Background: Hemodialysis is a kidney replacement therapy, but it has many complications identified, one of them is pain. Thus, we need non-pharmacological interventions that can be done by nurses, among them is progressive muscle relaxation (PMR), which is economically-efficient and no side effects.Objective: To determine the effect of progressive muscle relaxation on pain in hemodialysis patients.Methods: This is a quasi experimental design of time series design. The number of samples was 100 patients taken by simple random sampling. Progressive muscle relaxation (PMR) was given every day for 4 weeks. Research instrument  applied was Brief Pain Inventory. The data analysis employed independent t-test.Results: There was a decrease in pain level from week to week after the intervention, from the scale of 6 (moderate pain) to scale 3 (mild pain). There was a difference in the level of pain between the intervention group and the control group p <0.001.Conclusion: The therapy of non-pharmacological using a progressive muscle relaxation is proven to reduce pain in hemodialysis patients.

BACKGROUND: Assessing the quality of health services provided at home (home care) is a challenge. The formulation of indicators requires open-minded people, who able to formulate several purposes objectively, and play an active role in decision making. PURPOSE: To test the face validity of the home care quality indicator in stroke patients with the modified Delphi method. METHOD: Eighty-one indicators generated from previous studies were assessed using 3 processes to get the final results: 1) conducted modified Delphi in two rounds, namely rating or scoring by experts (using median scores); 2) reviewing qualitative suggestions from experts during the Delphi process (using comments from both Delphi rounds); 3) sorting out and correcting the grammar of the appropriate indicator (based on the median score > 7, and no disagreement). RESULT: Eighty-seven experts were involved in the first round Delphi and 34 experts in the second round. The experts were home care team selected from health care institutions in Yogyakarta with various professional backgrounds. Delphi process resulted in 67 indicators from 81 indicators which were divided into 10 domains: 1) Personal (2 indicators), 2) Documents (13 indicators), 3) Professionalism development (3 indicators), 4) Supporting facilities (8 indicators), 5) Administrative activities (4 indicators), 6) Health workers interaction with patients and families (15 indicators), 7) Physical conditions (2 indicators), 8) Self-actualization (1 indicator), 9) Psychological condition (5 indicators), 10) Family independent and coping (14 indicators). Selected indicators got to score more than 7 and no disagreement at all. CONCLUSION: Sixty-seven indicators of the quality of home care, which were generated from modified Delphi consensus, were face validated. Further research could be conducted particularly on the trial process of these indicators at the actual home dwelling service setting.

Many people with neurological impairment following stroke prefer home-based care instead of long-term hospitalization. This study aims to identify the physical and psychological outcomes of home-based care after a stroke. The studies were identified by searching the following electronic databases, PubMed, ProQuest, Web of Science, PsyARTICLES, MedLINE, CINAHL, and EBSCO. Twenty-seven articles analyzed and reviewed using the content analysis method. Most physical interventions resulted in increased upper body motor function. The most common equipment were treadmill and computer games. The studies we reviewed highlighted the muscle limb pain and falling as the adverse events that occur during home-based care, but most studies did not systematically document those adverse events. Home-based interventions are particularly effective to improve motor function and reduce anxiety and depression.

Background: Hypertension is one of the signficant risk factors for further severe cardiovascular diseases. Furthermore, the insidence of hypertension in adult age population has increased gradually. Thus, assessment of hypertension insidence and their risk factors in adult age people has given the beneficience for treating dan preventing program earlier. Aim: To analyze hypertension insidence in adult age and their risk factors that dominanly effect the occurance of hypertension. Method: This study was correlational with survey method. Accidental sampling was conducted to 120 respondents who live around Malioboro district. Hypertension was detected from systole and diastole value, while the risk factors of hypertension were age, gender, family disease history, type of activity, the number of cigarette each day, the length of smoking, random blood glucose, and body mass index. Analyzing the data used Pearson correlation if data were normal, or used Spearman correlation if data were not normal. Findings: From 120 participants, mean of systolic pressure was 120.7 mmHg and mean of diastolic pressure was 78.5 mmHg. Age mean was 39 years old, dominantly was woman amount 83 (69.2%), and without family disease history as 66 (55%). Mostly they had moderate physical activity amount 71 (59%). Mean of cigarette consumtion was 11 pieces/day, for 23 years. Random blood glucose mean was 131 mg/dL and mean of body mass index was 26 kg/m 2. Correlation analysis mentioned that body mass index had correlate with systolic and diastolic value significantly (p < 0.05). Conclusion: Systolic and diastolic pressure value in adult age were still normal. Risk factor that correlated significantly with adult age blood pressure was body mass index. Another risk factors such as cholesterol level, blood glucose in fasting condition and two hour post meal, also food consumtion were considered that should be included in next study.

Background: The short-term impact felt by critically ill patients and ventilators are Ventilator-Associated Pneumonia (VAP), which is added to the health mechanism due to muscle weakness and the occurrence of pressure sores or decubitus. Prevention of pneumonia in intubation patients is crucial because it can prevent hospital-acquired or nosocomial infections, which is a severe complication. Extensive skin destruction or pressure can cause depression in the blood supply and tissue damage. Decubitus will disturb the blood that enters the depressed (stressed) area and results in tissue death. Physical activity in ICU for critical patients is needed. Progressive mobilization of patients is one of the nurse interventions for patients. Objective: This research aims to identify the effect of progressive mobilization on the formation of pneumonia and (decubitus) in critically ill patients. Method: This research is a literature review accessed from internet database searches named PubMed, Pro-Quest, and Science direct with the keywords mobilization progressive, pneumonia, pressure sores. From the PubMed database, 12473 articles were found, 28986 articles from Pro Quest and Sciencedirect resulted in 51077 articles. After going through the screening process and eligibility, 7 articles fit the inclusion criteria. Results: The stages of progressive mobilization in preventing the risk of pressure sores were developed according to the level of mobility in the Early Mobilization Protocol. Based on the results of a review of 7 articles, mobilization exercises were carried out progressively from Level 1 -Level VI with Head of Bed (HOB) activity 30˚-45˚ until the patient can walk for 2 hours, starting in the first 48 hours after entering critical care and performed every day until 7 to 13-day treatment. Conclusion: This literature review shows that progressive mobilization reduces the incidence of pneumonia in ICU care and the risk of pressure sores. Training for nurses working in critical services is needed to increase knowledge and civilize clinical practices related to progressive mobilization I.