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Pasien anak sakit kritis yang memakai ventilasi mekanik maupun tidak, membutuhkan obat penenang dan atau analgesik untuk mengurangi kecemasan atau rasa sakit. Perawat memiliki peranan penting dalam penilaian sedasi secara kontinu, perawat bertanggung jawab memantau tingkat sedasi pasien sehingga mampu melaporkan status sedasi pasien secara tepat. Studi literatur ini bertujuan untuk meninjau lebih lanjut validitas dan reliabilitas instrumen Comfort Behaviour Scale. Pencarian literatur dilakukan dengan memanfaatkan platform publikasi internet periode studi 2011-2020 melalui Scopus, Proquest, Wiley Online library, serta sumber tambahan dari Researchgate dengan kata kunci pain assessment, COMFORT Behaviour Scale, sedation, children, PICU. Hasil studi literatur ini menunjukkan berbagai penelitian di beberapa negara dan instrumen Comfort Behaviour Scale terbukti valid dan reliabel digunakan dalam mengukur tingkat sedasi anak sakit kritis. Perawat disarankan menggunakan instrumen ini dalam manajemen nyeri dan sedasi yang komprehensif.

 

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Critically ill pediatric patients induced with or without mechanical ventilation need sedatives or analgesics to reduce their anxiety or pain. Nurses have an important role to asses sedation continuously and responsible to monitor patients sedation level, in order to record the patients sedation status appropriately. This literature study aims to profoundly review the validity and reliability of the Comfort Behavior Scale instrument. The literature research is carried out by utilizing the internet publication platform from 2011 to 2020 through Scopus, Proquest, Wiley Online library, as well as additional resources from Researchgate with the keywords pain assessment, COMFORT Behavior Scale, sedation, children and PICU. The results of this literature study show various studies in several countries have proven the validity and reliability of Comfort Behavior Scale instrument as the instrument to measure the sedation level of critically ill children. Nurses are considered to utilize this instrument in pain management and in conducting comprehensive sedation

 

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"Anak yang dirawat di ICU cenderung mengalami malnutrisi sejak masuk atau selama perawatan yang dapat memperberat penyakit dasar, memperpanjang lama rawat serta meningkatkan mortalitas. Baik underfeeding atapun overfeeding dapat terjadi di ICU Anak selama perawatan. Penelitian ini merupakan penelitian potong lintang, menggunakan data rekam medis. Selama 3 bulan penelitian. didapatkan 45 subjek penelitian. Dari 45 data pasien didapatkan 127 peresepan untuk menilai keseuaian peresepan dengan pemberian nutrisi pada pasien. Pemberian nutrisi pada pasien yang dirawat di ICU Anak merupakan hal yang sangat penting. Perlu perhitungan kebutuhan nutrisi yang cermat, pemberian nutrisi tepat yang sesuai kebutuhan pasien agar tidak terjadi malnutrisi yang lebih berat lagi.

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Children admitted to the Pediatric Intensive Care Unit (PICU) are at risk for poor and potentially worsening nutritional status, a factor that further increases comorbidities and complications, prolongs the hospital stay, increases cost and increases mortality. Both underfeeding and overfeeding are prevalent in PICU and may result in large energy imbalance. This was cross sectional study design, with 3 month consecutive sampling in PICU which met 45 patients as the subject and 127 prescription of nutrition. Nutrition support therapies in PICU is very important .Adequate nutrition therapy is essential to improve nutrition outcomes in critically ill children."

"Nyeri merupakan salah satu gejala yang paling sering dialami oleh pasien anak di ruang perawatan intensif yang dilakukan prosedur tindakan pengambilan darah. Perawat perlu memberikan asuhan keperawatan dengan menitikberatkan pada kenyamanan anak selama prosedur tindakan pengambilan darah di rumah sakit karena kenyamanan adalah hal penting dalam kualitas hidup pasien anak. Tujuan karya ilmiah ini adalah untuk menganalisis penerapan Teori Kenyamanan Kolcaba dalam proses asuhan keperawatan pada anak di ruang perawatan intensif yang mengalami nyeri saat pengambilan darah melalui pemberian intervensi terapi musik. Metode karya ilmiah ini adalah studi kasus pada lima pasien anak yang dirawat di ruang perawatan intensif yang mendapatkan prosedur tindakan pengambilan darah. Terdapat lima kasus pasien anak yang terpasang ventilasi mekanik yang diberikan asuhan keperawatan dengan pendekan Teori Kenyamanan Kolcaba dengan intervensi kenyamanan yang berbasis bukti yaitu intervensi terapi musik. Hasil menunjukkan bahwa Teori Kenyamanan Kolcaba dapat diterapkan dalam asuhan keperawatan anak dan terapi musik  efektif dalam menurunkan nyeri  pada anak yang dilakukan tindakan pengambilan darah.

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Pain is one of the most common symptoms experienced by pediatric patients in intensive care unit who are undergoing blood collection procedures. Nurses need to provide nursing care with an emphasis on children's comfort during blood collection procedures in hospitals because comfort is important in the quality of life of pediatric patients. The aim of this scientific work is to analyze the application of Kolcaba's Comfort Theory in the care process for children in intensive care who experience pain when taking blood through providing music therapy interventions. The method of this scientific work is a case study of five pediatric patients treated in intensive care who received a blood collection procedure. There were five cases of pediatric patients on mechanical ventilation who were given treatment using Kolcaba's Comfort Theory approach with evidence-based comfort interventions, namely music therapy interventions. The results show that Kolcaba's Comfort Theory can be applied in childcare and music therapy is effective in reducing pain in children who undergo blood sampling."

"Ventilasi mekanik berfungsi untuk menyelamatkan kehidupan, namun ventilasi mekanik merupakan tindakan invasif yang menimbulkan ketidaknyamanan berupa kecemasan, agitasi, dan rasa nyeri. Nyeri berdampak negatif pada tumbuh kembang anak. Tujuan penulisan karya ilmiah ini untuk memberikan gambaran asuhan keperawatan nyeri akut pada anak dengan ventilasi mekanik melalui identifikasi nyeri dan tingkat sedasi dengan instrumen Comfort Behaviour Scale dengan pendekatan Teori Kenyamanan Kolcaba. Terdapat lima kasus anak yang terpasang ventilasi mekanik yang mengalami nyeri dan diberikan asuhan keperawatan melalui pendekatan teori kenyamanan Kolcaba. Aplikasi teori kenyamanan Kolcaba terbukti efektif memberikan kenyamanan anak dengan ventilasi mekanik yang mengalami nyeri meliputi konteks kenyamanan fisik, psikospiritual, sosiokultural, dan lingkungan. Instrumen Comfort Behaviour Scale terbukti valid dan reliabel dalam mengukur tingkat sedasi serta dapat digunakan untuk tingkat nyeri anak dengan ventilasi mekanik. Instrumen ini dapat digunakan perawat dalam pengkajian nyeri dan tingkat sedasi anak yang terpasang ventilasi mekanik sehingga memudahkan dalam manajemen nyeri dan sedasi.

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Mechanical ventilation serves as live saving, but mechanical ventilation is an invasive procedure that causes discomfort in the form of anxiety, agitation, and pain. Pain has a negative impact on child development. The purpose is to provide an overview of acute pain nursing care for children with mechanical ventilation through identification of pain and sedation levels with a Comfort Behavior Scale instrument based on Kolcaba Comfort Theory approach. There were five cases of children with mechanical ventilation who experienced pain and were given nursing care through the Kolcaba comfort theory approach.

The application of the Kolcaba comfort theory has proven to be effective in providing comfort for children with mechanical ventilation who experience pain including the context of physical, psychospiritual, sociocultural, and environmental comfort. The Comfort Behavior Scale instrument proved to be valid and reliable in measuring the level of sedation and can be used for measuring pain in children with mechanical ventilation. This instrument can be used by nurses in the assessment of pain and the level of sedation of children who have mechanical ventilation that makes it easier for pain and sedation management."

"[ABSTRAKLatar belakang: Hiponatremia pasca tindakan operasi mayor pada populasi anak merupakan gangguan elektrolit yang sering terjadi. Penggunaan cairan yang belum tepat sering menimbulkan peningkatan kejadian hiponatremia yang berhubungan erat dengan meningkatnya berbagai komplikasi seperti edema otak, kejang, bahkan kematian. Populasi anak merupakan risiko tinggi karena perbandingan jaringan otak dan tulang tengkorak yang lebih besar sehingga ruang yang tersedia saat terjadi edema otak lebih sempit.Tujuan: Mengetahui insidens hiponatremia pada anak pasca tindakan operasi mayor.Metode: Studi retrospektif potong lintang dilakukan terhadap anak usia 1 bulan hingga 18 tahun yang menjalani tindakan operasi mayor dan masuk ruang perawatan intensif. Penelusuran status medik sesuai kriteria inklusi dilakukan sampai jumlah sampel terpenuhi. Pencatatan terhadap subjek yang meliputi data praoperasi, intraoperasi, serta pemantauan pascaoperasi dilakukan. Subjek yang memenuhi definisi hiponatremia (<135 mEq/L) diklasifikasikan sesuai derajat hiponatremia dan dilakukan pencarian lebih lanjut terhadap komplikasi.Hasil : Studi dilakukan terhadap 90 subjek yang terdiri dari 56,7% lelaki, dengan 51,1% memiliki rentang usia 1 bulan hingga 4 tahun. Sebanyak 47,8% subjek menjalani tindakan laparatomi dengan berbagai indikasi. Hampir semua subjek (93,3%) mendapat cairan hipotonik pascaoperasi. Insidens hiponatremia pascaoperasi sebesar 28,9% dengan 11,1% diantaranya merupakan hiponatremia sedang-berat. Rerata kadar natrium pascaoperasi adalah 130,1 ± 4,1 mEq/L dengan rerata total cairan 79,8 ± 27,4 ml/kg. Sebesar 30,9% subjek yang mendapatkan cairan hipotonik pascaoperasi mengalami kejadian hiponatremia dengan rerata lama rawat 5,6 ± 4 hari. Terdapat 1/26 subjek yang mengalami komplikasi berupa kejang dan edema otak.Simpulan: Insidens hiponatremia pasca tindakan operasi mayor di ruang perawatan intensif hampir mencapai 30% dan sebagian besar mendapat cairan hipotonik pascaoperasi. Penelitian lebih lanjut perlu dilakukan untuk mengevaluasi pemberian cairan pascaoperasi yang tepat untuk mencegah hiponatremia.

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ABSTRACTBackground: Hyponatremia is commonly found post major surgery in pediatric population. The use of improper fluid often leads to increasing incidence of hyponatremia which causes complications such as cerebral edema, seizure, and death. Pediatric is a high risk population due to the large ratio between the brain tissue and skull, so that the availability space.Hyponatremia after major surgery in pediatric population is a common electrolyte disorder. The use of improper fluid often lead to increased incidence of hyponatremia which is closely linked to the increasing variety of complications such as cerebral edema, seizures, and even death. Pediatric is high risk population due to the larger comparison of brain tissue and the skull so that the space available in the event of brain edema narrower.Objective: To describe the incidence of hyponatremia in children after major surgery.Methods: A retrospective cross-sectional study was conducted on children aged 1 month to 18 years who underwent major surgery and entered the intensive care ward. The inclusion subjects was traced from medical records. The data was recorded from preoperative, intraoperative, and postoperative monitoring. Subjects who met hyponatremia (<135 mEq/L) were classified according to the severity of hyponatremia and its complications.Results: Ninety subjects were enrolled in this study (56.7% male, 51.1% age 1 month-4 years). There were 47.8% subjects underwent laparotomy with a variety of indications. Almost all subjects (93.3%) received postoperative hypotonic fluid. The incidence of postoperative hyponatremia was 28.9%, while 11.1% among them were moderate-severe hyponatremia. The mean postoperative sodium levels was 130.1 ± 4.1 mEq/L with a mean total fluid 79.8 ± 27.4 ml/kg. There were 30.9% subjects who received hypotonic fluids and experienced hyponatremia with a mean length of stay 5.6 ± 4 days. One of 26 subjects with hyponatremia suffered from seizures and brain edema.Conclusions: The incidence of postoperative hyponatremia in pediatric intensive care reached nearly 30%, and almost all of them received hypotonic fluid. Therefore, further research should be performed to evaluate the appropriate fluid in order to anticipating postoperative hyponatremia, Background: Hyponatremia is commonly found post major surgery in pediatric population. The use of improper fluid often leads to increasing incidence of hyponatremia which causes complications such as cerebral edema, seizure, and death. Pediatric is a high risk population due to the large ratio between the brain tissue and skull, so that the availability space.Hyponatremia after major surgery in pediatric population is a common electrolyte disorder. The use of improper fluid often lead to increased incidence of hyponatremia which is closely linked to the increasing variety of complications such as cerebral edema, seizures, and even death. Pediatric is high risk population due to the larger comparison of brain tissue and the skull so that the space available in the event of brain edema narrower.Objective: To describe the incidence of hyponatremia in children after major surgery.Methods: A retrospective cross-sectional study was conducted on children aged 1 month to 18 years who underwent major surgery and entered the intensive care ward. The inclusion subjects was traced from medical records. The data was recorded from preoperative, intraoperative, and postoperative monitoring. Subjects who met hyponatremia (<135 mEq/L) were classified according to the severity of hyponatremia and its complications.Results: Ninety subjects were enrolled in this study (56.7% male, 51.1% age 1 month-4 years). There were 47.8% subjects underwent laparotomy with a variety of indications. Almost all subjects (93.3%) received postoperative hypotonic fluid. The incidence of postoperative hyponatremia was 28.9%, while 11.1% among them were moderate-severe hyponatremia. The mean postoperative sodium levels was 130.1 ± 4.1 mEq/L with a mean total fluid 79.8 ± 27.4 ml/kg. There were 30.9% subjects who received hypotonic fluids and experienced hyponatremia with a mean length of stay 5.6 ± 4 days. One of 26 subjects with hyponatremia suffered from seizures and brain edema.Conclusions: The incidence of postoperative hyponatremia in pediatric intensive care reached nearly 30%, and almost all of them received hypotonic fluid. Therefore, further research should be performed to evaluate the appropriate fluid in order to anticipating postoperative hyponatremia]"

"Gangguan integritas kulit merupakan salah satu permasalahan yang dapat dialami oleh anak dengan penggunaan alat bantu napas invasif, yaitu endotracheal tube (ETT). Alat bantu napas memerlukan perekat medis untuk menjaga posisi dalam keadaan aman. Perekat ini dapat menimbulkan cedera kulit yang dikenal dengan medical adhesive related skin injury (MARSI). Tujuan penulisan karya ilmiah ini adalah untuk memaparkan pencegahan gangguan integritas kulit menggunakan profilaksis hidrokoloid dengan pendekatan teori Kolcaba. Asuhan keperawatan menggunakan teori Kolcaba dipaparkan dalam studi kasus lima orang anak dengan rawatan intensif anak. Aplikasi teori Kolcaba menciptakan kenyamanan dari empat aspek yakni fisik, psikospiritual, sosiokultural, dan lingkungan. Penerapan profilaksis hidrokoloid terbukti mampu mencegah kejadian gangguan integritas kulit (MARSI). Berdasarkan hasil ini, perawat dapat menerapkan aspek kenyamanan untuk memberikan asuhan secara holistik, termasuk untuk mencegah terjadinya cedera pada kulit.

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Impaired skin integrity is one of the problems that can be experienced by children using invasive mechanical ventilation, such as endotracheal tube (ETT). Endotracheal tube requires medical adhesives to maintain a safe position. These adhesives can cause skin injuries known as medical adhesive-related skin injury (MARSI). The purpose of this scientific paper is to explain the prevention of impaired skin integrity using hydrocolloid prophylaxis with the Kolcaba theory approach. Nursing care using Kolcaba's theory is reported in a case study of five children in pediatric intensive care. The application of Kolcaba's theory creates comfort from four aspects: physical, psychospiritual, sociocultural, and environmental. The application of hydrocolloid prophylaxis has been shown to prevent the occurrence of impaired skin integrity (MARSI). Based on these results, nurses can apply the comfort aspect to provide holistic care, including preventing skin injury."

"Oksigenasi merupakan suatu proses pertukaran antara O2 dan CO2 sesuai dengan kebutuhan fisiologis tubuh untuk kelangsungan proses metabolisme sel tubuh dan aktivitas sel dan organ, dimana pemenuhan kebutuhan oksigen ini tidak terlepas dari sistem pernapasan. Kondisi kritis pada anak terjadi apabila mengalami kemunduran fungsi organ yang dapat mengganggu proses metabolisme tubuh yang dapat mengancam jiwa. Tujuan dari studi kasus ini untuk mengetahui pengaruh aplikasi teori konservasi Levine dalam asuhan pemenuhan kebutuhan oksigenasi pada anak kritis di ruang intensif. Studi kasus ini menggunakan desain deskriptif pada lima kasus anak kritis. Masalah yang terjadi: gangguan ventilasi spontan, penurunan kapasitas adaptif intrakranial, penurunan curah jantung, risiko perfusi serebral tidak efektif, risiko ketidakseimbangan elektrolit, risiko perdarahan, risiko infeksi dan ansietas. Asuhan keperawatan yang diberikan menggunakan pendekatan Levine dengan intervensi sesuai dengan masalah keperawatan menggunakan Standar Intervensi Keperawatan Indonesia. Hasilanalisis dari lima kasus terpilih di ruang intensif bahwa seluruh pasien memiliki gangguan pada konservasi energi terutama pada masalah oksigenasi dan terjadi penurunan kesadaran pada konservasi integritas struktural dengan respon organismik 2 (40%) pasien mengalami perburukan/meninggal dan 3(60%) pasien mengalami perbaikan yang secara menyeluruh (wholeness) ditandai dengan auskultasi ronchi berkurang, pola napas adekuat, hemodinamik stabil, kesadaran composmentis, pasien ekstubasi dan pindah ruangan/ rawat jalan.  Kesimpulan penerapan teori konservasi pada studi kasus melalui proses perawatan mulai dari pengkajian, trophicognosis, hipotesis intervensi serta evaluasi dengan melihat respon organismik secara satu kesatuan yang utuh (wholenes) sehingga teori ini dapat diterapkan pada anak kritis di ruang intensif.

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Oxygenation is an exchange process between O2 and CO2 in accordance with the body's physiological needs for the continuity of the body's cell metabolism processes and cell and organ activities, where the fulfillment of oxygen needs cannot be separated from the respiratory system. Critical conditions in children occur when there is a decline in organ function that can interfere with the body's metabolic processes which can be life-threatening.

The purpose of this case study is to determine the effect of Levine's conservation theory application in the care of oxygenation needs of critically ill children in intensive care. This case study uses a descriptive design in five cases of critically ill children. Problems that occur: impaired spontaneous ventilation, decreased intracranial adaptive capacity, decreased cardiac output, risk of ineffective cerebral perfusion, risk of electrolyte imbalance, risk of bleeding, risk of infection and anxiety. The nursing care provided uses the Levine approach with interventions according to nursing problems using the Indonesian Nursing Intervention Standards.

The results of the analysis of five selected cases in the intensive care unit showed that all patients had disturbances in energy conservation, especially in oxygenation problems and there was a decrease in awareness of the conservation of structural integrity with an organismic response. overall improvement (wholeness) is characterized by reduced auscultation crackles, adequate breathing pattern, stable hemodynamics, composmentis consciousness, extubated patients and moved rooms/outpatient.

The conclusion is the application of conservation theory to the case study through the treatment process starting from assessment, trophicognosis, intervention hypotheses and evaluation by looking at the organismic response as a whole so that this theory can be applied to critical children in the intensive room."

"Pendahuluan: Hospitalisasi merupakan peristiwa yang membuat traumatik bagi anak, terlebih pada anak yang dirawat di ruang PICU. Anak yang dirawat di PICU berisiko tinggi mengalami kerusakan integritas kulit karena mengalami imobilitas dan terpasang banyak alat kesehatan. Tujuan studi kasus ini adalah untuk memberikan gambaran pencegahan risiko terjadinya kerusakan integritas kulit pada anak melalui pengkajian kulit dengan menggunakan instrumen Braden QD dengan pendekatan model konservasi Levine. Pengkajian dilakukan berdasarkan konservasi Levine terhadap lima kasus terpilih yang berisiko mengalami kerusakan integritas kulit. Hipotesis, intervensi dan respon organismik ditujukan untuk mencapai adaptasi serta membuat klien mencapai keutuhan (wholeness). Pengkajian dengan menggunakan instrument Braden QD terbukti efektif mencegah terjadinya cedera tekan.

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Background: Hospitalization has become a traumatic event particularly in pediatric patients in pediatric intensive care unit (PICU). Pediatric patients who were admitted in PICU have a risk for impaired skin integrity particularly for those who had immobility and under medical treatment devices. This case study aimed at describing the risk prevention of impaired skin integrity in pediatric patients by skin assessment using Braden QD Scale through a Levine Conservation Model approach. Skin assessment was performed based on this Levin s model amongst five selected cases which have the risk for impaired skin integrity. Hypothesis, intervention, and organismic response were addressed to achieve an adaptation and eventually reached the patients wholeness. The skin assessment using Braden QD Scale was effective in preventing the pressure injury."

"Gangguan oksigenasi merupakan masalah yang sering dialami oleh pasien yang dirawat di ruang perawatan intensif anak. Oksigen merupakan kemponen yang penting dalam pembentukan energi sehingga gangguan oksigenasi dapat memengaruhi keseimbangan energi. Teori Konservasi Levine bertujuan untuk mempertahankan keutuhan pasien melalui empat prinsip konservasi yaitu konservasi energi, konservasi integritas strukrutal, konservasi integritas personal dan konservasi integritas sosial sehingga dapat diaplikasikan pada anak dengan gangguan oksigenasi. Salah satu intervensi keperawatan yang sesuai dengan prinsip konservasi energi pada pasien dengan masalah oksigenasi adalah pengaturan posisi lateral kanan. Tujuan dari karya ilmiah ini adalah memberikan gambaran mengenai aplikasi teori Konservasi Levine dalam pemenuhan kebutuhan oksigenasi dan pengaruh pengaturan posisi lateral kanan pada anak yang dirawat di ruang perawatan intensif. Asuhan keperawatan dengan pendekatan teori Konservasi Levine diberikan kepada lima anak yang terpasang ventilator. Proses keperawatan mulai dari pengkajian sampai evaluasi dilakukan berdasarkan empat prinsip konservasi. Evaluasi keperawatan menunjukkan adanya perbaikan kondisi pada beberapa pasien. Demikian halnya dengan pengaturan posisi lateral kanan dengan kemiringan 30° terbukti efektif meningkatkan saturasi oksigen pada anak yang terpasang ventilasi mekanik. Penulis merekomendasikan penggunaan teori Konservasi Levine dalam memberikan asuhan keperawatan kepada anak dengan gangguan oksigenasi di ruang perawatan intensif. Selain itu penulis merekomendasikan pengaturan posisi lateral kanan dengan kemiringan 30° untuk dapat diaplikasikan di ruang perawatan intensif anak serta dilakukan uji klinik lebih lanjut dengan sampel yang lebih besar sehingga dapat dijadikan dasar penyusunan standar operasional prosedur.

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Oxygenation impairment is one of the problems that is often experienced by patients treated in pediatric intensive care units. Oxygen is an important component in energy formation.  Oxygenation impairment can affect energy balance. Levine's Conservation theory focuses on maintaining patient wholeness through four conservation principles, namely conservation of energy, conservation of structural integrity, conservation of personal integrity, and conservation of social integrity so that it can be applied to children with oxygenation impairment. One of the nursing interventions that relate to the conservation of energy in patients with oxygenation impairment is the positioning with the right lateral position. The purpose of this scientific paper is to provide an overview of the application of Levine's Conservation theory in meeting oxygenation needs and the effect of right lateral position in children treated in intensive care units. Nursing care with the application Levine Conservation theory was given to five children who were on ventilators. The nursing process from assessment to evaluation was carried out based on four conservation principles. Nursing evaluation showed an improvement in the condition of several patients. Likewise, the right lateral position setting with a 30° tilt has shown to be effective in increasing oxygen saturation in children who are on mechanical ventilation. The author recommends the use of Levine's Conservation theory in providing nursing care to children with impaired oxygenation in intensive care units. In addition, the author recommends setting the right lateral position with a 30° tilt to be applied in the pediatric intensive care room and conducting further clinical trials with larger samples so that it can be used as a basis for compiling standard operating procedures."

"Gangguan oksigenasi merupakan masalah yang sering terjadi pada anak paliatif yang dirawat di ruang PICU dan sebagian besar anak mendapatkan bantuan ventilasi mekanik sehingga Integrasi perawatan pasien paliatif di ruang PICU merupakan hal yang penting. Tujuan penulisan karya ilmiah ini untuk memberikan gambaran asuhan keperawatan pasien paliatif dengan gangguan oksigenasi di ruang PICU dengan panduan intervensi perawatan pasien paliatif melalui pendekatan teori kenyamanan Kolcaba. Terdapat lima kasus anak paliatif yang mengalami gangguan oksigenasi dan diberikan asuhan keperawatan melalui pendekatan teori kenyamanan Kolcaba. Aplikasi teori kenyamanan Kolcaba efektif dalam memberikan kenyamanan anak paliatif yang mengalami gangguan oksigenasi di ruang PICU yang meliputi konteks kenyamanan fisik, psikospiritual, sosiokultural dan lingkungan. Panduan intervensi perawatan pasien paliatif di ruang PICU terbukti efektif untuk meningkatkan pengetahuan dan sikap perawat terkait perawatan pasien paliatif. Panduan intervensi ini dapat diaplikasikan oleh perawat untuk memberikan intervensi yang sesuai pada pasien paliatif di ruang PICU.Gangguan oksigenasi merupakan masalah yang sering terjadi pada anak paliatif yang dirawat di ruang PICU dan sebagian besar anak mendapatkan bantuan ventilasi mekanik sehingga Integrasi perawatan pasien paliatif di ruang PICU merupakan hal yang penting. Tujuan penulisan karya ilmiah ini untuk memberikan gambaran asuhan keperawatan pasien paliatif dengan gangguan oksigenasi di ruang PICU dengan panduan intervensi perawatan pasien paliatif melalui pendekatan teori kenyamanan Kolcaba. Terdapat lima kasus anak paliatif yang mengalami gangguan oksigenasi dan diberikan asuhan keperawatan melalui pendekatan teori kenyamanan Kolcaba. Aplikasi teori kenyamanan Kolcaba efektif dalam memberikan kenyamanan anak paliatif yang mengalami gangguan oksigenasi di ruang PICU yang meliputi konteks kenyamanan fisik, psikospiritual, sosiokultural dan lingkungan. Panduan intervensi perawatan pasien paliatif di ruang PICU terbukti efektif untuk meningkatkan pengetahuan dan sikap perawat terkait perawatan pasien paliatif. Panduan intervensi ini dapat diaplikasikan oleh perawat untuk memberikan intervensi yang sesuai pada pasien paliatif di ruang PICU.

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Impaired oxygenation is a problem that often occurs in palliative children who are treated in the PICU and most children receive mechanical ventilation assistance so that integration of palliative care in the PICU is important. The purpose of writing this scientific paper is to provide an overview of nursing care for palliative patients with impaired oxygenation in the PICU with guidance for palliative patient care interventions through the Kolcaba comfort theory approach. There were five cases of palliative children who experienced impaired oxygenation and were given nursing care through the Kolcaba comfort theory approach. The application of Kolcaba's theory of comfort is effective in providing comfort for palliative children who have impaired oxygenation in the PICU which includes the context of physical, psychospiritual, sociocultural and environmental comfort. Guidelines for palliative care interventions in the PICU room have proven to be effective in increasing nurses' knowledge and attitudes regarding palliative patient care. This intervention guide can be applied by nurses to provide appropriate interventions for palliative patients in the PICU."