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"Perubahan fisik, emosional, kognitif merupakan salah satu periode paling sensitive dalam kehidupan ibu pasca melahirkan. Kondisi pembengkakan payudara (breast engorgement) menjadi permasalahan umum yang terjadi pada ibu postpartum di masa menyusui, namun jika penatalaksanaan kurang tepat dapat mengakibatkan kondisi ketidaknyaman pasca melahirkan hingga mengganggu kondisi psikologis, mulai dari muncul kecemasan hingga depresi. Pemberian penatalaksanaan non farmakologi yang ada telah dilakukan untuk kebermanfaatan bagi ibu secara mandiri dan tenaga kesehatan di dalam menurunkan resiko mastitis yang dialami ibu selama proses menyusui. Metode yang digunakan dalam case study ini dengan fokus penerapan teori self-care Dorothea Orem dan teori Self-Transcendence Pamela G. Reed yang bertujuan untuk mengajarkan kemandirian pada ibu yang dimulai dari fase taking hold sampai masa nifas untuk mencapai kesejahteraan (well-being) dengan kesadaran (vulnerability) menyusui dan mencukupi kebutuhan nutrisi bayi sehingga ibu mampu mengaplikasikan kemampuan diri dalam mengelola afek positif dan negatif pada kondisi pembengkakan payudara (breast engorgement).

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Physical, emotional and cognitive changes are one of the most sensitive periods in a mother's life after giving birth. Breast engorgement is a common problem that occurs in postpartum mothers during breastfeeding, but if the management is not appropriate it can result in postpartum discomfort and psychological conditions, ranging from anxiety to depression. The provision of existing non-pharmacological management has been carried out for the benefit of mothers themselves and health workers in reducing the risk of mastitis experienced by mothers during the breastfeeding process. The method used in this case study focuses on the application of Dorothea Orem's self-care theory and Pamela G. Reed's Self-Transcendence theory which aims to teach independence to mothers starting from the taking hold phase until the postpartum period to achieve well-being by awareness (vulnerability) of breastfeeding and meeting the baby's nutritional needs so that the mother is able to apply her own abilities in managing positive and negative effects in conditions of breast engorgement."

"ABSTRAKDepresi merupakan salah satu gangguan psikologis yang terjadi pada ibu postpartum.Kejadian depresi postpartum Indonesia mencapai 20 dan di Provinsi Riau 15-20 ,angka tersebut harus ditekan menjadi 1 . Penelitian ini bertujuan untuk memperolehmodel yang efektif dalam mencegah depresi postpartum. Penelitian ini terdiri daridua tahap yaitu tahap pengembangan model dan uji model. Hasil penelitian tahappengembangan model diperoleh 7 tema terkait pengalaman adaptasi ibu hamil dari9 partisipan. Model ini berupa intervensi edukasi yang diberikan kepada ibu hamildan suami yang terdiri dari 4 komponen yaitu edukasi untuk mengurangistimulus, meningkatkan koping, meningkatkan respons adaptasi yang efektif sertameningkatkan dukungan sosial suami dalam upaya mencegah terjadinya depresipostpartum. Penelitian uji model menggunakan desain quasi experiment pre-post testwith control group, dengan teknik consecutive sampling terhadap 108 responden.Hasil penelitian menunjukkan bahwa Model Pencegahan Depresi Postpartm-Ratuefektif dalam meningkatkan pengetahuan, sikap, respons adaptasi fisiologis, konsepdiri, fungsi peran, interdependen, dukungan sosial suami, serta menurunkan kejadiandepresi postpartum. Dukungan sosial suami merupakan satu-satunya variabel yangpaling berpengaruh signifikan terhadap kejadian depresi postpartum. Model inidiharapkan dapat digunakan sebagai upaya preventif dalam mencegah terjadinyadepresi postpartum. Penelitian selanjutnya diharapkan untuk dapat mengembangkanintervensi lain dalam upaya mencegah depresi postpartum.Kata kunci: ibu hamil, suami, depresi postpartum

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ABSTRACTName Ratu KusumaStudent ID 1006753274Study Program Doctor of Nursing, Faculty of NursingUniversitas Indonesia.Title The Effectiveness of Ratu rsquo s Postpartum Depression PreventionModel towards the Prevention of Postpartum DepressionDepression is one of psychological disorders experienced among pregnant women.The incidence of postpartum depression in Indonesia reaches 20 and in Riau itselfreaches 15 20 , the particular number needs to be stresed to 1 . This study aims toobtain effective model in preventing postpartum depression. The study consisted intotwo phases, which were the development of the model and the trial itself. Theoutcome of the development of the model was seven themes related to the adaptiveexperiences of the pregnant women from nine participants. The model was aneducational intervention consisting of four main components which are education indecreasing stimulus, increasing coping, increasing effective response of adaptation, aswell as increasing social support of the husband in preventing the incidence ofpostpartum depression. The model was executed by quasi experiment pre post testwith control group design towards 108 respondents. The result showed that theRatu rsquo s Postpartum Depression Prevention Model was effective in increasingknowledge, attitude, behavior, physiological adaptation response, self concept, rolefunction, interdependent, and the social support of the husband, as well as loweringthe incidence of postpartum depression. The social support of the husband was themost signifiacnt variable towards the incidence of postpartum depression. This modelis expected to be used in preventing postpartum depression. In the future, theupcoming research is excpected to develop another intervention in preventing post partum depression."

"Pembengkakan payudara menjadi salah satu manifestasi klinis ibu postpartum yang sering muncul. Di Indonesia rata-rata 5% ibu postpartum mengalami masalah ini. Penelitian ini dilakukan untuk menganalisis asuhan keperawatan pada Ibu R (20 tahun) status paritas P1A0, postpartum hari ke-9 dengan masalah pembengkakan payudara. Intervensi yang dilakukan yaitu pemberian kompres kol sehari 2 kali selama 4 hari. Hasil observasi didapatkan adanya penurunan nyeri dari skala VAS 8 menjadi skala VAS 1 dan perubahan kondisi payudara dengan menggunakan instrumen Six Poin Engorgement Self-rated (SPES), dari skala 5 menjadi skala 1. Berdasarkan hasil penelitian ini, kol (Brassica oleracea var capitata) memiliki efektivitas untuk mengatasi masalah pembengkakan payudara. Selain kol terdapat berbagai cara yang dapat digunakan, dari hasil penelitian ini diharapkan akan muncul penelitian lain yang lebih bervariasi. Kata kunci: Bendungan ASI, kompres kol, pembengkakan payudara.

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Breast engorgement is one of the most common clinical manifestations of postpartum mothers. In Indonesia, an average of 5% of postpartum mothers experience this problem. This study was conducted to analyze nursing care in NY. R (20 years) with P1A0, 9th day postpartum with breastfeeding problems. The intervention was giving cabbage compresses 2 times a day for 4 days. The results of observations showed a decrease in pain from the VAS 8 scale to the VAS 1 scale and changes in breast condition using the Six Points Engorgement Self-rated (SPES) instrument, from a scale of 5 to a scale of 1. Based on the results of this study, cabbage (Brassica oleracea var capitata) has effectiveness in overcoming the problem of breast milk accumulation. Apart from cabbage, various ways can be used. From the results of this study, it is hoped that other, more varied studies will emerge. Keywords: Breast engorgement, breast milk, cabbage leaf."

"Postpartum Hemorrhage (PPH) merupakan suatu keadaan dimana kehilangan darah 500 ml atau lebih dalam 24 jam setelah persalinan ibu. PPH menduduki posisi pertama pada penyebab langsung pada kematian ibu dengan menyumbang 19,7% kematian ibu pada tingkat global. Berbagai kebijakan telah dikeluarkan untuk mengatasi masalah tingginya angka PPH, namun sampai saat ini angka kejadian PPH masih dapat dikatakan tinggi. Untuk dapat mengetahui penyebab yang mempengaruhi proses implementasi kebijakan pencegahan PPH dapat dilakukan melalui studi implementasi kebijakan publik. Penelitian ini membahas mengenai implementasi kebijakan pencegahan PPH diberbagai negara di dunia tahun 2022. Analisis implementasi kebijakan dilakukan menggunakan gabungan teori implementasi kebijakan publik yang dikemukakan oleh Van Meter and Van Horn, Grindle, Sabatier and Mazmanian, Edward III dan Peters. Tujuan penelitian ini adalah mengetahui analisis implementasi kebijakan pencegahan Postpartum Hemorrhage pada ibu dari berbagai negara di dunia. Penelitian ini menggunakan studi literature review melalui delapan database, yaitu Ebsco, Emerald, Sage, Science Direct, Scopus, Pubmed, BMC dan PMC. Terdapat 13 artikel terinklusi dari 7.153 artikel yang diidentifikasi dari kedelapan database. Hasil studi menunjukkan terdapat hubungan faktor komunikasi, sumber daya, disposisi, struktur birokrasi, standar dan sasaran kebijakan dan lingkungan terdapat pelaksanaan implementasi kebijakan PPH di berbagai negara.

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Postpartum Hemorrhage (PPH) is a condition in which blood loss of 500 ml or more within 24 hours after delivery of the mother. PPH occupies the first position in the direct cause of maternal death by contributing 19.7% of maternal deaths at the global level. Various policies have been issued to address the problem of the high rate of PPH, but until now the incidence of PPH is still high. To be able to find out the causes that affect the process of implementing PPH prevention policies, it can be done through a study of the implementation of public policies. This study discusses the implementation of PPH prevention policies in various countries in the world in 2022. Analysis of policy implementation is carried out using a combination of public policy implementation theories proposed by Van Meter and Van Horn, Grindle, Sabatier and Mazmanian, Edward III and Peters. The aim of this study was to determine the analysis of the implementation of Postpartum Hemorrhage prevention policies in mothers from various countries in the world. This study uses a literature review study through eight databases, namely Ebsco, Emerald, Sage, Science Direct, Scopus, Pubmed, BMC and PMC. There were 13 included articles out of 7,153 articles identified from the eight databases. The results of the study show that there is a relationship between communication factors, resources, disposition, bureaucratic structure, policy standards and objectives and the environment on the implementation of PPH policies in various countries."

"This student friendly textbook focuses on the most important topics of psychiatric-mental health nursing, from core concepts to nursing care for specific disorders. The eighth edition is focused on stimulating student critical thinking, thoroughly updated with the latest research."

"Gangguan psikiatri meningkatkan risiko penderitanya mengalami obesitas dan sindroma metabolik akibat interaksi faktor genetik, lingkungan, gejala penyakit psikiatri dan pengobatannya. Pengaturan asupan makan dan perubahan pola hidup tetap menjadi tatalaksana awal pada pasien dengan gangguan psikiatri. Penggunaan metformin telah disarankan dalam studi sebagai adjuvan dalam tatalaksana berat badan pada pasien gangguan psikiatri terutama yang menggunakan obat psikiatri dalam jangka panjang. Empat pasien rawat inap dengan gangguan psikiatri dipantau selama perawatan dan sebulan setelah rawat jalan dengan kontak per minggu. Dilakukan pencatatan masalah subjektif, objektif, riwayat peningkatan berat badan, riwayat pengobatan pola asupan serta pengukuran antropometri dan komposisi tubuh. Pola asupan harian dan 24 jam terakhir dikumpulkan dengan metode FFQ semi kuantitatif dan 24h dietary recall. Perencanaan terapi medik gizi dilakukan dengan restriksi kalori, peningkatan asupan protein, penyesuaian asupan karbohidrat, motivasi melakukan aktivitas fisik yang cukup dan pemberian metformin dengan dosis bertahap. Tiga pasien memiliki status gizi obes 2, 1 pasien memiliki status gizi obes morbid yang disertai massa lemak yang tinggi dan massa otot yang rendah. Seluruh pasien memiliki lingkar pinggang diatas normal, kadar kolesterol total, LDL yang tinggi dan HDL yang rendah. Tiga pasien tidak mematuhi preskripsi selama perawatan. Setelah rawat jalan, dua pasien memiliki caregiver yang memberikan pemantauan dan motivasi yang baik terhadap pasien selama sebulan dan terdapat penurunan berat badan, penurunan lingkar pinggang, dan perbaikan komposisi tubuh. Terapi medik gizi pada pasien dengan gangguan psikiatri membutuhkan kerjasama dengan caregiver agar dapat bermanfaat bagi pasien.

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Patients with psychiatric disorders experienced an increased risk of obesity and metabolic syndrome due to genetic, environmental, disease symptoms and medication factor. Diet and lifestyle modification remained the firstline modalities for management of obesity in patients with psychiatric disorders. Metformin as an adjuvant therapy is recommended for preventing weight gain in patients especially with long-time psychiatric medication usage. Four inpatients with various psychiatric disorders were monitored during hospital stay and one month after discharge with weekly contact for monitoring. Subjective symptoms and objective signs, including history of weight gain, psychiatric medication history, intake pattern, anthropometric and body composition measurements were recorded. Daily intake pattern and 24 hour food intake were recorded and analyzed with semi-quantitative FFQ method and 24h food recall, respectively. Energy restriction, adjustment of protein and carbohydrate intake, physical activity encouragement and oral metformin administration with increasing dose were implemented in all patients. Three patients were grade 2 obese, one patients was morbidly obese with high fat mass and low muscle mass. All patients showed an increased waist circumference, high total cholesterol and LDL level, and low HDL level. Three patients failed to comply with nutrition prescription. After discharge, two patients had a supportive caregivers that gave an adequate monitoring and encouragement. Weight loss, reduced waist circumference, and better body compositition were found in 2 patients with supportive caregivers. Medical nutrition therapy on patient with psychiatric disorder will benefit greatly from supportive caregiver to bring benefit for patients."

"[ABSTRAK Latar Belakang. Pasien TB-MDR sedang menjalankan pengobatan akan memengaruhi kondisi kejiwaan yang dapat disebabkan dari obat-obatan TB-MDR dan atau stres psikososial. Tujuan penelitian adalah mendapatkan gambaran gangguan psikiatri pada pasien TB-MDR dan stres psikososial yang memengaruhi. Metode. Penelitian ini menggunakan desain potong lintang dengan subjek penelitian berjumlah 50 orang. Pengambilan sampel pada subjek menggunakan metode konsekutif. Instrumen yang digunakan pada penelitian ini adalah MINI ICD-10 dan Life Experiences Survey (LES) dari Irwin G. Sarason yang terdiri dari 60 item yang dinilai dengan skala likert -3 sampai 3. Pada subjek dinilai dampak positif dan negatif stresor menggunakan instrumen LES. Data demografi meliputi usia, jenis kelamin, status pernikahan, jumlah anak, agama, suku, agama, pendapatan, tingkat pendidikan, obat-obatan yang digunakan dan jangka waktu pengobatan. Data dianalisis dengan menggunakan program SPSS untuk windows versi 20. Tingkat kemaknaan yang digunakan untuk uji statistik adalah p < 0,05.Hasil. Proporsi gangguan psikiatri pada subyek TB-MDR adalah 62%. Proporsi gangguan psikiatri pada subjek TB-MDR terbanyak pada gangguan depresi (32%) diikuti dengan risiko bunuh diri (26%), gangguan panik (24%), gangguan anxietas menyeluruh (20%), gangguan depresi berulang (12%), gangguan psikotik (12%), gangguan agorafobia (8%), gangguan obsesif kompulsif (8%), agorafobia dengan gangguan panik (4%), anorexia nervosa (2%) dan gangguan berkaitan dengan zat psikoaktif (2%). Sebagian besar subjek mendapatkan regimen standar pengobatan TB-MDR mengalami gangguan psikiatri sebesar 58,1%. Terdapat hubungan yang bermakna antara usia subjek dengan gangguan psikiatri sebesar <0,001, antara obat TB-MDR yang didapatkan dengan risiko bunuh diri (p<0,005) dan antara stresor psikososial dengan gangguan psikiatri.Kesimpulan. Terdapat gangguan psikiatri pada subjek TB-MDR selama menjalani pengobatan. Kelompok subjek TB-MDR dengan gangguan psikiatri cenderung memiliki skor stres negatif yang lebih tinggi (lebih banyak yang mengalami stresor negatif) dibandingan dengan subjek tanpa gangguan psikiatri.ABSTRACT Background. Patients with Multi Drug Resistance Tuberculosis (MDR-TB) during treatment can influence psychiatric conditions caused by MDR-TB drugs and psychosocial stress. The objective of this research is to describe various psychiatric disorders in patients with MDR-TB and various psychosocial stress during the treatment.

Methods. Design of this study is a cross-sectional design with total 50 subjects. Subjects were selected through consecutive sampling methods. Instruments used in this study were the MINI ICD-10 and Life Experiences Survey (LES) of Irwin G. Sarason which consists of 60 items of Likert scale ranging from -3 to 3. Subjects were assessed using the positive and negative impacts of stressors with LES instrument. Demographic data observed consist of age, gender, marital status, number of children, religion, ethnicity, religion, income, education level, drugs taken and the length of treatment. Data were analyzed using SPSS for Windows version 20. The level of significance used for the statistical tests was p <0.05.

Results. Proportion of psychiatric disorders in subjects with MDR-TB is 62%. Proportion of psychiatric disorders in subjects with MDR-TB are depressive disorders (32%) followed by risk of suicide (26%), panic disorder (24%), anxiety disorder (20%), recurrent depressive disorder (12%), psychotic disorder (12%), agoraphobia disorders (8%), obsessive compulsive disorder (8%), agoraphobia with panic disorder (4%), anorexia nervosa (2%) and psychoactive substances associated disorders (2%). Proportion of psychiatric disorders in subjects getting standard treatment regimen for MDR-TB are 58.1%. A significant relationship is made statistically between age of subjects with psychiatric disorders, MDR-TB drugs with suicide risk and psychosocial stressors with psychiatric disorders.

Conclusions. Psychiatric disorders were found in subjects with MDR-TB during treatment. Subject groups of MDR-TB with psychiatric disorders have higher negative stress score (more likely to have a negative stressor) than subjects without psychiatric disorders. ;Background. Patients with Multi Drug Resistance Tuberculosis (MDR-TB) during treatment can influence psychiatric conditions caused by MDR-TB drugs and psychosocial stress. The objective of this research is to describe various psychiatric disorders in patients with MDR-TB and various psychosocial stress during the treatment.

Methods. Design of this study is a cross-sectional design with total 50 subjects. Subjects were selected through consecutive sampling methods. Instruments used in this study were the MINI ICD-10 and Life Experiences Survey (LES) of Irwin G. Sarason which consists of 60 items of Likert scale ranging from -3 to 3. Subjects were assessed using the positive and negative impacts of stressors with LES instrument. Demographic data observed consist of age, gender, marital status, number of children, religion, ethnicity, religion, income, education level, drugs taken and the length of treatment. Data were analyzed using SPSS for Windows version 20. The level of significance used for the statistical tests was p <0.05.

Results. Proportion of psychiatric disorders in subjects with MDR-TB is 62%. Proportion of psychiatric disorders in subjects with MDR-TB are depressive disorders (32%) followed by risk of suicide (26%), panic disorder (24%), anxiety disorder (20%), recurrent depressive disorder (12%), psychotic disorder (12%), agoraphobia disorders (8%), obsessive compulsive disorder (8%), agoraphobia with panic disorder (4%), anorexia nervosa (2%) and psychoactive substances associated disorders (2%). Proportion of psychiatric disorders in subjects getting standard treatment regimen for MDR-TB are 58.1%. A significant relationship is made statistically between age of subjects with psychiatric disorders, MDR-TB drugs with suicide risk and psychosocial stressors with psychiatric disorders.

Conclusions. Psychiatric disorders were found in subjects with MDR-TB during treatment. Subject groups of MDR-TB with psychiatric disorders have higher negative stress score (more likely to have a negative stressor) than subjects without psychiatric disorders. , Background. Patients with Multi Drug Resistance Tuberculosis (MDR-TB) during treatment can influence psychiatric conditions caused by MDR-TB drugs and psychosocial stress. The objective of this research is to describe various psychiatric disorders in patients with MDR-TB and various psychosocial stress during the treatment.

Methods. Design of this study is a cross-sectional design with total 50 subjects. Subjects were selected through consecutive sampling methods. Instruments used in this study were the MINI ICD-10 and Life Experiences Survey (LES) of Irwin G. Sarason which consists of 60 items of Likert scale ranging from -3 to 3. Subjects were assessed using the positive and negative impacts of stressors with LES instrument. Demographic data observed consist of age, gender, marital status, number of children, religion, ethnicity, religion, income, education level, drugs taken and the length of treatment. Data were analyzed using SPSS for Windows version 20. The level of significance used for the statistical tests was p <0.05.

Results. Proportion of psychiatric disorders in subjects with MDR-TB is 62%. Proportion of psychiatric disorders in subjects with MDR-TB are depressive disorders (32%) followed by risk of suicide (26%), panic disorder (24%), anxiety disorder (20%), recurrent depressive disorder (12%), psychotic disorder (12%), agoraphobia disorders (8%), obsessive compulsive disorder (8%), agoraphobia with panic disorder (4%), anorexia nervosa (2%) and psychoactive substances associated disorders (2%). Proportion of psychiatric disorders in subjects getting standard treatment regimen for MDR-TB are 58.1%. A significant relationship is made statistically between age of subjects with psychiatric disorders, MDR-TB drugs with suicide risk and psychosocial stressors with psychiatric disorders.

Conclusions. Psychiatric disorders were found in subjects with MDR-TB during treatment. Subject groups of MDR-TB with psychiatric disorders have higher negative stress score (more likely to have a negative stressor) than subjects without psychiatric disorders. ]"