CRITICAL APPRAISAL

JURNAL KEPERAWATAN
DIAGNOSA HIPERTENSI
Kelompok 2
 PENURUNAN TEKANAN DARAH PADA
PASIEN HIPERTENSI
MENGGUNAKAN INTERVENSI SLOW
DEEP BREATHING EXERCISE

Penulis : Juli Andri, Fahri Permata,

Padila, Andry Sartika,
Muhammad Bagus Andrianto
Diterbitkan : Program Studi S1
Keperawatan Fakultas Ilmu
Kesehatan , Universitas
Muhammadiyah Bengkulu
Tanggal Terbit : Desember 2021
INTRODUCTION

1. Mengapa penelitian ini 2. Bagaimana jumlah

dilakukan ? sampel ?

Penelitian ini bertujuan untuk Pada penelitian ini sampel berjumlah

mengetahui pengaruh slow deep 30 orang dengan purposive sampling
breathing exercise terhadap
penurunan tekanan darah pada pasien
hipertensi di wilayah kerja puskesmas
telaga dewa kota bengkulu
BACKGROUND
3. Apakah instrumen dan 5. Apakah hal atau
pengukuran dari 4. Bagaimana analisis kejadian yang tak
variabel utama valid dan data, uji apa yang diinginkan selama proses
reliabel? digunakan ? penelitian ?
Penelitian ini menggunakan Analisis data dalam penelitian ini Pada penelitian ini peneliti tidak
pendekatan quasy experiment, uji t dependen, wilcoxon dan mann mencantumkan hal atau kejadian
teknik pengambilan sampel dalam whitney. yang tidak diinginkan selama
penelitian ini dengan purposive proses penelitian
sampling yakni sampel diambil
sesuai dengan kriteria peneliti
dengan sampel 30 orang. Dimana
15 untuk intervensi slow deep
breathing dan 15 intervensi
alternate nostril breathing.
 6. Apakah hasil penelitian sesuai dengan
penelitian sebelumnya ?
Berdasarkan hasil penelitian yang telah dilakukan oleh peneliti dengan slow deep
didapatkan 15 responden, kelompok 1 pemberian intervensi slow deep breathing.
Intervensi pada peneliti ini diberikan selama 4 hari dengan frekuensi 2 kali sehari
yaitu pagi dan sore.Hasil dari analisis univariat distribusi frekuensi tekanan darah
sistolik sebelum dan setelah diberikan intervensi slow deep breathing dengan p value
0,001. Ditribusi frekunsi tekanan darah diastolik sebelum dan setelah diberikan
intervensi slow deep breathing dengan p value 0,000 dengan demikian disimpulkan
bahwa intervensi slow deep breathing efektif dalam menurunan tekanan darah pada
penderita hipertensi, dimana dalam 4 hari setelah diberikannya intervensi sudah
terdapat penurunan tekanan darah. Dan didukung dengan hasil penelitian Andri et al.,
(2018) menunjukkan bahwa terdapat penurunan sistolik dengan t value = 3,632, p
value = 0,002 dan diastole t value = 4,226, p value = 0,001, bahwa terdapat pengaruh
pada penurunan tekanan darah. Sejalan dengan penelitian Tarigan et al., (2020) yang
menunjukkan bahwa ada Pengaruh tindakan Slow Deep Breathing Terhadap
penurunan Tekanan Darah Pada Lansia Di Pustu Desa Stungkit Binjai Tahun 2020.
 7. Apa manfaat penelitian untuk
praktik klinis ?
Pada penelitian ini bermanfaat dikarenakan Terapi relaksasi dilakukan untuk mencegah ketegangan
otot-otot akibat stres karena ketegangan dapat mempengaruhi keseimbangan tubuh. Untuk
mendapatkan rileksasi yaitu salah satunya dengan cara mengatur nafas dengan teknik slow deep
breathing (Nirmalasari, 2017). Menurut penelitian Gholamrezaei et al., (2021) yang menyatakan
bahwa slow deep breathing dapat mengurangi tingkat tekanan darah dalam jangka waktu yang
lama serta mempunyai peranan efek pengurangan tekanan psikologikal yang berhubungan dengan
penyebab hipertensi. Diketahui bahwa teknik slow deep breathing berupa purse lip breathing
(PLB) dapat membuat pasien menjadi lebih nyaman dan tenang dibandingkan teknik pernapasan
lain.
 SWEDISH MASSAGE SEBAGAI INTERVENSI KEPERAWATAN
INOVASI DALAM MENURUNKAN TEKANAN DARAH PADA LANSIA
HIPERTENSI

Penulis : Ritanti, Darnis Arneta Sari

Diterbitkan : Program Studi S1 Keperawatan
Fakultas Ilmu, Kesehatan,
Universitas Pembangunan Nasional
“Veteran” Jakarta
Tanggal Terbit : Februari 2020
SWEDISH MASSAGE SEBAGAI INTERVENSI KEPERAWATAN
INOVASI DALAM MENURUNKAN TEKANAN DARAH PADA LANSIA
HIPERTENSI

1. Mengapa penelitian ini 2. Bagaimana jumlah

dilakukan ? sampel ?

Penelitian ini bertujuan untuk Sampel dalam penelitian ini

mengetahui pengaruh swedish berjumlah 8 lansia yang menderita
mesage terhadap penurunan tekanan hipertensi
darah

3. Apakah instrumen dan
pengukuran dari
variabel utama valid dan
reliabel?
Penelitian ini merupakan penelitian
Quasi Eksperimen dengan One
Group pretest-posttest.
5. Apakah hal atau
4. Bagaimana analisis
kejadian yang tak
data, uji apa yang
diinginkan selama proses
digunakan ?
penelitian ?
Analisa data menggunakan Sample Pada penelitian ini peneliti tidak
Paired T-Test dengan hasil p value mencantumkan hal atau kejadian
0,000. Hal ini menunjukkan adanya yang tidak diinginkan selama
perbedaan yang signifikan antara proses penelitian
hasil pengukuran tekanan darah
sistolik dan diastolik sebelum dan
sesudah dilakukan terapi swedish
massage terapi
 6. Apakah hasil penelitian sesuai dengan
penelitian sebelumnya ?
hasil dari penelitian pada puskesmas limo depok data yang dilakukan terhadap dua
kelompok hasil pengukuran tekanan darah didapatkan bahwa p value sebesar 0,000.
Nilai p value lebih kecil dari tingkat kesalahan (0,000 < 0,05) maka dapat
disimpulkan terdapat perbedaan yang signifikan antara hasil pengukuran tekanan
darah sistolik dan diastolik saat sebelum dan sesudah dilakukan terapi Swedish
Massage.Hal ini berarti terdapat pengaruh terapi Swedish Massage dalam terhadap
penurunan tekanan darah sistolik dan diastolic. Dan didukung dengan Hasil
penelitian yang lain oleh Mohebbi et al., (2014) dan Givi (2016) dimana Swedish
Messase terbukti siginifican dapat menurunkan tekanan darah systole dan diastole
denga nilai p value < 0,001. Penelitian yang yang lain oleh Adawiyah, dkk (2017)
terlihat bahwa sesudah dilakukan terapi Swedish massage dari 20 responden terdapat
10 responden mengalami hipertensi ringan, 6 responden mengalami tekanan darah
normal tinggi, 2 responden mengalami hipertensi sedang, dan 2 responden
mengalami tekanan darah normal. Dimana rata-rata perubahan tekanan darah pada
setiap responden sesudah diberikan terapi Swedish massage sebesar 5 mmHg.
 7. Apa manfaat penelitian untuk
praktik klinis ?
Manfaat dari penelitian bahwa intervensi keperawatan
intervensi terapy Swedish Massage merupakan terapi
komplementer yang dinilai efektif, mudah
diaplikasikan, dan aman untuk menurunkan risiko
kerusakan fungsi system kardiovaskular dimana
hipertensinya menjadi salah satu pencetusnya.
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TABLE OF CONTENTS

01 02 03
INTRODUCTION BACKGROUND METHODOLOGY

04 05 06
RESULTS DISCUSSION CONCLUSION
01
INTRODUCTION
METHODOLOGY

STUDY DESIGN DATA COLLECTION

Outline the research design for the medical Explain the methods and tools used for data
breakthrough. Describe the type of study, collection, including patient records or
sample size, inclusion criteria and ethical examinations. Emphasize data accuracy and
considerations patient privacy

DATA ANALYSIS RESULTS VALIDATION

Describe the approach for analyzing the Discuss the steps taken to validate the results.
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or qualitative analysis techniques used to derive confirmed or peer-reviewed for scientific rigor
meaningful insights
RESULTS
DATA ANALYSIS COMPARISON
Present the analyzed data from the study. Describe Compare results with existing literature or
the methods used for analysis and highlight key previous studies. Highlight similarities,
findings and trends differences, and novel insights for knowledge

QUANT. RESULTS LIMITATIONS

Focus on numerical results derived from the Acknowledge study limitations. Discuss
analysis. Present percentages, means or challenges faced during data collection, analysis
correlations and use visual aids and interpretation

QUAL. RESULTS CONCLUSIONS

Discuss qualitative findings from interviews or Summarize the findings and their implications.
surveys. Present themes, patterns and include Discuss the impact on medical practice, patient
examples care or future research
50% 85%
Reduction in complications Success rate for the breakthrough

10x faster
This treatment is 10 times faster than
previous treatments
95%
Use percentages in your breakthrough
presentation to quantify and communicate
the frequency or proportion of an
important finding
COLUMN CHART

UNDERSTANDING THE
NUMBERS
Use this slide to present data on the
outcomes of patients who have received
treatment for a particular condition or
disease. A column chart can be an
effective way to illustrate changes in
patient outcomes over time. Consider
including data from clinical trials or real-
world patient populations to showcase
the impact

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MILESTONES

Discovery Preclinical research Early phase Phase I clinical trial

clinical trial

Phase II clinical trial Phase III clinical trial FDA review Post-market monitoring
TREATMENT OPTIONS
TREATMENT EFFICACY SIDE
OPTION RATE EFFECTS COST AVAILABILITY

MEDICATION A 80% Mild $$ Widely available

MEDICATION B 70% Moderate $$$ Available only with prescription

SURGERY 90% High $$$$ Requires specialized facilities

RADIATION THERAPY 75% Moderate $$ Available in most hospitals

IMMUNOTHERAPY 65% Moderate $$$$ Available only in select medical centers

PHYSICAL THERAPY 60% Mild $$ Widely available

CLINICAL TRIAL PHASES
PHASE 1: SAFETY AND DOSAGE PHASE 2: SIDE EFFECTS

● Participants: 20-100 healthy volunteers
● Objective: to determine safe dosage and identify side effects
● Duration: 6 months
● Success rate: 80% of participants completed the trial without
experiencing significant side effects
● Participants: up to several hundred people with the condition
● Objective: determine effectiveness and further evaluate safety
● Duration: 12 months
● Success rate: 65% of participants experienced a significant
improvement in symptoms

PHASE 3: LARGE-SCALE TESTING PHASE 4: POST-MARKET MONITORING

● Participants: from several hundred to thousands of people ● Participants: thousands of people with the condition who are
with the condition taking the drug
● Objective: to confirm effectiveness, monitor side effects, and ● Objective: to monitor long-term safety and effectiveness and
compare to detect rare side effects
standard treatments ● Duration: ongoing
● Duration: 24 months ● Success rate: no safety concerns identified in the two years
● Success rate: new treatment was better in 75% cases since the approval for market use
 DATA AND STATISTICS
KEY PERFORMANCE INDICATOR NUMBER TREND IN PATIENT OUTCOMES
Patients treated 2,500 ● Illustrate the trend in patient outcomes
over time
Success rate 95% ● Highlight the impact of the medical breakthrough on
patient outcomes
Average recovery time 3 days ● Describe any significant changes or improvements
observed in the graph

● List the key performance indicators (KPIs)

relevant to the medical breakthrough
● Enter the values or metrics for each KPI in
the table
● Discuss the significance of each KPI and its
relation to the breakthrough
● Highlight any notable achievements or
milestones reflected in the table
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IMPLICATIONS
“It's been a true lifesaver for me. I can enjoy life again without any discomfort”

—JOHN SMITH, PATIENT

“I've seen a significant improvement in patient outcomes. This breakthrough makes treatment more efficient
and personalized”

—DR. JANE DOE, MEDICAL PROFESSIONAL

“We are impressed with the safety and effectiveness of this breakthrough. It will greatly benefit patients and
healthcare systems”

—SANJAY PATEL, REGULATORY BODY REPRESENTATIVE

KEY MEMBERS
MARK JONES SARAH JAMES
Use a sentence that describes Use a sentence that describes
their job their job

Role: Lead researcher Role: Clinical trial manager

Contributions: Contributions:
● You can enter a description of the contributions ● You can enter a description of the contributions
here here
● You can enter a description of the contributions ● You can enter a description of the contributions
here here
● You can enter a description of the contributions ● You can enter a description of the contributions
here here
RESULTS AND CONCLUSIONS
BACKGROUND CONCLUSIONS
Briefly introduce the context of the investigation, such as the medical
condition or problem being addressed and the goals Briefly summarize the main findings of the
1 study or analysis
STUDY DESIGN
Discuss the implications of the findings and
Describe the design of the study, such as whether it was a randomized
controlled trial or observational study, the sample size and the inclusion
2 how they relate to the original research
and exclusion criteria question
FINDINGS
Summarize the main findings of the investigation, including statistical REFERENCES
results and any important trends or patterns observed
Include a reference page with the sources used in your
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the study or areas for future research
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