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"ABSTRAKKanker merupakan penyakit yang dapat menyebabkan gangguan nutrisi pada anak. Tujuan dari karya ilmiah akhir adalah menggambarkan aplikasi model konservasi Levine dalam melakukan asuhan keperawatan pada anak dengan kanker yang mengalami masalah ketidakseimbangan nutrisi kurang dari kebutuhan tubuh dan pencapaian kompetensi praktik spesialis keperawatan anak. Peran perawat yang dilakukan selama praktik residensi adalah sebagai pemberi asuhan, advokat, edukator, dan peneliti yang dilaksanakan dengan memperhatikan etik dan legal. Pendekatan model konservasi Levine menggunakan empat prinsip konservasi yaitu konservasi energi, integritas struktural, integritas personal, dan sosial. Empat prinsip konservasi tersebut diaplikasikan ke dalam proses keperawatan yang dimulai dengan pengkajian, trophicognosis, hipotesis, intervensi, dan evaluasi pada lima kasus kelolaan. Evaluasi yang didapat untuk masalah ketidakseimbangan nutrisi kurang dari kebutuhan tubuh adalah masalah teratasi sebagian ditandai dengan mual berkurang dan asupan makan meningkat. Model konservasi Levine dapat diaplikasikan pada anak dengan kanker dalam upaya konservasi energi dan peningkatan kualitas hidup anak.

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ABSTRACT

Children with cancer were potentially experienced nutritional imbalance. The purpose of the final report was to described the application of Levine Conservation Model in performing nursing care for children with cancer whom experienced problems nutritional imbalance, and achievement of residency competency for pediatric nursing. The role of the nurse performed during residency were conducted as direct nursing care, advocate, educator, and researcher based on professional, ethical and legal. Levine's model approach using four principles were conservation of energy, structural integrity, personal integrity, and social integrity. These conservation principles were applied to the nursing care since assessment, trophicognosis, hypothesis, intervention, and evaluation phases in five selected cases of patients. Organismic evaluation obtained for all nutritional imbalance problems were solved partially that can be measured from the lower level of nausea and the higher food intake. Levine conservation model may apply to nursing care in children with cancer who experienced nutritional problems to increase quality of life."

"Anak dengan kanker disebabkan oleh proses penyakit kanker itu sendiri dan efek samping dari pemberian terapi. Keluhan seperti mual muntah, diare, demam, dan mielosupresi berkontribusi terhadap kejadian dehidrasi pada anak kanker. Hidrasi adalah pemenuhan air sesuai kebutuhan. Karya ilmiah akhir ini bertujuan untuk memberikan gambaran aplikasi Model Adaptasi Roy (MAR) dalam memberikan asuhan keperawatan pada anak kanker yang berisiko mengalami ketidakseimbangan cairan. Metode karya ilmiah ini adalah studi kasus yang terdiri atas lima kasus anak kanker yang mendapatkan kemoterapi yang diberikan asuhan keperawatan dengan pendekatan MAR. Intervensi keperawatan berdasarkan evidence based practice adalah memberikan edukasi tentang hidrasi pada pengasuh anak kanker. Edukasi kepada pengasuh menggunakan multimedia video dan booklet terbukti efektif meningkatkan pengetahuan dan sikap positif dalam mendampingi anak kanker selama menjalani kemoterapi.

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Children with cancer can experience fluid imbalance disorders caused by cancer itself and the side effects of therapy. Complaints such as nausea, vomiting, diarrhea, fever, and myelosuppression contribute to the incidence of dehydration in children with cancer. Hydration is the fulfillment of water as needed. This final scientific paper aims to provide an overview of the Roy Adaptation Model (MAR) application in providing nursing care to cancer children who are at risk of fluid imbalance. The method of this scientific work is a case study consisting of five cases of cancer children who received chemotherapy and given nursing care with the MAR approach. Nursing intervention based-evidenced practice is to provide education about hydration to cancer caregivers. Education for caregivers using multimedia videos and booklets has proven to be effective in increasing knowledge and positive attitudes in assisting children with cancer during chemotherapy."

"Masalah nutrisi merupakan permasalahan yang sering dihadapi oleh anak kanker. Tujuan penulisan Karya Ilmiah Akhir ini adalah memberikan gambaran pelaksanaan Praktik Residensi Keperawatan Anak kanker yang mengalami masalah nutrisi dengan mengaplikasikan Model Konservasi Levine. Dalam pencapaian kompetensi sebagai Ners Spesialis Keperawatan Anak residen telah menjalankan peran sebagai pemberi asuhan keperawatan, peran koordinasi dan kolaborasi, pembuatan keputusan etik, advocator, dan innovator. Aplikasi Model Konservasi Levine tertuang dalam lima kasus terpilih, dimana trophicognosis yang umum ditemukan adalah ketidakseimbangan nutrisi kurang atau lebih dari kebutuhan tubuh. Intervensi diberikan berdasarkan empat prinsip konservasi. Hasil evaluasi terhadap trophicognosis ketidakseimbangan nutrisi menunjukkan adanya peningkatan terhadap kemampuan konservasi energi. Model Konservasi Levine dapat diterapkan pada klien anak dengan kanker yang mengalami masalah nutrisi. Pencapaian kompetensi dalam praktik residensi keperawatan anak telah memperkaya dan meningkatkan pengetahuan serta keterampilan klinis residen.

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Nutritional problem is commonly faced by children with cancer. The aim of this final assignment was to provide Nursing Practice Residency implementation of children with cancer which have nutritional problems by applying Levine Conservation Model. Competencies that had been made included providing nursing care, coordination and collaboration, ethical decision making, advocator and innovator. Levine Conservation Model was applied in five selected cases and the trophicognosis commonly found was imbalanced nutrition supply of the body needs. Interventions were given based on the four principles of conservation, that are conservation of energy, conservation of structural integrity, conservation of personal integrity, and conservation of social integrity. Evaluation of nutritional imbalance trophicognosis showed an increase in energy conservation ability. Levine Conservation Model can be applied to children with cancer who have a nutrition problem. Achievement of competence in the practice residency of nursing children have enriching and improving knowledge and clinical skills of resident."

"ABSTRAKMalnutrisi, kaheksia, dan obesitas/overweight merupakan masalah nutrisi yang sering ditemui pada anak kanker akibat dari proses penyakit dan efek kemoterapi. Karya Ilmiah Akhir ini bertujuan memberikan gambaran praktek ners spesialis dalam mengaplikasikan model adaptasi Roy pada asuhan keperawatan anak kanker yang mengalami masalah nutrisi. Praktek ners spesialis dilakukan untuk mencapai kompetensi sesuai peran perawat. Aplikasi model adaptasi Roy tertuang dalam lima kasus terpilih dengan masalah yang ditemukan adalah ketidakseimbangan nutrisi kurang dari kebutuhan tubuh, risiko nutrisi kurang dari kebutuhan tubuh dan obesitas. Pendidikan kesehatan berbasis pembuktian ilmiah digunakan sebagai salah satu intervensi keperawatan untuk meningkatkan adaptasi anak sehingga dapat bertoleransi terhadap pemenuhan kebutuhan nutrisi. Evaluasi keperawatan lima kasus tersebut adalah satu kasus beradaptasi secara integrasi, empat kasus beradaptasi secara kompensasi. Karya ilmiah ini merekomendasikan teori model adaptasi Roy dapat diaplikasikan pada asuhan keperawatan anak kanker dengan masalah nutrisi.

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ABSTRACTMalnutrition, cachexia, and obesity/overweight, is a common nutritional problem in children who have cancer as a result of the disease process and the effects of chemotherapy. The aim of this final assignment was to provide an overview of the practice specialist nurses by applying the Roy adaptation model in nursing care of children who have cancer with nutritional problems. Practice spesialis nurses to achieve competency according the role of nurses. Roy adaptation model was applied in five selected cases and the nursing problem found was imbalance nutrition less than the body needs, risk imbalance nutrition less than the body needs and obesity. Health education is evidence based practice be used as a nursing intervention to improve the adaptation level of the child so that it can tolerate the fulfillment of nutrition needs. Nursing evaluation in five selected cases was one case integrated adaptation level and four cases compensatory adaptation level. This paper recommend Roy adaptation model theory can be applied to nursing care in children who have cancer with nutrition problems.;"

"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."

"Kanker merupakan penyakit degeneratif yang dapat diderita oleh orang dewasa dan anak-anak dengan angka kejadian cukup tinggi di dunia. Sebanyak 50 anak dengan kanker mengalami gangguan dalam melaksanakan aktivitas perawatan diri sebagai akibat dari kanker tersebut maupun efek samping dari terapi kanker. Tujuan dari pembuatan karya ilmiah akhir ini adalah untuk memberikan gambaran mengenai aplikasi teori self-care Orem pada klien anak dengan kanker yang mengalami defisit perawatan diri: perawatan mulut di RSUPN Dr Cipto Mangunkusumo Jakarta. Selain itu, karya ilmiah akhir ini juga bertujuan untuk memberikan gambaran mengenai peran perawat spesialis anak di ruang rawat anak non infeksi. Terdapat lima kasus kelolaan yang dibahas dalam karya ilmiah ini yang semuanya memiliki masalah defisit perawatan diri: perawatan mulut. Asuhan keperawatan diberikan menggunakan pendekatan teori self-care Orem mulai dari pengkajian sampai dengan evaluasi. Hasil evaluasi menunjukkan ada klien yang dapat lebih mandiri dalam melakukan higiene oral namun ada pula yang tidak berhasil. Penulis merekomendasikan untuk memperhatikan usia dan tahap tumbuh kembang klien yang akan diberikan intervensi dengan aplikasi teori self-care karena hal tersebut berpengaruh terhadap keberhasilan intervensi.

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Cancer is a degenerative illness suffered by adults and children with high incidence in the world. Around 50 children with cancer are having difficulties in performing daily activities as a result of cancer itself or side effect of cancer therapy. This final report is a description of Internship Pediatric Nursing Program clinical practice. The aim of this final report is to give a brief description about the application of Orem rsquo s self care theory on children with cancer performing self care deficit oral hygiene thus giving description about the role of pediatric nurse in non infection children ward. There are five cases of children who are performing self care deficit oral hygiene explained here. Nursing care was performed using self care theory approach from assessment to evaluation. The result is that there are children who finally able to do oral hygiene independently, but there are also children who can not do oral hygiene independently. The recommendation of this report is that the children must be selected based on their age and developmental stage because those two factors contribute to the success of intervention."

"Karya Ilmiah Akhir ini memberikan gambaran pelaksanaan Program Residensi Ners Spesialis Keperawatan Anak, yang bertujuan memberikan gambaran tentang aplikasi Model adaptasi Roy dalam pemenuhan kebutuhan nutrisi pada anak dengan gizi buruk dan gambaran pencapaian kompetensi ners spesialis. Asuhan keperawatan gizi buruk menurut MAR bertujuan meningkatkan kemampuan adaptasi tubuh, mencegah dan meminimalkan dampak komplikasi refeeding syndrom. Lima kasus kelolaan ditemukan masalah ketidakseimbangan nutrisi kurang dari kebutuhan. Intervensi difokuskan untuk peningkatkan kemampuan adaptasi klien dengan aktivitas keperawatan menggunakan nursing intervention classification (NIC) dan evaluasi tingkat adaptasi menggunakan nursing outcome classification (NOC). Evaluasi adaptasi klien bervariasi dari tingkat adaptasi integral, kompensasi, dan kompromi.

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This final assignment provides an overview about the implementation residency practices of the specialist pediatric nurse program, The aims to provide an overview of the Roy adaptation model application in meeting the nutritional needs of children with severe malnutrition, and overview the achievement specialist nurse competency. Nursing care of malnutrition according to MAR aims to improve the body's ability to adaptation, to prevent and minimize the effects of refeeding syndrome complications. Five selected cases found a problem with imbalance nutrition less than demand. Interventions focused on enhancing the client's ability to adaptation to the nursing intervention using the nursing activity classification (NIC) and the evaluation of rate adaptation classification using nursing outcomes (NOC). Evaluation of rate adaptation varied clientele integral adaptation, compensatory, and compromise."

"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.]"