AV fistula allows external vascular access for hemodialysis patients. Because hemodialysis patients experience puncture wounds and stabbing pain approximately 300 times a year, development of methods to decrease pain intensity are of great importance. Some techniques, such as the Valsalva maneuver, are known to reduce pain. This study aims to assess the effect of the Valsalva maneuver on decreasing the intensity of AV fistula pain in patients receiving hemodialysis. The quasi-experimental research of pre and post without control applying consecutive sampling to get as many as 63 respondents. Pain intensity was measured by using the Numerical Pain Rating Scale (NPRS). The Valsalva maneuver was performed during insertion of the AV fistula needle for 16-20 seconds. The results showed significant differences in pain intensity between before and after the intervention with the difference in mean that is 1.35 (SD= 0.54), t= 19.70, p= 0.001. The Valsalva maneuver is effective in reducing the pain of AV fistula insertion because it stimulates the vagus nerve to induce an antinociceptive effect. Nurses are highly recommended to teach the Valsalva maneuver to patients undergoing routine hemodialysis.

Coronary heart disease (CHD) is a chronic inability of heart to draw an adequate blood on myocardium due to specific problem in coronary artery. When the artery that supplies myocardium is interrupted, thus the heart is unable pumping the blood effectively to fill up an adequate blood perfusion to vital organs and other peripheral tissues. If the perfusion is impaired in time of oxygenation, the patient will threatened by a sudden death. This is a quantitative, analytical and observational research with a design of case study control, in which the subject is CHD patients and the control is non-CHD patients. The research populations were 2318 outpatients with CHD who visited Heart Polyclinic at Zainoel Abidin Hospital Banda Aceh. The sample studied were 92 patients with CHD and 92 patients with non-CHD (control). We used primary and secondary data that processed through editing, coding, entry, cleaning and tabulating. The data was analyzed using univariate, bivariate and multivariate analysis. The results showed that the CHD occurrences are significantly influenced by eating behavior (p = 0,000), smoking habit (p = 0,000) and sporting habit (p = 0,000). Therefore, health workers are expected to increase health promotion in order to improve the quality of life of people, especially in elderly people, by adopting a healthy lifestyle and avoiding CHD risk factors. Moreover, people are also suggested to take regular lipid profile check up and keep off smoking habit in order to do early prevention of CHD.

AbstrakMenurut data Riskesdas (2013) sebanyak 40 persen orang meninggal karena serangan jantung tidak mengetahui kalau dirinya mengidap penyakit jantung koroner. Bila ditinjau dari gaya hidup masyarakat Aceh ada beberapa faktor risiko meningkatkan kejadian PJK terutama bila dilakukan secara berlebihan, antara lain merokok, minum kopi, makan makanan berlemak dan kurangnya aktifitas fisik serta tidak mampu mengendalikan stress. Faktor-faktor tersebut sebagai gaya hidup sangat berpotensi meningkatkan risiko PJK yang dibuktikan dari beberapa laporan statistik menunjukkan PJK di Aceh tertinggi. Tujuan penelitian untuk menganalisis determinan gaya hidup penderita penyakit jantung koroner di Rumah Sakit Zainoel Abidin. Penelitian kuantitatif dengan desain case control pada Bulan April 2017 di RSUD Zainoel Abidin menganalisis 206 kasus PJK dan 206 non PJK berdasarkan dokumen rekam medik dan menggunakan kuesioner tentang gaya hidup yang telah diuji validitas dan reliabilitas. Hasil penelitian menunjukkan determinan gaya hidup yang berhubungan bermakna adalah pola pengendalian stress, gaya hidup dan minum kopi dengan PJK (p<0,05), sedangkan pola makan tidak menunjukkan hubungan bermakna dengan PJK (p>0,05). Determinan gaya hidup yang paling dominan sebagai faktor risiko PJK adalah pengendalian stress dan kebiasaan minum kopi, yaitu pasien dengan riwayat pengendalian stress yang kurang efektif dan kebiasaan minum kopi lebih berisiko 4 kali dibandingkan pasien dengan pola pengendaian stress yang efektif dan tidak memiki kebiasaan minum kopi. Pengaruh gaya hidup terhadap PJK turut dipengaruhi oleh faktor pendapatan. Implikasi penelitian menawarkan kebijakan keterlibatan aktif berbagai pihak untuk melakukan upaya-upaya promotif dan preventif dengan melibatkan masyarakat dengan mengembangkan berbagai inovasi. Kata Kunci: Determinan, gaya hidup, penyakit jantung koroner, RS Zainoel Abidin AbstrackAccording to Riskesdas data (2013) as many as 40 percent of people die due to no heart attack know that he has coronary heart disease. When viewed from the lifestyle of the people of Aceh there are several risk factors for increasing the incidence of CHD, especially if done excessively, including smoking, drinking coffee, eating fatty foods and lack of physical activity and unable to control stress. These factors as lifestyle have the potential to increase the risk of CHD as evidenced by several statistical reports showing the highest CHD in Aceh. The purpose of this study was to analyze the lifestyle determinants of patients with coronary heart disease at Zainoel Abidin Hospital. Quantitative research with case control design in April 2017 at Zainoel Abidin Regional Hospital analyzed 206 cases of CHD and 206 non-CHDs based on medical record documents and used a questionnaire about lifestyle that had been tested for validity and reliability. The results showed that lifestyle determinants that were significantly related were stress control patterns, lifestyle and drinking coffee with CHD (p <0.05), while diet did not show a significant r...

AV fistula allows external vascular access for hemodialysis patients. Because hemodialysis patients experience puncture wounds and stabbing pain approximately 300 times a year, development of methods to decrease pain intensity are of great importance. Some techniques, such as the Valsalva maneuver, are known to reduce pain. This study aims to assess the effect of the Valsalva maneuver on decreasing the intensity of AV fistula pain in patients receiving hemodialysis. The quasi-experimental research of pre and post without control applying consecutive sampling to get as many as 63 respondents. Pain intensity was measured by using the Numerical Pain Rating Scale (NPRS). The Valsalva maneuver was performed during insertion of the AV fistula needle for 16-20 seconds. The results showed significant differences in pain intensity between before and after the intervention with the difference in mean that is 1.35 (SD= 0.54), t= 19.70, p= 0.001. The Valsalva maneuver is effective in reducing the pain of AV fistula insertion because it stimulates the vagus nerve to induce an antinociceptive effect. Nurses are highly recommended to teach the Valsalva maneuver to patients undergoing routine hemodialysis.

No abstract