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"Kanker pada anak terus meningkat jumlahnya setiap tahun, masalah nutrisi merupakan masalah yang sering dikeluhkan oleh anak dan keluarga sehingga, diperlukan asuhan keperawatan untuk mengatasi masalah tersebut. Karya Ilmiah Akhir ini bertujuan untuk memberikan gambaran aplikasi teori Comfort Kolcaba dalam asuhan keperawatan pada anak kanker dengan masalah nutrisi dan pencapaian kompetensi baik sebagai pemberi asuhan, advocator, counselor, educator, colaborator, dan agen perubah. Terdapat lima kasus kelolaan yang menjadi pembahasan dalam karya ilmiah ini, kelima kasus kelolaan mengalami masalah nutrisi. Masalah nutrisi didapatkan dari basil pengkajian berdasarkan pendekatan teori Comfort Kolcaba yaitu pengkajian fisik, psikospiritual, sosiokultural dan Iingkungan. Intervensi menggunakan tiga tipe perawatan standar comfort, coaching dan Comfort food for the soul. Tidak semua masalah nutrisi pada lima kasus kelolaan dapat teratasi dengan cepat, untuk menyelesaikan masalah nutrisi pada anak kanker dibutuhkan waktu dan kerjasama tim yang baik antara ibu, anak, dokter dan dietesien serta perawat.

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Pediatric cancer always increase every year, the problem of nutrition is often complained by the child and their family, so nursing care is required to solve the issue. This research aims to provide an overview of the application of theory Comfort Kolcaba in cancer nursing care in children with nutritional problems and the competence achievement as a caregiver, advocator, counselor, educator, colaborator, and agent of change. There were five cases managed that discussed in this research, and in five cases managed all experiencing nutritional problems. Nutrient problems obtained from the results of the assessment approach based on the theory of Comfort Kolcaba such as physical examination, psikospiritual, sociocultural and environmental. Interventions use three types of standard comfort care, coaching and Comfort food for the soul. Not all nutritional problems in the management of five cases can be resolved quickly, to solve the problem of childhood cancer nutrition takes time and good teamwork among mother, child, and dietision, doctors, and nurses."

"[ABSTRAKNyeri merupakan salah satu masalah utama pada pasien kanker anak. Karya Ilmiah Akhir ini bertujuan memberikan gambaran penerapan, analisis Comfort Theory Kolcaba pada pasien kanker anak dengan nyeri, dan pencapaian kompetensi ners spesialis keperawatan anak. Penerapan teori dilakukan pada lima pasien, menggunakan pendekatan proses keperawatan. Pengkajian dan penetapan masalah keperawatan menggunakan struktur taksonomi Kolcaba. Intervensi dan implementasi menggunakan intervensi kenyamanan standar, coaching, dan comfort food for the soul. Evaluasi menggunakan comfort behavior scale menunjukkan hasil diakhir perawatan, nyeri berkurang, terkontrol, dan kenyamanan bertambah. Kompetensi tercapai sesuai target. Comfort Theory bisa menjadi pilihan dalam merawat pasien kanker anak dengan nyeri.

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ABSTRACTPain is one of main problems in children with cancer. This study aimed to describe and to analyze: (1) the application of Kolcaba's Comfort Theory on children with cancer who experience pain, and (2) the competencies achieved by pediatric clinical nurse specialist. The theory was applied to five patients using nursing process approach. The assessment and decision of the nursing problem was conducted using Kolcaba's taxonomic structure. The intervention and implementation using standard comfort intervention, coaching, and comfort food for the soul. Comfort behavior scale was used for the evaluation. The results showed that at the end of the nursing implementation, pain was reduced, controlled, and the comfort was increased. The targeted competencies were achieved. Comfort Theory can be recommended for caring children with cancer.;Pain is one of main problems in children with cancer. This study aimed to describe and to analyze: (1) the application of Kolcaba's Comfort Theory on children with cancer who experience pain, and (2) the competencies achieved by pediatric clinical nurse specialist. The theory was applied to five patients using nursing process approach. The assessment and decision of the nursing problem was conducted using Kolcaba's taxonomic structure. The intervention and implementation using standard comfort intervention, coaching, and comfort food for the soul. Comfort behavior scale was used for the evaluation. The results showed that at the end of the nursing implementation, pain was reduced, controlled, and the comfort was increased. The targeted competencies were achieved. Comfort Theory can be recommended for caring children with cancer., Pain is one of main problems in children with cancer. This study aimed to describe and to analyze: (1) the application of Kolcaba's Comfort Theory on children with cancer who experience pain, and (2) the competencies achieved by pediatric clinical nurse specialist. The theory was applied to five patients using nursing process approach. The assessment and decision of the nursing problem was conducted using Kolcaba's taxonomic structure. The intervention and implementation using standard comfort intervention, coaching, and comfort food for the soul. Comfort behavior scale was used for the evaluation. The results showed that at the end of the nursing implementation, pain was reduced, controlled, and the comfort was increased. The targeted competencies were achieved. Comfort Theory can be recommended for caring children with cancer.]"

"[Demam merupakan gejala yang sering dialami anak dengan penyakit infeksi. Kondisi demam tinggi berdampak merugikan anak. Demam tinggi membuat anak tidak nyaman, serta meningkatkan kebutuhan kalori dan cairan. Teori Comfort dari Kolcaba memberikan arahan dalam pemenuhan rasa nyaman pada pasien. Karya ilmiah ini bertujuan memberikan gambaran asuhan keperawatan pada anak demam dengan mengaplikasikan teori comfort Kolcaba yang berfokus pada pemenuhan kebutuhan kenyamanan. Asuhan keperawatan dilakukan berdasarkan tahapan comfort yaitu pengkajian (kenyamanan fisik, psikospiritual, lingkungan dan sosiokultural), merumuskan diagnosa keperawatan, menetapkan intervensi (berdasarkan standar comfort, coaching, dan comfort food for the soul), implementasi, dan evaluasi. Teori comfort Kolcaba dapat diterapkan dalam asuhan anak demam. Dukungan dan keterlibatan dari orangtua juga sangat penting dalam perawatan anak, sehingga terlihat bahwa ke empat aspek kenyamanan harus saling mendukung untuk pencapaian kenyamanan secara holistik. , Fever is a symptom that is often experienced by children with infectious diseases. High fever condition adversely affects the child. High fever makes the child uncomfortable, and increase calorie and fluid needs. Comfort Theory of Kolcaba provides direction in compliance with comfort to the patient. This paper aims to provide an overview of nursing care in febrile children with comfort Kolcaba apply theory that focuses on meeting the needs of comfort. Nursing care is done by stages comfort assessment (physical comfort, psychospiritual, environmental and sociocultural), formulate nursing diagnoses, interventions set (based on standard comfort, coaching, and comfort food for the soul), implementation, and evaluation. Kolcaba comfort theory can be applied in the care of the child's fever. Support and involvement of parents is also very important in the care of children, so it appears that all four aspects must be mutually supportive comfort for the achievement of holistic comfort.]"

"Karya Ilmiah Akhir ini memberikan gambaran tentang pelaksanaan Program Residen Ners Spesialis Keperawatan Anak dalam bentuk kegiatan praktik Residensi I dan II. Karya Ilmiah Akhir ini bertujuan untuk memberikan gambaran aplikasi teori comfort Kolcaba dalam asuhan keperawatan pada anak dengan peningkatan suhu tubuh dan pencapaian kompetensi baik sebagai praktisi, pendidik, advokat, pengelola dan peneliti selama praktik residensi. Menurut comfort Kolcaba, peningkatan suhu tubuh merupakan salah satu gangguan pemenuhan kebutuhan rasa nyaman fisik yang berkaitan erat dengan kebutuhan rasa nyaman psikospiritual, sosiokultural dan lingkungan. Intervensi yang dilakukan adalah memonitor status hemodinamik, menganjurkan keluarga untuk selalu berada di samping pasien, mengajarkan keluarga dalam pemberian kompres air hangat dan mengatur suhu ruangan sesuai suhu tubuh pasien. Salah satu inovasi yang dilakukan adalah mengukur suhu tubuh dengan menggunakan termometer timpani dimana residen menerapkan salah satu kompetensi perawat spesialis sebagai ranah pengembangan profesional sekaligus memberikan kebutuhan rasa nyaman dan mencegah trauma pada anak.

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This Final Scientific Paper provides an overview of the implementation of the Resident Program Specialist Nurses in the form of practical activities Residency I and II. This Final Scientific aims is in order to provide an overview Comfort Kolcaba Theory Application of children nursing care by increased body temperature and achievement of competency either as a practitioner, educator, advocate, manager and researcher during practice residency. According to Kolcaba comfort theory, increasing body temperature is one of the comfortable sense of fulfillment disorders are strongly associated with physical comfort needs psikospiritual, sociocultural and environmental. Interventions need to be done is to monitor hemodynamic status, advised the family to accompanied the patient, the family teaches the provision of warm water compress and maintain the room's temperature according the patient's body temperature. One inovation need to be done is measure the body temperature using a thermometer tympanic where residents apply one domain competence as a specialist nurse professional development needs as well as providing a sense of comfort and prevent trauma to child."

"Karya Ilmiah Akhir ini memberikan gambaran tentang pelaksanaan Program Residensi Ners Spesialis Keperawatan Anak dalam bentuk kegiatan praktik residensi 1 dan 2. Karya Ilmiah Akhir ini bertujuan untuk memberikan gambaran aplikasi teori keperawatan “Comfort Theory” dari Katharine Kolcaba pada asuhan keperawatan anak dengan stoma dan pencapaian kompetensi baik sebagai pemberi asuhan, advocator, conselor, educator, colaborator, dan change agent selama praktik residensi. Salah satu komplikasi yang dapat terjadi pada anak dengan stoma adalah adanya kerusakan kulit peristoma. Masalah integritas kulit merupakan masalah keperawatan yang sering dijumpai pada anak dengan stoma sebagai akibat dari adanya kontak kulit dengan feses. Masalah integritas kulit dapat bersifat aktual maupun risiko seperti yang ditemukan pada lima kasus kelolaan. Tiga kategori intervensi keperawatan berdasarkan comfort theory telah diberikan untuk mengatasi masalah integritas kulit. Hasil evaluasi pada akhir perawatan menunjukkan bahwa tidak semua masalah integritas kulit ini dapat teratasi. Masih dibutuhkan banyak dukungan agar intervensi keperawatan dapat dilaksanakan secara optimal guna mencegah dan mengatasi masalah integritas kulit pada anak dengan stoma agar kebutuhan klien akan kenyamanan terpenuhi.

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Final assignment provides an overview about the implementation of the Residency Specialist Pediatric Ners Program in the form of practical activities residency 1 and 2. The aims from this final assignment is to provide an overview the application of nursing theory "Comfort Theory" Katharine Kolcaba on nursing care of children with a stoma and the achievement of competence well as caregivers, advocator, counselor, educator, colaborator, and change agent during practice residency. One of the stoma complications is periostomal skin damage that can occur among pediatric patients. The skin integrity is a common problem in children with a stoma as a result of stool contamination. Skin integrity problems can be actual or risk such as those found in five cases managed. Three categories of nursing interventions based on comfort theory has been given to solve the skin integrity problems. There are five pediatric patients with stoma were included in this study. The result of the study showed that not all of the skin integrity problems could be solved. In order to prevent and overcome of the skin integrity problem in children with stoma, a good quality and supports of the nursing interventions are needed that affects in fulfill of comfort needs."

"Penerapan teori Comfort Kolcaba ini dilakukan pada 5 kasus kelolaan yang berbeda untuk memenuhi kebutuhan rasa nyaman nyeri yang berfokus pada faktor fisik, psikospiritual, sosiokultural, dan lingkungan. Asuhan keperawatan untuk memenuhi kebutuhan rasa nyaman nyeri tersebut dilakukan dengan menggunakan intervensi standard comfort, coaching dan comfort food for the soul, yaitu dengan memberikan guided imagery sehingga pasien dapat mencapai tingkat kenyamanan relief, ease, dan transcendence. Evaluasi menggunakan numeric rating scale menunjukkan hasil diakhir perawatan nyeri berkurang, terkontrol dan peningkatan kenyamanan. Residen menyarankan agar meningkatkan peran kemitraan antara perawat, petugas kesehatan lainnya dan keluarga serta melakukan asuhan keperawatan berbasis evidence based practice dalam memberikan asuhan keperawatan pada pasien kanker anak yang mengalami nyeri.

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The application of this theory is done in 5 different managed cases to fulfil the needs of pain-comfort senses which is focused on physical, psychospiritual, sociocultural, and environmental factors. This nursing care uses standard comfort, coaching and comfort food for the soul to fulfil the needs of pain-comfort senses, that the clients can achieve relief, ease, and transcendence comfort. Resident suggests increasing the role of the partnership between nurses, other health workers and family and do nursing care based on evidence based practice."

"Gangguan rasa nyaman adalah perasaan kurang senang, lega dan sempurna dalam dimensi fisik, psikospiritual, lingkungan dan sosial. Perawat perlu menggunakan beberapa metode dalam mengurangi ketidaknyamanan anak saat di rumah sakit agar tidak memberikan dampak negatif dan trauma dimasa yang akan datang. Tujuan karya tulis ilmiah ini adalah untuk menganalisis penerapan Teori Comfort Kolcaba dalam proses asuhan keperawatan pada anak dengan masalah gangguan rasa nayaman. Metode karya ilmiah ini adalah studi kasus. Terdapat lima kasus anak di ruang IGD anak zona kuning yang diberikan asuhan keperawatan dengan pendekatan Teori Comfort Kolcaba. Aplikasi Comfort Kolcaba membagi tingkat kenyamanan dalam empat konteks yaitu kenyamanan fisik, psikospiritual, lingkungan dan sosiokultural. Intervensi keperawatan yang dilakukan adalah berdasarkan pendekatan berbasis bukti seperti distraksi, modifikasi lingkungan dan keterlibatan keluarga untuk meningkatkan kenyamanan anak. Penggunaan skerem bermotif kartun terbukti kurang efektif dalam menurunkan kecemasan anak saat dilakukan prosedur penusukan vena.

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Comfort disorders is feeling less happy, relieved, and perfect in physical, psychospiritual, environmental, and social dimensions. Nurses need to use several ways to reduce the child's discomfort while in hospital so that it does not have a negative impact and trauma in the future. The purpose of scientific writing is to analyze the application of Kolcaba's Comfort Theory in the nursing care process for children with comfort problems. The method of this scientific work is a case study. There are five cases of children in the yellow zone children's ER who were given nursing care with the Kolcaba Comfort Theory approach. The Comfort Kolcaba application divides the comfort level into four contexts: physical comfort, psychospiritual, environmental, and socio-cultural. Nursing interventions that are carried out are based on evidence-based approaches such as distraction, environmental modification, and family involvement to increase child comfort. The use of cartoon-patterned series proved to be less effective in reducing children's anxiety during the venipuncture procedure."

"Karya Ilmiah Akhir ini merupakan gambaran kegiatan praktik Residensi Ners Spesialis Keperawatan Anak dengan tujuan memberikan gambaran aplikasi Model Adaptasi Roy dalam melakukan asuhan keperawatan pada anak kanker dengan masalah ketidakseimbangan nutrisi kurang dari kebutuhan tubuh. Intervensi keperawatan dilakukan untuk meningkatkan mekanisme koping kognator dan regulator anak, sehingga mampu beradaptasi dengan masalah yang dialaminya. Evaluasi adaptasi klien dari lima kasus kelolaan bervariasi. Sebagian besar anak beradaptasi pada tingkat kompensasi, satu orang anak beradaptasi pada tingkat kompromi dan satu orang anak beradaptasi pada tingkat integritas.

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This study describes the residency activities of child nursing specialist. The aim of the study is to describe the application of Roy Adaptation Model in nursing children with cancer and nutritional imbalance (less than the body needs). The nursing intervention was conducted to improve children's kognator and regulator coping mechanism, so they could cope with their problems. Adaptation evaluation of five clients showed varies results. Three children adapted at compensatory level, one at compromised level, and one at integrated level."

"Masalah nutrisi merupakan permasalahan yang sering dihadapi oleh anak kanker. Tujuan penulisan Karya Ilmiah Akhir ini adalah memberikan gambaran pelaksanaan Praktik Residensi Keperawatan Anak kanker yang mengalami masalah nutrisi dengan mengaplikasikan Model Konservasi Levine. Dalam pencapaian kompetensi sebagai Ners Spesialis Keperawatan Anak residen telah menjalankan peran sebagai pemberi asuhan keperawatan, peran koordinasi dan kolaborasi, pembuatan keputusan etik, advocator, dan innovator. Aplikasi Model Konservasi Levine tertuang dalam lima kasus terpilih, dimana trophicognosis yang umum ditemukan adalah ketidakseimbangan nutrisi kurang atau lebih dari kebutuhan tubuh. Intervensi diberikan berdasarkan empat prinsip konservasi. Hasil evaluasi terhadap trophicognosis ketidakseimbangan nutrisi menunjukkan adanya peningkatan terhadap kemampuan konservasi energi. Model Konservasi Levine dapat diterapkan pada klien anak dengan kanker yang mengalami masalah nutrisi. Pencapaian kompetensi dalam praktik residensi keperawatan anak telah memperkaya dan meningkatkan pengetahuan serta keterampilan klinis residen.

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Nutritional problem is commonly faced by children with cancer. The aim of this final assignment was to provide Nursing Practice Residency implementation of children with cancer which have nutritional problems by applying Levine Conservation Model. Competencies that had been made included providing nursing care, coordination and collaboration, ethical decision making, advocator and innovator. Levine Conservation Model was applied in five selected cases and the trophicognosis commonly found was imbalanced nutrition supply of the body needs. Interventions were given based on the four principles of conservation, that are conservation of energy, conservation of structural integrity, conservation of personal integrity, and conservation of social integrity. Evaluation of nutritional imbalance trophicognosis showed an increase in energy conservation ability. Levine Conservation Model can be applied to children with cancer who have a nutrition problem. Achievement of competence in the practice residency of nursing children have enriching and improving knowledge and clinical skills of resident."

"Demam merupakan gejala yang sering dialami anak dengan penyakit infeksi. Kondisi demam tinggi berdampak merugikan anak. Demam tinggi membuat anak tidak nyaman dan orang tua cemas serta meningkatkan kebutuhan kalori dan cairan. Oleh karena itu dibutuhkan asuhan keperawatan model konservasi. Penulisan Karya Ilmiah Akhir ini bertujuan memberikan gambaran kegiatan pelaksanaan praktik residensi ners spesialis anak, gambaran aplikasi model konservasi dalam asuhan keperawatan demam pada anak yang mengalami penyakit infeksi. Model Konservasi Levine berfokus pada konservasi energi, integritas struktrur, personal dan sosial untuk mencapai keutuhan. Berdasarkan 5 kasus yang dibahas, intervensi yang diberikan untuk trophicognosis peningkatan suhu tubuh (demam) antara lain mengupayakan penurunan suhu tubuh, mempertahankan lingkungan sejuk dan nyaman, meningkatkan istirahat, memberikan asupan cairan dan nutrisi adekuat serta menurunkan kecemasan anak dan orang tua menggunakan konsep family centered care. Model Konservasi dapat diterapkan dalam asuhan anak demam. Disarankan untuk lebih meningkatkan upaya konservasi integritas personal dan sosial melalui pendidikan kesehatan pada keluarga.

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Fever is a symptom that is often experienced by children with infectious diseases. High fever conditions adversely affects children. High fever makes the child uncomfortable and parent’s anxiety and also increase calorie and fluid needs. Therefore, the child needs nursing care such as conservation model by Levine. This scientific final assignment to provide an overview of the implementation of the activities of child specialist nurse practice, an overview of applications of conservation models in nursing care of fever in children with infectious diseases. Levine Conservation Model focuses on energy conservation, structure integrity, personal and social to achieve wholeness. Based on 5 cases discussed, interventions given to trophicognosis increased body temperature (fever), which are to seek a decrease in body temperature, maintaining comfortable environment, improve rest, provide adequate nutrition and fluid intake as well as decrease the anxiety of children and parents using the concept of family-centered care. Conservation Model can be applied in the care of fever children. It is recommended to further enhance the conservation of personal integrity and social health through the family education."