PSIKIATRI KOMUNITAS
Psikiatri Komunitas : Merupakan bidang Ilmu Kedokteran Jiwa Masyarakat
Parameter-Parameter yang termasuk
- Populasi-Populasi
- Faktor penyebab (sosial-psikologik dan fisik
- Faktor tatalaksana & pencegahan dan rehabilitasi
- Pelayanan intra dan ekstramural
- Dll
Tujuan Program Psikiatri Komunitas
1. Mencapai lebih banyak anggota masyarakat
2. Penemuan kasus sedini mungkin
3. Memberi pertolongan dan perawatan dalam jumlah besar dalam masyarakat
Masalah-masalah yang ada dalam masyarakat meliputi :
1. Usaha kesehatan jiwa sekolah
2. Usaha kesehatan jiwa sehubungan dengan kesejahteraan ibu dan anak
3. Masalah penderita psikosis berat mis : pusing
4. Masalah kehidupan keluarga mis : emansipasi wanita, ibu yang berkarir, kesibukan suami istri
5. Masalah kenakalan remaja
6. Masalah pengangguran, gelandangan
7. Masalah urbanisasi
8. Masalah harapan yang meningkat
9. Masalah perbedaan si kaya dan si miskin
10. Dll
Menjalankan program psikiatri komunitas harus mempunyai :
1. Ciri-ciri khusus
2. Landasan
3. Kerangka
4. Evaluasi
Ciri-ciri khusus
1. Luas, mis : Prevensi, Puratif, Rehabilitasi
2. Kompleks : hubungan antar faktor saling berkaitan
3. Dinamis : perubahan sosial, perubahan teknologi
Landasan :
1. Konsep yang jelas
- Tujuan program
- Lingkup kerja
- Sasaran
2. Dukungan yang ada
- masyarakat
- pemerintah
- badan, lembaga
3. Kebutuhan dan tuntutan masyarakat ® perlu survey
4. Organisasi dan Mobilisasi sumber
Kerangka programDiperlukan untuk monitoring, pengerahan tujuan dan untuk evaluasi
Diagnosa KomunitasDiperlukan :
1. Sumber rujukan
2. Adanya daerah-daerah penetapan kesehatan yang baik pada Puskesmas
3. Rencana pelayanan dan pencegahan
4. Tatalaksana proyek dan non proyek
Teori Krisis
Suatu situasi atau kondisi lingkungan yang berubah atau suatu disfungsi sosial yang dapat menyebabkan orang-orang mengalami krisis identitas dimana ia akan kehilangan status peranannya.
Teori ini penting untuk usaha pencegahan (prevensi).
Dikenal 3 jenis prevensi
1. Prevensi primer mengurangi kasus-kasus baru dalam masyarakat
2. Prevensi sekunder untuk mengurangi lamanya gangguan
3. Prevensi Tertier untuk mengurangi kecacadan
Tatalaksana pengobatan psikiatri komunitasPada dasarnya dilakukan dalam masyarakat (lingkungan keluarga)Kasus-kasus tertentu ada yang dimasukkan ke RS misalnya
1. Perlu pengawasan medik yang ketat
2. Membahayakan dari sendiri
3. Membahayakan orang lain
Sifat pelayanan ada 3 jenis
1. Pengobatan akut
2. Pengobatan jangka panjang
3. Bersifat hukum untuk visum et repertum
Cara pengobatan ditujukan pada
1. Penderita
2. Keluarga
3. Masyarakat
EvaluasiGunanya :
1. Mengetahui hasil dari usaha
2. Mengetahui faktor-faktor penghambat
3. Untuk menyusun program lanjutan atau program lainnya
Jenis-jenis evaluasi
1. Evaluasi hasil
2. Evaluasi proses
3. Evaluasi biaya
4. Analisa kegagalan pengobatan
5. Tinjauan tatalaksana program khusus
6. Survey tokoh pemeran
7. Evaluasi struktur dari program
Metode yang dipakai
1. Metode perbandingan
2. Sistem analisa
Daerah jangkauan(Catchment area)
Yaitu daerah dengan batas-batas tertentu dimana seluruh aktivitas dan tanggung jawab dari pelaksanaan program kesehatan jiwa dilakukan
Faktor-Faktor yang harus dipertimbangkan pada daerah jangkauan
1. Sikon
2. Prasarana/pengangkutan
3. Tumpang tindih dengan daerah lain
4. Besar/kecilnya tuntutan masyarakat
5. Sarana yang ada
6. Fanatisme masyarakat
7. Perpindahan masyarakat
8. Sifat golongan tertentu
9. Batas-batas daerah sensus
10. Dll
Penelitian
Sama dengan bidang Ilmu Kedokteran lainnya.
Sabtu, 08 Desember 2007
Lymphatic Filariasis
• Lymphatic filariasis [lim-FA-tick fil-uh-RY-uh-sis] is a disease of the tropics. It is caused by infection with any of several round, thread-like parasitic worms. The most common is infection with a parasite that lives in the lymph system. This is called lymphatic filariasis.
• The parasite is spread from person to person by infected mosquitoes.
• Long-term exposure and repeated infections can cause severe damage to the lymph system and serious, debilitating complications.
• Prevention centers on controlling mosquito populations in communities and avoiding mosquito bites.
What is lymphatic filariasis?
Filariasis is an infection with any of several round, thread-like parasitic worms. The most common type of filariasis is infection with a parasitic worm that lives in the human lymph system. This is called lymphatic filariasis.
What is the infectious agent that causes lymphatic filariasis?
Filariasis is caused by three types of parasitic worms: Wuchereria bancrofti, Brugia malayi, and Brugia timori.
Where is lymphatic filariasis found?
Lymphatic filariasis is a disease of the tropics. Wuchereria bancrofti, the most common filariasis parasite, is found in Africa, India, Southeast Asia, the Pacific islands, the Caribbean, and South America. The Brugia malayi and Brugia timori parasites are found in Southeast Asia.
How is lymphatic filariasis spread?
Filariasis is spread from infected persons to uninfected persons by mosquitoes. Adult worms live in an infected person's lymph vessels. The females release large numbers of very small worm larvae, which circulate in an infected person's bloodstream. When the person is bitten by a mosquito, the mosquito can ingest the larvae. These develop in the mosquito and can then be spread to other people via mosquito bites. After a bite, the larvae pass through the skin, travel to the lymph vessels, and develop into adults, which live about 7 years. Then the cycle begins again.
What are the signs and symptoms of lymphatic filariasis?
Most of the signs and symptoms of filariasis are caused as a consequence of the adult worms living in the lymph system. Tissue damage caused by the worms restricts the normal flow of lymph fluid. This results in swelling, scarring, and infections. The legs and groin are most often affected.
How soon after exposure do symptoms appear?
Symptoms can appear 5-18 months after a mosquito bite.
How is lymphatic filariasis diagnosed?
Filariasis larvae can sometimes be detected in blood.
Who is at risk for lymphatic filariasis?
Those most at risk are people who live in or stay for a long time in tropical areas where the disease is common. Short-term tourists rarely get filariasis. Getting an infection with symptoms usually requires several mosquito bites over a long period of time.
What complications can result from lymphatic filariasis?
Lymphatic filariasis is rarely fatal, but it can cause recurring infections, fevers, severe inflammation of the lymph system, and a lung condition called tropical pulmonary eosinophilia (TPE). In about 5% of infected persons, a condition called elephantiasis causes the legs to become grossly swollen. This can lead to severe disfigurement, decreased mobility, and long-term disability. Testicular hydrocele is a disfiguring enlargement of the scrotum.
What is the treatment for lymphatic filariasis?
Treatment consists of: 1) medicine to kill circulating larvae and adult worms, 2) soap and water and skin care to prevent secondary infections, and 3) elevation, exercises, and, in some cases, pressure bandages to reduce swelling.
How common is lymphatic filariasis?
At least 120 million people in 73 countries worldwide are estimated to be infected with filariasis parasites. The most widespread is Wuchereria bancrofti, which affects about 100 million people in Africa, India, Southeast Asia, the Pacific islands, South America, and the Caribbean. The Brugia malayi and Brugia timori parasites affect about 12 million people in Southeast Asia.
Is lymphatic filariasis an emerging infectious disease?
Yes. Lymphatic filariasis is among the world's leading causes of permanent and long-term disability. The number of infected persons is increasing worldwide, due in large part to unchecked urbanization in many areas where the parasite is common.
How can lymphatic filariasis be prevented?
There is no vaccine for filariasis. Prevention centers on mass treatment with anti-filariasis drugs to prevent ingestion of larvae by mosquitoes, public health action to control mosquitoes, and individual action to avoid mosquito bites. To avoid being bitten by mosquitoes:
• If possible, stay inside between dusk and dark. This is when mosquitoes are most active in their search for food.
• When outside, wear long pants and long-sleeved shirts.
• Spray exposed skin with an insect repellent
• The parasite is spread from person to person by infected mosquitoes.
• Long-term exposure and repeated infections can cause severe damage to the lymph system and serious, debilitating complications.
• Prevention centers on controlling mosquito populations in communities and avoiding mosquito bites.
What is lymphatic filariasis?
Filariasis is an infection with any of several round, thread-like parasitic worms. The most common type of filariasis is infection with a parasitic worm that lives in the human lymph system. This is called lymphatic filariasis.
What is the infectious agent that causes lymphatic filariasis?
Filariasis is caused by three types of parasitic worms: Wuchereria bancrofti, Brugia malayi, and Brugia timori.
Where is lymphatic filariasis found?
Lymphatic filariasis is a disease of the tropics. Wuchereria bancrofti, the most common filariasis parasite, is found in Africa, India, Southeast Asia, the Pacific islands, the Caribbean, and South America. The Brugia malayi and Brugia timori parasites are found in Southeast Asia.
How is lymphatic filariasis spread?
Filariasis is spread from infected persons to uninfected persons by mosquitoes. Adult worms live in an infected person's lymph vessels. The females release large numbers of very small worm larvae, which circulate in an infected person's bloodstream. When the person is bitten by a mosquito, the mosquito can ingest the larvae. These develop in the mosquito and can then be spread to other people via mosquito bites. After a bite, the larvae pass through the skin, travel to the lymph vessels, and develop into adults, which live about 7 years. Then the cycle begins again.
What are the signs and symptoms of lymphatic filariasis?
Most of the signs and symptoms of filariasis are caused as a consequence of the adult worms living in the lymph system. Tissue damage caused by the worms restricts the normal flow of lymph fluid. This results in swelling, scarring, and infections. The legs and groin are most often affected.
How soon after exposure do symptoms appear?
Symptoms can appear 5-18 months after a mosquito bite.
How is lymphatic filariasis diagnosed?
Filariasis larvae can sometimes be detected in blood.
Who is at risk for lymphatic filariasis?
Those most at risk are people who live in or stay for a long time in tropical areas where the disease is common. Short-term tourists rarely get filariasis. Getting an infection with symptoms usually requires several mosquito bites over a long period of time.
What complications can result from lymphatic filariasis?
Lymphatic filariasis is rarely fatal, but it can cause recurring infections, fevers, severe inflammation of the lymph system, and a lung condition called tropical pulmonary eosinophilia (TPE). In about 5% of infected persons, a condition called elephantiasis causes the legs to become grossly swollen. This can lead to severe disfigurement, decreased mobility, and long-term disability. Testicular hydrocele is a disfiguring enlargement of the scrotum.
What is the treatment for lymphatic filariasis?
Treatment consists of: 1) medicine to kill circulating larvae and adult worms, 2) soap and water and skin care to prevent secondary infections, and 3) elevation, exercises, and, in some cases, pressure bandages to reduce swelling.
How common is lymphatic filariasis?
At least 120 million people in 73 countries worldwide are estimated to be infected with filariasis parasites. The most widespread is Wuchereria bancrofti, which affects about 100 million people in Africa, India, Southeast Asia, the Pacific islands, South America, and the Caribbean. The Brugia malayi and Brugia timori parasites affect about 12 million people in Southeast Asia.
Is lymphatic filariasis an emerging infectious disease?
Yes. Lymphatic filariasis is among the world's leading causes of permanent and long-term disability. The number of infected persons is increasing worldwide, due in large part to unchecked urbanization in many areas where the parasite is common.
How can lymphatic filariasis be prevented?
There is no vaccine for filariasis. Prevention centers on mass treatment with anti-filariasis drugs to prevent ingestion of larvae by mosquitoes, public health action to control mosquitoes, and individual action to avoid mosquito bites. To avoid being bitten by mosquitoes:
• If possible, stay inside between dusk and dark. This is when mosquitoes are most active in their search for food.
• When outside, wear long pants and long-sleeved shirts.
• Spray exposed skin with an insect repellent
Jumat, 30 November 2007
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