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"Praktek Spesialis Keperawatan Anak peminatan bedah anak ini bertujuan untuk melakukan praktek dengan mengaplikasikan model Teori Comfort Katherina Kolcaba. Peran sebagai pemberi asuhan keperawatan diterapkan pada 5 orang anak yang telah menjalani operasi yang mengalami rasa nyeri, dan satu orang pasien kelolaan utama yaitu pasien post operasi penutupan colostomi. Peran sebagai peneliti dalam melakukan penerapan tindakan keperawatan yang berbasis pembuktian ilmiah (evidence based nursing practise) yaitu dengan membuktikan terapi musik sebagai salah satu tehnik penanganan nyeri pada anak post operasi dan tindakan invasif. Peran sebagai inovator melalui penyusunan program pemberian terapi musik pada anak yang mengalami nyeri yang bertujuan untuk mengurangi nyeri dan meningkatkan kenyamanan pasien anak dan meningkatkan kualitas asuhan keperawatan. Hasil praktek ini menunjukan bahwa teori Comfort Katherina Kolcaba digunakan pada pasien yang mengalami rasa nyeri post operasi dan tindakan invasif, dan terapi musik efektif untuk mengurangi rasa nyeri yang dialami anak pada waktu tindakan, terutama nyeri ringan.

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Specialist Nursing Practice Children's specialization in pediatric surgery practice with the aim to apply the theory of Comfort models Katherina Kolcaba. Role as provider of nursing care applied to the 5 children who have undergone surgery are experiencing pain, and one patient that the patient's primary management of postoperative closure colostomi. Role as a researcher in performing nursing actions based on the application of scientific evidence (evidence based nursing practice model) to prove that music therapy as a pain management technique in children and postoperative invasive action.

Role as an innovator through the preparation of a program of music therapy on children who experience pain which aims to reduce pain and increase patient comfort and improve the child's quality of nursing care. This practice results show that the theory Comfort Katherina Kolcaba used in patients experiencing postoperative pain and invasive, and effective music therapy to reduce the pain experienced by the child at the time of the action, especially mild pain."

"Pasca pembedahan, anak berisiko mengalami gangguan keamanan yaitu risiko aspirasi akibat pemberian minum sebelum tingkat kesadarannya pulih. Gangguan keamanan tersebut akan mengakibatkan ketidaknyamanan pada anak berupa rasa nyeri dan sesak di daerah dada. Teori Comfort dari Kolcaba memberikan arahan dalam pemenuhan rasa nyaman pada pasien. Karya ilmiah ini bertujuan memberikan gambaran asuhan keperawatan pada anak pasca pembedahan dengan mengaplikasikan teori comfort Kolcaba yang berfokus pada pemenuhan kebutuhan keamanan. Asuhan keperawatan dilakukan berdasarkan tahapan comfort yaitu pengkajian (kenyamanan fisik, psikospiritual, lingkungan dan sosiokultural), merumuskan diagnosa keperawatan, menetapkan intervensi (berdasarkan standar comfort, coaching, dan comfort food for the soul), implementasi dan evaluasi. Pada lima pasien kelolaan yang berisiko mengalami aspirasi pasca pembedahan, empat pasien tidak mengalami aspirasi dan satu pasien mengalami aspirasi. Aspirasi terjadi dikarenakan kenyamanan sosiokultural tidak terpenuhi yaitu dukungan dan keterlibatan dari orangtua dalam perawatan anaknya. Sehingga terlihat bahwa ke empat aspek kenyamanan harus saling mendukung untuk pencapaian kenyamanan secara holistik.

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Post surgery children are in risk for safety problem such as aspiration becouse of fluid intake before they are fully conscious. The aspiration will cause comfort problem which manifestated as chest pain and chest tightness. Comfort theory from Kolcaba provides direction on meeting patient need of comfort. This paper aims to give an overview of post surgical children focused on meeting the need of safety. Nursing care was provided throught the stages of comfort assessment (physical comfort, psychospiritual, environtment and sociocultural), nursing diagnosis formulation, interventions plan (based on standard comfort, coaching, and comfort food for the soul), implementation and evaluation. Among five post surgical children which were in risk of aspiration, four children didn’t experience aspiration and one patient experienced aspiration. The aspiration was happened becouse of sociocultural comfort was not satisfied, where the support and involvement from parents in the care of their children was not adequate. So that the four aspects of comfort should be mutually supportive to the achievement of holistic comfort."

"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."

"Konsep utama teori comfort adalah melakukan penilaian terhadap struktur taksonomi antara tiga kenyamanan dikaitkan dengan empat pengalaman kenyamanan. Kebutuhan oksigen merupakan kebutuhan fisiologis bagi manusia. Pemenuhan kebutuhan oksigen merupakan fungsi sistem pernapasan dan sistem kardiovaskuler. Gangguan kedua sistem tersebut menyebabkan ketidaknyamanan pada anak karena kebutuhan oksigen terganggu. Perawat perlu membantu anak supaya kebutuhan oksigen terpenuhi agar anak dapat tumbuh dan berkembang dengan baik. Hal tersebut sesuai dengan prinsip comfort dari Kolcaba. Fokus bahasan adalah penggunaan teori comfort dalam memenuhi kebutuhan oksigenasi. Asuhan keperawatan dilakukan dengan proses keperawatan comfort. Terdapat lima kasus yang dibahas. Hasil akhir dari penerapan comfort mampu mengidentifikasi pengalaman kenyamanan anak dihubungkan dengan tipe kenyamanan.

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The main concept of comfort theory is assessing the taxonomic structure between the three comfort associated with four comfort experience. Oxygen demand is a physiological necessity for humans. Meeting the needs of oxygen is a function of the respiratory system and cardiovascular system. Disruption of both systems cause discomfort to the child because of the need of oxygen is interrupted. Nurses need to help children to oxygen needs are met so that children can grow and develop properly. This is in accordance with the principles of comfort Kolcaba. The focus of the discussion is the use of the theory of comfort to meet the needs of oxygenation. Nursing care is done with comfort nursing process. There are five cases discussed. The end result of the application of a comfort able to identify children experience the comfort associated with the type of comfort."

"Pasien yang dilakukan pembedahan hampir seluruhnya mengalami nyeri. Nyeri yang dialami oleh pasien pasca pembedahan dapat mempengaruhi kestabilan hemodinamik dan dapat menurunkan imunitas tubuh sehingga mengganggu proses penyembuhan. Tujuan dari karya akhir ilmiah ini adalah untuk memberikan gambaran penerapan teori keperawatan Comfort Kolcaba dan pendekatan Family Centered Care dalam mengatasi nyeri pada anak pasca pembedahan laparatomi. Penerapan teori comfort dalam melakukan asuhan keperawatan pada pasien pasca pembedahan dapat meningkatkan kepuasan keluarga dan efektif menurunkan nyeri pada pasien nyeri yang dipengaruhi faktor kecemasan. Aplikasi teori comfort yang ada belum menggunakan ceklist comfort karena perawatan difokuskan pada masalah nyeri sehingga evaluasi yang dipilih menggunakan skala nyeri FLACC dan VAS. Teori comfort dapat diaplikasikan terutama pada pasien yang mengalami nyeri ringan dan pasien dengan peningkatan skala nyeri yang dipengaruhi kecemasan.

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Patients who undergo surgery almost entirely feel pain. Pain experienced by patients after surgery could affect the stability of hemodynamic and decrease the body's immunity which can interrupt the healing process. The purpose of this study is to provide an overview of the application of nursing theory Comfort Kolcaba and Family Centered Care approach in dealing with post-surgical pain in children laparotomy. The application of the comfort theory in performing nursing care to patients after surgery can improve family satisfaction and effectively reduce pain in patients which influenced by anxiety. Recently, the application of comfort theory has not been implementing of an evaluation using a checklist comfort because the treatment is focused on the problem so that the evaluation of selected pain using the VAS pain scale and FLACC. Comfort theory can be applied, especially in patients with mild pain and increase pain scale which influenced by anxiety."

"[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.]"

"Demam merupakan gejala yang sering dialami anak dengan penyakit infeksi. Kondisi demam tinggi berdampak merugikan anak. Demam tinggi membuat anak tidak nyaman dan orang tua cemas serta meningkatkan kebutuhan kalori dan cairan. Oleh karena itu dibutuhkan asuhan keperawatan model konservasi. Penulisan Karya Ilmiah Akhir ini bertujuan memberikan gambaran kegiatan pelaksanaan praktik residensi ners spesialis anak, gambaran aplikasi model konservasi dalam asuhan keperawatan demam pada anak yang mengalami penyakit infeksi. Model Konservasi Levine berfokus pada konservasi energi, integritas struktrur, personal dan sosial untuk mencapai keutuhan. Berdasarkan 5 kasus yang dibahas, intervensi yang diberikan untuk trophicognosis peningkatan suhu tubuh (demam) antara lain mengupayakan penurunan suhu tubuh, mempertahankan lingkungan sejuk dan nyaman, meningkatkan istirahat, memberikan asupan cairan dan nutrisi adekuat serta menurunkan kecemasan anak dan orang tua menggunakan konsep family centered care. Model Konservasi dapat diterapkan dalam asuhan anak demam. Disarankan untuk lebih meningkatkan upaya konservasi integritas personal dan sosial melalui pendidikan kesehatan pada keluarga.

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Fever is a symptom that is often experienced by children with infectious diseases. High fever conditions adversely affects children. High fever makes the child uncomfortable and parent’s anxiety and also increase calorie and fluid needs. Therefore, the child needs nursing care such as conservation model by Levine. This scientific final assignment to provide an overview of the implementation of the activities of child specialist nurse practice, an overview of applications of conservation models in nursing care of fever in children with infectious diseases. Levine Conservation Model focuses on energy conservation, structure integrity, personal and social to achieve wholeness. Based on 5 cases discussed, interventions given to trophicognosis increased body temperature (fever), which are to seek a decrease in body temperature, maintaining comfortable environment, improve rest, provide adequate nutrition and fluid intake as well as decrease the anxiety of children and parents using the concept of family-centered care. Conservation Model can be applied in the care of fever children. It is recommended to further enhance the conservation of personal integrity and social health through the family education."

"Gangguan rasa nyaman adalah perasaan kurang senang, lega dan sempurna dalam dimensi fisik, psikospiritual, lingkungan dan sosial. Perawat perlu menggunakan beberapa metode dalam mengurangi ketidaknyamanan anak saat di rumah sakit agar tidak memberikan dampak negatif dan trauma dimasa yang akan datang. Tujuan karya tulis ilmiah ini adalah untuk menganalisis penerapan Teori Comfort Kolcaba dalam proses asuhan keperawatan pada anak dengan masalah gangguan rasa nayaman. Metode karya ilmiah ini adalah studi kasus. Terdapat lima kasus anak di ruang IGD anak zona kuning yang diberikan asuhan keperawatan dengan pendekatan Teori Comfort Kolcaba. Aplikasi Comfort Kolcaba membagi tingkat kenyamanan dalam empat konteks yaitu kenyamanan fisik, psikospiritual, lingkungan dan sosiokultural. Intervensi keperawatan yang dilakukan adalah berdasarkan pendekatan berbasis bukti seperti distraksi, modifikasi lingkungan dan keterlibatan keluarga untuk meningkatkan kenyamanan anak. Penggunaan skerem bermotif kartun terbukti kurang efektif dalam menurunkan kecemasan anak saat dilakukan prosedur penusukan vena.

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Comfort disorders is feeling less happy, relieved, and perfect in physical, psychospiritual, environmental, and social dimensions. Nurses need to use several ways to reduce the child's discomfort while in hospital so that it does not have a negative impact and trauma in the future. The purpose of scientific writing is to analyze the application of Kolcaba's Comfort Theory in the nursing care process for children with comfort problems. The method of this scientific work is a case study. There are five cases of children in the yellow zone children's ER who were given nursing care with the Kolcaba Comfort Theory approach. The Comfort Kolcaba application divides the comfort level into four contexts: physical comfort, psychospiritual, environmental, and socio-cultural. Nursing interventions that are carried out are based on evidence-based approaches such as distraction, environmental modification, and family involvement to increase child comfort. The use of cartoon-patterned series proved to be less effective in reducing children's anxiety during the venipuncture procedure."

"[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.]"

"Anak selama dirawat rentan mengalami berbagai masalah kesehatan termasuk kerusakan integritas kulit. Tujuan penulisan Karya Ilmiah Akhir ini adalah memberikan gambaran aplikasi Model Konservasi Levine dalam asuhan keperawatan dan gambaran pencapaian kompetensi serta peran perawat dalam asuhan keperawaatan pada anak yang berisiko mengalami kerusakan integritas kulit. Model Konservasi Levine berfokus pada peningkatan adaptasi melalui prinsip konservasi untuk mencapai keutuhan diri. Hasil evaluasi didapatkan bahwa integritas kulit semua kasus kelolaan dapat terjaga. Hal ini menunjukkan bahwa Model Konservasi Levine dapat diaplikasikan pada pasien yang berisiko mengalami kerusakan integritas kulit. Asuhan keperawatan dilaksanakan oleh residen dengan melaksanakan perannya sebagai pemberi asuhan, pendidik, pengelola asuhan, advokat, peneliti dan agen pembaharu.

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Children over the treated susceptible to a variety of health problems including damage to skin integrity. The purpose of this final scientific writing is to give an overview of applications Levine’s Conservation Model in nursing care and description of the achievement of competence and the role of nurses in the care in children at risk of damage to the integrity of the skin. Levine’s Conservation Model focuses on improving adaptation through conservation principles to achieve wholeness. Evaluation results showed that all cases of skin integrity can be maintained under management. This suggests that the Levine's Conservation Model can be applied to patients at risk of damage to the integrity of the skin. Carried out by the resident nursing care by carrying out its role as caregivers, educators, care managers, advocates, researchers and innovators agent. "