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"ABSTRAKAnsietas merupakan masalah kejiwaan yang sering dialami oleh seseorang dalam kehidupan sehari-hari dan khususnya yang mengalami penyakit fisik seperti hipertensi. Tindakan keperawatan ners, Thought Stoping, psikoedukasi keluarga dan terapi suportif diberikan pada klien ansietas dengan tujuan untuk melihat tanda gejala, kemampuan klien mengontrol ansietas, dan kemampuan keluarga dalam merawat. Tindakan keperawatan terhadap 5 klien ansietas dengan hipertensi yang dilaporkan dalam bentuk case series. Hasil yang didapatkan adalah terjadi hillagnya tanda gejala yaitu fokus pada kondisi sakit, takut pada konsekuensi tidak spesifik, adanya perubahan fisiologis, kurang mampu memecahkan masalah dan kurang konsentrasi. Sedangkan tanda gejala yang masih ditemukan diantaranya adalah adanya perubahan dalam kehidupan dan merepotkan kelurga. Kemampuan klien yang dimiliki mengalami peningkatan dalam mengontrol ansietas dan kemampuan keluarga dalam merawat. Studi ini merupakan salah satu evidence based efektivitas dari tindakan keperawatan ners dan ners spesialis terhadap klien dengan ansietas yang memerlukan evaluasi lanjut dengan jumlah sampel yang lebih besar dan jumlah pertemuan yang lebih sering.

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ABSTRACT

Anxiety is a psychiatric problem that is often experienced by a person in everyday life and especially those experiencing physical illnesses such as hypertension. Nursing care, Thought Stoping, family psychoeducation and supportive therapy are given to anxiety clients in order to see signs of symptom, the ability of the client to control anxiety, and the ability of the family to care for. Nursing action against 5 anxiety clients with hypertension reported in case series form. The results obtained are hillagnya signs of symptoms that focus on the condition of the pain, fear of non-specific consequences, the physiological changes, less able to solve problems and lack of concentration. While the signs of symptoms that are still found among them is a change in life and troublesome kelurga. The client's ability has improved in controlling anxiety and the ability of the family to care for. This study is one of the evidence-based effectiveness of nursing ners and specialist ners actions against clients with anxiety requiring further evaluation with larger sample quantities and more frequent meetings."

"Hipertensi dapat menyebabkan ansietas yang dapat mempengaruhi kualitas hidup dan beban bagi klien. Ansietas yang berkepanjangan menimbulkan perilaku maladaptif sehingga dapat menyebabkan ganggguan jiwa. Tujuan karya ilmiah akhir ini untuk memberikan gambaran tentang penerapan terapi suportif pada klien dengan hipertensi yang mengalami ansietas menggunakan pendekatan Social Support Theory. Terapi suportif diberikan kepada 15 klien hipertensi yang mengalami ansietas. Hasil penerapan terapi suportif ini menunjukan dapat menurunkan tanda dan gejala ansietas dan meningkatkan kemampuan klien dalam menggunakan sumber dukungan. Terapi suportif direkomendasikan sebagai terapi spesialis keperawatan untuk meningkatkan dukungan sosial dalam mengatasi ansietas.

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Hypertension can caused anxiety and may influence patient’s quality of life. Anxiety can be burden to patient with hypertension. Prolong anxiety may cause maladaptive behavior which can create mental health issues. The purpose of this final report is to describe the implementation of support therapy on hypertension patient who experience anxiety using social support theory. Support therapy was given onto hypertension 15 patients who experience anxiety. The result shows that the supportive therapy could decrease level of anxiety symptoms of hypertension patient and increase patient's ability in using supporting system. It is recommended that support therapy become nursing specialist therapy to improve social support in treating anxiety."

"Ansietas adalah perasaan samar tentang ketidaknyamanan atau ketakutan yang disertai respon otomatis, sebuah perasaan takut akan menyebabkan antisipasi terhadap bahaya NANDA 2012 (Herdman, 2012). Pemberian terapi thought stopping, relaksasi progresif dan psikoedukasi dapat menurunkan ansietas. Thought stopping merupakan terapi yang dapat diberikan pada klien dengan perilaku kekerasan (Boyd & Nihart, 1996). Tujuan penulisan karya ilmiah akhir ini adalah menggambarkan manajemen asuhan keperawatan klien ansietas dengan pendekatan model adaptasi Roy. Penerapan terapi thought stopping, relaksasi progresif dan psikoedukasi dilakukan pada 56 klien di ruang Melati Bawah dan Kebidanan 3 pada kurun waktu 20 Pebruari -20 April 2012. Hasil terapi thought stopping, relaksasi progresif dan psikoedukasi sangat efektif pada 56 klien dengan menunjukkan penurunan skala ansietas. Pemberian paket terapi juga menunjukkan efektif untuk klien dan keluarga selain mampu mengatasi pikiran negative dan mampu mengontrol emosi secara mandiri.

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Anxiety is a vague feeling of discomfort or dread accompanied by an automatic response to a feeling of fear which will lead to the anticipation of danger NANDA 2012 (Herdman, 2012). Stopping thought therapy, progressive relaxation and psychoeducation can reduce anxiety. Thought stopping is a therapy that can be given to the client with violent behavior (Boyd & Nihart, 1996).

The aim of this final scientific pappers is to describe the nursing care management on anxiety clients by approaching Roy adaptation model. Therapeutic application of thought stopping, progressive relaxation and psychoeducation were conducted on 56 clients in the Melati Bawah and Kebidanan 3 during the period 20 February - 20 April 2012.

The results of thought stopping therapy, progressive relaxation and psychoeducation is very effective on 56 clients with a demonstrated anxiety scale reduction. The therapy package is also demonstrated effectively for clients and families, which are able to overcome negative thoughts and control emotions independently."

"Ansietas sering ditemukan pada klien hipertensi akibat kekhawatiran kesehatan dan masa depannya. Selain itu, kegagalan berkomitmen untuk mengurangi faktor risiko dan rejimen pengobatan dalam kehidupan sehari-hari menjadi indikator klinis dengan nilai sensitif paling tinggi pada hipertensi. Karya tulis ilmiah ini bertujuan untuk mengetahui pengaruh tindakan keperawatan, progressive muscle relaxation, acceptance commitment therapy, dan psikoedukasi keluarga terhadap ansietas dan ketidakefektifan manajemen kesehatan klien hipertensi. Pemberian terapi progressive muscle relaxation, acceptance commitment therapy, dan psikoedukasi keluarga dapat menurunkan tanda dan gejala ansietas dan ketidakefektifan manajemen kesehatan secara bermakna pada klien hipertensi. Pemberian paket 3 terapi yaitu terapi progressive muscle relaxation, acceptance commitment therapy, dan psikoedukasi keluarga diketahui mampu menurunkan tanda dan gejala ansietas dan ketidakefektifan manajemen kesehatan lebih tinggi dibanding jika hanya diberikan satu terapi saja atau 2 terapi saja. Sehingga, terapi kombinasi 3 terapi lebih direkomendasikan dalam mengatasi ansietas dan ketidakefektifan manajemen kesehatan pada klien hipertensi.

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Anxiety is often found in hypertension clients due to worries about their health and future. In addition, failure to commit to reducing risk factors and treatment regimens in daily life is a clinical indicator with the highest sensitive value in hypertension. This scientific paper aims to determine the effect of nursing actions, progressive muscle relaxation, acceptance commitment therapy, and family psychoeducation on anxiety and ineffective health management of hypertensive clients. Provision of progressive muscle relaxation therapy, acceptance commitment therapy, and family psychoeducation can significantly reduce signs and symptoms of anxiety and ineffective health management in hypertensive clients. Giving a package of 3 therapies, namely progressive muscle relaxation therapy, acceptance commitment therapy, and family psychoeducation is known to be able to reduce signs and symptoms of anxiety and ineffective health management higher than if only given one therapy or only 2 therapies. Thus, combination therapy of 3 therapies is more recommended in overcoming anxiety and ineffective health management in hypertensive clients."

"Seseorang yang mengalami masalah kesehatan fisik dapat menimbulkan masalah kesehatan jiwa yaitu ansietas. Tujuan karya ilmiah akhir ini adalah untuk memberikan gambaran penerapan tindakan ners, terapi relaksasi otot progresif, penghentian pikiran, psikoedukasi keluarga, terapi suportif pada klien hipertensi yang mengalami ansietas. Metode yang digunakan dalam karya ilmiah ini adalah analisis kasus klien ansietas. Jumlah klien yang dikelola sebanyak 37 orang. Sebanyak 23 orang mendapatkan tindakan ners, relaksasi otot progresif, penghentian pikiran, psikoedukasi keluarga dan terapi suportif. Sebanyak 14 orang mendapatkan tindakan ners dan terapi suportif. Hasil yang ditemukan terjadi penurunan tanda gejala serta peningkatan kemampuan mengendalikan ansietas paling besar pada klien yang mendapatkan lima terapi. Tindakan ners, terapi relaksasi otot progresif, penghentian pikiran, psikoedukasi keluarga dan terapi suportif direkomendasikan sebagai terapi keperawatan pada ansietas.

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Someone who experience physical health problems can cause mental health problem, example anxiety. The purpose of study to illustrate the application of ners intervention, progressive muscle relaxation therapy, tought stopping therapy, family psychoeducation, supportive therapy in hypertension who experience anxiety. The method used is the case analisys in anxiety clients. The amount of clients are 34 people, 23 clients given ners intervention, progressive muscle relaxation therapy, tought stopping therapy, family psychoeducation, supportive therapy. 14 clients given ners intervention and supportive therapy. The results were found decrease the signs and symptoms anxiety and increase the ability of control anxiety most at clients who get five therapy. Progressive muscle relaxation therapy, tought stopping therapy, family psychoeducation, supportive therapy is recommended a nursing therapy in anxiety. "

"[ABSTRAKKlien hipertensi berisiko mengalami ansietas yang dapat mempengaruhi kualitas hidup klien. Penanganan fisik saja pada klien hipertensi tidaklah cukup, karena ansietas dengan hipertensi saling mempengaruhi. Tujuan karya ilmiah akhir ini untuk memberikan gambaran tentang penerapan terapi keperawatan jiwa individu (terapi generalis dan terapi PMR) dan terapi kelompok (terapi suportif dan SHG) pada klien ansietas dengan hipertensi menggunakan pendekatan keperawatan transkultural. Tindakan keperawatan jiwa individu dan kelompok diberikan kepada klien ansietas dengan hipertensi sebanyak 16 klien. Hasil penerapan tindakan keperawatan jiwa individu adalah menurunkan tanda dan gejala ansietas rata-rata sebanyak 5 orang dan membuat klien memiliki rata-rata 24 kemampuan sedangkan hasil penerapan tindakan keperawatan jiwa individu dan kelompok adalah menurunkan tanda dan gejala ansietas rata-rata sebanyak 3 orang dan membuat klien memiliki rata-rata 34 kemampuan. Penelitian ini merekomendasikan agar pihak puskesmas dapat melanjutkan tindakan keperawatan individu dan kelompok secara berkesinambungan.

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ABSTRACTClients hypertension at risk of anxiety that can affect the quality of life of clients. Physical handling of the client hypertension is not enough, because anxiety and hypertension affect each other. This final goal of scientific work to provide an overview of the application of the individual soul nursing therapy (therapy and therapy generalist PMR) and group therapy (supportive therapy and SHG) on the client anxiety and hypertension approach transcultural nursing. Nursing action of individual and group life given to the client anxiety and hypertension as many as 16 clients. The results of the implementation of nursing actions of the individual soul is to lower the signs and symptoms of anxiety an average of 5 people and makes the client has an average of 24 capabilities, while the results of the implementation of nursing actions of individual and group life is to lower the signs and symptoms of anxiety mean average as many as three people and making the client has an average of 34 capabilities. This study recommends that the clinic can continue nursing actions of individuals and groups on an ongoing basis., Clients hypertension at risk of anxiety that can affect the quality of life of clients. Physical handling of the client hypertension is not enough, because anxiety and hypertension affect each other. This final goal of scientific work to provide an overview of the application of the individual soul nursing therapy (therapy and therapy generalist PMR) and group therapy (supportive therapy and SHG) on the client anxiety and hypertension approach transcultural nursing. Nursing action of individual and group life given to the client anxiety and hypertension as many as 16 clients. The results of the implementation of nursing actions of the individual soul is to lower the signs and symptoms of anxiety an average of 5 people and makes the client has an average of 24 capabilities, while the results of the implementation of nursing actions of individual and group life is to lower the signs and symptoms of anxiety mean average as many as three people and making the client has an average of 34 capabilities. This study recommends that the clinic can continue nursing actions of individuals and groups on an ongoing basis.]"

"Klien dengan penyakit fisik cenderung mengalami ansietas dan kondisi tersebut dapat memperburuk kondisi fisiknya. Karya ilmiah akhir ini bertujuan untuk mengetahui hasil penerapan terapi penghentian pikiran, relaksasi otot progresif, terapi kognitif dan psikoedukasi keluarga terhadap respons ansietas klien. Responden sejumlah 71 klien ansietas dengan penyakit fisik, terdiri dari 36 klien mendapatkan paket pertama yaitu tindakan ners dan ners spesialis (terapi penghentian pikiran, relaksasi otot progresif dan psikoedukasi keluarga) serta 35 klien mendapatkan paket kedua yaitu tindakan ners dan ners spesialis (terapi kognitif dan psikoedukasi keluarga). Analisis dilakukan terhadap tanda dan gejala dan kemampuan klien dan keluarga sebelum dan sesudah dilakukan tindakan keperawatan. Hasil penerapan tindakan paket pertama dan paket kedua menunjukkan penurunan tanda gejala ansietas secara bermakna pada semua respons, kedua paket tidak ada perbedaan signifikan. Kedua paket tindakan ini direkomendasikan untuk mengatasi ansietas pada klien.

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Clients with physical illness tend to experience anxiety and the condition can worsen their physical condition. The aim of this study was to determine the result of the implementation of the thought stopping therapy, progressive muscle relaxation therapy, cognitive therapy and family psychoeducation for client with anxiety. A total of 71 anxiety clients with physical illness participated in this study, from which 36 clients received the first intervention: general nurses and nurse specialists intervention (thought stopping therapy, progressive muscle relaxation and family psychoeducation) and 35 clients received the second intervention: general nurses and nurse specialists intervention (cognitive therapy and family psychoeducation).

The analysis was conducted on the signs and symptoms of anxiety clients and the ability of clients and families before and after the nursing intervention. The results of the first and second of nursing intervention showed a decrease in signs and symptoms of anxiety on all the responses and the increased capacity of clients and families in overcoming anxiety. There was no significant difference from giving the first and second intervention in the reduction of the signs and symptoms of anxiety. This intervention, therefore, is recommended to overcome anxiety in clients."

"Pasien Diabetes Mellitus, akan menimbulkan masalah gangguan  fisik yaitu nyeri akut/kronis, dan gangguan psikologis (kecemasan,) bila tidak ditanganii dengan baik.Tujuan dari penelitian ini menerapkan terapi penghentian pikiran, relaksasi otot progresif, dan psikoedukasi keluarga pada kelompok kontrol dan intervensi. Penelitian ini mengunakan desain penelitian operasional research dengan jumlah sampel 38 individu dibagi menjadi 18 induvidu kelompok kontrol dan 22 kelompok intervensi. Hasil analisis Mann-whitney menunjukkan bahwa terdapat perbedaan antara kelompok kontrol yang diberikan TKN, edukasi keluarga, pendampingan, dan latihan mandiri dengan kelompok intervensi yang diberikan TKN, edukasi keluarga, pendampingan, dan latihan mandiri, terapi penghentian pikiran, terapi otot progresif dan psikoedukasi keluarga  secara bermakna (p value < 0,05). Penerapan TKN, edukasi keluarga, pendampingan, dan latihan mandiri, terapi penghentian pikiran, terapi otot progresif dan psikoedukasi keluarga direkomendasikan karena dapat menurunkan nyeri dan ansietas pada klien diabetes melitus, meningkatkan kemampuan pasien dan kemampuan keluarga dalam merawat nyeri dan ansietas dengan diabetes melitus.

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Diabetes Mellitus patients will cause physical problems, namely acute/chronic pain, and psychological disorders (anxiety) if not treated properly. The aim of this research is to apply thought stopping therapy, progressive muscle relaxation, and family psychoeducation in the control and intervention groups. This research used an operational research design with a sample size of 38 individuals divided into 18 control groups and 22 intervention groups. The results of the Mann-Whitney analysis showed that there were differences between the control group which was given TKN, family education, assistance and independent training and the intervention group which was given TKN, family education, assistance and independent training, thought stopping therapy, progressive muscle therapy and family psychoeducation significantly (p value < 0.05). The application of TKN, family education, mentoring and independent training, thought stopping therapy, progressive muscle therapy and family psychoeducation are recommended because they can reduce pain and anxiety in clients with diabetes mellitus, increase the patient's ability and the family's ability to treat pain and anxiety with diabetes mellitus."

"Klien gagal jantung yang mengalami nyeri dan ansietas, memerlukan upaya untuk mengatasnya supaya tidak memperberat kondisi sakit fisik klieni . Tujuan dari karya ilmiah akhir spesialis ini menerapkan tindakan keperawatan ners, edukasi keluarga, terapi penghentian  pikiran, dan psikoedukasi keluarga terhadap nyeri dan ansietas pada pada klien gagal jantung di rumah sakit umum. Penelitian ini menggunakan desain operational research dengan jumlah sampel 36 klien yang dibagi menjadi 17 klien  dalam kelompok kontrol dan 19  klien dalam  kelompok intervensi. Hasil analisis Mann-whitney menunjukkan bahwa terdapat perbedaan antara kelompok kontrol yang diberikan TKN, edukasi keluarga dan pendampingan serta latihan mandiri dengan kelompok intervensi yang diberikan TKN, edukasi keluarga, terapi penghentian pikiran dan psikoedukasi keluarga  secara bermakna (p value < 0,05). Penerapan  TKN, terapi penghentian pikiran dan psikoedukasi keluarga direkomendasikan karena dapat menurunkan  tanda gejala nyeri dan ansietas, meningkatkan kemampuan klien mengatasi nyeri dan ansietas dan kemampuan keluarga merawat klien gagal jantung.

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Heart failure clients who experience pain and anxiety require efforts to overcome this so as not to aggravate the client's physical illness. The aim of this specialist's final scientific work is to apply health protection measures, family education, thought prevention therapy, and family psychoeducation to pain and anxiety in heart failure clients in public hospitals. . This research used an operational research design with a sample size of 36 clients divided into 17 clients in the control group and 19 clients in the intervention group. The results of the Mann-Whitney analysis showed that there was a significant difference between the control group that was given TKN, family education and mentoring and independent training and the intervention group that was given TKN, family education, thought empowerment therapy and family psychoeducation (p value < 0.05). The application of TKN, thought strengthening therapy and family psychoeducation is recommended because it can reduce signs of pain and anxiety, increase the client's ability to deal with pain and anxiety and the family's ability to care for clients with heart failure. "

"Prevalensi hipertensi di Dunia maupun Indonesia semakin tinggi. Semakin banyak jumlah penyakit kronis yang dimiliki seseorang, maka risiko mengalami gangguan mental emosional semakin tinggi. Klien yang menderita satu penyakit kronis beresiko 2,6 kali lebih besar untuk mengalami gangguan mental emosional. Hipertensi tidak hanya berdampak pada fisik melainkan juga memunculkan dampak psikologis pada klien, dan dampak psikologis yang paling banyak terjadi adalah ansietas. Tujuan penelitian ini adalah untuk mengetahui pengaruh terapi penghentian pikiran (TS), Acceptance and Commitment Therapy (ACT) dan psikoedukasi keluarga (FPE) terhadap ansietas dan kepatuhan pengobatan. Desain penelitian menggunakan operational research. Tiga puluh tujuh klien hipertensi yang mengalami ansietas diberikan tindakan keperawatan Ners dan terapi penghentian pikiran, Acceptance and Commitment Therapy (ACT) dan psikoedukasi keluarga. Instrumen yang digunakan adalah instrumen tanda gejala ansietas FIK UI, Self Reporting Questionaire (SRQ), Hamilton Anxiety Rating Scale, dan Morisky Medication Adherence Scale-8. Semua instrumen telah terbukti valid dan reliabel. Hasil menunjukkan terdapat penurunan rata-rata tekanan darah dan ansietas yang signifikan setelah diberikan kombinasi tindakan keperawatan ners, terapi penghentian pikiran, Acceptance and Commitment Therapy dan psikoedukasi keluarga (p value <0,05) sementara kepatuhan pengobatan dan kemampuan klien serta keluarga mengalami peningkatan yang signifikan (p value <0,05) baik setelah mendapat kombinasi TKN+FPE atau TKN+FPE+TS maupun TKN+FPE+TS+ACT. Tindakan keperawatan Ners dan terapi penghentian pikiran, Acceptance and Commitment Therapy (ACT) dan psikoedukasi keluarga direkomendasikan sebagai terapi yang dapat menurunkan ansietas dan meningkatkan kepatuhan pengobatan pada klien hipertensi.

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The prevalence of hypertension in the World and Indonesia is getting higher. The more the number of chronic diseases a person has, the higher the risk of experiencing emotional mental disorders. Clients who suffer from a chronic illness are 2.6 times more at risk of experiencing mental emotional disorders. Hypertension not only affects the physical but also raises a psychological impact on the client, and the most psychological impact occurs is anxiety. The purpose of this study was to determine the effect of thought stopping therapy (TS), Acceptance and Commitment Therapy (ACT) and family psychoeducation (FPE) on anxiety and medication adherence. The research design uses operational research. Thirty-seven hypertensive clients with anxiety were given nursing care and thought stopping therapy, Acceptance and Commitment Therapy (ACT) and family psychoeducation. The instruments used were FIK UI anxiety symptoms, Self Reporting Questionaire (SRQ), Hamilton Anxiety Rating Scale, and Morisky Medication Adherence Scale-8. All instruments have been proven valid and reliable. The results showed that there was a significant decrease in average blood pressure and anxiety after a combination of nurses' nursing care, thought stopping therapy, Acceptance and Commitment Therapy and family psychoeducation (p value <0.05) while treatment adherence and the ability of clients and families increased significantly significant (p value <0.05) both after receiving a combination of TKN + FPE or TKN + FPE + TS or TKN + FPE + TS + ACT. Nursing actions and thought stopping therapy, Acceptance and Commitment Therapy (ACT) and family psychoeducation are recommended as therapies that can reduce anxiety and improve medication adherence to hypertensive clients."