Papers by Cokorda Lesmana
Public Health and Preventive Medicine Archive, Jun 30, 2023
Background and purpose: The pandemic of COVID-19 is an unprecedented medical and economic challen... more Background and purpose: The pandemic of COVID-19 is an unprecedented medical and economic challenge for healthcare system. The number of patients during pandemic of COVID-19 had a rapid growth which led to changes in services aspects that threaten financial viability of hospitals, including private hospitals. This study aims to determine the efforts of private hospitals in maintaining financial stability during the pandemic of COVID-19. Methods: A qualitative study with a multi-case design carried out in 7 (seven) private hospitals in Denpasar. Informants were obtained based on a purposive sampling approach. This study recruited 19 informants from 7 private hospitals in Denpasar. Data was collected through in-depth interviews conducted face-toface, using the Zoom and Whatsapp applications. The data were analysed using a content analysis approach. Results: Almost all hospitals stated that their finances disrupted. Financial mitigation efforts were difficult to do, hospital preparation and responses were dependent on the hospital's financial condition and regulations that changing, and recovery efforts were not easy either because in general the community's economy has not recovered. Conclusion: Private hospital finances were experiencing disruption. Mitigation efforts were difficult to do due to the unpredictable changing regulations and policies during the pandemic. Based on the study results, it can be recommended that the hospital management needs to develop a service strategy that is able to overcome the problem of the surge in the number of patients.
Public Health and Preventive Medicine Archive, Jul 1, 2021
Background and purpose: WHO supports the implementation of complementary therapy services in heal... more Background and purpose: WHO supports the implementation of complementary therapy services in health facilities to increase comprehensive health services coverage. Sanglah Hospital is developing the pranic healing service as part of the development of Indonesia's medical tourism and traditional health. This study aims to determine the extent to which the feasibility, obstacles, challenges, and opportunities of the pranic healing service implemented at Sanglah Hospital. Methods: This study employed a mixed-methods design with a case study approach. The data were collected from March to April 2020 using in-depth interview with 23 informants by collecting information on acceptance, readiness, requests, and service management. Documents and archival records were also collected. The survey data were collected using a selfadministered questionnaire from 40 respondents by collecting information on patients' requests and acceptance aspects. The qualitative data analysis was performed thematically and presented in a narrative form. The survey data were analyzed using univariate analysis. Results: The pranic healing service received support from the Ministry of Health and the hospital management, had a good acceptance from health workers and patients, was the only complementary service of its kind in health facilities throughout Indonesia and had the potential for the development of medical tourism. Obstacles and challenges found were related to workforce management, regulatory readiness, referral systems, and the development of inpatient services. Conclusion: Pranic healing service could be implemented at Sanglah Hospital because they had substantial support and because of demand and acceptance aspects. However, obstacles and challenges on the implementation and practicality aspects should be overcome for the sustainability of this service. The pranic healing has a good potency since to date, it is the only one available in Indonesia which is also potential for the development of medical tourism.
Public Health and Preventive Medicine Archive, 2021
Background and purpose: WHO supports the implementation of complementary therapy services in heal... more Background and purpose: WHO supports the implementation of complementary therapy services in health facilities to increase comprehensive health services coverage. Sanglah Hospital is developing the pranic healing service as part of the development of Indonesia’s medical tourism and traditional health. This study aims to determine the extent to which the feasibility, obstacles, challenges, and opportunities of the pranic healing service implemented at Sanglah Hospital.Methods: This study employed a mixed-methods design with a case study approach. The data were collected from March to April 2020 using in-depth interview with 23 informants by collecting information on acceptance, readiness, requests, and service management. Documents and archival records were also collected. The survey data were collected using a self-administered questionnaire from 40 respondents by collecting information on patients’ requests and acceptance aspects. The qualitative data analysis was performed themati...
Public Health and Preventive Medicine Archive, 2019
Background and purpose: Drug dispensing errors have a major impact on the incidence of medication... more Background and purpose: Drug dispensing errors have a major impact on the incidence of medication errors, and can be very dangerous to patients and affect the quality of care. Root cause analysis (RCA) is an approach to prevent dispensing errors by identifying the root of the problem, make efforts to improve comprehensively across departments so that incidence of dispensing errors are not repeated. The purpose of this study is to determine the differences in the incidence of dispensing errors before and after the RCA.Methods: This is a descriptive study by calculating the incidence of dispensing errors before and after the RCA, conducted in four inpatient wards at Sanglah Hospital Denpasar. Dispensing errors were categorized into ten types namely errors in drug’s identity, name, dosage, number of drugs, absence of high alert labels, incorrect drug preparations, incorrect strength, expired drugs, incorrect place of delivery and incorrect instructions. In February and April 2018 the...
Journal of Clinical and Cultural Psychiatry, 2021
Internet addiction in adolescent during pandemic COVID-19 will be predicted to be increased more ... more Internet addiction in adolescent during pandemic COVID-19 will be predicted to be increased more than ever. There is need prevention or intervention program to solve this problem. Hatha yoga is considered to be impact mind-body stress relieving exercise found that improve the internet addiction sign and symptoms, but lack of evidence reviews about neurobiology model that effect Hatha yoga and internet addiction. This present review summarizes about Hatha yoga epigenetic mechanism effects could improve in internet addiction. PubMed, ResearchGate and Google scholar have been searched with the following key terms “Internet Addiction and Yoga”, “Yoga and Mental Health”, “Addiction”, “Yoga”, “Addiction and COVID-19”, “exercises and mental health”, “exercise and brain neuroplasticity” from December 2019 up to December 2020. Study in the internet addiction found that significant the expression level of the mRNA of D5 dopamine receptor was significant down-regulated in peripheral blood lymp...
Risk Management and Healthcare Policy, 2021
Purpose: We aim to study the level of mental health distress and COVID-19 prevention in practice ... more Purpose: We aim to study the level of mental health distress and COVID-19 prevention in practice behaviors among general practitioners (GPs) in Bali, Indonesia, as well as their determinants. Methods: We conducted a cross-sectional online survey. Survey recruitment material was disseminated by purposive snowballing through regional professional association as well as research team's personal acquaintances. The survey measured mental health status by DASS-21 questionnaire and practice behavior by a questionnaire based on WHO recommendations for hand hygiene and PPE use during the COVID-19 pandemic. We conducted multivariate analyses to identify independent determinants for mental health and practice behavior. Results: Analyses included 635 (41.75%) of GPs in Bali. Mental health status was relatively good with prevalence of depression, anxiety, and stress of 13.2%, 19.7%, and 11% respectively, lower than previous studies in Indonesia and elsewhere. Practice behavior, however, was not considerably lower with only 65.4% and 32.1% reported consistent hand hygiene and recommended PPE use respectively. Routine optional PPE use was reported by 23.6% of respondents. Long working hours and fear of COVID-19 was identified as detrimental to mental health while consistent hand hygiene improved it. Meanwhile, workplace, work setting, and fear of COVID-19, were identified as determinants for PPE use. GPs working in primary health centers and private hospitals were also found to have less adherence to hand hygiene protocols. Conclusion: Our results showed relatively good mental health status along with inadequate infection prevention in practice behavior of GPs in Bali, Indonesia. Intervention should be made to improve practice behavior. Determinants of practice behavior identified in this study could help to pinpoint intervention targets.
The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, Apr 28, 2022
Background: Posttraumatic Stress Disorder (PTSD) is a serious psychological trauma disorder. Trea... more Background: Posttraumatic Stress Disorder (PTSD) is a serious psychological trauma disorder. Treatment of psychological trauma tends to focus on patients' memory. Clinical Spiritual-Hypnosis Assisted Therapy is a culturally sensitive treatment that combines elements of psychodynamic hypnosis, cognitive-behavioral and humanistic therapies. Methods: The current interventional single-blind randomized control study assessed the biobehavioural effectiveness of spiritual-hypnosis on cortisol and PTSD symptomatology in adults with childhood trauma. Participants were divided into spiritual hypnosis (n = 15) and a control group (n = 14) that received fluoxetine. This study used PCL-C & CTQ to screen the presence and severity of PTSD symptoms. Results: Spiritual hypnosis was significantly better than fluoxetine at reducing PTSD symptoms, while both treatments had similar effects on cortisol modification. Conclusions: Spiritual-Hypnosis Assisted Therapy for PTSD patients with childhood trauma appears to have a noteworthy effect in reducing PTSD clinical symptoms and results in a comparable to the pharmacological treatment modification of the HPA axis cortisol markers.
Personality and Individual Differences
Acta Medica Philippina
Objective. Current evidence has shown academic stress to be associated with student maladaptive b... more Objective. Current evidence has shown academic stress to be associated with student maladaptive behavior. This study aimed to investigate the effect of a problem-focused coping stress management program on first-year medical students’ self-efficacy, psychological distress and find its effect on salivary cortisol. Method. Forty students who scored high on academic stress and external locus of control were randomly selected as the intervention (n = 26) and control group (n = 14). An intervention in the form of a problem-focused coping stress management program was organized. The intervention was a 1½-hour training class conducted once a week for four weeks. Results. There was a significant difference in self-efficacy between the intervention and control groups (p-value = 0.029). The self-efficacy score was significantly higher after the intervention (19.31 ± 2.396 vs 21.27 ± 2.677, p = 0.005). Likewise, a significant difference in the psychological distress between the two groups was ...
Journal of Affective Disorders
Scientific Reports
This paper examines whether compliance with COVID-19 mitigation measures is motivated by wanting ... more This paper examines whether compliance with COVID-19 mitigation measures is motivated by wanting to save lives or save the economy (or both), and which implications this carries to fight the pandemic. National representative samples were collected from 24 countries (N = 25,435). The main predictors were (1) perceived risk to contract coronavirus, (2) perceived risk to suffer economic losses due to coronavirus, and (3) their interaction effect. Individual and country-level variables were added as covariates in multilevel regression models. We examined compliance with various preventive health behaviors and support for strict containment policies. Results show that perceived economic risk consistently predicted mitigation behavior and policy support—and its effects were positive. Perceived health risk had mixed effects. Only two significant interactions between health and economic risk were identified—both positive.
International Journal of Social Psychiatry
Objectives: Despite its high prevalence and considerable burden, depression is not handled with t... more Objectives: Despite its high prevalence and considerable burden, depression is not handled with the required urgency in Indonesia. Existing data from the government does not specifically note its prevalence and symptoms manifestation. This study screened depression in Surabaya, where the prevalence of mood disorder was reported to be higher than the national prevalence, in order to identify where action is most needed. Methods: Cross-sectional study with non-random sampling. Participants consisted of samples from general population categorised as non-high-risk group, and prisoners, sex workers and drug users categorised as high-risk group. Depression screening was done using MINI-ICD10 self-rated depression questionnaire. Correlation between screening results and demographic data was analysed using chi-square test. Results: Positive depression screening was significantly associated with grouping and educational background. High-risk group and participants with lower education backgr...
Sport and Fitness Journal
Latar Belakang: Anak dengan ASD termasuk dalam gangguan kesehatan mental yang menunjukkan ganggua... more Latar Belakang: Anak dengan ASD termasuk dalam gangguan kesehatan mental yang menunjukkan gangguan pada kontrol motorik dasar, gangguan pada kinerja otot dan ketrampilan motorik konsisten dengan dispraksia yang sering menimbulkan gangguan berupa keseimbangan dinamis. Tujuan: Untuk menganalisis intervensi fisioterapi berupa Perceptual Motor Approach dan Specific Balance Training dalam meningkatkan keseimbangan dinamis anak dengan ASD. Metode: Penelitian ini menggunakan rancangan eksperimental penelitian two group pre and post test design. Responden pada penelitian melibatkan 22 anak ASD di Pusat Layanan Autis (PLA) Kota Denpasar yang dibagi menjadi dua kelompok. Sebelas orang anak pada Kelompok I diberikan Perceptual Motor Approach, sebelas orang anak pada Kelompok II diberikan Specific Balance Training. Latihan diberikan tiga kali seminggu selama delapan minggu. Keseimbangan dinamis diukur dengan Four square step test. Waktu saat melakukan Four square step test diukur dengan stopwa...
Journal of Clinical and Cultural Psychiatry
Background: Schizophrenia is a severe mental disorder in the psychiatric field, is chronic, and i... more Background: Schizophrenia is a severe mental disorder in the psychiatric field, is chronic, and is characterized by recurring relapse. The causative factor that plays an important role is the expressed emotion (EE) of the family. The aim of this study was to determine the expressed emotion scores of families who treated schizophrenic patients at Sanglah Hospital. Methods: The study used a cross-sectional analytical method. Measurement of the EE of families using the Family Questionnaire (FQ). Data were analyzed descriptively and used the Spearman correlation test with a significance level of p <0.05. Results: The research participants were 61 families of schizophrenia patients treated at Sanglah Hospital, female (57.4%), and average age 45 years old. The results showed a correlation between the family’s expressed emotion score and the frequency of recurrence of schizophrenic patients in Sanglah Hospital, which was statistically significant (R=0.611, p <0.001). That value shows...
Journal of Clinical and Cultural Psychiatry
Background: A good quality of life in the elderly must be maintained because good quality of life... more Background: A good quality of life in the elderly must be maintained because good quality of life is an optimal condition for the elderly to live their daily lives. Depression in the elderly will have a severe impact on physical, social life where it will reduce the quality of life. This study was conducted to assess the relationship of quality of life with depression in the elderly. Method: This study uses a cross-sectional method, conducted in May-June 2019, using WHOQOL-BREf, GDS, AMT, ADL. Results: A total of 195 elderly participated, average age 67 years, married 94.4 percent, mostly 45.1 percent did not go to school, ADL was found to be normal, there was moderate cognitive impairment as much as 13.3 percent, and depression 80 percent. There was a significant relationship between quality of life and depression (OR: 1.22; 95% IK 1.02-3.97), which means that elderly people with poor quality of life have a higher risk of depression. Conclusion: There is a significant negative corr...
Journal of Clinical and Cultural Psychiatry
Background: One type of psychiatric disorder that is still controversial is online game addiction... more Background: One type of psychiatric disorder that is still controversial is online game addiction. A massively multiplayer online role-playing game (MMORPG) has the highest prevalence of game addiction, especially in Asian countries. The goal of this study was to see the correlation between personality traits, openness, conscientiousness, extraversion, agreeableness, and neuroticism with the occurrence of online game addiction. Methods: A cross-sectional study was conducted on 248 adult online games players throughout Denpasar through proportional stratified random sampling randomization by searching for online game addiction status based on Indonesian Game Online Questionnaires’ (IGOQ) and Five-Factor Personality Traits based on the International Personality Item Pool (IPIP NEO- PI). Results: The prevalence rate of online game addiction in online game center players in Denpasar obtained 27%, the majority are students, male, Hindu, Bali. On average, playing more than 35 hours a week...
Journal of Clinical and Cultural Psychiatry
Background: Schizophrenia is a severe mental disorder that requires collaborative approach from t... more Background: Schizophrenia is a severe mental disorder that requires collaborative approach from the health care provider, family, and the society in its management. Adequate support from the family of people with schizophrenia plays a significant role in their recovery. However, providing support to these patients might become a significant burden among caregiver that it might induce the occurrence of stress, mood changes, and anxiety. This research aimed to determine the correlation between caregiver burden and the mental problems that might be experienced by caregivers of people with schizophrenia. Patients and Methods: This qualitative research employed a cross-sectional analytic design. Samples were obtained consecutively in June and July 2018. The questionnaires used were the 22 item Zarit Burden Interview (ZBI) and the 42 item Depression, Anxiety and Stress Scale (DASS-42). Results: A number of 69 subjects participated. The caregiving burden demonstrated strong positive signif...
Journal of Clinical and Cultural Psychiatry
Background: Patients admitted to the ICU are often in a state of uncertainty. This has an impact ... more Background: Patients admitted to the ICU are often in a state of uncertainty. This has an impact on the welfare of caregivers and other family members. This study aimed to determine the relationship between religiosity and the level of anxiety experienced by caregivers while accompanying patients in the ICU. Materials and Method: This study is a non-experimental observational cross-sectional study with analytic correlational design. The research sample was taken as many as 33 people as samples were carried out by consecutive sampling method. Results: Religiosity is negatively related to mild to moderate anxiety (R=-0.484, p >0.05). Religion is positively related to levels of moderate to severe anxiety (R=0.402, p=0.038). Conclusion: There is a negative relationship with the level of moderate strength between religiosity variables with mild to moderate levels of anxiety and there is a positive relationship between religiosity and moderate to very severe levels of anxiety in family...
Journal of Clinical and Cultural Psychiatry
Background: Perimenopause covers the period immediately before the menopause and the first year a... more Background: Perimenopause covers the period immediately before the menopause and the first year after the last menstrual period. In addition to the changes in the menstrual cycle, women in the perimenopause phase often report a number of perimenopausal complaints and depressive disorders. This study aims to determine the prevalence of perimenopausal complaints and depression experienced in nurses at Sanglah General Hospital. Methods: The study uses a cross-sectional analytical. The measurement of perimenopause complaints uses the Menopause Rating Scale (MRS) questionnaire and the depression measurement uses the Beck Depression Inventory-II questionnaire (BDI-II). The data are analyzed descriptively, it uses the Fisher test and linear regression test with significance level p <0.05. Results: Nurses who have perimenopausal complaints are 62.7%. Besides, depression is experienced by 23.8% of nurses who have perimenopausal complaints. The complained somatic symptoms with a mild degre...
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Papers by Cokorda Lesmana