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"Model pemberian asuhan keperawatan merupakan metode/pendekatan yang sangat penting dalam memberikan asuhan keperawatan berkualitas. Tujuan penelitian ini adalah memperoleh model asuhan penyakit kronis pada anak usia sekolah yang mengidap thalassemia f3 mayor untuk meningkatkan kualitas hidupnya. Penelitian ini menggunakan desain riset operasional melalui tiga tahapan penelitian. Tahap I: Identifikasi kebutuhan melalui penelitian kualitatif Tahap II: pengembangaan Modified Chronic Care Model hasil integrasi antara penelitian tahap I, studi literatur, dan konsultasi pakar. Tahap III: uji coba model dengan rancangan quasi experiment with control group. Metode sampling menggunakan simple random sampling dengan jumlah sampel sebanyak 148.Hasil penelitian menunjukkan :1) Tahap I: diperoleh 15 tema;2) Tahap II: dihasilkan modifikasi chronic care model dengan 1 buku asuhan keperawatan, 2 buku saku untuk pasien dan keluarga, 1 buku saku untuk perawat; 3) Tahap III: sikap keluarga, kualitas hidup anak, pengelolaan diri dan status fungsional anak yang mendapat intervensi Modified Chronic Care Model lebih tinggi dibandingkan dengan anak yang tidak mendapat intervensi.Kesimpulan, Modified Chronic Care Model efektif meningkatkan kualitas hidup anak, meningkatkan kemampuan pengelolaan diri anak, meningkatkan status fungsional anak dan meningkatkan sikap keluarga dalam merawat anak.Rekomendasi : 1) Replikasi model di rumah sakit pemerintah lain;2) Pelatihan berkelanjutan bagi perawat di ruang rawat thalassemia; 3) Penelitian lanjut yaitu penghitungan ratio tenaga perawat dengan pasien.

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Nursing care model is the important thing for better quality of nursing care. The aim of this study is to develop nursing care model for thalassemic school age children. This study used operational research design through three stages namely Stage I: Identifying problems and needs. Stage II: Developing the Modified Chronic care Model resulted from integration of the results of stage 1 studies, literature studies, and expert consultation; Stage III: Testing the model with the quasi experiments with control group design. Sampling strategy used simple random sampling method with 148 samples.Results ofresearch were obtained:1) Stage I: 15 themes were obtained;2) Stage II: Modification of Chronic Care Model with 1 book o f nursing care, 2 pocket books for patients and their family, 1 pocket book for nurses;3) Stage III: Children's quality of life, functional status and self-management who received Modified Chronic Care Model intervention were higher than children who didn't receive. Family attitudes who received Modified Chronic Care Model intervention were higher than family who didn't receive.In conclusion, Modified Chronic Care Model effectively increases thalassemic school age children's quality of life, functional status, self- management, and family attitude.Recommendations:1) Replicate similar models in other government hospitals;2) Keep continuing training for nurses in thalassemic unit;3) study about patient-nurse ratio."

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Jumlah lansia dengan hipertensi semakin meningkat di Indonesia, namun sebagian berlanjut mengalami komplikasi hipertensi sebagai akibat tekanan darah yang tidak berkontrol. Pengembangan model asuhan keperawatan lanjut usia berbasis komunitas ini merupakan salah satu usaha dalam meningkatkan outcome status kesehatan lansia dengan hipertensi dengan mengoptimalkan sumber-sumber yang ada dimasyarakat. Penelitian ini bertujuan mengidentifikasi masalah dan kebutuhan lanjut usia dengan hipertensi, mengembangkan model asuhan keperawatan lanjut usia dengan hipertensi berbasis komunitas, serta mengidentifikasi pengaruhnya terhadap manajemen diri hipertensi, kelola masa lansia, dukungan keluarga, tekanan darah, dan kualitas hidup lansia dengan hipertensi. Desain penelitian merupakan riset operasional. Tahap pertama menggunakan studi kualitatif dengan 64 partisipan, tahap ke dua pengembangan model, dan tahap ketiga penelitian quasy experiment pre-post with control group dengan 80 lansia hipertensi. Tahap pertama didapatkan 8 tema yaitu:1) Keluhan terkait penuaan dan hipertensi, 2) Pengetahuan dan kepercayaan tentang hipertensi, 3) Perubahan perilaku setelah hipertensi, 4) Hambatan pelayanan kesehatan bagi lansia, 5) Kebutuhan dalam mengelola hipertensi untuk lansia, 6) Dukungan pengelolaan penyakit, 7) Perilaku manajemen diri hipertensi, dan 8) Kepatuhan minum obat. Tahap kedua diperoleh model asuhan keperawatan lanjut usia dengan hipertensi berbasis komunitas yang memiliki komponen lanjut usia dengan hipertensi yang memiliki 4P perilaku manajemen diri, keluarga dengan 5 tugas keluarga, kader hipertensi dengan 5 tugas kader hipertensi, kelompok swabantu lanjut usia dengan hipertensi, dan perawat dengan 4 tugas perawat. Tahap ketiga implementasi model asuhan keperawatan lanjut usia dengan hipertensi berbasis komunitas berpengaruh secara bermakna terhadap manajemen diri hipertensi, kelola masa lansia, dukungan keluarga, tekanan darah sistolik dan tekanan darah diastolik, dan  kualitas hidup lansia.

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Indonesia has a large number of elderly who live with hypertension, but some continue to experience hypertension complications as a result of uncontrolled blood pressure. The development of the model community-based nursing care for the elderly with hypertension is one of the efforts to improve the health status outcomes of the elderly with hypertension by optimizing existing resources in the community. This study aims: 1) to identify the problems and needs of elderly with hypertension, 2) to develop the model of community-based nursing care for elderly with hypertension and 3) to assess the effectiveness of the model on self-management of the elderly with hypertension, health status: blood pressure, the elderly developmental tasks attainment,  quality of life of the elderly with hypertension and the family disease management. This is operational research design. The first step is a qualitative study with 64 participants, the second step is the model development, and the third step is the quasi-experiment research with pre-post control groups with 80 elderly with hypertension. The first study found 8 themes, namely: 1) problems related to aging and hypertension, 2) knowledge and beliefs about hypertension 3) behavior changes after hypertension, 4) Barriers to health services for the elderly, 5) the needs to manage hypertension for the elderly, 6) Disease management support, 7) hypertensive self-management behavior, and 8) medication compliance. The second step is the development of community-based nursing care for the elderly with hypertension. Components of the model are elderly with hypertension with 4 self-management behavior tasks, the elderlys family with 5 family health tasks, the hypertension cadre with 5 tasks, the elderly self-help group with hypertension, and the primary care nurses. The third step is the evaluation of the model. There is a significant improvement in hypertension self-management, health status of the elderly (reduction of systolic blood pressure and diastolic blood pressure), the elderly developmental tasks attainment, the quality of life of the elderly, and the family disease management.

 

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"Inkontinensia urin (IU) pasca stroke merupakan salah satu gejala sisa stroke yang mempengaruhi seluruh kehidupan pasien baik fisik, psikologis, sosial, dan spiritual pasien. Penelitian ini bertujuan mengembangkan model asuhan keperawatan berbasis teori human becoming dan self-care deficit theory of nursing dan teridentifikasi pengaruhnya terhadap penurunan insomnia dan peningkatan kualitas hidup pasien IU pasca stroke. Penelitian ini terbagi atas dua tahap yaitu penelitian kualitatif (studi kasus) yang melibatkan 18 informan, kemudian dilanjutkan dengan penyusunan model dan penelitian kuantitatif (non-equivalent control group pretest-posttest design) yang melibatkan 56 responden secara consecutive sampling, yang dibagi dalam kelompok intervensi dan kelompok kontrol dengan lama intervensi 8 minggu. Penelitian tahap ini dilakukan di empat rumah sakit di Kota Kendari kemudian dilanjutkan di rumah pasien. Hasil penelitian tahap satu didapatkan lima tema dari hasil wawancara mendalam sehingga dihasilkan model pengelolaan IU pasca stroke beserta buku panduan intervensi model, modul untuk pasien dan perawat. Hasil penelitian tahap dua membuktikan bahwa model ini berpengaruh dalam menurunkan insomnia dan meningkatkan kualitas hidup dengan p value < 0,05. Kesimpulan hasil penelitian yaitu model asuhan keperawatan berbasis teori human becoming dan self-care deficit theory of nursing berpengaruh dalam menurunkan insomnia dan meningkatkan kualitas hidup pasien

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Post-stroke urinary incontinence (UI) is one of the sequelae of stroke that affects the patient's entire life (physically, psychologically, socially, and spiritually). This study aims to develop a nursing care model based on the theory of human becoming and self-care deficit theory of nursing and identify its effect on decreasing insomnia and improving quality of life. This research was divided into two stages, namely qualitative research (case study) involving 18 informants, then continued with model development and quantitative research (non-equivalent control group pretest-posttest design) involving 56 respondents by consecutive sampling. Respondents were divided into the intervention group and the control group with an intervention duration of 8 weeks. This research was conducted in four hospitals in Kota Kendari and then continued at the patient's home. The results of the first phase of the study obtained five themes from the results of in-depth interviews so that a post-stroke UI management model was produced along with a model intervention guide, modules for patients and nurses. The results of the second stage of the study proved that the post-stroke UI management model had an effect on reducing insomnia and improving quality of life with p value <0.05. The conclusion of the research is that nursing care model based on the theory of human becoming and self-care deficit theory of nursing has an effect on reducing insomnia and improving the patient's quality of life"

"Rendahnya kualitas hidup lansia di PSTW belum mendapatkan perhatian dari berbagai pihak, sementara keinginan lansia tinggal di panti semakin meningkat di Sumbar. Salah satu penyebab adalah pergeseran nilai budaya perawatan lansia di keluarga. Tujuan penelitian untuk memperoleh model keperawatan pendampingan lansia berbasis budaya minang, untuk meningkatkan kualitas asuhan, status kesehatan, kepuasan dan kualitas hidup lansia di panti. Disain penelitian yang digunakan riset operasional, terdiri dari tiga tahap. Tahap I: identifikasi dasar pengembangan model, melaluimetode campuran dengan desain ethnografi terfokus dan desain deskriptif. Tahap II: pengembangaan model keperawatan pendampingan lansia berbasis budaya merupakan integrasi tema tahap 1, studi literatur dan konsultasi pakar; Tahap III: uji coba model dengan quasi experiment with control group design. Jumlah sampel kelompok intervensi 52 orang, dan 51 orang kelompok kontrol. HasilSal penelitian  tahap I: kompetensi budaya, perilaku merawat, status kesehatan, kepuasan dan kualitas hidup status masih rendah (kurang 50%), penelitian kualitatif diperoleh 19 tema; tahap II, dihasilkan model pendampingan lansia berbasis budaya minang dilengkapi 3 modul, 1 buku kerja, dan panduan bagi komponen model; tahap III: intervensi berhasil meningkatkan kualitas asuhan, status kesehatan, kepuasan dan kualitas hidup lansia di PSTW Sumbar. Kesimpulan: model memiliki efektifitas intervensi tertinggi pada kualitas asuhan (komunikasi, kebersihan dan pelayanan), kualitas hidup (spiritualitas), status kesehatan, kepuasan hidup, kompetensi budaya dan perilaku merawat. Rekomendasi: 1) model dapat dipakai di PSTW diwilayah lain diluar Sumbar dengan melakukan penyesuaian; 2)Pendidikan dan pelatihan berkelanjutan bagi seluruh staf panti; 3)Penelitian lanjutan yaitu pengembangan instrument kompetensi budaya untuk petugas panti.

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The low quality of life of the elderly at PSTW has not received much attention from various parties, while the desire of the elderly to live in the institution has increased in West Sumatra. This happened because of the shift in the value of the elderly care culture in the family. The aim of the study was to obtain a nursing assistance model for elderly people based on Minang culture, to improve the quality of care, health status, satisfaction and quality of life for elderly people at the orphanage. Research uses the operational research research design, which consists of three stages. Stage I: identification of basic model development, through mixed research with focused ethnographic design and descriptive design. Stage II: development of a culture-based elderly mentoring nursing model is the integration of the theme of stage 1, literature study and expert consultation; Stage III: trial model with quasi experiment with control group design. The number of samples in the intervention group was 52 people, and 51 were control groups. The results of phase I research: cultural competence, caring behavior, health status, satisfaction and quality of life status are still low (50% less), qualitative research obtained 19 themes; phase II, produced an elderly mentoring model based on Minang culture equipped with 3 modules, 1 workbook, and guidance for model components; stage III: the intervention managed to improve the quality of care, health status, satisfaction and quality of life of the elderly in West Sumatra PSTW. Conclusion: the model has the highest effectiveness of intervention on the quality of care (communication, cleanliness and service), quality of life (spirituality), health status, life satisfaction, cultural competence and caring behavior. Recommendations: 1) the model can be used in PSTW in other regions outside of West Sumatra by making adjustments; 2) Continuous education and training for all nursing staff; 3) Further research is the development of cultural competency instruments for nursing staff."

"Latar belakang: Peningkatan usia harapan hidup dan jumlah lansia yang tinggal di panti menimbulkan tantangan dalam mempertahankan status fungsional dan kualitas hidup mereka. Intervensi Model KMD diharapkan dapat membantu mempertahankan status fungsional serta meningkatkan kualitas hidup lansia.Tujuan: Menilai efektivitas Model KMD dalam mempertahankan status fungsional dan meningkatkan kualitas hidup lansia di panti. Metodologi: Penelitian menggunakan desain riset operasional tiga tahap. Tahap pertama fenomenologi deskriptif melibatkan 64 tim multidisiplin, tahap kedua pengembangan model melibatkan 4 pakar dan 7 tim multidisiplin, dan tahap ketiga pre test and post test design melibatkan 47 tim multidisiplin serta 328 lansia dengan purposive sampling. Hasil: Tersusun sepuluh tema dasar untuk pengembangan model, termasuk tiga modul perangkat Model KMD. Tidak ditemukan perbedaan signifikan pada status fungsional lansia (p=0,079), kualitas hidup umum (p=0,307), dan kualitas hidup kesehatan (p=0,386) antara kelompok intervensi dan kontrol. Namun, kelompok intervensi menunjukkan peningkatan rata-rata kualitas hidup pada aspek umum, psikologis, dan sosial. Simpulan: Model KMD efektif dalam mengubah perilaku tim multidisiplin dan mempertahankan status fungsional lansia, khususnya lansia dengan disabilitas ringan hingga sedang, serta meningkatkan kualitas hidup lansia, terutama dalam ranah umum, psikologi, dan sosial. Saran: Model KMD diterapkan dalam waktu lama dengan kelompok homogen untuk memperkuat kapasitas pelayanan lansia di panti.

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Background: Increasing life expectancy and the number of older people living in institutions pose challenges in maintaining their functional status and quality of life. The KMD Model intervention is expected to help maintain the functional status and improve the quality of life of the elderly. Objectives: To assess the effectiveness of the KMD Model in maintaining functional status and improving quality of life of older adults in nursing homes. Methodology: A three-stage operational research design was used. The first stage descriptive phenomenology involved 64 multidisciplinary teams, the second stage model development involved 4 experts and 7 multidisciplinary teams, and the third stage pre test and post test design involved 47 multidisciplinary teams and 328 elderly with purposive sampling. Results: ten basic themes for model development, including three modules of the KMD Model toolkit. No significant differences were found in the functional status of the elderly (p=0.079), general quality of life (p=0.307), and health quality of life (p=0.386) between the intervention and control groups. However, the intervention group showed an increase in the average quality of life in general, psychological, and social aspects. Conclusion: The KMD model is effective in changing the behavior of the multidisciplinary team and maintaining the functional status of the elderly, especially the elderly with mild to moderate disabilities, and improving the quality of life of the elderly, especially in the general, psychological, and social domains. Suggestion: The KMD model should be applied for a long time with homogeneous groups to strengthen the capacity of elderly services in nursing homes."

"Tujuan penelitian ini mengembangkan model asuhan keperawatan berbasis spiritual pada klien penyakit fisik kronis serta dampaknya pada mutu asuhan keperawatan. Disain penelitian menggunakan action research, terdiri dari tiga tahap. Tahap awal, mengidentifikasi masalah menggunakan metode riset kualitatif bersifat fenomenologi. Hasil berupa kesenjangan antara kebutuhan dan harapan klien tentang asuhan keperawatan spiritual selama dirawat dan kemampuan serta motivasi perawat dalam memberikan asuhan keperawatan berbasis spiritual. Tahap kedua mengembangkan draft model asuhan keperawatan berbasis spiritual dan modul pelatihan bagi perawat. Tahap ketiga, memvalidasi model dan modul. Penelitian Tahap tiga menggunakan quasi experiment dengan rancangan Non equivalen (pretest and posttest) control group. Responden adalah perawat dari 3 RSIJ berjumlah 131 orang terbagi menjadi 3 kelompok, kelompok pelatihan 59 orang, membaca modul 38 orang dan kontrol 34 orang. Analisis data mengunakan paired t test, anova dan GLM. Hasil Penelitian menunjukan peningkatan kemampuan perawat yang bermakna antara sebelum dan sesudah pelatihan p<0,05. Terjadi Peningkatan kemampuan dan penurunan motivasi pada ketiga kelompok perawat dalam memberikan asuhan keperawatan berbasis spiritual setelah 3 bulan pelatihan dengan p<0,000. Selanjutnya, untuk mengetahui efektifitas implementasi hasil pelatihan telah digunakan disain penelitian preexperimental, rancangan alternative treatment posttest only with nonequivalen groups. Seratus orang klien dengan DM menjadi subjek penelitian. Analisis data menggunakan Chi-Square dan GLM. Hasil analisis GLM multivariat menunjukkan kemampuan perawat berpengaruh terhadap mutu asuhan keperawatan khususnya layanan spiritualitas dan kepuasan klien (p<0,05). Kesimpulan; model dan modul asuhan keperawatan berbasis spiritual pada klien rawat inap dengan penyakit fisik kronis meningkatkan kemampuan dan motivasi perawat dalam memberikan asuhan keperawatan berbasis spiritual dan berdampak positif pada mutu asuhan keperawatan. Selain itu, diinstitusi pendidikan, model ini juga dapat diintegrasikan dalam kurikulum keperawatan baik keperawatan dasar maupun keperawatan klinik. Sedangkan pada tatanan layanan, model dan modul ini dapat digunakan untuk melakukan pelatihan pada perawat.;

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The purpose of this study was to develop nursing care model based on chronic illness patient spiritual need and to investigate the impact of model toward nursing care quality. This study utilized an action research, consisted of three stages; first stage was to identify the problem using qualitative research method with a fenomenology approach. The result, demostrated that there were differences between patient need and nurse competence to fulfill spiritual care; second stage was to develop a draft of model and study guide for nurses training and the third stage was to evaluate the effectiveness of study guide and its implementation based on the training. This study uses a quasi experiment with non equivalent pre-post test with control group design. One hundred and thirty one nurses were selected from three hospital and divided into three groups, 59 samples as training group, 38 samples as study guide readers and 34 samples as control group. The data was analyse by paired t test, anova and GLM. The result revealed that there were ability alteration before and after training p<0.05. There was an improvement of ability and reduction of motivation in spiritually nursing care in all groups three month after training, p<0.000. The next step was to evaluated the effectiveness of implementation of training with pre-experimental, alternative treatment post test only with nonequivalent groups approach. Using 100 diabetic mellitus patient, the data was analysed by chi-square and GLM. The GLM multivariat analisys illustrated nurse competence related to nursing care quality particularly to spiritual care and patient satisfaction, p<0.05. Model and module of nursing spiritual care to inpatient patient with chronic illness was capable to improve nurses competence and motivation to provide spiritual based nursing care and had possitive impact to quality of nursing care. Moreover, in educational institutions, this model can also be integrated in the nursing curriculum of both fundamental and clinical. While in the order of service, this model and module can be used to conduct training for nurses.Key words : nurses competency, motivation."

"Diabetes Melitus merupakan penyakit kronik yang memiliki konotasi kebudayaan oleh karena itu dalam penanganannya perlu memperhatikan aspek kebudayaan pasien. Keberagaman kebudayaan pasien berdampak pada adanya kebutuhan asuhan keperawatan yang peka budaya. Penelitian ini bertujuan untuk mengembangkan Model Asuhan Keperawatan Peka Budaya (Model AKPB) dan mengidentifikasi pengaruh model tesebut terhadap kepuasan pasien Diabetes Melitus. Penelitian dengan desain kuasi eksperimen melibatkan 208 orang pasien Diabetes Melitus yang dirawat di dua rumah sakit umum pusat di Jakarta.Instrumen yang digunakan merupakan hasil modifikasi sejumlah instrumen yang berhubungan dengan kompetensi budaya dan kepuasan pasien terhadap asuhan keperawatan. Hasil penelitian diperoleh ada perbedaan yang bermakna antara kepuasan pasien pada kelompok intervensi dibandingkan dengan kelompok kontrol(p= 0,000). Hasil analisis multivariat menunjukkan bahwa pasien yang mendapat asuhan keperawatan peka budaya lebih tinggi kepuasannya sebanyak 5,2 kali dibandingkan dengan pasien pada kelompok kontrol. Kesimpulan penelitian ini adalah Model Asuhan Keperawatan Peka Budaya terbukti dapat meningkatkan kepuasan pasien Diabetes Melitus. Saran untuk penelitian selanjutnya adalah perlu dilakukan penelitian pada kasus pasien dengan gangguan kesehatan yang lain.

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As a chronic disease Diabetes Mellitus has a cultural association therefore its management should consider the cultural aspect of the patient.The cultural diversity among patients has an impact on the increase demand of culturally sensitive nursing care. The purpose of this study is to develop a model of culturally sensitive nursing care (Model AKPB) for diabetic patient and its impact on patient satisfaction regarding nursing care. The design of quasi experimental was used with 208 diabetic patient from two different hospitals involved in this study.Modified instrument from culturally competent nursing care and satisfaction for nursing care were developed and utilized. The result shown that there is a statistically different between the staisfaction of patient amongs intervention group and control group (p= 0,000). Multivariate analysis shown that the satisfaction of patients from intervention group 5.2 times higher than control group. As conclusion, there is an evidence that the model of culturally sensitive nursing care has increased the satisfaction of diabetic patient. Further research needed to identify the effectiveness of this model for other different health problems."

"Kerusakan struktur dan penurunan fungsi ginjal pada anak pengidap Systemic Lupus Erythematosus (SLE) dengan komplikasi Chronic Kidney Disease (CKD) mengakibatkan penumpukan produk sisa-sisa metabolisme yang disebut uremia. Komplikasi ini mengakibatkan terjadinya gangguan integritas kulit berupa kulit kering (xerosis) yang dapat mempengaruhi kualitas hidup pasien dan menimbulkan infeksi lebih lanjut. Karya ilmiah ini bertujuan memberikan gambaran asuhan keperawatan pada anak pengidap SLE dengan komplikasi CKD dan menganalisis penerapan intervensi pemberian Virgin Coconut Oil (VCO) pada masalah gangguan integritas kulit. Intervensi diterapkan sebanyak dua kali dalam sehari dan dilakukan selama 3 hari. Metodologi yang digunakan adalah metode studi kasus. Hasil analisis menunjukkan bahwa terdapat penurunan luas kulit yang mengalami xerosis yang ditandai dengan penurunan nilai overall dry skin score dari 4 menjadi 3 dan keluarga mampu melakukan perawatan kulit secara mandiri. Rekomendasi dari studi kasus ini adalah diharapkan pemberian VCO dapat menjadi terapi penunjang sebagai upaya untuk mengatasi gangguan integritas kulit pada kondisi xerosis.

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Structural damage and decreased kidney function in children with Systemic Lupus Erythematosus (SLE) with the Chronic Kidney Disease (CKD) complication caused accumulation of metabolic waste products called uremia. This complication resulted in impaired skin integrity in the form of dry skin (xerosis) which can affect the patient's quality of life and lead to further infection. This scientific work aims to provide an overview of nursing care in children with SLE with complication of CKD and to analyze the intervention of Virgin Coconut Oil (VCO) application to the impaired skin integrity area. The intervention applied twice a day and has been carried out for 3 days. The methodology used is the case study method. The results of the analysis showed that there was a decrease in the area of skin with xerosis which was indicated by a decrease in the overall dry skin score of 4 to 3 and the family was able to perform skin care independently. The recommendation from this case study is application of VCO can be a supporting therapy as an effort to overcome impaired skin integrity in xerosis conditions."

"[ABSTRAKKarya Ilmiah Akhir ini merupakan kumpulan dari laporan praktik residensi medikal bedah yang terdiri dari laporan kasus kelolaan, penerapan terapi musik berdasarkan evidenced based Nursing dan laporan inovasi tentang pelatihan pengkajian ESAS dan penatalaksanaannya. Praktik ini menerapkan asuhan keperawatan pada pasien kanker dengan menggunakan pendekatan The Corbin and Strauss Chronich Illness Trajectory Model. Fokus dari teori ini adalah menerapkan 9 fase perjalanan penyakit yaitu fase pretrajectory, trajectory, stable, unstable, crisis, acut, comeback, downward dan dying. Tujuan dari pendekatan teori ini adalah untuk mengetahui perjalanan penyakit kanker. Salah satu upaya untuk mengurangi kecemasan pada pasien kemoterapi adalah dengan terapi musik. Pelatihan perawat dapat meningkatkan kemampuan mengkaji ESAS dan memberikan penatalaksanaannya. The Corbin and Strauss Chronich Illness Trajectory Model, terapi musik dan pelatihan pengkajian ESAS dan penatalaksanaannya dapat diaplikasikan pada tatanan klinik untuk meningkatkan kualitas pelayanan keperawatan.

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ABSTRACTScientific work is a compilation of the final report medical surgical nursing practice ressidency wich consist of case report under management, the application of music therapy based on evidenced based nursing and innovation report on training of ESAS ( Edmonton Symptomp Assesment System) and it's tretment. This is implement nursing care to cancer patients using theorical approach The Corbin and Strauss Chronich Illness Trajectory Model. The focus of this theory is the apllication of nine phase of chronic illness, consist : pretrajectory, trajectory, stable, unstable, crisis, acut, comeback, downward and dying. The purpose of the theorical approach is to know the trajectory of disease especially cancer. One effort to reduce anxiety related chemotherapy of the patient was music therapy. Training of ESAS and it's treatment will increasing the skill of nurse to asses ESAS and it's treatment. The Corbin and Strauss Chronich Illness Trajectory Model, music therapy and assesment & treatment ESAS training can apllicated in clinical to increse quality of nursing., Scientific work is a compilation of the final report medical surgical nursing practice ressidency wich consist of case report under management, the application of music therapy based on evidenced based nursing and innovation report on training of ESAS ( Edmonton Symptomp Assesment System) and it's tretment. This is implement nursing care to cancer patients using theorical approach The Corbin and Strauss Chronich Illness Trajectory Model. The focus of this theory is the apllication of nine phase of chronic illness, consist : pretrajectory, trajectory, stable, unstable, crisis, acut, comeback, downward and dying. The purpose of the theorical approach is to know the trajectory of disease especially cancer. One effort to reduce anxiety related chemotherapy of the patient was music therapy. Training of ESAS and it's treatment will increasing the skill of nurse to asses ESAS and it's treatment. The Corbin and Strauss Chronich Illness Trajectory Model, music therapy and assesment & treatment ESAS training can apllicated in clinical to increse quality of nursing.]"

"Penyakit gagal ginjal kronis merupakan penyakit yang cukup kompleks dan menimbulkan beberapa tanda dan gejala yang membuat ketidaknyaman dan mempengaruhi kualitas hidup pasien. Pruritus merupakan salah satu gejala yang cukup sering terjadi pada pasien CKD terutama pasien dengan hemodialisis. Penyebab munculnya pruritus karena disregulasi kekebalan tubuh, xerosis, hiperparatiroidisme, akumulasi toksin uremik, disfungsi saraf, mekanisme histamin, dan mekanisme opioid. Masalah ini jika tidak diselesaikan maka akan menimbulkan masalah lain seperti ketidaknyamanan, gangguan tidur, luka bekas garukan, dan menurunkan kualitas hidup pasien. Masalah integritas kulit yang terjadi dapat ditangani dengan penerapan intervensi pemberian lotion pada pasien. Karya ilmiah ini akan menjelaskan terkait intervensi pemberian lotion berbasis ceramide pada pasien CKD dengan pruritus. Pemberian intervensi dilakukan setiap hari selama 7 hari rawat di ruang rawat inap secara rutin dan evaluasi dilakukan dengan Numeric Rating Scale setelah dilakukan perawatan penuh. Hasil intervensi menunjukkan perubahan skor gatal yang dirasakan pasien yaitu dari skala 10 menjadi skala 1. Kesimpulannya adalah penerapan lotion berbasis ceramide direkomendasikan untuk mengurangi pruritus pada pasien CKD dan meningkatkan kesejahteraan pasien selama masa perawatan.

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Chronic kidney disease (CKD) is one of complex diseases which can cause signs and symptoms affecting the patient's comfort and quality of life. Pruritus is one of the most common symptoms of CKD patient undergoing hemodialysis. The causes of pruritus are for example immune system dysregulation, xerosis, hyperparathyroidism, toxic uremia accumulation, nervous dysfunction, histamine mechanism, and opioid use mechanism. This problem if left untreated can give rise to a number of other problems such as discomfort, sleep problems, wounded skin from scratching, and overall decease in quality of life. Skin integrity impairment can be treated with a lotion use intervention for the patient. This scientific paper will explain the intervention on the use of ceramide-based lotion for CKD patient with pruritus. The intervention is performed routinely every day for seven days in the inpatient ward with the evaluation using Numeric Rating Scale after intervention completion. The result of the intervention shows the reduction of itchiness score from 10 to 1. The conclusion is that the use of ceramide-based lotion is recommended to reduce pruritus in CKD patient to increase quality of life during hospitalization period."