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"ABSTRAKPemberian posisi yang salah dapat meningkatkan risiko morbiditas dan mortalitas. Artikel ini bertujuan untuk menggali pemberian posisi (positioning) dan nesting pada bayi prematur di NICU. Penelitian ini berupa studi literatur tahun 2007-2017, serta pengalaman penulis dalam aplikasi pemberian posisi dan nest di dua rumah sakit rujukan nasional dalam lima tahun terakhir. Hasil studi ini menunjukkan beberapa posisi yang dapat diberikan pada bayi prematur di antaranya adalah posisi supinasi, lateral kiri, lateral kanan, pronasi, dan quarter/semi pronasi. Posisi pronasi dan kuarter/semi pronasi direkomendasikan untuk bayi prematur dengan Respiratory Distress Syndrome (RDS). Posisi lateral kanan direkomendasikan untuk bayi prematur dengan Gastroesofageal reflux (GER). Posisi supinasi merupakan alternatif terakhir pemberian posisi pada bayi prematur dengan kontraindikasi posisi pronasi, kuarter/semi pronasi, dan lateral. Pembuatan nest dapat dimodifikasi dari potongan beberapa kain yang digulung. Perawat hendaknya meningkatkan pengetahuan dan keterampilan agar mampu memberikan variasi posisi sesuai kondisi dan indikasi bayi yang dirawat di NICU."

"[ABSTRAKBayi prematur dapat mengalami hambatan kenaikan berat badan yang disebabkan oleh usia gestasi, penyakit penyerta, dan pengalaman nyeri atau stres. Hambatan kenaikan berat badan dapat diatasi dengan asuhan keperawatan yang tepat dalam pemenuhan kebutuhan nutrisi pada bayi prematur. Asuhan keperawatan dengan Model Konservasi Levine telah digunakan pada aplikasi praktik residensi di Ruang Neonatus Rumah Sakit Cipto Mangunkusumo dalam menganalisis kenaikan berat badan bayi prematur pada lima kasus terpilih mulai dari Bulan Maret-Mei tahun 2015. Analisis kasus didapatkan dari tahap pengkajian, tropikognosis, hipotesis, intervensi, dan evaluasi. Tropikognosis yang telah teridentifikasi yaitu risiko gangguan pemenuhan kebutuhan nutrisi. Intervensi telah dilakukan berdasarkan prinsip konservasi dan hasil evaluasinya yaitu bayi prematur mengalami kenaikan berat badan dengan konservasi energi. Kenaikan berat badan pada bayi prematur menunjukkan keberhasilan dari penerapan asuhan keperawatan berbasis Model Konservasi Levine.

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ABSTRACTThe preterm infant can has an obstacle of increasing weight which is caused by gestational age, health problems which followed and pain/ stress experience. The obstacle of increasing weight can be handled with giving nursing care in proper nutrition needs. Nursing care with Levine?s Conservation Model has been applied in residence practice application in neonates wards Cipto Mangunkusumo hospital to analyze increasing weight of preterm infant in five selected cases start from March until May 2015. Case analyze is founded from assessment, trophicognosis, hypothesis, intervention, and evaluation. Trophicognosis which identified was disturbance risk in fullfil nutrition needs. Intervention were done based on conservation principle and the result of evaluation that preterm infant has increasing weight with energy conservation. Increasing weight in preterm infant showed a successful application of nursing care based on Levine?s Conservation Model. ;The preterm infant can has an obstacle of increasing weight which is caused by gestational age, health problems which followed and pain/ stress experience. The obstacle of increasing weight can be handled with giving nursing care in proper nutrition needs. Nursing care with Levine?s Conservation Model has been applied in residence practice application in neonates wards Cipto Mangunkusumo hospital to analyze increasing weight of preterm infant in five selected cases start from March until May 2015. Case analyze is founded from assessment, trophicognosis, hypothesis, intervention, and evaluation. Trophicognosis which identified was disturbance risk in fullfil nutrition needs. Intervention were done based on conservation principle and the result of evaluation that preterm infant has increasing weight with energy conservation. Increasing weight in preterm infant showed a successful application of nursing care based on Levine?s Conservation Model. , The preterm infant can has an obstacle of increasing weight which is caused by gestational age, health problems which followed and pain/ stress experience. The obstacle of increasing weight can be handled with giving nursing care in proper nutrition needs. Nursing care with Levine’s Conservation Model has been applied in residence practice application in neonates wards Cipto Mangunkusumo hospital to analyze increasing weight of preterm infant in five selected cases start from March until May 2015. Case analyze is founded from assessment, trophicognosis, hypothesis, intervention, and evaluation. Trophicognosis which identified was disturbance risk in fullfil nutrition needs. Intervention were done based on conservation principle and the result of evaluation that preterm infant has increasing weight with energy conservation. Increasing weight in preterm infant showed a successful application of nursing care based on Levine’s Conservation Model. ]"

"Kelahiran bayi prematur dan perawatan di ruang rawat intensif neonatus merupakan peristiwa yang menyebabkan sumber stres pada orang tua khususnya ibu. Penelitian ini bertujuan untuk mendapatkan pemahaman yang mendalam mengenai pengalaman ibu selama perawatan masa awal kehidupan bayi prematur di ruang rawat intensif neonatus RSUP Dr. Soeradji Tirtonegoro Klaten. Desain penelitian kualitatif dengan pendekatan fenomenologi ini pada delapan partisipan. Analisis data menggunakan metode Colaizzi dan menghasilkan tujuh tema penelitian, yaitu: reaksi ibu, proses berduka, dampak perawatan bayi prematur, koping diri ibu, upaya ibu untuk meningkatkan hubungan kelekatan (bonding attachment), dukungan terhadap ibu, dan harapan selama perawatan bayi prematur.

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The birth and treatment of premature infants in the neonatal intensive care unit is the event that makes it the source of stress to parents especially the mother. This study aims to gain a deeper understanding of the experience of mother during the early life of premature infants in the neonatal intensive care unit of Dr. Soeradji Tirtonegoro Central Hospital, Klaten. This qualitative research design with phenomenology approach took eight participants. The data analysis uses Colaizzi method and produced seven research themes, namely: the mothers reaction, the grieving process, the impact of premature infant care, mother's self 'coping efforts, the mothers' attempts to improve the close and attached relationship (bonding attachment), the support for the mother, and expectations for the care of premature infants."

"Pelibatan ibu dalam perawatan bayi prematur merupakan salah satu komponen konsep family centered care. Penelitian ini bertujuan untuk mengidentifikasi pengaruh pelibatan ibu terhadap interaksi ibu-bayi dan kepercayaan diri ibu dalam merawat bayi prematur. Desain penelitian yang digunakan adalah kuasi eksperimen one-group pretest-posttest design. Penelitian ini melibatkan 16 orang ibu-bayi yang dipilih dengan teknik konsekutif di ruang Perinatologi RSUP Fatmawati Jakarta selama bulan Mei-Juni 2013. Hasil analisis statistik menunjukkan bahwa skala interaksi ibu-bayi dan kepercayaan diri ibu meningkat secara signifikan (p=0,0005). Hasil penelitian ini merekomendasikan upaya peningkatan pelibatan ibu dalam perawatan bayi prematur di ruang Perinatologi.

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Mothers involvement in premature infant care is a component of the family centered care. The purpose of this study was to identify the impact of mothers involvement on mother-infant interactions and maternal confidence in premature infant care. This study used a quasy experimental with one-group pretest-posttest design. Sixteen partisipants were choosed using consecutive sampling technique in Neonatal Unit Level I-II RSUP Fatmawati Jakarta during May-June 2013. The result of statistic analysis showed that mother-infant interactions scale and maternal confidence increase significantly (p=0,0005). This study recommends the improvement of mothers involvement in premature infant care in neonatal unit."

"Tujuan Millennium Development Goals keempat adalah menurunkan angka kematian bayi baru lahir. Ibu yang tidak percaya diri menghambat pertumbuhan dan perkembangan bayi tersebut. Penelitian fenomenologi pada Sembilan partisipan ini bertujuan memperoleh gambaran tentang pengalaman ibu merawat bayi prematur di rumah. Pengumpulan data menggunakan indepth interview. Hasil analisa tematik didapatkan tujuh tema yaitu kondisi stres ibu terhadap penampilan bayi, kekhususan merawat bayi, dukungan terhadap ibu, kesulitan yang dialami ketika merawat bayi, kebahagiaan merawat bayi, kebutuhan ibu merawat bayi, dan harapan ibu dengan bayi prematur. Disarankan ibu mendapat dukungan sosial selama merawat bayi prematur dirumah dan penelitian lebih lanjut terkait dengan stres dan koping pada ibu dengan bayi prematur.

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The fourth goal of Millennium Development Goals is to reduce mortality of newborns. Mothers who do not feel confident in caring the babies will hamper the growth and development of the babies. This study is phenomenological on the nine participants. This study aims to gain an overview of the experience of mothers in caring premature babies at home. Data were collected using indepth interviews. The results of thematic analysis got seven themes, namely the mother's stress on the appearance of the baby, specificity for babies care, support to mothers, the difficulties experienced when caring for babies, the joy of caring for babies, premature baby care needs, and expectations of mothers to the premature baby. Recommended for mothers to have social support in caring for a premature baby at home. The further researches related to stress and coping in mothers with premature babies are needed."

"Kelahiran bayi prematur dan perawatan di ruang rawat intensif neonatusmerupakan peristiwa yang menyebabkan sumber stres pada orang tua khususnyaibu. Penelitian ini bertujuan untuk mendapatkan pemahaman yang mendalammengenai pengalaman ibu selama perawatan masa awal kehidupan bayi prematurdi ruang rawat intensif neonatus RSUP Dr. Soeradji Tirtonegoro Klaten. Desain penelitian kualitatif dengan pendekatan fenomenologi ini pada delapan partisipan. Analisis data menggunakan metode Colaizzi dan menghasilkan tujuh tema penelitian, yaitu: reaksi ibu, proses berduka, dampak perawatan bayi prematur, koping diri ibu, upaya ibu untuk meningkatkan hubungan kelekatan (bonding attachment), dukungan terhadap ibu, dan harapan selama perawatan bayi prematur.

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The birth and treatment of premature infants in the neonatal intensive care unit is the event that makes it the source of stress to parents especially the mother. This study aims to gain a deeper understanding of the experience of mother during the early life of premature infants in the neonatal intensive care unit of Dr. Soeradji

Tirtonegoro Central Hospital, Klaten. This qualitative research design with phenomenology approach took eight participants. The data analysis uses Colaizzi method and produced seven research themes, namely: the mothers? reaction, the grieving process, the impact of premature infant care, mother?s self ?coping efforts, the mothers? attempts to improve the close and attached relationship (bonding attachment), the support for the mother, and expectations for the care of premature infants.

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"Penelitian ini dilakukan untuk mengetahui pengaruh perawatan metode kanguru (PMK) terhadap fungsi fisiologis pada bayi prematur yang terpasang ventilasi mekanik. Penelitian ini menggunakan desain randomized control trial (RCT) yang melibatkan 50 responden bayi prematur yang terpasang ventilasi mekanik dan dibagi menjadi dua kelompok, yaitu kelompok kontrol (perawatan rutin rumah sakit) 25 responden dan kelompok intervensi (bayi dilakukan PMK) 25 responden sesuai kriteria inklusi. PMK dilakukan tiga hari berturut-turut selama satu jam/hari. Hasil analisis uji perbedaan menujukkan adanya perbedaan saturasi oksigen secara bermakna pada saat dilakukan PMK (p=0.000; α=0,05) dan frekuensi pernapasan intra (p= 0,007), dan post (p= 0,027) pada kelompok kontrol dan kelompok intervensi. Berdasarkan hasil tersebut, adanya pengaruh perawatan metode kanguru terhadap fungsi fisiologis pada bayi prematur yang terpasang ventilasi mekanik. Intervensi ini diharapkan dapat dilanjutkan sebagai prosedur di ruang NICU karena sudah terbukti dapat mempercepat weaning ventilator.

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his study was conducted to determine the effect of the kangaroo method of care (PMK) on the physiological function of mechanically ventilated premature infants. This study used a randomized control trial (RCT) design involving 50 premature infants who were mechanically ventilated and divided into two groups, namely the control group (routine hospital care) 25 respondents and the intervention group (babies undergoing PMK) 25 respondents according to the inclusion criteria. . PMK is carried out three days in a row for one hour/day. The results of the analysis of the difference test showed that there was a significant difference in oxygen saturation during PMK (p=0.000; α=0.05) and intra-respiratory frequency (p= 0.007), and post (p= 0.027) in the control group and the intervention group. Based on these results, there is an effect of kangaroo treatment on physiological function in mechanically ventilated premature infants. It is hoped that this intervention can be continued as a procedure in the NICU room because it has been proven to speed up ventilator weaning"

"Karya ilmiah akhir ini memberikan gambaran penerapan Model Konservasi Levine pada asuhan keperawatan pada bayi dengan risiko kerusakan integritas kulit dan pencapaian kompetensi sebagai spesialis keperawatan anak. Trophicognosis risiko kerusakan integritas kulit menurut Levine merupakan gangguan pada integritas struktur. Intervensi keperawatan dilakukan untuk mengatasi masalah integritas struktur tersebut dengan memperhatikan pula konservasi energi, konservasi integritas personal dan konservasi integritas sosial. Intervensi dilakukan dengan menerapkan aspek perawatan kulit dan cara memposisikan yang benar. Evaluasi yang dilakukan dengan mengkaji respon organismik bayi, menunjukkan bahwa belum semua bayi mampu mencapai wholeness yang ditandai dengan cedera pada nares, namun sudah mengalami perbaikan. Perawat memegang peranan yang sangat penting dalam pencegahan cedera pada nares yaitu pemilihan alat yang tepat, pemantauan dan pemenuhan kenyamanan bayi sehingga bayi tidak banyak bergerak dan mempercepat proses penyapihan continuous positive airway pressure (CPAP).

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This Final Assignment gave an overview about the application of Levine's Conservation Model in nursing care of baby with risk of skin integrity breakdown and competency achievement as a pediatric nurse specialist. According to Levine, trophicognosis of skin integrity breakdown was the structure integrity impaiment. Nursing interventions was undertaken to solve structure integrity problem, and also energy conservation, personal conservation and social conservation. Nursing interventions applied the skin care aspetcs and positioning. Evaluation had been done by evaluate the organismic responses of the baby, showed that not all the baby got wholenes, was marked by nares injury, but getting better. Nurse had the crucial role to prevent nares injury, that to choise the appropriate tool, monitored ang gave baby’s comfort so the baby did not much to move and weaned the continuous positive airway pressure (CPAP) as soon as possible."

"Prematuritas merupakan penyebab kematian ke-2 pada bayi 0 - 6 hari, yang diakibatkan karena immaturitasnya hampir seluruh organ tubuh bayi. Penelitian ini bertujuan untuk mengetahui efektivitas penggunaan nesting dan posisi prone pada bayi prematur terhadap saturasi oksigen dan frekuensi nadi. Desain yang digunakan adalah quasi experiment, dengan rancangan pre and post with control test. Jumlah responden sebanyak 15 bayi. Terdapat perbedaan bermakna saturasi oksigen antara bayi yang menggunakan nesting dan posisi prone (p value<0,05), namun tidak ada perbedaan bermakna antara penggunaan nesting dan posisi prone terhadap frekuensi nadi. Penggunaan nesting dan posisi prone dapat digunakan sebagai salah satu bentuk intervensi keperawatan.

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Prematury is the second etiology of mortality for 0 until 6th day of first life of newborn that caused by immaturity of their organs.The aim of this research is to explore efectiveness of using nesting and prone positon with oxygen saturation and heart rate in preterm baby. The design used quasi experiment, with pre and post with control test model. The amount of sample are 15. There is a significant difference between SaO2 using nesting dan prone position, in adversely there is no significant difference between heart rate. Using nesting and prone position can be a model of nursing intervention that implication of this research."

"Pelibatan ibu dalam perawatan bayi prematur merupakan salah satu komponen konsep family centered care. Penelitian ini bertujuan untuk menguji pengaruh pelibatan ibu terhadap interaksi ibu dan bayi dan kepercayaan diri ibu dalam merawat bayi prematur. Desain penelitian yang digunakan adalah kuasi eksperimen one-group pretest-posttest. Penelitian ini melibatkan 16 orang ibu dan bayinya yang dipilih dengan teknik konsekutif di ruang Perinatologi di sebuah RSUP di Jakarta, selama sebulan. Instrumen yang digunakan untuk menilai interaksi ibu-bayi adalah terjemahan Modified Observation of Communication Interaction dan kepercayaan diri ibu diukur menggunakan Maternal Confidence Questionaire yang juga diterjemahkan. Hasil analisis statistik menunjukkan bahwa skala interaksi ibu-bayi dan kepercayaan diri ibu meningkat secara signifikan (p= 0,0005). Hasil penelitian ini merekomendasikan upaya peningkatan pelibatan ibu dalam perawatan bayi prematur di ruang Perinatologi.

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Enhancement of Mother-Infant Interaction and Maternal Confidence: The Impact of Mother Involvement in Infant Care in the Neonatology Unit. Mothers? involvement in premature infant care is one of components of the family centered care. The purpose of this study was to examine the impact of mothers? involvement on mother-infant interactions and maternal confidence in premature infant care. This study used a quasy experimental with one-group pretest-posttest design. Sixteen participants were selected using consecutive sampling technique in Neonatal Unit Level I-II in General Hospital in Jakarta during one month. Modified Observation of Communication Interaction was translated in to Indonesian and used to observe mother-infant interaction and maternal confidence measured by translated Maternal Confidence Questionaire. The result of statistic analysis showed that mother-infant interactions scale and maternal confidence increase significantly (p= 0.0005). This study recommends the improvement of mothers? involvement in premature infant care in neonatal unit."