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"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."

"Untuk menjadi seorang Ners Spesialis Keperawatan Medikal Bedah, seorang residen harus menjalani Praktik residensi sesuai dengan kekhususan tersebut. Residen spesialis keperawatan medikal bedah berperan sebagai pemberi pelayanan dalam asuhan keperawatan profesional menggunakan pendekatan model adaptasi Roy pada kasus utama gagal ginjal terminal yang menjalani hemodialisis. Residen berperan sebagai peneliti menerapkan tindakan keperawatan berbasis bukti dengan topik refleksologi kaki untuk meningkatkan kualitas tidur pasien hemodialisis. Dari penerapan keperawatan berbasis bukti ini didapat hasil perubahan kualitas tidur pada pasien hemodialisis yang mendapatkan refleksologi kaki sebelum dan sesudah tindakan.

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To become a urinary system nurse specialist, a student must undergo the residency practice of medical surgical nursing in accordance with the specificity. The resident of the medical Surgical Nursing Specialist acts as a service provider in professional nursing care using the Roy adaptation model approach in the main case of terminal kidney failure on HD. Resident acts as researcher using evidence-based nursing actions with foot reflexology to improve sleep quality hemodialysis patients. From the application of evidence-based nursing, the results of changes in sleep quality were obtained in hemodialysis patients who received foot reflexology before and after the action."

"Gangguan pada system endokrin menimbulkan dampak yang kompleks pada system tubuh dan salah satunya adalah diabetes melitus (DM). Diabetes melitus merupakan penyakit kronis dan jumlahnya terus meningkat di seluruh dunia termasuk di Indonesia. Pencegahan komplikasi memerlukan peran dari berbagai multidisiplin ilmu, salah satunya perawat spesialis medikal bedah dalam memberikan asuhan keperawatan dengan menggunakan pendekatan model adaptasi Roy. Model adaptasi Roy dapat dijadikan dalam acuan dalam memberikan asuhan keperawatan yang holistik dan komprehensif dengan meminimalkan stimulus yang mempengaruhi adaptasi agar tercapai perilaku yang adaptif. Komplikasi kronik yang banyak terjadi adalah masalah kaki DM sehingga diperlukan pencegahan dengan melakukan praktek berdasarkan bukti (evidence based practice): pengaruh masase kaki secara manual terhadap sensasi proteksi, nyeri, dan Ankle Brachial Indek (ABI) pasien DM tipe 2. Peran perawat spesialis juga sebagai innovator untuk mengkaji pengetahuan pasien sebelum memberi edukasi dengan menggunakan format evaluasi edukasi sehingga dapat diketahui tingkat pengetahuan pasien. Perawat cukup memberi edukasi sesuai kebutuhan yang diperlukan pasien.

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Endocrine system disorders create complex impacts towards body systems and one of those is Diabetes Mellitus. Diabetes mellitus is a choronic disease and its prevalence is continuously increasing worldwide including Indonesia. A multidisciplinary approach is essential to prevent DM complications and improve patient's quality of life. The medical surgical nurse specialist is expected to have a central role in diabetes care, and to perform nursing care based on Roy's adaptation model. Roy adaptation model can be utilized as a framework for nurses in providing a holistic and comprehensive nursing care by minimizing stimuli that affect patient's ability to become adaptive. Mostly chronic complication of DM is foot ulceration, so prevention with evidence based practice is needed: the effect of manual foot massage for protective sensation, pain, and Ankle Brachial Index (ABI) patient DM type 2. The medical surgical nurse specialist took park as the innovator to assess patient's knowledge before giving health education with evaluation format to see the level of patient knowledge. The nurse only educates the patient as needed."

"[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.]"

"ABSTRAKLatar belakang: Peran perawat maternitas dalam merawat klien dengan neoplasma ovarium kistik adalah dengan menerapkan asuhan keperawatan komprehensif yang bertujuan dalam peningkatan respon adaptif sehat atau sakit serta memberikan kenyamanan, ketentraman, dan kelegaan bagi klien baik secara fisik, psikologi, sosial, dan spiritual. Teori yang dapat digunakan adalah teori adaptasi Roy dan kenyamanan Kolcaba.Ilustrasi kasus: Dua dari lima kasus kelolaan menjalani pembedahan, sedangkan tiga kasus harus menunda operasi untuk perbaikan keadaan umum terlebih dahulu karena adanya anemia dan menjalani transfusi darah. Pembedahan yang dilakukan adalah Histerektomi Salpingo Ooforektomi Bilateral, Lympadenektomi, Adhesiolisis, dan Appendiktomi. Kemudian dilakukan intervensi keperawatan berdasarkan respon, dengan adanya respon yang berbeda dari setiap klien terhadap asuhan keperawatan yang diberikan, maka dilakukan modifikasi intervensi keperawatan.Kesimpulan: kedua teori ini sesuai untuk diterapkan pada klien dengan neoplasma ovarium kistik dalam meningkatkan kenyamanan dan membantu klien beradaptasi secara fisiologis dengan kondisi yang dialaminya.

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ABSTRACTABSTRACT Background The role of maternity nurses in caring for clients with cystic ovarian neoplasms is to apply comprehensive nursing care aimed at improving healthy or sick adaptive responses and providing comfort, tranquility and relief for clients physically, psychologically, socially, and spiritually. The theory that can be used is the theory of Roy 39 s adaptation and the comfort of Kolcaba.Case illustration Two out of five cases underwent surgery, while three cases had to postpone surgery to repair the general condition first because of anemia and undergo blood transfusions. Surgery is performed Histerectomy Bilateral Ooforectomy, Lympadenektomi, Adhesiolisis, and Appendiktomi. Then nursing intervention based on the response, with different responses from each client to nursing care given, then modified nursing intervention.Conclusion both of these theories are appropriate to be applied to clients with cystic ovarian neoplasms in enhancing comfort and helping clients adapt physiologically to the conditions they experience."

"Praktek klinik spesialis keperawatan medikal bedah pada sistem perkemihan secara keseluruhan bertujuan untuk memberikan asuhan keperawatan tingkat lanjut, menerapkan praktek keperawatan berbasis bukti serta berperan sebagai agen pembaharu di ruang perawatan. Peran sebagai pemberi asuhan keperawatan dilakukan dengan menggunakan pendekatan Model Adaptasi Roy pada 30 pasien gangguan sistem perkemihan dan pada pasien urolithiasis sebagai kasus utama. Peran sebagai peneliti dilakukan melalui penerapan Evidence Based Nursing berupa penerapan format DSI Dialysis Symptom Index pada 164 pasien hemodialisis terbukti memudahkan perawat dalam mengidentifikasi keseluruhan sindroma hemodialisis yang dialami pasien. Peran sebagai inovator dilakukan dengan menerapkan latihan ROM Range of Motion terbukti dapat menurunkan nilai fatigue yang diukur dengan format FACIT-F Functional Assessment of Chronic Illness Therapy- Fatigue

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Clinical practice of medical surgical nursing specialist in urinary system aimed to provide the advance nursing care to implement the evidence based nursing and to act as an innovator in the treatment room. The role as a caregiver in nursing process was carried out using Roy's Adaptation Theory toward 30 patients with urinary system disorder and toward an urolithiasis patient as a main case. The role as a researcher was carried out by implementing evidence based nursing about assessment of hemodialysis syndrome by using DSI Dialysis Symptom Index on 164 hemodialysis patients that can facilitate nurses to identify all of patient's hemodialysis syndrome. The role as an innovator was carried out by doing Range of Motion ROM exercise that was proven to reduce fatigue level measuring by FACIT F Functional Assessment of Chronic Illness Therapy Fatigue."

"Perawat memiliki peran dalam meningkatkan pengetahuan dan keterampilan pasien dalam upaya meningkatkan pencegahan perburukan penyakit yang dapat menurunkan derajat kesehatan mereka.Peningkatan prevalensi penyakit kardiovaskular secara langsung mengakibatkan peningkatan hospitalisasi dan kematian. Perawat memiliki peran dalam meningkatkan pengetahuan dan keterampilan pasien dalam upaya meningkatkan pencegahan perburukan penyakit yang dapat menurunkan derajat kesehatan mereka dengan menjalankan perannya baik sebagai pemberi asuha, pendidik, peneliti, dan pembaharu. Peran sebagai pemberi asuhan keperawatan dan pendidik diterapkan pada 31 pasien dengan berbagai macam kasus kardiovaskular baik kasus medical maupun surgical. Pendekatan teori model yang digunakan adalah Teori Adaptasi Sister Callista Roy. Hasil analisis praktek menunjukkan bahwa teori Adaptasi Roy dapat digunakan pada asuhan keperawatan klien dengan gangguan sistem kardiovaskular. Peran peneliti dilakukan dengan melakukan uji kelayakan Zadit Burden Interview sebagai instrument pengkajian beban caregiver pada klien dengan gagal jantung. Hasil uji validitas dan reliabilitas menunjukkan bahwa instrument tersebut memiliki reliabilitas yang cukup baik, namun harus dimodifikasi kembali dikarenakan terdapat 5 pertanyaan yang tidak valid. Adapun peran sebagai pembaharu adalah dengan merancang screening kebutuhan paliatif. Hasil uji validitas menunjukkan adanya hubungan yang positif dan kuat antara skor paliatif dengan beratnya gejala r=0,53, p=0,004.

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Nurses have a role in improving the knowledge and skills of patients in an effort to improve the prevention of worsening disease that can reduce their health status. Increased prevalence of cardiovascular disease directly leads to increased hospitalization and death. Nurses have a role in improving the knowledge and skills of patients in an effort to improve the prevention of disease deterioration that can reduce their health by performing their role as a caregiver, educator, researcher, and inovator. Roles as nursing caregivers and educators are applied to 31 patients with various cardiovascular cases in both medical and surgical cases. The model theory approach used is Sister Callista Roy Adaptation Theory. The results of the practice analysis show that Roy's Adaptation theory can be used on client's nursing care with cardiovascular system disorders. The role of the researcher was conducted by conducting the Zadit Burden Interview feasibility test as a caregiver burden assessment instrument on clients with heart failure. Validity and reliability test results indicate that the instrument has a good enough reliability, but must be modified again because there are 5 invalid questions. The role of inovator is by designing palliative needs screening. The results of the validity test showed a positive and strong correlation between the palliative score and the symptomp burden r = 0.53, p = 0.004."

"Praktik Spesialis Keperawatan Medikal Bedah dengan kekhususan pada sistem muskuloskeletal ini bertujuan untuk mengaplikasikan peran perawat sebagai pemberi asuhan, pengelola, pendidik dan peneliti. Peran sebagai pemberi asuhan dilakukan dengan mengelola satu kasus utama; fraktur tertutup intertrokhanter femur dan 30 pasien yang mengalami masalah pada sistem muskuloskeletal dengan pendekatan teori adaptasi Roy. Peran perawat sebagai peneliti dilakukan dengan penerapan tindakan keperawatan yang berbasis bukti ilmiah (Evidence-Based Nursing Practice) yaitu dengan menerapakan foot massage untuk mengurangi nyeri dan kecemasan pada pasien paska pembedahan fraktur ekstremitas bawah. Sedangkan peran sebagai pengelola dilakukan dengan menyusun protokol pengembangan ERAS untuk pasien yang akan menjalani operasi hip. Seluruh rangkaian kegiatan tersebut bertujuan untuk mewujudkan asuhan keperawatan yang komprehensif dalam rangka meningkatkan kualitas pelayananan keperawatan.Clinical Practice of Medical-Surgical Nursing Spesialialist in specialty of orthopaedic nursing aims to apply the role of nurse as a direct patient care provider, managers, educators and researchers in the clinical setting. Role as a care provider has done by one patient (major managed cases) with closed fracture intertrochanter femur and 30 patients with musculoskeletal problems using adaptation Roy Nursing theory approach. The role of nurses as a researchers has contructed by applying the nursing action based by evidence is foot massage to reduce pain and anxiety in patients after surgery for lower limb fracture. While the role as a nursing manager is done by comliling the ERAS development protocol for patients who undergo hip surgery. All activities aim to realizing the holistic nursing care in order to improve the quality of nursing services."

"Saat ini profesi keperawatan telah mengalami perkembangan. Munculnya seorang perawat spesialis diharapkan dapat meningkatkan mutu pelayanan keperawatan dalam bidang kekhususannya, salah satu bidangnya yaitu keperawatan digestif. Program pendidikan spesialis keperawatan diadakan untuk memenuhi harapan tersebut. Penulisan KIAS bagi mahasiswa residen peminatan digestif, berisi tentang pengalamannya merawat 30 pasien dengan masalah sistem pencernaan menggunakan pendekatan teori model adaptasi Roy, penerapan intervensi keperawatan berdasarkan bukti ilmiah (evidence based practice), serta pelaksanaan proyek inovasi. Melakukan studi kasus dengan 30 pasien kelolaan menggunakan pendekatan teori model adaptasi roy, sesuai untuk digunakan pada pasien dengan kanker kolorektal. Penerapan evidence based nursing aromatherapy massage cukup efektif menurunkan kecemasan dan peningkatan kualitas tidur pasien pra-operasi kolorektal. Penerapan video edukasi efektif meningkatkan pengetahuan pasien pra-operasi kolostomi. Perawat yang berkompetensi massage diperlukan, agar ada alternatif intervensi keperawatan yang berkaitan dengan kecemasan dan kualitas tidur. Pemberian video edukasi stoma, diharapkan menjadi satu paket perawatan pasien stoma.

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Nowadays the nursing profession has developed. The emergence of a specialist nurse is expected to improve the quality of nursing services in their specialty areas, one of the fields being digestive nursing. Nursing specialist education programs are held to meet these expectations. The writing of KIAS for digestive resident students contains the experience of treating 30 patients with digestive system problems using Roy's adaptation model theory approach, the application of evidence-based nursing interventions, and the implementation of innovation projects. Conducted a case study with 30 patients under management using a theoretical approach to the Roy adaptation model, suitable for use in patients with colorectal cancer. The application of evidence based nursing aromatherapy massage is quite effective in reducing anxiety and improving sleep quality in colorectal preoperative patients. The application of educational videos effectively increases the patient's knowledge of pre-colostomy surgery. Nurses with competence in massage are needed, so that there are alternative nursing interventions related to anxiety and sleep quality. Providing stoma education videos, is expected to be a package of stoma patient care."

"Pelaksanaan praktek residensi keperawatan medical bedah peminatan imunologi ditujukan supaya perawat residen mampu memberikan asuhan keperawatan spesialis dalam menerapkan evidence-based nursing (EBN) yang berperan sebagai inovator dan edukator di pelayanan keperawatan. Peran perawat residen sebagai pemberi asuhan keperawatan dilakukan dengan menerapkan teori adaptasi Roy pada pasien dengan HIV dan AIDS dengan TB Paru dan 30 pasien HIV dan AIDS dengan infeksi oportunistik lainnya. Masalah keperawatan yang paling banyak didapatkan yaitu risiko ketidakseimbangan elektrolit, intervensi keperawatan yang dilakukan adalah pemantauan elektrolit dengan tujuan keseimbangan elektrolit meningkat. Penerapan EBN pemberian probiotik yogurt pada pasien dengan HIV, AIDS dan keganasan yang menunjukkan kandidiasis oral berupa plak putih pada lidah. Probiotik yogurt diberikan 2 kali sehari selama 5 hari dengan penilaian evaluasi skor tongue coating Miyazaki, hasil menunjukkan 45,6% terjadi penurunan skor dari grade 3 menjadi grade 0. Proyek inovasi pemberian edukasi dengan materi infeksi oportunistik yang menunjukkan pengetahuan dan sikap ODHA meningkat setelah pemberian edukasi.

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The implementation of medical surgical residency practice with specialization in immunology is intended for resident nurses to provide specialist nursing care in implementing evidence-based nursing (EBN) which acts as an innovator and educator in services that are capable of being involved. The role of the resident nurse as a care giver is carried out by applying Roy's adaptation theory to patients with HIV and AIDS with pulmonary TB and 30 HIV and AIDS patients with other opportunistic infections. The most commonly encountered problem is the risk of going to electrolyte court, the engagement intervention for the risk of electrolyte stress is electrolyte monitoring with the aim of increasing electrolyte balance. Application of EBN giving probiotic yogurt to patients with HIV, AIDS and malignancy showing oral candidiasis in the form of white plaque on the tongue. Probiotic yogurt was given 2 times a day for 5 days with an evaluation of the Miyazaki tongue coating score, the results showed a 45.6% decrease in score from grade 3 to grade 0. An innovation project providing education with material on opportunistic infections which shows that the knowledge and attitudes of PLWHA have increased after providing education."