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"Laporan ini merupakan rangkuman laporan praktek keperawatan maternitas residen selama satu tahun. Residen menjalankan peran dan fungsi sebagai pemberi pelayanan keperawatan, konselor, advokad, edukator, koordinator, pengelola, kolaborator, dan peneliti dalam upaya meningkatkan kesehatan reproduksi perempuan selama melaksanakan praktek di rumah sakit dan komunitas. Diantara sekian banyak masalah kesehatan reproduksi perempuan, kanker serviks stadium lanjut merupakan fokus of interest residen dengan menerapkan teori keperawatan adaptasi Roy. Diagnosa kanker selalu menimbulkan krisis yang menuntut klien dan keluarga untuk selalu beradaptasi dengan perubahan status kesehatannya. Penerapan teori ini terbukti dapat memberikan asuhan keperawatan pada klien secara komprehensif. Selama menjalani praktek residen banyak mendapatkan dukungan dan beberapa hambatan yang menjadi wahana pembelajaran untuk pendewasaan diri residen.

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This report is a summary of residential practice report of maternity nursing specialist during one year. The resident performed the role and function as a maternity care provider, a counselor, an advocate, an educator, a coordinator, a manager, a collaborator, and a researcher to improve the women reproductive health during implementing nursing practice in the hospital and community. Among many female reproductive health problems, the late-stage cervical cancer was the resident's focus of interest with the application of Roy’s Adaptation Nursing Theory. A cancer diagnosis always causes a crisis demanding a client and the family to adapt to the changes of his/her health status. It is proved that the application of this theory could provide a comprehensive nursing care to a client. During the practice period the resident obtained much supports and some obstacles that educated the resident to be a mature person."

"Kanker Ovarium adalah pertumbuhan sel - sel yang abnormal pada satu atau dua bagian indung telur. Kanker ovarium merupakan penyakit ganas ginekologi kedua diseluruh dunia, pada tahun 2013 ditemukan 22240 pasien dimana 14.030 (15%) meninggal dunia akibat kanker ovarium tersebut. Laporan ini bertujuan memberikan gambaran tentang pelaksanaan praktik spesialis keperawatan maternitas dalam menjalankan perannya sebagai pendidik, pelindung, pengelola, kolaborator, komunikator, konselor, koordinator, agen perubah dan peneliti dalam memberikan asuhan keperawatan pada klien kanker ovarium dengan menggunakan teori adaptasi Roy. Model teori keperawatan adaptasi Roy efektif dilakukan pada kedua kasus ibu dengan kanker ovarium, aplikasi teori tersebut membantu menyelesaikan masalah keperawatan di fase akut maupun di fase pemulihan. Pada klien kanker ovarium perlu adanya pengabungan teori Loss and Griving dengan adaptasi Roy untuk membantu klien mempertahankan keadaan psikologis klien dalam tahap menerima. Penulis mampu mencapai target kompetensi dalam praktik klinik keperawatan maternitas residensi dengan baik.

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Ovarian cancer is the growth of abnormal cells in one or two parts of the ovary. Ovarian cancer is the second gynecological malignant disease throughout the world. In 2013 there were 22,240 patients that 14,030 (15%) died from the ovarian cancer. This report aimed to provide an overview of the implementation of maternity nursing specialist practice in carrying out its role as an educator~ a protector, a manager, a collaborator, a communicator, a counselor, a coordinator, an agent of change and a researchers in providing nursing care to the ovarian cancer clients using Roy adaptation theory. Roy adaptation nursing theory model was effectively performed in both cases of women with ovarian cancer, the application of the theory helped to solve the nursing problem in the acute phase and in the recovery phase. The combination of Loss & Grieving and Roy Adaptation Theory could help ovarian cancer clients to maintain their psychological state in the receiving phase. The author was able to achieve the target competencies in maternity nursing residency clinical practice successfully."

"[ABSTRAKPelayanan keperawatan merupakan bagian integral dari pelayanan kesehatan dan masalah kesehatan reproduksi perempuan menjadi bagian yang tak terpisahkan dari sistim pelayanan kesehatan secara keseluruhan. Residen keperawatan maternitas dalam melaksanakan perannya dituntut mampu memberikan asuhan keperawatan sesuai dengan kebutuhan masyarakat di berbagai tatanan pelayanan kesehatan. Dalam upaya memberikan asuhan keperawatan, residen mengelola tujuh pasien dengan kista ovarium di dua rumah sakit yang berbeda dengan menggunakan pendekatan teori Adaptasi Roy. Dari ketujuh kasus tersebut, lima kasus jenis kista coklat dengan karakteristik munculnya keluhan dipengaruhi oleh siklus menstruasi dan dua kasus lain berjenis kista denoma. Dengan adanya berbagai perubahan dalam diri penderita kista ovarium, maka teori keperawatan Adaptasi Roy dianggap tepat diterapkan pada pasien dengan kista ovarium. Laporan akhir residensi juga memapartkan capaian 100% untuk target kompetensi pada tiga lahan praktek dan berusaha memodifikasi setiap hambatan yang ada selama pelaksanaan praktik residensi.

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ABSTRACTNursing service is an integral part of healthcare services and women's reproductive health problems become an integral part of the overall healthcare system. Maternity nursing resident in performing its role is demanded to provide nursing care in accordance with the needs of the community in a variety of healthcare structures. In providing nursing care, resident managed seven patients with ovarian cysts at two different hospitals using Roy Adaptation Theory approach. Of the seven cases, five cases were chocolate cyst type characterized by the emergence of complaints influenced by menstrual cycle and two other cases were denoma cyst. Since ovarian cysts patients experienced various changes, Roy Adaptation Nursing Theory was considered appropriate to be applied on patients with ovarian cysts. The final report also described the achievement of 100% of the target competencies in the three fields of practice and try to modify any existing obstacles during the residency practice., Nursing service is an integral part of healthcare services and women's reproductive health problems become an integral part of the overall healthcare system. Maternity nursing resident in performing its role is demanded to provide nursing care in accordance with the needs of the community in a variety of healthcare structures. In providing nursing care, resident managed seven patients with ovarian cysts at two different hospitals using Roy Adaptation Theory approach. Of the seven cases, five cases were chocolate cyst type characterized by the emergence of complaints influenced by menstrual cycle and two other cases were denoma cyst. Since ovarian cysts patients experienced various changes, Roy Adaptation Nursing Theory was considered appropriate to be applied on patients with ovarian cysts. The final report also described the achievement of 100% of the target competencies in the three fields of practice and try to modify any existing obstacles during the residency practice.]"

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Pasien penyintas kanker ginekologi mengalami masalah kesehatan yang kompleks dan memiliki kebutuhan-kebutuhan yang tidak terpenuhi. Kebutuhan tersebut meliputi kebutuhan fisik, psikologis, sosial, dan spiritual. Pasien penyintas kanker dengan masalah kekambuhan kanker mengharuskan pasien beradaptasi secara adaptif dan mendapatkan kenyamanan dalam menjalani kondisinya saat ini. Teori yang dapat digunakan pada kasus dengan kekambuhan adalah teori adaptasi Roy dan kenyamanan Kolcaba. Penerapan teori keperawatan pada lima pasien kelolaan yang mengalami kekambuhan dengan berbagai diagnosis kanker yang berbeda-beda. Dua orang didagnosis kanker serviks, dua orang lainnya kanker ovarium dan satu orang lainnya kanker vagina. Karena respon yang berbeda dari setiap pasien terhadap asuhan keperawatan yang diberikan, maka dilakukan modifikasi intervensi keperawatan. Kedua teori ini sesuai untuk diterapkan pada pasien penyintas kanker ginekologi dalam meningkatkan kenyamanan dan membantu klien beradaptasi secara fisiologis dengan kondisi yang dialaminya.

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Penerapan teori keperawatan Roy Adaptation dan Comfort Kolcaba pada Kanker Ginekologi. Kasus pasien kanker Ginekologi mengalami masalah kesehatan yang tidak terduga dan kebutuhan yang tidak terpenuhi. Kebutuhan tersebut antara lain fisik, psikologis, sosial, dan spiritual. Penderita masalah kekambuhan kanker dituntut untuk beradaptasi secara adaptif dan merasa nyaman dalam menjalani kondisi mereka saat ini. Teori-teori yang dapat digunakan dalam kasus-kasus berulang adalah adaptasi Roy dan kenyamanan Kolcaba. Penerapan teori keperawatan pada lima pasien yang dirawat yang mengalami kekambuhan dengan berbagai diagnosa kanker yang berbeda. Dua orang didiagnosis menderita kanker serviks, dua lainnya menderita kanker ovarium dan satu lagi menderita kanker vagina. Karena setiap pasien memberikan respon yang berbeda terhadap asuhan keperawatan yang diberikan, maka modifikasi intervensi keperawatan harus dilakukan.

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"ABSTRAK Karya Ilmiah Akhir ini disusun sebagai laporan akhir dari praktik residensi ners spesialis keperawatan Maternitas yang berfokus pada penerapan teori keperawatan Konservasi Levin dan Comfort Kolkaba pada asuhan keperawatan pasien yang mengalami kanker serviks sadium IIIB. Tujuan penulisan pelaporan ini adalah untuk memberikan gambaran kegiatan tentang pelaksanaan praktik residensi Ners Spesialis Keperawatan Maternitas dengan fokus penerapan teori keperawatan Levine dan Comfort Kolkaba pada pasien dengan kanker serviks stadium IIIB dalam menjalankan perannya sebagai direct care provider, konselor, advokat, edukator, koordinator, kolaborator, komunikator, change agent dan peneliti. Apliaksi teori keperawatan Konservasi Levin dan Comfort Kolkaba efektif dilakukan pada lima kasus pasien dengan kanker serviks stadium IIIB. Teori keperawatan Konservasi Levin menjadi pilihan pada pasien dengan kanker serviks di ruang perawatan untuk memperbaiki keadaan umum pasien sesuai kemampuan adapatasi pasien terhadap konservasi energi, integritas struktural, integritas personal dan integritas sosial . Kenyamanan adalah kebutuhan dasar manusia oleh karena itu perawat menggabungkan teori konservasi Levine dengan kenyamanan Kolkaba pada pada tiga pasien kanker serviks stadium IIIB yang sudah dilakukan nefrostomi. Kata kunci: Asuhan keperawatan, kanker serviks stadium IIIB, teori keperawatan Levin, teori keperawatan Kolkaba ABSTRACT Final scientific report of clinical practice maternity nursing specialist which focus on the application of Nurisng Theory Conservation Levin and Comfort Kolkaba in Nursing Care of patients with Cerviks cancer thirtd stadium. xv 55 pages. 1 table 2 scheme 8 appendixes ABSTRACTThis final scientific paper is prepared as a final report of residency practice of nursing specialist of Maternity nursing which focuses on applying the nursing theory of Levin Conserve and Comfort Kolkaba on nursing care of patients who have cervical cancer IIIB. The purpose of this report is to provide an overview of activities on the implementation of residency practice Ners Maternity Nursing Specialist with a focus on the application of Levin and Comfort Kolkaba nursing theory in patients cervical cancer with stage IIIB in performing its role as a direct care provider, counselor, advocate, educator, coordinator, collaborator, communicators, change agents and researchers. Application of nursing theory Conservation of Levin and Comfort Kolkaba was effective in five cases of patients with stage IIIB cervical cancer. The Levin Conservation Nursing Theory becomes an option in patients with cervical cancer in the treatment room to improve the general state of the patient according to the patient 39 s ability to adapt the conservation energy, structural integrity, personal integrity and social integrity . Convenience is a basic human need therefore nurses combine Levine conservation theory with Kolkaba comfort in three patients with stage IIIB cervical cancer who have done nephrostomy. Keyword Nursing process, Cervical cancer, Levin rsquo s nursing theory, Kolkaba nursing theoryReferences 15 2006 2017 "

"[ABSTRAKPermasalahan kesehatan di Indonesia diantaranya seputar kesehatan ibu dan kesehatan perempuan. Ners spesialis keperawatan maternitas yang memiliki peran dan fungsi pada kesehatan perempuan diharapkan dapat berperan dalam mengatasi permasalahan kesehatan perempuan. Karya ilmiah akhir ini bertujuan untuk memberikan gambaran pelaksanaan praktek residensi ners spesialis keperawatan maternitas dengan fokus penerapan teori keperawatan "need for help Wiedenbach" pada fase akut dan "conservation Levine" pada fase pemeliharaan dalam asuhan keperawatan tujuh kasus perdarahan akibat kanker serviks. Masalah keperawatan prioritas pada tahap akut adalah resiko hipovolemi. Masalah pada tahap konservasi adalah gangguan perfusi jaringan, gangguan nutrisi dan kelemahan. Evaluasi pada tahap akut adalah tidak terjadi syok hipovolemi. Evaluasi pada tahap konservasi adalah gangguan perfusi jaringan teratasi, klien dapat meningkatkan asupan nutrisi dan dapat meningkatkan kemampuan beraktifitas. Kompetensi selama pelaksanaan praktek keperawatan maternitas dapat dicapai. Ners spesialis keperawatan maternitas diharapkan mampu menerapkan teori model keperawatan dalam pelaksanaan asuhan keperawatan sesuai dengan kondisi dan kebutuhan pasien.

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ABSTRACTHealth problems in Indonesia are including maternal and women's health. Maternity nursing specialists who have the role and function on the women's health are expected to play a role in addressing women's health problems. This final scientific work aimed to describe the implementation of maternity nursing specialist residency practice focused on the application of Wiedenbach Need for Help Theory which was performed in the acute phase and Levine Conservation Theory which was done in the maintenance phase in nursing care of cervical cancer bleeding was performed on seven patients. The prior nursing problem in the acute phase was risk for hypovolemic. The problems in the conservation stage were tissue perfusion disorder, altered nutrition, and weakness. The evaluation in the acute phase was hipovolemic shock did not occur. The evaluations in the conservation phase were the tissue perfusion disorder was resolved, as well as the client can increase the nutritional intake and the ability to do the activity. The maternity nursing specialist competencies were achieved during the residency practice. The maternity nursing specialists are expected to be able to apply the nursing model theory in the implementation of nursing care in accordance with the patient's conditions and needs., Health problems in Indonesia are including maternal and women's health. Maternity nursing specialists who have the role and function on the women’s health are expected to play a role in addressing women's health problems. This final scientific work aimed to describe the implementation of maternity nursing specialist residency practice focused on the application of Wiedenbach Need for Help Theory which was performed in the acute phase and Levine Conservation Theory which was done in the maintenance phase in nursing care of cervical cancer bleeding was performed on seven patients. The prior nursing problem in the acute phase was risk for hypovolemic. The problems in the conservation stage were tissue perfusion disorder, altered nutrition, and weakness. The evaluation in the acute phase was hipovolemic shock did not occur. The evaluations in the conservation phase were the tissue perfusion disorder was resolved, as well as the client can increase the nutritional intake and the ability to do the activity. The maternity nursing specialist competencies were achieved during the residency practice. The maternity nursing specialists are expected to be able to apply the nursing model theory in the implementation of nursing care in accordance with the patient’s conditions and needs.]"

"Kanker serviks menjadi salah satu penyebab kematian perempuan di dunia, dimana insiden kanker serviks dilaporkan meningkat dari tahun ke tahun. Proses pengobatan kanker serviks adalah rangkaian yang panjang, sehingga sering menyebabkan klien menjadi stres, depresi, yang akan memengaruhi kualitas hidup pasien. Proses perawatan pada lima kasus kanker serviks telah diterapkan menggunakan integrasi teori adaptasi Roy dengan konsep dukungan sosial. Model adaptasi Roy merupakan model keperawatan yang mencakup aspek biologis, psikologis, sosial, kultural dan spiritual, bertujuan untuk memaksimalkan kemampuan adaptasi pasien terhadap krisis yang dihadapi dengan peran dukungan sosial keluarga di dalamnya. Tujuan dari laporan ini adalah memberikan gambaran tentang pelaksanaan praktik residensi ners spesialis dalam pengelolaan kasus klien dengan kanker serviks dengan pendekatan studi kasus yang menerapkan teori adaptasi Roy dan konsep dukungan sosial.

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Cervical cancer is one of the causes of death of women in the world, where the incidence of cervical cancer is reported to increase from year to year. The treatment therapy for women diagnosed with cervical cancer is a long series, so it often causes clients to become stressed, depressed, greatly affects the quality of life of patients. The treatment therapy in five cases of cervical cancer has been applied using the integration of Roy's theory of adaptation with the concept of social support. Roy's adaptation model is a nursing model, includes biological, psychological, social, cultural and spiritual aspects, aimed at maximizing the patient's adaptive ability to the crisis faced with the role of family social support. The purpose of this report is to provide an overview of specialist nurses residency practices in managing client with cervical cancer cases. The case study approach applies Roys adaptation theory and the concept of social support.

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"Perawat maternitas memiliki kompetensi yang berkontribusi dalam pencapaian tujuan Millennium Development Goals melalui pengembangan fungsi dan peran perawat sebagai Spesialis Keperawatan Maternitas. Tujuan penulisan laporan ini untuk memberikan gambaran pelaksanaan praktek Spesialis Keperawatan Maternitas dalam menjalankan perannya sebagai care giver, konselor, advokat, edukator, koordinator, kolaborator, komunikator, peneliti, dan agen pembaharu dalam memberikan asuhan keperawatan pada perempuan sepanjang periode kehidupannya dengan menerapkan teori keperawatan. Fokus laporan juga pada penerapan teori Adaptasi Roy dan Symptom Management Humphreys digunakan pada klien kanker ovarium post operasi sitoreduktif dengan kemoterapi. Kedua teori ini sesuai diterapkan untuk meningkatkan kualitas hidup klien melalui peningkatan respon adaptif setelah operasi sitoreduktif dan pengelolaan gejala saat kemoterapi.

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Maternity nurses contributes to achieve the MDGs goals by improving role and function as maternity nursing specialist. The purpose of this report is to describe the implementation of Maternity Nursing Specialist practices in their role as care giver, counselor, advocate, educator, coordinator, collaborator, communicator and innovator by applying nursing theory in nursing care of women througout their life. The Roy Adaptation Theory and the Symptom Management was used to apply nursing care of client with ovarian cancer post cytoreductive surgery and chemotherapy. Both theory are suitable to use in ovarian cancer patients post cytoreductive surgery with chemotherapy to achieve quality of life."

"Kista endometriosis atau chocolate cyst adalah tumor jinak yang sering terjadi pada sistem reproduksi perempuan saat ini. Perempuan dengan masalah ini akan mengalami gangguan pada kualitas hidup seorang perempuan baik secara fisik, psikospiritual, lingkungan maupun sosiokultural. Resiko lainnya adalah timbulnya keganasan pada sistem reproduksi. Tujuan dari laporan ini adalah memberikan gambaran tentang pelaksanaan praktik residensi ners spesialis yaitu pengelolaan kasus klien kista endometriosis dengan pendekatan studi kasus yang menerapkan teori comfort dan loss & grief. Asuhan diberikan untuk mengatasi ketidaknyamanan yang dialami klien baik secara fisik, psikospiritual, lingkungan dan sosiokultural, pada saat penatalaksanaan pembedahan dilakukan pada klien. Pemilihan konsep teori keperawatan comfort yang dielaborasi dengan teori loss & grief dapat saling melengkapi sehingga asuhan yang diberikan dapat lebih maksimal.

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Endometriosis cyst or chocolate cyst is a benign tumor that often occurs in the female reproductive system currently. Women with this problem will experience impaired of life quality physically, psycho-spiritually, environmentally and socio-culturally. Another risk is the incidence of malignancies in the reproductive system. The purpose of this report was to provide an overview of the implementation of nurse specialist residency practice, namely case management of clients with endometriosis cysts with an approach of a case study applying the comfort and loss and grief theory. Care was given to overcome the discomfort experienced by clients physically, psycho-spiritually, environmentally and socio-culturally, during the surgery management was performed to the client. The selection of comfort nursing theory concept elaborated with loss and grief theory can complete each other so that the care provided can be maximized."

"Kesehatan reproduksi merupakan masalah penting untuk diperhatikan dalam rangka meningkatkan derajat kesehatan perempuan. Sebagai salah satu usaha untuk mencapai tujuan tersebut, dilaksanakanlah program ners spesialis keperawatan maternitas. Karya ilmiah akhir ini bertujuan untuk memberikan gambaran pelaksanaan praktek residensi ners spesialis keperawatan maternitas dengan fokus penerapan model konsep need for help Wiedenbach pada fase akut dan self care Orem pada fase pemeliharaan pada asuhan keperawatan klien dengan retensio plasenta. Masalah keperawatan pada tahap akut yaitu kekurangan volume cairan, gangguan integritas jaringan, dan kecemasan, sementara pada tahap pemeliharaan adalah gangguan pemenuhan kebutuhan sehari-hari, ketidakefektifan proses menyusui, dan risiko infeksi. Tindakan yang dilakukan meliputi resusitasi cairan, pengeluaran plasenta, perbaikan kontraksi uterus, dan pendidikan kesehatan tentang perawatan pada ibu dan bayi. Evaluasi pada fase akut yaitu perdarahan berkurang, kontraksi uterus kuat, dan pada fase pemeliharaan yaitu peningkatan kemandirian klien.

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Reproductive health is a critical problem that needs attentions in order to increase the female health level. As an attempt to reach this goal, a maternity nursing specialist program is performed. This final scientific work aimed to describe the residential practice of maternity nursing specialist which focused on the application of Wiedenbach's concept of need for help during the acute phase and Orem's self care model during the maintenance phase in the nursing care to a client with placenta retention.

Nursing problems in the acute stage were fluid volume deficit, impaired tissue integrity, and anxiety, while in the maintenance stage were daily needs fulfillment, ineffective breastfeeding, and risk of infection. The nursing intervention included fluid resuscitation, placenta delivery, uterine contraction improvement, and health education related to mother and baby care. The evaluation in the acute phase included reduced bleeding and good uterine contraction, while in the maintenance phase included the enhancement of client's independency."