear model-repeated measure was used to quantify the contrast of increases in infants’ body weight among groups for days 1-4; 4-8; and 8-12. Results: There were no significant differences between the five types of nutrients in terms of increase in the infants’ body weight in day 1-4 (p > 0,68); day 4-8 (p > 0,65); day 8-12 (p > 0,12). Conclusion: Although it not likely to accelerate the infant’s weight, mother’s own milk is still the first recommendation due to its immunity components, nutritional elements, and safety.

Background: A relationship between oral microbiota and susceptibility to SARS-CoV-2 infection has been extensively studied. However, the relationship between oral commensal flora and expression of angiotensin-converting enzyme 2 (ACE2) remains to be established. In this observational study, we collected saliva from patients with COVID-19 and evaluated the relationship between ACE2 expression and Candida albicans as well as with selected gram-negative bacteria (Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, and Veillonella parvula). We investigated how this may be directly or indirectly involved in oral dysbiosis in patients with COVID-19. Methods: We included 23 hospitalized patients admitted to Universitas Indonesia Hospital with PCR-confirmed COVID-19, with six healthy participants serving as controls. Saliva and tongue surface swabs were collected from patients with diabetes (DG) and without diabetes (NDG) and subject controls. Using quantitative PCR (qPCR) we assessed the mRNA expression of ACE2, the abundance of C. albicans, and the transcription levels of its biofilm-associated genes, agglutinin-like protein 3 (ALS3), hyphal wall protein 1 (HWP1), and yeast-form wall protein 1 (YWP1). We also counted the relative proportion of the three selected gram-negative oral bacteria in saliva. All analyses were performed to determine the relationship between ACE2 expression and C. albicans and gram-negative bacteria. Results: ACE2 mRNA expression was significantly higher in tongue swab samples than in saliva. However, no significant difference was observed between the patient groups. Conversely, DG patients had a significantly higher abundance of C. albicans in saliva compared to NDG patients and control group patients. The correlation and sensitivity/specificity relationship between ACE2 expression and C. albicans or the selected oral bacteria were also observed. Conclusions: The data show that ACE2 expression can be detected in saliva of patients with COVID-19 and its association with C. albicans and gram-negative oral bacteria might contribute toward developing an oral dysbiosis based predictor for prognosis of COVID-19 severity.

The period of 1000 days of life plays an important role in determining the quality of children's growth and development. Accessibility of quality health services through the MCH handbook is an important strategy for improving maternal and child health. The purpose of this review is to present an overview of the use and usefulness of the possession of a specific MCH handbook on maternal, infant and child outcomes, as well as the potential for further research development. The method of systematic study and study search through the ProQuest, EBSCOhost, and Scopus databases, with the keywords maternal and child health handbook, home based record, mother, newborn, infant, and child, published from January 2008 to October 2018. Furthermore, filtering of articles and data abstraction. A total of 56 articles on the use of the MCH handbook that met the eligibility/inclusion criteria were screened, and 16 articles were selected for a systematic review. The variety of existing studies, has proven the benefits, functions, and effectiveness of the MCH handbook on the health of mothers, infants, and children. The categories of use and use of MCH handbook are integrated with home-based records, namely as an effective tool to facilitate improvement in health-seeking behavior; continuous care; health communication, information and education; as well as home based health records. In order to fill the gap, further research can be directed at evaluating especially premature babies/LBW as part of a population of newborns with high risk. The use of digital technology in improving the implementation of interventions and the accessibility of MCH handbook is also important to be developed.

The incidence of infections in preterm infants is still quite high. In this study, oral care with human breast milk was implemented in risk preterm infants as a precaution. The study was conducted using a quasi-experimental method with a non- equivalent control group and posttest only design in 40 risk preterm infants. The participants were divided into two groups of 20. The data were analyzed using independent t-test and a Wilcoxon test. The results show that this intervention has an effect on the incidence of late-onset sepsis in preterm infants. The effect is based on symptoms: body temperature instability (p = 0.021), C-reactive protein (p = 0.006), and leukocytes (p = 0.020) all indicated differences between the two groups. It is recommended that this practice be adopted as a routine therapy program in perinatology. Keywords: exclusive breastfeeding, late-onset sepsis, oral care, risk preterm infants, sepsis Abstrak Perawatan Mulut Mencegah Sepsis Neonatorum Awitan Lambat pada Bayi Prematur Risiko Tinggi. Angka kejadian infeksi setelah lahir pada bayi prematur masih cukup tinggi. Pelaksanaan intervensi pemberian oral care menggunakan air susu ibu pada bayi prematur risiko tinggi telah dilakukan sebagai pencegahan. Penelitian dilakukan menggunakan metode kuasi eksperimen dengan desain post-test only, kelompok kontrol non ekuivalen, pada 40 bayi prematur risiko tinggi sebagai sampel. Responden dibagi menjadi dua kelompok, masing-masing kelompok 20 responden. Data dianalisis menggunakan uji t independen dan wilcoxon. Hasil Intervensi ini terbukti memiliki manfaat terhadap dalam menurunkan kejadian sepsis neonatorum awitan lambat pada bayi prematur berdasarkan tanda klinis seperti ketidakstabilan suhu tubuh (p value 0,021), hasil pemeriksaan C-Reaktif Protein (p value 0,006) dan leukosit (p value 0,020) yang menunjukkan adanya perbedaan yang bermakna antara kelompok kontrol dan kelompok intervensi. Intervensi ini diharapkan dapat dilanjutkan menjadi program terapi rutin yang akan dilakukan di ruang rawat perinatologi. Kata Kunci: ASI eksklusif, bayi prematur, oral care, sepsis, sepsis neonatorum awitan lambat

BackgroundThe hospitalization of children during the COVID-19 pandemic has affected their physical and mental health. Pediatric nurses have faced challenges in providing high-quality nursing care for children and their families. However, the pediatric nursing care recommendations for COVID-19 patients in the hospital setting remain unclear. The current scoping review provides recommendations for nursing interventions for pediatric COVID-19 patients in the hospital setting.Methods and findingsThe selected articles containing management and nursing recommendations for COVID-19 that have occurred in pediatric patients ages 0-19 years old. A search strategy was developed and implemented in seven databases. We included peer-reviewed articles that reported observational or interventional studies, as well as policy papers, guides or guidelines, letters and editorials, and web articles. A total of 134 articles and other documents relevant to this review were included. We categorized the results based on The Nursing Intervention Classification (NIC) taxonomy which consists of six domains (e.g., Physiological: Basic); eleven classes (e.g., Nutrition Support); and eighteen intervention themes (e.g., Positioning, Family Presence Facilitation, Family Support, and Discharge Planning).ConclusionApart from the intervention of physical problems, there is a need to promote patient- and family-centered care, play therapy, and discharge planning to help children and families cope with their new situation.

Introduction: Low birth weight (LBW) infants who have been hospitalized are exposed to various conditions that provoke discomfort, which could trigger a stress response and growth disorders. This study aimed to identify the effects of auditory stimuli from Murottal Quran when it comes to the comfort and weight of LBW infants. Methods: This study used a clinical randomized controlled trial design involving 52 low birth weight infants. The infants were randomly assigned to either the intervention group (n=26) or the control (n=26). The intervention of Murottal Quran was given using a speaker 4 times a day for 20 minutes every 3 hours. This intervention was conducted for three days. Results: The results of this study show that there is a significant difference in the comfort of low birth weight infants after Murottal Qur’an on the first, second, and third days between the intervention and control groups (p=0.014;

Pemberian posisi yang salah dapat meningkatkan risiko morbiditas dan mortalitas. Artikel ini bertujuan untuk menggali pemberian posisi (positioning) dan nesting pada bayi prematur di NICU. Penelitian ini berupa studi literatur tahun 2007-2017, serta pengalaman penulis dalam aplikasi pemberian posisi dan nest di dua rumah sakit rujukan nasional dalam lima tahun terakhir. Hasil studi ini menunjukkan beberapa posisi yang dapat diberikan pada bayi prematur di antaranya adalah posisi supinasi, lateral kiri, lateral kanan, pronasi, dan quarter/semi pronasi. Posisi pronasi dan kuarter/semi pronasi direkomendasikan untuk bayi prematur dengan Respiratory Distress Syndrome (RDS). Posisi lateral kanan direkomendasikan untuk bayi prematur dengan Gastroesofageal reflux (GER). Posisi supinasi merupakan alternatif terakhir pemberian posisi pada bayi prematur dengan kontraindikasi posisi pronasi, kuarter/semi pronasi, dan lateral. Pembuatan nest dapat dimodifikasi dari potongan beberapa kain yang digulung. Perawat hendaknya meningkatkan pengetahuan dan keterampilan agar mampu memberikan variasi posisi sesuai kondisi dan indikasi bayi yang dirawat di NICU. Kata Kunci: Bayi prematur, pemberian posisi, nest, perawatan intensif Abstract Positioning and Nesting for the Preterm Infant: Evaluation for Nursing Care in Neonatal Intensive Care Unit (NICU). Incorrect positioning may increase the risk of morbidity and mortality. This article aims to explore positioning and nesting in a preterm infant in NICU. This study is a literature study in 2007-2017, as well as documentation of the application of positioning and nest at two national top referral hospitals in the last five years. The alternative position for preterm infants include supine, left lateral, right lateral, pronation, and quarter/semi-prone positions. The pronation and quarter/semi-prone are recommended for preterm infants with Respiratory Distress Syndrome (RDS). Right lateral positions are recommended for preterm infants with Gastroesophageal reflux (GER). The supination is the last alternative when the other positions are contraindicated. The nurses can modify nest from pieces of some rolled fabric. Nurses should increase their knowledge and skills in order to be able to provide proper position according to the conditions and indications of the infant cared in NICU. Keywords: intensive care, nest, positioning, preterm infant

COVID-19 vaccination in adolescents is important because the adolescent population has the highest incidence of COVID-19. This study aimed to explore the factors associated with COVID-19 vaccination adherence among Indonesian adolescents. This cross-sectional study involved 7986 adolescents, polled through online and offline surveys conducted in six major islands of Indonesia. The online questionnaire was distributed through popular social messaging and social media platforms. Our team also contacted schools and public places to recruit participants from remote areas. In total, 7299 respondents completed the questionnaire. Binary logistic analysis revealed that higher levels of knowledge, positive attitudes, and confidence in the COVID-19 vaccine were significantly associated with higher COVID-19 vaccination adherence in adolescents. Sociodemographic factors were also significantly associated with higher adherence to vaccination programs. Meanwhile, younger age and habitation in private housing were related to lower adherence to the vaccination program. Parental factors related to adolescent compliance were education level, household income, history of infection of family or friends with COVID-19, and working status. The national authorities and stakeholders should take extensive measures to increase attitude, knowledge, confidence, and family support among adolescence through multiple channels.

Prone positioning is an important treatment procedure for preterm infants with Respiratory Distress Syndrome (RDS). However, the accuracy with which preterm infants in the Neonatal Intensive Care Unit (NICU) are placed in the prone position is impacted by several factors. The current study aimed to identify these factors. One hundred and twenty-eight nurses were included in this cross-sectional study. Direct observations of the research subjects were used to collect the research data. The participants completed a research questionnaire that included their demographic data and three others to obtain information on their clinical experience, knowledge of positioning, caring behaviors, and efficacy. Independent factors likely to affect preterm infant positioning were evaluated using multivariate logistic regression. The alpha level was set at 5%. Knowledge (p=0.002) and caring behavior (p=0.009) significantly influenced the accuracy with which nurses placed preterm infants with RDS in the prone position. Nursing efficacy, infant’s bodyweight, gestational age, the institution, and DNR decisions did not significantly impact accuracy. NICU nursing staff require interventions to increase their knowledge of the accurate positioning of preterm infants with RDS.

Low-Birth-Weight (LBW) infants have very small veins, and there is a risk of needing multiple insertions to establish peripheral intravenous access. This study aimed to examine the impacts of multiple insertions during peripheral intravenous access in LBW infants. This cross-sectional study involved 216 respondents. Data were analyzed with the Spearman correlation. The results showed a significant relationship (p

Invasive procedures commonly cause recurring pain in preterm infants. Noninvasive pain management is an essential part of nursing intervention in the Neonatal Intensive Care Unit (NICU). The study’s aim is to identify the impact of touch therapy on pain in premature infants undergoing invasive treatments. The method was a quasi- experiment with 63 premature infants. The premature infants were classified into four groups: i) Mother’s touch Therapy (MTT), ii) Mother’s Voice Stimulus (MVS), iii) a combination of MTT and MVS, and iv) routine care. The observed infants’ pain scores were determined through a multiple regression model using the Generalized Estimating Equation (GEE) method. The GEE test showed that the combination of touch and sound therapy significantly reduced pain in premature infants undergoing invasive measures (p

Having a Low Birth Weight (LBW) is one of the risk factors that may lead to stunting in children under five years old. An education program based on the Maternal and Child Health handbook (MCH) for the first 1000 days of a child’s life is one way to prevent the impact of stunting by improving the mothers’ knowledge and self-confidence to look after LBWB. The study is designed along the line of pre-post quasi-experimental research with a control group, involving 69 samples of mothers with LBWB that match the predetermined criteria. Twenty three of these mothers whose babies were cared for in the perinatology ward were provided with instructions from the MCH handbook, another group of 23 mothers received the same instructions with additional audiovisual media from a mobile application, and the remaining 23 mothers only received verbal instructions in the ward. The data were analyzed using the Paired t-test/Wilcoxon and Kruskall-Wallis tests. The analysis revealed that the MCH handbook based instruction provided a significant boost on the score of mother’s knowledge and confidence, before and after they have received the instructions, both in the group that received the MCH handbook based instruction (p

Peripheral intravenous line placement might lead to some risks and complications in low birth weight (LBW) infants including phlebitis, which shows varying percentages. This study aimed to analyze the causative factors of phlebitis among LBW infants in a perinatology ward. A total of 106 LBW infants who selected using a consecutive sampling technique were analyzed with cross-sectional method. Data were collected when LBW infants started receiving infusions until the infusion was stopped under certain conditions, using the Infusion Nurses Society (INS) phlebitis scale and the Neonatal Infant Pain Scale (NIPS) as the instrument. The variables related to phlebitis under bivariate analysis included the clinical experience of intravenous insertion, infusion pumps, site of insertion, neonatal birth weight, and the administration of total parenteral nutrition. The most significant risk factor of phlebitis was the nurses’ clinical experience of intravenous insertion (< 2 years). Therefore, the results of this study can be considered to improve the quality of nursing care in perinatology ward.

The process of breastfeeding for newborns in the special care room often experiences obstacles due to diverse factors, such as environmental factors, hospitalization impact, and maternal discomfort during breastfeeding. The aim of this study was to determine whether breastfeeding pillows decrease maternal discomfort during breastfeeding. This research employed a randomized control trial (RCT) design involving 70 participants who were divided into an intervention (n=35) and a control group (n=35) based on the inclusion criteria. The intervention group used a breastfeeding pillow while breastfeeding the baby, and the control group provided ASI (breast milk) as recommended in the treatment room. The data measurement instruments were an observation sheet and the body part discomfort scale (BPDS). The BPDS comprised 4 assessments: the initial assessment, day I assessment, day II assessment, and the final assessment. The results of the GLM-RM analysis showed a significant reduction in maternal discomfort among participants using breastfeeding pillows (P

Most preterm infants often need to be hospitalized more than one week in intensive care, so they undergo numerous repeated painful procedures such as blood collection. The study aimed to identify the effect of facilitated tucking for pain respond that is physiological parameter and duration of crying in preterm infants during blood collection. The study design was quasi experimental with nonequivalent control group pretest-posttest design. Fourty babies were divided into two groups; the intervention group (n= 20) who received facilitated tucking during blood collection and the control group (n= 20) without facilitated tucking, with consecutive sampling technique. Statistical analyses used were General Linear Model+post hoc, Mann-Whitney, and Independent T-Test. There were significant means the difference in the heart rate, oxygen saturation, and duration of crying infants between non-intervention and intervention group. Duration of crying infants in intervention is shorter than the control group. Facilitated tucking is effective in pain reduction and crying time during blood collection. This finding implies a part of developmental care and should be attention for promoting pain management infants. Keywords: developmental care, facilitated tucking, pain, preterm infants Efektivitas Facilitated Tucking Terhadap Respon Nyeri Bayi Prematur Selama Pengambilan Darah di Unit Perinatal di Jakarta. Mayoritas bayi prematur akan mengalami perawatan yang lama di ruang intensif, sehingga terpapar sejumlah prosedur menyakitkan berulang yang menimbulkan respon nyeri salah satunya pengambilan darah. Tujuan dari penelitian ini untuk mengidentifikasi pengaruh penerapan facilitated tucking terhadap respon nyeri berupa parameter fisiologis dan lama menangis selama dilakukan pengambilan darah. Desain penelitian adalah quasi experimental dengan nonequivalent control group pretest-posttest design. Empat puluh bayi pada sampel penelitian dibagi menjadi dua kelompok; kelompok intervensi (n= 20) dengan facilitated tucking dan kelompok kontrol (n= 20) tanpa facilitated tucking, diambil secara consecutive sampling. Analisis menggunakan uji General Linear Model+post hoc, Mann-Whitney, dan Independent T-Test. Ada perbedaan signifikan rerata frekuensi nadi, saturasi oksigen, dan lama menangis antara kedua kelompok selama pengambilan darah. Lama menangis pada kelompok intervensi menjadi lebih singkat. Facilitated tucking efektif mengurangi nyeri dan lama menangis selama pengambilan darah. Facilitated tucking dapat diterapkan sebagai bagian dari asuhan perkembangan untuk mendukung program pengendalian nyeri pada neonatus. Kata kunci: asuhan perkembangan, bayi prematur, facilitated tucking, nyeri

Dominasi penyakit pada anak di Indonesia mulai bergeser dari penyakit akut menjadi penyakit kronis. Perawatan jarak jauh (home hospital) merupakan tren pada anak dengan penyakit kronis yang membutuhkan perawatan kontinu dalam waktu yang lama. Artikel ini bertujuan untuk menggali potensi penerapan sistem mobile–health di Indonesia. Telaah literatur dari artikel ini didapatkan dari PubMed, CINAHL, dan Medline sejak tahun 2004-2014. Mobile–health merupakan aplikasi yang menawarkan integrasi berbagai fungsi perawatan melalui penggunaan telepon pintar. Beberapa negara percontohan seperti Amerika Serikat, Swedia, dan Jepang telah membuktikan kontribusi mobile – health dalam meningkatkan kualitas pelayanan. Indonesia sejauh ini belum melakukan pengembangan mobile – health di berbagai layanan kesehatan. Penggunaan telepon pintar di Indonesia telah meluas untuk berbagai tujuan, sehingga aplikasi mobile – health untuk pelayanan keperawatan anak sangat mungkin dan mudah diterapkan. Perawat anak di Indonesia hendaknya mulai mengambil inisiatif untuk mengenali aplikasi program, melakukan riset, dan kolaborasi dengan beberapa profesi terkait agar dapat berkontribusi terhadap perbaikan pelayanan kesehatan di masa yang akan datang. Abstract Mobile-Health Application as The Efforts to Improve of Nursing Service Quality in Children with Chronic Disease at Home Hospital Set: Literature Review. The dominance of the disease in children in Indonesia began to shift from the acute disease into a chronic disease. Care distance (home hospital) is a trend in children with chronic diseases who require continuous treatment for a long time. This article aimed to explore the potential application of mobile-health system in Indonesia. Literature reviews in this study were obtained from PubMed, CINAHL and Medline since 2004-2014. Mobile-health is an application that offers the integration of various functions of the above treatments through the use of smartphones. Some pilot countries such as the USA, Sweden, and Japan has proved mobile contribution - health in improving the quality of service. Up to now, Indonesia has not yet conducted any mobile-health development at various health service. In fact, the use of smartphone in Indonesia has been extended for numerous purposes, therefore mobile-health application is possibly and easily implemented in pediatric nursing area. The pediatric nurse in Indonesia should commence an initiative to identify kind of applications, conduct research, and collaborate with some associated disciplines to contribute to the improvement of future health services. Keywords: mobile-health, child with chronic illness, home hospitals

Stroke is a one of major problem in palliative care. Spiritual and depression assessment of the family is an important element in the process of palliative care for stroke survivors. The purpose of this study was to know the description of the spiritual well-being among stroke family caregiver family and its relationship with depression. This study used cross-sectional design. Spiritual well-being scale (SWBS) was used to see the spiritual well-being of the family and the Center for Epidemiologycal Studies Depression Scale (CES-D) to measure depression and was filled in by 44 Stroke families. The results of the study reported that the spiritual well-being of stroke family caregiver was in the high category and depression in the medium category. There was a relationship between the spiritual well-being of the family and depression in stroke patients (p=0.000). This study suggest a comprehensive assessment of the spiritual well-being and depression in stroke family and the need for future research about family interventions to decrease depression and increase spiritual well-being.

Abstrak Neonates Intensive Care Units (NICU) merupakan tempat penting untuk bayi prematur yang sekaligus merupakan tempat berbahaya akibat karakteristik NICU. NICU dapat meningkatkan risiko gangguanperkembangan bayi. Gangguan ini dapat dicegah melalui penerapan asuhan perkembangan. Newborn Individualized Developmental Care and Assessment Program (NIDCAP) merupakan metode asuhan perkembangan yang dianggap sebagai salah satu pendekatan terbaik dalam pemberian asuhan perkembangan dengan pertimbangan NIDCAP mampu memberikan pelayanan secara individual berdasarkan isyarat bayi dengan pendekatan perawatan berfokus keluarga. Pengukuran efektifitas NIDCAP didasarkan pada respon neurobehavioral bayi prematur saat berada di NICU. NIDCAP terbukti dapat memperbaiki pola tidur bayi, dan respons fisiologis bayi seperti saturasi oksigen, pernafasan, dan nadi. Hasil studi literatur menunjukkan bahwa asuhan perkembangan dengan menggunakan metode NIDCAP tidak berpengaruh terhadap hasil perkembangan bayi prematur jangka panjang. Studi dan pengkajian yang mendalam diperlukan untuk menemukan asuhan perkembangan dengan menggunakan metode yang lebih efektif dan efisien. Kata Kunci: Bayi prematur, hasil jangka panjang, Newborn Individualized Developmental Care and Assessment Program (NIDCAP) Abstract A Review: Newborn Individualized Developmental Care and Assessment Program (NIDCAP) to Development of Long-Term Results Premature Infants. Neonatal Intensive Care Unit (NICU) is both vital spot for preterm infant and also dangerous spot which caused by NICU’s characteristics. NICU increases the risk of infant developmental disturbance. Infant developmental disturbance can be prevented by implementing Developmental care in NICU setting. Newborn Individualized Developmental Care and Assessment Program (NIDCAP) is method who beingregarded as one of the best approach for delivering developmental care with those consideration NIDCAP is able to give an individual service base on the infant cues trough family-centered care approach. The measurement of NIDCAP effectiveness is shown by the infant’s neurobehavioral response in the NICU. NIDCAP can repair the baby’s sleep-awake pattern, and her physiological response such as oxygen saturation, respiration rater, and hearth rate. This study show that the implementation of developmental care using the NIDCAP method doesn’t affect to the long-term outcome for the preterm infants. The further research is needed to find out the other developmental care method which is more effective and efficient. Keywords: Long-term outcome, Newborn Individualized Developmental Care and Assessment Program (NIDCAP), preterm infant.

Background The available evidence suggests that inflammatory responses, in both systemic and oral tissue, contribute to the pathology of COVID-19 disease. Hence, studies of inflammation biomarkers in oral fluids, such as saliva, might be useful to better specify COVID-19 features. Methods In the current study, we performed quantitative real-time PCR to measure salivary levels of C-reactive protein (CRP) and interleukin-6 (IL-6) in saliva obtained from patients diagnosed with mild COVID-19, in a diabetic group (DG; n = 10) and a non-diabetic group (NDG; n = 13). All participants were diagnosed with periodontitis, while six participants with periodontitis but not diagnosed with COVID-19 were included as controls. Results We found increases in salivary total protein levels in both the DG and NDG compared to control patients. In both groups, salivary CRP and IL-6 levels were comparable. Additionally, the levels of salivary CRP were significantly correlated with total proteins, in which a strong and moderate positive correlation was found between DG and NDG, respectively. A linear positive correlation was also noted in the relationship between salivary IL-6 level and total proteins, but the correlation was not significant. Interestingly, the association between salivary CRP and IL-6 levels was positive. However, a moderately significant correlation was only found in COVID-19 patients with diabetes, through which the association was validated by a receiver operating curve. Conclusions These finding suggest that salivary CRP and IL-6 are particularly relevant as potential non-invasive biomarker for predicting diabetes risk in mild cases of COVID-19 accompanied with periodontitis.

Background: The available evidence suggests that inflammatory responses, in both systemic and oral tissue, contribute to the pathology of COVID-19 disease. Hence, studies of inflammation biomarkers in oral fluids, such as saliva, might be useful to better specify COVID-19 features. Methods: In the current study, we performed quantitative real-time PCR to measure salivary levels of C-reactive protein (CRP) and interleukin-6 (IL-6) in saliva obtained from patients diagnosed with mild COVID-19, in a diabetic group (DG; n = 10) and a non-diabetic group (NDG; n = 13). All participants were diagnosed with periodontitis, while six participants with periodontitis but not diagnosed with COVID-19 were included as controls. Results: We found increases in salivary total protein levels in both the DG and NDG compared to control patients. In both groups, salivary CRP and IL-6 levels were comparable. Additionally, the levels of salivary CRP were significantly correlated with total proteins, in which a strong and moderate positive correlation was found between DG and NDG, respectively. A linear positive correlation was also noted in the relationship between salivary IL-6 level and total proteins, but the correlation was not significant. Interestingly, the association between salivary CRP and IL-6 levels was positive. However, a moderately significant correlation was only found in COVID-19 patients with diabetes, through which the association was validated by a receiver operating curve. Conclusions: These finding suggest that salivary CRP and IL-6 are particularly relevant as potential non-invasive biomarker for predicting diabetes risk in mild cases of COVID-19 accompanied with periodontitis.

Background: The available evidence suggests that inflammatory responses, in both systemic and oral tissue, contribute to the pathology of COVID-19 disease. Hence, studies of inflammation biomarkers in oral fluids, such as saliva, might be useful to better specify COVID-19 features. Methods: In the current study, we performed quantitative real-time PCR to measure salivary levels of C-reactive protein (CRP) and interleukin-6 (IL-6) in saliva obtained from patients diagnosed with mild COVID-19, in a diabetic group (DG; n = 10) and a non-diabetic group (NDG; n = 13). All participants were diagnosed with periodontitis, while six participants with periodontitis but not diagnosed with COVID-19 were included as controls. Results: We found increases in salivary total protein levels in both the DG and NDG compared to control patients. In both groups, salivary CRP and IL-6 levels were comparable. Additionally, the levels of salivary CRP were significantly correlated with total proteins, in which a strong and moderate positive correlation was found between DG and NDG, respectively. A linear positive correlation was also noted in the relationship between salivary IL-6 level and total proteins, but the correlation was not significant. Interestingly, the association between salivary CRP and IL-6 levels was positive. However, a moderately significant correlation was only found in COVID-19 patients with diabetes, through which the association was validated by a receiver operating curve. Conclusions: These finding suggest that salivary CRP and IL-6 are particularly relevant as potential non-invasive biomarker for predicting diabetes risk in mild cases of COVID-19 accompanied with periodontitis.