PENGARUH DISCHARGE PLANNING TERSTRUKTUR TERHADAP SELF-CARE DAN RISIKO STROKE BERULANG PADA PASIEN PASCA STROKE

Thresna Paramarini; Maria Astrid

doi:10.36916/jkm.v11i1.497

Authors

Thresna Paramarini Program Studi Keperawatan, STIK Sint Carolus, Jakarta, Indonesia
Maria Astrid Program Studi Keperawatan, STIK Sint Carolus, Jakarta, Indonesia

DOI:

https://doi.org/10.36916/jkm.v11i1.497

Keywords:

Structured Discharge Planning; Risk of Recurrent Stroke; Self-care; Stroke

Abstract

Background: Stroke is characterized by a high risk of recurrence, with impacts that are often more severe than the initial attack. Therefore, a strong justification is needed for implementing structured discharge planning. This process is crucial in bridging the transition of care from the hospital to the home through systematic education for families, in order to prevent preventable stroke recurrences.

Purpose: This study analyzes the effect of structured discharge planning on improving self-care and reducing the risk of recurrent stroke in post-stroke patients

Methods: This quantitative study used a quasi-experimental pretest-posttest control group design. A total sample of 70 patients who met the inclusion criteria was divided into an intervention group receiving structured discharge planning and a control group receiving conventional discharge planning. Self-care was measured using the Barthel Index, and the risk of recurrent stroke was measured using the Essen Stroke Risk Score (ESRS). The questionnaire data were then analyzed using parametric t-tests and ANOVA.

Result: The study showed a significant increase in self-care levels in the intervention group (p<0.001), with the mean score increasing from 5.57 to 10.17. Meanwhile, the risk of recurrent stroke decreased significantly in the intervention group (p<0.001), shifting from high to moderate and low categories, while the control group remained at high risk.

Implication: Structured discharge planning is an evidence-based health intervention that effectively increases patient independence and reduces the risk of recurrent stroke, not simply an administrative procedure. With its relatively low cost and significant clinical impact, this intervention deserves to be a national flagship program to shift the paradigm of stroke care from an acute-phase orientation to a patient-centered continuum of care

References

Aisyah, A., Arsyawina, A., & Widiastuti, H. P. (2023). Pengaruh Penerapan Discharge Planning dengan Media Leaflet terhadap Kesiapan Pulang Pasien Jantung di RSD dr. H. Soemarno Sosroatmodjo Tanjung Selor. SAINTEKES: Jurnal Sains, Teknologi Dan Kesehatan, 2(2), 257–265. https://doi.org/10.55681/saintekes.v2i2.81

Artajaya, K. D. S., Dewi, N. L. P. T., & Pramesti, T. A. (2025). Gambaran Tingkat Kemandirian Pasien Pasca Stroke di RSUD Tabanan. Jurnal Pustaka Keperawatan (Pusat Akses Kajian Keperawatan), 4(2), 538–545. https://doi.org/10.55382/jurnalpustakakeperawatan.v4i2.1675

Badan Kebijakan Pembangunan Kesehatan (BKPK). (2023). Survei Kesehatan Indonesia (SKI) 2023 Dalam Angka. Kementerian Kesehatan Republik Indonesia. https://www.badankebijakan.kemkes.go.id/ski-2023-dalam-angka/

Cahyaningtyas, M. D., Kristiyawati, S. P., & Yono, N. H. (2024). Faktor-Faktor Resiko Kejadian Stroke Berbasis Stroke Risk ScoreCard. Vitamin: Jurnal Ilmu Kesehatan Umum, 2(4), 30–44. https://doi.org/10.61132/vitamin.v2i4.641

Fitriyanti, D., & Rahmalia, S. (2026). Teori Self-care dari Orem: Filosofi dan Praktek dalam Keperawatan. Jurnal Keperawatan Abdurrab, 9(2), 1–9. https://doi.org/10.36341/jka.v9i2.6178

Green, T. L., McNair, N. D., Hinkle, J. L., Middleton, S., Miller, E. T., Perrin, S., Power, M., Southerland, A. M., & Summers, D. V. (2021). Care of the Patient with Acute Ischemic Stroke (Posthyperacute and Prehospital Discharge): Update to 2009 Comprehensive Nursing Care Scientific Statement: A Scientific Statement from the American Heart Association. Stroke, 52(5), e179–e197. https://doi.org/10.1161/STR.0000000000000357

Handayani, F., Widyastuti, R. H., & Eridani, D. (2019). Buku panduan bagi kader dan keluarga penatalaksanaan stroke di rumah. Universitas Diponegoro. https://eprints.undip.ac.id/80790/1/Buku_panduan_penatalaksanaan_stroke.pdf

Hidayah, N., & Abidah, R. S. (2024). Peningkatan Self-care sebagai Upaya Pasien Pasca Stroke. Hospital Majapahit (Jurnal Ilmiah Kesehatan Politeknik Kesehatan Majapahit Mojokerto), 16(2), 244–261. https://doi.org/10.55316/hm.v16i2.1092

Hinkle, J. L., Cheever, K. H., & Overbaugh, K. J. (2021). Brunner & Suddarth’s textbook of medical-surgical nursing (15th ed). Wolters Kluwer Health. https://shop.lww.com/Brunner---Suddarth-s-Textbook-of-Medical-Surgical-Nursing/p/9781975161033?srsltid=AfmBOoqer8kALlXxCxVmwBGYbQ_oovUpsp3nkU95tqRoZG2sjw6s2N8U

Juwita, H., Sjattar, E. L., Majid, A., & Lukman, S. (2021). Kolaborasi Multidisiplin Pelaksanaan Discharge Planning. Aksiologiya: Jurnal Pengabdian Kepada Masyarakat, 5(4), 524–537. https://doi.org/10.30651/aks.v5i4.5079

Kim, J.-T., Kim, B. J., Park, J.-M., Lee, S. J., Cha, J.-K., Park, T. H., Lee, K. B., Lee, J., Hong, K.-S., Lee, B.-C., Kim, D.-E., Choi, J. C., Kwon, J.-H., Shin, D.-I., Sohn, S. Il, Lee, J. S., Lee, J., & Bae, H.-J. (2020). Risk of recurrent stroke and antiplatelet choice in breakthrough stroke while on aspirin. Scientific Reports, 10(1), 16723. https://doi.org/10.1038/s41598-020-73836-0

Kurniati, M. F., Khayudi, B. A., & Efendi, Y. (2024). Pengaruh Intervensi Supportive Educative System Berbasis Integrasi Self-care Menurut Dorothea Orem terhadap Upaya Pencegahan Stroke. Jurnal Ilmiah Keperawatan (Scientific Journal of Nursing), 10(3), 527–532. https://doi.org/10.33023/jikep.v10i3.2283

Laila, N., Armiyati, Y., & Soesanto, E. (2024). Discharge planning improved quality of life on stroke patient: a review. Riset Informasi Kesehatan, 13(2), 117–127. https://doi.org/10.30644/rik.v13i2.873

Li, S., Chen, R., Zhang, L., Li, H., Gong, Y., Hang, Y., Cao, J., & Zhang, H. (2025). Relationships Between Quality of Discharge Teaching, Readiness for Hospital Discharge, Self‐Efficacy and Self‐Management in Patients with First‐Episode Stroke: A Cross‐Sectional Study. Journal of Clinical Nursing, 34(7), 2830–2839. https://doi.org/10.1111/jocn.17481

Peng, S., Liu, X., Cao, W., Liu, Y., Liu, Y., Wang, W., Zhang, T., Guan, X., Tang, J., & Zhang, Q. (2023). Global, regional, and national time trends in mortality for stroke, 1990–2019: An age-period-cohort analysis for the global burden of disease 2019 study and implications for stroke prevention. International Journal of Cardiology, 383, 117–131. https://doi.org/10.1016/j.ijcard.2023.05.001

Rachamin, Y., Grischott, T., & Neuner-Jehle, S. (2021). Implementation of a complex intervention to improve hospital discharge: process evaluation of a cluster randomised controlled trial. BMJ Open, 11(5), e049872. https://doi.org/10.1136/bmjopen-2021-049872

Rofi’i, M. (2022). Discharge planning pada pasien di Rumah Sakit. Undip Press. https://penerbit.undip.ac.id/index.php/penerbit/catalog/book/288

Saidi, S., & Andrianti, S. (2021). Perbedaan Teknik Relaksasi Nafas Dalam Dan Teknik Slow Stroke Back Massage Terhadap Skala Nyeri Pada Penderita Low Back Pain Di Puskesmas Jaya Loka. Injection: Nursing Journal, 1(1), 32–43. https://jurnal.stikesbhaktihusada.ac.id/index.php/INJECTION/article/download/64/pdf

Saragih, I. D., Everard, G., Saragih, I. S., & Lee, B. (2023). The beneficial effects of transitional care for patients with stroke: A meta‐analysis. Journal of Advanced Nursing, 80(2), 789–806. https://doi.org/10.1111/jan.15850

Sripanom, S. (2025). Application of Orem’s Theory in Nursing Care for Patients with Ischemic Stroke: A Case Study. Thai Journal of Nursing and Midwifery Practice, 12(1), 157–169. https://he02.tci-thaijo.org/index.php/apnj/article/view/272346

Sriwahyuni, S., Haskas, Y., Kadrianti, E., Alfiah, A., Hasifah, H., Jamaluddin, M., & Mutmainnah, A. (2025). Pengaruh Edukasi Berbasis Teori Orem terhadap Self-care Pasien DMTII di Wilayah Kerja Puskesmas Tamalanrea Makassar. Natural: Jurnal Pelaksanaan Pengabdian Bergerak Bersama Masyarakat., 3(3), 141–151. https://doi.org/10.61132/natural.v3i3.1704

Suhadi, S., & Purboningsih, W. (2020). Pengaruh Dukungan Kelompok Klub Stroke bagi Anggotanya dalam Perawatan Klien Pasca Stroke terhadap Kejadian Stroke Berulang. Jurnal Penelitian Perawat Profesional, 2(2), 217–226. https://doi.org/10.37287/jppp.v2i2.116

Suwandewi, A., Baihaqi, M. F., Maulida, M. H., Maryam, M., & Sonia, S. (2024). Penerapan Barthel Index Terhadap Tingkat Kemandirian Aktivitas Harian Lansia Jamaah Lansia Masjid KH. Ahmad Dahlan Banjarmasin. Jurnal Pengabdian Ilmu Kesehatan, 4(1), 55–65. https://doi.org/10.55606/jpikes.v4i1.3214

Wardhani, R. P., & Mulyono, S. (2023). Pemanfaatan Telenursing terhadap Kualitas Hidup Bayi Post Rawat NICU. Journal of Telenursing (JOTING), 5(1), 1353–1359. https://doi.org/10.31539/joting.v5i1.5202

Wulandari, A. T., Fadila, E., Santoso, R. B. E., & Unok, W. (2025). Determinan Kejadian Stroke Berulang. Ensiklopedia of Journal, 7(2), 316–320. https://doi.org/10.33559/eoj.v7i2.2968