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"Anak yang mengalami penyakit ginjal kronis (PGK) dapat mengalami gangguan ketidakseimbangan cairan. Karya ilmiah akhir ini bertujuan untuk memberikan gambaran aplikasi Model Adaptasi Roy (MAR) dalam memberikan asuhan keperawatan pada anak penyakit ginjal kronis yang mengalami ketidakseimbangan cairan. Teori Roy mengkonseptualisasikan proses keperawatan menjadi enam langkah yaitu pengkajian perilaku, pengkajian stimulus, diagnosis keperawatan, penetapan tujuan, intervensi, dan evaluasi. Metode karya ilmiah ini adalah studi kasus yang terdiri atas lima kasus anak PGK yang menjalani hemodialisis yang diberikan asuhan keperawatan dengan pendekatan Model Adaptasi Roy. Berdasarkan hasil pengkajian pala lima anak masalah yang muncul yaitu ketidakseimbangan cairan, selain itu masalah lainya seperti gangguan tumbuh kembang, penampilan peran tidak efektif, risiko penurunan curah jantung, risiko perdarahan, risiko infeksi, defisit pengetahuan. Intervensi keperawatan yang diberikan pada masalah ketidakseimbangan cairan yaitu menimbang berat badan pra HD, mengkaji berat badan kering, berat badan sebelumnya, melakukan perawatan akses kateter dan memberikan edukasi tentang edukasi kebutuhan gizi, cairan dan perawatan akses menggunakan video. Kesimpulan aplikasi teori Roy dapat diterapkan pada anak penyakit ginjal kronis dengan masalah ketidaseimbangan cairan.

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Children with chronic kidney disease (CKD) can experience imbalance disorders. Fluid restriction is one of the nursing interventions to overcome fluid balance disorders. This final scientific work aims to provide an overview of the application of the Roy Adaptation Model (MAR) in providing nursing care to children with chronic kidney disease who experience fluid imbalance. Roy's theory conceptualizes the nursing process into six steps, namely behavioral assessment, stimulus assessment, nursing diagnosis, goal setting, intervention, evaluation. Provides an overview of the application of nursing care to children with chronic kidney disease who experience fluid imbalance in the dialysis unit using the Roy Adaptation Model approach. The method of this scientific work is a case study consisting of five cases of CKD children undergoing hemodialysis who were given nursing care using the Roy Adaptation Model approach. The nursing intervention provided based on evidence-based practice is providing education about nutritional needs, fluids and access care using videos. Implementing a quality improvement project by providing effective education increases the knowledge of caregivers of children with chronic kidney disease undergoing hemolysis. The conclusion is that the application of Roy's theory can be applied to children with chronic kidney disease who have fluid imbalance problems."

"Anak dengan kanker disebabkan oleh proses penyakit kanker itu sendiri dan efek samping dari pemberian terapi. Keluhan seperti mual muntah, diare, demam, dan mielosupresi berkontribusi terhadap kejadian dehidrasi pada anak kanker. Hidrasi adalah pemenuhan air sesuai kebutuhan. Karya ilmiah akhir ini bertujuan untuk memberikan gambaran aplikasi Model Adaptasi Roy (MAR) dalam memberikan asuhan keperawatan pada anak kanker yang berisiko mengalami ketidakseimbangan cairan. Metode karya ilmiah ini adalah studi kasus yang terdiri atas lima kasus anak kanker yang mendapatkan kemoterapi yang diberikan asuhan keperawatan dengan pendekatan MAR. Intervensi keperawatan berdasarkan evidence based practice adalah memberikan edukasi tentang hidrasi pada pengasuh anak kanker. Edukasi kepada pengasuh menggunakan multimedia video dan booklet terbukti efektif meningkatkan pengetahuan dan sikap positif dalam mendampingi anak kanker selama menjalani kemoterapi.

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Children with cancer can experience fluid imbalance disorders caused by cancer itself and the side effects of therapy. Complaints such as nausea, vomiting, diarrhea, fever, and myelosuppression contribute to the incidence of dehydration in children with cancer. Hydration is the fulfillment of water as needed. This final scientific paper aims to provide an overview of the Roy Adaptation Model (MAR) application in providing nursing care to cancer children who are at risk of fluid imbalance. The method of this scientific work is a case study consisting of five cases of cancer children who received chemotherapy and given nursing care with the MAR approach. Nursing intervention based-evidenced practice is to provide education about hydration to cancer caregivers. Education for caregivers using multimedia videos and booklets has proven to be effective in increasing knowledge and positive attitudes in assisting children with cancer during chemotherapy."

"Latar belakang Gagal tumbuh atau failure to thrive adalah kondisi keterlambatan pertumbuhan fisik pada anak, dimana terjadi kegagalan penambahan berat badan yang sesuai dengan grafik pertumbuhan normal, dibandingkan dengan tinggi badan. Beberapa kondisi menjadi faktor risiko terjadinya gangguan pertumbuhan terutama pada neonatus. Studi ini memberikan gambaran penerapan Model Adaptasi Roy dalam asuhan keperawatan pada lima kasus neonatus dengan risiko gangguan pertumbuhan.Presentasi kasus Kasus 1 neonatus laki-laki, dengan extremely preterm usia gestasi 27 minggu, berat badan lahir 870 gram, neonatus kurang bulan kecil masa kehamilan (NKB-KMK), RDS, TTN, septikemia, tersangka SNAD, neonatal jaundice, terpasang ventilator mode high frequency oscilation (HFO), terpasang orogastric (OGT), diet ASI 12x1 ml, TPN PG 2 dengan GIR 4,7, kebutuhan kalori kurang dari target, interpretasi kurva Fenton dibawah persentil 50, berat badan menurun, usia enam hari 860 gram. Kasus 2 perempuan, extremely preterm usia gestasi 26 minggu, berat badan lahir 744 gram, NKB-KMK, RDS, tersangka SNAD, PDA, neonatal jaundice. Terpasang ventilator, sementara puasa, grafik Fenton berada dibawah persentil 50, kebutuhan kalori kurang dari target. Kasus 3 dan 4 neonatus berjenis kelamin perempuan, lahir dengan extremely preterm dan very preterm, terpasang ventilator, kebutuhan kalori kurang dari target, sementara dipuasakan karena kondisi belum stabil. Kasus 5 perempuan, usia gestasi 37 minggu, BBL 2610 gram, berat badan saat dikaji 2340 gram. Diagnosis medis gastroschizis post tutup defek hari ke 27, terpasang non invasif ventilasi, sementara puasa produksi OGT kehijauan, BB/PB berada di -3SD s/d <-2 SD (gizi kurang). Evaluasi respons adaptif dari kelima pasien didapatkan kebutuhan kalori terpenuhi sesuai target.Kesimpulan Hasil pengkajian perilaku dan stimulus mode fisiologis-fisik kelima kasus didapatkan empat kasus berisiko mengalami gangguan pertumbuhan dari kondisi neonatus lahir prematur, terpasang ventilator, penundaan pemberian makan karena kondisi klinis, risiko infeksi/sepsis serta kondisi medis lain yang mempengaruhi. Satu neonatus aterm gagal tumbuh karena gastroschizis post tutup defek, dengan produksi OGT kehijauan. Nutrisi optimal baik enteral maupun parenteral diperlukan pada kondisi neonatus tersebut untuk meningkatkan respons adaptif.

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Background Failure to thrive or failure to thrive is a condition of delayed physical growth in children, in which there is a failure to gain weight according to the normal growth chart, compared to height. Several conditions are risk factors for growth disorders, especially in neonates. This study provides an overview of the application of the Roy Adaptation Model in nursing care to five cases of neonates with a risk of growth retardation.

Case presentation Case 1 male neonate, with extremely preterm gestational age 27 weeks, birth weight 870 gram, small preterm neonate for gestational age (NKB-KMK), RDS, TTN, septicemia, TSK SNAD, neonatal jaundice, put on ventilator mode high frequency oscillation (HFO), installed orogastric (OGT), diet ASI 12x1 ml, TPN PG 2 with GIR 4.7, caloric requirement less than target, interpretation of Fenton curve below 50th percentile, decreased body weight, age six days 860 gram. Cases of 2 women, extremely preterm, gestational age 26 weeks, birth weight 744 grams, NKB-KMK, RDS, suspected SNAD, PDA, neonatal jaundice. Installed on a ventilator, while fasting, the Fenton chart is below the 50th percentile, calorie needs are less than the target. Cases 3 and 4 female baby were born extremely preterm and very preterm, were attached to a ventilator, their caloric needs were less than the target, while they were fasted because their condition was not yet stable. Case 5 female, gestational age 37 weeks, BBL 2610 grams, body weight when studied 2340 grams. Medical diagnosis of gastroschizis post closed defect on day 27, installed non-invasive ventilation, while fasting green OGT production, BB/PB was in -3SD to <-2 SD (malnutrition). Evaluation of the adaptive response of the five patients found that the calorie needs were fulfilled according to the target.

Conclusion The results of the assessment of the behavior and stimulus of the physiological-physical mode of five cases found that four cases were at risk of experiencing growth retardation from the condition of the neonate born prematurely, being placed on a ventilator, delaying feeding due to clinical conditions, risk of infection/sepsis and other affecting medical conditions. One term neonate failed to thrive because of a closed post gastroschizis defect, with greenish OGT production. Optimal nutrition, both enteral and parenteral, is needed in these neonatal conditions to increase adaptive responses."

"Latar belakang Gagal tumbuh atau failure to thrive adalah kondisi keterlambatan pertumbuhan fisik pada anak, dimana terjadi kegagalan penambahan berat badan yang sesuai dengan grafik pertumbuhan normal, dibandingkan dengan tinggi badan. Beberapa kondisi menjadi faktor risiko terjadinya gangguan pertumbuhan terutama pada neonatus. Studi ini memberikan gambaran penerapan Model Adaptasi Roy dalam asuhan keperawatan pada lima kasus neonatus dengan risiko gangguan pertumbuhan. Presentasi kasus Kasus 1 neonatus laki-laki, dengan extremely preterm usia gestasi 27 minggu, berat badan lahir 870 gram, neonatus kurang bulan kecil masa kehamilan (NKB-KMK), RDS, TTN, septikemia, tersangka SNAD, neonatal jaundice, terpasang ventilator mode high frequency oscilation (HFO), terpasang orogastric (OGT), diet ASI 12x1 ml, TPN PG 2 dengan GIR 4,7, kebutuhan kalori kurang dari target, interpretasi kurva Fenton dibawah persentil 50, berat badan menurun, usia enam hari 860 gram. Kasus 2 perempuan, extremely preterm usia gestasi 26 minggu, berat badan lahir 744 gram, NKB-KMK, RDS, tersangka SNAD, PDA, neonatal jaundice. Terpasang ventilator, sementara puasa, grafik Fenton berada dibawah persentil 50, kebutuhan kalori kurang dari target. Kasus 3 dan 4 neonatus berjenis kelamin perempuan, lahir dengan extremely preterm dan very preterm, terpasang ventilator, kebutuhan kalori kurang dari target, sementara dipuasakan karena kondisi belum stabil. Kasus 5 perempuan, usia gestasi 37 minggu, BBL 2610 gram, berat badan saat dikaji 2340 gram. Diagnosis medis gastroschizis post tutup defek hari ke 27, terpasang non invasif ventilasi, sementara puasa produksi OGT kehijauan, BB/PB berada di -3SD s/d <-2 SD (gizi kurang). Evaluasi respons adaptif dari kelima pasien didapatkan kebutuhan kalori terpenuhi sesuai target.Kesimpulan Hasil pengkajian perilaku dan stimulus mode fisiologis-fisik kelima kasus didapatkan empat kasus berisiko mengalami gangguan pertumbuhan dari kondisi neonatus lahir prematur, terpasang ventilator, penundaan pemberian makan karena kondisi klinis, risiko infeksi/sepsis serta kondisi medis lain yang mempengaruhi. Satu neonatus aterm gagal tumbuh karena gastroschizis post tutup defek, dengan produksi OGT kehijauan. Nutrisi optimal baik enteral maupun parenteral diperlukan pada kondisi neonatus tersebut untuk meningkatkan respons adaptif.

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Background Failure to thrive or failure to thrive is a condition of delayed physical growth in children, in which there is a failure to gain weight according to the normal growth chart, compared to height. Several conditions are risk factors for growth disorders, especially in neonates. This study provides an overview of the application of the Roy Adaptation Model in nursing care to five cases of neonates with a risk of growth retardation. Case presentation Case 1 male neonate, with extremely preterm gestational age 27 weeks, birth weight 870 gram, small preterm neonate for gestational age (NKB-KMK), RDS, TTN, septicemia, TSK SNAD, neonatal jaundice, put on ventilator mode high frequency oscillation (HFO), installed orogastric (OGT), diet ASI 12x1 ml, TPN PG 2 with GIR 4.7, caloric requirement less than target, interpretation of Fenton curve below 50th percentile, decreased body weight, age six days 860 gram. Cases of 2 women, extremely preterm, gestational age 26 weeks, birth weight 744 grams, NKB-KMK, RDS, suspected SNAD, PDA, neonatal jaundice. Installed on a ventilator, while fasting, the Fenton chart is below the 50th percentile, calorie needs are less than the target. Cases 3 and 4 female baby were born extremely preterm and very preterm, were attached to a ventilator, their caloric needs were less than the target, while they were fasted because their condition was not yet stable. Case 5 female, gestational age 37 weeks, BBL 2610 grams, body weight when studied 2340 grams. Medical diagnosis of gastroschizis post closed defect on day 27, installed non-invasive ventilation, while fasting green OGT production, BB/PB was in -3SD to <-2 SD (malnutrition). Evaluation of the adaptive response of the five patients found that the calorie needs were fulfilled according to the target.

Conclusion The results of the assessment of the behavior and stimulus of the physiological-physical mode of five cases found that four cases were at risk of experiencing growth retardation from the condition of the neonate born prematurely, being placed on a ventilator, delaying feeding due to clinical conditions, risk of infection/sepsis and other affecting medical conditions. One term neonate failed to thrive because of a closed post gastroschizis defect, with greenish OGT production. Optimal nutrition, both enteral and parenteral, is needed in these neonatal conditions to increase adaptive responses."

"Anak dengan penyakit ginjal kronik (PGK) akan dilakukan prosedur pengambilan darah dan pemberian agen stimulasi eritropoietin secara rutin dan berkala untuk meminimalkan risiko gagal ginjal secara progresif. Segala rasa sakit dan ketidaknyamanan yang terkait dengan suntikan dapat berdampak negatif terhadap kepatuhan pengobatan dan pengalaman anak secara keseluruhan. Gejala nyeri berpotensi membatasi kondisi fisik dan fungsional anak, sehingga memerlukan penanganan dengan prinsip konservasi energi. Nyeri merupakan suatu bentuk ancaman dari konservasi integritas struktural pada Model Konservasi Levine yang dapat memengaruhi integritas keutuhan dari pasien. Salah satu intervensi keperawatan yang dapat dijadikan sebagai konservator energi adalah dengan penerapan virtual reality yang dapat mengelola nyeri pasien. Tujuan karya ilmiah ini adalah memberikan gambaran pelaksanaan asuhan keperawatan dengan masalah nyeri akut melalui pendekatan Teori Konservasi Levine dan menganalisis efektivitas virtual reality untuk mengurangi nyeri akut selama prosedur penusukan pembuluh darah vena dan pemebrian eritropoietin di Unit Dialisis Anak. Asuhan keperawatan diberikan kepada lima kasus kelolaan pada anak PGK dengan menggunakan Model Konservasi Levine. Asuhan keperawatan diberikan selama tiga hari dengan hasil evaluasi keperawatan yang menunjukkan respons organisme yang baik. Demikian halnya dengan penggunaan virtual reality yang terbukti efektif menurunkan nyeri pada anak PGK. Model Konservasi Levine dapat direkomendasikan dalam asuhan keperawatan pada anak dengan nyeri akut di Unit Dialisis Anak. selain itu, inovator merekomendasikan penggunaan virtual reality dapat diaplikasikan dan diuji klinik lebih lanjut dengan sampel yang lebih besar sehingga dapat dijadikan dasar penyusunan standar operasional prosedur.

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Children with chronic kidney disease (CKD) will undergo blood collection procedures and administer erythropoietin stimulation agents regularly and periodically to minimize the risk of progressive kidney failure. Any pain and discomfort associated with the injection may negatively impact the course of treatment and the child's overall experience. Pain symptoms have the potential to limit a child's physical and functional condition, so they require treatment using energy conservation principles. Pain is a form of threat to the conservation of structural integrity in Levine's Conservation Model which can affect the patient's integrity. One surgical intervention that can be used as an energy conservator is the application of virtual reality which can manage patient pain. The aim of this scientific work is to provide an overview of the implementation of treatment for acute pain problems using Levine's Conservation Theory approach and the effectiveness of virtual reality to reduce acute pain during vein puncture procedures and erythropoietin administration in the Children's Dialysis Unit. Mortality care was provided to five cases of treatment for CKD children using the Levine Conservation Model. Sanitary napkin care was given for three days with evaluation results showing a good organism response. Likewise, the use of virtual reality has been proven to be effective in reducing pain in CKD children. Levine's Conservation Model can be recommended in caring for children with acute pain in the Pediatric Dialysis Unit. Apart from that, the innovator recommends that the use of virtual reality can be applied and tested further in clinical trials with larger samples so that it can be used as a basis for developing standard operational procedures."

"Lingkungan perawatan intensif anak dapat menjadi stimulus yang memengaruhi proses adaptasi anak maupun orang tua/wali. Orang tua akan mengalami tekanan psikologis yang berat seperti stres dan kecemasan. Asuhan keperawatan dengan pendekatan model adaptasi Roy diharapkan dapat membantu proses adaptasi orang tua ketika anak menjalani perawatan di ruang intensif. Tujuan karya tulis ilmiah ini untuk memberikan gambaran aplikasi teori model adaptasi Roy pada orang tua yang mengalami stres dan kecemasan di ruang perawatan intensif anak serta mengembangkan inovasi orientasi pasien baru melalui video untuk menurunkan stres dan kecemasan orang tua. Proses keperawatan digambarkan pada lima kasus dengan menggunakan model adaptasi Roy. Proses keperawatan yang khas pada model adaptasi Roy terdapat pada pengkajian yang dilakukan dua tahap yaitu pengkajian perilaku dan stimulus. Proses selanjutnya menyusun diagnosis, tujuan, dan implementasi keperawatan. Hasil evaluasi akhir diketahui empat dari lima orang tua memiliki respons konsep diri yang adaptif. Kecemasan orang tua menurun setelah mendapatkan video orientasi pada hari pertama anak dirawat. Oleh sebab itu, model adaptasi Roy dapat diaplikasikan pada orang tua yang mengalami stres dan kecemasan di ruang perawatan intensif anak. Inovasi video orientasi dapat dijadikan alternatif media penyampaian informasi yang konsisten kepada orang tua pada saat hari pertama anak dirawat di ruang intensif

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The paediatric intensive care unit can be a stimulus that influences the adaptation process of children and their parents or guardians. Parents will experience severe psychological pressure, such as stress and anxiety. Nursing care using the Roy adaptation model approach is expected to help parents' adaptation processes when children undergo treatment in intensive care. The aim of this scientific paper is to provide an overview of the application of Roy's adaptation model theory to parents who experience stress and anxiety in paediatric intensive care and to develop new patient orientation innovations via video to reduce parental stress and anxiety. The nursing process is described in five cases using Roy's adaptation model. The typical nursing process in the Roy adaptation model consists of an assessment carried out in two stages, namely behavioural and stimulus assessment. The next process develops a diagnosis, goals, and implementation of nursing. The final evaluation results showed that four out of five parents had an adaptive self-concept response. Parental anxiety decreased after receiving an orientation video on the child's first day of care. Therefore, Roy's adaptation model can be applied to parents who experience stress and anxiety in paediatric intensive care. The orientation video innovation can be used as an alternative medium for delivering consistent information to parents on the child's first day of care in the intensive care unit."

"ABSTRAKMalnutrisi, kaheksia, dan obesitas/overweight merupakan masalah nutrisi yang sering ditemui pada anak kanker akibat dari proses penyakit dan efek kemoterapi. Karya Ilmiah Akhir ini bertujuan memberikan gambaran praktek ners spesialis dalam mengaplikasikan model adaptasi Roy pada asuhan keperawatan anak kanker yang mengalami masalah nutrisi. Praktek ners spesialis dilakukan untuk mencapai kompetensi sesuai peran perawat. Aplikasi model adaptasi Roy tertuang dalam lima kasus terpilih dengan masalah yang ditemukan adalah ketidakseimbangan nutrisi kurang dari kebutuhan tubuh, risiko nutrisi kurang dari kebutuhan tubuh dan obesitas. Pendidikan kesehatan berbasis pembuktian ilmiah digunakan sebagai salah satu intervensi keperawatan untuk meningkatkan adaptasi anak sehingga dapat bertoleransi terhadap pemenuhan kebutuhan nutrisi. Evaluasi keperawatan lima kasus tersebut adalah satu kasus beradaptasi secara integrasi, empat kasus beradaptasi secara kompensasi. Karya ilmiah ini merekomendasikan teori model adaptasi Roy dapat diaplikasikan pada asuhan keperawatan anak kanker dengan masalah nutrisi.

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ABSTRACTMalnutrition, cachexia, and obesity/overweight, is a common nutritional problem in children who have cancer as a result of the disease process and the effects of chemotherapy. The aim of this final assignment was to provide an overview of the practice specialist nurses by applying the Roy adaptation model in nursing care of children who have cancer with nutritional problems. Practice spesialis nurses to achieve competency according the role of nurses. Roy adaptation model was applied in five selected cases and the nursing problem found was imbalance nutrition less than the body needs, risk imbalance nutrition less than the body needs and obesity. Health education is evidence based practice be used as a nursing intervention to improve the adaptation level of the child so that it can tolerate the fulfillment of nutrition needs. Nursing evaluation in five selected cases was one case integrated adaptation level and four cases compensatory adaptation level. This paper recommend Roy adaptation model theory can be applied to nursing care in children who have cancer with nutrition problems.;"

"Karya Ilmiah Akhir ini membahas aplikasi Teori Adaptasi Roy dalam asuhan keperawatan pada anak dengan gangguan pemenuhan kebutuhan nutrisi di ruang perawatan anak. Fokus pembahasan terhadap lima kasus berbeda dalam karya ilmiah akhir ini adalah penggunaan teori Adaptasi Roy dalam memenuhi kebutuhan nutrisi anak. Asuhan keperawatan dilakukan melalui proses keperawatan yang meliputi pengkajian perilaku dan stimulus; merumuskan tujuan; menentukan dan melaksanakan intervensi; dan evaluasi. Tujuan keperawatan anak dengan gangguan pemenuhan kebutuhan nutrisi adalah mempertahankan dan meningkatkan perilaku adaptif serta merubah perilaku yang tidak efektif menjadi adaptif. Kemampuan adaptasi anak dapat dilihat dari keempat mode yaitu mode fisiologis, konsep diri, fungsi peran dan interdependence.

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This scientific asignment explored about the application of the Roy's Adaptation Theory in nursing care of children with disorders of nutrition in the child care unit. Five different cases under discussion here, the focus of discussion is the use of the Roy's Adaptation Theory in meet the need of nutrition. Nursing care through Roy's nursing process which includes behavior and stimulus assessment, nursing diagnosis, intervention and evaluation. The goal of nursing is to maintain and enhance adaptive behavior and change ineffective behaviors into adaptive. Adaptability of children can be seen from the fourth mode is the physiological mode, self-concept, role function and interdependence."

"Janin dan bayi prematur menghabiskan sebagian besar waktunya untuk tidur di dalam dan di luar rahim. Tidur dianggap sebagai aktivitas penting pada periode neonatal, serupa dengan pernapasan dan nutrisi. Kebisingan merupakan salah satu penyebab gangguan pola tidur pada bayi prematur di ruang perawatan intensif neonatal dan berdampak pada gangguan tumbuh kembang. Studi ini memberikan gambaran penerapan Model Adaptasi Callista Roy dalam asuhan keperawatan pada lima kasus bayi prematur dengan risiko gangguan pola tidur. Desain yang digunakan adalah studi kasus yang didapatkan dari lima kasus terpilih. Teori Adaptasi Callista Roy mampu memfasilitasi perawat untuk menggali masalah keperawatan pada bayi prematur secara komprehensif. Pemberian edukasi Bundles Alert to Alarm kepada seluruh perawat neonatal menggunakan media pitstop dapat menurunkan angka kebisingan diruang perawatan neonatal. Penerapan teori Adaptasi Callista Roy dan penerapan Bundles allert to alarm dapat direkomendasikan untuk diterapkan dalam asuhan keperawatan yaitu dapat memfasilitasi istirahat tidur bayi prematur yang dirawat di ruang perawatan neonatal.

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Fetuses and premature babies spend most of their time sleeping inside and outside the womb. Sleep is considered an important activity in the neonatal period, similar to breathing and nutrition. Noise is one of the causes of disturbed sleep patterns in premature babies in the neonatal intensive care room and has an impact on growth and development disorders. This study provides an overview of the application of the Callista Roy Adaptation Model in nursing care in five cases of premature babies at risk of sleep pattern disorders. The design used is a case study obtained from five selected cases. Callista Roy's Adaptation Theory is able to facilitate nurses to comprehensively explore nursing problems in premature babies. Providing Bundles Alert to Alarm education to all neonatal nurses using pitstop media can reduce noise levels in the neonatal care room. The application of Callista Roy's Adaptation theory and the application of Bundles alert to alarm can be recommended for application in nursing care, namely it can facilitate sleep for premature babies who are cared for in the neonatal care room."

"Karya Ilmiah Akhir ini merupakan gambaran kegiatan praktik Residensi Ners Spesialis Keperawatan Anak dengan tujuan memberikan gambaran aplikasi Model Adaptasi Roy dalam melakukan asuhan keperawatan pada anak kanker dengan masalah ketidakseimbangan nutrisi kurang dari kebutuhan tubuh. Intervensi keperawatan dilakukan untuk meningkatkan mekanisme koping kognator dan regulator anak, sehingga mampu beradaptasi dengan masalah yang dialaminya. Evaluasi adaptasi klien dari lima kasus kelolaan bervariasi. Sebagian besar anak beradaptasi pada tingkat kompensasi, satu orang anak beradaptasi pada tingkat kompromi dan satu orang anak beradaptasi pada tingkat integritas.

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This study describes the residency activities of child nursing specialist. The aim of the study is to describe the application of Roy Adaptation Model in nursing children with cancer and nutritional imbalance (less than the body needs). The nursing intervention was conducted to improve children's kognator and regulator coping mechanism, so they could cope with their problems. Adaptation evaluation of five clients showed varies results. Three children adapted at compensatory level, one at compromised level, and one at integrated level."