Penyakit jantung dan pembuluh darah masih menjadi penyebab kematian nomer satu di dunia saat ini, sehingga memerlukan tindakan yang tepat dan komprehensif untuk meningkatkan harapan hidupnya. Tindakan mengatasi masalah penyakit jantung koroner salah satunya dengan pembedahan. Bedah jantung pada pasien dapat menimbulkan respon pasien secara fisik dan psikologis pada tahapan pra, intra, dan pasca-operasi yang masing masing berbeda intervensinya. Model intervensi keperawatan perioperatif DOE EXHIS diharapkan mampu mengatasi masalah nyeri, kecemasan dan imobilisasi pada tahapan bedah jantung. Penelitian ini bertujuan menciptakan model intervensi keperawatan perioperatif berbasis smartphone yang mampu menurunkan nyeri, kecemasan, dan meningkatkan mobilisasi dini pasien bedah jantung. Penelitian ini terdiri dari 3 tahap. Desain penelitian tahap pertama research and development, tahap kedua true eksperiment design dan tahap ketiga cross sectional. Besar sampel 86 responden, 43 kelompok perlakuan, 43 kelompok kontrol. Intervensi model intervensi berupa terapi doa, edukasi, exercise therapy, hipnosis dan musik diberikan pada kelompok perlakuan, sedangkan kelompok kontrol diberikan gold standard intervensi sesuai clinical pathway di rumah sakit. Hasil penelitian sebagian besar responden berusia dewasa, berjenis kelamin laki-laki, tingkat pendidikan menengah pada kelompok intervensi dan S1 pada kelompok kontrol, Suku Jawa, jenis operasi CABG, ada riwayat nyeri, ada dukungan keluarga, ada penyebab stress, penghasilan diatas UMK, tingkat pengetahuan sedang, maturasi emosional matur, dan seluruh responden tidak ada riwayat trauma. Model intervensi keperawatan perioperatif DOE EXHIS berbasis smartphone berpengaruh secara signifikan dalam menurunkan skor nyeri, kecemasan dan meningkatkan mobilisasi dini (p<0,05). Model intervensi keperawatan perioperatif DOE EXHIS berbasis smartphone berpengaruh secara langsung terhadap nyeri dan kecemasan, tetapi tidak berpengaruh langsung terhadap mobilisasi dini. Model intervensi keperawatan perioperatif DOE EXHIS berbasis smartphone berpengaruh tidak langsung terhadap mobilisasi dini yang di mediasi oleh kecemasan. Model intervensi keperawatan perioperatif DOE EXHIS berbasis smartphone dapat digunakan oleh perawat untuk menurunkan nyeri nyeri, kecemasan dan meningkatkan mobilisasi dini pasien bedah jantung.
The heart and blood vessel disease is still the number one cause of death in the world today, so it requires appropriate and comprehensive intervention to increase life expectancy. One of the measures to overcome coronary heart disease is surgery. Cardiac surgery in patients can cause the patient's physical and psychological responses in the pre, intra, and postoperative stages, each of which has different interventions. The DOE EXHIS perioperative nursing intervention model is expected to be able to overcome the problems of pain, anxiety and immobilization at the cardiac surgery stage. This study aims to create a smartphone-based perioperative nursing intervention model that is able to reduce pain, anxiety, and increase early mobilization of cardiac surgery patients. This research consisted of 3 stages. The first stage of the research design is research and development, the second stage is true experimental design and the third stage is cross sectional. The sample size was 86 respondents, 43 treatment groups, 43 control groups. Intervention model interventions in the form of prayer therapy, education, exercise therapy, hypnosis and music were given to the treatment group, while the control group was given the gold standard of intervention according to the clinical pathway in the hospital. The results of the study most of the respondents were adult, male, secondary education level in the intervention group and S1 in the control group, Javanese, type of CABG operation, there was a history of pain, there was family support, there were causes of stress, income was above the minimum wage, level of moderate knowledge, mature emotional maturation, and all respondents had no history of trauma. The smartphone-based DOE EXHIS perioperative nursing intervention model significantly reduced pain scores, anxiety and increased early mobilization (p <0.05). The smartphone-based DOE EXHIS perioperative nursing intervention model directly affects pain and anxiety, but does not directly affect early mobilization. The smartphone-based DOE EXHIS perioperative nursing intervention model has an indirect effect on anxiety-mediated early mobilization. The smartphone-based DOE EXHIS perioperative nursing intervention model can be used by nurses to reduce pain, anxiety and increase early mobilization of cardiac surgery patients. |
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