Abstract Background: Post-Intensive Care Syndrome (PICS) encompasses cognitive, motor, and mental impairments persisting for years in ICU survivors. Despite its significance, the prevalence of PICS in Indonesia remains uncertain due to limited research and a lack of validated measurement tools. This study aims to translate and validate the PICS Questionnaire for use among ICU survivors in Indonesia. Methods: The study followed a two-phase approach: translation and evaluation. The translation phase adhered to the 10-step process of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines. The analysis phase involved 184 subjects, using Confirmatory Factor Analysis (CFA) for validation and Cronbach's α and Intraclass Correlation Coefficient (ICC) for reliability testing. Results: The CFA reported factor loadings (λ >0.40) for each item in its relevant domain. Fit index values indicated a good-to-acceptable fit. Internal reliability was high for the mental, physical, and cognitive domains (0.812 vs. 0.779 vs. 0.855), with Cronbach's α of > 0.70. Test-retest reliability and ICC demonstrated dependable results (>0.70) for each domain. Conclusion: The translated and validated Indonesian PICS Questionnaire demonstrates good validity and reliability. This tool will enable healthcare professionals to assess PICS among ICU survivors in Indonesia and facilitate further research on its prevalence and impact on quality of life.
Intensive Care Unit ; Quality of Life ; Surveys and Questionnaires ; Factor Analysis ; Statistical ; Indonesia

BACKGROUND : Exergames have been proven to effectively improve physical function, particularly in the elderly. Although, older adults were once considered a low-tech population, tailored exergame interventions have proven beneficial. However, utilizing virtual reality (VR) in group presents challenges related to both cognitive acceptance and cardiovascular tolerance. This study aimed to evaluate cardiovascular responses, safety, and exercise intensity or VR-based exergaming in an acute care setting and to explore what to consider when giving exergames to subjects with high comorbidity. METHODS : This pre-post study used the Oculus Meta Quest 2® platform in 32 elderly participants. Each completed a single exergame session. Pre- and post-session assessments included measurements of heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Cardiopulmonary sentinel signs were monitored thoroughly. RESULTS : Post-exergame HR was significantly higher than baseline (82 [18] beats per minute [bpm] versus 79 [17] bpm; p = 0.004; mean difference: 4 [8] bpm). Blood pressure decreased slightly, but not significantly (SBP: −1 [14] mmHg, p = 0.837; DBP: 0 [12] mmHg, p = 0.829). Most participants experienced light-intensity activities (n = 26, 81%). No sentinel events occurred. CONCLUSIONS A single session of VR exergaming safely increased HR above baseline in elderly participants, with activity predominantly classified as light intensity. Further studies should explore the determinants of exergame intensity to optimize prescriptions and tailoring.
elderly ; exergames ; heart rate ; virtual reality

Objective: Stress urinary incontinence (SUI) is a common problem that affects the quality of life of women worldwide. Pelvic floor muscle training (PFMT) is an effective conservative first-line treatment for SUI. However, low compliance with PFMT is one of the main reasons for therapeutic failure. Indirect supervision using a guidebook may improve PFMT outcomes. To develop a PFMT guidebook using the analyze, design, development, implementation, and evaluation (ADDIE) method. Methods: A guidebook was developed from July 2020 to April 2021 using the ADDIE method. This prospective study used mixed methods, namely qualitative analysis, focus group discussions, and in-depth interviews, and involved various experts from urogynecology, urology, medical rehabilitation, and physiotherapy departments. A pilot study was conducted on patients with SUI to evaluate the effectiveness of the guidebook. Results: The ADDIE method was successfully implemented to develop the PFMT guidebook. The formative evaluation of the ADDIE steps mainly focused on the PFMT technique, content clarity, illustration, design, and color choice of the book. After the pilot study, the guidebook significantly improved Incontinence Impact Questionnaire, Short Form, 1-hour pad test, and perineometer scores. However, the pilot study showed no significant improvement in Urogenital Distress Inventory, Short Form scores. Conclusion The PFMT guidebook developed using the ADDIE method improved outcomes in patients with SUI.