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"Peningkatan kasus kanker serviks di Indonesia mengakibatkan permasalahan kompleks, menyangkut seluruh aspek kehidupan, membutuhkan penanganan holistik agar pasien adaptif. Penelitian ini bertujuan untuk membuat dan mengevaluasi model asuhan keperawatan holistik-adaptif sebagai upaya membantu mengatasi permasalahan melalui peningkatan kemampuan adaptasi pasien secara fisik, psikologis, sosial dan spiritual. Desain penelitian Action research dengan pendekatan mixed methods pada pengkajian masalah, pengembangan, dan evaluasi model. Model diaplikasikan di Bandung pada 96 responden pada dua kelompok berbeda. Sampel diambil purposive, matching, randomization. Hasil menggambarkan model yang diterapkan mampu membantu kelompok intervensi beradaptasi 22,4 kali dibanding kelompok kontrol, p=0,005. Confounding faktor adalah self-efficacy. Faktor lainnya yang berpengaruh adalah pekerjaan, dan stadium penyakit. Keberhasilan intervensi ditentukan oleh kemampuan perawat/bidan saat melakukan asuhan keperawatan.

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The complex problems caused by increasing cases of cervical cancer in Indonesia needs a holistic approach to guide patient adaptive to new condition. This research aims to create a model to help patient during adaptation process physically, psychological, socially and spiritually. Design was action research, used mixed methods during problem identification, model development and model evaluation. Model applied at a General Hospital in Bandung. Samples were taken purposively, matching, randomization. The results illustrate the ratio between the intervention and control groups based on adaptability was 22,4 : 1, p=0,005. Confounding factors was self-efficacy. Other factors that influences adaptation process were stadium and work. Success of the intervention determined by the ability of nurses or midwives in performing nursing care."

"Nyeri pada pasien kanker serviks berupa nyeri kronik. Beberapa dampak dari nyeri kronik seperti kelemahan, depresi, insomnia, hambatan pada kehidupannya sehari-hari seperti mandi, berpakaian dan makan akan mempengaruhi kualitas hidup pasien. Perawatan paliatif merupakan jenis pelayanan kesehatan yang berfokus untuk meringankan gejala seperti nyeri sehingga diharapkan kualitas hidup pasien dapat meningkat. Imajinasi terbimbing adalah terapi komplementer yang digunakan untuk mengurangi nyeri dengan memanfaatkan narasi atau cerita yang tujuannya untuk mempengaruhi pikiran seseorang agar fokus dalam berimajinasi dan berkhayal. Tujuan dari laporan asuhan keperawatan ini adalah untuk menganalisis manfaat penerapan intervensi imajinasi terbimbing pada pasien kanker serviks yang menjalani operasi laparatomi debulking dan sistoscopi. Intervensi keperawatan yang diberikan berupa intervensi relaksasi nafas dalam dan imajinasi terbimbing. Setelah diberikan terapi imajinasi terbimbing dengan durasi 30 menit selama 4 hari berturut-turut, terjadi penurunan skala nyeri dari nyeri sedang (skala 6-4) menjadi ringan (skala 1-3). Selain itu, pasien juga menunjukan ekspresi yang lebih tenang, meningkatnya toleransi dalam beraktivitas, dan tidak tampak meringis kesakitan. Oleh karena itu, intervensi imajinasi terbimbing dapat digunakan sebagai upaya alternatif nonfarmakologis yang melengkapi intervensi farmakologis analgetik untuk mengurangi nyeri pada pasien kanker. Kata kunci: imajinasi terbimbing, kanker serviks, nyeri, perawatan paliatif

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Pain in cervical cancer patients in the form of chronic pain. Some of the effects of chronic pain such as weakness, depression, insomnia, obstacles in daily life such as bathing, dressing and eating will affect the patient's quality of life. Palliative care is a type of health service that focuses on alleviating symptoms such as pain so that the patient's quality of life is expected to improve. Guided imagination is a complementary therapy that is used to reduce pain by utilizing narratives or stories whose purpose is to influence one's mind to focus on imagining and imagining. The purpose of this nursing care report is to analyze the benefits of implementing guided imagination interventions in cervical cancer patients undergoing debulking laparotomy and cystoscopy. The nursing interventions provided are deep breathing relaxation interventions and guided imagination. After being given guided imagination therapy with a duration of 30 minutes for 4 consecutive days, the pain scale decreased from moderate pain (scale 6-4) to mild (scale 1-3). In addition, the patient also showed a calmer expression, increased tolerance in activities, and did not seem to wince in pain. Therefore, guided imagination intervention can be used as an alternative non- pharmacological effort that complements analgesic pharmacological interventions to reduce pain in cancer patients"

"ABSTRAKPelaksanaan praktek klinik selama masa residensi keperawatan peminatan onkologi bertujuan untuk mampu menampilkan peran perawat spesialis sebagai pemberi asuhan keperawatan lanjut, pendidik, advokat, konselor, kolaborator, pembaharu dan peneliti, Peran pemberi asuhan keperawatan lanjut dilakukan dengan menggunakan Model Adaptasi Roy pada pasien Leiomyosarcoma Uterus dan 30 pasien kanker lainnya. Perilaku maladaptif paling banyak adalah mode adaptasi fisiologis dengan diagnosa keperawatan nyeri kronis. Intervensi keperawatan berupa manajemen nyeri ditujukan untuk meningkatkan adaptasi pasien dalam mengontrol nyeri kanker. Evidence Based Nursing dilakukan dengan menerapkan instrumen pengkajian MASCC Antiemesis Tool pada tujuh belas pasien yang menjalani program kemoterapi dan mengalami keluhan mual muntah akibat kemoterapi dengan hasil MASCC Antiemesis Tool merupakan instrumen pengkajian yang spesifik dan sensitif untuk mengkaji mual muntah akibat kemoterapi. Program inovasi kelompok berupa pembuatan media video panduan dan pelaksanaan intervensi kombinasi Progressive Muscle Relaxation dan Guided Imagery terbukti efektif sebagai tindakan mandiri keperawatan dalam manajemen nyeri kanker.

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ABSTRACT<>br>Implementation of clinical practice during the residency of nursing oncology aims to be able to showcase the role of specialist nurse as advanced nursing care provider , educator, advocator, counselor, collaborator, innovator and researcher. Role of specialist as advance nursing care provider is done by using Roy Adaptation Model on Leiomyosarcoma Uterus and 30 other cancer patients. Maladaptive behavior at most is a physiological adaptation mode with a chronic pain nursing diagnosis. Nursing outcome of pain management are aimed at improving patient adaptation in controlling cancer pain. Evidence Based Nursing was performed by applying the MASCC Antiemesis Tool assessment instrument to seventeen patients undergoing chemotherapy and experiencing chemotherapy induced nausea and vomiting. The MASCC Antiemesis Tool is a specific and sensitive instrument for assessing chemotherapy induced nausea and vomiting. The innovation program was making of video guide media and implementation of combination interventions of Progressive Muscle Relaxation and Guided Imagery proved effective as nursing intervention in the management of cancer pain."

"ABSTRAKPenerapan asuhan keperawatan di rawat jalan rumah sakit umum saat ini belum optimal. Masalah yang ditemukan di rawat jalan adalah klien belum mampu merawat diri, belum puas terhadap asuhan keperawatan, dan belum mendapatkan informasi tentang perawatan diri. Penelitian ini bertujuan untuk mengidentifikasi pengaruh implementasi model asuhan keperawatan rawat jalan Inayah (AKRJI) terhadap perawatan diri dan kepuasan klien di rawat jalan rumah sakit umum. Penelitian ini menggunakan metode kuantitatif dengan metoda quasi eksperimen dan analisis Uji-T Paired, Uji-T Unpaired, analisis regresi linier ganda dan R Square untuk menilai Kesesuaian Fit Model. Penelitian ini dilakukan di Rawat Jalan Rumah Sakit Umum. Intervensi dilakukan pada 9 perawat pelaksana di rawat jalan medikal bedah yang dilatih menggunakan model AKRJI, setelah itu perawat tersebut melaksanakannya pada 1000 klien rawat jalan. Sampel penelitian ini 2000 klien untuk kelompok kontrol dan kelompok intervensi rawat jalan medikal bedah.Hasil penelitian memperlihatkan kenaikan kemampuan perawatan diri dan kepuasan secara bermakna pada klien intervensi yang menunjukkan lebih tinggi hasilnya dibandingkan kelompok kontrol. Faktor yang paling berpengaruh adalah pelaksanaan Model AKRJI. Kesesuaian model AKRJI fit menjelaskan model yang dapat meningkatkan perawatan diri dan kepuasan klien. Saran Model AKRJI dapat dilaksanakan pada pelayanan keperawatan di rawat jalan rumah sakit umum.

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ABSTRACT

Application of nursing care in outpatient general hospital currently not optimal. Problems were found in outpatient client is not able to care for themselves, not satisfied with the nursing care, and no information about self care. This study aimed to identify the effect of implementasion Inayah outpatient nursing care models (IONC) to self care and satisfaction in outpatient general hospital. This study uses the quantitative method with quasi-experimental and analysis T Test, multiple linear regression analysis and R Square to assess the suitability Fit Model. This research was conducted at the Outpatient General Hospital. Interventions conducted on 9 nurses in medical-surgical outpatient, who trained using IONC model, after which the nurse implement at 1000 outpatient clients. The research sample is 2000 clients for the control group and the intervention group outpatient medical-surgical.

The results showed the increase in the ability of self care and satisfaction significantly in the intervention showed a higher result than the control group. The most influential factor is the implementation of the IONC Model. IONC fit fitness model describes a model that can improve self care and satisfaction. Suggestions the IONC Model can be carried out on an outpatient nursing care in general hospitals."

"Sekitar 490.000 perempuan di seluruh dunia didiagnosa menderita kanker serviks danrata-rata 240.000 kasus kematian perempuan terjadi akibat kanker serviks dan hampir80% dari kasus tersebut terjadi di negara-negara berkembang (WHO, 2008). Nyerimerupakan keluhan terbanyak yang dirasakan penderita kanker. Seperti halnya dikatakanoleh Abernethy, Keefe, McCrory, Scipio, (2006), angka kejadian nyeri pada semuapasien kanker sekitar 25% pada kanker yang baru terdiagnosa dan sekitar 60% sampaidengan 90% pada kanker stadium lanjut. Dodd, Miaskowski, dan Paul (2001)mengidentifikasi terjadinya nyeri pada pasien dengan kanker yang mendapatkankemoterapi. Tujuan :dari penelitian ini mendapatkan gambaran efektifitas Brief CBTterhadap nyeri dengan menggunakan instrumen Numeric Rating Scale (NRS) dan PerceivedMeaning Cancer Pain Inventory (PMCPI). Metoda : quasi experimental pre post test withcontrol group, teknik consecutive sampling terhadap 51 sampel : 26 intervensi dan 25kontrol. Hasil penelitian ditemukan penurunan intensitas nyeri dan PMCPI yang mendapatCBT lebih besar dibanding yang tidak mendapat CBT (p-value < 0,05). Rekomendasi: BriefCBT dijadikan terapi terpadu dalam manajemen nyeri pada pasien kanker serviks.

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Approximately 490,000 women worldwide are diagnosed with cervical cancer and

anaverage of 240,000 female deaths occur from cervical cancer and nearly 80% of these

cases occur in developing countries (WHO, 2008). Pain is a complaint that is felt most

cancer patients. As well said by Abernethy, Keefe, McCrory, Scipio, (2006), the incidence

of pain in all cancer patients about 25% in the newly diagnosed cancers and approximately

60% to 90% in advanced cancer. Dodd, Miaskowski, and Paul (2001) identified the

occurrence of pain in patients with cancer receiving chemotherapy. The purpose: to get an

overview of the research on the effectiveness of brief CBT pain using instruments Numeric

Rating Scale (NRS) and Perceived Meanings Cancer Pain Inventory (PMCPI). Method:

quasi-experimental pre-post test with control group, 51 consecutive sampling technique to

sample: 26 intervention and 25 control. The results found reductions in pain intensity and

PMCPI that gets bigger than that CBT did not receive CBT (p-value <0,05).

Recommendation: Brief CBT therapy be integrated in the management of pain in patients

with cervical cancer."

"Karya ilmiah akhir ini merupakan praktik klinik lanjut keperawatan medikal bedah pada kasus keganasan yang terdiri dari pengelolaan kasus utama Leukimia Myeloid Akut dan 30 resume menggunakan pendekatan Model Konservasi Levine, penerapan Evidence Based Nursing EBN penggunaan larutan lidah buaya pada pasien leukemia dan limfoma yang menderita stomatitis akibat kemoterapi serta inovasi keperawatan modifikasi pengkajian Malignant Wound Assessment Tool MWAT . Masalah keperawatan terbanyak yang muncul pada konservasi energi adalah nyeri, konservasi integritas struktural adalah resiko tinggi infeksi, konservasi integritas personal adalah cemas dan konservasi integritas sosial adalah hambatan interaksi sosial. Penggunaan larutan lidah buaya mampu menurunkan stomatitis dan nyeri stomatitis pada pasien leukemia yang mendapatkan kemoterapi. Modifikasi pengkajian MWAT dan asuhan keperawatan pada pasien luka kanker diharapkan mampu meningkatkan asuhan keperawatan yang berkualitas.

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This Scientific report was an advanced medical surgical nursing clinical practice of malignancies cases consist one major case of Acute Myeloid Leukemia and 30 summaries using Levine rsquo s Conservation Model, the application of Evidence Based Nursing EBN applying aloe vera solution in patients with leukemia and lymphoma chemotherapy induced mucositis and nursing innovation Malignant Wound Assessment Tool MWAT assessment modification. The majority of nursing problems that arise on energy conservation was pain, in structural integrity conservation was high risk of infection, in personal integrity conservation was anxiety and social integrity conservation was a social interaction impaired. Aloe vera solution was able to reduce mucositis and pain in patients with leukemia that received chemotherapy. MWAT assessment modifications and nursing care in patients with wound cancer might increase the quality of nursing care."

"ABSTRAK Kanker serviks yang paling sering menyerang wanita dan menjadi salah satu penyakit serius di dunia yang mengancam jiwa. Insiden kanker serviks dilaporkan meningkat dari tahun ke tahun. Perempuan yang didiagnosa menderita kanker serviks dan menjalani terapi pengobatan sangat berpengaruh terhadap kualitas hidup pasien. Pengelolaan penderita lebih banyak berfokus pada kondisi sakit fisik, dan belum secara holistik integratif. Perawatan palliative belum mendapat perhatian khusus dalam memberikan asuhan keperawatan, masing-masing tenaga kesehatan hanya memberikan pelayanan t e r h a d a p kebutuhan fisik yang dirasakan penderita. Berdasarkan data WHO, terdapat lebih dari 40 juta orang di dunia yang membutuhkan perawatan palliative, namun hanya 14 saja yang baru memperolah perawatan tersebut. Sama halnya di Indonesia, masih banyak masyarakat yang belum mengetahui perawatan palliative itu sangat penting dalam upaya peningkatan kualitas hidup penderita. Tujuan dari laporan ini adalah memberikan gambaran tentang pelaksanaan praktik residensi ners spesialis yaitu pengelolaan kasus klien kanker serviks dengan pendekatan studi kasus yang menerapkan teori adaptasi roy dan Konsep Palliative Care, dapat saling melengkapi sehingga asuhan dapat diberikan lebih maksimal.

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ABSTRACTCervical cancer most often affects women and becomes one of the world 39 s most life threatening illnesses. The incidence of cervical cancer is reported to increase from year to year. The treatment therapy for women diagnosed with cervical cancer greatly affects the quality of life of patients. Patient management focuses more on physical illness, and has not been holistically integrative. Palliative care has not received special attention in providing nursing care, each health worker only provide services to the physical needs of patients. Based on WHO data, there are more than 40 million people in the world who require palliative care, but only 14 are just getting the treatment. Similarly in Indonesia, there are still many people who do not know that palliative care is very important in an effort to improve the quality of life of patients. The purpose of this report is to provide an overview of the implementation of residency practice of ners specialist case management of cervical cancer clients. The application of Roy 39 s Theory of Adaptation and the Concept of Palliative Care can be complementary so that gives more leverage to the care."

"ABSTRAKAnalisis Praktik Residensi Keperawatan Medikal Bedah pada Kanker Lambung dengan Pendekatan Model Adaptasi Roy di Rumah Sakit Kanker Dharmais dan Cipto Mangunkusumo Jakarta Karya ilmiah ini bertujuan memberikan gambaran analisis praktik residensi Keperawatan Medikal Bedah selama 2 semester tentang penerapan teori model keperawatan dalam studi kasus, dan analisis hasil penerapan tindakan mandiri keperawatan berbasis pembuktian ilmiah (evidence based nursing practice), serta analisis hasil inovasi kelompok terhadap fenomena yang ditemui selama praktik residensi. Penerapan peran perawat profesional dalam proses asuhan keperawatan dengan menggunakan teori adaptasi Roy dilakukan pada kasus karsinoma nasofaring dan berbagai kasus keganasan lainnya terbukti bermanfaat membantu dan meningkatkan kemampuan adaptasi pasien terhadap stimulus internal dan esternal yang dialami. Kegiatan aplikasi tindakan mandiri keperawatan berdasarkan pembuktian ilmiah pelaksanaan guided imagery dan progressive muscle relaxation bukti bermanfaat untuk mengurangi nyeri dan meningkatkan kualitas hidup pasien. Pada proyek inovasi manajemen nyeri pada pasien kanker yang menjalani kemoterapi di ruang rawat inap dengan memfasilitasi pembuatan multi media video guided imagery dan progressive muscle relaxation perawat dalam manajemen nyeri. Peran perawat profesional dapat dijalankan dalam setiap tahap kegiatan praktik residensi keperawatan medikal bedah peminatan onkologi secara holistik dan komprehensif meliputi upaya promotif, reventif, kuratif, dan rehabilitatif. Kata kunci: Adaptasi Roy, kanker, guided imagery dan progressive muscle relaxation, Manajemen nyeri.

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ABSTRACTractice Analysis of Medical Surgical Nursing Surgery on Stomach Cancer with Roy's Adaptation Model Approach at Dharmais Cancer Hospital and Cipto Mangunkusumo Jakarta This paper aims to provide an overview of residency medical Surgical Nursing residency analysis for 2 semesters on the application of nursing model theory in case study, and analysis of the results of the implementation of scientifically based nursing based action (evidence based nursing practice), and analysis of group innovation results on the phenomenon encountered during residency practice. The application of the role of professional nurses in the nursing care process using Roy's adaptation theory was done in cases of nasopharyngeal carcinoma and other malignant cases proved helpful in improving the patient's adaptability to internal and esternal stimuli. The activities of self-directed nursing action based on scientific proof of guided imagery and progressive muscle relaxation are useful to reduce pain and improve patient's quality of life. In the pain management innovation project in cancer patients undergoing chemotherapy in the inpatient room by facilitating the creation of multi media video guided imagery and progressive muscle relaxation nurses in pain management. The role of professional nurse can be carried out in every stage of medical residency practice of medical surgical treatment of oncology specialization holistically and comprehensively covering promotive, reventif, curative and rehabilitative efforts. Keywords: Roy's adaptation, cancer, guided imagery and progressive muscle relaxation, pain management"

"ABSTRAKAsuhan keperawatan holistik peka budaya (AKHPB) sangat penting diberikan pada ibu pascaseksio sesarea. Tujuan penelitian yaitu memperoleh model asuhan keperawatan holistik peka budaya yang efektif untuk meningkatkan kemampuan merawat dan kepuasan.Penelitian ini menggunakan pendekatan action research melalui tiga tahap penelitian yaitu:Tahap I, identifikasi masalah pelayanan dengan penelitian kualitatif dengan desain fenomenologi deskriptif dan kuantitasif deskriptif.Tahap II, solusi pengembangaan model asuhan keperawatan holistik peka budaya pada ibu pascaseksio melalui pengembangan instrumen, seminar pakar dan pelatihan kompetensi budaya perawat pelaksana. Tahap III, uji coba dan evaluasi model dengan desain quasi experiment with control group design. Hasil tahap I, diperoleh 5 tema dari partisipan ibu pascaseksio dan 6 tema dari perawat pelaksana , tahap II, dihasilkan model asuhan keperawatan holistik peka budaya dengan dua modul dan panduan bagi perawat, hasil pelatihan didapatkan peningkatan pengetahuan, kesadaran diri, sikap, ketrampilan peka budaya dan kemampuan mendokumentasikan asuhan keperawatan.Tahap III, terdapat perbedaan bermakna kemampuan merawat diri, dan kemampuan merawat bayi dan kepuasan antara sebelum dan sesudah implementasi model.Kesimpulan, model Asuhan keperawatan holistik peka budaya efektif meningkatkan kemampuan merawat diri, kemampuan merawat bayi, dan kepuasan ibu pascaseksio. Rekomendasi: (1) replikasi model pada budaya yang berbeda, (2) implementasi model di setiap rumah sakit, (3) Pelatihan berkelanjutan bagi perawat maternitas, (4) pengembangan kurikulum pendidikan berbasis budaya dan (5) penelitian lanjut yaitu model AKHPB meningkatkan kesehatan reproduksi perempuan.

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ABSTRAKCulturally sensitive, holistic nursing care (CSHNC) is very important to be given to postcaesarean mothers. The purpose of the study was to obtain a model of culturally sensitive, holistic nursing care which is effective to improve the ability of care and satisfaction.This research applied an action research approach through three stages of research, namely:Stage I, the identification of service problems by qualitative research with phenomenological descriptive and quantitative descriptive design.Stage II, the solution of the culturally sensitive, holistic nursing care model development to postcaesarean mothers through the instrument development, expert seminars and cultural competency training for staff nurses. Stage III, Model trial and evaluation with a quasi-experiment design with control group design. The first stage acquired 5 themes from postcaesarean mother participants and 6 themes from nurses. Stage II produced a model of culturally sensitive, holistic nursing care with two modules and guides for nurses, the training results were the increase of knowledge, self-awareness, attitudes, culturally sensitive skills, and the ability to document the nursing care.Stage III, there was a significant difference of self-care and infant care ability, as well as the satisfaction before and after the implementation of the model. In conclusion, the model of culturally sensitive, holistic nursing care was effective to enhance the postcaesarean mothers? self-care and infant-care ability, as well as the maternal satisfaction.Recommendations: (1) the replication of the model in different cultures, (2) the implementation of the model in every hospital, (3) the ongoing training for maternity nurses, (4) the development of culture-based education curriculum and (5) the further research, namely CSHNC model to improve female reproductive health."