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SKALA KECEMASAN HARS

Skoring kecemasan dapat ditentukkan dengan gejala yang ada dengan menggunakan
Hamilton Anxietas Rating Scale

1. Komponen HARS terdiri dari 14 Komponen yaitu :

1. Perasaan Cemas

Cemas

Takut

Mudah tersinggung

Firasat buruk

2. Ketegangan

Lesu

Tidur tidak tenang

Gemetar

Gelisah
Mudah terkejut

Mudah menangis

3. Ketakutan Pada :

Gelap

Ditinggal sendiri

Orang Asing

Binatang besar

Keramaian lalulintas

Kerumunan orang banyak

4. Gangguan Tidur

Sukar tidur

Terbangun malam hari

Tidak puas, bangun lesu

Sering mimpi buruk

Mimpi menakutkan

5. Gangguan kecerdasan

Daya ingat buruk

6. Perasaan Depresi

Kehilangan minat

Sedih

Bangun dini hari

Berkurangnya kesenangan pada hobi


Perasaan berubah ubah sepanjang hari

7. Gejala somatic

Nyeri otot kaki

Kedutan otot

Gigi gemertak

Suara tidak stabil

8. Gejala Sensorik

Tinitus

Penglihatan kabur

Muka merah dan pucat

Merasa lemas

Perasaan di tusuk tusuk

9. Gejala kardiovakuler

Tachicardi

Berdebar debar

Nyeri dada

Denyut nadi mengeras

Rasa lemas seperti mau pingsan

Detak jantung hilang sekejap

10. Gejala Pernapasan

Rasa tertekan di dada

Perasaan tercekik
Merasa napas pendek atau sesak

Sering menarik napas panjang

11. Gejala Saluran Pencernaan makanan ;

Sulit menelan

Mual, muntah

Enek

Konstipasi

Perut melilit

Defekasi lembek

Gangguan pemcernaan

Nyeri lambung sebelum dan sesudah makan

Rasa panas di perut

Berat badan menurun

Perut terasa panas atau kembung

12. Gejala Urogenital :

Sering kencing

Tidak dapat menahan kencing

13. Gejala Vegetatif / Otonom

Mulut kering

Muka kering

Mudah berkeringat

Sering pusing atau sakit kepala


Bulu roma berdiri

14. Perilaku sewaktu wawancara

Gelisah

Tidak tenang

Jari gemetar

Mengerutkan dahi atau kening

Muka tegang

Tonus otot meningkat

Napas pendek dan cepat

Muka merah

B. Cara Penilaian

Dengan sistim scoring yaitu :

Skor 0 = Tidak ada gejala

Skor 1 = Ringan ( Satu gejala)

Skor 2 = Sedang ( Satu atau dua gejala)

Skor 3 = Berat (Lebih dua gejala)

Skor 4 = Sangat berat (Semua Gejala)

Bila :

Skor < 6 = Tidak ada kecemasan

Skor 6-14 = Kecemasan Ringan

Skor 15 27 = Kecemasan sedang

Skor > 27 = Kecemasan Berat


CRYSTALLOID PRELOAD SHOWS TRANSIENT SUPERIORITY OVER COLLOID,
OR THEIR COMBINATION IN SPINAL ANAESTHESIA-INDUCED
HYPOTENSION PROPHYLAXIS FOR CAESAREAN SECTION.
Authors:
Osazuwa IH
Ebague A
Source:
Nigerian Journal Of Medicine: Journal Of The National Association Of Resident Doctors
Of Nigeria [Niger J Med] 2015 Apr-Jun; Vol. 24 (2), pp. 137-43.
Publication Type:
Journal Article; Randomized Controlled Trial
Language:
English
Journal Info:
Publisher: The Association Country of Publication: Nigeria NLM ID: 100888321
Publication Model: Print Cited Medium: Print ISSN: 1115-2613 (Print) Linking ISSN:
11152613 NLM ISO Abbreviation: Niger J Med Subsets: MEDLINE
Imprint Name(s):
Original Publication: [Lagos, Nigeria] : The Association,
MeSH Terms:
Anesthesia, Obstetrical*/adverse effects
Anesthesia, Obstetrical*/methods
Anesthesia, Spinal*/adverse effects
Anesthesia, Spinal*/methods
Colloids*/administration & dosage
Colloids*/adverse effects
Hypotension*/etiology
Hypotension*/prevention & control
Isotonic Solutions*/administration & dosage
Isotonic Solutions*/adverse effects
Adult ; Cesarean Section/methods ; Dose-Response Relationship, Drug ; Double-Blind
Method ; Drug Monitoring ; Drug Therapy, Combination ; Female ; Fluid
Therapy/methods ; Humans ; Pregnancy ; Rehydration Solutions/administration & dosage
; Rehydration Solutions/adverse effects ; Treatment Outcome
Abstract:
Background: Many studies comparing different intravenous fluid types usually do not
use equipotent volumes of 3:1 crystalloid: colloid ratio in such comparisons. Conflicting
results emanate from such studies. This study was designed to compare the efficacy of
equipotent volumes of crystalloid, colloid and combination of crystalloid/colloid in
spinal anaesthesia-induced hypotension prophylaxis.
Methodology: Pregnant women scheduled for elective Caesarean section were
prospectively randomized to three groups to each received either 1 500 ml of Ringers
lactate, or 500 ml of 6% pentastarch or a combination of 250 ml of 6% pentastarch and
750 ml of Ringers lactate intravenous fluid preload, before spinal anaesthesia.
Hemodynamic variables were monitored.
Results: First 10 minutes, crystalloid showed better efficacy in hypotension prophylaxis
over the other regimen. In the next 30 minutes however, there were no significant
differences between the groups.
Conclusion: Crystalloids proved more effective than colloid or their combination in
hypotension prophylaxis in the first 10 minutes after spinal anaesthesia.
Substance Nomenclature:
0 (Colloids)
0 (Isotonic Solutions)
0 (Rehydration Solutions)
0 (crystalloid solutions)
Entry Date(s):
Date Created: 20150910 Date Completed: 20150930
Update Code:
20151204
PMID:
26353424