Sumber : BPS
4
MASALAH KESEHATAN LANSIA
(Riskesdas 2007)
Dalam persen
5
Keturunan
8% KESEHATAN
PADA LANSIA
Pelayanan
Lingkungan Kesehatan Kesehatan
29% 10%
Paling besar
Perilaku pengaruhnya
53%
Depresi
Kecemasan
Hipertensi
Stress Obesitas
Merokok
Alkoholik
Serangan Asma
Angina
Pectoris
Appendiks :
1. Pengaruh pemberian musik terhadap penurunan tekanan darah pada lansia (Anonim, 2008)
2. Pengaruh terapi bekam terhadap penurunan tekanan darah (Fikri, 2010)
3. Pengaruh masase kaki dengan minyak esensial lavender terhadap penurunan tekanan darah
penderita hipertensi primer usia 45-59 tahun (Ramadhani, 2010)
NYERI
Insidensi
• Beberapa penelitian menunjukkan 25% sampai 50% lansia
yang tinggal dalam komunitas menderita masalah nyeri yang
penting dibandingkan dengan 45% sampai 80% lansia yang
tinggal di panti werdha
• Kanker merupakan sumber nyeri hebat di kalangan lansia dan
banyak lansia yang menderita akibat penyakit vaskuler periver
yang nyeri, herpes zoster, atritis, temporal, sumber nyeri dan
lainnya adalah kram tangkai, sakit kepala dan lain-lain.
• Akibat Nyeri :
– Depresi, berkurangnya sosialisasi, gangguan tidur, hambatan
ambulasi dan peningkatan kebutuhan terhadap perawatan
kesehatannya dan bahaya akibat nyeri, penurunan kebugaran,
gangguan gaya berjalan, jatuh, rehabilitasi, lambatnya malnutrisi.
Chapter 1 : The Injury Response Process
• Mediators of inflamation
– Heparin inhibits coagulation
– Histamine vasodilation of arterioles & increased
vascular permeability edema
– Kinins produce pain
– Neutrophils first line cellular defense phagocytes
– Prostaglandins produce pain too + same effect with
histamin
– Serotonin local vasoconstriction
– Leukotrienes cause smooth muscle contraction +
increase vascular permeability
Chapter 1 : The Injury Response Process
• Edema reduction
– Key : prevent from occurring
– Strategies to reduce edema :
• Voluntary muscle contraction
• Compression devices
• Elevation
• Electrically-induced muscle contraction (muscle milking)
• Pasive Range of Motion
• Massage
• Passive Motion
• Compression Wraps
Chapter 2 : The Physiology and Psychology of Pain
• Assesment of Pain
– Where is your pain?
– When did your pain begin?
– What is duration of your pain?
– Have you ever experienced this pain before?
– Can you describe how the pain feels?
– Is the pain getting better or worse?
– Does your pain increase with activity?
– Do you have more pain after activity?
– Do you have pain at night?
Chapter 2 : The Physiology and Psychology of Pain
• Acute Pain
– < 6 months
– Cause by the activation nociceptors
– When the tissue has healed acute pain ends
• Chronic Pain
– Nociceptive chronic pain continual activates nociceptors ex:
arthritis
– Neuropathic chronic pain abnormality neuron of the pain system
– Characteristics : last longer than 6 months, difficulty in sleeping,
depression, etc.
Thermal Modalities
• Skin thermoreceptors high responsive to
heat and cold
• Mechanisme :
– Conduction : e.g ice pack, moist heat pack
– Convection : e.g warm or cold whirlpool
– Radiation : e.g infrared lamp
– Evaporation : e.g vapocoolant spray
– Conversion : e.g short wave diathermy, ultrasound
Thermal Modalities
The Effects Cold Modalities
Local effect Systemic Effect
• Vasocontriction • General vasocontraction in response to
• Decreased rate of cell metabolism cooling of the posterior hypothalamus
resulting in a decreased need of oxygen • Decreased respiratory and heart rates
• Decreased production of cellular wastes • Shivering and increased muscle tone
• Reduction in inflammation
• Decreased nerve conduction velocity
• Decreased pain
• Decreased muscle spasm
• Decreased muscular force production
General Indication & Contraindication for Cold
Treatments
Indications Contraindications
• Acute injury or inflammation • Cardiac or respiratory involvement
• Acute or chronic pain • Uncovered open wounds
• Small, superficial, first-degree burns • Circulatory insufficiency
• Postsurgical pain and edema • Cold allergy/cold induced urticaria
• Use in conjunction with rehabilitation • Anesthetic skin
exercises • Advanced diabetes
• Spasticity accompanying central • Peripheral vascular disease
nervous system disorders • Raynaud’s phenomenon
• Acute or chronic muscle spasm • Lupus
• Neuralgia
Effect (cold application) on inflammation
Oxygen consumptiom ↓ ↑
Cell wastes ↓ ↑
Fluid viscosity ↑ ↓
Capillary permeability ↓ ↑
Inflammation ↓ ↑
Pain ↓ ↓