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"Kanker merupakan penyakit kronis yang banyak terjadi akibat adanya perubahan pola hidup tidak sehat pada masyarakat perkotaan. Keluhan yang muncul pada penderita kanker khususnya pada anak adalah nyeri. Masalah nyeri dapat diselesaikan dengan manajemen nyeri nonfarmakologi seperti intervensi distraksi visual. Distraksi visual merupakan pengalihan nyeri yang dilakukan dengan melihat sesuatu yang indah, membaca, dan menonton video kesukaan. Penulisan karya ilmiah ini bertujuan untuk menganalisis asuhan keperawatan anak dengan nyeri kanker, dan menganalisisi penerapan intervensi dstraksi visual pada anak dengan nyeri kanker. Hasil karya ilmiah ini menunjukkan distraksi visual efektif dalam menurunkan skala nyeri anak dari skala 6-5 nyeri sedang menjadi skala 0-3 nyeri ringan . Karya ilmiah ini diharapkan dapat menjadi studi kasus manajemen nyeri kanker pada anak yang kemudian dapat dikembangkan menjadi penelitian dan landasan manajemen nyeri kanker pada anak.

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Cancer is a chronic disease usually caused by unhealthy lifestyle changes in urban society. Cancer patients especially children are often experience pain as the perceived reactions of the disease. Pain problem can be managed by pain management such as visual distraction intervention. Visual distraction works by shifting pain with seeing something beautiful, reading, or watching favourite videos. The purpose of paper is to analyse nursing care and pain management through visual distraction of a child with cancer pain. The result from this study shows visual distraction intervention effectively reduced the pain experiencing by cancer child from scale 6-5 medium pain to scale 0-3 mild pain . This paper can be developed in the future as a research activity and the foundation of cancer pain management."

"Pertumbuhan penduduk di daerah perkotaan menyebabkan munculnya masalah kesehatan bagi penduduk tersebut, salah satunya ialah kelainan kongenital pada bayi baru lahir, yakni hipospadia. Penanganan yang dilakukan ialah dengan cara pembedahan. Rasa nyeri merupakan salah satu efek dari pembedahan pada klien anak dengan hipospadia. Nyeri akut diangkat sebagai masalah keperawatan utama karena merupakan masalah aktual yang harus segera ditangani. Pengkajian keperawatan yang dilakukan pada seorang klien di ruang bedah anak memberikan hasil bahwa nyeri akut merupakan keluhan utama. Asuhan keperawatan yang bertujuan untuk mengurangi rasa nyeri telah dilakukan pada klien dengan teknik distraksi melalui terapi audiovisual. Selama enam hari perawatan klien mengalami penurunan skala nyeri yang diukur dengan Wong-Baker Face Pain Scale yaitu dari skor 3 menjadi 1. Hasil karya ilmiah ini diharapkan dapat menjadi pertimbangan bagi perawat ruangan untuk meningkatkan manajemen nyeri nonfarmakologi dengan teknik distraksi melalui terapi audiovisual.

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Population growth in urban areas caused health problems for the population. One of which is congenital abnormalities in newborns, that is hypospadias. Hypospadias correction is one of the common surgical procedures performed by pediatric urologists. Pain is one of the effect of surgery on a child with hypospadias. Acute pain as a major nursing diagnoses because it is an actual problem that should be completed. Based on the assessment of nursing that has done on patient results that it is a major problem. Nursing care aimed to reduce pain has done to patient with audiovisual distraction technique. During six days of treatments patient showing in decreased of pain scale measured by Wong Baker Face Pain Scale from the score 3 to 1. The result can be considered as an intervention of non pharmalogical management of pain with distraction technique through audiovisual therapy."

"Pembangunan pesat yang terjadi di daerah perkotaan membawa berbagai dampak, termasuk dampak terhadap kesehatan. Salah satu dampak terhadap kesehatan adalah meningkatnya jumlah pasien bedah yang membutuhkan operasi. Tahun 2016, 11 dari seluruh penyakit di dunia dapat diselesaikan dengan prosedur pembedahan dan 84 diantaranya adalah kasus pembedahan pada anak. Indonesia, khsususnya di RSUPN Dr. Cipto Mangunkusumo selaku salah satu pusat rujukan bedah anak nasional, lebih dari setengah pasien anak yang dirawat sepanjang tahun 2016 merupakan pasien bedah pencernaan. Tindakan pembedahan biasanya akan disertai keluhan nyeri pasca operasi.Penelitian ini dilakukan untuk menganalisis manajemen nyeri non-farmakologis pada anak pasca pembedahan digestif. Metode yang digunakan adalah laporan kasus asuhan keperawatan yang dilakukan pada dua orang anak yang berbeda dengan intervensi utama teknik distraksi audio visual menggunakan kacamata virtual reality VR dan tanpa menggunakan kacamata VR. Hasil evaluasi selama 4 hari dilakukan manajemen nyeri non-farmakologis menunjukkan bahwa teknik distraksi audio visual menggunakan kacamata VR lebih efektif dibandingkan tanpa menggunakan kacamata VR.

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Urban developmental have so many effects, including the health. One of the effects is increasing number of surgical patients. In 2016, 11 of all diseases in the world can be solved by surgical procedures and 84 of them are surgical cases in children. Indonesia, especially in Dr. Cipto Mangunkusumo as one of the nation 39;s largest childcare referral centers, more than half of the pediatric patients treated during 2016 are gastrointestinal patients. Surgery usually will be accompanied by postoperative pain management.

This study was conducted to analyze the management of non-pharmacological pain in children after digestive surgery. The method used is case report based on nursing care were gived to two different children with a major intervention of audio visual distraction techniques using virtual reality VR glasses and without the use of VR glasses. The evaluation after 4 day intervention with non-pharmacologic pain management showed that audio visual distraction technique using VR glasses was more effective than without using VR glasses."

"[ABSTRAKNyeri pembedahan menimbulkan cemas, takut dan perubahan perilaku maladaptif anak. Perlu asuhan keperawatan berkualitas dalam mengatasi nyeri anak. Karya ilmiah akhir bertujuan menggambarkan aplikasi comfort theory Kolcaba dalam memberikan asuhan keperawatan pasien pasca bedah yang mengalami nyeri. Intervensi ditentukan berdasarkan comfort theory yaitu mengukur skala nyeri, memberikan posisi nyaman, memberikan madu, mengajarkan keluarga manajemen nyeri serta memberikan reinforcement positif keterlibatan keluarga dalam perawatan. Evaluasi hasil menunjukkan aplikasi comfort theory dalam keperawatan perlu ditunjang faktor-faktor lain seperti kondisi pasien, lingkungan dan tim pelayanan kesehatan dalam mencegah dan mengatasi nyeri. Rekomendasi karya ilmiah ini adalah teori keperawatan sebaiknya diaplikasikan dalam asuhan keperawatan.

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ABSTRACTSurgical pain causes anxiety, fear and change in children's behaviours. A good quality of nursing care is needed to overcome children's pain. This scientific paper aimed to illustrate the application of comfort theory Kolcaba in providing nursing care to patients suffered post-surgical pain. Intervention was determined based on comfort theory which included: measure pain scale, provide a comfortable position, offer honey, teach families management of pain, and give positive reinforcement on family involvement during the care. Result's evaluation indicated thet comfort application in nursing theory need to be supported by other factors such as the condition of the patient, the environment and health care team to prevent and overcome pain. This scientific paper recommends the application of nursing theory in providing nursing care., Surgical pain causes anxiety, fear and change in children's behaviours. A good quality of nursing care is needed to overcome children's pain. This scientific paper aimed to illustrate the application of comfort theory Kolcaba in providing nursing care to patients suffered post-surgical pain. Intervention was determined based on comfort theory which included: measure pain scale, provide a comfortable position, offer honey, teach families management of pain, and give positive reinforcement on family involvement during the care. Result's evaluation indicated thet comfort application in nursing theory need to be supported by other factors such as the condition of the patient, the environment and health care team to prevent and overcome pain. This scientific paper recommends the application of nursing theory in providing nursing care.]"

"Praktik spesialis Keperawatan Anak peminatan non infeksi ini bertujuan untuk melakukan praktik dengan mengaplikasikan peran perawat melalui pendekatan Model Adaptasi Roy. Peran sebagai pemberi asuhan keperawatan diterapkan pada 5 orang pasien anak kanker yang mengalami masalah nyeri, dan satu orang pasien kelolaan utama yaitu pasien limfoma non hodgkin yang mengalami infiltrasi ke dalam sistem saraf pusat. Peran sebagai peneliti dalam melakukan penerapan tindakan keperawatan yang berbasis pembuktian ilmiah (evidence based nursing practice) yaitu dengan membuktikan terapi musik sebagai salah satu teknik penanganan nyeri pada anak dengan kanker. Peran sebagai inovator melalui penyusunan program pemberian terapi musik pada anak dengan kanker yang bertujuan untuk mengurangi nyeri dan meningkatkan kenyamanan pasien anak kanker, dan meningkatkan kualitas asuhan keperawatan. Hasil praktik ini menunjukkan bahwa Model Adaptasi Roy efektif digunakan pada pasien anak kanker yang mengalami masalah nyeri, dan terapi musik efektif untuk mengurangi nyeri yang dialami anak kanker, terutama pada nyeri ringan sedang.

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Pediatric Nursing Practice specialist in non-infection aims to practice by applying the role of nurses through the Roy Adaptation Model approach. Role as nursing care was applied to 5 patients of cancer pain, and a patient with non-Hodgkin's lymphoma with infiltration into the central nervous system is the main case. Role as researcher was caried out by applying evidence based nursing practice to prove that music therapy as a pain management technique in children with cancer. Role as an innovator through the preparation of a program of music therapy in children with cancer that aims to reduce pain and increase of comfort on children with cancer pain, and improving the quality of nursing care . This practice results indicate that the Roy Adaptation Model effective use in pediatric patients with cancer pain, and music therapy effective for reducing cancer pain on children with cancer, especially in mild or moderate pain."

"[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.]"

"Nyeri merupakan salah satu dampak yang dirasakan pasien anak saat hospitalisasi. Tiup kincir sebagai media terapi teknik relaksasi napas dalam dan distraksi untuk menurunkan skala nyeri. Penulisan ini bertujuan untuk menggambarkan asuhan keperawatan dengan penggunaan terapi bermain tiup kincir sebagai salah satu intervensi menurunkan skala nyeri pada anak usia pra sekolah saat hospitalisasi. Hasil intervensi menunjukkan bahwa tiup kincir dapat menurunkan skala nyeri yang dirasakan oleh anak dari skala 10 menjadi 5 menggunakan Wong Baker FACES Pain Scale. Analisis ini merekomendasikan dilakukannya asuhan keperawatan psikososial yang terintegrasi dengan asuhan keperawatan fisik pada anak yang mengalami nyeri saat hospitalisasi.

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Pain is one of the effects felt by child patients during hospitalization. Blow the windmill as a therapeutic tool for deep breathing and distraction techniques to reduce the scale of pain. This writing aims to describe nursing care with the use of windmill inflatable play therapy as one of the interventions to reduce the scale of pain in pre-school age children during hospitalization. Intervention results showed that windmills could reduce the scale of pain felt by children from a scale of 10 to 5 using Wong Baker FACES Pain Scale. This analysis recommends doing psychosocial nursing care that is integrated with physical nursing care in children who experience pain during hospitalization."

"Gizi buruk merupakan salah satu masalah perkotaan yang sering terjadi pada anak. Anak dengan gizi buruk yang dirawat di rumah sakit beresiko mengalami masalah tidur yang mengakibatkan terhambatnya penyembuhan fisik anak. Karya tulis ini bertujuan untuk memberikan gambaran asuhan keperawatan pada anak dengan masalah gizi buruk yang mengalami gangguan tidur. Masalah keperawatan yang ditegakkan meliputi ketidakefektifan bersihan jalan napas, penurunan curah jantung, ketidakseimbangan nutrisi: kurang dari kebutuhan tubuh dan gangguan pola tidur. Asuhan keperawatan yang diberikan yaitu terapi musik lullabies dengan durasi 60 menit dan dilakukan dua kali dalam sehari, yaitu saat tidur siang dan malam hari. Intervensi musik ini dapat menjadi pertimbangan bagi institusi pelayanan kesehatan untuk mengatasi masalah tidur pada anak.

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Undernutrition is one of the most common urban problems in children. Undernutrition children are vulnerable to experience sleep problem during their hospitalization period lead to delayed healing process. This paper aims to describe the implementation of nursing intervention in children with malnutrition that experience sleep disorders. Nursing problems that emerged were ineffective airway clearance, decreased cardiac output, imbalanced nutritional: less than body and sleep patterns disorder. The nursing intervention conducted was lullabies music therapy with duration of 60 minutes and twice a day; day and night. This paper is expected to be considered for health care institutions to implement music therapy in overcoming sleep disorders in children."

"Praktek Spesialis Keperawatan Anak peminatan bedah anak ini bertujuan untuk melakukan praktek dengan mengaplikasikan model Teori Comfort Katherina Kolcaba. Peran sebagai pemberi asuhan keperawatan diterapkan pada 5 orang anak yang telah menjalani operasi yang mengalami rasa nyeri, dan satu orang pasien kelolaan utama yaitu pasien post operasi penutupan colostomi. Peran sebagai peneliti dalam melakukan penerapan tindakan keperawatan yang berbasis pembuktian ilmiah (evidence based nursing practise) yaitu dengan membuktikan terapi musik sebagai salah satu tehnik penanganan nyeri pada anak post operasi dan tindakan invasif. Peran sebagai inovator melalui penyusunan program pemberian terapi musik pada anak yang mengalami nyeri yang bertujuan untuk mengurangi nyeri dan meningkatkan kenyamanan pasien anak dan meningkatkan kualitas asuhan keperawatan. Hasil praktek ini menunjukan bahwa teori Comfort Katherina Kolcaba digunakan pada pasien yang mengalami rasa nyeri post operasi dan tindakan invasif, dan terapi musik efektif untuk mengurangi rasa nyeri yang dialami anak pada waktu tindakan, terutama nyeri ringan.

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Specialist Nursing Practice Children's specialization in pediatric surgery practice with the aim to apply the theory of Comfort models Katherina Kolcaba. Role as provider of nursing care applied to the 5 children who have undergone surgery are experiencing pain, and one patient that the patient's primary management of postoperative closure colostomi. Role as a researcher in performing nursing actions based on the application of scientific evidence (evidence based nursing practice model) to prove that music therapy as a pain management technique in children and postoperative invasive action.

Role as an innovator through the preparation of a program of music therapy on children who experience pain which aims to reduce pain and increase patient comfort and improve the child's quality of nursing care. This practice results show that the theory Comfort Katherina Kolcaba used in patients experiencing postoperative pain and invasive, and effective music therapy to reduce the pain experienced by the child at the time of the action, especially mild pain."

"Hipospadia merupakan kelainan kongenital dimana muara uretra anak tidak berada di ujung penis. Hipospadia dapat dikoreksi dengan operasi. Perawatan paska bedah hipospadia menimbulkan nyeri pada anak. Salah satu intervensi untuk mengurangi nyeri menggunakan tehnik distraksi dengan bermain dan bercerita. Teknik distraksi bermain dan bercerita merupakan salah satu penalaksanaan nyeri non farmakologis. Tindakan perawatan luka pasca operasi pada An. M menimbulkan nyeri pada anak sehingga perlu dilakukan penanganan untuk mengurangi nyeri yang dirasakan. Hasil dari penerapan tehnik distraksi bermain dan bercerita ini selama 3 hari terbukti efektif menurunkan skala nyeri dari 6 menjadi 3 dengan menggunakan skala FLACC.

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Hypospadias is a congenital defect in which the child s urethral opening is not located at the tip of the penis. Hypospadias can be repaired by surgery. Post operative treatment of hypospadias causes pain in children. One of the interventions in reducing pain is by using distraction technique through playing games and telling stories. Distraction technique of playing and story telling is one of non pharmacological pain management. Postoperative wound care on An M causes pain therefore a nursing care is necessary needed to reduce the pain. Results showed that 3 days application of playing and storytelling was effective to reduce the pain scale from 6 to 3 measured by using FLACC scale."