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"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."

"Salah satu tujuan dari MDGs adalah menurunkan angka kematian ibu dan bayi. Upaya penurunan angka kematian ibu dan bayi di Indonesia belum memuaskan, target Indonesia menurunkan angka kematian ibu 102 per 100.000 kelahiran hidup pada tahun 2015. Peran ners spesialis keperawatan maternitas sebagai praktisi keperawatan, pendidik, konselor, advokat, pengelola, koordinator, kolaborator, peneliti dan agen pembaharu sangat diperlukan untuk menurunkan angka kematian ibu dan bayi. Tujuan umum pembuatan laporan akhir praktik residensi adalah untuk memberikan gambaran pelaksanaan kegiatan praktik residensi dengan fokus penerapan model keperawatan Need for Help Wiedenbach dan Self Care Orem pada asuhan keperawatan ibu hamil dengan kontraksi dini. Aplikasi teori keperawatan Need for Help Wiedenbach dan Self Care Orem efektif dilakukan pada lima ibu hamil dengan kontraksi dini. Integrasi model keperawatan Need for Help Wiedenbach diterapkan pada fase akut. Sedangkan pada fase pemeliharaan dilakukan asuhan keperawatan dengan Self Care Orem. Aplikasi teori tersebut berhasil membantu menyelesaikan masalah keperawatan dan menghentikan kontraksi uterus sampai usia kehamilan aterm. Setelah melaksanakan praktik residensi spesialis keperawatan maternitas, penulis mampu mencapai target kompetensi dengan baik.

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One of the MDGs goals is to lower maternal and infant mortality rate. Efforts to lessen maternal and infant mortality rate in Indonesia are unsatisfactory. Indonesia's target is to reduce maternal mortality to 102 per 100,000 live births in 2015. Roles of maternity nursing specialist nurses as care givers, educators, counselors, advocates, coordinators, managers, collaborators, researchers and change agents are needed to lower maternal and infant mortality rate.

The goal of the residency practice final report is to provide an overview of the implementation of residency practice focused on Wiedenbach Need for Help and Orem Self Care Nursing Model on nursing care of pregnant women with early contractions.

The application of Wiedenbach Need for Help and Orem Self Care nursing theory was effectively done to five pregnant women with early contractions. The integration of Wiedenbach Need for Help nursing model was applied in the acute phase. While in the maintenance phase, Orem Self Care nursing care was performed. The application of the theory was successfully help to solve nursing problems and to stop the uterine contractions until term gestation. After performing the maternity nursing specialist residency practice, the author was able to achieve the competency targets well."

"Program MDGs mempuyai tujuan untuk meningkatkan kesehatan ibu dengan menurunkan angka kematian ibu (AKI) dan meningkatkan kesehatan reproduksi untuk perempuan pada tahun 2015. Oleh sebab itu pemerintah membuat berbagai program untuk mencapai tujuan MDGs tersebut. Persalinan dengan tindakan seksio sesarea dan tubektomi merupakan upaya tindakan untuk menyelamatkan kondisi ibu dan bayinya yang mengalami resiko, yang tidak bisa melahirkan dengan cara pervaginam. Kelahiran dengan seksio sesarea dapat beresiko terjadinya komplikasi 25 kali lebih besar dibanding persalinan pervaginam dan juga tindakan tubektomi dapat menimbulkan masalah psikososial pada ibu. Peran ners spesialis keperawatan maternitas sebagai pemberi perawatan, pendidik, konselor, koordinator, komunikator, advokat, agen perubahan dan peneliti sangat diperlukan untuk mengurangi terjadinya komplikasi akibat efek pembedahan seksio sesarea pasca partum dan melaksanakan perannya pada pelayanan keperawatan maternitas untuk membantu menurunkan AKI. Tujuan umum dari penulisan ini adalah memberikan gambaran kegiatan pelaksanaan praktek residensi Ners Spesialis Keperawatan Maternitas fokus pada kasus ibu postpartum seksio sesarea dan tubektomi dengan penerapan teori selfcare dan teori comfort. Aplikasi teori tersebut berhasil membantu permasalahan yang dialami pasien secara biopsikososial. Pelaksanaan praktek residensi spesialis keperawatan maternitas telah dilakukan sesuai kompetensi, sehingga mampu mencapai target kompetensi dengan baik.

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Program MDGs is to goals increase maternal health by reducing maternal mortality rate (MMR) and increase to reproductive health for women in 2015. Therefore government made programs to target The goals MDGs. Delivery by cesarean section and tubectomy are the attempts to save the state of the mother, who are in risk condition and cannot give vaginal delivery and the risky baby. Births by cesarean section can cause risk complications at 25 times than vaginal delivery, in the other hand tubectomy may cause psychosocial problem.

The role of maternity nursing specialist nurse as caregiver, educator, counselor, coordinator, communicator, advocate, the agent of change and researcher is needed to reduce the occurrence of complications due to the effects of postpartum cesarean surgery and do its role in maternity nursing services to contribute on reducing the MMR.

The purpose of this study was to depict the implementation of the nurses? residency practice of Maternity Nursing Specialist nurse which focuses on the case of Caesarean section and maternal postpartum tubectomy selfcare with the application of theory and the theory of comfort. The application of the theory succeeds in helping the problems experienced by the patient bio-psychosocially. Doing the practice of residency maternity nursing specialists have done appropriate competencies, so that able to achieve the competencies very well."

"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 "

"[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."

"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."

"[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 .]"

"ABSTRAKPersalinan prematur dapat menimbulkan beberapa masalah pada ibu dan bayi. Salah satu penyebab persalinan prematur adalah kontraksi dini yaitu kontraksi yang terjadi pada kehamilan kurang dari 37 minggu. Pengelolaan pada ibu hamil kontraksi dini dengan mengaplikasikan teori Konservasi Levine dan Kenyamanan Kolcaba bertujuan untuk mempertahankan kehamilan sampai aterm dan mengatasi ketidaknyamanan. Pendekatan proses keperawatan mulai dari pengkajian sampai evaluasi diterapkan pada kelima ibu hamil kontraksi dini. Beberapa masalah keperawatan yang muncul adalah risiko cidera janin, risiko cidera maternal, kesiapan peningkatan kenyamanan, cemas, dan peningkatan support sistem. Melalui konservasi energi, konservasi integritas struktur, konservasi integritas personal dan konservasi integritas sosial kelima ibu bebas kontraksi dan pulang dengan perawatan konservatif. Hasil ini dapat digunakan untuk mengelola ibu hamil kontraksi dini pada area maternitas.

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ABSTRACTOne of the causes of preterm labor is preterm uterine contractions, is defined as uterine contractions that occurs at less than 37 weeks gestational. Preterm uterine contractions is major of cause of morbidiby which can be reduced by role of maternity nursing specialist. Management of preterm uterine contractions by applied levine?s conservation and comfort theory aimed term gestasional dan made wholleness. This study used nursing process, was including assessing, diagnosing, planning, implementing, and evaluating. Some nursing diagnosis are risk for Injury: the fetus, risk of injury the maternal , Altered comfort: pain , anxiety, and improves support systems. the integrity were evidenced, based on Levine?s conservational principles, in terms of conservation of energy, structural, personal and social integrity, and comfort theory reduced preterm uterine contraction. These results can be used to manage preterm uterine contractions. "

"Karya ilmiah akhir disusun sebagai laporan praktik residensi ners spesialis keperawatan maternitas yang menggambarkan pencapaian kompetensi ners spesialis keperawatan maternitas dengan fokus pada aplikasi teori keperawatan need for help dan symptom management pada ibu hamil dengan preeklampsia berat. Kompetensi ners spesialis keperawatan maternitas diwujudkan dengan penerapan peran dan fungsi perawat sebagai pemberi pelayanan keperawatan, advokat. manajer, rehabilitator, komunikator, edukator, kolaborator, dan agen perubah. Aplikasi teori keperawatan need for help Wiedenbach dan symptom management Humphreys pada ibu hamil dengan preeklampsia berat dapat mengatasi masalah keperawatan selama fase akut dan pemeliharaan.

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This final report is created as a report of maternity nursing specialist residency practice which describes the achievement of maternity nursing specialist's competencies focused on the application of 'need for help' and 'symptom management' nursing theory to pregnant women with severe preeclampsia. The competencies of a maternity nursing specialist were actualized by the implementation of roles and functions as a nursing care provider, an advocate, a manager, a rehabilitator, a communicator, an educator, a collaborator, and a change agent The application of Wiedenbach's 'need for help' nursing theory and Humphreys theory of symptom management to pregnant w9men with severe preeclampsia could solve the nursing problems during acute and maintenance phase."