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"ABSTRAKGagal jantung dan hipertensi merupakan penyakit tidak menular yang menjadipenyebab 70 kematian di dunia serta menyebabkan ansietas dan gangguan citratubuh. Tindakan keperawatan ners dan ners spesialis Acceptance and commitmenttherapy diberikan pada klien agar dapat meningkatkan penerimaan dan komitmenmerawat penyakit untuk mencapai kesembuhan. Psikoedukasi keluarga dilakukan agarkeluarga mampu membantu merawat klien dalam menghadapi penyakitnya. Metodeyang digunakan berupa laporan kasus dalam bentuk case series pada 3 klien dewasadengan gagal jantung dan hipertensi. Hasil menunjukkan bahwa ketiga klienmengalami penurunan gejala pada aspek kognitif berupa sulit konsentrasi, fokus padadiri sendiri, tidak menerima perubahan tubuh; afektif: khawatir, malu dan putus asa;fisilogis: gangguan tidur dan tidak nafsu makan; perilaku: melamun, penurunanproduktivitas; dan sosial: sulit menikmati kegiatan harian serta terjadi peningkatankemampuan klien dalam menerima penyakit dan komitmen merawat ansietas dangangguan citra tubuh. Pemberian tindakan keperawatan ners dan ners spesialis acceptance and commitment therapy serta psikoedukasi keluarga perlu dibudayakandalam pemberian pelayanan keperawatan di unit umum. Kata kunci: Ansietas, Gangguan Citra Tubuh, Acceptance and commitment therapy,psikoedukasi keluarga

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ABSTRACTABSTRACT: Heart failure and hypertention are a non communicable diseases that cause 70 of deathsin the world and causes ansietas and impaired body image. Nursing Intervention Therapyas usual and Acceptance and commitment therapy is given to the client in order to increaseacceptance of the disease and commit to caring anxiety and impaired body image. FamilyPsychoeducation is given to improve family ability for caring client. The method used iscase reports in the form of case series in 3 adult with heart failure and hipertention. Theresults showed that the three clients experienced a decrease in symptoms on the cognitiveaspect of difficulty concentrating, focusing on self, decline body changes Affective worry,shame and despair Fisilogis sleep disorders and no appetite Behavior daydreaming,decreased productivity And social it is difficult to enjoy daily activities as well asincreasing the ability of clients in receiving illness and commitment to care for anxiety andimpaired body image. Nursing intervention and acceptance and commitment therapy and family psychoeducation should be realised in the provision of nursing services."

"Latar Belakang: Kanker kolorektal merupakan salah satu penyakit kanker tertinggi di Indonesia. Fokus perawatan selama ini lebih banyak tentang cara merawat stoma. Namun masalah psikososial gangguan citra tubuh yang melekat pada pasien sering diabaikan. Tujuan penulisan karya ilmiah ini untuk memberikan gambaran penerapan acceptance commitment therapy dan family psychoeducation pada gangguan citra tubuh pasien kanker kolorektal dengan pendekatan teori chronic sorrow. Metode yang digunakan yaitu laporan kasus hasil asuhan keperawatan jiwa spesialistik yang dilakukan pada 31 orang pasien dan 31 orang caregiver. Intervensi dilakukan selama 2 siklus kemoterapi rawat inap masing – masing 5 hari rawat dengan rata – rata pertemuan 45 – 60 menit. Hasil pengukuran pre dan post menunjukan penurunan tanda gejala gangguan citra tubuh. Perubahan tanda gejala paling dominan yaitu aspek kognitif, aspek fisiologis dan aspek sosial. Dampak lain yang dihasilkan yaitu meningkatnya dukungan keluarga dan kualitas hidup pasien. Intervensi ini dapat diaplikasikan pada gangguan citra tubuh pada pasien kanker kolorektal.

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Colorectal cancer is one of the highest cancers in Indonesia. The focus of treatment so far is more about how to treat stomas. However, psychosocial problems of body image disorders inherent in patients are often overlooked. The purpose of writing this scientific paper is to provide an overview of the application of acceptance commitment therapy and family psychoeducation in body image disorders of colorectal cancer patients with a chronic sorrow theory approach. The method used was a case report of specialist psychiatric nursing care results carried out on 31 patients and 31 caregivers. The intervention was performed during two cycles of inpatient chemotherapy of 5 days each with an average meeting of 45 – 60 minutes. The results of pre and post-measurements showed a decrease in symptoms of body image disorders. The most dominant changes in symptom signs are cognitive, physiological, and social. Another impact that resulted was an increase in family support and patients' quality of life. This intervention can be applied to body image disorders in colorectal cancer patients."

"Ansietas sering ditemukan pada klien hipertensi akibat kekhawatiran kesehatan dan masa depannya. Selain itu, kegagalan berkomitmen untuk mengurangi faktor risiko dan rejimen pengobatan dalam kehidupan sehari-hari menjadi indikator klinis dengan nilai sensitif paling tinggi pada hipertensi. Karya tulis ilmiah ini bertujuan untuk mengetahui pengaruh tindakan keperawatan, progressive muscle relaxation, acceptance commitment therapy, dan psikoedukasi keluarga terhadap ansietas dan ketidakefektifan manajemen kesehatan klien hipertensi. Pemberian terapi progressive muscle relaxation, acceptance commitment therapy, dan psikoedukasi keluarga dapat menurunkan tanda dan gejala ansietas dan ketidakefektifan manajemen kesehatan secara bermakna pada klien hipertensi. Pemberian paket 3 terapi yaitu terapi progressive muscle relaxation, acceptance commitment therapy, dan psikoedukasi keluarga diketahui mampu menurunkan tanda dan gejala ansietas dan ketidakefektifan manajemen kesehatan lebih tinggi dibanding jika hanya diberikan satu terapi saja atau 2 terapi saja. Sehingga, terapi kombinasi 3 terapi lebih direkomendasikan dalam mengatasi ansietas dan ketidakefektifan manajemen kesehatan pada klien hipertensi.

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Anxiety is often found in hypertension clients due to worries about their health and future. In addition, failure to commit to reducing risk factors and treatment regimens in daily life is a clinical indicator with the highest sensitive value in hypertension. This scientific paper aims to determine the effect of nursing actions, progressive muscle relaxation, acceptance commitment therapy, and family psychoeducation on anxiety and ineffective health management of hypertensive clients. Provision of progressive muscle relaxation therapy, acceptance commitment therapy, and family psychoeducation can significantly reduce signs and symptoms of anxiety and ineffective health management in hypertensive clients. Giving a package of 3 therapies, namely progressive muscle relaxation therapy, acceptance commitment therapy, and family psychoeducation is known to be able to reduce signs and symptoms of anxiety and ineffective health management higher than if only given one therapy or only 2 therapies. Thus, combination therapy of 3 therapies is more recommended in overcoming anxiety and ineffective health management in hypertensive clients."

"Perilaku kekerasan merupakan perilaku yang sering ditemui pada klien dengan skizofrenia yang mengakibatkan klien dapat mencederai diri sendiri, orang lain dan lingkungannya serta menjadi penyebab rehospitalisasi. Tindakan keperawatan ners, dan Acceptance Commitment Therapy ACT diberikan pada klien dengan tujuan untuk menurunkan tanda gejala risiko perilaku kekerasan, meningkatkan kemampuan klien mengontrol emosi, menerima masalahnya dan berkomitmen, sedangkan Family Psychoeducation FPE diberikan dengan tujuan meningkatkan kemampuan keluarga dalam merawat klien. Tindakan keperawatan diberikan kepada 5 klien risiko perilaku kekerasan dengan menggunakan pendekatan model stres adaptasi stuart. Hasil yang didapatkan adalah terjadi penurunan tanda gejala risiko perilaku kekerasan pada aspek kognitif, afektif, fisiologis, perilaku dan sosial, terjadi peningkatan kemampuan klien dalam mengontrol emosi, menerima masalahnya, dan berkomitmen, serta kemampuan keluarga dalam merawat. Hasil penanganan kasus ini merekomendasikan pentingnya pelaksanaan tindakan keperawatan ners sendiri terhadap klien dan keluarga serta menggunakan sistem rujukan jika tindakan keperawatan ners tidak mampu mengatasi masalah klien. Penelitian lebih lanjut juga diperlukan dengan kelompok kontrol dan follow-up berkelanjutan untuk melihat sejauh mana komitmen klien terhadap terapi.

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Agressive behavior is frequently occured in clients with schizophrenia that resulted clients injured themselves, others and the environment and caused rehospitalization. Nursing intervention Therapy As Usual TAU , and Acceptance Commitment Therapy ACT were delivered in order to reduce signs of violent behavior, improve clients ability to control anger, to accept the problems and commit to the therapy, while Family Psychoeducation FPE was given to improve the family 39 s ability in caring for clients. TAU, ACT and FPE were given to 5 clients of risk of agressive behavior by using the stuart tress adaptation model approach. The finding indicated decrease in signs of agressive behavior on cognitive, affective, physiological, behavioral and social aspects, increasing client 39 s ability to control anger, accept problems, and commit to the therapy, as well as family rsquo s ability in caring. The results of this case report recommends the importance of implementing nursing intervention TAU itself both on clients and the families and using a referral system to the specialist nurse if TAU are not able to solve client rsquo s problem. Further research is also required with continuous control group and follow up intervention to see how committed clients are to the therapy."

"Heart failure and hypertension are non-communicable diseases that are responsible for 70% of deaths worldwide and cause anxiety and impaired body image. Nursing interventions (therapy in general) and acceptance and commitment therapy increase patients’ acceptance of the disease and commitment to alleviate anxiety and improve impaired body image. Meanwhile, family psychoeducation improves the family’s ability to care for the patient. This case report presents two patients with heart failure and hypertension. The two patients experienced a decrease in symptoms on the cognitive aspects (difficulty concentrating, focusing on self, and decline body changes), affective aspects (worry, shame, and despair), physiological aspects (sleep disorders and appetite), and behavioral aspects (daydreaming, decreased productivity, and social difficulties). Patients who find difficulty enjoying daily activities and increasing their ability and commitment to overcome anxiety and impaired body image should receive nursing intervention, acceptance and commitment therapy, and family psychoeducation as part of nursing services."

"ABSTRAKAnsietas merupakan masalah kejiwaan yang sering dialami oleh seseorang dalam kehidupan sehari-hari dan khususnya yang mengalami penyakit fisik seperti hipertensi. Tindakan keperawatan ners, Thought Stoping, psikoedukasi keluarga dan terapi suportif diberikan pada klien ansietas dengan tujuan untuk melihat tanda gejala, kemampuan klien mengontrol ansietas, dan kemampuan keluarga dalam merawat. Tindakan keperawatan terhadap 5 klien ansietas dengan hipertensi yang dilaporkan dalam bentuk case series. Hasil yang didapatkan adalah terjadi hillagnya tanda gejala yaitu fokus pada kondisi sakit, takut pada konsekuensi tidak spesifik, adanya perubahan fisiologis, kurang mampu memecahkan masalah dan kurang konsentrasi. Sedangkan tanda gejala yang masih ditemukan diantaranya adalah adanya perubahan dalam kehidupan dan merepotkan kelurga. Kemampuan klien yang dimiliki mengalami peningkatan dalam mengontrol ansietas dan kemampuan keluarga dalam merawat. Studi ini merupakan salah satu evidence based efektivitas dari tindakan keperawatan ners dan ners spesialis terhadap klien dengan ansietas yang memerlukan evaluasi lanjut dengan jumlah sampel yang lebih besar dan jumlah pertemuan yang lebih sering.

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ABSTRACT

Anxiety is a psychiatric problem that is often experienced by a person in everyday life and especially those experiencing physical illnesses such as hypertension. Nursing care, Thought Stoping, family psychoeducation and supportive therapy are given to anxiety clients in order to see signs of symptom, the ability of the client to control anxiety, and the ability of the family to care for. Nursing action against 5 anxiety clients with hypertension reported in case series form. The results obtained are hillagnya signs of symptoms that focus on the condition of the pain, fear of non-specific consequences, the physiological changes, less able to solve problems and lack of concentration. While the signs of symptoms that are still found among them is a change in life and troublesome kelurga. The client's ability has improved in controlling anxiety and the ability of the family to care for. This study is one of the evidence-based effectiveness of nursing ners and specialist ners actions against clients with anxiety requiring further evaluation with larger sample quantities and more frequent meetings."

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Ulkus diabetik merupakan komplikasi diabetes melitus berupa neuropati dan  iskemik.Klien ulkus diabetik mengalami luka di  kaki yang penyembuhannya membutuhkan waktu yang lama sehingga rentan mengalami ansietas dan gangguan citra tubuh. Ansietas merupakan rasa takut yang tidak jelas disertai dengan perasaan ketidakpastiandan ketidaknyamanan sedangkan gangguan citra tubuh merupakan persepsi yang tidak jelas terhadap bentuk, struktur dan fungsi tubuh.Tujuan penelitian adalah untuk mengetahui pengaruh tindakan keperawatan ners, terapi penerimaan komitmen(TPK) dan psikoedukasi keluarga terhadap ansietas dan citra tubuh klien ulkus diabetik. Metode penelitian menggunakan desain kuantitatif dengan pendekatan Quasy Experimental Pre-Post with Control Group. Responden sejumlah 20 orangdengan total samplingwithpurposive sampling. Peneliti menggunakan kuesioner.Hasil penelitian menunjukkan bahwa kondisiansietas, citra tubuh, kondisi ulkus mengalami penurunan. Kemampuan menerima dan berkomitmenserta kemampuan keluarga merawat menjadi meningkat secara signifikan. Kesimpulan penelitian ini adalah ada pengaruh tindakan keperawatan ners, terapi penerimaan komitmen (TPK) dan psikoedukasi keluarga terhadap ansietas dan citra tubuh klien ulkus diabetik. Diharapkan penelitian ini dapat diaplikasikan dalam mengatasi penyakit  komplikasi fisik dengan gangguan psikososial.

 

 

 

Kata kunci : Ulkus Diabetik, Ansietas, Citra Tubuh, Tindakan Keperawatan Ners, Terapi Penerimaan Komitmen(TPK) dan Psikoedukasi keluarga

 

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Diabetic ulcers are complications of diabetes mellitus in the form of neuropathy and ischemia. Diabetic ulcer clients experience wounds on the legs which healing takes a long time so they are prone to experiencing anxiety and body image disorders. Anxiety is an unclear fear accompanied by a feeling of uncertainty and discomfort while body image disturbance is an unclear perception of the shape, structure and function of the body. anxiety and body image of diabetic ulcer client. The research method used a quantitative design with a Quasy Experimental Pre-Post with Control Group approach. There were 20 respondents with total sampling with purposive sampling. Researchers used a questionnaire. The results showed that the condition of anxiety, body image, and ulcer conditions decreased. The ability to accept and commit and the ability of the family to care for them is significantly improved. The conclusion of this study is that there is an effect of nursingaction,acceptance commitment therapy (ACT) and family psychoeducation on anxiety and body image of diabetic ulcer clients. It is hoped that this research can be applied in dealing with physical complications and psychosocial disorders.

Keywords :Diabetic Ulcers, Anxiety, Body Image, Effects of Acceptances and Commitment Therapy( ACT) and family psychoeducation

 

 

 

 

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"Prevalensi hipertensi di Dunia maupun Indonesia semakin tinggi. Semakin banyak jumlah penyakit kronis yang dimiliki seseorang, maka risiko mengalami gangguan mental emosional semakin tinggi. Klien yang menderita satu penyakit kronis beresiko 2,6 kali lebih besar untuk mengalami gangguan mental emosional. Hipertensi tidak hanya berdampak pada fisik melainkan juga memunculkan dampak psikologis pada klien, dan dampak psikologis yang paling banyak terjadi adalah ansietas. Tujuan penelitian ini adalah untuk mengetahui pengaruh terapi penghentian pikiran (TS), Acceptance and Commitment Therapy (ACT) dan psikoedukasi keluarga (FPE) terhadap ansietas dan kepatuhan pengobatan. Desain penelitian menggunakan operational research. Tiga puluh tujuh klien hipertensi yang mengalami ansietas diberikan tindakan keperawatan Ners dan terapi penghentian pikiran, Acceptance and Commitment Therapy (ACT) dan psikoedukasi keluarga. Instrumen yang digunakan adalah instrumen tanda gejala ansietas FIK UI, Self Reporting Questionaire (SRQ), Hamilton Anxiety Rating Scale, dan Morisky Medication Adherence Scale-8. Semua instrumen telah terbukti valid dan reliabel. Hasil menunjukkan terdapat penurunan rata-rata tekanan darah dan ansietas yang signifikan setelah diberikan kombinasi tindakan keperawatan ners, terapi penghentian pikiran, Acceptance and Commitment Therapy dan psikoedukasi keluarga (p value <0,05) sementara kepatuhan pengobatan dan kemampuan klien serta keluarga mengalami peningkatan yang signifikan (p value <0,05) baik setelah mendapat kombinasi TKN+FPE atau TKN+FPE+TS maupun TKN+FPE+TS+ACT. Tindakan keperawatan Ners dan terapi penghentian pikiran, Acceptance and Commitment Therapy (ACT) dan psikoedukasi keluarga direkomendasikan sebagai terapi yang dapat menurunkan ansietas dan meningkatkan kepatuhan pengobatan pada klien hipertensi.

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The prevalence of hypertension in the World and Indonesia is getting higher. The more the number of chronic diseases a person has, the higher the risk of experiencing emotional mental disorders. Clients who suffer from a chronic illness are 2.6 times more at risk of experiencing mental emotional disorders. Hypertension not only affects the physical but also raises a psychological impact on the client, and the most psychological impact occurs is anxiety. The purpose of this study was to determine the effect of thought stopping therapy (TS), Acceptance and Commitment Therapy (ACT) and family psychoeducation (FPE) on anxiety and medication adherence. The research design uses operational research. Thirty-seven hypertensive clients with anxiety were given nursing care and thought stopping therapy, Acceptance and Commitment Therapy (ACT) and family psychoeducation. The instruments used were FIK UI anxiety symptoms, Self Reporting Questionaire (SRQ), Hamilton Anxiety Rating Scale, and Morisky Medication Adherence Scale-8. All instruments have been proven valid and reliable. The results showed that there was a significant decrease in average blood pressure and anxiety after a combination of nurses' nursing care, thought stopping therapy, Acceptance and Commitment Therapy and family psychoeducation (p value <0.05) while treatment adherence and the ability of clients and families increased significantly significant (p value <0.05) both after receiving a combination of TKN + FPE or TKN + FPE + TS or TKN + FPE + TS + ACT. Nursing actions and thought stopping therapy, Acceptance and Commitment Therapy (ACT) and family psychoeducation are recommended as therapies that can reduce anxiety and improve medication adherence to hypertensive clients."

"Klien dengan penyakit kanker cenderung mengalami masalah psikososial salah satunya ansietas yang berdampak terhadap kesehatan mental. Karya ilmiah akhir ini bertujuan untuk mengetahui penerapan terapi penghentian pikiran, terapi penerimaan dan komitmen serta  psikoedukasi keluarga terhadap respon penurunan  tanda dan gejala ansietas dengan pendekatan teori Stuart dan Swanson. Responden berjumlah 30 klien dengan diagnosa medis kanker, 15 klien diberikan intervensi keperawatan berupa tindakan keperawatan ners generalis ditambah terapi penghentian pikiran dan terapi psikoedukasi keluarga serta 15 klien diberikan Intervensi keperawatan  berupa terapi ners generalis, terapi penghentian pikiran, terapi penerimaan dan komitmen serta terapi psikoedukasi keluarga. Analisis dilakukan terhadap respon tanda dan gejala ansietas serta kemampuan klien dan keluarga sebelum dan sesudah dilakukan tindakan keperawatan. Hasil penerapan Intervensi keperawatan ners generalis dan ners spesialis penghentian pikiran, terapi penerimaan dan komitmen dan psikoedukasi keluarga menurunkan tanda dan gejala ansietas secara bermakna pada semua respon, terdapat perbedaan signifikan pada penurunan tanda dan gejala respon kognitif pada intervensi keperawatan  ners generalis, terapi penghentian pikiran, terapi penerimaan dan komitmen dan psikoedukasi keluarga.

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Clients with cancer tend to experience psychosocial problems, one of which is anxiety that has an impact on mental health. This latest scientific paper aims to determine the application of mind cessation therapy, acceptance and commitment therapy as well as family psychoeducation to the response to decreased signs and symptoms of anxiety with the theoretical approach of Stuart and Swanson. The respondents were 30 clients with a medical diagnosis of cancer, 15 clients were given nursing interventions in the form of generalist nurse nursing actions plus mind cessation therapy and family psychoeducational therapy and 15 clients were given nursing interventions in the form of generalist nurse therapy, mind cessation therapy, acceptance and commitment therapy and family psychoeducation therapy. Analysis was carried out on the response of signs and symptoms of anxiety as well as the ability of clients and families before and after nursing treatment. The results of the implementation of nursing interventions for generalist nurses and nurses with cessation of thoughts, acceptance and commitment therapy and family psychoeducation significantly decreased signs and symptoms of anxiety in all responses, there was a significant difference in the decrease in signs and symptoms of cognitive response in nursing interventions for generalist nurses, mind cessation therapy, acceptance and commitment therapy and family psychoeducation."

"Pendahuluan : Kesehatan jiwa merupakan komponen integral dari kesehatan dan kesejahteraan yang mendasari kemampuan individu untuk mengambil keputusan, membangun hubungan, dan membentuk dunia ditempat yang ditinggali. Rawat inap dan penyakit kronis meningkatkan level distres psikologis yang dialami klien terutama ansietas dan ketidakefektifan koping. Ansietas dan ketidakefektifan koping berdampak negatif pada diri klien diantaranya dapat memperburuk kondisi medisnya, kualitas hidup menurun, meningkatnya penggunaan dan biaya layanan kesehatan serta penurunan kepatuhan pengobatan. Tujuan : Memberikan gambaran hasil penerapan acceptance commitment therapy dan family psychoeducation pada klien ansietas dan ketidakefektifan koping menggunakan pendekatan model adaptasi Roy di Rumah Sakit Umum. Hasil : Terdapat penurunan tanda gejala ansietas dan ketidakefektifan koping setelah diberikan acceptance commitment therapy dan family psychoeducation. Selain itu terdapat peningkatan kemampuan individu dan keluarga dalam mengatasi masalah ansietas dan ketidakefektifan koping. Kesimpulan : Acceptance Commitment Therapy dan Family Psychoeducation dengan pendekatan model adaptasi Roy direkomendasikan untuk diberikan pada klien dengan ansietas dan ketidakefektifan koping.

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Introduction: Mental health is an integral component of health and well-being that underlies an individual's ability to make decisions, build relationships, and shape the world in which they live. Hospitalization and chronic illness increase the level of psychological distress experienced by clients, especially anxiety and ineffective coping. Anxiety and ineffective coping have a negative impact on clients, including worsening medical conditions, decreasing quality of life, increasing use and costs of health services and decreasing medication compliance. Objective: To provide an overview of the results of applying acceptance commitment therapy and family psychoeducation to clients with anxiety and ineffective coping using the Roy adaptation model approach at a General Hospital. Results: There was a decrease in signs of anxiety symptoms and ineffective coping after being given acceptance commitment therapy and family psychoeducation. Apart from that, there is an increase in the ability of individuals and families to overcome anxiety problems and ineffective coping. Conclusion: Acceptance Commitment Therapy and Family Psychoeducation with the Roy adaptation model approach are recommended for clients with anxiety and ineffective coping."