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Abstrak :
Pendahuluan: Pasien dengan gagal jantung sangat rentan mengalami readmisi yang disebabkan oleh berbagai masalah seperti persepsi terhadap gejala, pengobatan, kepatuhan diet, dukungan sosial, kemampuan kognitif dan ekonomi dalam melaksanakan perawatan diri, persepsi penyakit dan akses ke perawatan kesehatan. Perawatan paliatif kardiovaskular khususnya pada pasien gagal jantung bertujuan agar pasien dan keluarga mendapatkan ketenangan dan merasakan suasana aman baik secara fisik, psikososial, spiritual, dan permasalahan lainnya, serta membuat pasien dan keluarga memiliki pemahaman yang sama dengan perspektif medis. Oleh karena itu penelitian ini bertujuan untuk mengeksplorasi pengalaman keluarga pasien gagal jantung yang mendapatkan perawatan paliatif.  Metode: Penelitian menggunakan jenis penelitian kualitatif dengan pendekatan fenomenologi deskriptif. Partisipan dalam penelitian ini yaitu keluarga pasien gagal jantung yang memiliki pengalaman mendapatkan perawatan paliatif, mampu berkomunikasi dengan baik dan jelas, serta bersedia untuk menjadi partisipan dengan memberikan persetujuan melalui informed consent.  Hasil: Tema-tema yang teridentifikasi dalam pelelitian ini yaitu: (1) Keluarga mengenali keluhan fisik pasien gagal jantung yang mendapatkan perawatan paliatif, (2) Dukungan keluarga dalam perawatan pasien gagal jantung yang mendapatkan perawatan paliatif, (3) Alasan mendapatkan perawatan paliatif, (4) Persepsi keluarga terhadap perawatan paliatif.  Kesimpulan: Keluarga memainkan peran penting dalam perawatan pasien gagal jantung yang mendapatkan perawatan paliatif dalam mendampingi pasien selama perawatan di rumah sakit hingga perawatan selanjutnya ketika pulang kerumah. Dengan adanya dukungan dari tim perawatan paliatif dalam bentuk pendampingan bagi pasien dan keluarga, mampu memberikan dampak positif serta meningkatkan kualitas hidup. Sehingga dibutuhkan tim perawatan paliatif khususnya perawat kardiovaskular yang professional yang dapat memenuhi kebutuhan pasien gagal jantung beserta keluarga dalam memberikan layanan perawatan paliatif yang berkualitas di Indonesia. ......Introduction: Patients with heart failure are very susceptible to readmission caused by various problems such as perception of symptoms, medication, dietary compliance, social support, cognitive and economic abilities in carrying out self-care, perception of illness and access to health care. Cardio palliative care, especially for patients with heart failure, aims to make patients and families feel calm and feel a safe atmosphere both physically, psychosocially, spiritually, and other problems, as well as to make patients and families have the same understanding from a medical perspective. Therefore, this study aims to explore the experiences of families of heart failure patients receiving palliative care. Method: This research uses a qualitative research type with a descriptive phenomenological approach. Participants in this study were families of heart failure patients who had experience in receiving palliative care, were able to communicate well and clearly, and were willing to become participants by giving informed consent. Results: The themes identified in this research were: (1) Families recognize the physical complaints of heart failure patients who receive palliative care, (2) Family support in caring for heart failure patients receiving palliative care, (3) Reasons for receiving palliative care, (4) Family perceptions of palliative care. Conclusion: The family plays an important role in the care of heart failure patients who receive palliative care in accompanying patients during treatment at the hospital until further care when they return home. With the support of the palliative care team in the form of assistance for patients and families, it can have a positive impact and improve the quality of life. So that a palliative care team is needed, especially professional cardiovascular nurses who can meet the needs of heart failure patients and their families in providing quality palliative care services in Indonesia.

Abstrak :
Gagal jantung merupakan penyakit kronis dengan angka re-hospitaliasi dan angka mortalitas yang tinggi. Pasien gagal jantung masih mengalami berbagai masalah terkait symptom burden dan distress psikologis yang mempengaruhi kualitas hidup. Tujuan dari penelitian ini adalah untuk mengidentifikasi hubungan symptom burden dan distress psikologis pasien gagal jantung dengan kebutuhan perawatan paliatif di ruang rawat inap. Metode penelitian ini menggunakan metode studi deskriptif analitik korelasional dengan pendekatan cross sectional. Ukuran sampel sebanyak 120 pasien ditetapkan dengan purposive sampling. Responden diberikan tiga kuesioner yaitu Edmonton Symptom Assessment Scale (ESAS), Hospital Anxiety and Depression Scale (HADS), Problems and Needs in Palliative Care (PNPC). Hasil riset menunjukkan symptom burden (70%) dan distress psikologis (82,5%) pasien gagal jantung tahap lanjut berasa pada tingkat ringan. Dan seluruh responden (100%) menyatakan memiliki masalah perawatan paliatif dan sebanyak (92,5 %) yang membutuhkan perawatan paliatif. Hubungan yang signifikan antara symptom burden dengan masalah dan kebutuhan perawatan paliatif dengan dengan p value <0,0001. Terdapat hubungan antara distress psikologis dengan masalah perawatan paliatif dengan p value <0,0001, namun tidak ada hubungan antara distress psikologis dengan kebutuhan perawatan paliatif dengan p value 0,211. Rekomendasi dari hasil penelitian ini adalah perlunya pendekatan paliatif dalam melakukan intervensi psikologis dan pentingnya edukasi terhadap pasien dan keluarga terkait dengan efek samping dari pengobatan dan progresivitas penyakit. ......Heart failure is a chronic disease with a high rehospitalization rate and mortality rate. Heart failure patients still experience various problems related to symptom burden and psychological distress that affect their quality of life. The purpose of this study was to identify the relationship between symptom burden and psychological distress in heart failure patients with a need for palliative care in the inpatient unit. This research method uses a correlational analytic descriptive study method with a cross-sectional approach. The sample size of 120 patients was determined by purposive sampling. Respondents were given three questionnaires, namely the Edmonton Symptom Assessment Scale (ESAS), the Hospital Anxiety and Depression Scale (HADS), and Problems and Needs in Palliative Care (PNPC). The results of the research showed that the symptom burden (70%) and psychological distress (82.5%) of advanced heart failure patients were at a mild level. And all respondents (100%) said they had palliative care problems, and as many (92.5%) needed palliative care. There is a significant relationship between symptom burden with problems and the need for palliative care, with a p value of 0.0001. There is a relationship between psychological distress and palliative care problems with a p value of 0.0001, but there is no relationship between psychological distress and the need for palliative care with a p value of 0.211. Recommendations from the results of this study include the need for a palliative approach to conduct psychological intervention and the importance of educating patients and their families regarding the side effects of treatment and disease progression.

Abstrak :
Program pembatasan cairan perlu dilakukan pada pasien gagal jantung yang mengalami hipervolemia. Pembatasan cairan berdampak positif terhadap kualitas hidup pasien, tetapi intervensi tersebut tidak menyenangkan dan menantang. Pasien melaporkan ketidaknyamanan akibat rasa haus yang tidak terkontrol dan xerostomia yang sangat mengganggu. Penelitian ini bertujuan untuk mengidentifikasi perbedaan pengaruh pemberian stroberi beku sebanyak 3 kali/hari dan 5 kali/hari terhadap rasa haus dan xerostomia pasien gagal jantung yang menjalani program pembatasan cairan. Penelitian ini merupakan Randomized Controlled Trial (RCT) dengan single-blind dan parallel group design yang terdiri dari 3 kelompok, yaitu kelompok frozen strawberry 0 (FS0), 3 kali/hari (FS3), dan 5 kali/hari (FS5). Responden berjumlah 22 pasien gagal jantung pada masing-masing kelompok. Hasil penelitian menunjukkan bahwa terdapat perbedaan intensitas haus, distress haus, dan xerostomia yang signifikan antara ketiga kelompok (p 0,00; α 0,05). Namun, analisis perbandingan antara kelompok frozen strawberry 3 kali/hari dengan 5 kali/hari dalam penelitian ini menunjukkan bahwa tidak terdapat perbedaan intensitas haus (p = 0,45), distress haus (p = 0,08), dan xerostomia (p = 0,69) yang signifikan diantara kedua kelompok tersebut (p > α). Pemberian stroberi beku 3 kali/hari memiliki pengaruh yang sama dengan pemberian stroberi beku 5 kali/hari. Penelitian ini merekomendasikan perawat untuk mengatasi haus dan xerostomia pada pasien gagal jantung yang menjalani pembatasan cairan dengan memberikan stroberi beku 3 kali/hari ataupun 5 kali/hari. Penelitian selanjutnya diharapkan dapat mencari alternatif buah yang memiliki kandungan serupa dengan stroberi, namun lebih murah dan lebih mudah didapatkan pasien. ......Fluid restriction programs need to be carried out in patients with heart failure who experience hypervolemia. Fluid restriction has a positive impact on patients' quality of life, but the intervention is unpleasant and challenging. Patients report discomfort due to uncontrolled thirst and xerostomia which is very disturbing. This study aimed to identify differences in the effect of giving frozen strawberries 3 times/day and 5 times/day on thirst and xerostomia in heart failure patients undergoing a fluid restriction program. This study was a Randomized Controlled Trial (RCT) with single-blind and parallel group design consisting of 3 groups, namely frozen strawberry group 0 (FS0), 3 times/day (FS3), and 5 times/day (FS5). Respondents were 22 heart failure patients in each group. The results showed that there were significant differences in thirst intensity, thirst distress, and xerostomia between the three groups (p 0.00; α 0.05). However, a comparative analysis between the frozen strawberry 3 times/day and 5 times/day groups in this study showed that there was no difference in thirst intensity (p = 0.45), thirst distress (p = 0.08), and xerostomia (p = 0.69) which was significant between the two groups (p > α). Giving frozen strawberries 3 times/day has the same effect as giving frozen strawberries 5 times/day. This study recommends that nurses treat thirst and xerostomia in heart failure patients undergoing fluid restriction by giving frozen strawberries 3 times/day or 5 times/day. Future research is expected to be able to find alternative fruit that has a similar content to strawberries, but is cheaper and easier to obtain for patients.

Abstrak :
Penyakit kardiovaskular menjadi salah satu penyebab kematian tertinggi di tingkat global. Upaya tindakan pencegahan dan tatalaksana terus dikembangkan untuk mengatasi permasalahan ini. Perawat spesialis memiliki peran sebagai pemberi asuhan keperawatan langsung, menerapkan evidence base nursing dan melakukan inovasi keperawatan. Praktik residensi spesialis keperawatan medikal bedah telah dilaksanakan untuk mengaplikasikan peran tersebut. Peran sebagai pemberi asuhan keperawatan langsung dilakukan dengan memberikan asuhan keperawatan pada 30 kasus kelolaan resume dan kasus kelolaan utama ADHF dengan teori Model Adaptasi Roy. Peran sebagai peneliti dijalankan dengan melakukan edukasi self-care pasien gagal jantung menggunakan metode teach-back. Peran perawat sebagai inovator dilakukan dengan menyusun proyek inovasi tentang penggunaan Munro Pressure injury Risk Assessment Scale untuk mencegah kejadian Perioperative related Pressure injury. Hasil analisis praktik menunjukkan bahwa Model Adaptasi Roy efektif digunakan untuk pasien dengan gangguan sistem kardiovaskular, edukasi self-care pada pasien gagal jantung dengan metode teach-back dapat meningkatkan pengetahuan, efikasi diri dan kemampuan self-care. Selain itu Munro Pressure injury Risk Assessment Scale dapat diterapkan untuk mencegah kejadian Perioperative related Presure Injury. ......Cardiovascular disease is one of the leading causes of death globally. Efforts to carry out management and prevention are always being developed to overcome this problem. Nurse specialists have a role as direct nursing care providers, applying evidence-based nursing and carrying out nursing innovations. The residency practice of medical-surgical nursing specialists has been implemented to apply for this role. The role of a direct nursing care provider is carried out by providing nursing care in 30 resume cases and ADHF main cases with Roy’s Adaptation Model theory. The role of a researcher is carried out by conducting self-care education for heart failure patients with the teach-back method. The role of nurses as innovators is carried out by developing an innovative project, namely "Using the Munro Pressure Injury Risk Assessment Scale to Prevent Perioperative-Related Pressure Injury." The results of practice analysis show that the Roy Adaptation Model is effective for patients with cardiovascular system disorders, and self-care education in heart failure patients with the teach-back method can improve knowledge, self-efficacy, and self-care abilities. In addition, the Munro Pressure Injury Risk Assessment Scale can be applied to prevent perioperative-related Pressure injury events.

Abstrak :
schemic Heart Disease merupakan salah satu penyebab kematian paling umum di dunia dan frekuensinya terus meningkat setiap tahunnya. Hal ini menjadi tantangan yang besar bagi seorang Ners dalam pelayanan kesehatan di Indonesia. Praktik ilmu keperawatan yang berkualitas harus diimbangi dengan pembuktian secara Evidence Base Nursing (EBN) karena EBN bisa menjadi landasan dalam melaksanakan peran pemberi asuhan, pendidik, peneliti, dan innovator yang profesional. Praktik residensi telah memberikan pengalaman dan menambah pengetahuan residensi tentang keperawatan kardiovaskular. Penerapan teori Lydia Hall: Care, Core, dan Cure dilakukan oleh residensi pada 30 kasus resume dan satu kasus kelolaan yaitu pada pasien dengan STEMI. Peran peneliti telah dilakukan dengan menerapkan EBN tentang penerapan Slow Deep Breathing Relaxation Exercise (SDBRE) setelah chest tube removal pada pasien yang menjalani CABG di Ruang Intermediate Ward Bedah. Penerapan SDBRE didapatkan efektif dalam menurunkan nyeri setelah chest tube removal. Peran Inovasi dilakukan dengan menyusun protokol Munro Scale untuk mencegah kejadian Perioperative Related Pressure Injury pada pasien Bedah jantung. Munro Scale didapatkan mampu mendeteksi adanya resiko Pressure Injury, mudah dipahami oleh perawat, dan mudah dilaksanakan oleh perawat kamar bedah dalam perawatan. Namun sebaiknya follow up pengkajian Munro Scale dilakukan di ruangan ICU bedah, IW Bedah, dan Rawat Inap. ......Ischemic Heart Disease is one of the most common causes of death in the world and its frequency continues to increase every year. This is a big challenge for a nurse in health services in Indonesia. Quality nursing practice must be balanced with Evidence Based Nursing (EBN) evidence because EBN can be the basis for carrying out the role of professional caregivers, educators, researchers, and innovators. Residency practice has provided experience and increased residency knowledge about cardiovascular nursing. The application of Lydia Hall's theory: Care, Core, and Cure was carried out by residencies in 30 resume cases and one managed case, namely in patients with STEMI. The role of researchers has been carried out by applying EBN regarding the application of Slow Deep Breathing Relaxation Exercise (SDBRE) after chest tube removal in patients undergoing CABG in the Intermediate Ward of Surgery. The application of SDBRE was found to be effective in reducing pain after chest tube removal. The role of innovation is carried out by compiling the Munro Scale protocol to prevent Perioperative Related Pressure Injury in cardiac surgery patients. The Munro Scale was found to be able to detect the risk of Pressure Injury, easily understood by nurses, and easily implemented by operating room nurses in treatment. However, follow-up studies of the Munro Scale should be carried out in the surgical ICU, IW Surgery, and Inpatient rooms.