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"Praktik spesialis Keperawatan Anak peminatan non infeksi ini bertujuan untuk melakukan praktik dengan mengaplikasikan peran perawat melalui pendekatan Model Adaptasi Roy. Peran sebagai pemberi asuhan keperawatan diterapkan pada 5 orang pasien anak kanker yang mengalami masalah nyeri, dan satu orang pasien kelolaan utama yaitu pasien limfoma non hodgkin yang mengalami infiltrasi ke dalam sistem saraf pusat. Peran sebagai peneliti dalam melakukan penerapan tindakan keperawatan yang berbasis pembuktian ilmiah (evidence based nursing practice) yaitu dengan membuktikan terapi musik sebagai salah satu teknik penanganan nyeri pada anak dengan kanker. Peran sebagai inovator melalui penyusunan program pemberian terapi musik pada anak dengan kanker yang bertujuan untuk mengurangi nyeri dan meningkatkan kenyamanan pasien anak kanker, dan meningkatkan kualitas asuhan keperawatan. Hasil praktik ini menunjukkan bahwa Model Adaptasi Roy efektif digunakan pada pasien anak kanker yang mengalami masalah nyeri, dan terapi musik efektif untuk mengurangi nyeri yang dialami anak kanker, terutama pada nyeri ringan sedang.

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Pediatric Nursing Practice specialist in non-infection aims to practice by applying the role of nurses through the Roy Adaptation Model approach. Role as nursing care was applied to 5 patients of cancer pain, and a patient with non-Hodgkin's lymphoma with infiltration into the central nervous system is the main case. Role as researcher was caried out by applying evidence based nursing practice to prove that music therapy as a pain management technique in children with cancer. Role as an innovator through the preparation of a program of music therapy in children with cancer that aims to reduce pain and increase of comfort on children with cancer pain, and improving the quality of nursing care . This practice results indicate that the Roy Adaptation Model effective use in pediatric patients with cancer pain, and music therapy effective for reducing cancer pain on children with cancer, especially in mild or moderate pain."

"[ABSTRAKNyeri merupakan salah satu masalah utama pada pasien kanker anak. Karya Ilmiah Akhir ini bertujuan memberikan gambaran penerapan, analisis Comfort Theory Kolcaba pada pasien kanker anak dengan nyeri, dan pencapaian kompetensi ners spesialis keperawatan anak. Penerapan teori dilakukan pada lima pasien, menggunakan pendekatan proses keperawatan. Pengkajian dan penetapan masalah keperawatan menggunakan struktur taksonomi Kolcaba. Intervensi dan implementasi menggunakan intervensi kenyamanan standar, coaching, dan comfort food for the soul. Evaluasi menggunakan comfort behavior scale menunjukkan hasil diakhir perawatan, nyeri berkurang, terkontrol, dan kenyamanan bertambah. Kompetensi tercapai sesuai target. Comfort Theory bisa menjadi pilihan dalam merawat pasien kanker anak dengan nyeri.

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ABSTRACTPain is one of main problems in children with cancer. This study aimed to describe and to analyze: (1) the application of Kolcaba's Comfort Theory on children with cancer who experience pain, and (2) the competencies achieved by pediatric clinical nurse specialist. The theory was applied to five patients using nursing process approach. The assessment and decision of the nursing problem was conducted using Kolcaba's taxonomic structure. The intervention and implementation using standard comfort intervention, coaching, and comfort food for the soul. Comfort behavior scale was used for the evaluation. The results showed that at the end of the nursing implementation, pain was reduced, controlled, and the comfort was increased. The targeted competencies were achieved. Comfort Theory can be recommended for caring children with cancer.;Pain is one of main problems in children with cancer. This study aimed to describe and to analyze: (1) the application of Kolcaba's Comfort Theory on children with cancer who experience pain, and (2) the competencies achieved by pediatric clinical nurse specialist. The theory was applied to five patients using nursing process approach. The assessment and decision of the nursing problem was conducted using Kolcaba's taxonomic structure. The intervention and implementation using standard comfort intervention, coaching, and comfort food for the soul. Comfort behavior scale was used for the evaluation. The results showed that at the end of the nursing implementation, pain was reduced, controlled, and the comfort was increased. The targeted competencies were achieved. Comfort Theory can be recommended for caring children with cancer., Pain is one of main problems in children with cancer. This study aimed to describe and to analyze: (1) the application of Kolcaba's Comfort Theory on children with cancer who experience pain, and (2) the competencies achieved by pediatric clinical nurse specialist. The theory was applied to five patients using nursing process approach. The assessment and decision of the nursing problem was conducted using Kolcaba's taxonomic structure. The intervention and implementation using standard comfort intervention, coaching, and comfort food for the soul. Comfort behavior scale was used for the evaluation. The results showed that at the end of the nursing implementation, pain was reduced, controlled, and the comfort was increased. The targeted competencies were achieved. Comfort Theory can be recommended for caring children with cancer.]"

"Penyakit Hirschsprung merupakan penyakit kongenital yang disebabkan oleh tidak adanya sel ganglion pada usus. Salah satu penatalaksanaan penyakit Hirschsprung adalah dengan prosedur pembedahan yang dapat menimbulkan nyeri pada bayi dan anak. Beberapa penelitian telah dilakukan terkait nyeri jangka panjang pada bayi, di mana nyeri yang tidak diatasi dapat berdampak pada fisiologis, psikososial, dan perubahan perilaku bayi di masa dewasa menjadi lebih temperamen. Perawat berperan penting dalam mengurangi nyeri pada anak. Asuhan keperawatan yang dapat dilakukan untuk mengatasi nyeri pada anak meliputi manajemen nyeri farmakologis dan non farmakologis. Penulis menerapkan salah satu teknik non farmakologis pada klien An. Y berusia 5 bulan post operasi tutup kolostomi dengan penerapan teknik Non Nutritive Sucking sebelum, selama dan setelah prosedur perawatan luka dan pemberian medikasi. Evaluasi nyeri dilakukan menggunakan instrumen Face-Leg-Activity-Cry-Consolability Scale. Setelah dilakukan intervensi selama tiga hari, diperoleh penurunan skala nyeri dari 6 menjadi 1. Penulis merekomendasikan pemberian NNS sebagai salah satu pilihan untuk mengurangi nyeri pasca pembedahan pada bayi dengan kolaborasi pemberian analgesik sebelum prosedur yang dapat menimbulkan nyeri seperti perawatan luka dan pemberian medikasi agar nyeri dapat teratasi dengan optimal.

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Hirschsprungs disease is a congenital disease caused by the absence of ganglion cells in the intestine. One of the management of Hirschsprung's disease is a surgical procedure that can cause pain in infants and children. Several studies have been conducted regarding long-term pain in infants, which unresolved pain can have impacts on physiology, psychosocial, and changes in infants behavior in adulthood to become more temperament. Nurses play an important role in reducing pain in children. Nursing care that can be done to deal with pain in children includes pharmacological and non-pharmacological pain management. The author applies one of the non-pharmacological techniques to clients named Y aged 5 months with postoperative colostomy closure by applying Non Nutritive Sucking technique before, during, and after the wound care and administration of medication procedure. Pain evaluation was performed using the Face-Leg-Activity-Cry-Consolability Scale instrument. After three days of intervention, the scale of pain was reduced from 6 to 1. The author recommends NNS as an option to reduce postoperative pain in infants by collaborating with analgesics prior to procedures that can cause pain such as wound care and medication so that pain can optimally resolved."

"Karya ilmiah ini menjelaskan tentang aplikasi Comfort Theory (Kolkaba) pada anak dalam pemenuhan rasa nyaman nyeri di ruang non infeksi. Penerapan Comfort Theory Kolkaba ini dilaksanakan pada 5 kasus kelolaan yang berbeda untuk memenuhi kebutuhan rasa nyaman nyeri yang berfokus pada faktor fisik, psikospiritual, lingkungan dan sosial. Pemenuhan rasa nyaman nyeri sangat penting bagi anak yang di rawat dengan kanker. Tindakan keperawatan untuk memenuhi rasa nyaman tersebut di laksanakan secara mandiri, kolaborasi dan pendidikan kesehatan, sehingga diharapkan klien mencapai rasa nyaman relief, ease, dan transcendence. Ners spesialis keperawatan anak menerapkan tindakantindakan keperawatan pada klien, diperlukan dukungan dan kerjasama yang baik antara tim kesehatan, anak dan orang tua, sehingga pemberian asuhan keperawatan menjadi optimal.

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This final assignment explains about the application of Kolkaba’s Comfort Theory in children with in the fulfillment of a sense of comfort in the pain of noninfectious pediatric ward. Application of Comfort Theory Kolkaba was held on 5 different cases managed to meet the comfort needs of pain that focus on physical factors, psikospiritual, environmental and social. Fulfillment of a sense of comfort is very important for the pain in hospitalized children with cancer. Nursing actions to meet the comfort is carried on independently, collaboration and health education, so expect the client to achieve a sense of comfort relief, ease, and transcendence. Specialist nurses apply the nursing child nursing actions on the client, required the support and good cooperation between the health teams, children and parents, thus providing nursing care to be optimal."

"Karya Ilmiah Akhir ini memaparkan kegiatan praktik residensi spesialis keperawatan anak, mencakup pemberian asuhan keperawatan dan pencapaian kompetensi. Penerapan asuhan keperawatan berfokus pada perawatan anak dengan klien yang terpasang kolostomi. Masalah yang paling sering terjadi adalah risiko kerusakan integritas kulit. Masalah risiko kerusakan integritas kulit adalah berisiko mengalami perubahan kulit yang buruk. Aplikasi Model Adaptasi Roy dapat menyelesaikan masalah klien dengan risiko kerusakan integritas kulit untuk mencapai respon yang adaptif. Keberhasilan asuhan keperawatan ditunjang oleh kompetensi perawat anak melalui berbagai perannya, yaitu sebagai pemberi pelayanan, pendidik, manager, serta peneliti. Pelaksanaan asuhan keperawatan dengan pendekatan Model Adaptasi Roy diharapkan dapat diaplikasikan secara komprehensif dalam mengatasi masalah klien dengan kasus bedah dengan pendekatan konsep family centered care.

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The final Scientific paper describes activities specialist nursing practice residency of pediatric, includes the provision of nursing care and the achievement of competence. Application of nursing care focuses on treatment clients of children with colostomy bag attached. The most common problem is the risk of impairment to skin integrity. The risk of impairment to skin integrity problems are at risk of a bad skin changes. Roy Adaptation Model application can resolve the issue with the client's risk of damage to skin integrity to achieve the adaptive response. The success of nursing care supported by pediatric nurse competencies through a variety of roles, namely as service providers, educators, managers, and researchers. Implementation of nursing care by Roy Adaptation Model approach is expected to be applied comprehensively to address client issues with surgical cases involving the family as the embodiment of the concept of family centered care."

"Permasalahan yang sering muncul dalam merawat klien dengan ventilasi mekanik di PICU adalah masalah keperawatan ketidakefektifan bersihan jalan napas. Salah satu teori keperawatan yang dapat diaplikasikan di ruang perawatan intensif adalah Model Konservasi Myra E. Levine yang mempunyai 3 konsep dasar yaitu konservasi, adaptasi dan keutuhan (wholeness). Tahapan proses keperawatan yang dilakukan adalah melakukan pengkajian, merumuskan trophicognosis dan hypothesis yang tepat, mengimplementasikan rencana dan melakukan evaluasi terhadap setiap respon organismik klien yang bertujuan untuk membantu klien beradaptasi selama dalam perawatan dan mencapai wholeness sebagai seorang individu yang unik. Intervensi yang dapat dilaksanakan untuk mempertahankan bersihan jalan napas yang efektif, antara lain fisioterapi dada, penghisapan lendir, humidifikasi, inhalasi, dan mobilisasi. Peran Ners Spesialis Keperawatan Anak selama merawat anak dengan ventilasi mekanik adalah sebagai praktisi, pendidik, advokat dan peneliti. Ners Spesialis Keperawatan Anak diharapkan terus mengembangkan ilmu pengetahuan dan teknologi dibidang keperawatan untuk meningkatkan kualitas asuhan keperawatan pada klien dan keluarga.

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Nursing problem that often arises in caring of pediatric patient with mechanical ventilation at PICU is ineffectiveness of airway clearance. One of the nursing theories that can be applied in intensive care unit is Myra E. Levine Conservation Model which has 3 basic concepts. Those concepts are conservation, adaptation and wholeness. Stages of the nursing process are assesment, formulate appropriate trophicognosis and hypothesis, implementing the intervention and evaluating every client organismic response that is aimed to help clients adapting during the treatment and achieving wholeness as a unique individual. Interventions that can be implemented to maintain an effective airway clearance are chest physiotherapy, mucus suction, humidification, inhalation, and mobilization. The Role of Ners Specialist of Pediatric Nursing for caring of a pediatric patient with mechanical ventilation is as practitioner, educator, advocate and researcher. Ners specialist of pediatric nursing are expected to continue develop knowledge and technology in the field of nursing to improve the quality of nursing care to clients and families."

"Karya Ilmiah Akhir ini memberikan gambaran tentang pelaksanaan Program Residen Ners Spesialis Keperawatan Anak dalam bentuk kegiatan praktik Residensi I dan II. Karya Ilmiah Akhir ini bertujuan untuk memberikan gambaran aplikasi teori comfort Kolcaba dalam asuhan keperawatan pada anak dengan peningkatan suhu tubuh dan pencapaian kompetensi baik sebagai praktisi, pendidik, advokat, pengelola dan peneliti selama praktik residensi. Menurut comfort Kolcaba, peningkatan suhu tubuh merupakan salah satu gangguan pemenuhan kebutuhan rasa nyaman fisik yang berkaitan erat dengan kebutuhan rasa nyaman psikospiritual, sosiokultural dan lingkungan. Intervensi yang dilakukan adalah memonitor status hemodinamik, menganjurkan keluarga untuk selalu berada di samping pasien, mengajarkan keluarga dalam pemberian kompres air hangat dan mengatur suhu ruangan sesuai suhu tubuh pasien. Salah satu inovasi yang dilakukan adalah mengukur suhu tubuh dengan menggunakan termometer timpani dimana residen menerapkan salah satu kompetensi perawat spesialis sebagai ranah pengembangan profesional sekaligus memberikan kebutuhan rasa nyaman dan mencegah trauma pada anak.

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This Final Scientific Paper provides an overview of the implementation of the Resident Program Specialist Nurses in the form of practical activities Residency I and II. This Final Scientific aims is in order to provide an overview Comfort Kolcaba Theory Application of children nursing care by increased body temperature and achievement of competency either as a practitioner, educator, advocate, manager and researcher during practice residency. According to Kolcaba comfort theory, increasing body temperature is one of the comfortable sense of fulfillment disorders are strongly associated with physical comfort needs psikospiritual, sociocultural and environmental. Interventions need to be done is to monitor hemodynamic status, advised the family to accompanied the patient, the family teaches the provision of warm water compress and maintain the room's temperature according the patient's body temperature. One inovation need to be done is measure the body temperature using a thermometer tympanic where residents apply one domain competence as a specialist nurse professional development needs as well as providing a sense of comfort and prevent trauma to child."

"Karya ilmiah akhir ini membahas tentang penerapan model Konservasi Levine dalam pemberian asuhan keperawatan pada pada anak dengan gangguan pernapasan. Infeksi saluran pernapasan akut merupakan suatu gangguan pulmonal yang memiliki efek samping hipoksemia dan kegagalan pernapasan melalui pemberian asuhan keperawatan dengan menerapkan prinsip konservasi untuk mempertahankan keseimbangan energi, konservasi integritas struktural, personal dan sosial. Beberapa masalah keperawatan yang ditemukan antara lain gangguan pertukaran gas, ketidakefektifan pola napas dan ketidakefektifan bersihan jalan napas. Model Konservasi diharapkan menjadi acuan praktik keperawatan pada pada anak dengan gangguan pernapasan.

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The end scientific work is about the application of the Levine's Conservation model in the provision of nursing care to children with respiratory disorders. Respiratory infection acute is a pulmonary disorder that has a side effect of hypoxemia and respiratory failure. The side effects of hypoxemia and respiratory failure can be minimized through the provision of nursing care by applying the principle of conservation of energy to maintain balance, conservation of structural integrity, personal and social. Some nursing problems were found among other disorders of gas exchange, breathing pattern ineffective airway clearance and ineffectiveness. This Conservation model is expected to be a reference of nursing practice in children with respiratory disorders."

"[ABSTRAKNyeri pembedahan menimbulkan cemas, takut dan perubahan perilaku maladaptif anak. Perlu asuhan keperawatan berkualitas dalam mengatasi nyeri anak. Karya ilmiah akhir bertujuan menggambarkan aplikasi comfort theory Kolcaba dalam memberikan asuhan keperawatan pasien pasca bedah yang mengalami nyeri. Intervensi ditentukan berdasarkan comfort theory yaitu mengukur skala nyeri, memberikan posisi nyaman, memberikan madu, mengajarkan keluarga manajemen nyeri serta memberikan reinforcement positif keterlibatan keluarga dalam perawatan. Evaluasi hasil menunjukkan aplikasi comfort theory dalam keperawatan perlu ditunjang faktor-faktor lain seperti kondisi pasien, lingkungan dan tim pelayanan kesehatan dalam mencegah dan mengatasi nyeri. Rekomendasi karya ilmiah ini adalah teori keperawatan sebaiknya diaplikasikan dalam asuhan keperawatan.

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ABSTRACTSurgical pain causes anxiety, fear and change in children's behaviours. A good quality of nursing care is needed to overcome children's pain. This scientific paper aimed to illustrate the application of comfort theory Kolcaba in providing nursing care to patients suffered post-surgical pain. Intervention was determined based on comfort theory which included: measure pain scale, provide a comfortable position, offer honey, teach families management of pain, and give positive reinforcement on family involvement during the care. Result's evaluation indicated thet comfort application in nursing theory need to be supported by other factors such as the condition of the patient, the environment and health care team to prevent and overcome pain. This scientific paper recommends the application of nursing theory in providing nursing care., Surgical pain causes anxiety, fear and change in children's behaviours. A good quality of nursing care is needed to overcome children's pain. This scientific paper aimed to illustrate the application of comfort theory Kolcaba in providing nursing care to patients suffered post-surgical pain. Intervention was determined based on comfort theory which included: measure pain scale, provide a comfortable position, offer honey, teach families management of pain, and give positive reinforcement on family involvement during the care. Result's evaluation indicated thet comfort application in nursing theory need to be supported by other factors such as the condition of the patient, the environment and health care team to prevent and overcome pain. This scientific paper recommends the application of nursing theory in providing nursing care.]"

"Penulisan karya ilmiah akhir ini bertujuan untuk mengaplikasikan teori Adaptasi Roy dalam perawatan anak dengan peningkatan tekanan intrakranial. Pemantauan yang ketat terhadap kemungkinan terjadinya cedera otak sekunder pada anak disertai dengan pemberian posisi kepala ditinggikan 30 derajat, stimulasi seminimal mungkin, perawatan dalam satu waktu serta pemilihan tindakan yang tidak memberikan rangsangan yang dapat berakibat fatal buat pasien sangat penting dilakukan. Teori Adaptasi Roy sangat sesuai diterapkan pada kasus ini karena pengkajian yang dilakukan sangat detail dan dapat memfasilitasi perawat untuk melakukan monitoring dengan ketat terhadap kemungkinan terjadi komplikasi lebih lanjut walaupun ada faktor lain yang turut berperan seperti berat ringannya penyakit, lokasi tumor dan lamanya tumor menekan bagian lain dari otak itu sendiri.

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This final scientific work aimed to apply Roys Adaptation Theory in nursing care for children with raised intracranial pressure. It is important to strict monitoring to possibility of secondary brain damage, lift up the head about 30, give nursing care in one time to minimize stimulating, and effectively select the less stimulating interventions that caused fatality. The Roys Adaptation theory is appropriate to applied in this case because the assessment is carried out very detailed and it facilitates nurses to monitor closely the possibility of further complication although another factors such as severity of the disease, tumor location, and the duration of the tumor pressure to the brain."