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"Penyakit kronik adalah masalah kesehatan yang terjadi selama lebih dari tiga bulan, yang mempengaruhi aktivitas anak, dan membutuhkan hospitalisasi yang lebih sering, dan perawatan kesehatan dirumah, Contoh dari penyakit kronik adalah penyakit jantung, kanker, penyakit respirasi kronik, gagal ginjal, dan diabetes. Kondisi keterbatasan aktivitas yang terjadi pada anak dengan penyakit kronik adalah seperti sesak saat beraktivitas atau kelemahan otot. Jika anak mengalami gangguan aktivitas maka istirahatnya juga akan terganggu. Tujuan dari penelitian ini adalah untuk menggambarkan aplikasi Self Care Deficit Nursing Theory (SCDNT) dalam melakukan asuhan keperawatan pada anak dengan penyakit kronik yang mengalami masalah pada aktivitas dan istirahat. Penelitian ini menggunakan metode studi kasus pada lima pasien anak yang mengalami masalah pada aktivitas dan istirahatnya. Hasil dari penelitian ini menunjukkan bahwa masalah keperawatan aktivitas dan istirahat seperti hambatan mobilitas fisik, intoleransi aktivitas, dan gangguan pola tidur, sudah teratasi. Namun ada beberapa yang belum teratasi tetapi sudah menunjukkan adanya perbaikan dari tingkat aktivitas dan kemandirian klien.

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Chronic illness is a health problem that occurs for more than three months, affecting the child’s activities, and require ore frequent hospitalization, and home health care. The examples of chronic illness are heart disease, cancer, chronic respiratory disease, renal failure, and diabetes. The conditions of limitation activity are activity limitations tightness on exertion or muscle weakness. If the activity of the child has impaired, the rest also be disrupted. The purpose of this studi is to describe the application of Self-Care Deficit Nursing Theory (SCDNT) to care the children with chronic illness who have problems in activity and rest. This study used case study method to five pediatric patients that have problems in activity and rest. The result of this study show that the nursing problem of activity and rest, such as physical mobility impaired, activity intolerance, and sleep pattern disruption, has been resolved. However there are some unresolved but has shown that an improvement of the activity and independence level of clients."

"Salah satu kelompok penyakit metabolik yang terjadi karena kelainan sekresi insulin, kerja insulin atau keduanya adalah Diabetes Melitus (DM) yang ditandai dengan hiperglikemia. Kondisi hiperglikemia yang berkepanjangan menyebabkan DM menjadi salah satu masalah kesehatan yang besar di seluruh dunia karena komplikasinya dapat muncul secara akut maupun kronik. Perawat berperan penting dalam menurunkan angka morbiditas dan mortalitas melalui Diabetes Self- Management Education (DSME) dan Diabetes Self-Management Support (DSMS) untuk mencegah komplikasi dan membantu meningkatkan perubahan gaya hidup yang penting bagi individu. Penerapan DSME dan DSMS dapat dilakukan perawat dengan mengaplikasikan teori Self Care Dorothea Orem pada proses keperawatan. Penerapan teori ini berfokus pada kemampuan individu dalam melakukan tindakan keperawatan mandiri, mengenali dan mengatur kebutuhan perawatannya. Penerapan evidence based practice sesuai program DSME dan DSMS dalam upaya meningkatkan self care pasien DM adalah melalui penggunaan buku harian Pemantauan Gula Darah Mandiri (PGDM). Proyek inovasi latihan kekuatan otot dan keseimbangan dilakukan pada pasien DM lansia untuk mencegah jatuh, meningkatkan kekuatan otot dan keseimbangan berjalan.

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One of metabolic diseases that occurs due to abnormalities in insulin secretion, insulin action or both is diabetes mellitus (DM). It is characterized by hyperglycemia. Prolonged of hyperglycemia causes various complication become major health problem worldwide. Nurses play an important role in reducing morbidity and mortality through the Diabetes Self-Management Education (DSME) and Diabetes Self-Management Support (DSMS) to prevent the complications and improve lifestyle changes. Framework of DSME and DSMS were applied using Dorothea Orem's Self Care. The application of this theory focuses on the individual's ability to independently perform nursing actions, identify and manage the treatment needs. Evidence-based practice related to DSME and DSMS programs by using Self Monitoring Blood Glucose Diary (SMBG). The inovation project was muscle strengths and balances exercises in elderly diabetic patients with neuropathy, in other to prevent falls and improve the muscle strengths and balances."

"Diabetes mellitus merupakan penyakit kronik pada system endokrin yang paling banyak dijumpai dipelayanan kesehatan. Perawat dalam memberikan asuhan keperawatan dapat menggunakan berbagai metode pendekatan, salah satunya dengan model pendekatan Self Care Orem yang menggunakan pendekatan untuk memandirikan pasien diabetes melalui manajemen diabetes secara mandiri.Residensi keperawatan medikal bedah peminatan keperawatan endokrin bertujuan melakukan analisis terhadap penerapan model pendekatan Self Care Orem dalam melakukan kegiatan pemberian asuhan keperawatan. Selain itu juga dilakukan penerapan praktek berbasis bukti dengan pengkajian 3 menit kaki diabetesdi poliklinik penyakit dalam diharapkan dapat menjadi skrining terhadap pencegahan terjadinya ulkus diabetik. Selain penerapan Evidence Based Nursing Practice juga dilakukan penerapan inovasi promosi kesehatan dengan tujuan untuk memandirikan pasien dalam melakukan perawatan diri sehari-hari dalam mencegah terjadinya komplikasi diabeti yang dilakukan dipoliklinik penyakit dalam RS. Ciptomangunkusumo, Jakarta. Diharapkan dengan penerapan asuhan keperawatan dengan menggunakan pendekatan Self Care Orem, serta penerapan pengkajian 3 menit kaki diabetik dan promosi kesehatan dapat menjadi acuan dalam penerapan asuhan keperawatan yang komprehensif dan terintegrasi, sehingga pada akhirnya diharapkan dapat meningkatkan kulaitas asuhan keperawatan.

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Diabetes mellitus is a chronic disease in the endocrine system of the most prevalent in health care system. Nurses in providing nursing care can use various methods for approach , one of them with models of Orem Self Care approach.

That uses approach for diabetic patients through independent diabetes management. Nursing specialist of Medical-Surgical practice for endocrine conduct an analysis of the application models of Orem Self Care approach in the provision of nursing care activities. It also made the application of evidencebased practice with an assessment of the diabetic foot in 3 minutes in outpatient

with diabetic, with the aims to be screened foot problems for prevention of diabetic ulcers.

In addition to the application of evidence -based nursing practice is also carried

out the implementation of inovation prgramme health promotion. The purpose of

this programme is promote patient ability to be independent for perform daily

self-care and prevention from diabetic complication in Cipto Mangunkusumo

Hospital at Jakarta. The cxpectation of implementation of nursing care by using Orem Self Care Approach, 3 minutes diabetic foot assessment and health promotion can be a reference in the implementation of nursing care is comprehensive and integrated , which in turn is expected to improve the quality of nursing care ."

"Karya Ilmiah Akhir ini merupakan gambaran pelaksanaan praktik ners spesialis keperawatan anak selama 2 semester. Karya Ilmiah Akhir ini memfokuskan pada aplikasi Self-Care Deficit Nursing Theory (SCDNT) yang dikembangkan oleh Orem pada klien anak dengan gangguan pemenuhan kebutuhan cairan. SCDNT terdiri dari 3 teori yang saling berhubungan yaitu teori self-care, self-care deficit, dan nursing system. Asuhan keperawatan dimulai dengan pengumpulan data. Diagnosa keperawatan yang ditetapkan berdasarkan pada therapeutic self-care demands dan keadekuatan dari self-care agency. Prescriptive operations dibuat dengan melibatkan klien anak dan keluarga sehingga dapat ditetapkan nursing of methods yang tepat berdasarkan nursing system yang dibutuhkan klien anak. Residen melaksanakan regulatory operations dan menerapkan Family Centered Care (FCC). Selanjutnya residen melakukan control operations, dimana dari kelima kasus yang dikelola oleh residen 3 klien telah teratasi dan 2 klien belum teratasi (masih dirawat di rumah sakit). Berdasarkan hal tersebut residen merekomendasikan bahwa SCDNT dapat diaplikasikan pada klien anak dengan gangguan pemenuhan kebutuhan cairan.

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This Final Scientific Work describes of specialist nursing practice in pediatric nursing for 2 semesters. This Final Scientific Work focuses on the application Self-Care Deficit Nursing Theory (SCDNT) developed by Orem on the child client with fluid imbalances. SCDNT consists of three interrelated theories, namely the theory of self-care, self-care deficit, and nursing system. Nursing care begins with data collection. Nursing diagnosis is determined based on therapeutic self care demands and the adequacy of self-care agency. Prescriptive operations made with the involvement of children and families so that clients can set the proper nursing of methods based on the nursing system required the child client. Resident had done regulatory operations and implement Family Centered Care (FCC). The next resident to control operations, which of the five cases are managed by the resident 3 clients have been resolved and 2 clients have not been resolved (still being treated in hospital). Based on the resident recommended that SCDNT can be applied to a client meeting the needs of children with fluid imbalances."

"Laporan ini bertujuan untuk memaparkan analisis perawatan pasien diabetes melitus (DM) dengan ulkus diabetes post amputasi yang menggunakan model self care Orem sebagai kerangka kerjanya. Tiga puluh pasien DM juga terlibat dalam perawatan ini. Proyek tindakan keperawatan berbasis pembuktian ilmiah (evidence based nursing practice) dilakukan untuk melihat efektifitas program edukasi self efficacy dalam memperbaiki self care pasien DM tipe 2 saat berada di rumah. Proyek inovasi menghasilkan panduan berupa booklet latihan kekuatan dan keseimbangan pada pasien DM dengan nuropati perifer. Hasil analisis menunjukkan bahwa model self care Orem dapat diterapkan pada perawatan pasien DM dan program edukasi self efficacy menunjukkan hasil ada peningkatan perilaku self care pasien DM saat berada di rumah. Pasien DM dengan neuropati perifer memperoleh manfaat dari latihan kekuatan dan keseimbangan melalui pemberian booklet.

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This report aims to describe the analysis of nursing care for diabetic patients with ulcus diabetic post amputation using self care Orem?s model as a framework. Thirty diabetic patients involved in this care. The Evidence Based Nursing Practice (EBNP) project was an education self efficacy program intervention toward self care in type 2 diabetes mellitus patients. The innovation project produced guideline booklet regarding strengths and balances exercise in patients with diabetic peripheral neuropathy. The analysis showed that self care Orem model could be applied in the care for patients with diabetes and the self efficacy program could improve self care for patients with diabetes at home. Diabetic patients with peripheral neuropathy are benefited from the strengths and balances exercise training given from the booklet."

"[ABSTRAK Nama WidiaWatiNPM 1206195810Program Studi Ners Spesialis Keperawatan Medikal BedahJudul Penerapan Asuhan Keperawatan Model Self Care Orem pada Pasien Diabetes Melitus dengan Ulkus di RSUPN Cipto Mangunkusumo Diabetes melitus merupakan penyakit metabolik yang terjadi karena kelainan sekresi insulin kerja insulin atau keduanya yang ditandai dengan Hiperglikemia Kondisi hiperglikemia yang tidak teratasi dapat menimbulkan berbagai komplikasi baik komplikasi akut maupun kronik Salah satu komplikasi kronik adalah ulkus diabetes Seiring dengan meningkatnya jumlah kejadian DM maka prevalensi ulkus diabetes akan meningkat juga Di Indonesia ulkus diabetes dan ganggren merupakan komplikasi diabetes yang paling banyak dirawat di rumah sakit Penanganan ulkus diabetes yang tidak optimal menyebabkan meningkatnya hari rawat inap Kondisi luka menimbulkan gangguan pemenuhan kebutuhan perawatan diri bagi pasien Perawat berperan penting dalam membantu pemenuhan Self Care pasien Untuk itu penerapan asuhan keperawatan model Self Care Orem berfokus pada kemampuan individu dalam melakukan tindakan perawatan mandiri mengenali dan mengatur kebutuhan perawatannya Penerapan Evidence Based Nursing adalah terapi Progressive Muscle Relaxation PMR dan latihan nafas merupakan latihan untuk meningkatkan kontrol glikemik dan menurunkan tingkat stress pada pasien DM tipe 2 Sedangkan Inovasi Keperawatan yang diberikan bertujuan meningkatkan Self Care dengan cara meningkatkan kemampuan pasien dalam Self Health Assessment Kata kunci Diabetes melitus Ulkus diabetes Model Self Care Orem ABSTRAK Nama WidiaWatiNPM 1206195810Program Studi Ners Spesialis Keperawatan Medikal BedahJudul Penerapan Asuhan Keperawatan Model Self Care Orem pada Pasien Diabetes Melitus dengan Ulkus di RSUPN Cipto Mangunkusumo Diabetes melitus merupakan penyakit metabolik yang terjadi karena kelainan sekresi insulin kerja insulin atau keduanya yang ditandai dengan Hiperglikemia Kondisi hiperglikemia yang tidak teratasi dapat menimbulkan berbagai komplikasi baik komplikasi akut maupun kronik Salah satu komplikasi kronik adalah ulkus diabetes Seiring dengan meningkatnya jumlah kejadian DM maka prevalensi ulkus diabetes akan meningkat juga Di Indonesia ulkus diabetes dan ganggren merupakan komplikasi diabetes yang paling banyak dirawat di rumah sakit Penanganan ulkus diabetes yang tidak optimal menyebabkan meningkatnya hari rawat inap Kondisi luka menimbulkan gangguan pemenuhan kebutuhan perawatan diri bagi pasien Perawat berperan penting dalam membantu pemenuhan Self Care pasien Untuk itu penerapan asuhan keperawatan model Self Care Orem berfokus pada kemampuan individu dalam melakukan tindakan perawatan mandiri mengenali dan mengatur kebutuhan perawatannya Penerapan Evidence Based Nursing adalah terapi Progressive Muscle Relaxation PMR dan latihan nafas merupakan latihan untuk meningkatkan kontrol glikemik dan menurunkan tingkat stress pada pasien DM tipe 2 Sedangkan Inovasi Keperawatan yang diberikan bertujuan meningkatkan Self Care dengan cara meningkatkan kemampuan pasien dalam Self Health Assessment Kata kunci Diabetes melitus Ulkus diabetes Model Self Care Orem ABSTRACT Name WidiaWatiNPM 1206195810Study Program Postgraduate of Nursing Science programTitle Nursing care by Orem rsquo s self care model application for diabetes mellitus patient with diabetic ulcer in RSUPN Cipto Mangunkusumo Diabetes mellitus is metabolic disease because alter secretion act of insulin or both showed by hyperglycemia Hyperglycemia uncontrolled can cause complication either acute or chronic One of chronic complication is diabetic ulcer Increasing prevalence of diabetes could be assumed that could increase prevalence of diabetic ulcer either In Indonesia diabetic ulcer and gangrene were the most diabetes complication that was hospitalized Care of diabetic ulcer that was not optimal could cause length of stay LOS in hospital Diabetic ulcer could cause needs of self care demand disturbance for patient Nurse had important role in help self care demand for patient For that reason application of nursing care with self care Orem model focused on individual ability to do self care recognize and regulate care requirement Evidence Based Nursing about Progressive Muscle Relaxation PMR therapy and breathing exercise for enhance blood glucose control and reduce stress level in diabetes type 2 patient whereas nursing innovation purposed to enhance self care through increasing patient ability for Self Health Assessment Keywords Diabetes mellitus diabetic ulcer Orem rsquo s Self Care Model;ABSTRACT Name WidiaWatiNPM 1206195810Study Program Postgraduate of Nursing Science programTitle Nursing care by Orem rsquo s self care model application for diabetes mellitus patient with diabetic ulcer in RSUPN Cipto Mangunkusumo Diabetes mellitus is metabolic disease because alter secretion act of insulin or both showed by hyperglycemia Hyperglycemia uncontrolled can cause complication either acute or chronic One of chronic complication is diabetic ulcer Increasing prevalence of diabetes could be assumed that could increase prevalence of diabetic ulcer either In Indonesia diabetic ulcer and gangrene were the most diabetes complication that was hospitalized Care of diabetic ulcer that was not optimal could cause length of stay LOS in hospital Diabetic ulcer could cause needs of self care demand disturbance for patient Nurse had important role in help self care demand for patient For that reason application of nursing care with self care Orem model focused on individual ability to do self care recognize and regulate care requirement Evidence Based Nursing about Progressive Muscle Relaxation PMR therapy and breathing exercise for enhance blood glucose control and reduce stress level in diabetes type 2 patient whereas nursing innovation purposed to enhance self care through increasing patient ability for Self Health Assessment Keywords Diabetes mellitus diabetic ulcer Orem rsquo s Self Care Model;ABSTRACT Name WidiaWatiNPM 1206195810Study Program Postgraduate of Nursing Science programTitle Nursing care by Orem rsquo s self care model application for diabetes mellitus patient with diabetic ulcer in RSUPN Cipto Mangunkusumo Diabetes mellitus is metabolic disease because alter secretion act of insulin or both showed by hyperglycemia Hyperglycemia uncontrolled can cause complication either acute or chronic One of chronic complication is diabetic ulcer Increasing prevalence of diabetes could be assumed that could increase prevalence of diabetic ulcer either In Indonesia diabetic ulcer and gangrene were the most diabetes complication that was hospitalized Care of diabetic ulcer that was not optimal could cause length of stay LOS in hospital Diabetic ulcer could cause needs of self care demand disturbance for patient Nurse had important role in help self care demand for patient For that reason application of nursing care with self care Orem model focused on individual ability to do self care recognize and regulate care requirement Evidence Based Nursing about Progressive Muscle Relaxation PMR therapy and breathing exercise for enhance blood glucose control and reduce stress level in diabetes type 2 patient whereas nursing innovation purposed to enhance self care through increasing patient ability for Self Health Assessment Keywords Diabetes mellitus diabetic ulcer Orem rsquo s Self Care Model;ABSTRACT Name WidiaWatiNPM 1206195810Study Program Postgraduate of Nursing Science programTitle Nursing care by Orem rsquo s self care model application for diabetes mellitus patient with diabetic ulcer in RSUPN Cipto Mangunkusumo Diabetes mellitus is metabolic disease because alter secretion act of insulin or both showed by hyperglycemia Hyperglycemia uncontrolled can cause complication either acute or chronic One of chronic complication is diabetic ulcer Increasing prevalence of diabetes could be assumed that could increase prevalence of diabetic ulcer either In Indonesia diabetic ulcer and gangrene were the most diabetes complication that was hospitalized Care of diabetic ulcer that was not optimal could cause length of stay LOS in hospital Diabetic ulcer could cause needs of self care demand disturbance for patient Nurse had important role in help self care demand for patient For that reason application of nursing care with self care Orem model focused on individual ability to do self care recognize and regulate care requirement Evidence Based Nursing about Progressive Muscle Relaxation PMR therapy and breathing exercise for enhance blood glucose control and reduce stress level in diabetes type 2 patient whereas nursing innovation purposed to enhance self care through increasing patient ability for Self Health Assessment Keywords Diabetes mellitus diabetic ulcer Orem rsquo s Self Care Model, ABSTRACT Name WidiaWatiNPM 1206195810Study Program Postgraduate of Nursing Science programTitle Nursing care by Orem rsquo s self care model application for diabetes mellitus patient with diabetic ulcer in RSUPN Cipto Mangunkusumo Diabetes mellitus is metabolic disease because alter secretion act of insulin or both showed by hyperglycemia Hyperglycemia uncontrolled can cause complication either acute or chronic One of chronic complication is diabetic ulcer Increasing prevalence of diabetes could be assumed that could increase prevalence of diabetic ulcer either In Indonesia diabetic ulcer and gangrene were the most diabetes complication that was hospitalized Care of diabetic ulcer that was not optimal could cause length of stay LOS in hospital Diabetic ulcer could cause needs of self care demand disturbance for patient Nurse had important role in help self care demand for patient For that reason application of nursing care with self care Orem model focused on individual ability to do self care recognize and regulate care requirement Evidence Based Nursing about Progressive Muscle Relaxation PMR therapy and breathing exercise for enhance blood glucose control and reduce stress level in diabetes type 2 patient whereas nursing innovation purposed to enhance self care through increasing patient ability for Self Health Assessment Keywords Diabetes mellitus diabetic ulcer Orem rsquo s Self Care Model]"