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Abstrak :
Self-care merupakan bagian penting dalam upaya peningkatan kualitas hidup pasien gagal jantung. Self-care adalah pengambilan keputusan secara natural oleh individu dalam berperilaku untuk mempertahankan kestabilan fisiologis tubuhnya dan sebagai respon terhadap tanda dan gejala yang terjadi pada diri individu. Keadekuatan individu dalam melakukan self-care dapat dipengaruhi oleh berbagai faktor internal maupun eksternal dari individu. Identifikasi faktor tersebut menjadi bagian penting untuk memberikan asuhan keperawatan mengenai self-care yang efektif. Penelitian ini bertujuan untuk mengidentifikasi pengaruh dari karakteristik responden, status fungsional, komorbiditas, lama diagnosis, tingkat pengetahuan, tingkat depresi, serta dukungan sosial terhadap self-care. Desain penelitian menggunakan cross sectional survey pada 120 responden yang diambil dengan tehnik purposive sampling di Poliklinik Jantung. Penelitian menggunakan kuesioner SCHFI (self-care heart failure index) dalam mengukur self-care responden. Hasil penelitian menunjukan pekerjaan (p=0,055; CI 95%), pendidikan (p=0,232; CI 95%), dan penghasilan (p=0,027; CI 95%) mempengaruhi self-care individu secara signifikan. Responden yang bekerja, berpendidikan tinggi, dan berpenghasilan lebih dari Rp. 2.000.000 memiliki self-care yang lebih adekuat.

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Adherence to self-care is important for heart failure patients to improve their quality of life. Self-care defined as individual naturalistic decision making process that's patients use in the choice of behaviors that maintain physiological stability and as a respons to underlying sign and symptoms. Understanding the factors that enable or inhibit self-care is essential in developing effective health care interventions. The Aim of study was to analyze and identified factors (characteristic, functional class, comorbidity, time was diagnosed, knowledge, depression, and social support) influencing self-care. Cross sectional design used in this study to measure 120 outpatients using Self-Care Heart Failure Index (SCHFI) Indonesian version questioner. The result of the study indicated employe/e patients (p=0,055; CI 95%), have education higher than junior high school (p=0,232; CI 95%), and have income higher than Rp. 2.000.000 (p=0,027; CI 95%) showed more adequate in self-care behaviour. Self-care strategies for HF should targeted for patient with lower education, unemployed, and have an income lower than Rp. 2.000.000 to improve their quality of life.

Abstrak :
Praktik Spesialis Keperawatan Medikal Bedah peminatan respirasi memiliki tujuan untuk mencapai kompetensi Ners Spesialis Respirasi. Pencapaian kompetensi dilakukan melalui 3 bentuk kegiatan, antara lain: pengelolaan 30 pasien gangguan sistem respirasi dengan menggunakan pendekatan teori model Adaptasi Roy, pengelolaan kasus kompleks dengan pendekatan teori model Adaptasi Roy, penerapan Tehnik Pernapasan Buteyko pada pasien asma sebagai suatu praktik keperawatan berbasis bukti (Evidence Based Practice Nursing), dan pelaksanaan inovasi keperawatan: pembuatan WSD Pionir dengan sistem 1 botol sebagai upaya peningkatan kualitas pelayanan dan keamanan pasien (patient safety). Praktik dilaksanakan selama 9 bulan di RSUP Persahabatan sebagai rumah sakit pusat rujukan nasional penyakit paru. Ners spesialis respirasi mencapai kompetensi sebagai expert practice, educator, innovator/agent of change, researcher, dan consultant selama praktik di rumah sakit. Hasil dari pencapaian kompetensi didapatkan kesimpulan bahwa teori model Adaptasi Roy dapat diterapkan dengan efektif pada kasus-kasus gangguan respirasi terutama kasus TB Paru, Kanker Paru, dan pasien Pneumonia. Penerapan teori Adaptasi Roy pada pasien dengan ventilator sulit diterapkan terutama pada mode pangkajian konsep diri, fungsi peran, dan interdependensi. Pelaksanaan EBNP tehnik pernapasan Buteyko selama 1 bulan memberikan pengaruh secara signifikan pada peningkatan kualitas hidup pasien asma, nilai Arus Puncak Respirasi (APE), dan nilai control pause (CP). Pembuktian keefektifan botol WSD Pionir terhadap kualitas dan kemananan pasien akan diuji secara ilmiah melalui proses penelitian. ......The residency practicum of medical surgical nursing with a specialization in respiratory aimed to facilitate residents in achieving the competences as Respiratory Nurse Specialists. After the completion of the residency practicum, students would be able to achieve the competences as clinical experts, educators, innovators/ change agents, researchers, and consultants in respiratory care. Three major activities during the practicum were: 1) the application of Roy adaptation model- based nursing care and complex case management to 30 patients with respiratory disorders, 2) the application of Buteyko breathing method to asthmatic patients as an evidence- based nursing practice, and 3) the implementation of innovative project: the creation of water- seal drainage- pioneer with one- bottle system as an effort to improve patient safety and quality care. The practicum was completed in 9 months at Persahabatan Hospital as a top referral hospital for respiratory care. Results of the practicum activities revealed that Roy adaptation model was effective to improve patient safety as well as quality care to patients with respiratory disorders, particularly patients with pulmonary tuberculosis, lung cancer, and pneumonia. In addition, the results showed that the application of Buteyko breathing method for a month significantly enhanced the quality life of asthmatic patients, increased the respiratory peak flow and control pause values. Further studies, nonetheless, are required to examine the effectiveness of WSD pioneer to the improvement of patient safety and quality care.