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"Perilaku kekerasan merupakan salah satu manifestasi dari gangguan jiwa berat akibat perubahan cara pandang penderitanya melihat diri dan lingkungannya. Tanda dan gejala pasien dengan risiko perilaku kekerasan memerlukan penatalaksanaan yang komprehensif pada tingkat individu, kelompok dan keluarga. Tujuan penulisan karya ilmiah akhir spesialis ini adalah memberikan gambaran penerapan dari tindakan keperawatan generalis individu, Assertiveness Training (AT), Terapi Aktifitas Kelompok (TAK), Terapi Suportif (TS) dan Family Psychoeducation (FPE). Penulisan karya ilmiah ini menggunakan pendekatan metode case report. Pasien berjumlah 15 orang yang dibagi menjadi 3 kelompok dengan masing-masing terdiri dari 5 pasien sesuai kriteria inklusi. Kelompok pertama adalah pasien risiko perilaku kekerasan yang diberikan terapi generalis individu dan AT, kelompok kedua adalah pasien yang diberikan terapi generalis individu, AT, TAK dan TS, dan kelompok ketiga adalah pasien yang diberikan secara komprehensif yaitu terapi generalis individu, AT, TAK, TS dan FPE. Hasil menunjukkan bahwa pada tiap kelompok terjadi penurunan tanda dan gejala secara signifikan, dan yang paling signifikan adalah kelompok 3 yang diberikan terapi individu, kelompok dan keluarga. Tindakan keperawatan yang diberikan secara komprehensif sangat direkomendasikan untuk dilakukan di rumah sakit jiwa untuk menghasilkan penurunan tanda dan gejala risiko perilaku kekerasan yang lebih optimal.

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Violent behavior is one of the manifestations of severe mental disorders due to changes in the way sufferers see themselves and their environment. Signs and symptoms of patients at risk of violent behavior require comprehensive management at the individual, group and family levels. The purpose of writing this specialist final scientific paper is to provide an overview of the application of individual generalist nursing actions, Assertiveness Training (AT), Group Activity Therapy (GAT), Supportive Therapy (ST) and Family Psychoeducation (FPE). The writing of this scientific work uses a case report method approach. There were 15 patients divided into 3 groups, each consisting of 5 patients according to the inclusion criteria. The first group is patients at risk of violent behavior who are given individual generalist therapy and AT, the second group is patients who are given individual generalist therapy, AT, GAT and ST, and the third group is patients who are given comprehensively, namely individual generalist therapy, AT, GAT, ST and FPE. The results showed that in each group there was a significant decrease in signs and symptoms, and the most significant was group 3 which was given individual, group and family therapy. Nursing actions provided comprehensively are highly recommended to be carried out in psychiatric hospitals to produce a more optimal reduction in signs and symptoms of risk of violent behavior."

"Pendahuluan : Kesehatan jiwa merupakan komponen integral dari kesehatan dan kesejahteraan yang mendasari kemampuan individu untuk mengambil keputusan, membangun hubungan, dan membentuk dunia ditempat yang ditinggali. Rawat inap dan penyakit kronis meningkatkan level distres psikologis yang dialami klien terutama ansietas dan ketidakefektifan koping. Ansietas dan ketidakefektifan koping berdampak negatif pada diri klien diantaranya dapat memperburuk kondisi medisnya, kualitas hidup menurun, meningkatnya penggunaan dan biaya layanan kesehatan serta penurunan kepatuhan pengobatan. Tujuan : Memberikan gambaran hasil penerapan acceptance commitment therapy dan family psychoeducation pada klien ansietas dan ketidakefektifan koping menggunakan pendekatan model adaptasi Roy di Rumah Sakit Umum. Hasil : Terdapat penurunan tanda gejala ansietas dan ketidakefektifan koping setelah diberikan acceptance commitment therapy dan family psychoeducation. Selain itu terdapat peningkatan kemampuan individu dan keluarga dalam mengatasi masalah ansietas dan ketidakefektifan koping. Kesimpulan : Acceptance Commitment Therapy dan Family Psychoeducation dengan pendekatan model adaptasi Roy direkomendasikan untuk diberikan pada klien dengan ansietas dan ketidakefektifan koping.

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Introduction: Mental health is an integral component of health and well-being that underlies an individual's ability to make decisions, build relationships, and shape the world in which they live. Hospitalization and chronic illness increase the level of psychological distress experienced by clients, especially anxiety and ineffective coping. Anxiety and ineffective coping have a negative impact on clients, including worsening medical conditions, decreasing quality of life, increasing use and costs of health services and decreasing medication compliance. Objective: To provide an overview of the results of applying acceptance commitment therapy and family psychoeducation to clients with anxiety and ineffective coping using the Roy adaptation model approach at a General Hospital. Results: There was a decrease in signs of anxiety symptoms and ineffective coping after being given acceptance commitment therapy and family psychoeducation. Apart from that, there is an increase in the ability of individuals and families to overcome anxiety problems and ineffective coping. Conclusion: Acceptance Commitment Therapy and Family Psychoeducation with the Roy adaptation model approach are recommended for clients with anxiety and ineffective coping."

"[ABSTRAKPerilaku kekerasan merupakan perilaku atau tindakan seseorang ketika tidak mampu mengatasi stressor yang dialaminya, ditunjukkan dengan perilaku aktual berupa kekerasan baik pada diri sendiri, orang lain, maupun lingkungan baik secara verbal maupun non verbal (Stuart, 2013). Tujuan penulisan karya ilmiah akhir ini adalah menggambarkan penerapan assertiveness training dan terapi kelompok suportif menggunakan Teori Stres Adaptasi Stuart dan Teori Adaptasi Roy pada klien risiko perilaku kekerasan di Rumah Sakit Marzoeki Mahdi Bogor. Intervensi keperawatan yang dilakukan adalah assertiveness training pada 6 klien dan kombinasi terapi assertiveness training dan terapi kelompok suportif pada 12 orang klien dalam kurun waktu 16 Februari - 17 April 2015 di ruang Dewi Amba. Hasil pelaksanaan assertiveness training dan terapi kelompok suportif dapat menurunkan tanda dan gejala perilaku kekerasan pada aspek kogitif, afektif, fisiologis, perilaku, dan sosial serta meningkatkan kemampuan adaptif dalam menghadapi peristiwa yang menimbulkan perilaku kekerasan. Rekomendasi penelitian ini adalah assertiveness training dan terapi kelompok suportif dapat dijadikan standar terapi spesialis keperawatan jiwa.

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ABSTRACTViolent behavior occurs when a person is not capable of responding to stressors. This behavior can be manifested by hurting oneself, others, or environment verbally or non verbally (Stuart, 2013). The purpose of this scientific paper was to report the application of assertiveness training and supportive group therapy utilizing the Stuart?s Stress-Adaptation Theory and Roy?s Adaptation Theory towards the clients with potential risk violent behavior who were hospitalized at Marzoeki Mahdi Hospital in Bogor. Assertiveness training was conducted to six clients and combination of assertiveness training and supportive group therapy to twelve clients during a period of 16 February ? 17 April 2015 at Dewi Amba Ward. The result of assertiveness training and supportive group therapy depicted that there were decreased signs and symptoms of violent behaviors at all aspects of cognitive, affective, physiological, behavior, and social as well as improvement of ability of clients to be more adaptive in responding to the any stressful situation that can stimuli violent behaviors. It is recommended that assertiveness training and supportive group therapy can be used as a standard of mental healthpsychiatric nursing specialized therapy., Violent behavior occurs when a person is not capable of responding to stressors. This behavior can be manifested by hurting oneself, others, or environment verbally or non verbally (Stuart, 2013). The purpose of this scientific paper was to report the application of assertiveness training and supportive group therapy utilizing the Stuart’s Stress-Adaptation Theory and Roy’s Adaptation Theory towards the clients with potential risk violent behavior who were hospitalized at Marzoeki Mahdi Hospital in Bogor. Assertiveness training was conducted to six clients and combination of assertiveness training and supportive group therapy to twelve clients during a period of 16 February – 17 April 2015 at Dewi Amba Ward. The result of assertiveness training and supportive group therapy depicted that there were decreased signs and symptoms of violent behaviors at all aspects of cognitive, affective, physiological, behavior, and social as well as improvement of ability of clients to be more adaptive in responding to the any stressful situation that can stimuli violent behaviors. It is recommended that assertiveness training and supportive group therapy can be used as a standard of mental healthpsychiatric nursing specialized therapy.]"

"[ABSTRAKSkizophrenia paranoid memperlihatkan tanda dan gejala perilaku kekerasan yang berisiko cedera bagi klien dan lingkungan. Tujuan Karya Ilmiah ini untuk mengetahui pengaruh terapi generalis, latihan asertif, psikoedukasi keluarga terhadap tanda dan gejala, kemampuan klien, keluarga. Metode yang digunakan deskriptif analitik dengan memberikan terapi generalis, latihan asertif, pada 20 klien dan selanjutnya pada 7 klien diberikan psikoedukasi pada keluarga. Pemberian terapi generalis, latihan asertif pada 13 klien menunjukkan penurunan tanda, gejala, peningkatan kemampuan klien. Pemberian terapi generalis, latihan asertif, psikoedukasi keluarga pada 7 klien dan keluarganya menunjukkan penurunan tanda dan gejala, peningkatan kemampuan yang lebih besar daripada pemberian terapi generalis, latihan asertif. Direkomendasikan kombinasi terapi generalis, latihan asertif, psikoedukasi keluarga pada klien resiko perilaku kekerasan.

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ABSTRACTSkizophrenia paranoid shows signs, symptoms of aggressive behavior are at risk of injury for the client, the environment. The purpose of this scientific masterpiece to know influence of generalist therapy, assertiveness training, family psychoeducation against the mark, the symptoms, the capabilities of the client, family. Analitic descriptive method used by providing a generalist therapy, assertiveness training, on 20 asertif the client and client's given on 7 psikoeducation in the family. Generalist therapy, assertiveness training, on 13 clients shows a decrease in signs and symptoms, increased the ability of the client. Generalist therapy, assertiveness training, family psychoeducation in 7 clients, and family shows a decrease in signs, symptoms, and improved skills an increase greater than on the giving of generalist therapy, assertiveness training, family psychoeducation. Recommended combination generalist therapy, assertiveness training, family psychoeducation on the client's risk of aggressive behavior., Skizophrenia paranoid shows signs, symptoms of aggressive behavior are at risk of injury for the client, the environment. The purpose of this scientific masterpiece to know influence of generalist therapy, assertiveness training, family psychoeducation against the mark, the symptoms, the capabilities of the client, family. Analitic descriptive method used by providing a generalist therapy, assertiveness training, on 20 asertif the client and client's given on 7 psikoeducation in the family. Generalist therapy, assertiveness training, on 13 clients shows a decrease in signs and symptoms, increased the ability of the client. Generalist therapy, assertiveness training, family psychoeducation in 7 clients, and family shows a decrease in signs, symptoms, and improved skills an increase greater than on the giving of generalist therapy, assertiveness training, family psychoeducation. Recommended combination generalist therapy, assertiveness training, family psychoeducation on the client's risk of aggressive behavior.]"

"Perilaku kekerasan merupakan respon maladaptif dari marah. Respon Maladaptif yang muncul dari marah dapat mengancam dan membahayakan diri sendiri, keluarga dan lingkungan masyarakat sehingga meraka memerlukan pengobatan dan perawatan dirumah sakit. Tujuan penulisan karya ilmiah akhir ini adalah menggambarkan penerapan terapi cognitive behaviour therapy dan assertive training dengan pendekatan Model Adaptasi Roy pada klien risiko perilaku kekerasan di Rumah Sakit Marzoeki Mahdi Bogor. Intervensi keperawatan yang dilakukan adalah cognitive behaviour therapy dan assertive training pada 8 orang dan assertive training pada 10 orang klien dalam kurun waktu 17 Februari - 18 April 2014 di Ruang Gatot Kaca RSMM Bogor. Hasil pelaksanaan cognitive behaviour therapy dan assertive training dapat menurunkan tanda dan gejala perilaku kekerasan pada aspek kognitif, afektif, fisiologis, perilaku dan sosial dan peningkatan kemampuan koping adaptif dalam menghadapi peristiwa yang menimbukan perilaku kekerasan. Berdasarkan hasil diatas rekomendasi penulisan ini adalah terapi cognitive behaviour therapy dan assertive training pada klien risiko perilaku kekerasan dapat dijadikan standar terapi spesialis keperawatan jiwa.

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Violence behavior is a maladaptive response of anger. Maladaptive Response that occur in anger can menca and endanger ownself, family and society enviroment so they need treatment and medication in hospital. The aim of this Study is to describe the application of Cognitive Behavior Therapy and assertive training by using Roy Adaptation Model to client risk of violent behavior at Marzoeki Mahdi Hospital. in Bogor. Nursing interventions was cognitive behavior therapy and assertive training on 8 people and assertive training to 10 clients during 17 February to 18 April 2014 at Gatot Kaca Room RSMM in Bogor.

The results of the implementation of assertive training and cognitive behavior therapy may reduce signs and symptoms of violence behavior in cognitive, affective, physiological, behavioral and social and increase in adaptive coping skills to face of events that raises violence behavior. Based on the result above, recommendation from this paper is Cognitive Behavior Therapy and Assertive Training can be used as standard therapy of psychiatric nursing specialist to client with risk of violence behavior Key Word: Risk of Violence Behavior."

"Pendahuluan : Psikosis dan skizofrenia menunjukkan terjadi peningkatan setiap tahunnya baik di Indonesia dan dunia. Skizofrenia adalah penyakit otak kronis yang sindrom klinisnya melibatkan perubahan pikiran, emosi, persepsi, gerakan dan perilaku individu. Gejala positif dari skizofrenia salah satunya halusinasi sedangkan risiko perilaku kekerasan muncul akibat halusinasi dan waham. Klien dengan risiko perilaku kekerasan dan halusinasi, asuhan yang diberikan dalam bentuk tindakan keperawatan generalis dan spesialis. Tindakan keperawatan generalis (individu, kelompok, keluarga) begitu juga dengan Tindakan keperawatan spesialis (individu, kelompok, keluarga) meliputi latihan asertif, terapi kognitif perilaku dan psikoedukasi keluarga. Tujuan : Diketahuinya karakteristik, predisposisi, presipitasi, perubahan tanda gejala, kemampuan, dan perubahan, perbedaan tanda gejala, kemampuan Metode : Desain karya ilmiah akhir spesialis ini menggunakan operational research terdiri dari enam tahap pelaksanaan Hasil : tindakan keperawatan generalis dan spesialis secara bermakna dapat menurunkan tanda gejala risiko perilaku kekerasan dan halusinasi serta secara bermakna meningkatkan kemampuan klien dan keluarga. Kesimpulan : tindakan keperawatan generalis dan spesialis direkomendasikan karena dapat mengurangi tanda gejala dan meningkatkan kemampuan klien dan keluarga.

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Introduction: Psychosis and schizophrenia show an increase every year both in Indonesia and the world. Schizophrenia is a chronic brain disease whose clinical syndrome involves changes in an individual's thoughts, emotions, perceptions, movements and behavior. One of the positive symptoms of schizophrenia is hallucinations, while the risk of violent behavior arises due to hallucinations and delusions. Clients at risk of violent behavior and hallucinations, care is provided in the form of generalist and specialist nursing actions. Generalist nursing actions (individual, group, family) as well as specialist nursing actions (individual, group, family) include assertive training, cognitive behavioral therapy and family psychoeducation. Purpose: To find out characteristics, predisposition, precipitation, changes in signs and symptoms, abilities, and changes, differences in signs and symptoms, abilities. Methods: The design of this specialist's final scientific work using operational research consists of six implementation stages. Results: Generalist and specialist nursing actions can significantly reduce signs of risk of violent behavior and hallucinations and significantly improves the client's and family's abilities. Conclusion: generalist and specialist nursing actions are recommended because they can reduce signs and symptoms and increase the capabilities of clients and families."

"Defisit perawatan diri adalah salah satu gejala negatif dari skizoprenia, merupakan ketidakmampuan melakukan perawatan diri. Tujuan penulisan karya ilmiah akhir ini adalah memberikan gambaran penerapan terapi generalis, terapi aktivitas kelompok, terapi perilaku dan psikoedukasi keluarga terhadap tanda dan gejala serta kemampuan klien defisit perawatan diri. Metode yang digunakan adalah deskriptif analitik melalui pendekatan model stres adaptasi Stuart dan model adaptasi Roy di Rumah Sakit Jiwa. Penerapan terapi generalis dan terapi aktivitas kelompok pada 40 klien, dengan hasil 16 klien mengalami penurunan tanda dan gejala serta peningkatan kemampuan perawatan diri. Penerapan terapi perilaku dan psikoedukasi keluarga merupakan terapi lanjutan hanya terhadap 24 klien, hasilnya 23 klien mengalami penurunan tanda dan gejala serta peningkatan kemampuan klien dan keluarga dalam perawatan diri klien. Direkomendasikan kombinasi terapi perilaku dan psikoedukasi keluarga dengan pendekatan model stres adaptasi Stuart dan model adaptasi Roy menjadi standar terapi spesialis keperawatan jiwa untuk klien defisit perawatan diri.

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Self-care deficit is one of the negative symptoms of schizophrenia, an inability to perform self-care. The purpose of writing this final scientific work is to provide a description of the application of generalist therapy, group activity therapy, behavior therapy and family psychoeducation for signs and symptoms as well as the client's ability to self-care deficit. The method used is descriptive analytic approach stress adaptation model of Stuart and Roy adaptation model at the Mental Hospital. Application of generalist therapy and groups therapeutic activity at 40 client, with the results of 16 clients decreased signs and symptoms as well as improving self-care ability. The application of behavior therapy and family psychoeducation is an advanced therapy only for 24 clients, the result is 23 clients decreased signs and symptoms as well as improving the ability of clients and families in self-care clients. Recommended combination of behavior therapy and family psychoeducation with stress adaptation model approach Stuart and Roy adaptation model become standard therapy for the soul of nursing specialist client self-care deficit."

"Gangguan mental emosional dapat terjadi pada individu yang mengalami kondisi kesehatan yang kronis. Pasien yang sedang menjalani pengobatan medis ditemukan 25% diantaranya mengalami depresi dengan berbagai variasinya. Proses penyakit yang melemahkan juga merupakan hal yang berperan menyebabkan ketidakberdayaan klien dengan penyakit kronis. Ketidakberdayaan dan gejala depresi menunjukkan hubungan yang signifikan dan positif dengan ide untuk bunuh diri. Hasil pemberian tindakan keperawatan ners, terapi kognitif, psikoedukasi keluarga dan terapi suportif dapat menurunkan tanda gejala dan meningkatkan kemampuan klien penyakit kronis dengan ketidakberdayaan beserta keluarganya. Perlunya optimalisasi dan pengembangan pelayanan kesehatan jiwa kepada klien dengan masalah psikososial terkhusus klien dengan ketidakberdayaan di tatanan pelayanan puskesmas.

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Mental emotional disorder can occur in individuals with chronic illness. Patients who are undergoing medical treatment was found 25% had depression with different variations. Debilitating disease process also plays the lead powerlessness clients with chronic illness. Hopelessness and depression symptoms showed a significant and positive relationship with the idea of suicide.

Ners intervention, cognitive therapy, family psychoeducation and supportive therapy can reduce signs and symptoms, increase ability of clients chronic illness with hopelessness and their families. Optimization and development of mental health services needs to clients with psychosocial problems especially those of client with hopelessness in the primary health care center."

"Remaja merupakan kelompok usia yang rentan mengalami adaptasi negatif terhadap proses perubahan yang terjadi pada masa pertumbuhan dan perkembangannya. Penyalahgunaan NAPZA merupakan salah satu bentuk adaptasi remaja dalam menghadapi perubahan yang terjadi. Penelitian ini bertujuan untuk melihat pengaruh terapi kelompok terapeutik dan assertiveness training terhadap aspek perkembangan, kemampuan penolakan penyalahgunaan NAPZA, dan Penggunaan NAPZA pada remaja.. Penelitian ini menggunakan desain quasi-experimental pre-posttest with control group dengan dua tahap penelitian, yaitu penelitian pertama melakukan survey penggunaan NAPZA menggunakan Drugs Abuse Scale Test (DAST-20) pada 613 responden. Tahap kedua 174 responden dengan kategori bersih penggunaan NAPZA yang terbagi menjadi dua kelompok intervensi 1 dan intervensi 2. Kelompok intervensi 1 mendapatkan terapi kelompok terapeutik dan assertiveness training dan kelompok 2 mendapatkan terapi kelompok terapeutik dan latihan mandiri. Hasil survey menunjukkan bahwa 79% remaja bersih dari penggunaan NAPZA. Hasil penelitian menunjukkan bahwa terjadi peningkatan aspek perkembangan yang signifikan setelah mendapatkan terapi kelompok terapeutik (p-value < 0.05) dan semakin meningkat setelah mendapatkan assertiveness training. Kemampuan penolakan penyalahgunaan NAPZA meningkat dignifikan setelah terapi kelompok terapeutik dan assertiveness training (p-value<0.05) tetapi tidak meningkat setelah terapi kelompok terapeutik dan latihan mandiri (p-value>0.05). Penggunaan NAPZA tidak meningkat dan bertahan berseih setelah terapi kelompok terapeutik dan assertiveness training. Terapi kelompok terapeutik di rekomendasikan untuk upaya pencegahan penyalahgunaan NAPZA pada remaja pada remaja.

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Adolescent are vulnerable group whi can shown negative adaptation according the process of change. Substance abuse is a responses related negative adaptation in adolescent. This research goals is examine influence of the therapeutic group therapy the assertiveness training on developmental aspects, the ability to rejected susbsatnce abuse, and Substance Abuse Level in adolescents. The research uses quasi-experimental design pre-posttest with control group with two stages of research, which is the first research to conduct a survey using Drugs Abuse Scale Test (DAST-20) in 613 respondents. The second phase is 174 respondents has clear from substance abuse was divided into two intervention groups 1 and Intervention 2. Intervention Group 1 gets therapeutic group therapy and assertiveness training and Group 2 get therapeutic Group therapy and self-training.

The survey showed that 79% of teenagers were clean from substance abuse. The results showed that there was an increase in the significant developmental aspects after obtaining therapeutic Group therapy (P-value of < 0.05) and increasing after obtaining assertiveness training. The ability to decline the abuse of NAPZA increases significantly after therapeutic group therapy and assertiveness training (P-value < 0.05) but does not increase after therapeutic group therapy and self-training (p-value > 0.05). The use of NAPZA does not increase and persist after therapeutic group therapy and assertiveness training. Therapeutic group therapy is recommended for the prevention of abuse of NAPZA in adolescents in adolescents."

"Pendahuluan:Masalah psikososial kurang diperhatikan dalam penanganan pasien di Rumah Sakit Umum. Hal itu terlihat dari intervensi keperawatan untuk masalah psikososial yang belum maksimal dan berkembang. Pasien di Rumah Sakit Umum belum memiliki kemampuan untuk mengatasi masalah psikososial yang dialami akibat dari gangguan fisik yang terjadi. Metode: Intervensi keperawatan terapi penghentian pikiran, terapi kognitif, psikoedukasi keluarga diberikan pada 18 pasien sebagai kelompok satu, sedangkan terapi penghentian pikiran dan psikoedukasi keluarga diberikan pada 18 pasien lainnya sebagai kelompok dua. Hasil: Penelitian ini menunjukkan penurunan tanda gejala serta peningkatan kemampuan lebih maksimal dalam mengatasi ansietas dan harga diri rendah siatuasional setelah diberikan terapi penghentian pikiran, terapi kognitif, dan psikoedukasi keluarga. Pembahasan: kombinasi pemberian terapi penghentian pikiran,terapi kognitif, dan psikoedukasi keluarga, memaksimalkan penurunan tanda gejala serta meningkatkan kemampuan pasien dalam mengatasi ansietas dan harga diri rendah situasional dengan pendekatan model adaptasi Roy.

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Introduction: Psychosocial problems are less considered in the treatment of patients in General Hospitals. This can be seen from nursing interventions for psychosocial problems that have not been maximized and developed. Patients in General Hospitals do not yet have the ability to overcome psychosocial problems experienced as a result of physical disorders that occur Methods: Nursing intervention thought stopping therapy, cognitive therapy, family psychoeducation were given to 18 patients as group one, while mind cessation therapy and family psychoeducation were given to 18 other patients as group two. Results: This study showed a decrease in signs of symptoms and an increase in maximal ability to overcome anxiety and low cianational self-esteem after being given mind cessation therapy, cognitive therapy, and family psychoeducation. Discussion: a combination of thought stopping therapy, cognitive therapy, and family psychoeducation, maximizing symptom reduction and improving the patient's ability to cope with anxiety and situational low self-esteem with Roy's adaptation model approach."