Pengaruh Intervensi Multimodalitas Terhadap Kualitas Hidup Pasien Paru Obstruktif Kronik Stabil Usia Lanjut Yang Mengalami Sindrom Gagal Pulih

Meldy Muzada Elfa, Dr.dr.I Dewa Putu Pramantara S, Sp.PD., K.Ger ., Dr.dr. Probosuseno, Sp.PD., K.Ger, SE,MM

2024 | Tesis-Subspesialis | SUBSPESIALIS ILMU PENYAKIT DALAM

Latar belakang

Berdasarkan data Riskesdas tahun 2021, terlihat peningkatan angka harapan hidup yang diproyeksikan pada tahun 2045 terdapat 63,7 juta penduduk usia lanjut. Dengan peningkatan angka harapan hidup, meningkat pula prevalensi penyakit kronis seperti penyakit paru obstruktif kronis (PPOK) dan juga permasalahan sindrom gagal pulih yang dapat meningkatkan morbiditas PPOK dan menurunkan kualitas hidup penderita. Intervensi multimodal dengan intervensi nutrisi, rehabilitasi medik, dan pursed lip breathing diharapkan mampu memperbaiki kualitas hidup penderita. Namun demikian belum ada penelitian mengenai intervensi multimodal sehingga peneliti bertujuan untuk melihat dampak perbaikan kualitas hidup intervensi multipmodal pada pasien PPOK usia lanjut dengan sindrom gagal pulih

Metode

Penelitian ini merupakan penelitian eksperimental dengan metode open-label randomized controlled trial yang dilakukan di RSUD Ulin Banjarmasin dari Februari 2023 hingga Juli 2023. Kelompok kontrol adalah pasien PPOK stabil usia lanjut yang tidak mendapatkan intervensi multimodal sedangkan kelompok intervensi memperoleh intervensi multimodal. Kualitas hidup dinilai dengan skor St George’s Respiratory Questionnaire (SGRQ) dan analisis perbedaan intervensi terhadap skor SGRQ dilakukan menggunakan Uji T tidak berpasangan.

Hasil

Terdapat total 60 subjek yaitu 30 subjek kelompok kontrol dan 30 subjek kelompok intervensi dengan 27 (45%) subjek laki-laki dan 33 (55%) subjek perempuan. Tidak terdapat perbedaan rearata usia antara kelompok kontrol (71,53 + 6,25 tahun) dan intervensi (70,50 + 6,01 tahun), p=0,477. Terdapat perbedaan signifikan skor SGRQ pada kelompok intervensi dibandingkan kelompok kontrol dengan perbedaan selisih rerata -11,34+ 20,14 pada kelompok -30,20 + 26,25 pada kelompok intervensi, p=0,003.

Kesimpulan

Intervensi multimodalitas meningkatkan kualitas hidup pada pasien PPOK stabil usia lanjut dengan sindrom gagal pulih

 Background

A predicted rise in life expectancy in 2045 will result in 63.7 million older persons, according to Riskesdas figures for 2021. As life expectancy rises, so does the frequency of chronic illnesses like chronic obstructive pulmonary disease (COPD) as well as failure to thrive in elderly. These factors can worsen the morbidity of COPD and lower the quality of life of the patients. It is anticipated that multimodal management involving pursed lip breathing, medical rehabilitation, and dietary intervention will enhance the quality of life for those affected. We aim to investigate the effects of multimodal intervention on the quality of life of elderly patients with failure to thrive.

Method

This research is an experimental study using an open-label randomized controlled trial method which was conducted at the Ulin District Hospital Banjarmasin from February 2023 to July 2023. The control group was elderly with stable COPD patients who did not receive multimodal intervention, while the intervention group received multimodal intervention. Quality of life was assessed by the St George's Respiratory Questionnaire (SGRQ) score and unpaired T test was carried out to evaluate the difference of SGRQ in the two groups.

Results

There were a total of 60 subjects, each group consisted of 30 with  a total of 27 (45%) male subjects and 33 (55%) female subjects. There was no difference in age average between the control group (71.53  + 6.25 years) and the intervention group (70.50  + 6.01 years), p=0.477. There was a significant difference in SGRQ scores in the intervention group compared to the control group with a mean difference of -11.34  + 20.14 in the control group and - 30.20  + 26.25 in the intervention group, p=0.003.

Conclusion

Multimodality intervention improves quality of life in elderly stable COPD patients with failure to thrive.

Kata Kunci : Multimodality intervention, failure to thrive, stable COPD, geriatric, SGRQ