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Luka tekan adalah kerusakan terlokalisir pada bagian kulit atau jaringan dibawahnya sebagai akibat dari tekanan dan gesekan yang terus menerus sehingga terjadi iskemia, nekrosis, yang dapat meluas secara radial hingga lapisan jaringan yang lebih dalam. Tujuan penulisan karya ilmiah ini adalah untuk memberikan gambaran mengenai pemenuhan kebutuhan pada anak yang mengalami kerusakan integritas kulit melalui penerapan reposisi dengan pendekatan Teori Kenyaman Kolcaba. Terdapat lima kasus anak yang dirawat di ruang infeksi yang diberikan asuhan keperawatan dengan pendekatan Teori Kenyamanan Kolcaba. Aplikasi Teori Kenyamanan Kolcaba dapat menjamin kenyamanan pada anak yang mengalami kerusakan integritas kulit melalui empat konteks kenyamanan yaitu kenyamanan fisik, psikospiritual, lingkungan, dan sosiokultural. Penerapan reposisi setiap 2 jam terbukti efektif terhadap peningkatan skor Braden Q dan mencegah terjadinya luka tekan pada anak. Perawat diharapkan mampu melakukan deteksi dini terhadap kerusakan integritas kulit menggunakan Skala Braden Q dan menerapkan reposisi setiap 2 jam pada anak dengan tetap memperhatikan kenyamanan anak untuk meningkatkan kualitas hidup pada anak yang mengalami kerusakan integritas kulit.

 

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A pressure injury is localized damage to the skin or tissue beneath as a result of continuous pressure and friction wgich lead to ischemia and necrosis. This injury may extend radially to a deeper layer of the tissue. The purpose of this paper is to provide an overview of needs fulfillment of the children who have damaged skin integrity through the application of repositioning and integrate the Kolcaba Theory of Comfort. There were five cases of children treated in the infectious room who were given nursing care with the Kolcaba’s Comfort Theory. The Application of Kolcaba’s Comfort Theory can ensure comfort in a child who has damaged skin integrity according to four comfort contexts: physical, psychospiritual, environmental, and sociocultural comfort. The application of repositioning every two hours proved effective against increase Braden Q scores and preventing the occurrence of pressure injury in children. Nurses are expected to be able to detect early damage of the skin integrity using the Braden Q Scale and apply the reposition every two hours as well as paying attention to the child's comfort to improve the quality of life in children who have damaged skin integrity.

 

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"Gangguan integritas kulit merupakan salah satu permasalahan yang dapat dialami oleh anak dengan penggunaan alat bantu napas invasif, yaitu endotracheal tube (ETT). Alat bantu napas memerlukan perekat medis untuk menjaga posisi dalam keadaan aman. Perekat ini dapat menimbulkan cedera kulit yang dikenal dengan medical adhesive related skin injury (MARSI). Tujuan penulisan karya ilmiah ini adalah untuk memaparkan pencegahan gangguan integritas kulit menggunakan profilaksis hidrokoloid dengan pendekatan teori Kolcaba. Asuhan keperawatan menggunakan teori Kolcaba dipaparkan dalam studi kasus lima orang anak dengan rawatan intensif anak. Aplikasi teori Kolcaba menciptakan kenyamanan dari empat aspek yakni fisik, psikospiritual, sosiokultural, dan lingkungan. Penerapan profilaksis hidrokoloid terbukti mampu mencegah kejadian gangguan integritas kulit (MARSI). Berdasarkan hasil ini, perawat dapat menerapkan aspek kenyamanan untuk memberikan asuhan secara holistik, termasuk untuk mencegah terjadinya cedera pada kulit.

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Impaired skin integrity is one of the problems that can be experienced by children using invasive mechanical ventilation, such as endotracheal tube (ETT). Endotracheal tube requires medical adhesives to maintain a safe position. These adhesives can cause skin injuries known as medical adhesive-related skin injury (MARSI). The purpose of this scientific paper is to explain the prevention of impaired skin integrity using hydrocolloid prophylaxis with the Kolcaba theory approach. Nursing care using Kolcaba's theory is reported in a case study of five children in pediatric intensive care. The application of Kolcaba's theory creates comfort from four aspects: physical, psychospiritual, sociocultural, and environmental. The application of hydrocolloid prophylaxis has been shown to prevent the occurrence of impaired skin integrity (MARSI). Based on these results, nurses can apply the comfort aspect to provide holistic care, including preventing skin injury."

"[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.]"

"Ventilasi mekanik berfungsi untuk menyelamatkan kehidupan, namun ventilasi mekanik merupakan tindakan invasif yang menimbulkan ketidaknyamanan berupa kecemasan, agitasi, dan rasa nyeri. Nyeri berdampak negatif pada tumbuh kembang anak. Tujuan penulisan karya ilmiah ini untuk memberikan gambaran asuhan keperawatan nyeri akut pada anak dengan ventilasi mekanik melalui identifikasi nyeri dan tingkat sedasi dengan instrumen Comfort Behaviour Scale dengan pendekatan Teori Kenyamanan Kolcaba. Terdapat lima kasus anak yang terpasang ventilasi mekanik yang mengalami nyeri dan diberikan asuhan keperawatan melalui pendekatan teori kenyamanan Kolcaba. Aplikasi teori kenyamanan Kolcaba terbukti efektif memberikan kenyamanan anak dengan ventilasi mekanik yang mengalami nyeri meliputi konteks kenyamanan fisik, psikospiritual, sosiokultural, dan lingkungan. Instrumen Comfort Behaviour Scale terbukti valid dan reliabel dalam mengukur tingkat sedasi serta dapat digunakan untuk tingkat nyeri anak dengan ventilasi mekanik. Instrumen ini dapat digunakan perawat dalam pengkajian nyeri dan tingkat sedasi anak yang terpasang ventilasi mekanik sehingga memudahkan dalam manajemen nyeri dan sedasi.

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Mechanical ventilation serves as live saving, but mechanical ventilation is an invasive procedure that causes discomfort in the form of anxiety, agitation, and pain. Pain has a negative impact on child development. The purpose is to provide an overview of acute pain nursing care for children with mechanical ventilation through identification of pain and sedation levels with a Comfort Behavior Scale instrument based on Kolcaba Comfort Theory approach. There were five cases of children with mechanical ventilation who experienced pain and were given nursing care through the Kolcaba comfort theory approach.

The application of the Kolcaba comfort theory has proven to be effective in providing comfort for children with mechanical ventilation who experience pain including the context of physical, psychospiritual, sociocultural, and environmental comfort. The Comfort Behavior Scale instrument proved to be valid and reliable in measuring the level of sedation and can be used for measuring pain in children with mechanical ventilation. This instrument can be used by nurses in the assessment of pain and the level of sedation of children who have mechanical ventilation that makes it easier for pain and sedation management."

"Anak sangat rentan mengalami kerusakan integritas kulit karena kondisi kulit yang lebih sensitif dan tipis dibandingkan orang dewasa. Pemakaian popok sekali pakai yang menjadi tren di kalangan ibu yang memiliki anak balita semakin meningkatkan risiko dan kejadian kerusakan integritas kulit berupa ruam popok. Tujuan penulisan ini adalah memberikan gambaran aplikasi model adaptasi Roy pada anak yang mengalami kerusakan integritas kulit berupa ruam popok. Model adaptasi Roy digambarkan pada 5 kasus pasien anak yang mengalami kerusakan integritas kulit. Asuhan keperawatan berdasarkan model adaptasi Roy dimulai dengan pengkajian perilaku yang terdiri dari pengkajian fisiologis, konsep diri, fungsi peran dan interpedensi. Pengkajian tahap dua adalah pengkajian stimulus yang terdiri dari stimulus fokal, kontekstual dan residual. Setelah mendapatkan data melalui pengkajian, penulis merumuskan masalah keperawatan yang timbul berdasarkan respon anak apakah adaptif atau inefektif. Intervensi dan evaluasi keperawatan diberikan berdasarkan Standar Intervensi Keperawatan Indonesia (SIKI). Model adaptasi Roy direkomendaikan dalam memberikan asuhan keperawatan pada anak dengan kerusakan integritas kulit berupa ruam popok. Model ini akan lebih baik jika digunakan pada anak dengan umur yang lebih tua.

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Children are very vulnerable to skin damage because the skin is more sensitive and thin compared to adults. The use of disposable diapers is a trend among mothers in todler and children, increasing the risk and independence of skin damage to diaper rash. The purpose of this response is to provide an overview of the application of Roy's adaptation model in children who repair damaged skin consisting of diaper rash. Roy's adaptation model illustrates 5 cases of pediatric patients. Nursing care based on Roy's adaptation model begins with an assessment of behavior consisting of physiological, self-concept, role functions and interpedence. The assessment was completed with a stimulus assessment consisting of focal, contextual and residual stimulus. After getting data based on the assessment, the authors formulate nursing problems that arise based on whether the child's response is adaptive and/ or uneffective. Nursing interventions and evaluations are given based on nursing care Standar Intervensi Keperawatan Indonesia (SIKI). Roy's adaptation model is recommended in providing nursing care to children with skin protection in the form of diaper rash. There’s would be better if this model use in older children"

"Anak yang dirawat di rumah sakit sering terjadi Moisture Assosiated Skin Damage (MASD) dan medical adhesive – related skin injuries (MARSI) menimbulkan perasaan tidak nyaman seperti nyeri dapat memberikan citra buruk pada pelayanan yang diberikan oleh petugas kesehatan selama anak dirawat di rumah sakit dan berdampak pada perawatan yang panjang serta biaya perawatan akan lebih besar. Penelitian ini bertujuan untuk pencegahan kejadian MASD dan MARSI pada anak selama perawatan. Rancangan penelitian menggunakan quasi eksperiment pretest dan posttest dengan kelompok kontrol. Penelitian ini mengambil sampel 39 pasien pada kelompok intervensi dan kontrol pada ruangan general infeksi dengan menggunakan alat ukur braden q, barthel indek dan menggunakan no sting skin barrier film. Hasil penelitian ini menunjukan bahwa ada perbedaan bermakna antara sebelum dan sesudah dilakukan pemberian no sting skin barrier film untuk pencegahan terjadinya MASD dan MARSI dengan hasil antara kelompok intervensi sebesar 100 % dengan kelompok kontrol sebesar 84,6 % ( MASD) dengan 6 sampel ada maserasi pada kulit dan 66,7 % (MARSI) dan 26 sampel terdapat maserasi pada kulit anak

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Hospitalized pediatric patients frequently experience Moisture Associated Skin Damage (MASD) and Medical Adhesive- Related Skin Injuries (MARSI). This condition will cause discomfort sensations such as pain and can give a negative image to the services provided by health workers while the child is in the hospital. Additionally MASD dan MARSI have a long-term impact on the health of the child and will increase the cost in the long run. This study aims to prevent the occurrence of MASD and MARSI in children during treatment in hospital. The research design used a quasi experiment pretest and posttest with control group. This research was conducted in the general ward infection with 39 sample in intervention group and control used a braden q and barthel indeq instrument and using no sting skin barrier film. This study showed a significant difference between before and after used of no sting skin barrier film to prevent MASD and MARSI in intervention group 100 % and the control group of 84, 6 % (MASD) and 66,7% (MARSI) ; 6 samples had maceration."

"ABSTRAKDiaper dermatitis sering terjadi pada anak anak yang berisiko menimbulkan rasa gatal, nyeri, dan ketidaknyamanan. Pendekatan keperawatan untuk memberikan kenyamanan pada pasien didasarkan pada teori Comfort Kolcaba. Teori ini membahas tentang kenyamanan dalam empat konteks kenyamanan yaitu: fisik, psikospiritual, sosial budaya, dan lingkungan, Perianal care dengan menggunakan air merupakan salah satu Evidence Based Nursing Practice yang dapat diterapkan untuk mencegah dan mengatasi diaper dermatitis sehingga kenyamanan pasien dapat teratasi. Hasil dari penerapan teori ini dilakukan pada anak dengan kerusakan integritas kulit. Teori Kenyamanan Kolcaba dapat meningkatkan kesehatan pasien, kepuasan pasien dan keluarga terhadap pelayanan keperawatan bertambah.

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ABSTRACTDiaper dermatitis is common in children who are at risk of itching, pain. This leads to discomfort in children. The nursing approach to comforting patients is based on Comfort Kolcaba 39 s 2003 theory. This theory discusses comfort in four comfort contexts physical, psychospiritual, socio cultural, and environmental. Perianal care is one of the Evidence Based Nursing Practice that can be applied to prevent and treat diaper dermatitis so that patient comfort can be overcome. The result of the application of this Theory can be applied to children with impaired skin integrity. The implementation of Kolcaba Comfort Theory can improve patient health, patient and family satisfaction on nursing services will increase."

"Angka Kematian Ibu, Bayi dan Balita masih tinggi di Indonesia. Salah satu usaha penurunannya adalah dengan memanfaatan data dan informasi untuk membantu perencanaan program. SP2TP adalah informasi yang potensial dalam membantu perencanaan program di Puskesmas. Di wilayah Puskesmas Tapos masih terjadi kematian ibu, bayi dan balita pada tahun 2013. Dan belum dilakukannya pemanfataan SP2TP di Puskesmas Tapos dalam medukung perencanaan program KIA. Desain yang digunakan dalam penelitian ini adalah kualitatif dengan pendekatan operational research. Cara pengumpulan data dengan wawancara dan telaaah dokumen. Hasil penelitian menunjukkan bahwa dari proses analisis situasi masalah dengan cara melihat cakupan dan target, identifikasi masalah dengan pembuatan pohon masalah, prioritas masalah dengan teknik skoring, penetapan tujuan, alternatif pemecahan masalah hingga penyusunan rencana operasional. Dari proses penyusunan perencanaan operasional dengan memanfaatkan SP2TP diketahui masalah di Program KIA Puskesmas Tapos disebabkan oleh masalah kesehatan lingkungan yang masih rendah.

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Maternal Mortality, Infant and Toddlers still high in Indonesia. One attempt decline is the utilization of data and information to help planning the program. SP2TP is a potential information to help planning programs at primary helath care. Based of profile, in regional of primary helath care in Tapos still going on maternal mortality, infant and toddler in 2013. And utilization of SP2TP is not optiml for supporting maternal and child health program planning. The design used in this study is a qualitative approach to operational research. The data collected through interviews and searching literature.

The results showed that the analysis of the situation of the problem by looking at the scope and targets, identifying problems with the manufacture of the problem tree, priority issues with scoring techniques, goal the program, alternative solutions to the preparation of operational plans. From the preparation of the operational planning process by utilizing of SP2TP, a known problem of maternal and child health program at primary health care in Tapos is caused environmental health program coverage was still low."