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"Nyeri merupakan stimulus yang dapat merusak perkembangan otak bayi prematur. Tujuan penelitian mengetahui pengaruh developmental care terhadap respon nyeri akut pada bayi prematur yang dilakukan prosedur invasif. Penelitian ini menggunakan rancangan quasi experimental non equivalent control group, before and after design, dengan jumlah sampel 42 bayi prematur terdiri dari 21 responden sebagai kelompok kontrol dan 21 sebagai kelompok intervensi. Hasil penelitian ada perbedaan yang signifikan dari respon nyeri akut sebelum dan sesudah dilakukan developmental care (p value=0,000). Rekomendasi penelitian developmental care perlu diterapkan dalam memberikan asuhan keperawatan pada bayi prematur dan diharapkan ada penelitian lanjutan tentang pengaruh developmental care terhadap perkembangan bayi prematur di kemudian hari baik dari aspek kognitif, bahasa maupun motorik.

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Pain is a stimulus that can damage the developing brains of premature babies. The objectives of this research was to determine the effects of developmental care on acute pain response in premature babies who had been performed invasive procedures. This study used quasiexperiment research design non equivalen control group, before and after design, involving 42 sample consisted of 21 premature babies in both control and intervention group.

This study found that there was a significant difference on acute pain responses before and after developmental care been implemented (p value=0,000). Recommendation from this research are developmental care needs to be applied in nursing care for premature babies and it also important to investigate the long term influence of developmental care on development of premature babies either from the aspect of cognitive, languange and motor skills."

"Nyeri merupakan stimulus yang dapat merusak perkembangan otak bayi prematur. Tujuan penelitian mengetahui pengaruh developmental care terhadap respon nyeri akut pada bayi prematur yang dilakukan prosedur invasif. Penelitian ini menggunakan rancangan quasi experimental non equivalent control group, before and after design, dengan jumlah sampel 42 bayi prematur terdiri dari 21 responden sebagai kelompok kontrol dan 21 sebagai kelompok intervensi. Hasil penelitian ada perbedaan yang signifikan dari respon nyeri akut sebelum dan sesudah dilakukan developmental care (p value=0,000). Rekomendasi penelitian developmental care perlu diterapkan dalam memberikan asuhan keperawatan pada bayi prematur dan diharapkan ada penelitian lanjutan tentang pengaruh developmental care terhadap perkembangan bayi prematur di kemudian hari baik dari aspek kognitif, bahasa maupun motorik.

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Pain is a stimulus that can damage the developing brains of premature babies. The objectives of this research was to determine the effects of developmental care on acute pain response in premature babies who had been performed invasive procedures. This study used quasiexperiment research design non equivalen control group, before and after design, involving 42 sample consisted of 21 premature babies in both control and intervention group.

This study found that there was a significant difference on acute pain responses before and after developmental care been implemented (p value=0,000). Recommendation from this research are developmental care needs to be applied in nursing care for premature babies and it also important to investigate the long term influence of developmental care on development of premature babies either from the aspect of cognitive, languange and motor skills."

"Nyeri merupakan stimulus yang dapat merusak perkembangan otak bayi prematur. Developmental care merupakan salah satu strategi untuk mengurangi respon nyeri akibat prosedur invasif. Penelitian ini bertujuan untuk mengetahui pengaruh developmental care terhadap respons nyeri akut pada bayi prematur yang dilakukan prosedur invasif. Penelitian menggunakan rancangan quasi experimental non equivalent control group, before and after design, dengan jumlah sampel 42 bayi prematur terdiri dari 21 responden sebagai kelompok kontrol dan 21 sebagai kelompok intervensi yang dipilih dengan teknik sampling accidental sampling. Pada penelitian ini didapatkan hasil ada perbedaan selisih skor respons nyeri akut antara kelompok yang diberikan developmental care dan kelompok kontrol (p= 0,000; α= 0,05), developmental care menurunkan skor nyeri sebesar 2,05 poin. Developmental care perlu diterapkan dalam memberikan asuhan keperawatan pada bayi prematur. Penelitian lanjutan tentang pengaruh developmental care terhadap perkembangan bayi prematur pada dari aspek kognitif, bahasa, dan motorik perlu dilakukan.

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Pain is a stimulus that can damage the developing brains of premature babies. Developmental care is one strategy in reduce pain caused by invasive procedure. The objective of this research was to determine the effects of developmental care on acute pain response in premature babies who had been performed invasive procedure. This study used quasiexperiment research design non equivalen control group, before and after design, involving 42 sample consisted of 21 premature babies in both control and intervention groups, technical sampling used accidental sampling. This study founded that there was a significant difference in change score of acute pain response between on intervention and control groups (p= 0.000; α= 0.05), developmental care decreased 2,05 point of pain scores). Developmental care was recommended to be applied in nursing care for premature babies. Further research on effect developmental care on development of premature babies influence cognitive, languanges, and motor skills aspects need to be designed."

"Bayi prematur memerlukan perawatan dan perhatian lebih dibandingkan dengan bayi yang lahir cukup bulan. Selain itu kelahiran bayi prematur juga menimbulkan kecemasan dan mempengaruhi kepercayaan diri ibu merawat bayi. Dalam perawatan, bayi prematur membutuhkan kenyamanan. Ketidaknyamanan yang dirasakan bayi akan berdampak pada developmental care dan kemampuan bayi bertahan hidup. Keterlibatan orang tua dalam merawat bayi dapat memberikan kenyamanan pada bayi. Sehingga kemampuan ibu dalam merawat bayi prematur di rumah sangat penting agar bayi dapat terhindar dari penyakit yang dapat menyebabkan rawat ulang, gangguan pertumbuhan dan perkembangan pada masa balita seperti mengalami stunting, bahkan non communicable diseases saat dewasa. Oleh karena itu diperlukan penerapan asuhan keperawatan pada bayi prematur yang dapat memberikan kenyamanan secara holistik. Karya Ilmiah Akhir Spesialis ini bertujuan untuk memberikan gambaran aplikasi teori Comfort Kolkaba dalam asuhan keperawatan pada bayi prematur. Desain yang digunakan adalah dengan metode studi kasus yang didapatkan dari lima kasus terpilih. Teori Comfort Kolkaba mampu memfasilitasi perawat untuk menggali masalah keperawatan pada bayi prematur secara komprehensif. Pemberian edukasi kepada ibu menggunakan media audiovisual berupa video mengenai perawatan bayi prematur dapat meningkatkan kepercayaan diri ibu (nilai p < 0,05), sehingga ibu dapat merawat bayinya dengan baik dan bayi dapat tumbuh optimal. Penerapan teori Comfort Kolkaba dan edukasi menggunakan video tentang perawatan bayi prematur dapat direkomendasikan untuk diterapkan dalam asuhan keperawatan pada bayi prematur.

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Premature babies require more care and attention compared to full-term babies. In addition, premature birth also causes anxiety and affects the mother's confidence in caring for the baby. In care, premature babies need comfort. The discomfort felt by the baby will have an impact on developmental care and the baby's ability to survive. Parental involvement in caring for the baby can provide comfort to the baby. So the mother's ability to care for premature babies at home is very important so that the baby can avoid diseases that can cause re-hospitalization, growth and development disorders in toddlers such as stunting, and even non-communicable diseases as adults. Therefore, it is necessary to apply nursing care to premature babies that can provide holistic comfort. This Specialist Final Scientific Paper aims to provide an overview of the application of Kolkaba's Comfort theory in nursing care for premature babies. The design used is the case study method obtained from five selected cases. Kolkaba's Comfort theory is able to facilitate nurses to explore nursing problems in premature babies comprehensively. Providing education to mothers using audiovisual media in the form of videos regarding premature baby care can increase mother's confidence (p value < 0,05), so that the mother can care for her baby well and the baby can grow optimally. The application of Comfort Kolkaba's theory and education using videos on premature baby care can be recommended for application in nursing care for premature babies."

"Pengosongan lambung merupakan masalah yang sering terjadi pada bayi prematur akibat imaturitas sistem gastrointestinal. Tujuan dari studi kasus ini adalah melakukan analisis penerapan Teori Konservasi Levine pada lima bayi prematur yang mengalami masalah pemenuhan kebutuhan nutrisi melalui pemberian posisi miring kanan, pronasi dan miring kiri bergantian selama tiga hari. Pendekatan Teori Konservasi Levine dilakukan dengan menggunakan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Hasil penerapan intervensi pengaturan posisi pronasi dengan pendekatan Teori Konservasi Levine dapat menurunkan kejadian muntah, distensi abdomen dan pengeluaran residu lambung. Perawat dapat menjadikan intervensi tersebut sebagai standar prosedur operasional pada bayi prematur yang mengalami masalah pengosongan lambung.

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Gastric emptying is a common problem in premature infants due to immaturity of the gastrointestinal system. The objective of this case study was to analyze the application of Levine's Conservation Theory to five premature infants who had problems in fulfilllment the nutritional needs through giving alternate position in the right lateral position, pronation and left lateral position for three days. Levine's Conservation Theory was used by applying the principle of energy conservation, structural integrity conservation, personal integrity conservation, and social integrity conservation. The results showed that the implementation of pronation positioning using Levine's Conservation Theory can reduce the frequency of vomiting, abdominal distension, and gastric residual. Nurses can apply the intervention as a standard operating procedure in premature infants who experience gastric emptying."

"ABSTRAKBayi yang lahir prematur berisiko mengalami permasalahan kesehatan, sehingga membutuhkan perawatan yang intens dari sejak di rumah sakit sampai ketika bayi sudah boleh dipulangkan ke rumah. Tujuan dari penelitian ini adalah untuk mengetahui pengaruh edukasi dalam perencanaan pulang terhadap pengetahuan dan keterampilan ibu merawat bayi prematur. Penelitian ini merupakan studi quasi experiment dengan rancangan pre and post-test without control design. Sampel penelitian ini adalah 35 ibu yang melahirkan bayi prematur dan bayinya di rawat di ruang Perinatologi sebuah rumah sakit di Jakarta. Sampel diambil secara consecutive sampling. Intervensi penelitian adalah pemberian edukasi menggunakan media pembelajaran booklet dan audiovisual yang berisi tentang ASI, teknik menyusui, perawatan metode kanguru, cara pencegahan infeksi, dan tanda bahaya pada bayi. Hasil penelitian menunjukkan bahwa setelah diberikan edukasi selama perencanaan pulang, pengetahuan ibu merawat bayi prematur rata-rata mengalami kenaikan skor sebesar 29,52, aspek keterampilan menyusui skornya naik sebesar 33,29 dan keterampilan perawatan metode kanguru terdapat kenaikan skor sebesar 30,25. Hasil analisis menunjukkan bahwa ada perbedaaan yang signifikan antara rata-rata skor pengetahuan ibu merawat bayi prematur, skor keterampilan menyusui, dan skor keterampilan perawatan metode kanguru (PMK) sebelum dan setelah diberikan edukasi selama perencanaan pulang (p> 0,001). Pelaksanaan program edukasi selama perencanaan pulang yang dilakukan selama tiga hari dapat meningkatkan pengetahuan dan keterampilan ibu merawat bayi prematur. Edukasi dalam perencanaan pulang sebaiknya rutin diterapkan di rumah sakit sebagai intervensi keperawatan mandiri agar makin meningkatkan kualitas pelayanan keperawatan.ABSTRACTDischarge Planning Improving Knowledge and Skill Mother Who Birth Premature to Take Care Baby. Premature babies have a greater risk for health problems. Therefore, they need an intensive care since they are in the hospital until they go home. The purpose of this research was to find out the influence of education program for the knowledge and skills of the mothers on caring for their premature babies during discharge planning. This research was a quasi-experimental study with pre and post-test design without control groups. The sample of this research was 35 mothers who gave birth to premature babies and their babies receive care at a perinatology room in a hospital in Jakarta. The sample was taken using consecutive sampling. The intervention in this research was giving an education to the mothers of premature babies using booklet and audiovisual as the learning media containing information about breast milk, breastfeeding technique, kangaroo mother care, the method for infection prevention, and warning signs in babies. The research finding showed that after giving the education during the discharge planning, the knowledge of the mothers on caring for their babies, on average, had an increased score of 29.52, the score for the skills aspect increased by 33.29, and the score for kangaroo care mother skills increased by 30.25. The result of the analysis showed that there was a significant difference between the average score of the knowledge of the mothers on caring for premature babies, the score of breastfeeding skills, and the score for kangaroo care mother skills before and after the education program during the discharge planning (p> 0.001). The implementation of the education program during discharge planning that was done for three days could increase the knowledge and skills of the mothers on caring for their premature babies. The education during discharge planning should be conducted regularly at the hospital as an independent nursing intervention to improve the quality of nursing services."

"Pengontrolan suhu tubuh sangat penting pada bayi prematur karena fluktuasi suhu meningkatkan ketidakseimbangan tingkat metabolisme bayi baru lahir. Pengaturan suhu tubuh yang buruk menjadi sasaran faktor lingkungan yang dapat menyebabkan kehilangan panas yang cepat sehingga rentan terhadap peningkatan risiko morbiditas dan mortalitas akibat hipotermia. Tujuan dari penelitian ini untuk mengetahui penerapan teori Konservasi  Levine dalam mengatasi masalah risiko termoregulasi tidak efektif pada bayi baru prematur di ruang Perinatologi. Model Konservasi Levine berfokus pada peningkatan adaptasi dan mempertahankan integritas diri (wholeness) dengan menggunakan prinsip konservasi. Masalah risiko termoregulasi tidak efektif merupakan salah satu gambaran terganggunya konservasi energi mencakup ketersediaan dan pengeluaran energi bayi baru lahir dan menyebabkan terjadinya peningkatan konsumsi oksigen dengan mempertahankan fungsi normal termogenesis

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Body temperature control is very important in preterm infant because temperature fluctuations improve the balance. Poor body temperature regulation is the target of environmental factors that can cause rapid heat loss, making them susceptible to an increased risk of morbidity and mortality due to hypothermia. The purpose of this study was to determine the application of Levine's Conservation theory in overcoming the problem of ineffective thermoregulation risk in premature newborns in the Perinatology room. Levine's Conservation Model focuses on increasing adaptation and maintaining wholeness using conservation principles. The problem of the risk  ineffective thermoregulation is one of the features of the disruption energy conservation and energy expenditure of baby and causes an increase in oxygen consumption by maintaining normal thermogenesis function.

 

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"Latar belakang: Prematuritas merupakan salah satu kelainan yang masih menjadi masalah global. Kejadian prematuritas tidak hanya terjadi di negara berkembang tetapi juga di negara maju. Beberapa kondisi ibu hamil dapat memicu keadaan hipoksia dalam rahim sehingga menyebabkan kelahiran prematur. Keadaan plasenta menggambarkan kesejahteraan janin intra uteri. Kondisi hipoksia seluler memicu ekspresi HIF-1α yang menjadi faktor transkripsi bagi CA9 sebagai penanda hipoksia. Penelitian ini bertujuan menganalisis pengaruh hipoksia terhadap plasenta prematur. Metode: Sampel menggunakan plasenta prematur yang hipoksia (H) dan nonhipoksia (N) sebagai kontrol. Parameter yang dinilai adalah struktur histologis plasenta (Hematoksilin-Eosin), regulator hipoksia HIF-1α (imunohistokimia), dan penanda hipoksia CA9 (ELISA). Hasil: Penilaian struktur histologis menunjukkan adanya perbedaan jumlah pembuluh darah fetus antara kedua kelompok secara bermakna, dimana pada kelompok hipoksia jumlah pembuluh darah fetus lebih banyak dibandingkan kelompok non-hipoksia. Distribusi intensitas ekspresi HIF-1α kedua kelompok juga berbeda bermakna. Rerata kadar CA9 kedua kelompok tidak berbeda bermakna, namun terdapat kecenderungan rerata kadar CA9 kelompok hipoksia lebih tinggi 28% dibandingkan yang non-hipoksia. Kesimpulan: Pengaruh hipoksia terhadap plasenta prematur pada tingkat molekuler berupa stabilitas protein HIF-1α yang menyebabkan peningkatan jumlah pembuluh darah fetus dan terjadi kecenderungan peningkatan sintesis protein CA9.

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Background: Prematurity is a disorder that is still a global problem. Incidence of prematurity is a problem in developing and also in developed countries. Certain condition accompanying pregnancies may trigger uterine hypoxia, causing premature birth. The placental condition is related with the intra-uterine fetal condition. Cellular hypoxic condition caused by systemic chronic hypoxia, lead to stabilization of HIF-1α protein, a transcription factor of CA9. This study aimed to analyze the effect of hypoxia on the premature placenta.

Methods: Samples from hypoxic premature placenta (H) and non-hypoxic premature placenta (N) were collected. Parameters assessed were histological structure of the placenta (Hematoxylin-Eosin), expression of HIF-1α (immunohistochemistry) and the level of CA9 (ELISA).

Results: Assessment of histological structure showed the number of fetal blood vessels were differed significantly between the two group, wherein the hypoxia group was more than the non-hypoxia. The distributions of HIF-1α expression between the two groups were also differed significantly. The average level of CA9 between two groups were not significant, but there is a tendency of higher level of CA9 in the hypoxia group (28% higher compared to the non-hypoxia group).

Conclusion: It is concluded that the effect of the hypoxia on premature placenta in this study occured at molecular level and lead to HIF-1α protein stability that causes an increase of the number of fetal blood vessel and synthesis of CA9 protein."

"Bayi prematur mudah kehilangan panas, salah satunya saat dilakukan tindakan invasif pengambilan darah. Penelitian mengunakan crossover design (desain ekperimen kontrol silang) dimana melakukan 2 uji coba intervensi yang bertujuan membandingkan 2 tindakan yang berbeda pada sampel yang sama. Responden dibagi menjadi 2 kelompok A & B masing-masing 18 bayi prematur. Analisis menggunakan uji statistik independent T,test. Tindakan invasif di inkubator pintu terbuka nilai p 0,001, secara statistik terdapat perbedaan rerata yang bermakna terhadap penurunan suhu tubuh bayi prematur; sedangkan radiant warmer nilai p 0,001 secara statistik terdapat perbedaan rerata yang bermakna terhadap peningkatan suhu tubuh bayi prematur sebelum dan sesudah tindakan invasif pengambilan darah di bawah radiant warmer. Radiant warmer mampu menghindari terjadinya hipotermia pada bayi prematur saat dilakukan tindakan invasif. Radiant warmer sebagai pemancar hangat dapat direkomendasikan untuk melakukan tindakan invasif pengambilan darah, tetapi tidak digunakan untuk perawatan secara rutin karena dapat meningkatkan IWL.

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The premature infants tend to heat loss quickly. It can be occurred when they get invasive procedure venous puncture. The research uses crossover design by conducting 2 intervention tests to compare 2 different treatment to the same sample. This research involves two group of respondents; A and B with consists of 18 premature infants in each group. The process of data analisys uses statistical Independent T.Test. Intervention are conducted in open incubator p value 0,001 statistically range related to heat loss in premature infants. On the other hand, radiant warmer p value 0,001 statistically refers to the defferent range of heat gain before and after invasive procedure for venous puncture is given radiant warmert. Radiant warmer prevent the premature infant from hypothermia during invasive procedure. As its benefit, it becomes the preferable way to do invasive procedure. However, it is inadvisable for routine care of newborn infant since it can increase IWL."

"Bayi prematur lahir dengan berbagai permasalahan kesehatan dan membutuhkan perawatan khusus yang dapat menyebabkan kecemasan dan stres orang tua. Kualitas asuhan keperawatan yang bermutu dengan menerapkan asuhan perkembangan dapat dinilai dengan kepuasan orang tua. Penelitian ini bertujuan mengetahui hubungan penerapan asuhan perkembangan yang dipersepsikan oleh perawat dengan kepuasan orang tua bayi prematur di ruang neonatus. Penelitian kuantitatif dengan desain cross sectional ini menggunakan sampel berjumlah 52 perawat dan 52 orang tua bayi prematur. Tehnik pengambilan sampel yang digunakan adalah consecutive sampling Data dikumpulkan menggunakan kuesioner dan dianalisis menggunakan pearson. Hasil analisis menunjukkan terdapat hubungan yang bermaksna antara penerapan asuhan perkembangan dengan kepuasan orang tua bayi prematur (p value <0,001, p<0,05). Penerapan asuhan perkembangan yang baik dapat meningkatkan kualitas perawatan terhadap bayi dan juga meningkatkan kepuasan orang tua. Asuhan perkembangan perlu diterapkan di ruang neonatus sebagai upaya meningkatkan asuhan keperawatan pada bayi dan kepuasan orang tua.

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Premature infants born with several of health problems and needs special care can cause anxiety and stress of parents. A qualified nursing care by implementing developmental care can be assessed through parent satisfaction of premature infants. This study aims to recognize the relationship of developmental care application perceived by nurse with parental satisfaction of premature infants in neonatus care unit. This quantitative study used cross sectional design. The sample included 52 neonatus nurses and 52 parents of premature infants used consecutive sampling method. Data were collected using a questioners and analyzed using Pearson.

The analysis results show that there is significant relationship between developmental care applications with parent satisfaction of premature infants (p value=<0,001, p<0,05). The application of developmental care in premature infants may improve the quality of care and increase parens satisfaction. Developmental care need to be implemented as an effort to improve nursing care of infants and parents satisfaction."