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"Perdarahan postpartum merupakan penyokong utama kematian ibu secara global, dan memiliki implikasi fisiologis dan psikososial bagi ibu, bayi, keluarga dan masyarakat serta penyedia pelayanan kesehatan. Laporan praktik residensi ners spesialis maternitas ini, menerapkan peran dan fungsi perawat dan teori model keperawatan Need for Help Wiedenbach dan Comfort Kolcaba pada kasus perdarahan postpartum. Penerapan teori Wiedenbach dan Kolcaba pada kelima kasus kelolaan dapat diterapkan dan memenuhi kebutuhan pertolongan segera dan kenyamanan klien sehingga pelayanan asuhan keperawatan sesuai dengan harapan klien. Kekuatan teori Wiedenbach pda fase akut berfokus pada kebutuhan "here and now" yang dibutuhkan klien dengan segera, fokus pengkajian adalah fisik dan psikologis. Teori Comfort Kolcaba melengkapi dengan pengkajian aspek fisik, psikospiritual, lingkungan dan sosial, dengan intervensi yang dilakukan meliputi standart comfort intervention, coaching dan comfort food for thr soul. Perawat spesialis maternitas perlu meningkatkan peran dan fungsinya di tatanan pelayanan kesehatan, baik sebagai pemberi pelayanan, edukator, advokat, pengelola, kolaborator, dan komunikator.

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Postpartum Haemmoragic and maternal mortality have physiological and psychosocial implications. This Reports residency practice nurses maternity specialist, is a report for one year by applying roles and functions of nurses and nursing model theory Need for Help Wiedenbach and Comfort Kolcaba in case of postpartum hemorrhage. The application of the theory Wiedenbach and Kolcaba in five cases under management can be applied and meet the immediate relief needs and comfort of the client so that the nursing care services in accordance with the expectations of its clients. The Strength of the theory Wiedenbach on acute phase focuses on the needs of "here and now" that takes the client immediately, the focus of the assessment is physical and psychological.

Comfort Kolcaba complements theory with an assessment of the physical, psychospiritual, environmental and social, with interventions include standard comfort intervention, coaching and comfort food for thr soul. Maternity specialist nurses need to enhance the role and functions in order of health care, both as service providers, educators, lawyers, managers, collaborators and communicators."

"Angka kematian ibu (AKI) merupakan salah satu indikator untuk menentukan derajat kesehatan ibu. AKI secara nasional masih relatif tinggi. Penyebab AKI antara lain perdarahan setelah persalinan, eklamsia, dan infeksi. Selain itu, AKI juga disebabkan oleh faktor tiga terlambat dan empat terlalu. Perdarahan menempati persentase tertinggi penyebab kematian ibu. Laporan ini memberikan gambaran tentang pelaksanaan praktik residensi Ners Spesialis Keperawatan Maternitas fokus pada kasus perdarahan postpartum dengan penerapan kedua teori yaitu "Need for Help Wiedenbach" pada keadaan emergensi dan teori "Conservation Levine" untuk pemulihan ibu postpartum dengan perdarahan. Fokus teori keperawatan “Need for Help Wiedenbach” adalah memberikan pertolongan sesuai dengan kebutuhan pasien saat ini yaitu pada kasus ini saat terjadi perdarahan. Kemudian setelah fase akut teratasi, asuhan keperawatan diberikan untuk mempertahankan keseimbangan energi ibu postpartum setelah mengalami perdarahan. Perawat perlu memahami dan melaksanakan perannya sebagai pemberi asuhan keperawatan, pendidik, konselor, advokat, koordinator, kolaborator, peneliti, dan agen pembaharu dalam pelayanan praktik keperawatan.

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MMR is still relatively high nationally. The causes of MMR may include postpartum hemorrhage, eclampsia, and infection. In addition, MMR is also caused by the “three delays” and “four frequently occurring factors” among women. Bleeding is the highest percentage of the causes of maternal death. This report provided an overview of the practice implementation by resident maternity nursing specialist focused on the application theories of Need for Help from Wiedenbach during acute stage and Conservation from Levine during recovery stage with postpartum hemorrhage. The nursing theory of "Need for Help Wiedenbach" is indented to provide help in accordance with the needs of patients here and now in case of postpartum hemorrhage. Then after the acute phase is managed, the nursing care is given to maintain energy balance of postpartum women after bleeding. The nurses need to understand and carry out their roles as providers of nursing cares, educator, counselor, advocate, coordinator, collaborator, researcher, and innovator in the nursing maternity practices."

"Indikator capaian dari SDG’s salah satunya menurunkan angka kematian ibu dan bayi. Indonesia akan berusaha menurunkan angka kematian ibu menjadi kurang dari 70 kematian per 100.000 kelahiran hidup pada tahun 2030. Kematian ibu dan bayi disebabkan terjadinya persalinan prematur. Persalinan prematur dapat disebabkan adanya kontraksi uterus sehingga terjadi dilatasi serviks pada usia kehamilan 20-36 minggu. Ancaman persalinan prematur akan mengakibatkan gawat janin dan komplikasi pada bayi baru lahir. Study kasus pada lima ibu hamil yang mengalami kontraksi dini dengan fokus mengimplementasikan teori need for help pada keadaan emergency dan penerapan teori comfort Kolcaba pada tahap pemulihan. Ibu hamil akan mendapatkan intervensi tatalaksana tokolitik dan terapi relaksasi dengan self-hypnosis yang membantu ibu untuk mengontrol ketidaknyamanan dan menurunkan kecemasan selama di rumah sakit. Aplikasi tersebut berhasil membantu ibu hamil melalui tahap kegawatan dan meningkatkan kenyamanan serta mencegah kontraksi uterus berulang sehingga ibu dapat mempertahankan kehamilan sampai usia kehamilan aterm.

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The achievement indicators of SDG’s are one of them reducing maternal and infant mortality. Indonesia will try to reduce maternal mortality to less than 70 deaths per 100,000 live births by 2030. Maternal and neonatal deaths are caused by preterm labor. Premature labor can be caused by uterine contractions resulting in cervical dilatation at 20-36 weeks' gestation. The threat of preterm labor will result in fetal distress and complications in newborns. Case studies on five pregnant women who experienced premature contractions with a focus on implementing the need for help theory in an emergency and the application of the Kolcaba comfort theory in the recovery phase. Pregnant women will get a tocolytic management intervention and relaxation therapy with self-hypnosis that helps the mother to control discomfort and reduce anxiety during the hospital. The application is successful in helping pregnant women go through the emergency phase and increase comfort and prevent repeated uterine contractions so that the mother can maintain the pregnancy until the term gestational age."

"[ABSTRAKAngka kematian ibu saat ini masih tinggi yang disebabkan karena komplikasi pada kehamilan dan persalinan, oleh karena itu perlunya peran tenaga kesehatan yang terkait termasuk perawat maternitas untuk memberikan pelayanan kesehatan profesional. Perawat spesialis maternitas dituntut mampu menjalankan perannya secara komprehensif. Laporan ini bertujuan untuk menggambarkan praktik residensi ners spesialis maternitas meliputi asuhan keperawatan pada masa prenatal, intranatal, dan postnatal normal dan berisiko serta bayi baru lahir normal dan berisiko, serta perempuan dengan masalah reproduksi dan ginekologi. Residen juga melakukan asuhan keperawatan dengan focus penerapan teori need for help dan comfort pada ibu bersalin dengan persalinan memanjang. Hasil menunjukkan bahwa kedua model efektif dapat diterapkan pada keenam kasus ibu bersalin dengan persalinan memanjang. Pencapaian kompetensi perawat spesialis maternitas dilakukan dengan penerapan peran perawat secara komprehensif.

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ABSTRACTMaternal mortality rate is still high due to pregnancy and labor complication, therefore the role of health professionals including maternity nurses is needed to provide a professional health care. Maternity nursing specialists are demanded to be able to perform their roles comprehensively. This report aimed to describe the residency practice of maternity nursing specialist including nursing care of normal and high risk prenatal, intranatal, and postnatal as well as normal and high risk newborns, and women with reproductive and gynecological problems. Resident also performed nursing care focused on the application of Wiedenbach Need for Help and Kolcaba Comfort Theory on intrapartum mothers with prolonged labor. Results showed that both models could be applied effectively to the six cases of intrapartum mothers with prolonged labor. The achievement of maternity nursing specialist competencies was conducted by the implementation of the nurse's roles comprehensively., Maternal mortality rate is still high due to pregnancy and labor complication, therefore the role of health professionals including maternity nurses is needed to provide a professional health care. Maternity nursing specialists are demanded to be able to perform their roles comprehensively. This report aimed to describe the residency practice of maternity nursing specialist including nursing care of normal and high risk prenatal, intranatal, and postnatal as well as normal and high risk newborns, and women with reproductive and gynecological problems. Resident also performed nursing care focused on the application of Wiedenbach Need for Help and Kolcaba Comfort Theory on intrapartum mothers with prolonged labor. Results showed that both models could be applied effectively to the six cases of intrapartum mothers with prolonged labor. The achievement of maternity nursing specialist competencies was conducted by the implementation of the nurse's roles comprehensively.]"

"Persalinan kala dua memanjang merupakan kondisi yang memerlukan penanganan perawat agar tidak terjadi dehidrasi atau kelelahan pada ibu dan mencegah gawat janin. Penatalaksanaan keperawatan pada ibu yang mengalami persalinan kala dua memanjang dengan memberikan asuhan keperawatan secara fisik dan psikologis. Metode yang digunakan adalah studi kasus dengan fokus penerapan teori need for help Wiedenbach dan comfort Kolcaba pada asuhan keperawatan ibu yang mengalami persalinan kala dua memanjang. Aplikasi teori need for help Wiedenbach dan comfort Kolcaba efektif diterapkan pada kelima kasus yang berfokus pada masa intranatal baik secara fisik dan psikologis, mencegah dampak persalinan kala dua memanjang terhadap kondisi ibu dan janin serta mengkaji pernyataan klien tentang bantuan yang dibutuhkan kepada perawat. Dengan intervensi keperawatan yang sesuai dengan bantuan yang dibutuhkan klien maka masalah klien dalam keadaan emergency teratasi dan kebutuhan rasa nyaman dapat terpenuhi.

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Prolonged second stage of labor is a condition requiring nurse handling to avoid dehydration or fatigue of the mother and prevent fetal distress. Management of nursing in mother who experience prolonged labor by giving physical and psychological nursing care. The method used is case study with focus on the application of the theory of need for help Wiedenbach and comfort Kolcaba on nursing care in mother who experienced prolonged second stage of labor. The application of need for help Wiedenbach and comfort Kolcaba theories effectively applied to the five cases that focused on intranatal phase both physically and psychological, prevent the impact of prolonged second stage of labor in mother and fetus condition, as well as reviewing the clients statement about the assistance needed to the nurse. Appropriate nursing interventions can address client problems in an emergency and comfort needs can be met."

"Karya ilmiah akhir ini disusun sebagai laporan dari praktik residensi spesialis keperawatan Maternitas yang berfokus pada penerapan teori keperawatan Need for Help Wiedenbach dan Comfort Kolcaba pada asuhan keperawatan ibu yang mengalami partus lama Tujuan penulisan laporan ini untuk memberikan gambaran pelaksanaan praktik Spesialis Keperawatan Maternitas dalam menjalankan perannya sebagai pemberi pelayanan keperawatan edukator konselor advokat pengelola kolaborator komunikator dan koordinator agen perubah dan peneliti dalam memberikan asuhan keperawatan pada perempuan sepanjang periode kehidupannya dengan menerapkan teori keperawatan Aplikasi teori keperawatan need for help Wiedenbach dan Theory of Comfort Kolcaba efektif dilakukan pada enam ibu dengan partus lama Aplikasi teori tersebut berhasil membantu menyelesaikan masalah keperawatan dan meningkatkan kenyamanan klien selama persalinan Setelah melaksanakan praktik residensi spesialis keperawatan maternitas penulis mampu mencapai target kompetensi dengan baik Kata kunci asuhan keperawatan partus lama teori keperawatan 'comfort' teori keperawatan 'need for help'

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This final scientific report aimed to report the clinical practice of maternity nursing specialist which focus on the application of Wiedenbach's theory of the need for help and Kolcaba's theory of comfort in the nursing care to clients who experience prolonged labour The purpose of this report is to describe the implementation of maternity nursing specialist practices in their role as care giver educator counselor advocate collaborator communicator coordinator innovators and researchers The competencies also achieved through application of nursing theory in the nursing care The application of Wiedenbach's theory of need for help and Kolcaba's theory of comfort in the nursing care was effective to resolve client's health problem and increased the comfort of the mother during labour After finishing residential practice of maternity nursing specialist the competencies was achieved with a good result Keyword nursing process nursing theory of comfort nursing theory of need for help prolonged labour "

"Asuhan keperawatan klien dengan Ketuban Pecah Dini dengan penerapan teori model Need for Help Wiedenbach dan Comfort Kolcaba menjadi kerangka praktek Residensi keperawatan maternitas selama satu tahun. Laporan ini bertujuan untuk memberikan gambaran asuhan keperawatan pada child bearing normal, risiko tinggi, Bayi baru lahir normal dan risiko tinggi, perempuan yang mengalami masalah reproduksi dan ginekologi yang dilaksanakan pada tatanan klinik maupun komunitas. Hasil residensi menunjukkan bahwa model tersebut efektif dan efisen dalam membantu kelima permasalahan tersebut. Pada kasus KPD dengan terminasi persalinan pada ibu primipara perlu diperkuat dengan teori Mercer untuk membantuibu dalam pencapaian perannya. Pencapaian kompetensi perawat spesialis maternitas dilakukan melalui penerapan peran perawat secara komprehensif.

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Integration of theoretical model Need for Help Wiedenbach with Comfort Kolcaba in nursing care to clients with premature rupture of membrane became framework of maternal health nursing specialist student practice for a year. This report aims to provide an overview of nursing care at risk of normal child bearing, and high risk, normal newborn, and high risk women who experience reproductive problems ang gynecology. Which conducted at the clinical and community setting. It showed the both models were effective and efficienct to seven client and family with premature rupture of membrane.Client with PROM and primipara need to be strengthened with Mercer theory to help the mother achievement her role. The nurse specialist maternity competencies were achieves through applying nurse roles comprehensively."

"Perdarahan postpartum merupakan salah satu situasi kegawatan maternal yangmembutuhkan penanganan segera. Penanganan kegawatan diprioritaskan untukmencegah syok hipovolemia yang mengancam jiwa. Setelah stabil, klien akan mendapatperawatan lanjutan untuk pemulihan. Di masa pemulihan, klien masih membutuhkanbantuan untuk mengatasi gangguan yang masih muncul, merawat diri, danmempersiapkan diri untuk memulai peran barunya. Penerapan integrasi modelkeperawatan Need For Help Wiedenbach dan Konsep Adaptasi Roy merupakan formatpengkajian yang sesuai untuk kondisi pada lima kasus yang dikelola Residen. Residenmengaplikasikan Evidence-Based Practice Nursing (EBPN) dalam perawatan klienperdarahan postpartum fase pemulihan. EBPN yang digunakan bertujuan untukmengatasi kecemasan klien akibat trauma dan hospitalisasi. EBPN yang digunakansebagai intervensi keperawatan adalah teknik afirmasi positif. Teknik Afirmasi positifdalam pengelolaan lima kasus kelolaan berpengaruh signifikan dalam menurunkan nilaikecemasan klien. Teknik afirmasi efektif untuk membantu klien menghadapi masalahpsikologis pasca perdarahan postpartum yang menimbulkan stres dan trauma. Perawatyang bertugas mengelola klien-klien dengan perdarahan postpartum fase pemulihandapat menggunakan integrasi model keperawatan sebagai acuan bagi perawatankliennya. Perawat maternitas juga dapat menggunakan teknik afirmasi positif untukmenurunkan tingkat kecemasan pada klien-klien dengan gangguan perdarahanpostpartum.

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Postpartum hemorrhage is one of the maternal emergencies which need immediate

treatment. The emergency management is prioritized to avoid hypovolemic shock which

can be life threatening. Once stable, clients will receive further treatment for recovery.

During the recovery period, clients still need help to overcome problems that still occur,

to take care of themselves, and to prepare to start their new roles. The application of

Needs Help Wiedenbach nursing model integration and Roy's Adaptation Concept is an

assessment format that is suitable for the conditions of the five cases managed by the

Resident. Resident applies EvidenceBased Practice Nursing (EBPN) in the treatment of

postpartum hemorrhage clients in the recovery phase. EBPN is used to treat clients’

anxiety caused by trauma and hospitalization. The use of EBPN as a nursing

intervention is a positive affirmation technique. Positive affirmation technique in the

five managed cases management significantly affects in reducing clients’ anxiety. The

affirmation technique is effective to help clients to face psychological issues after

postpartum hemorrhage which causes stress and trauma. Nurses who are in charge of

supporting clients with postpartum hemorrhage in the recovery phase can use the

nursing model integration as a reference for treatment for their patients. Maternity

nurses can use positive affirmation techniques as well to reduce anxiety levels of clients

with postpartum hemorrhage disorders."

"[Karya ilmiah akhir ini disusun sebagai laporan dari praktik residensi spesialis keperawatan Maternitas yang berfokus pada penerapan teori keperawatan Need for Help Wiedenbach dan Comfort Kolcaba pada asuhan keperawatan ibu yang mengalami retensio plasenta. Tujuan penulisan laporan ini untuk memberikan gambaran aplikasi teori Wiedenbach dan Kolcaba pada kasus retensio plasenta serta memberikan gambaran pelaksanaan praktik Spesialis Keperawatan Maternitas dalam menjalankan perannya sebagai pemberi pelayanan keperawatan, edukator, konselor, advokat, pengelola, kolaborator, komunikator dan koordinator, agen perubah dan peneliti dalam memberikan asuhan keperawatan pada perempuan sepanjang periode kehidupannya dengan menerapkan teori keperawatan. Aplikasi teori keperawatan need for help Wiedenbach dan Theory of Comfort Kolcaba efektif dilakukan pada lima ibu dengan retensio plasenta. Teori keperawatan Need for Help dari Wiedenbach menjadi pilihan untuk kasus retensio plasenta diruang gawat darurat. Penekanan teori ini berdasarkan kebutuhan ibu harus segera dipenuhi yang sifatnya gawat darurat. Labor is a holistic event and Comfort is a holistic phenomenon. Kenyamanan adalah fenomena holistik dan kebutuhan dasar manusia. Oleh karena itu perawat berupaya mengatasi kelemahan teori need for help Wiedenbach dengan menggabungkannya dengan Theory of Comfort Kolcaba. Teori keperawatan ini untuk mengatasi ketidaknyamanan dari aspek fisik, psikospiritual, sosial dan lingkungan sehingga asuhan keperawatan secara komprehensif dapat diberikan. Theory of Comfort Kolkaba terintegrasi dalam penerapan teori need for help Wiedenbach pada asuhan keperawatan ibu dengan retensio plasenta., This final scientific report aimed to report the clinical practice of maternity nursing specialist which focus on the application of Wiedenbach’s theory of the need for help and Kolcaba’s theory of comfort in the nursing care to clients who experience retained placenta. The purpose of this report to provide an overview of the application and Kolcaba Wiedenbach theory in the case of retained placenta and describe the implementation of maternity nursing specialist practices in their role as care giver, educator, counselor, advocate, collaborator, communicator, coordinator, innovators and researchers. Application of nursing theory need for help Wiedenbach and theory of Comfort Kolcaba effectively done in five women with retained placenta. Nursing theory Need for Help from Wiedenbach be an option for retained placenta cases in emergency ward. The emphasis of this theory is based on the needs of the mother must be met emergency nature. Labor is a holistic event and Comfort is a holistic phenomenon. Comfort is a holistic phenomenon and basic human needs. Therefore, the nurse tried to address the weaknesses of the theory of the need for help Wiedenbach combine with theory of Comfort Kolcaba. This nursing theory to address the discomfort of physical aspects, phsycospiritual, social and environment so comprehensively nursing care can be given. Theory of Comfort Kolcaba integrated in the application of the theory of the need for help Wiedenbach nursing mothers with retained placenta .]"

"Nama Bestfy AnitasariProgram Studi Magister Ilmu Keperawatan Kekhususan Keperawatan MaternitasJudul Aplikasi teori keperawatan need for help wiedenbach dan social support pada kasus abortus inkomplit Kehamilan diharapkan dapat berlangsung aman dan lancar hingga melahirkan Akan tetapi wanita hamil sangat beresiko mengalami penyulit atau komplikasi yang tidak diinginkan salah satunya adalah abortus inkomplit Fenomena tersebut mendorong profesi keperawatan untuk terus mengembangkan ilmu sejalan dengan tuntutan masyarakat terhadap pelayanan kesehatan yang berkualitas Laporan ini bertujuan menggambarkan pelaksanaan praktek residensi keperawatan maternitas selama satu tahun meliputi asuhan keperawatan pada masa childbearing normal dan resiko tinggi bayi baru lahir normal dan resiko tinggi perempuan yang mengalami masalah reproduksi dan ginekologi di tatanan klinik maupun di komunitas Residen juga melakukan asuhan keperawatan pada kasus focus of interest yaitu abortus inkomplit dengan mengaplikasikan teori need for help yang dikombinasikan dengan teori social support Laporan ini juga mengemukakan hambatan dan dukungan pada pelaksanaan praktek residensi Selain itu laporan ini juga memaparkan tentang kegiatan pencapaian kompetensi perawat spesialis maternitas melalui penerapan peran sebagai pemberi perawatan pendidik konselor koordinator komunikator advokat agen perubahan dan peneliti Kata Kunci Abortus inkomplit peran perawat teori Need for Help teori Social Support.

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Name Bestfy AnitasariStudy Program Master of Nursing Science Specialize in Maternity Nursing Title Application of Need For Help and Social Support Nursing Model Theory on Incomplete Abortion Pregnancy is expected to take place safely and smoothly until delivery However pregnant women are particularly at risk to experience complications or unwanted complications one of which is an incomplete abortion This phenomenon encourages the nursing profession to continue to develop in line with the science community demands for quality health care This report aims to describe the implementation of maternity nursing practice residency for one year covers nursing care during the childbearing normal and high risk normal newborns and high risk women who have problems in reproductive and gynecological clinic and in the community structure Resident also performs nursing care on a case that is the focus of interest by applying the theory of incomplete abortion need for help is combined with the theory of social support The report also noted the barriers and support the implementation of the practice residency In addition this report also describes about the activities of achievement of competencies through the application maternity nurse specialist role as caregiver educator counselor coordinator communicator advocate change agent and researcher Keywords incomplete abortion the role of the nurse Need for Help theory the theory of Social Support"