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"Demam merupakan gejala yang sering dialami anak dengan penyakit infeksi. Kondisi demam tinggi berdampak merugikan anak. Demam tinggi membuat anak tidak nyaman, serta meningkatkan kebutuhan kalori dan cairan. Teori Comfort dari Kolcaba memberikan arahan dalam pemenuhan rasa nyaman pada pasien. Karya ilmiah ini bertujuan memberikan gambaran asuhan keperawatan pada anak demam dengan mengaplikasikan teori comfort Kolcaba yang berfokus pada pemenuhan kebutuhan kenyamanan. 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. Teori comfort Kolcaba dapat diterapkan dalam asuhan anak demam. Dukungan dan keterlibatan dari orangtua juga sangat penting dalam perawatan anak, sehingga terlihat bahwa ke empat aspek kenyamanan harus saling mendukung untuk pencapaian kenyamanan secara holistik.

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Fever is a symptom that is often experienced by children with infectious diseases. High fever condition adversely affects the child. High fever makes the child uncomfortable, and increase calorie and fluid needs. Comfort Theory of Kolcaba provides direction in compliance with comfort to the patient. This paper aims to provide an overview of nursing care in febrile children with comfort Kolcaba apply theory that focuses on meeting the needs of comfort. Nursing care is done by stages comfort assessment (physical comfort, psychospiritual, environmental and sociocultural), formulate nursing diagnoses, interventions set (based on standard comfort, coaching, and comfort food for the soul), implementation, and evaluation. Kolcaba comfort theory can be applied in the care of the child's fever. Support and involvement of parents is also very important in the care of children, so it appears that all four aspects must be mutually supportive comfort for 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."

"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."

"Kanker pada anak terus meningkat jumlahnya setiap tahun, masalah nutrisi merupakan masalah yang sering dikeluhkan oleh anak dan keluarga sehingga, diperlukan asuhan keperawatan untuk mengatasi masalah tersebut. Karya Ilmiah Akhir ini bertujuan untuk memberikan gambaran aplikasi teori Comfort Kolcaba dalam asuhan keperawatan pada anak kanker dengan masalah nutrisi dan pencapaian kompetensi baik sebagai pemberi asuhan, advocator, counselor, educator, colaborator, dan agen perubah. Terdapat lima kasus kelolaan yang menjadi pembahasan dalam karya ilmiah ini, kelima kasus kelolaan mengalami masalah nutrisi. Masalah nutrisi didapatkan dari basil pengkajian berdasarkan pendekatan teori Comfort Kolcaba yaitu pengkajian fisik, psikospiritual, sosiokultural dan Iingkungan. Intervensi menggunakan tiga tipe perawatan standar comfort, coaching dan Comfort food for the soul. Tidak semua masalah nutrisi pada lima kasus kelolaan dapat teratasi dengan cepat, untuk menyelesaikan masalah nutrisi pada anak kanker dibutuhkan waktu dan kerjasama tim yang baik antara ibu, anak, dokter dan dietesien serta perawat.

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Pediatric cancer always increase every year, the problem of nutrition is often complained by the child and their family, so nursing care is required to solve the issue. This research aims to provide an overview of the application of theory Comfort Kolcaba in cancer nursing care in children with nutritional problems and the competence achievement as a caregiver, advocator, counselor, educator, colaborator, and agent of change. There were five cases managed that discussed in this research, and in five cases managed all experiencing nutritional problems. Nutrient problems obtained from the results of the assessment approach based on the theory of Comfort Kolcaba such as physical examination, psikospiritual, sociocultural and environmental. Interventions use three types of standard comfort care, coaching and Comfort food for the soul. Not all nutritional problems in the management of five cases can be resolved quickly, to solve the problem of childhood cancer nutrition takes time and good teamwork among mother, child, and dietision, doctors, and nurses."

"[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.]"

"Demam merupakan respon tubuh terhadap adanya infeksi. Anak dengan demam dapat mengalami gangguan fisiologis, gelisah, dehidrasi, dan ketidaknyamanan. Penanganan demam dilakukan dengan menurunkan suhu tubuh secara perlahan dan memberikan kenyamanan pada anak. Salah satu penanganan demam nonfarmakologi berupa tepid water sponge yang menjadi rekomendasi jika dipadukan dengan terapi farmakologi. Pendekatan keperawatan untuk memberikan kenyamanan pada pasien didasarkan pada teori Comfort Kolcaba yang meliputi aspek kenyamanan fisik, psikospiritual, sosiokultural, dan lingkungan. Asuhan keperawatan menggunakan teori Comfort Kolcaba dapat digunakan sebagai salah satu acuan dalam pemberian asuhan keperawatan pada anak dengan demam.

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Fever is the body's response to infection. Children with fever may experience physiological disorders, anxiety, dehydration, and discomfort. Handling fever is done by slowly lowering the body temperature and provide comfort to the child. One of non pharmacological treatment to fever is tepid water sponge that recommended when it combined with pharmacological therapy. The nursing approach to comforting patient is based on Kolcaba Comfort theory which includes aspects of physical comfort, psychospiritual, sociocultural, and environment. Kolcaba comfort theory can be used as a reference in the provision of nursing care in children with fever."

"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."

"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."

"Karya Ilmiah Akhir ini merupakan gambaran pelaksanaan kegiatan praktik keperawatan ners spesialis anak selama satu tahun yang dimulai dari tanggal 3 Oktober 2011 sampai dengan 20 April 2012 yang menerapkan peran dan fungsi dari ners spesialis keperawatan anak. Karya Ilmiah Akhir ini memfokuskan pada aplikasi Teori Konservasi Levine dalam asuhan keperawatan klien anak yang mengalami peningkatan suhu tubuh di ruang perawatan penyakit infeksi. Pengkajian yang dilakukan meliputi konservasi energi, konservasi integritas struktur, konservasi integritas personal dan konservasi integritas sosial. Tropikognosis dan justifikasi yang dirumuskan meliputi dari keempat konservasi tersebut. Hipotesa, planning dan implementasi disesuaikan dengan konservasi energi, konservasi integritas struktur, konservasi integritas personal dan konservasi integritas sosial. Dari hasil evaluasi didapatkan bahwa kelima kasus klien terpilih yang mengalami peningkatan suhu tubuh setelah diberikan asuhan keperawatan, didapatkan hasil 5 klien semuanya terbebas dari demam dan semuanya pulang dengan kondisi bebas demam. Selanjutnya dalam memberikan asuhan keperawatan pada klien anak, residen merekomendasikan untuk menerapkan prinsip caring, atraumatic care, family centered care dan upaya pencegahan infeksi nosokomial dengan cara bekerja sesuai dengan standar operasional prosedur dan standar asuhan keperawatan serta memperhatikan prinsip sterilitas dan teknik aseptik yang dapat dilakukan dengan tindakan cuci tangan dengan handrub. Sebagai inovator residen melakukan modifikasi ruang tindakan menjadi ruangan yang bernuansa anak untuk meminimalkan atraumatic care dan residen juga melakukan discharge planning dimulai dari pasien baru sampai pasien pulang dan membuat media penkes sebagai media untuk melakukan pendidikan kesehatan pada orang tua dan keluarga pasien.

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This final scientific paper is a clinical nursing practice report of pediatrics nurse specialist practice that is conducted for one year from 3rd October 2011 until 20th April 2012 by applying the role and function of pediatrics nurse specialist. The paper is focusing on the application of Levine’s conservation theory into nursing care of children suffering from hyperthermia in infection ward. The assessment that is performed including conservation of energy, the structure of conservation integrity, personal integrity conservation, and social integrity conservation. Tropicognoses and justification, which are formulated including the fourth areas of conservation. Hipotesa, plan, and implementation are customized with conservation of energy, the structure of conservation integrity, personal integrity conservation, and social integrity conservation. Based on the conducted evaluation, it was resulted that from five chosen clients who suffering from hypothermia, after receiving nursing care they were recover from hyperthermia and discharged home with normal body temperature. Moreover, in providing nursing care to children, resident recommends to apply the principal of caring, atraumatic care, family centered care and effort preventing nosocomial infection by working based on standard operating procedure and nursing care standard, and also applying sterile principal and aseptic technique by washing hand with handrub. As an innovator, resident modified the intervention room as a child room with some decorations in order to minimize atraumatic care. The resident was also made a discharge planning with starting from obtaining new patient until discharging home, and provided health education for parents and family of clients."

"Penerapan teori Comfort Kolcaba ini dilakukan pada 5 kasus kelolaan yang berbeda untuk memenuhi kebutuhan rasa nyaman nyeri yang berfokus pada faktor fisik, psikospiritual, sosiokultural, dan lingkungan. Asuhan keperawatan untuk memenuhi kebutuhan rasa nyaman nyeri tersebut dilakukan dengan menggunakan intervensi standard comfort, coaching dan comfort food for the soul, yaitu dengan memberikan guided imagery sehingga pasien dapat mencapai tingkat kenyamanan relief, ease, dan transcendence. Evaluasi menggunakan numeric rating scale menunjukkan hasil diakhir perawatan nyeri berkurang, terkontrol dan peningkatan kenyamanan. Residen menyarankan agar meningkatkan peran kemitraan antara perawat, petugas kesehatan lainnya dan keluarga serta melakukan asuhan keperawatan berbasis evidence based practice dalam memberikan asuhan keperawatan pada pasien kanker anak yang mengalami nyeri.

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The application of this theory is done in 5 different managed cases to fulfil the needs of pain-comfort senses which is focused on physical, psychospiritual, sociocultural, and environmental factors. This nursing care uses standard comfort, coaching and comfort food for the soul to fulfil the needs of pain-comfort senses, that the clients can achieve relief, ease, and transcendence comfort. Resident suggests increasing the role of the partnership between nurses, other health workers and family and do nursing care based on evidence based practice."