ANIMAL NAMING TEST UNTUK MENGIDENTIFIKASI GANGGUAN KOGNITIF AKIBAT ENSEFALOPATI HEPATIKUM PADA PASIEN SIROSIS HEPATIS: EVIDENCE BASED NURSING

Yulia Sihombing; Debie Dahlia; Yunisar Gultom; Liya Arista

doi:10.24843/coping.2024.v12.i01.p04

Yulia Sihombing Universitas Pelita Harapan
Debie Dahlia Universitas Indonesia
Yunisar Gultom Rumah Sakit Dr. Cipto Mangunkusumo
Liya Arista Universitas Indonesia

DOI: https://doi.org/10.24843/coping.2024.v12.i01.p04

Abstract

Fibrosis hati dan konversi dari arsitektur normal hati menjadi nodul-nodul abnormal pada pasien sirosis hepatis menyebabkan kegagalan hati menjalankan fungsinya (dekompensata) dan menimbulkan komplikasi yakni ensefalopati hepatikum, baik itu ensefalopati hepatikum bersifat laten/asimtomatik (covert hepatic encephalopathy) ataupun yang bersifat nyata (overt hepatic encephalopathy). Animal Naming Test (ANT) yang merupakan suatu tes dengan pertanyaan verbal sederhana untuk mengidentifikasi fungsi mental seseorang dapat digunakan untuk mengetahui gangguan fungsi mental yang berhubungan dengan ensefalopati hepatikum. Untuk mengidentifikasi penerapan Evidence Based Nursing (EBN) yakni penggunaan ANT sebagai tes fungsi kognitif sederhana yang dapat digunakan sebagai skrining awal gangguan kognitif terutama yang bersifat laten/covert pada pasien dengan sirosis hepatis yang tidak teridentifikasi dengan asesmen klinis rutin yang tersedia yakni pertanyaan verbal untuk menilai orientasi waktu, tempat dan orang; dan asesmen klinis menggunakan West Haven Criteria (WHC). Penelitian ini merupakan studi penerapan EBN dengan total sampling sebanyak 16 orang, yang merupakan seluruh pasien dengan sirosis hepatis yang menjalani rawat inap di satu ruang perawatan penyakit dalam di satu rumah sakit pusat rujukan nasional di Jakarta. Penerapan EBN dilakukan dengan menggunakan ANT untuk mengidentikasi ada/tidaknya gangguan fungsi kognitif pada pasien sirosis dan membandingkannya dengan asesmen rutin yang dilakukan. ANT yang diterapkan pada 16 pasien sirosis dapat mengidentifikasi 12 orang pasien yang mengalami gangguan kognitif, yakni 8 orang lebih banyak bila dibandingkan dengan menggunakan asesmen WHC yakni 4 orang, dan tidak terdeteksi atau 0 orang bila menggunakan asesmen pertanyaan verbal orientasi waktu, tempat, dan orang. ANT dapat digunakan sebagai salah satu asesmen dan skrining awal untuk mendeteksi gangguan fungsi kognitif pasien dengan sirosis hepatis.

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