Hubungan antara status artritis reumatoid dengan kemampuan kognitif pada pasien perempuan di Rumah Sakit Umum Siloam Lippo Village

Halim, Gracielle Jaya (2023) Hubungan antara status artritis reumatoid dengan kemampuan kognitif pada pasien perempuan di Rumah Sakit Umum Siloam Lippo Village. Bachelor thesis, Universitas Pelita Harapan.

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Abstract

Artritis reumatoid (AR) merupakan penyakit inflamasi pada sendi yang paling sering dijumpai. Selain dapat berdampak pada persendian, AR juga dapat berdampak pada bagian tubuh yang lain. Berdasarkan studi-studi yang telah dilakukan, ditemukan adanya penurunan kemampuan kognitif pada individu dengan AR yang dapat menjadi beban pada individu-individu tersebut. Penelitian ini dilakukan untuk mengetahui hubungan antara status artritis reumatoid dengan kemampuan kognitif di Indonesia. Bahan yang digunakan dalam penelitian adalah lembar kuesioner yang berisikan lembar informed consent dan meliputi pertanyaan mengenai identitas pasien, keadaan mental pasien (HADS), dan penilaian mandiri terhadap limitasi fungsional dan disabilitas (HAQ). Kuesioner diberikan pada pasien perempuan dengan AR yang berobat pada Poliklinik Alergi Imunologi dan pasien perempuan lain berkarakteristik sama yang berobat pada Poli Penyakit Dalam Rumah Sakit Umum Siloam Lippo Village. Selain itu, dilakukan juga tes kemampuan kognitif (MoCA) secara langsung. Pada pasien perempuan dengan AR juga diambil data mengenai Laju Endap Darah (LED) dan C-reactive protein (CRP). Data yang terkumpul kemudian dianalisis menggunakan SPSS versi 29.0. Variabel kategorik akan dianalisis menggunakan chi-square dan variabel numerik akan dianalisis menggunakan T-test dan Mann-U Whitney. Regresi logistik kemudian dilakukan untuk mengontrol variabel confounding. Pada penelitian yang melibatkan 45 pasien AR dan 45 kontrol ini, ditemukan adanya hubungan yang signifikan antara status AR dan kemampuan kognitif (p < 0,001). Gangguan fungsi kognitif ditemukan lebih banyak pada pasien AR dibandingkan dengan kontrol. Hasil dari regresi logistik menunjukan hasil OR = 7.43 (95% CI = 2,713-20,348) untuk pasien AR setelah disesuaikan dengan variabel usia (p < 0,001). Tidak ditemukan adanya hubungan yang signifikan antara lama menderita, aktivitas penyakit, penggunaan glukokortikoid oral, penggunaan DMARDs, dan derajat limitasi fungsi dengan kemampuan kognitif pada penelitian ini (p > 0.05). Selain itu, pasien AR juga mempunyai nilai rerata yang lebih rendah pada domain visuospasial, bahasa, delayed recall, dan orientasi pada tes MoCA. / Rheumatoid arthritis (RA) is the most common inflammatory disease affecting the joints. Other than attacking the joints, RA can affect other parts of the body. According to other studies that had been conducted earlier, it is found that there is a decline in cognitive function in individuals with RA which can be a burden to these individuals. This study conducted to determine the correlation between RA status and cognitive function in Indonesia This study used a questionnaire which contained an informed consent form and included questions about the patient's identity, the patient's mental state (HADS), and a self-administered assessment of functional limitations and disability (HAQ). Questionnaire were given to female patients with AR who seek treatment at the Allergy Immunology Polyclinic and other female patients who seek treatment at the Internal Medicine Polyclinic of Siloam Hospital Lippo Village. In addition, a direct cognitive ability test (MoCA) was also conducted. In female patients with RA, data about erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were also be taken. The collected data were analysed using SPSS version 29.0. Categorical variables were analyzed using chi-square and numerical variables were analyzed using T-test and Mann-U Whitney. Logistic regression were used to controlled the confounding variables. In this study, which included 45 RA patient and 45 control, we found a significant correlation between RA status and cognitive function (p < 0,001). Cognitive impairment was more prevalent in RA patients than the control. Logistic regression resulted in the value of OR = 7.43 (95% CI = 2,713-20,348) for RA patients after being adjusted by age variables (p < 0,001). No significant relationship between duration of illness, disease activity, use of oral glucocorticoids, use of DMARDs, and degree of functional limitation with cognitive functions were found in this study (p > 0.05). Furthermore, AR patients also had significantly lower mean scores (p <0.05) in the visuospatial, language, delayed recall, and orientation domains on the MoCA test.

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