The Role of Families in Preventing Uric Acid Relapse in the Elderly in SilagaVillage, Siniu District, Parigi Moutong Regency

Introduction: Gout or commonly called gout arthritis is a disease that arises suddenly, repeatedly and is very painful, which generally occurs in the big toe or other joints. The elderly said they did not get information and support from their families about how to prevent gout recurrence. The purpose of this study was to determine the role of the family in the prevention of gout recurrence in the elderly in Silanga Village, Siniu District, ParigiMoutong Regency. Method: The type of research used is descriptive research, the population in this study is the elderly who suffer from gout in Silanga Village, Siniu District, ParigiMoutong Regency, a total of 39 people. The sample in this study was the entire population as a sample, amounting to 39 people. The sampling method is non-probability sampling with a total sampling approach model. Result: It shows that of 39 respondents stated that most of the family roles are sufficient (53.8%), good family roles (23.1%) and less family roles (23.1%). It is hoped that families will give more roles to gout sufferers, namely in the form of a role as a motivator, a role as an educator, and a role as a family nurse. Suggestions for health workers to be more active in providing information about gout, causative factors, and ways to prevent gout recurrence and always involve families to assist the elderly. Conclusion: It is hoped that the family will increase the role given to the elderly in preventing the recurrence of gout in terms of the role as a motivator.


Introduction
Gout or commonly called gout arthritis is a disease that arises suddenly, repeatedly and is painful, which generally occurs in the toe or other joints. Gout is one of several very dangerous diseases because it not only interferes with health but can also cause physical disabilities (Asaidi, 2010). High uric acid levels in the blood can cause a buildup of uric acid in the joints and other organs of the body, this buildup of uric acid makes the joints sore, painful and inflamed (Sutanto, 2013).
Uric acid rarely directly causes death or fatality in sufferers, but high uric acid can cause several dangerous diseases with high mortality rates such as hypertension, dyslipidemia, kidney disease, obesity, and heart disease. These diseases can appear as complications or comorbid with the incidence of gout (Fandi, 2014).
Based on the World Health Organization (WHO) in 2017, the prevalence of gout in the world was 34.2%, gout often occurs in developed countries such as America, the prevalence of gout in America is 26.3% of the total population. The increase in the incidence of gout does not only occur in developed countries but also occurs in developing countries, one of which is Indonesia (Arifki, 2021).
The prevalence of gout in Indonesia is increasing. According to Riskesdas 2018, the prevalence of gout based on a diagnosis in Indonesia is 7.30%, and the prevalence of gout based on a doctor's diagnosis is at age 15 years, the highest prevalence is at age 75 years (18.96%). There are also more women (8.46%) while men (6.13%), and the prevalence of gout according to the characteristics of education is not/never been to school (13.66%), farm laborers (9.86%), based on rural residence (7.83%) (Riskesdas, 2018). Prevention of uric acid recurrence is by limiting purine intake or low purines, energy intake according to needs, consuming more carbohydrates, reducing fat consumption, consuming lots of fluids, not consuming alcoholic beverages, consuming enough vitamins and minerals, consuming fruits and vegetables, getting checkups. themselves in the laboratory to determine uric acid levels in the blood, reduce strenuous Niswa Salamung, Noviany Banne Rasiman, Maftuha, Ni Ketut Elmiyanti, Freny Ravika Mbaloto: The Role of Families in Preventing Uric Acid Relapse in the Elderly … physical activity, always maintain a healthy lifestyle and exercise regularly (Amrulloh, 2017).
The role of the family is very necessary in the care of the elderly, namely by maintaining and caring for the condition of elderly family members in order to remain in an optimal and productive state (Syamdarniati, 2013). The role of the family is divided into two, namely the first formal role and informal role. Formal roles are the role of the father, the role of the mother and the role of the child. Meanwhile, the informal role is the role as a motivator, the role as an educator, and the role as a family nurse (Friedman, 2002).
Based on initial data collection on May 3, 2021, there were 39 people with gout in Silanga Village. And from the results of interviews with several elderly people, it was found that the family did not give the elderly a role to prevent the recurrence of gout, namely the role as a motivator, role as educator and role as family nurse.
Based on the description above, the authors are interested in conducting research on "The role of the family in preventing gout recurrence in the elderly in Silanga Village, Siniu District, ParigiMoutong Regency".

Method
The type of research used is descriptive research, namely research that describes the phenomenon of the variables studied (Notoatmodjo, 2010). This study aims to describe the role of the family in the prevention of gout recurrence in the elderly in Silanga Village, Siniu District, ParigiMoutong Regency. The research was carried out from 27 July to 03 August 2021 in Silanga Village, Siniu District, ParigiMoutong Regency. The population in this study were all gout sufferers in Silanga Village totaling 39 people. The sample in this study was the entire population as a sample in Silanga Village, totaling 39 people with the sampling method being non-probability sampling with a total sampling approach model.

Result
The role of the family in this study is divided into 3 categories, namely Good (if the percentage of respondents' answers are 76% -100%), sufficient (if the results of the percentage of respondents' answers are 56% -75%) and less (if the results of the percentage of respondents' answers are <56%). Which can be seen in  Table 4.7 shows that most of the roles of the family are sufficient, amounting to 21 respondents (53.8%), the role of the good family is 9 respondents (23.1%) and the role of the family is less than 9 respondents (23.1%).

Discussion
Based on the results of the study, 39 respondents stated that most of the family roles given to respondents were in the sufficient category. The researcher assumes that the family has played a role as a motivator, role as an educator and a role as a family nurse quite well. This can be seen in filling out the questionnaire for the elderly who answered that the role given by the family was good enough, the family provided information about gout, the family took the elderly to the puskesmas and posyandu, the family informed them about foods that should not be consumed by gout sufferers, the family provided support to the elderly and their families also take care of the elderly when they are sick In accordance with the theory developed by Friedman (1988) that situational events are events that confront the family and will definitely affect the role function of each family member and this situation is a stressful event. And the theory put forward by Notoadmodjo (2003) that the role of the family as an educator must be further improved because the family is a very important support system in providing health education in the family.
This study is in line with research conducted by Festy (2012) on "The role of the family in the implementation of medical rehabilitation in stroke patients". With the results of the research, the role of the family as a motivator is in the good category (78%), the role of the family as an educator is very poor (39%), and the role as a family nurse is categorical enough (65%).

Conclusion
Based on the results of the study, it can be concluded that in this study the role of the family in preventing gout recurrence in the elderly in Silanga Village, Siniu District, Parigi Moutong Regency, the role given by the family is quite good. It is hoped that the family will increase the role given to the elderly in preventing the recurrence of gout in terms of the role as a motivator, the role as an educator and the role as a family nurse so that the elderly are more enthusiastic and active in preventing gout recurrence. It is also hoped that health workers can involve the family to assist the elderly because the role of the family can influence the behavior of the elderly in their daily activities.